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Machida A, Oishi A, Ikeda J, Kurihara J, Yoneda A, Tsuiki E, Hirata Y, Murakami R, Kitaoka T. Factors Associated with Success of Switching to Faricimab for Neovascular Age-Related Macular Degeneration Refractory to Intravitreal Aflibercept. Life (Basel) 2024; 14:476. [PMID: 38672747 PMCID: PMC11051354 DOI: 10.3390/life14040476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 02/28/2024] [Accepted: 04/01/2024] [Indexed: 04/28/2024] Open
Abstract
We investigated the factors associated with the success of switching to faricimab for type 1 macular neovascularization (MNV) refractory to intravitreal aflibercept (IVA). This retrospective cohort study included patients with type 1 MNV who were switched to faricimab because they were refractory to IVA at two centers. The primary endpoint was a more than two-week extension of the treatment interval after 6 months. In addition, factors related to the success or failure of extension and visual and anatomical outcomes were assessed. The analysis included 43 eyes from 43 patients. Extended dosing intervals of >2 weeks were identified in 14 eyes (32.6%). A short dosing interval before switching, absence of polypoidal lesions, and thin central choroidal thickness before switching were identified as factors involved in successful extension. For patients with refractory type 1 MNV, switching to faricimab is a safe and potential option to extend existing dosing intervals.
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Affiliation(s)
- Akira Machida
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan; (A.M.); (J.I.); (E.T.); (Y.H.); (R.M.); (T.K.)
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan; (A.M.); (J.I.); (E.T.); (Y.H.); (R.M.); (T.K.)
| | - Junichiro Ikeda
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan; (A.M.); (J.I.); (E.T.); (Y.H.); (R.M.); (T.K.)
| | - Junko Kurihara
- Department of Ophthalmology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki 852-8104, Japan
| | - Ai Yoneda
- Department of Ophthalmology, The Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki 852-8104, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan; (A.M.); (J.I.); (E.T.); (Y.H.); (R.M.); (T.K.)
| | - Yuki Hirata
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan; (A.M.); (J.I.); (E.T.); (Y.H.); (R.M.); (T.K.)
| | - Ryuya Murakami
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan; (A.M.); (J.I.); (E.T.); (Y.H.); (R.M.); (T.K.)
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki 852-8102, Japan; (A.M.); (J.I.); (E.T.); (Y.H.); (R.M.); (T.K.)
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Machida A, Oishi A, Tsuiki E, Maekawa Y, Kurihara J, Hirata Y, Machida E, Kitaoka T. INVESTIGATION OF INCIDENCE AND CAUSES OF ACUTE VISION LOSS DURING ANTI-VASCULAR ENDOTHELIAL GROWTH FACTOR THERAPY FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION DURING A FOUR-YEAR FOLLOW-UP. Retina 2023; 43:888-896. [PMID: 36657167 DOI: 10.1097/iae.0000000000003740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE To investigate the incidence, risk factors, and outcomes of patients with age-related macular degeneration who experienced acute vision loss despite periodic injections of anti-vascular endothelial growth factor treatment for 4 years. METHODS This retrospective cohort study included patients who were diagnosed with treatment-naive neovascular age-related macular degeneration and completed a 4-year follow-up. The incidence and risk factors for the occurrence of three or more lines of visual loss at every checkup were investigated. RESULTS The analysis included 76 eyes of 76 patients. Acute vision loss occurred in 30 eyes (39.5%) over 4 years. Lower baseline best-corrected visual acuity and disrupted ellipsoid zone were independent predictors of vision loss occurrence. Although the causes and timing of visual acuity loss varied, retinal pigment epithelium tears were observed only in the first year. Most patients (86.7%) who experienced vision loss recovered their vision to pre-loss levels at least once; however, the final best-corrected visual acuity was worse than that in the group that did not experience acute vision loss. CONCLUSION Approximately half of the patients with age-related macular degeneration experienced acute vision loss during a 4-year follow-up, despite continuous anti-vascular endothelial growth factor treatment. Most patients recovered from vision losses temporarily; however, they experienced worse visual outcomes subsequently.
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Affiliation(s)
- Akira Machida
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Miyagi S, Oishi A, Tsuiki E, Kitaoka T. Geometric Morphometrics Can Predict Postoperative Visual Acuity Changes in Patients With Epiretinal Membrane: A Retrospective Study. Transl Vis Sci Technol 2023; 12:24. [PMID: 36692457 PMCID: PMC9896846 DOI: 10.1167/tvst.12.1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Abstract
Purpose To investigate the efficacy of the geometric morphometrics method for the evaluation of retinal deformation in patients with epiretinal membrane (ERM) and determine whether the degree of deformation can serve as a predictive factor for postoperative visual outcome. Methods We retrospectively evaluated data from 29 eyes of 29 patients with primary ERM. Preoperative optical coherence tomography images were compared with images of their normal fellow eyes using the geometric morphometrics thin-plate spline technique. Conventional parameters such as retinal layer thickness and previously reported indices were also measured. The correlation between the preoperative parameters and visual acuity was evaluated. Statistical comparisons were performed using a paired t-test, and associations between the optical coherence tomography image parameters and visual acuity were determined using Spearman's rank correlation coefficient. Results Bending energy, which was calculated using geometric morphometrics, was significantly associated with visual acuity as well as conventional optical coherence tomography parameters and previously reported indices. Multiple regression analysis showed that bending energy was an independent predictive factor for postoperative visual acuity changes. Conclusions The geometric morphometrics method is an effective approach for evaluating the severity of ERM and predicting the efficacy of surgery. Translational Relevance Geometric morphometrics can effectively evaluate retinal deformation in eyes with epiretinal membrane.
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Affiliation(s)
- Sugao Miyagi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Japan
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Kawano S, Imai T, Sakamoto T, Yamamoto S, Baba T, Sato E, Kitahashi M, Tatsumi T, Miura G, Niizawa T, Sakamoto T, Yamakiri K, Yamashita T, Otsuka H, Sameshima S, Yoshinaga N, Sonoda S, Hirakata A, Koto T, Inoue M, Hirota K, Itoh Y, Orihara T, Emoto Y, Sano M, Takahashi H, Tokizawa R, Yamashita H, Nishitsuka K, Kaneko Y, Nishi K, Yoshida A, Ono S, Hirokawa H, Sogawa K, Omae T, Ishibazawa A, Kishi S, Akiyama H, Matsumoto H, Mukai R, Morimoto M, Nakazawa M, Suzuki Y, Kudo T, Adachi K, Ishida S, Noda K, Kase S, Mori S, Ando R, Saito M, Suzuki T, Takahashi K, Nagai Y, Nakauchi T, Yamada H, Kusaka S, Tsujioka D, Tsujikawa A, Suzuma K, Ishibashi T, Sonoda KH, Ikeda Y, Kohno R, Keijiro Ishikawa, Kondo M, Kozawa M, Kitaoka T, Tsuiki E, Ogura Y, Yoshida M, Morita H, Kato A, Hirano Y, Sugitani K, Terasaki H, Iwase T, Ito Y, Ueno S, Kaneko H, Nonobe N, Kominami T, Azuma N, Yokoi T, Shimada H, Nakashizuka H, Hattori T, Shinojima A, Kutagawa Y, Shiraga F, Morizane Y, Kimura S, Ikeda T, Kida T, Sato T, Fukumoto M, Emi K, Nakashima H, Ohji M, Kakinoki M, Sawada O, Takeuchi S, Tanaka S, Iida T, Koizumi H, Maruko I, Hasegawa T, Kogure A, Iijima H, Oshiro T, Tateno Y, Kikushima W, Sugiyama A, Yoneyama S, Kadonosono K, Sato S, Yamane S. Differences in primary retinal detachment surgery conducted on holidays and workdays analyzed using the Japan Retinal Detachment Registry. Jpn J Ophthalmol 2022; 66:271-277. [DOI: 10.1007/s10384-022-00911-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 01/28/2022] [Indexed: 10/18/2022]
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Yamada K, Oishi A, Kusano M, Kinoshita H, Tsuiki E, Kitaoka T. Effect of inverted internal limiting membrane flap technique on small-medium size macular holes. Sci Rep 2022; 12:731. [PMID: 35031664 PMCID: PMC8760271 DOI: 10.1038/s41598-021-04739-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 12/24/2021] [Indexed: 11/09/2022] Open
Abstract
Inverted internal limiting membrane (ILM) flap technique was developed to achieve macular hole (MH) closure in large MH and refractory cases. In this study, we evaluate the effect of the technique for small-medium size MH. We recruited patients who underwent vitrectomy for small-medium size (< 400 μm) MH with either inverted ILM flap technique (flap group) or with conventional ILM peeling (peeling group). Using propensity score, 21 eyes of 21 patients in the peeling group were matched against 21 eyes of 21 patients in the flap group. We compared MH closure rate, postoperative visual acuity, and recovery of the external limiting membrane (ELM) and ellipsoid zone (EZ). The MH closure rate was not different between the two groups (flap vs peeling: 90% vs 100%, P = 0.49). Whereas there was no significant difference in visual acuity improvement between the two groups, the flap group showed more disruption of the ELM 3 months after surgery and of the EZ at 3 and 6 months after surgery (P = 0.02, P = 0.03, and P = 0.04, respectively). The result suggested that inverted ILM flap technique does not have additional benefits for small-medium size MHs and may delay recovery of retinal integrity.
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Affiliation(s)
- Kanako Yamada
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan.
| | - Mao Kusano
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Hirofumi Kinoshita
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki, 852-8102, Japan
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Iwanaga A, Utani A, Koike Y, Okubo Y, Kuwatsuka Y, Endo Y, Tanizaki H, Wataya-Kaneda M, Hatamochi A, Minaga K, Ogi T, Yamamoto Y, Ikeda S, Tsuiki E, Tamura H, Maemura K, Kitaoka T, Murota H. Clinical practice guidelines for pseudoxanthoma elasticum (2017): Clinical Practice Guidelines for Pseudoxanthoma Elasticum Drafting Committee: Clinical Practice Guidelines for Pseudoxanthoma Elasticum Drafting Committee. J Dermatol 2022; 49:e91-e98. [PMID: 35019155 DOI: 10.1111/1346-8138.16301] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 12/22/2021] [Accepted: 12/23/2021] [Indexed: 11/29/2022]
Abstract
Pseudoxanthoma elasticum (PXE) is a progressive hereditary disease that affects tissues such as the skin, retina, blood vessels, and gastrointestinal tracts. Therefore, comprehensive medical care across clinical departments specialized in specific organs is needed to provide the best clinical practices to PXE patients. The Japanese version of clinical guidelines developed by the Japanese Dermatological Association was published in 2017, and aimed to promote equal accessibility of PXE-related medical care. Here, the English version of Japanese guideline is reported, and is intended to be worldwide reference for medical care of PXE.
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Affiliation(s)
- Akira Iwanaga
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Atsushi Utani
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuta Koike
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yumi Okubo
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yutaka Kuwatsuka
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuichiro Endo
- Department of Dermatology, Graduate School of Medicine, Kyoto University, Dermatology, Kyoto, Japan
| | - Hideaki Tanizaki
- Department of Dermatology, Kansai Medical University Hospital, Osaka, Japan
| | | | - Atsushi Hatamochi
- Department of Dermatology, Dokkyo Medical University, Tochigi, Japan
| | - Kosuke Minaga
- Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Tomoo Ogi
- Department of Genetics, Research Institute of Environmental Medicine, Nagoya, Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology, Kyoto University Graduate School of Medicine and Public Health, Kyoto, Japan
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroshi Tamura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroyuki Murota
- Department of Dermatology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Matsumoto M, Suzuma K, Akiyama F, Yamada K, Harada S, Tsuiki E, Kitaoka T. Retinal Vascular Resistance Significantly Correlates With Visual Acuity After 1 Year of Anti-VEGF Therapy in Central Retinal Vein Occlusion. Transl Vis Sci Technol 2021; 10:19. [PMID: 34559183 PMCID: PMC8475282 DOI: 10.1167/tvst.10.11.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate whether the resistivity of all retinal vessels, termed total capillary resistance (TCR), after anti-vascular endothelial growth factor (VEGF) treatment was correlated with the outcomes of patients with macular edema secondary to central retinal vein occlusion (CRVO). Methods In total, 67 patients with nonischemic CRVO were enrolled in this retrospective observational case series. In each patient, we examined visual acuity; central retinal thickness (CRT); mean blur rate (MBR), which represents retinal blood flow velocity; and TCR. MBR and TCR were measured by laser speckle flowgraphy. Results During the 1-year follow-up period, nine of 67 eyes (13.4%) converted to the ischemic type (converted group), whereas 58 eyes (86.6%) remained unchanged (nonischemic group). Mean CRT significantly decreased in all groups; however, the mean visual acuity significantly improved only in the nonischemic group. Mean MBR significantly increased in the nonischemic group but remained unchanged in the converted group. Mean TCR was significantly reduced in the nonischemic group but remained unchanged in the converted group. Multiple linear regression analysis revealed that MBR and TCR were the independent factors with the strongest and second strongest correlations with visual acuity after treatment, respectively. Conclusions These findings suggest that measurements of the independent factors MBR and TCR are useful for evaluating anti-VEGF treatments in patients with CRVO. Translational Relevance Development of clinically relevant technologies.
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Affiliation(s)
- Makiko Matsumoto
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Kagawa University, Kagawa, Japan
| | - Fumito Akiyama
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kanako Yamada
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shiori Harada
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Matsumoto M, Suzuma K, Akiyama F, Yamada K, Harada S, Tsuiki E, Kitaoka T. Retinal Microvascular Resistance Estimated from Waveform Analysis Is Significantly Higher With a Threshold Value in Central Retinal Vein Occlusion. Transl Vis Sci Technol 2020; 9:4. [PMID: 33288991 PMCID: PMC7571322 DOI: 10.1167/tvst.9.11.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/07/2020] [Indexed: 11/25/2022] Open
Abstract
Purpose Evaluation of blood flow is useful for understanding the severity of central retinal vein occlusion (CRVO). Actual blood flow may be determined by the resistivity of the retinal vein in CRVO. We have previously evaluated mean blur rate (MBR) to reflect total retinal blood flow velocity in CRVO cases using laser speckle flowgraphy (LSFG). This study evaluated retinal total vascular resistance in CRVO cases using the new index of total capillary resistance (TCR) from LSFG. Methods We measured the TCR of 68 CRVO patients who visited Nagasaki University Hospital between 2009 and 2016 and 42 age-matched controls without systemic disease. We compared TCRs among control eyes, CRVO fellow eyes, and CRVO affected eyes. A CRVO threshold value was then obtained from the receiver operating characteristic curve. Results MBR was significantly lower for CRVO affected eyes (20.3 ± 8.2) than for control eyes (37.5 ± 8.4; P < 0.01) and CRVO fellow eyes (36.4 ± 10.0; P < 0.01, Dunn's test). TCR was significantly higher for CRVO affected eyes (1.20 ± 0.55) than for control eyes (0.68 ± 0.2; P < 0.01) and CRVO fellow eyes (0.81 ± 0.28; P < 0.01, Dunn's test). The threshold for the presence of CRVO was 0.93 and area under the curve was 0.84. Conclusions By measuring TCR in addition to MBR, more detailed information regarding CRVO pathology can be obtained. Translational Relevance Comparison of values before and after treatment may be useful for evaluating the effects of treatment.
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Affiliation(s)
- Makiko Matsumoto
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Kagawa University, Kagawa, Japan
| | - Fumito Akiyama
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Kanako Yamada
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Shiori Harada
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Yoshida S, Murakami T, Nozaki M, Suzuma K, Baba T, Hirano T, Sawada O, Sugimoto M, Takamura Y, Tsuiki E. Review of clinical studies and recommendation for a therapeutic flow chart for diabetic macular edema. Graefes Arch Clin Exp Ophthalmol 2020; 259:815-836. [PMID: 32997288 DOI: 10.1007/s00417-020-04936-w] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/03/2020] [Accepted: 09/10/2020] [Indexed: 12/25/2022] Open
Abstract
Diabetic macular edema (DME), characterized by exudative fluid accumulation in the macula, is the most common form of sight-threatening retinopathy in patients with diabetes. The management of DME has changed considerably in recent years, especially following the development of intravitreal anti-vascular endothelial growth factor therapy which has emerged as a first-line therapy for center-involved DME. Laser treatment, intravitreal steroid therapy, and vitrectomy are also important treatment options for DME. We believe that it is important to choose the most appropriate treatment option for DME based on the clinical evidences, in addition to the careful consideration of individual patients' general or ocular condition, DME characteristics, patients' motivation, and compliance to the treatment in real-world clinical practice. In this review, we have summarized important clinical evidences for the main treatments for DME, presented an expert review for these evidences, and proposed a recommended therapeutic flow chart for DME. We hope that our review of the clinical evidences and the recommended therapeutic flow chart for DME will contribute to better treatment outcome for DME.
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Affiliation(s)
- Shigeo Yoshida
- Department of Ophthalmology, Kurume University School of Medicine, 67 Asahi-machi, Kurume-shi, Fukuoka, 830-0011, Japan.
| | - Tomoaki Murakami
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawaharacho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Miho Nozaki
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1-Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya-Shi, Aichi, 467-8601, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology, Kagawa University Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kagawa, Kita-gun, 761-0793, Japan
| | - Takayuki Baba
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba, 260-8677, Japan
| | - Takao Hirano
- Department of Ophthalmology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto-shi, Nagano, 390-8621, Japan
| | - Osamu Sawada
- Department of Ophthalmology, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu-shi, Shiga, 520-2192, Japan
| | - Masahiko Sugimoto
- Department of Ophthalmology, Mie University Graduate School of Medicine, 2-174, Edobashi, Tsu-shi, Mie, 514-8507, Japan
| | - Yoshihiro Takamura
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, 23-3, Matsuokashimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Sakamoto 1-7-1, Nagasaki-shi, Nagasaki, 852-8523, Japan
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Tsuiki E, Kusano M, Kitaoka T. Complication associated with intravitreal injection of tissue plasminogen activator for treatment of submacular hemorrhage due to rupture of retinal arterial macroaneurysm. Am J Ophthalmol Case Rep 2019; 16:100556. [PMID: 31650084 PMCID: PMC6804720 DOI: 10.1016/j.ajoc.2019.100556] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 02/28/2019] [Accepted: 09/16/2019] [Indexed: 11/29/2022] Open
Abstract
Purpose To report the possible complications of intravitreal injection of tissue plasminogen activator (t-PA) for the treatment of submacular hemorrhage associated with retinal arterial macroaneurysm (RAM). Observations A 75-year-old man complained of a sudden diminution of visual acuity in his left eye. Fundus examination of this eye revealed rupture of a RAM (0.5 disc diameters (DD) in size), submacular hemorrhage and hemorrhage under the internal limiting membrane (ILM). The patient had untreated hypertension and his systolic blood pressure was over 200 mmHg. Intravitreal injection of t-PA (42,000 units/0.07 ml) was given 1 day before undergoing vitrectomy. On the following day, the fundus was no longer visible because of a dense vitreous hemorrhage. After performing vitrectomy to remove the dense vitreous hemorrhage, we confirmed a marked increase in subretinal hemorrhage, and seemed to have markedly enlarged the macroaneurysm (6 DD). In addition, macular hole was found to have occurred. One week after surgery, the macular hole closed. Four months after surgery, best-corrected visual acuity improved from 20/400 to 20/40. Conclusions and Importance Untreated hypertension and the use of t-PA can cause re-ruptured RAM and deterioration of subretinal hemorrhage. In this case, a macular hole was also occurred. Since there are risks of various complications, it is necessary to be careful in the use of t-PA for RAM.
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Affiliation(s)
- Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Mao Kusano
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan
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Tsuiki E, Suzuma K, Matsumoto M, Mohamed YH, Kitaoka T. Oral kallidinogenase improved visual acuity and maintained chorioretinal blood flow levels after treatment for diabetic macular edema. Clin Ophthalmol 2018; 12:1845-1852. [PMID: 30275681 PMCID: PMC6158001 DOI: 10.2147/opth.s168420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Purpose This study was designed to investigate the therapeutic effects of oral kallidinogenase medication as an adjuvant therapy in treating patients with diabetic macular edema (DME). Study design This was a prospective, open-labeled, randomized study. Methods All patients were given posterior sub-Tenon triamcinolone acetonide (STTA) injection and focal laser treatment session for DME. The patients were subdivided into two groups: 1) those treated with oral kallidinogenase for at least 6 months after local treatment (treated group) and 2) those treated without oral kallidinogenase (untreated group). In this study, best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness (SCT), and chorioretinal blood flow level were measured in 17 patients (19 eyes). Chorioretinal blood flow levels at the disc and macula were measured by laser speckle flowgraphy and evaluated using the mean blur rate (MBR). These data were measured at baseline and at 1, 3, and 6 months after treatment initiation. Results BCVA at 6 months after treatment significantly improved in treated group (P<0.05). But the mean CRT after treatment significantly decreased in both groups. There was no significant difference in the mean SCT at baseline between the two groups. The mean SCT after treatment in treated group was significantly thinner than that before treatment (P<0.05). Compared to baseline (100%), MBR at the disc and the macula at 6 months after treatment significantly decreased to 84.8% and 86.2%, respectively, in untreated group (P<0.05), though it remained unchanged at 98.7% and 99.7% in treated group. Conclusion Oral kallidinogenase medication is useful as an adjuvant therapy to enhance the therapeutic effect of STTA in DME patients.
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Affiliation(s)
- Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Kiyoshi Suzuma
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Makiko Matsumoto
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Yasser Helmy Mohamed
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan,
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Fujikawa A, Mohamed YH, Kinoshita H, Matsumoto M, Uematsu M, Tsuiki E, Suzuma K, Kitaoka T. Visual outcomes and prognostic factors in open-globe injuries. BMC Ophthalmol 2018; 18:138. [PMID: 29884145 PMCID: PMC5994054 DOI: 10.1186/s12886-018-0804-4] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 05/30/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Ocular trauma is an important cause of visual loss worldwide. Improvements in our knowledge of the pathophysiology and management of ocular trauma during the past 30 years, in conjunction with advances in the instrumentation and techniques of ocular surgery, have improved the efficacy of vitreoretinal surgery in injured eyes. The aim of the current study was to determine the visual outcomes and prognostic factors of open-globe injuries in the Japanese population. METHODS Retrospective study of 59 eyes of 59 patients presented with open globe injuries between September 2008 and March 2014 at Nagasaki University Hospital was conducted. Demographic factors including age, gender, and clinical data such as cause of injury, presenting visual acuity (VA), location of injury, type of injury, lens status, presence of intraocular foreign body, types of required surgeries, and final VA were recorded. According to the classification of Ocular Trauma Classification Group, wound location was classified into three zones. Chi-square test was used to compare presented data. RESULTS Out of the 59 patients, 46 were placed in the Light Perception (LP) group, and 13 were placed in the No Light Perception (NLP) group. Work-related trauma was the most common cause (27 eyes) followed by falls (19eyes). Work-related trauma was common in males (P = 0.004), while falls was significantly common in females (P = 0.00001). Zone III injuries had statistically significantly poor prognostic factor compared to other zones (P = 0.04). All cases of NLP group (100%) presented with rupture globe. Poor VA at first visit (P = 0.00001), rupture globe (P = 0.026), history of penetrating keratoplasty (PK) (P = 0.017), retinal detachment (RD) (P = 0.0001), vitreous hemorrhage (VH) (P = 0.044), and dislocation of crystalline lens (P = 0.0003) were considered as poor prognostic factors. CONCLUSION Poor VA at first visit, rupture globe, zone III injuries, history of penetrating keratoplasty, RD, VH, and dislocation of crystalline lens were found to be poor prognostic factors. PPV had a good prognostic value in open globe injuries associated with posterior segment involvement.
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Affiliation(s)
- Azusa Fujikawa
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Yasser Helmy Mohamed
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan. .,Department of Ophthalmology, EL-Minia University Hospital, EL-Minia, Egypt.
| | - Hirofumi Kinoshita
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Makiko Matsumoto
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Masafumi Uematsu
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Eiko Tsuiki
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
| | - Kiyoshi Suzuma
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine Kyoto University, Kyoto, Japan
| | - Takashi Kitaoka
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki, Nagasaki, 852-8501, Japan
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Matsumoto M, Suzuma K, Yamada Y, Tsuiki E, Fujikawa A, Kitaoka T. RETINAL BLOOD FLOW AFTER INTRAVITREAL BEVACIZUMAB IS A PREDICTIVE FACTOR FOR OUTCOMES OF MACULAR EDEMA ASSOCIATED WITH CENTRAL RETINAL VEIN OCCLUSION. Retina 2018; 38:283-291. [PMID: 28151838 PMCID: PMC5841858 DOI: 10.1097/iae.0000000000001531] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE To investigate whether retinal blood flow levels after intravitreal bevacizumab (IVB) treatment are correlated with the outcomes of patients with macular edema secondary to central retinal vein occlusion. METHODS This retrospective observational case study enrolled 44 cases nonischemic central retinal vein occlusion. In each patient, visual acuity, central retinal thickness, and mean blur rate, which was measured by laser speckle flowgraphy and represents retinal blood flow velocity, were examined. RESULTS At the end of the follow-up period (19.8 ± 8.8 months), 4 of 44 eyes (9.1%) converted to the ischemic type (converted group), whereas 40 (90.9%) remained unchanged (nonischemic group). Mean central retinal thickness significantly decreased and mean visual acuity significantly improved at 1 month after the first IVB injection in each group. Mean mean blur rate in the nonischemic group significantly increased, whereas it was unchanged in the converted group. The difference between the two groups was already significant after the first IVB injection. Subsequently, visual acuity worsened in the converted group. Multiple linear regression analysis indicated that the strongest correlation was between the last visual acuity and the last mean blur rate. CONCLUSION Blood flow measurements are useful for evaluating IVB treatments. Blood flow after IVB can predict outcomes in patients with central retinal vein occlusion.
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Affiliation(s)
- Makiko Matsumoto
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Fujikawa A, Mohamed YH, Kinoshita H, Tsuiki E, Kitaoka T. Spontaneous dislocation of the posterior chamber intraocular lens. Int Ophthalmol 2017; 38:1111-1117. [DOI: 10.1007/s10792-017-0567-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2016] [Accepted: 05/15/2017] [Indexed: 11/28/2022]
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Iwanaga A, Okubo Y, Yozaki M, Koike Y, Kuwatsuka Y, Tomimura S, Yamamoto Y, Tamura H, Ikeda S, Maemura K, Tsuiki E, Kitaoka T, Endo Y, Mishima H, Yoshiura KI, Ogi T, Tanizaki H, Wataya-Kaneda M, Hattori T, Utani A. Analysis of clinical symptoms andABCC6mutations in 76 Japanese patients with pseudoxanthoma elasticum. J Dermatol 2017; 44:644-650. [DOI: 10.1111/1346-8138.13727] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 11/10/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Akira Iwanaga
- Department of Dermatology; Graduate School of Biomedical Sciences; Nagasaki University Nagasaki Japan
| | - Yumi Okubo
- Department of Dermatology; Graduate School of Biomedical Sciences; Nagasaki University Nagasaki Japan
| | - Mariko Yozaki
- Department of Dermatology; Graduate School of Biomedical Sciences; Nagasaki University Nagasaki Japan
| | - Yuta Koike
- Department of Dermatology; Graduate School of Biomedical Sciences; Nagasaki University Nagasaki Japan
| | - Yutaka Kuwatsuka
- Department of Dermatology; Graduate School of Biomedical Sciences; Nagasaki University Nagasaki Japan
| | - Saori Tomimura
- Department of Dermatology; Graduate School of Biomedical Sciences; Nagasaki University Nagasaki Japan
| | - Yosuke Yamamoto
- Department of Healthcare Epidemiology Research; Graduate School of Medicine; Kyoto University; Kyoto Japan
- Department of Dermatology; Graduate School of Biomedical Sciences; Kyoto University; Kyoto Japan
| | - Hiroshi Tamura
- Department of Ophthalmology and Visual Sciences; Graduate School of Medicine; Kyoto University; Kyoto Japan
- Division of Medical Information Technology and Administration Planning; Kyoto University Hospital; Kyoto Japan
| | - Satoshi Ikeda
- Department of Cardiovascular Medicine; Graduate School of Biomedical Sciences; Nagasaki University; Nagasaki Japan
| | - Koji Maemura
- Department of Cardiovascular Medicine; Graduate School of Biomedical Sciences; Nagasaki University; Nagasaki Japan
| | - Eiko Tsuiki
- Department of Ophthalmology; Graduate School of Biomedical Sciences; Nagasaki University; Nagasaki Japan
| | - Takashi Kitaoka
- Department of Ophthalmology; Graduate School of Biomedical Sciences; Nagasaki University; Nagasaki Japan
| | - Yuichiro Endo
- Department of Dermatology; Graduate School of Biomedical Sciences; Kyoto University; Kyoto Japan
| | - Hiroyuki Mishima
- Department of Human Genetics; Graduate School of Biomedical Sciences; Nagasaki University; Nagasaki Japan
| | - Koh-Ichiro Yoshiura
- Department of Human Genetics; Graduate School of Biomedical Sciences; Nagasaki University; Nagasaki Japan
| | - Tomoo Ogi
- Department of Genetics; Research Institute of Environmental Medicine; Nagoya University; Aichi Japan
| | | | - Mari Wataya-Kaneda
- Department of Dermatology; Graduate School of Medicine; Osaka University; Osaka Japan
| | - Tomoyasu Hattori
- Department of Dermatology; Graduate School of Medicine; Gunma University; Gunma Japan
| | - Atsushi Utani
- Department of Dermatology; Graduate School of Biomedical Sciences; Nagasaki University Nagasaki Japan
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Kiuchi Y, Yokoyama T, Takamatsu M, Tsuiki E, Uematsu M, Kinoshita H, Kumagami T, Kitaoka T, Minamoto A, Neriishi K, Nakashima E, Khattree R, Hida A, Fujiwara S, Akahoshi M. Glaucoma in Atomic Bomb Survivors. Radiat Res 2013; 180:422-30. [DOI: 10.1667/rr3273.2] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Tsuiki E, Suzuma K, Ueki R, Maekawa Y, Kitaoka T. Enhanced depth imaging optical coherence tomography of the choroid in central retinal vein occlusion. Am J Ophthalmol 2013; 156:543-547.e1. [PMID: 23688711 DOI: 10.1016/j.ajo.2013.04.008] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2012] [Revised: 04/05/2013] [Accepted: 04/05/2013] [Indexed: 02/03/2023]
Abstract
PURPOSE To evaluate subfoveal choroidal thickness in patients with central retinal vein occlusion (CRVO) using enhanced depth imaging optical coherence tomography. DESIGN Retrospective observational study. METHODS We measured bilateral subfoveal choroidal thickness, averaged for 100 scans, in 36 patients (mean age, 66 ± 15 years; 26 women and 10 men) with unilateral CRVO by using the enhanced depth imaging methods of the Spectralis optical coherence tomography system. Twenty-two patients were treated with intravitreal bevacizumab (1.25 mg/0.05 mL), and subfoveal choroidal thickness was measured before and after treatment. Statistical analysis was performed to compare subfoveal choroidal thickness of CRVO and fellow eyes and to compare subfoveal choroidal thickness before and after intravitreal bevacizumab. RESULTS Mean subfoveal choroidal thickness measured in 36 eligible eyes of 36 patients was 257.1 ± 83.2 μm, which was significantly greater than that in fellow eyes (222.6 ± 67.8 μm; P < .01, paired t test). There was strong correlation between CRVO eyes and fellow eyes (r = 0.79, P < .01). Mean subfoveal choroidal thickness after intravitreal bevacizumab was 227.7 ± 65.1 μm, which was significantly thinner than that before intravitreal bevacizumab therapy (266.9 ± 79.0 μm; P < .01, paired t test). CONCLUSIONS Subfoveal choroidal thickness of CRVO eyes was significantly greater than that of fellow eyes and decreased significantly after intravitreal bevacizumab treatment. Enhanced depth imaging optical coherence tomography can be used to evaluate choroidal involvement in CRVO and may assist noninvasive diagnosis and management of this disease.
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Yamada Y, Suzuma K, Ryu M, Tsuiki E, Fujikawa A, Kitaoka T. Systemic factors influence the prognosis of diabetic macular edema after pars plana vitrectomy with internal limiting membrane peeling. Curr Eye Res 2013; 38:1261-5. [PMID: 23972000 DOI: 10.3109/02713683.2013.820327] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE/AIMS To evaluate the prognostic factors for the best corrected visual acuity (BCVA) and central subfield macular thickness (CSMT) after vitrectomy with internal limiting membrane (ILM) peeling for diabetic macular edema. MATERIALS AND METHODS A total of 44 eyes of 35 patients who had undergone vitrectomy with ILM peeling between March 2008 and September 2009 were examined. The relationships between preoperative systemic or ocular factors and BCVA or CSMT were evaluated before and at 6 months after the surgical procedure. RESULTS Mean logarithm of the minimum angle of resolution improved from 0.74 ± 0.35 (mean ± SD) preoperatively to 0.55 ± 0.4 at 6 months postoperatively (p = 0.001). There was a significant improvement of the CSMT from 482 ± 116 μm before the operation to 355 ± 126 μm 6 months after the operation (p < 0.0001). The preoperative CSMT was significantly thicker with ischemic disease (p = 0.0016). Preoperative BCVA was significantly lower when subfoveal hard exudate was present (p = 0.0005). At the 6-month follow-up, CSMT was significantly thicker when there was a higher glycosylated hemoglobin (p = 0.008). BCVA at the 6-month follow-up was significantly lower in the group without any diabetes treatment history (p = 0.0075) prior to the diagnosis of diabetic retinopathy. CONCLUSIONS While BCVA and CSMT were associated with ocular factors before surgery, they were associated with glycemic control postoperatively. Glycemic control may be important for retinal thickness after ocular surgery.
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Affiliation(s)
- Yoshihisa Yamada
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University , 1-7-1 Sakamoto, Nagasaki 852-8501 , Japan
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Iwanaga A, Yozaki M, Yagi Y, Maemura K, Tsuiki E, Kitaoka T, Tanioka M, Tamura H, Yamamoto Y, Hattori T, Isogai Z, Ogi T, Yoshiura K, Utani A. Identification of ABCC6 gene mutations in the Japanese patients with pseudoxanthoma elasticum (PXE). J Dermatol Sci 2013. [DOI: 10.1016/j.jdermsci.2012.11.477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Matsumoto M, Suzuma K, Maki T, Kinoshita H, Tsuiki E, Fujikawa A, Kitaoka T. Succinate increases in the vitreous fluid of patients with active proliferative diabetic retinopathy. Am J Ophthalmol 2012; 153:896-902.e1. [PMID: 22265145 DOI: 10.1016/j.ajo.2011.10.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2011] [Revised: 09/29/2011] [Accepted: 10/01/2011] [Indexed: 01/07/2023]
Abstract
PURPOSE To examine vitreous succinate levels from proliferative diabetic retinopathy (PDR) patients and ascertain their association with PDR activity. DESIGN Comparative case series. METHODS A total of 81 eyes of 72 PDR patients were divided into active PDR (22 eyes), quiescent PDR (21 eyes), and active PDR with intravitreal bevacizumab injection (38 eyes). Twenty epiretinal membrane (ERM) patients (21 eyes) served as controls. RESULTS Mean vitreous succinate levels were 1.27 μM in ERM and 2.20 μM in PDR, with the differences statistically significant (P = .03). When comparing mean vitreous succinate levels (active PDR: 3.32 μM; quiescent PDR: 1.02 μM; active PDR with intravitreal bevacizumab injection: 1.20 μM), significant differences were found between active and quiescent PDR (P < .01) and between active PDR and active PDR with intravitreal bevacizumab injection (P < .01). Even though succinate levels were low, retinopathy activities were very high in patients with active PDR with intravitreal bevacizumab injection. Mean vitreous vascular endothelial growth factor (VEGF) levels (active PDR: 1696 pg/mL; quiescent PDR: 110 pg/mL; active PDR with intravitreal bevacizumab injection: n.d.) were similar to previous reports. Mean vitreous erythropoietin levels (active PDR: 703 mIU/mL; quiescent PDR: 305 mIU/mL; active PDR with intravitreal bevacizumab injection: 1562 mIU/mL) suggested very high retinopathy activities in patients with active PDR with intravitreal bevacizumab injection. CONCLUSIONS Succinate, like VEGF, may be an angiogenic factor that is induced by ischemia in PDR. Although succinate is reported to promote VEGF expression, VEGF inhibition decreases succinate. Thus, VEGF, via a positive feedback mechanism, may regulate succinate.
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Suzuma K, Yamada Y, Liu M, Tsuiki E, Fujikawa A, Kitaoka T. Comparing central retinal thickness in diabetic macular edema measured by two different spectral-domain optical coherence tomography devices. Jpn J Ophthalmol 2011; 55:620-4. [PMID: 21887610 DOI: 10.1007/s10384-011-0085-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2011] [Accepted: 07/25/2011] [Indexed: 10/17/2022]
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Suzuma K, Tsuiki E, Matsumoto M, Fujikawa A, Kitaoka T. Retro-mode imaging of fibrovascular membrane in proliferative diabetic retinopathy after intravitreal bevacizumab injection. Clin Ophthalmol 2011; 5:897-900. [PMID: 21760719 PMCID: PMC3133008 DOI: 10.2147/opth.s22843] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Indexed: 01/20/2023] Open
Abstract
The F10 is a new commercially available scanning laser confocal ophthalmoscope (SLO) that can perform multiple functions. We determined the usefulness of noninvasive evaluation of proliferative diabetic retinopathy (PDR) pathologies before and after intravitreal injection of bevacizumab (IVB) using the new indirect viewing system of the retro-mode function of the F10 SLO, and compared the images histologically with surgically excised fibrovascular membrane from two cases. In PDR, neovascular vessels in fibrovascular membrane were clearly seen with the retro-mode, even after IVB and without blood flow. The F10 SLO may be useful in evaluating neovascular vessels in fibrovascular membrane in PDR and for determining the precise retinal changes in diabetic retinopathy.
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Affiliation(s)
- Kiyoshi Suzuma
- Department of Ophthalmology and Visual Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
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Tsuiki E, Fujita A, Ohsaki Y, Cheng J, Irie T, Yoshikawa K, Senoo H, Mishima K, Kitaoka T, Fujimoto T. All-trans-Retinol Generated by Rhodopsin Photobleaching Induces Rapid Recruitment of TIP47 to Lipid Droplets in the Retinal Pigment Epithelium. ACTA ACUST UNITED AC 2007; 48:2858-67. [PMID: 17525222 DOI: 10.1167/iovs.06-0768] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE To investigate the effect of light stimulation on lipid droplets (LDs) and LD proteins in the retinal pigment epithelium (RPE). METHODS Dark-adapted mouse eyes were exposed to intense flashes of light, and ARPE-19 cells were treated with all-trans-retinol. The two specimens were labeled with BODIPY493/503 for LDs and with antibodies for three LD proteins: adipocyte differentiation-related protein (ADRP), TIP47, and Rab18. The labeling intensity in fluorescence microscopy was quantified by image analysis. Localization of mutated TIP47 was also examined. Immunoelectron microscopy was performed for ADRP in mouse RPE. Expression of TIP47 in ARPE-19 cells was knocked down by RNA interference (RNAi), and its effect on retinyl ester storage was measured by HPLC. RESULTS Both flashes of light on mouse eyes and all-trans-retinol on ARPE-19 cells caused rapid translocation of TIP47 from the cytosol to LDs, whereas ADRP distributed constitutively in LDs. The density of LDs did not show visible changes by any treatment. The localization of TIP47 to LDs was abolished when either the amino-terminal or the carboxyl-terminal half of the molecule was deleted, but was enhanced by a short deletion in the carboxyl terminus. Manipulation of TIP47 expression by RNAi or cDNA transfection did not affect the retinyl ester amounts in ARPE-19 cells significantly. CONCLUSIONS All-trans-retinol generated by photobleaching in the retina induces rapid translocation of TIP47 to LDs in the RPE.
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Affiliation(s)
- Eiko Tsuiki
- Department of Anatomy and Molecular Cell Biology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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Tsuiki E, Fujikawa A, Miyamura N, Yamada K, Mishima K, Kitaoka T. Visual field defects after macular hole surgery with indocyanine green-assisted internal limiting membrane peeling. Am J Ophthalmol 2007; 143:704-5. [PMID: 17386287 DOI: 10.1016/j.ajo.2006.10.051] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2006] [Revised: 10/17/2006] [Accepted: 10/27/2006] [Indexed: 10/23/2022]
Abstract
PURPOSE To report visual field defects after macular hole surgery with indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling. DESIGN Interventional consecutive case series. METHODS A retrospective review of 140 eyes with macular hole after vitrectomy with ILM peeling. The group with 0.25% of ICG for ILM peeling consisted of 96 eyes. The group without ICG consisted of 44 eyes. RESULTS Nasal visual field defects occurred in 11 eyes, temporal visual field defects in seven eyes, and concentric visual field defects in one eye. In the group with ICG, nasal visual field defects were far higher in the left eye than in the right eye. CONCLUSIONS We speculate that the postoperative nasal visual field defects were caused by the enhanced toxicity of ICG resulting from the exposure to illumination.
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Kitaoka T, Tsuda Y, Deguchi H, So K, Tsuiki E, Kinoshita A, Kishikawa Y, Amemiya T. [Standard values of inter-inner canthal, inter-outer canthal, and inter-pupillary distances in normal Japanese infants and children]. Nippon Ganka Gakkai Zasshi 2001; 105:411-4. [PMID: 11449692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/20/2023]
Abstract
UNLABELLED PURPOSE AND MATERIALS: We studied inter-inner canthal distance(DIC), inter-outer canthal distance (DOC), and inter-pupillary distance (PD) in 1,006 normal Japanese infants and children to establish the normal ratio of DIC/PD and DOC/DIC for the diagnosis of congenital anomalies such as Waardenburg syndrome. RESULTS DIC, DOC, and PD increased significantly from one month after birth to 12 years of age. DIC and DOC were stable but PD increased from 13 years of age to 15 years of age in junior high school. The DIC/PD and DOC/DIC averages were 0.61 and 2.73, respectively, one month after birth and 0.63 and 2.69 at three months after birth. On the other hand, DIC/PD and DOC/DIC were stable at 0.55-0.59 and 2.45 from 8 to 15 years of age. CONCLUSION Since there have been no reports on standard values of DIC, DOC and PD in infants, we established the standard values in this study. These values are expected to be very useful in the diagnosis of neural crest cell migration anomalies, such as Waardenburg syndrome.
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Affiliation(s)
- T Kitaoka
- Department of Ophthalmology, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan
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