1
|
Ishikawa S, Sasaki T, Maruyama T, Shinoda K. Proportion and characteristics of lacrimal drainage pathway disease and keratopathy in non-infectious corneal perforation using lacrimal syringing test. Sci Rep 2023; 13:19734. [PMID: 37957234 PMCID: PMC10643640 DOI: 10.1038/s41598-023-47248-9] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Accepted: 11/10/2023] [Indexed: 11/15/2023] Open
Abstract
Lacrimal drainage pathway disease-associated keratopathy (LDAK) has been associated with corneal perforation, which arises from both infectious and non-infectious corneal disorders. However, patients with corneal perforation are often not routinely tested for LDAK, and the potential risk posed by LDAK in the development of corneal ulcers has not been investigated in detail. This study aimed to assess the proportion and characteristics of LDAK in patients with non-infectious corneal perforation using lacrimal syringing test. This study enrolled 56 patients with corneal perforation treated at Saitama Medical University Hospital between January 2016 and September 2022. The causes of corneal perforation were trauma (n = 17, 30%), infection (n = 19, 34%), non-infection (n = 16, 29%), and unknown (n = 4, 7%). A lacrimal syringing test was performed on 12 patients with non-infectious corneal perforation and 4 with an unknown diagnosis. Among the 16 patients with non-infectious corneal perforation, 13 (81%) had lacrimal drainage disease, but only 3 (19%) patients had lacrimal puncta, as revealed by slit-lamp examinations. The primary bacterial species identified in lacrimal obstructive disease and lacrimal canaliculitis were Staphylococcus spp. and Actinomycetes spp. respectively. Lower temporal and peripheral corneal perforations were common. All patients underwent lacrimal surgery, and 6 (38%) were treated for corneal perforation without corneal surgery. Interestingly, several patients with LDAK who did not exhibit any lacrimal duct obstruction on slit-lamp examination. The study findings demonstrate the significance of the lacrimal syringing test for assessing LDAK in patients with corneal perforation, indicating LDAK as a potential cause of corneal perforation.
Collapse
Affiliation(s)
- Sho Ishikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan.
| | - Takanori Sasaki
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takafumi Maruyama
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| |
Collapse
|
2
|
Ishikawa S, Sasaki T, Maruyama T, Shinoda K. Modified Basket Suture for a Floppy or Irregular Iris in Endothelial Keratoplasty. Cornea 2023; 42:1465-1468. [PMID: 37506357 PMCID: PMC10538609 DOI: 10.1097/ico.0000000000003359] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 06/03/2023] [Accepted: 06/20/2023] [Indexed: 07/30/2023]
Abstract
ABSTRACT Performing endothelial keratoplasty in an eye with a damaged or irregular iris can result in uneven air filling, air escape behind the pupil, anterior iris curvature, a shallow anterior chamber, an uneven anterior chamber depth, difficulty inserting and opening the graft, and iris trauma. We herein present a modified basket suture technique to prevent these iris complications. Before insertion of the corneal donor graft, a double-armed 9-0 polypropylene suture on a curved needle is inserted from 4 equidistant points at the corneal limbus to create a box configuration directly anterior to the iris. These sutures prevent the iris from moving toward the cornea and the anterior chamber from becoming shallow when air replacement is performed. The suture also reduces intraoperative or postoperative iris-related problems because the air filling is more uniform and less prone to migration.
Collapse
Affiliation(s)
- Sho Ishikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takanori Sasaki
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takahumi Maruyama
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| |
Collapse
|
3
|
Komi Y, Katsumoto T, Yoshikawa Y, Shibuya M, Shoji T, Makita J, Shinoda K. Case of Spontaneous Closure and Recurrence of Macular Hole in Vitrectomized Eye. Int Med Case Rep J 2023; 16:641-645. [PMID: 37808920 PMCID: PMC10557958 DOI: 10.2147/imcrj.s429577] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 09/14/2023] [Indexed: 10/10/2023] Open
Abstract
Rationale Development and spontaneous closure of a macular hole (MH) in a vitrectomized eye is relatively rare. We report our findings in a case in which vitrectomy was performed successfully to treat a vitreous hemorrhage (VH), but a MH developed eight months later. The MH spontaneously closed 2 weeks later, but then reopened. A second vitrectomy was performed with insertion of the internal limiting membrane flap into the MH which led to the successful closure of the MH. The purpose of this article is to present an explanation of how MH developed in this eye without vitreous traction. Patient A 64-year-old woman visited an eye clinic with vision reduction in her right eye of 3 days duration. A VH was detected in the right eye and pars plana vitrectomy (PPV) was performed. A retinal tear was detected which was the origin of the VH. The vision was restored to a decimal visual acuity of 1.2. Eight months later, the patient noticed that her vision was distorted and was referred to our hospital. Diagnosis Optical coherence tomographic (OCT) images showed a thin epiretinal membrane on the macula, cystoid changes in the macular area, and a full-thickness MH. Interventions The MH closed spontaneously in two weeks, however a lamellar MH with an epiretinal proliferation (EP) developed 11 months later. Two months later, OCT showed cyst-like changes in the retina and a full-thickness MH. A second PPV was performed with the insertion of the ILM flap and EP into the MH to close the MH. Her visual acuity improved, and distorted vision was not present. Lessons Clinicians should be aware that a MH can develop in a vitrectomized eye without vitreous traction but can close spontaneously. We conclude that careful follow-up examinations are necessary even in vitrectomized eyes.
Collapse
Affiliation(s)
- Yuki Komi
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Takeshi Katsumoto
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Masayuki Shibuya
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
- Koedo Eye Institute, Kawagoe, Saitama, Japan
| | - Jun Makita
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| |
Collapse
|
4
|
Igawa Y, Shoji T, Weinreb R, Miyake Y, Yoshikawa Y, Takano S, Shinoda K. Early changes in photopic negative response in eyes with glaucoma with and without choroidal detachment after filtration surgery. Br J Ophthalmol 2023; 107:1295-1302. [PMID: 35396212 PMCID: PMC10447412 DOI: 10.1136/bjophthalmol-2021-320730] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 03/26/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND/AIMS To evaluate the electroretinographic (ERG) changes in the early postoperative period following glaucoma filtration surgery, and its relationship with choroidal detachment (CD). METHODS This retrospective observational single-centre study included 57 consecutive patients with primary open-angle glaucoma who underwent unilateral glaucoma filtration surgery. The patients were divided into two groups according to the presence or absence of CD. ERG components, including the photopic negative response (PhNR), a-wave and b-wave were compared before and after surgery using skin electrodes. RESULTS There were 46 patients in the non-CD group and 11 in the CD group. ERG was recorded within 5.1 (2.1 to 8.1) (mean (95% CI)) days after surgery. In the non-CD group, the PhNR amplitude, PhNR/b-wave amplitude ratio and PhNR implicit time improved significantly after surgery (p=0.008, 0.002 and 0.039, respectively). In the CD group, the amplitude of the PhNR, a-wave and b-wave were significantly deteriorated after surgery (p=0.002, 0.001 and 0.001, respectively). Postoperative intraocular pressure (IOP) (p=0.031) and postoperative CD (p<0.001) were significantly associated with change in the PhNR amplitude in the univariate models. In the multivariate analysis, severe CD (stage 3) cases tended to be deteriorated more. CONCLUSION Even in the early postoperative period within several days, the PhNR amplitude increased with IOP lowering following filtration surgery in the absence of CD. The presence of CD may arrest the improvement of the retinal ganglion cell function. The present results enhance understanding the structural and functional recovery after glaucoma surgery and the role of postoperative CD.
Collapse
Affiliation(s)
- Yuro Igawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Robert Weinreb
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California, San Diego, California, USA
| | | | - Yuji Yoshikawa
- Ophthalmology, Saitama Medical University Hospital, Moroyama-machi, Saitama, Japan
| | - Shunichiro Takano
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
- Ophthalmology, Teikyo University School of Medicine Graduate School of Medicine, Itabashi-ku, Japan
| |
Collapse
|
5
|
Ishikawa S, Sasaki T, Maruyama T, Murayama K, Shinoda K. Effectiveness and Adherence of Dry Eye Patients Who Switched from Short- to Long-Acting Diquafosol Ophthalmic Solution. J Clin Med 2023; 12:4495. [PMID: 37445527 DOI: 10.3390/jcm12134495] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 06/30/2023] [Accepted: 06/30/2023] [Indexed: 07/15/2023] Open
Abstract
Long-acting (lasting extend) diquafosol ophthalmic solution 3% (DQSLX) is administered three times daily versus six times daily for the currently approved diquafosol ophthalmic solution (DQS). We investigated the efficacy and adherence of switching from DQS to DQSLX in patients with dry eye disease. We retrospectively enrolled 54 patients (17 men and 37 women) with eye drop prescription changes from DQS to DQSLX between December 2022 and March 2023. The number of eye drops, subjective symptoms, tear breakup time (TBUT), and fluorescein staining scores from baseline to 4 weeks after starting DQSLX were evaluated. Participants then chose between DQSLX and DQS. Patients administered DQSLX three times per day, as listed on the package insert, 88.9% of the time; significantly higher than the 5.6% of patients who used DQS six times per day, as instructed. The DQSLX group showed significant improvements in symptoms and fluorescein staining scores (23.3 ± 20.1 and 0.8 ± 1.7, respectively) compared with the baseline (37.8 ± 24.1 and 1.1 ± 1.5, p = 0.01 and <0.001, respectively). The TBUT in the DQSLX group (5.0 ± 2.5 s) did not significantly improve compared to the DQS group (4.5 ± 1.7 s) (p = 0.75). Fifty-one (94.4%) patients opted to continue DQSLX because of the pleasant feeling of the eye drops, long-lasting moisture, and less frequent administration. The efficacy and adherence of DQSLX was comparable to DQS.
Collapse
Affiliation(s)
- Sho Ishikawa
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Takanori Sasaki
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Takahumi Maruyama
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | | | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| |
Collapse
|
6
|
Ishikawa S, Yamaguchi S, Hashimoto M, Shinoda K. Effect of a single warm compress prior to ophthalmic surgery on ocular surface and intraoperative visibility: a randomised controlled study. BMJ Open Ophthalmol 2023; 8:e001307. [PMID: 37493693 PMCID: PMC10335455 DOI: 10.1136/bmjophth-2023-001307] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 06/12/2023] [Indexed: 07/27/2023] Open
Abstract
PURPOSE We investigated the effects of a warm compress immediately before surgery on the ocular surface and intraoperative visibility during surgery. METHODS A randomised controlled quasi-experiment at Saitama Medical University Hospital. From November 2020 to September 2021, 200 patients scheduled for endophthalmic surgery were randomly assigned to a group that received a hot compress with a spontaneously heating eye mask (HM group) or a group that received only an eye mask (control group). The eye masks were applied for 20 min from 2 hours before surgery, and before and after mask application in the non-invasive tear break-up time (NIBUT), tear meniscus height (TMH) and obstruction score of the meibomian gland (meiboscore) were evaluated. The time from wetting to dry blurring of the corneal surface (corneal blurring time, CBT) was also compared before and after the warm compress. RESULTS We enrolled 100 patients in the HM group (mean age 69.0±13.3 years) and 99 patients in the control group (mean age 69.5±16.2 years). In the control group, there were no significant changes in the NIBUT, meiboscore or TMH before and after eye mask use, whereas in the HM group, the NIBUT increased from 6.7±5.1 to 9.5±5.6 s (p<0.001), the meiboscore improved from 0.71±0.93 to 0.63±0.96 (p=0.03) and the TMH significantly improved from 0.22±0.08 to 0.24±0.08 mm (p<0.001). The CBT was longer the HM group than control group (33.5±13.4 s, 25.7±14.9 s, respectively, p=0.01). CONCLUSIONS The condition of the ocular surface and intraoperative visibility improved after a single warm compress. TRIAL REGISTRATION NUMBER UMIN R000047286.
Collapse
Affiliation(s)
- Sho Ishikawa
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Japan
| | - Saori Yamaguchi
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Japan
| | - Miho Hashimoto
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma-gun, Japan
| |
Collapse
|
7
|
Makita J, Yoshikawa Y, Kanno J, Igawa Y, Kumagai T, Takano S, Katsumoto T, Shoji T, Shibuya M, Shinoda K. Electroretinographic and Optical Coherence Tomographic Evaluations of Eyes with Vitreoretinal Lymphoma. J Clin Med 2023; 12:3957. [PMID: 37373651 DOI: 10.3390/jcm12123957] [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: 04/16/2023] [Revised: 05/19/2023] [Accepted: 06/02/2023] [Indexed: 06/29/2023] Open
Abstract
Vitreoretinal lymphomas (VRLs) present with different clinical characteristics. However, only a few case reports have been published that evaluated the retinal function and the retinal morphology. The relationship between retinal morphology and function of eyes with a vitreoretinal lymphoma (VRL) was investigated via optical coherence tomography (OCT) and electroretinography (ERG). The ERG and OCT findings in 11 eyes of 11 patients (69.4 ± 11.5 years old) who were diagnosed with VRL at the Saitama Medical University Hospital between December 2016 to May 2022 were studied. The decimal best-corrected visual acuity ranged from hand movements to 1.2 (median 0.2). Histopathological studies of the vitreous specimens showed class II VRL in one eye, class III VRL in seven eyes, class IV VRL in two eyes, and class V VRL in one eye. The IgH gene rearrangement was positive in three of the six eyes tested. The OCT images showed morphological abnormalities in 10 of the 11 (90.9%) eyes. Severe attenuation was found for the amplitudes of the b-wave of the DA 0.01 ERG in 6 of 11 eyes (54.5%), the DA 3.0 a-wave in 5 of 11 eyes (45.5%), the DA 3.0 b-wave in 36.4%, the LA 3.0 a-wave in 36.4%, the LA 3.0 b-wave in 18.2%, and flicker responses in 36.4% of the eyes. None of the DA 3.0 ERGs had a negative shape (b/a < 1.0). In the five eyes in which the a-wave was severely attenuated, hyperreflective dots were observed subretinally. The ERG analysis in eyes with a VRL indicates a relatively severe dysfunction of the outer retinal layer and was helpful in determining the site of the morphological changes in eyes with VRL.
Collapse
Affiliation(s)
- Jun Makita
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Yuro Igawa
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Tomoyuki Kumagai
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Shunichiro Takano
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Takeshi Katsumoto
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
- Koedo Eye Institute, Saitama 350-1123, Japan
| | - Masayuki Shibuya
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama 350-0495, Japan
| |
Collapse
|
8
|
Sasaki T, Shoji T, Kanno J, Ishii H, Yoshikawa Y, Ibuki H, Shinoda K. Correction: Sasaki et al. Automatic Determination of the Center of Macular Hole Using Optical Coherence Tomography En Face Images. J. Clin. Med. 2022, 11, 3167. J Clin Med 2023; 12:jcm12010392. [PMID: 36615196 PMCID: PMC9821581 DOI: 10.3390/jcm12010392] [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] [Received: 12/07/2022] [Accepted: 12/12/2022] [Indexed: 01/05/2023] Open
Abstract
There was an error in the original publication [...].
Collapse
|
9
|
Yamaguchi S, Yoshikawa Y, Chino M, Shinoda K. A Case of Dellen Formation following 27-Gauge Vitrectomy with Rapid Improvement by Scleral and Conjunctival Sutures. Case Rep Ophthalmol 2023; 14:607-612. [PMID: 37942233 PMCID: PMC10629856 DOI: 10.1159/000534501] [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] [Received: 08/31/2023] [Accepted: 10/01/2023] [Indexed: 11/10/2023] Open
Abstract
Introduction Dellen is a corneal disease characterized by shallow, saucer-like excavations at the corneal margin. Herein, we presented a case of dellen formation that developed following a 27-gauge pars plana vitrectomy (PPV) and was rapidly resolved using scleral and conjunctival sutures. Case Presentation A 73-year-old woman underwent a 27-gauge PPV for the epiretinal membrane of the right eye. Intraoperatively, owing to coexisting diabetic retinopathy, the peripheral vitreous was shaved, and retinal photocoagulation was performed on the peripheral retina. The intraocular pressure (IOP) was 15 mm Hg on 1 day after the PPV and on postoperative day 4; however, on day 14, the IOP decreased to 10 mm Hg, and conjunctival bleb formation was observed. By day 18, the bleb height remained unchanged, and dellen formation was noted at the corneal periphery. Because of marked corneal thinning, conjunctival and scleral sutures were placed 20 days following the PPV. Intraoperative findings revealed leakage from the scleral wound at the trocar puncture site. The IOP increased to 20 mm Hg at 19 h following the suture, resulting in the disappearance of the bleb and dellen. Since then, the bleb or dellen did not recur. Conclusion We encountered a case of late-onset scleral wound cleavage 2 weeks following microincision vitreous surgery, resulting in bleb and dellen formation, which was immediately managed by the scleral and conjunctiva suturing.
Collapse
Affiliation(s)
- Saori Yamaguchi
- Department of Ophthalmology, Saitama Medical University, Iruma, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Japan
| | - Minami Chino
- Department of Ophthalmology, Saitama Medical University, Iruma, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma, Japan
| |
Collapse
|
10
|
Kanno J, Shoji T, Ishii H, Ibuki H, Yoshikawa Y, Sasaki T, Shinoda K. Deep Learning with a Dataset Created Using Kanno Saitama Macro, a Self-Made Automatic Foveal Avascular Zone Extraction Program. J Clin Med 2022; 12:jcm12010183. [PMID: 36614984 PMCID: PMC9821090 DOI: 10.3390/jcm12010183] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 12/08/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
The extraction of the foveal avascular zone (FAZ) from optical coherence tomography angiography (OCTA) images has been used in many studies in recent years due to its association with various ophthalmic diseases. In this study, we investigated the utility of a dataset for deep learning created using Kanno Saitama Macro (KSM), a program that automatically extracts the FAZ using swept-source OCTA. The test data included 40 eyes of 20 healthy volunteers. For training and validation, we used 257 eyes from 257 patients. The FAZ of the retinal surface image was extracted using KSM, and a dataset for FAZ extraction was created. Based on that dataset, we conducted a training test using a typical U-Net. Two examiners manually extracted the FAZ of the test data, and the results were used as gold standards to compare the Jaccard coefficients between examiners, and between each examiner and the U-Net. The Jaccard coefficient was 0.931 between examiner 1 and examiner 2, 0.951 between examiner 1 and the U-Net, and 0.933 between examiner 2 and the U-Net. The Jaccard coefficients were significantly better between examiner 1 and the U-Net than between examiner 1 and examiner 2 (p < 0.001). These data indicated that the dataset generated by KSM was as good as, if not better than, the agreement between examiners using the manual method. KSM may contribute to reducing the burden of annotation in deep learning.
Collapse
Affiliation(s)
- Junji Kanno
- Department of Ophthalmology, Saitama Medical University School of Medicine, Iruma 350-0495, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University School of Medicine, Iruma 350-0495, Japan
- Koedo Eye Institute, Kawagoe 350-1123, Japan
- Correspondence: ; Tel.: +81-49-276-1250
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University School of Medicine, Iruma 350-0495, Japan
| | - Hisashi Ibuki
- Department of Ophthalmology, Saitama Medical University School of Medicine, Iruma 350-0495, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University School of Medicine, Iruma 350-0495, Japan
| | - Takanori Sasaki
- Department of Ophthalmology, Saitama Medical University School of Medicine, Iruma 350-0495, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University School of Medicine, Iruma 350-0495, Japan
| |
Collapse
|
11
|
Suga A, Yoshitake K, Minematsu N, Tsunoda K, Fujinami K, Miyake Y, Kuniyoshi K, Hayashi T, Mizobuchi K, Ueno S, Terasaki H, Kominami T, Nao-I N, Mawatari G, Mizota A, Shinoda K, Kondo M, Kato K, Sekiryu T, Nakamura M, Kusuhara S, Yamamoto H, Yamamoto S, Mochizuki K, Kondo H, Matsushita I, Kameya S, Fukuchi T, Hatase T, Horiguchi M, Shimada Y, Tanikawa A, Yamamoto S, Miura G, Ito N, Murakami A, Fujimaki T, Hotta Y, Tanaka K, Iwata T. Genetic characterization of 1210 Japanese pedigrees with inherited retinal diseases by whole-exome sequencing. Hum Mutat 2022; 43:2251-2264. [PMID: 36284460 DOI: 10.1002/humu.24492] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 09/18/2022] [Accepted: 10/21/2022] [Indexed: 01/25/2023]
Abstract
Inherited retinal diseases (IRDs) comprise a phenotypically and genetically heterogeneous group of ocular disorders that cause visual loss via progressive retinal degeneration. Here, we report the genetic characterization of 1210 IRD pedigrees enrolled through the Japan Eye Genetic Consortium and analyzed by whole exome sequencing. The most common phenotype was retinitis pigmentosa (RP, 43%), followed by macular dystrophy/cone- or cone-rod dystrophy (MD/CORD, 13%). In total, 67 causal genes were identified in 37% (448/1210) of the pedigrees. The first and second most frequently mutated genes were EYS and RP1, associated primarily with autosomal recessive (ar) RP, and RP and arMD/CORD, respectively. Examinations of variant frequency in total and by phenotype showed high accountability of a frequent EYS missense variant (c.2528G>A). In addition to the two known EYS founder mutations (c.4957dupA and c.8805C>G) of arRP, we observed a frequent RP1 variant (c.5797C>T) in patients with arMD/CORD.
Collapse
Affiliation(s)
- Akiko Suga
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kazutoshi Yoshitake
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Laboratory of Aquatic Molecular Biology and Biotechnology, Aquatic Bioscience, Graduate School of Agricultural and Life Sciences, The University of Tokyo, Tokyo, Japan
| | - Naoko Minematsu
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kazushige Tsunoda
- Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kaoru Fujinami
- Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | | | - Kazuki Kuniyoshi
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takaaki Hayashi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kei Mizobuchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Shinji Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Ophthalmology, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Hiroko Terasaki
- Nagoya University, Institutes of Innovation for Future Society, Nagoya, Japan
| | - Taro Kominami
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Nobuhisa Nao-I
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Go Mawatari
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University School of Medicine, Teikyo, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Teikyo University School of Medicine, Teikyo, Japan.,Department of Ophthalmology, Saitama Medical University, Iruma-gun, Japan
| | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Kumiko Kato
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Tetsuju Sekiryu
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Makoto Nakamura
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Sentaro Kusuhara
- Division of Ophthalmology, Department of Surgery, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | | | - Kiyofumi Mochizuki
- Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan
| | - Hiroyuki Kondo
- Department of Ophthalmology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Itsuka Matsushita
- Department of Ophthalmology, University of Occupational and Environmental Health, Kitakyushu, Japan
| | - Shuhei Kameya
- Nippon Medical School Chiba Hokusoh Hospital, Chiba, Japan
| | - Takeo Fukuchi
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | - Tetsuhisa Hatase
- Division of Ophthalmology and Visual Science, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan
| | | | - Yoshiaki Shimada
- Department of Ophthalmology, Fujita Health University, Fujita, Japan
| | - Atsuhiro Tanikawa
- Department of Ophthalmology, Fujita Health University, Fujita, Japan
| | - Shuichi Yamamoto
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Gen Miura
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Nana Ito
- Department of Ophthalmology and Visual Science, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan
| | - Takuro Fujimaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Japan.,Kohinata Eye Clinic, Tokyo, Japan
| | - Yoshihiro Hotta
- Department of Ophthalmology, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Koji Tanaka
- Division of Ophthalmology, Department of Visual Sciences, Nihon University School of Medicine, Chiyoda-ku, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| |
Collapse
|
12
|
Kost Y, Mieczkowska K, Deutsch A, Nazarian R, Muskat A, Hosgood D, Lin J, Shinoda K, Daily J, Kabarriti R, Ohri N, McLellan B. Bacterial Decolonization to Prevent Acute Radiation Dermatitis: A Randomized Controlled Trial. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.361] [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: 11/24/2022]
|
13
|
Terauchi G, Shinoda K, Yagura K, Kawashima M, Matsumoto SC, Mizota A, Miyake Y. Electroretinographic Assessments of Macular Function after Brilliant Blue G Staining for Inner Limiting Membrane Peeling. J Clin Med 2022; 11:jcm11216404. [PMID: 36362633 PMCID: PMC9654685 DOI: 10.3390/jcm11216404] [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] [Received: 09/23/2022] [Revised: 10/22/2022] [Accepted: 10/23/2022] [Indexed: 11/30/2022] Open
Abstract
Purpose: The purpose of this study was to determine the effect of brilliant blue G (BBG) staining of the inner limiting membrane (ILM) on macular function. Method: Fourteen eyes of 14 patients consisting of 9 men and 5 women who underwent vitreous surgery with ILM peeling were studied. The mean age of the patients was 68.8 ± 9.14 years. Three eyes had a macular hole and eleven eyes had an epiretinal membrane. The ILM was made more visible by spraying 0.25% BBG into the vitreous cavity. The macular function was assessed by recording intraoperative focal macular electroretinograms (iFMERGs) before and after the intravitreal spraying of the BBG dye. The iFMERGs were recorded three times after core vitrectomy. The first recording was performed before the BBG injection (Phase 1, baseline), the second recording was performed after the spraying of the BBG and washing out the excess BBG (Phase 2), and the third recording was performed after the ILM peeling (Phase 3). All recordings were performed after 5 min of light-adaptation and stabilization of the intraocular conditions. The iFMERGs were recorded twice at each phase. The implicit times and amplitudes of the a- and b-wave, the PhNR, and the d-wave were measured. Wilcoxon signed-rank test were used to determine the significance of differences of the findings at Phase 2 vs. Phase 1 and Phase 3 vs. Phase 1. A p value < 0.05 was taken to be statistically significant. Results: The average implicit times of the a-wave, b-wave, PhNR, and d-wave were not significantly different in Phase 1, 2, and 3. The average a-wave, b-wave, PhNR, and d-wave amplitudes at Phase 1 did not differ significantly from that at Phase 2 and at Phase 3. Conclusions: The results indicated that the intravitreal injection of BBG does not alter the physiology of the macula, and we conclude that BBG is safe. We also conclude that iFMERGs can be used to monitor the macular function safely during intraocular surgery.
Collapse
Affiliation(s)
- Gaku Terauchi
- School of Medicine, Teikyo University, Tokyo 173-8606, Japan
| | - Kei Shinoda
- School of Medicine, Teikyo University, Tokyo 173-8606, Japan
- Faculty of Medicine, Saitama Medical University, Saitama 350-0495, Japan
- Correspondence: ; Tel.: +81-3-3964-1225
| | - Kazuma Yagura
- School of Medicine, Teikyo University, Tokyo 173-8606, Japan
| | | | - Soiti Celso Matsumoto
- School of Medicine, Teikyo University, Tokyo 173-8606, Japan
- Matsumoto Eye Clinic, Tokushima 771-1705, Japan
| | - Atsushi Mizota
- School of Medicine, Teikyo University, Tokyo 173-8606, Japan
| | - Yozo Miyake
- Kobe Eye Center Next Vision, Kobe 650-0047, Japan
| |
Collapse
|
14
|
Yoshikawa Y, Kanno J, Shinoda K, Makita J. Evaluation of macular visibility through a high-order aspheric intraocular lens using a simulated model eye. Medicine (Baltimore) 2022; 101:e31018. [PMID: 36253979 PMCID: PMC9575836 DOI: 10.1097/md.0000000000031018] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We evaluated the macular visibility of a newly designed extended depth of focus (EDOF) intraocular lenses (IOL) using a wide viewing system for macular manipulation (Risight;60D, Carl Zeiss Meditec AG) in a model eye and compared it with various other types of IOLs. We used a model eye that was constructed based on the Glustrand model to compare a newly designed EDOF IOL (DIB00V; Johnson & Johnson Surgical Vision), an EDOF IOL with a diffraction grating (ZXR00V; Johnson & Johnson surgical Vision), and a monofocal aspheric (DCB00V; Johnson & Johnson Vision, XY-1; HOYA Surgical Optics, Tokyo, Japan) or spherical IOL (NX70s; Santen Pharmaceutical Co., Ltd). In the model eye, a 1951 United States Air Force (USAF) test was placed at the location of the macula. The contrasts in a range of spatial frequencies were quantified using the images obtained from the 1951 USAF test target. The contrast at each spatial frequency was plotted and integrated to calculate the area under the curve contrast (AUC-contrast). Qualitative evaluations showed that good-quality images were obtained for all IOLs. At a spatial frequency of 16 LP/mm, the average contrast was the highest for the DIB00V and NX70s (0.216 each). The highest average contrast at 32 LP/mm was obtained using the NX70s (0.128), and at 64 LP/mm using the DIB00V (0.123). The horizontal AUC-contrast was the highest for the NX70s (8.754), and the vertical AUC-contrast was the highest for the DIB00V (8.334). On average, the DIB00V had the highest AUC-contrast value (8.227). The high-order aspheric IOL, DIB00V, was found to exhibit good macular visibility despite being an EDOF IOL.
Collapse
Affiliation(s)
- Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
- *Correspondence: Yuji Yoshikawa, Department of Ophthalmology, Saitama Medical University Hospital, 38 Morohongo, Moroyama-machi, Iruma-gun, Saitama 350-0495, Japan (e-mail: )
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Jun Makita
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| |
Collapse
|
15
|
Yoshikawa Y, Shoji T, Kanno J, Ishii H, Chino M, Igawa Y, Shinoda K, Miyake Y. Relationship Between Deep Retinal Macular Vessel Density and Bipolar Cell Function in Glaucomatous Eyes. Transl Vis Sci Technol 2022; 11:4. [PMID: 36180028 PMCID: PMC9547355 DOI: 10.1167/tvst.11.10.4] [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: 11/24/2022] Open
Abstract
Purpose To evaluate the correlation between macular retinal function and the changes in the macular retinal vascular structure in glaucomatous eyes. Methods The study included patients with glaucoma who visited Saitama Medical University and underwent optical coherence tomography angiography, and multifocal electroretinographic examinations at the same time between February 2020 and April 2021. Correlations among the ocular parameters, macular vessel density, and multifocal electroretinographic parameters were evaluated using a mixed model. Results Forty-one eyes (mean deviation, −12.4 ± 7.8 dB) of 24 subjects (mean age, 75.2 ± 8.3 years) were included in the analysis. There were no significant correlations for macular vessel density in the superficial retinal layer. However, macular vessel density in the deep retinal layer showed a significant positive correlation with P1–N1 amplitude (coefficient = 0.724; P = 0.001). There were no significant correlations between the optical coherence tomography parameters and any of the multifocal electroretinographic parameters. Conclusions A decrease in N1–P1 amplitude was observed in glaucomatous eyes in relation to a reduction in macular vessel density in the deep retinal layer, which suggests that ischemia-induced bipolar cell dysfunction may be involved in the intermediate retinal dysfunction associated with glaucoma. Translational Relevance Intermediate retinal dysfunction in glaucoma is related to the changes in deep retinal microvasculature.
Collapse
Affiliation(s)
- Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Minami Chino
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Yuro Igawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | | |
Collapse
|
16
|
Kost Y, Muskat A, Mieczkowska K, Deutsch A, Shinoda K, McLellan B. 798 Interleukin-17 pathway activation in radiation dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.812] [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: 11/27/2022]
|
17
|
Ishikawa S, Chino M, Shinoda K. A rigid gas permeable contact lens discovered embedded in the upper eyelid 7 years after trauma: A case report. Int J Surg Case Rep 2022; 96:107316. [PMID: 35759986 PMCID: PMC9240359 DOI: 10.1016/j.ijscr.2022.107316] [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] [Received: 04/20/2022] [Revised: 06/13/2022] [Accepted: 06/13/2022] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION Rigid gas permeable (RGP) contact lenses implanted in the upper eyelid may remain asymptomatic. It is important to evert the upper eyelid even in the absence of definite pain. PRESENTATION OF CASE A 74-year-old woman with a history of rheumatoid arthritis visited a local clinic because of right eye discomfort that had persisted for 5 months. Eversion of the upper eyelid revealed an embedded foreign body, and she was referred to our hospital. A transparent and smooth-surfaced foreign body was found embedded at the center of the upper eyelid conjunctiva. Additionally, fatty tissues were found behind the foreign body. Computed tomography (CT) and magnetic resonance imaging (MRI) revealed a foreign body rich in water at the same site. The foreign body was a spherical object with a diameter of 9 mm reaching as deep as the tarsus. On removal, the foreign body was identified as an RGP contact lens. On further questioning, it was discovered that the patient had lost an RGP contact lens 7 years earlier. The symptoms disappeared after removal of the foreign body. DISCUSSION RGP contact lenses are not detected on MRI scans, but cysts around the lenses are detected, which may result in multiple detections. CT cannot differentiate a foreign body from granulation tissue. The foreign body itself or a reactive granuloma can be seen when the eyelid is everted. CONCLUSION A contact lens embedded in the eyelid without symptoms is rare but can be detected via a detailed interview, visual examination, and diagnostic imaging.
Collapse
Affiliation(s)
- Sho Ishikawa
- Corresponding author at: Department of Ophthalmology, Saitama Medical University, 38 Morohongo, Moroyama, Saitama 350-0495, Japan.
| | | | | |
Collapse
|
18
|
Konishi M, Mizushima I, Kawano M, Murayama T, Nakazaki S, Shinoda K, Kido T, Katsuki Y, Fujinaga H, Watanabe T, Motomura H, Matsushita I. POS0675 IMPACT OF PAST USE OF DISEASE MODIFYING ANTI-RHEUMATIC DRUGS ON JAK INHIBITOR TREATMENT FOR RHEUMATOID ARTHRITIS - DATA FROM THE FUKUI ISHIKAWA TOYAMA DATABASE OF RHEUMATOID ARTHRITIS. Ann Rheum Dis 2022. [DOI: 10.1136/annrheumdis-2022-eular.1443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BackgroundCurrently, five types of Janus kinase inhibitors (JAKis) are used for rheumatoid arthritis (RA) treatment. The number of cases in which multiple JAKis have been prescribed is increasing. However, the real-world efficacy and safety of JAKis and related factors require further evaluation.ObjectivesThe primary objective of this study was to elucidate the impact of past use of disease-modifying anti-rheumatic drugs on RA treatment using JAKis. The secondary objective was to investigate the safety profiles of these agents in a real-world setting.MethodsOf the 303 JAKi-treated patients in the Fukui Ishikawa Toyama Database of RA included in this study, 30 had switched from one JAKi to another (JJ group), 214 switched from a biologic agent to a JAKi (BJ group), and 47 were naïve to either biologics or JAKis (NJ group). We compared baseline factors, treatment response, and JAKi continuation rates among the three groups. Factors related to JAKi discontinuation were assessed using Cox regression analysis. Furthermore, we investigated adverse events and reported them using exposure-adjusted incidence rates (EAIR; incidence rates per 100 patient-years).ResultsData from the 303 cases were analyzed (mean age = 63.6 years; female, 82%; mean RA duration, 176 months). Of the 303 patients, 118, 106, 50, and 29 were treated with tofacitinib, baricitinib, peficitinib, and upadacitinib, respectively, on initial observation. Rate of concomitant use with methotrexate and prednisolone was 52% and 49%, respectively.Regarding efficacy, no significant differences were observed among the three groups in terms of treatment response and JAKi continuation rates, except for the 6-month treatment response between the JJ and NJ groups. Cox regression analysis of the 303 cases revealed that only past use of JAKis during the disease history was significantly associated with JAKi discontinuation. The Kaplan–Meier method showed that patients who previously used JAKis had significantly shorter median JAKi treatment duration than those without such a history (20.9 vs. 54.7 months; p = 0.012). Treatment response was significantly poor in patients who had previously used JAKis, especially 6 months after treatment initiation.In terms of safety, the total exposure period for the 303 cases was 495 person-years, and the total number of adverse events was 161 (EAIR, 32.5). There were 12 cases (EAIR, 2.5) of serious infections, 23 cases (EAIR, 5.1) of herpes zoster, 7 cases (EAIR, 1.4) of malignant tumors, and 4 cases (EAIR, 0.8) of MACE. Adverse events led to JAKi discontinuation in 34 patients (EAIR, 6.9); the main causes of adverse events leading to treatment discontinuation were infectious diseases in 10 cases (EAIR, 2) and neoplasms in 4 cases (EAIR, 0.8). Within 1 year of initiating JAKi therapy, 21 patients discontinued treatment owing to adverse events, which accounted for 27% of the reasons for treatment discontinuation.We also investigated cases of JAKi dose reduction, observed in 42 of the 303 cases. Among them, 10 patients required a re-increase in the JAKi dose, and 13 patients (56.5%) were able to maintain the reduced dose for more than 1 year. The remaining 19 patients were excluded from the analysis because the treatment duration at the lower dose had not exceeded 1 year at the time of data extraction. No difference in disease activity at the time of dose reduction was observed between those who maintained the new dose and those who did not (mean DAS28-CRP: 1.48 ± 0.26 vs. 1.89 ± 0.62).ConclusionPast use of JAKis may contribute to decreased response and continuation rates for JAKi treatment. In this study, conducted in Japan, development of herpes zoster was found to the most frequent adverse event among the priority survey items.AcknowledgementsI have no acknowledgements to declare.Disclosure of InterestsNone declared
Collapse
|
19
|
Inami W, Shibuya M, Kumagai T, Makita J, Shinoda K. A Case of Intraocular Lymphoma Diagnosed by Subretinal Fluid Biopsy. Int Med Case Rep J 2022; 15:111-115. [PMID: 35345499 PMCID: PMC8956477 DOI: 10.2147/imcrj.s345149] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Received: 10/31/2021] [Accepted: 03/09/2022] [Indexed: 11/23/2022] Open
Abstract
Although intraocular lymphoma (IOL) mainly has have vitreous opacity and subretinal infiltration, its clinical symptoms are diverse. We report a case of IOL that mainly showed exudative retinal detachment in which analysis of IgH gene rearrangement (AIGHR) of the collected subretinal fluid sample was useful for diagnosis. A 77-year-old woman developed decreased left visual acuity for 1 month. She had been treated for dermatomyositis, diabetes mellitus, and right parotid tumor for 3 years. Visual acuity was 0.1 OD and counting fingers OS. Slit-lamp examination showed grade 4 (Emery-Little classification) nuclear cataract in both eyes and keratoprecipitates and tan vitreous opacity in the left eye. Fundoscopy details were unclear except for a vaguely observable optic nerve head due to yellow-brown vitreous opacity, which we judged as an old vitreous hemorrhage. Phacovitrectomy was performed and almost total retinal detachment was found, except for a part of the superior periphery. Since no retinal break was found and a wide range of thin membrane-like tissue was found on the surface of the retina, the surgeon suspected primary IOL and performed unplanned biopsy. The peripheral vitreous was collected as a sample, and then the subretinal fluid was collected through an intentional break to prevent mixing with other fluids. The subretinal strand was gently removed and collected. Cytology showed class III, the IL10/IL6 ratio was low, and AIGHR was positive. Postoperatively, fundus autofluorescence showed no abnormality, no leakage was observed on fluorescein and indocyanine green angiography, and the location of typical infiltration lesions under the retina was unclear. There were no positive findings on systemic examinations and a diagnosis of primary IOL was made. The main symptoms of this case were vitreous opacity and exudative retinal detachment, and AIGHR using subretinal fluid was useful for diagnosis.
Collapse
Affiliation(s)
- Wataru Inami
- Department of Ophthalmology, Saitama Medical University Faculty of Medicine, Saitama, Japan
| | - Masayuki Shibuya
- Department of Ophthalmology, Saitama Medical University Faculty of Medicine, Saitama, Japan
| | - Tomoyuki Kumagai
- Department of Ophthalmology, Saitama Medical University Faculty of Medicine, Saitama, Japan
| | - Jun Makita
- Department of Ophthalmology, Saitama Medical University Faculty of Medicine, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University Faculty of Medicine, Saitama, Japan
| |
Collapse
|
20
|
Inami W, Yoshikawa Y, Shibuya M, Kanno J, Kikuchi S, Sakaki Y, Katsumoto T, Shoji T, Makita J, Shinoda K. Quantitative assessment of macular function after surgery for optic disc pit maculopathy: A case report. Medicine (Baltimore) 2021; 100:e28254. [PMID: 34941100 PMCID: PMC8702281 DOI: 10.1097/md.0000000000028254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/25/2021] [Indexed: 01/05/2023] Open
Abstract
RATIONALE We describe a case of optic disc pit maculopathy (ODP-M) in which vitrectomy with juxtapapillary laser (JPL) treatment led to the reattachment of retinoschisis (RS) as well as serous retinal detachment (SRD). PATIENT CONCERNS An 80-year-old man complained of distorted vision and decreased visual acuity (VA) in his left eye for 12 months. DIAGNOSIS We conducted quantitative functional evaluation on the area of RS and SRD using the Humphrey visual field analyzer. Fundus examination and optical coherence tomography showed SRD and RS in connection with the optic disc. The best-corrected logarithm of the minimum angle of resolution (logMAR) VA was 0.7. INTERVENTIONS The patient underwent JPL treatment combined with pars plana vitrectomy. During surgery, posterior vitreous detachment and tamponade were created with sulfur hexafluoride. OUTCOMES After surgery, SRD (and subsequently RS) gradually reduced and had completely disappeared at 31 months. VA gradually improved and was 0.0 (logMAR) at 28 months. The analysis of the mean macular thickness of the central 3-mm diameter showed that the macula thickness recovered to 300 μm at 17 months postoperatively. Retinal sensitivity began to improve at 24 months postoperatively and had increased at 48 months postoperatively. LESSONS In conclusion, vitrectomy with JPL treatment for ODP-M had a favorable anatomical outcome as well as a long-term functional outcome. These findings provide useful information for clinicians who are planning a therapeutic strategy, including the choice of surgical procedure for ODP-M.
Collapse
|
21
|
Shoji T, Ishii H, Kanno J, Sasaki T, Yoshikawa Y, Ibuki H, Shinoda K. Distance between the center of the FAZ measured automatically and the highest foveal bulge using OCT-angiography in elderly healthy eyes. Sci Rep 2021; 11:21485. [PMID: 34728680 PMCID: PMC8563986 DOI: 10.1038/s41598-021-00826-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 06/22/2021] [Accepted: 10/19/2021] [Indexed: 11/09/2022] Open
Abstract
The center of the fovea, termed the foveola, is the area of highest visual acuity, has the highest density of cone photoreceptors. We investigated the distance between the automatically-determined center of the foveal avascular zone (FAZ) and the manually-determined highest foveal bulge (FB) point using single swept-source optical coherence tomography angiography (OCTA) instrument. This cross-sectional study included 49 eyes of 49 individuals (34 women and 15 men; median age: 68 years) with no history of ocular disorders. The FAZ in the superficial capillary plexus was automatically determined using the Kanno-Saitama macro method, and the center of the FAZ was automatically determined using ellipse approximation. Another candidate foveal center, the highest FB point, was determined manually on the serial cross-sectional B-scan images. As a result, the foveal center was manually identified as the highest FB point on B-scan OCTA images. The center of the FAZ was more likely to be located inferior to the highest FB point (p = 0.031). In participants with a total (linear) distance of more than 50 μm between the center of the FAZ and the highest FB point, the displacement was significantly more in the horizontal direction than in the vertical direction (p = 0.017). These results can be applicable to further studies regarding the spatial relationships between the center of the FAZ and the highest FB point in various macular diseases or previously-treated eyes.
Collapse
Affiliation(s)
- Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma, Saitama, 350-0495, Japan.
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Takanori Sasaki
- Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Hisashi Ibuki
- Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, 38 Morohongo Moroyama-machi, Iruma, Saitama, 350-0495, Japan
| |
Collapse
|
22
|
Yoshikawa Y, Kumagai T, Shinoda K. Vitreous Noise on Optical Coherence Tomography as an Early Finding of Brolucizumab-Related Intraocular Inflammation. Case Rep Ophthalmol 2021; 12:797-803. [PMID: 34720980 PMCID: PMC8525295 DOI: 10.1159/000518809] [Citation(s) in RCA: 1] [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: 06/22/2021] [Accepted: 07/27/2021] [Indexed: 11/26/2022] Open
Abstract
We describe a case of brolucizumab-related intraocular inflammation (IOI) detected using vitreous haze on optical coherence tomography (OCT) at an early stage before the patient was aware of any symptom. A 69-year-old female presented with decreased right vision. The patient was diagnosed with pachychoroidal neovasculopathy and started intravitreal aflibercept (IVA) with a 3+ treat-and-extend strategy (TAE). Although the serous retinal detachment (SRD) disappeared after IVA treatment, the patient was managed with treatment every 4 weeks without extending the treatment interval To shorten the treatment interval, intravitreal brolucizumab (IVBr) was started 44 weeks after starting IVA treatment. After initiating IVBr treatment, the SRD completely disappeared. However, 16 weeks after starting IVBr, OCT showed noise in the vitreous cavity, which had not been seen before, and infrared images showed a black smoke-like shadow over the macula. Despite these findings, the patient had no subjective symptoms, and so IVBr was re-administered with an 8-week TAE interval. Five days after IVBr treatment, vitreous inflammatory cells were observed, and the noise in the vitreous cavity and the smoke-like shadow in the infrared image were further enhanced. We diagnosed the patient with brolucizumab-related IOI, and anti-inflammatory treatment was initiated. After extensive treatment, the vitreous opacity gradually disappeared, and the vitreous noise on OCT and the black smoke-like shadow on infrared images disappeared. IOI may have already been present 16 weeks after starting IVBr treatment, when we judged that there was no inflammation and IVBr was re-administered. When following patients receiving IVBr, IOI may be detected by OCT at an earlier stage by evaluating vitreous haze.
Collapse
Affiliation(s)
- Yuji Yoshikawa
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Tomoyuki Kumagai
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| |
Collapse
|
23
|
Yoshikawa Y, Shoji T, Kanno J, Ibuki H, Ozaki K, Ishii H, Inami H, Shinoda K. Examination of Age-Related Retinal Vascular Changes in the Macula Using Optical Coherence Tomography Angiography of the Eyes After Cataract Surgery. Clin Ophthalmol 2021; 15:3687-3695. [PMID: 34511872 PMCID: PMC8420780 DOI: 10.2147/opth.s323882] [Citation(s) in RCA: 1] [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: 06/11/2021] [Accepted: 08/19/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose Optical coherence tomography angiography (OCTA) allows noninvasive observation of the retinal vasculature, and image analysis can be used to calculate the retinal vessel density and foveal avascular zone (FAZ) area. A previous study showed that macular vessel density and the signal strength index (SSI) of OCTA images increased significantly after cataract surgery. However, the effect of aging on OCTA analysis remains unclear. This study aimed to investigate age-related changes in macular vascularization while excluding the effects of cataracts. Patients and Methods OCTA imaging of the macula was performed in adult patients who had undergone cataract surgery between February 2018 and May 2019 and in young healthy participants between April 2017 and April 2018. Results The median (quartiles) age of the overall study population was 59.0 (27.0, 69.0) years, and no severe refractive error was observed (axial length: 24.2 ± 1.3 [mean ± SD] mm; spherical equivalent: 0.75 [−2.25, 0.00] diopter). When we investigated the relationship between macular vessel density and age after excluding the effects of cataracts, we found that the macular vessel density showed age-related changes even in the absence of the effects of the SSI. However, the FAZ area was not affected by age. Conclusion Macular vessel density decreased with age, even when the effects of cataracts were excluded. The effects of age and cataracts should be considered when designing studies and interpreting OCTA findings of the retinal vasculature.
Collapse
Affiliation(s)
- Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hisashi Ibuki
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kimitake Ozaki
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hiromi Inami
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| |
Collapse
|
24
|
Mine I, Shoji T, Kumagai T, Yoshikawa Y, Kosaka A, Shinoda K. Central Visual Field Sensitivity With and Without Background Light Given to the Nontested Fellow Eye in Glaucoma Patients. J Glaucoma 2021; 30:537-544. [PMID: 33350657 DOI: 10.1097/ijg.0000000000001764] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 11/21/2020] [Indexed: 11/25/2022]
Abstract
PRECIS This study showed the difference of monocular visual sensitivity between with and without background light given to the nontested fellow eyes in glaucoma patients. Monocular sensitivity measurements of the worse eyes with fellow eye's background light conditions should carefully be considered when assessing the impact of functional impairment in glaucoma patients. PURPOSE The purpose of this study was to investigate the difference between monocular sensitivities measured with and without background light given to the nontested fellow eye in glaucoma patients using a new perimeter named "imo." METHODS In this cross-sectional study, we examined 102 eyes of 51 patients (mean age, 65.1±14.9 y) with open-angle glaucoma who were affected with at least 1 significant point in the central 10 degrees. We conducted a routine ophthalmic examination and visual field testing using the Humphrey Field Analyzer 24-2 and 10-2 programs. The eyes were assigned to "better" and "worse" categories based on the visual acuity and central visual thresholding. Subsequently, we compared the central visual sensitivities with and without background light given to the nontested fellow eye. RESULTS The mean sensitivity (MS) in the central 5 points of the visual field of the worse eyes was better when measured with background light than without background light (P=0.037) given to the nontested fellow eye. No significant difference was seen among the MS in the visual field of the better eyes. After dividing the patients into low (n=25) and high sensitivity (n=26) groups, only the low sensitivity group in worse eyes had higher MS with background light than without background light (P<0.05) given to the nontested fellow eye. CONCLUSIONS Monocular sensitivities measured with background light given to the nontested fellow eye were higher than those without background light in the worse eye group of glaucoma patients. Monocular MS measurements of the worse eyes with fellow eye's background light conditions and their related indices should thus carefully be considered when assessing the impact of functional impairment in glaucoma patients.
Collapse
Affiliation(s)
- Izumi Mine
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama Prefecture, Japan
| | | | | | | | | | | |
Collapse
|
25
|
Ozawa H, Ueno S, Ohno-Tanaka A, Sakai T, Hashiguchi M, Shimizu M, Fujinami K, Ahn SJ, Kondo M, Browning DJ, Shinoda K, Yokogawa N. Ocular findings in Japanese patients with hydroxychloroquine retinopathy developing within 3 years of treatment. Jpn J Ophthalmol 2021; 65:472-481. [PMID: 34014447 DOI: 10.1007/s10384-021-00841-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 10/10/2020] [Accepted: 03/26/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To describe the characteristics of Japanese patients with hydroxychloroquine (HCQ) retinopathy developing within 3 years of treatment outset. STUDY DESIGN Retrospective case series METHODS: Three patients with HCQ retinopathy developing within 3 years of treatment outset have been identified in Japan since HCQ became available in 2015. Their medical charts, containing optical coherence tomography (OCT), fundus autofluorescence imaging, and visual field tests, were reviewed. RESULTS The treatment durations and cumulative doses until onset were 29-36 months and 182-326 g, respectively. The first patient had possible pre-existing maculopathy, although the abnormalities were ambiguous. The second and third patients had impaired renal function. The patients did not complain of severe visual disturbance at diagnosis, but visual field loss and disruption of the outer retinal segments consisting of a parafoveal pattern in the first case and a pericentral pattern (localized, 8 or more degrees from the center of the fovea) in the second and third cases were clearly observed on OCT. Even after HCQ discontinuation, their retinopathy showed slight progression on the visual field tests and OCT images. A blood sample was obtained from 1 patient on the day after HCQ discontinuation, and the whole blood level of HCQ was measured using validated liquid chromatography-tandem mass spectrometry. The HCQ level 27 h after the last dose was high, at 2240 ng/mL (suggested threshold > 1733 ng/mL). CONCLUSION Ophthalmologic screening from the initiation of HCQ treatment detected 3 cases of HCQ retinopathy developing within 3 years of treatment outset, including a patient with a high blood level of HCQ.
Collapse
Affiliation(s)
- Hiroko Ozawa
- Department of Ophthalmology, Kawasaki Municipal Hospital, Kanagawa, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Shinji Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, 65 Tsuruma-cho, Showa-ku, Nagoya, 466-8550, Japan.
| | - Akiko Ohno-Tanaka
- Department of Ophthalmology, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| | - Takao Sakai
- Department of Ophthalmology, Chubu Rosai Hospital, Nagoya, Japan
| | - Masayuki Hashiguchi
- Division for Evaluation and Analysis of Drug Information, Faculty of Pharmacy, Keio University, Tokyo, Japan
| | - Mikiko Shimizu
- Department of Pharmaceutics and Pharmacometrics, School of Pharmacy, Shujtsu University, Okayama, Japan
| | - Kaoru Fujinami
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Genetics, UCL Institute of Ophthalmology, London, UK
| | - Seong Joon Ahn
- Department of Ophthalmology, Hanyang University Hospital, Seoul, Korea
| | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - David J Browning
- Charlotte, Eye, Ear, Nose, and Throat Associates, Charlotte, NC, USA
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Naoto Yokogawa
- Department of Rheumatic Diseases, Tokyo Metropolitan Tama Medical Center, Tokyo, Japan
| |
Collapse
|
26
|
Matsushima T, Yoshikawa Y, Shimura A, Yajima A, Ojima Y, Shinoda K. Electrophysiological Monitoring of Focal and Entire Retinal Function during Treatment with Intravitreal Methotrexate for Intraocular Lymphoma. Case Rep Ophthalmol 2021; 12:277-282. [PMID: 34054470 PMCID: PMC8138215 DOI: 10.1159/000514189] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 09/12/2020] [Accepted: 01/03/2021] [Indexed: 11/19/2022] Open
Abstract
We describe the electroretinographic findings of a case of primary intraocular lymphoma (PIOL) wherein the patient received intravitreal injections of methotrexate (ivMTX). A 62-year-old man developed blurred vision and complained of decreased visual acuity (VA) in his right eye. Fundus examination showed vitreous opacity and multiple subretinal yellowish lesions. Optical coherence tomography (OCT) revealed subretinal and intraretinal infiltrations. The full-field electroretinogram (ffERG) showed subnormal combined rod-cone response and multifocal electroretinogram (mfERG) recorded using skin electrodes showed severe attenuation of the response compared with the other eye. Pars prana vitrectomy, phacoemulsification, and lens implantation were performed to remove the opacity, and vitreous biopsy revealed a high ratio of interleukin 10–6 (76.0). There was no systemic malignant lesion, and the patient was diagnosed with PIOL. Treatment with ivMTX (400 μg/0.1 mL) was started. One month later, the intraretinal infiltration had disappeared, and mfERG revealed recovery of the response density from the central area. Two months later, OCT showed recovery of the foveal ellipsoid and interdigitation zones, and VA recovered to 20/17; mfERG showed maintenance of macular function. However, the amplitude of a- and b-waves in the ffERG gradually decreased. Macular function recovered, but there was also a decrease in total retinal function. mfERG and ffERG recorded using skin electrodes were useful in monitoring macular and entire retinal function with repeated examinations and showed recovery and maintenance of macular function in a case of PIOL treated with ivMTX.
Collapse
Affiliation(s)
- Takashi Matsushima
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Airi Shimura
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Ayana Yajima
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yui Ojima
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| |
Collapse
|
27
|
Fujita K, Imamura Y, Shinoda K, Matsumoto S, Yuzawa M. Fundus Autofluorescence after Half-Dose Photodynamic Therapy for Chronic Central Serous Chorioretinopathy. Biomed Hub 2021; 6:1-5. [PMID: 33564669 DOI: 10.1159/000512662] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 10/29/2020] [Indexed: 11/19/2022] Open
Abstract
Introduction To evaluate the fundus autofluorescence (FAF) images 1 year after half-dose photodynamic therapy (hdPDT) for chronic central serous chorioretinopathy (CSC). Methods Forty-six eyes of 46 consecutive patients with chronic CSC underwent hdPDT. Short wavelength-elicited FAF images and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded before and at 1, 3, 6, 9, and 12 months after the hdPDT. The FAF images at 1 month were compared to those at 12 months after the hdPDT. Results The serous retinal detachment (SRD) was resolved in all eyes. The best-corrected visual acuity (BCVA) improved significantly from 0.13 ± 0.28 logarithm of minimum angle of resolution (logMAR) units before to 0.01 ± 0.17 logMAR units at 12 months after the hdPDT (p = 0.001; paired t test). The mean choroidal thickness decreased significantly from 365.4 ± 103.0 µm to 284.3 ± 92.5 µm at 12 months (p < 0.001). Abnormal FAF images were present within the irradiated area in all the eyes before the hdPDT. In 5 of 46 eyes, identifiable changes of the FAF images were observed 12 months after hdPDT. None of the eyes had the confluent hypo-FAF type during the follow-up period. Univariate analyses showed that the choroidal thickness before hdPDT correlated significantly with hypo-FAF enlargement (p = 0.005). However, multivariate analyses showed that the association was not significant (p = 0.06). Conclusions The progression of the RPE damages occurred in approximately one-tenth of the eyes that underwent hdPDT for chronic CSC. The long-term effect of progression of hypo-FAF on visual functions remains to be determined.
Collapse
Affiliation(s)
- Kyoko Fujita
- Department of Ophthalmology, Aichi Medical University, Aichi, Japan
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Soiti Matsumoto
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Itabashi, Tokyo, Japan
| | - Mitsuko Yuzawa
- Department of Ophthalmology, Nihon University Hospital, Tokyo, Japan
| |
Collapse
|
28
|
Yokogawa N, Ohno-Tanaka A, Hashiguchi M, Shimizu M, Ozawa H, Ueno S, Shinoda K, Browning DJ. Early-Onset Hydroxychloroquine Retinopathy and a Possible Relationship to Blood Levels: Comment on the Article by Petri et al. Arthritis Rheumatol 2021; 73:358-359. [PMID: 32856370 DOI: 10.1002/art.41497] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2020] [Accepted: 08/10/2020] [Indexed: 11/11/2022]
|
29
|
Fujita K, Shinoda K, Imamura Y, Matsumoto CS, Oda K. Improvement of Low Luminance Visual Acuity in Patients with Chronic Central Serous Chorioretinopathy after Half-Dose Verteporfin Photodynamic Therapy. J Clin Med 2020; 9:E3980. [PMID: 33316889 PMCID: PMC7764769 DOI: 10.3390/jcm9123980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 11/18/2020] [Accepted: 12/07/2020] [Indexed: 11/20/2022] Open
Abstract
Patients with central serous chorioretinopathy (CSC) often complain of visual difficulties under low luminance conditions. In this study, we evaluated low luminance visual acuity (LLVA) after half-dose verteporfin photodynamic therapy (hdPDT) in eyes with CSC. The study included eight eyes of eight patients with chronic CSC that underwent hdPDT. The best-corrected visual acuity, LLVA and optical coherence tomography (OCT) findings were evaluated at baseline, and at 1, 3, 6, 9, and 12 months after hdPDT. LLVA was measured at six levels of background luminance. Serous retinal detachment was completely resolved in all eyes. Although the mean LLVA at 1 month did not improve significantly compared to baseline at all luminance levels, significant improvements were observed at 3, 6, 9, and 12 months (p < 0.05). In OCT images, although the ellipsoid zone was not detectable in all eyes before hdPDT, it was observed in 2 eyes at 1 month, in 7 eyes at 3 months, and in all eyes from 6 months. The LLVA and the ellipsoid zone improved similarly with postoperative time courses. In conclusion, hdPDT improves LLVA in eyes with chronic CSC. The recovery of the ellipsoid zone may play a part in improving LLVA after hdPDT.
Collapse
Affiliation(s)
- Kyoko Fujita
- Department of Opthalmology, Aichi Medical University School of Medicine, Aichi 480-1195, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University School of Medicine, Saitama 350-0495, Japan;
| | - Yutaka Imamura
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Mizonokuchi, Kanagawa 213-8507, Japan;
| | - Celso Soiti Matsumoto
- Department of Ophthalmology, Teikyo University School of Medicine, University Hospital Itabashi, Tokyo 173-8606, Japan;
| | - Koichi Oda
- Department of Communication, Tokyo Woman’s Christian University, Tokyo 167-8585, Japan;
| |
Collapse
|
30
|
Shibuya M, Yoshikawa Y, Katsumoto T, Shoji T, Kondo H, Miyakoshi H, Shinoda K. Author Correction: Electroretinographic recordings with skin electrodes to assess effects of vitrectomy with gas tamponade on eyes with rhegmatogenous retinal detachment. Sci Rep 2020; 10:4539. [PMID: 32139782 PMCID: PMC7058605 DOI: 10.1038/s41598-020-61545-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
31
|
Ozaki K, Yoshikawa Y, Ishikawa S, Katsumoto T, Shibuya M, Shoji T, Kondo H, Matsumoto S, Shinoda K. Correction: Electroretinograms recorded with skin electrodes in silicone oil-filled eyes. PLoS One 2020; 15:e0242757. [PMID: 33201921 PMCID: PMC7671554 DOI: 10.1371/journal.pone.0242757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
|
32
|
Shoji T, Kanno J, Weinreb RN, Yoshikawa Y, Mine I, Ishii H, Ibuki H, Shinoda K. OCT angiography measured changes in the foveal avascular zone area after glaucoma surgery. Br J Ophthalmol 2020; 106:80-86. [PMID: 33153992 PMCID: PMC8685609 DOI: 10.1136/bjophthalmol-2020-317038] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [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: 06/09/2020] [Revised: 09/10/2020] [Accepted: 10/03/2020] [Indexed: 01/10/2023]
Abstract
Background/Aims To evaluate quantitative changes in the foveal avascular zone (FAZ) area after glaucoma surgery using swept-source optical coherence tomography angiography (SS-OCTA). Methods Fifty-four consecutive patients with primary open-angle glaucoma (POAG) who met the inclusion criteria and underwent unilateral glaucoma surgery to reduce intraocular pressure (IOP) between April 2018 and July 2019. Eyes underwent IOP-lowering glaucoma surgery and their fellow (non-surgical) eyes were included. OCTA of the macula was performed in both eyes before glaucoma surgery and 3 months postoperatively. Two blinded examiners reviewed the image quality. Within- and between-group comparisons of the FAZ area and correlation of the FAZ area with age, IOP, central sensitivity and clinical variables. Results The mean (±SD) age was 66.7±11.3 years. After surgery, the IOP and FAZ area significantly decreased from 22.1±9.5 mmHg to 10.3±3.5 mmHg and from 0.485±0.193 mm2 to 0.446±0.174 mm2, respectively (both p<0.001). Conversely, in the non-surgery group, the preoperative and postoperative mean FAZ areas (0.398±0.119 mm2 and 0.396±0.110 mm2, respectively) did not significantly differ (p=0.469). Change in the FAZ area significantly correlated with the preoperative FAZ area, preoperative foveal sensitivity and change in IOP (all p<0.05). Conclusions The FAZ area is decreased with IOP-lowering surgery in patients with POAG, and change in the FAZ area was significantly correlated with both preoperative foveal sensitivity and change in IOP.
Collapse
Affiliation(s)
- Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Junji Kanno
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Robert N Weinreb
- Hamilton Glaucoma Center and Shiley Eye Institute, Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, California, USA
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Izumi Mine
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hirokazu Ishii
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hisashi Ibuki
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Iruma, Saitama, Japan
| |
Collapse
|
33
|
Kumagai T, Shoji T, Yoshikawa Y, Mine I, Kanno J, Ishii H, Saito A, Ishikawa S, Kimura I, Shinoda K. Comparison of central visual sensitivity between monocular and binocular testing in advanced glaucoma patients using imo perimetry. Br J Ophthalmol 2020; 104:1258-1534. [PMID: 32152139 PMCID: PMC7587224 DOI: 10.1136/bjophthalmol-2019-315251] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2019] [Revised: 01/24/2020] [Accepted: 02/03/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND/AIM This study aimed to compare central visual sensitivity under monocular and binocular conditions in patients with glaucoma using the new imo static perimetry. METHODS Fifty-one consecutive eyes of 51 patients with open-angle glaucoma who were affected with at least one significant point in the central 10° were examined in this cross-sectional study. Monocular and binocular random single-eye tests were performed using the imo perimeter and the Humphrey field analyser (HFA) 24-2 and 10-2 tests. The eyes were assigned to 'better' and 'worse' categories based on the visual acuity and central visual thresholding. Central visual sensitivity results obtained by monocular, binocular random single-eye tests and binocular simultaneous both eye test were compared. RESULTS The average mean deviation with the HFA 24-2 was -5.5 (-1.5, -14.6) dB (median, (IQR)) in the better eyes and -18.0 (-12.9, -23.8) dB in the worse eyes. The mean sensitivity in the central 4 points of the visual field (VF) of the worse eyes was lower when measured under the binocular eye condition than under the monocular condition. Conversely, this value of the better eyes was greater when measured under the binocular eye condition than under the monocular condition. CONCLUSIONS The central sensitivity of the better eyes was better and that of the worse eyes poorer with binocular testing than with monocular testing in patients with glaucoma. Although monocular VF testing is still the most straightforward means to monocularly monitor glaucoma at clinical settings, binocular testing, such as provided with imo perimetry, may be a useful clinical tool to predict the effect of VF impairments on a patient's quality of visual life.
Collapse
Affiliation(s)
- Tomoyuki Kumagai
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Yuji Yoshikawa
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Izumi Mine
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Junji Kanno
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Hirokazu Ishii
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Akane Saito
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Sho Ishikawa
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| | - Itaru Kimura
- Department of Ophthalmology, Tokai University Hachioji Hospital, Hachioji, Tokyo, Japan
| | - Kei Shinoda
- Department of Ophtalmology, Saitama Medical University, Iruma, Saitama, Japan
| |
Collapse
|
34
|
Fujinami K, Liu X, Ueno S, Mizota A, Shinoda K, Kuniyoshi K, Fujinami-Yokokawa Y, Yang L, Arno G, Pontikos N, Kameya S, Kominami T, Terasaki H, Sakuramoto H, Nakamura N, Kurihara T, Tsubota K, Miyake Y, Yoshiake K, Iwata T, Tsunoda K. RP2-associated retinal disorder in a Japanese cohort: Report of novel variants and a literature review, identifying a genotype-phenotype association. Am J Med Genet C Semin Med Genet 2020; 184:675-693. [PMID: 32875684 DOI: 10.1002/ajmg.c.31830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 07/28/2020] [Accepted: 07/28/2020] [Indexed: 01/10/2023]
Abstract
The retinitis pigmentosa 2 (RP2) gene is one of the causative genes for X-linked inherited retinal disorder. We characterized the clinical/genetic features of four patients with RP2-associated retinal disorder (RP2-RD) from four Japanese families in a nationwide cohort. A systematic review of RP2-RD in the Japanese population was also performed. All four patients were clinically diagnosed with retinitis pigmentosa (RP). The mean age at examination was 36.5 (10-47) years, and the mean visual acuity in the right/left eye was 1.40 (0.52-2.0)/1.10 (0.52-1.7) in the logarithm of the minimum angle of resolution unit, respectively. Three patients showed extensive retinal atrophy with macular involvement, and one had central retinal atrophy. Four RP2 variants were identified, including two novel missense (p.Ser6Phe, p.Leu189Pro) and two previously reported truncating variants (p.Arg120Ter, p.Glu269CysfsTer3). The phenotypes of two patients with truncating variants were more severe than the phenotypes of two patients with missense variants. A systematic review revealed additional 11 variants, including three missense and eight deleterious (null) variants, and a statistically significant association between phenotype severity and genotype severity was revealed. The clinical and genetic spectrum of RP2-RD was illustrated in the Japanese population, identifying the characteristic features of a severe form of RP with early macular involvement.
Collapse
Affiliation(s)
- Kaoru Fujinami
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK
| | - Xiao Liu
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Shinji Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University, Tokyo, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Teikyo University, Tokyo, Japan.,Department of Ophthalmology, Saitama Medical University, Moroyama Campus, Saitama, Japan
| | - Kazuki Kuniyoshi
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Yu Fujinami-Yokokawa
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.,Division of Public Health, Yokokawa Clinic, Suita, Japan
| | - Lizhu Yang
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Gavin Arno
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK.,North East Thames Regional Genetics Service, UCL Great Ormond Street Institute of Child Health, NHS Foundation Trust, London, UK
| | - Nikolas Pontikos
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK
| | - Shuhei Kameya
- Department of Ophthalmology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Taro Kominami
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Hiroyuki Sakuramoto
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Natsuko Nakamura
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Teikyo University, Tokyo, Japan.,Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yozo Miyake
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Aichi Medical University, Nagakute, Japan.,Next vision, Kobe Eye Center, Kobe, Japan
| | - Kazutoshi Yoshiake
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Kazushige Tsunoda
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | | |
Collapse
|
35
|
Fujinami K, Oishi A, Yang L, Arno G, Pontikos N, Yoshitake K, Fujinami-Yokokawa Y, Liu X, Hayashi T, Katagiri S, Mizobuchi K, Mizota A, Shinoda K, Nakamura N, Kurihara T, Tsubota K, Miyake Y, Iwata T, Tsujikawa A, Tsunoda K. Clinical and genetic characteristics of 10 Japanese patients with PROM1-associated retinal disorder: A report of the phenotype spectrum and a literature review in the Japanese population. Am J Med Genet C Semin Med Genet 2020; 184:656-674. [PMID: 32820593 DOI: 10.1002/ajmg.c.31826] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 07/26/2020] [Accepted: 07/27/2020] [Indexed: 01/14/2023]
Abstract
Variants in the PROM1 gene are associated with cone (-rod) dystrophy, macular dystrophy, and other phenotypes. We describe the clinical and genetic characteristics of 10 patients from eight Japanese families with PROM1-associated retinal disorder (PROM1-RD) in a nationwide cohort. A literature review of PROM1-RD in the Japanese population was also performed. The median age at onset/examination of 10 patients was 31.0 (range, 10-45)/44.5 (22-73) years. All 10 patients showed atrophic macular changes. Seven patients (70.0%) had spared fovea to various degrees, approximately half of whom had maintained visual acuity. Generalized cone (-rod) dysfunction was demonstrated in all nine subjects with available electrophysiological data. Three PROM1 variants were identified in this study: one recurrent disease-causing variant (p.Arg373Cys), one novel putative disease-causing variant (p.Cys112Arg), and one novel variant of uncertain significance (VUS; p.Gly53Asp). Characteristic features of macular atrophy with generalized cone-dominated retinal dysfunction were shared among all 10 subjects with PROM1-RD, and the presence of foveal sparing was crucial in maintaining visual acuity. Together with the three previously reported variants [p.R373C, c.1551+1G>A (pathogenic), p.Asn580His (likely benign)] in the literature of Japanese patients, one prevalent missense variant (p.Arg373Cys, 6/9 families, 66.7%) detected in multiple studies was determined in the Japanese population, which was also frequently detected in the European population.
Collapse
Affiliation(s)
- Kaoru Fujinami
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK
| | - Akio Oishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Lizhu Yang
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Gavin Arno
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK.,North East Thames Regional Genetics Service, UCL Great Ormond Street Institute of Child Health, Great Ormond Street NHS Foundation Trust, London, UK
| | - Nikolas Pontikos
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Moorfields Eye Hospital, London, UK
| | - Kazutoshi Yoshitake
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yu Fujinami-Yokokawa
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,UCL Institute of Ophthalmology, London, UK.,Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.,Division of Public Health, Yokokawa Clinic, Suita, Japan
| | - Xiao Liu
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,Southwest Hospital/Southwest Eye Hospital, Third Military Medical University (Army Medical University), Chongqing, China
| | - Takaaki Hayashi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Satoshi Katagiri
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kei Mizobuchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University, Tokyo, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Teikyo University, Tokyo, Japan.,Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Natsuko Nakamura
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Teikyo University, Tokyo, Japan.,Department of Ophthalmology, The University of Tokyo, Tokyo, Japan
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Yozo Miyake
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Aichi Medical University, Nagakute, Japan.,Next vision, Kobe Eye Center, Hyogo, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kazushige Tsunoda
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | | |
Collapse
|
36
|
Kitsu K, Shinoda K, Mizuno Y, Yagura K, Terauchi G, Matsumoto CS, Ochi M, Mizota A. Effect of Paracentesis on Retinal Function Associated With Changes in Intraocular Pressure Caused by Intravitreal Injections. Transl Vis Sci Technol 2020; 9:10. [PMID: 32879766 PMCID: PMC7442866 DOI: 10.1167/tvst.9.9.10] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 05/21/2020] [Accepted: 07/02/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose Intravitreal injections of antivascular endothelial growth factor agents are widely performed, and subsequent intraocular pressure increase may cause retinal nerve fiber damage. This study aimed to determine the effects of paracentesis before intravitreal injection of an antivascular endothelial growth factor on electroretinograms. Methods This was a retrospective observational study in a university hospital. Twenty-five eyes of 25 patients who underwent intravitreal injections of antivascular endothelial growth factor agents were selected for evaluation. Intraocular pressures and electroretinograms were recorded before surgery (baseline), after anterior chamber paracentesis, and after intravitreal injection. The amplitudes and latencies of the a- and b-waves, photopic negative response, and oscillatory potential were measured. Changes in each component of the electroretinograms, intraocular pressure, and relationships between these two factors were investigated. The preoperative and postoperative ocular perfusion pressure was calculated based on blood pressure. Results The amplitudes of the b-waves were significantly smaller after intravitreal injection than at baseline (P = 0.02), while no significant change was found in the other components during surgery. There were no significant changes in the latencies of any component during surgery. The intraocular pressure was significantly lower (P < 0.001) after anterior chamber paracentesis (6.8 ± 4.3 mm Hg) compared to baseline (24.1 ± 8.1 mm Hg) or after intravitreal injection (17.1 ± 9.6 mm Hg; P < 0.001). Conclusions Performing anterior chamber paracentesis before an intravitreal injection can prevent the intraocular pressure elevation and thus minimize the electrophysiological retinal dysfunction. Translational Relevance Anterior chamber paracentesis before an intravitreal injection mitigates the adverse effects on retinal function.
Collapse
Affiliation(s)
- Kazuma Kitsu
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.,Department of Ophthalmology, Saitama Medical University Faculty of Medicine, Saitama, Japan
| | - Yoshinobu Mizuno
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuma Yagura
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Gaku Terauchi
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Celso Soiti Matsumoto
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan.,Matsumoto Eye Clinic, Tokushima, Japan
| | - Masato Ochi
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| |
Collapse
|
37
|
Suda M, Yoshikawa Y, Terauchi G, Matsumoto S, Shoji T, Shinoda K, Mizota A, Kobayashi Y. Magnification Effect of Foveal Avascular Zone Measurement Using Optical Coherence Tomography Angiography. Biomed Hub 2020; 5:79-86. [PMID: 32775337 DOI: 10.1159/000507501] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 11/27/2019] [Accepted: 03/26/2020] [Indexed: 01/08/2023] Open
Abstract
Purpose The aim of this study was to evaluate the foveal avascular zone (FAZ) of healthy subjects and examine the magnification effect. Methods A total of 33 healthy volunteers were enrolled and all subjects were eligible for analysis. Optical coherence tomography angiography (OCTA) examination scanned 3 × 3 mm of the macular area. The FAZ area was measured on the superficial OCTA en face image with and without correction by axial length. The relationship between changes in the FAZ area after correction with the axial length was examined. Results The mean age was 21.9 ± 0.6 years. The mean axial length was 24.87 ± 1.17 mm and mean spherical equivalent (SE) value was -3.64 ± 2.83 diopters (D). The FAZ area was 0.26 ± 0.10 mm2 before the axial length correction and 0.27 ± 0.10 mm2 after the correction. In the eyes that had an axial length longer than or equal to 26 mm or SE less than or equal to -6 D, the FAZ area after correction was significantly larger than that before correction (p < 0.01). The change of FAZ area after correction with axial length was significantly correlated with the axial length (R 2 = 0.88, p < 0.01) or SE value (R 2 = 0.55, p < 0.01). Conclusion FAZ areas were comparable to previous reports. In high myopic cases, the magnification effect needs to be considered when evaluating the FAZ area.
Collapse
Affiliation(s)
- Mika Suda
- Department of Orthoptics, Teikyo University Faculty of Medical Technology, Tokyo, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Gaku Terauchi
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Soiti Matsumoto
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshiharu Kobayashi
- Department of Orthoptics, Teikyo University Faculty of Medical Technology, Tokyo, Japan
| |
Collapse
|
38
|
Fujinami-Yokokawa Y, Fujinami K, Kuniyoshi K, Hayashi T, Ueno S, Mizota A, Shinoda K, Arno G, Pontikos N, Yang L, Liu X, Sakuramoto H, Katagiri S, Mizobuchi K, Kominami T, Terasaki H, Nakamura N, Kameya S, Yoshitake K, Miyake Y, Kurihara T, Tsubota K, Miyata H, Iwata T, Tsunoda K. Clinical and Genetic Characteristics of 18 Patients from 13 Japanese Families with CRX-associated retinal disorder: Identification of Genotype-phenotype Association. Sci Rep 2020; 10:9531. [PMID: 32533067 PMCID: PMC7293272 DOI: 10.1038/s41598-020-65737-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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] [Received: 03/25/2019] [Accepted: 05/06/2020] [Indexed: 11/09/2022] Open
Abstract
Inherited retinal disorder (IRD) is a leading cause of blindness, and CRX is one of a number of genes reported to harbour autosomal dominant (AD) and recessive (AR) causative variants. Eighteen patients from 13 families with CRX-associated retinal disorder (CRX-RD) were identified from 730 Japanese families with IRD. Ophthalmological examinations and phenotype subgroup classification were performed. The median age of onset/latest examination was 45.0/62.5 years (range, 15-77/25-94). The median visual acuity in the right/left eye was 0.52/0.40 (range, -0.08-2.00/-0.18-1.70) logarithm of the minimum angle of resolution (LogMAR) units. There was one family with macular dystrophy, nine with cone-rod dystrophy (CORD), and three with retinitis pigmentosa. In silico analysis of CRX variants was conducted for genotype subgroup classification based on inheritance and the presence of truncating variants. Eight pathogenic CRX variants were identified, including three novel heterozygous variants (p.R43H, p.P145Lfs*42, and p.P197Afs*22). A trend of a genotype-phenotype association was revealed between the phenotype and genotype subgroups. A considerably high proportion of CRX-RD in ADCORD was determined in the Japanese cohort (39.1%), often showing the mild phenotype (CORD) with late-onset disease (sixth decade). Frequently found heterozygous missense variants located within the homeodomain underlie this mild phenotype. This large cohort study delineates the disease spectrum of CRX-RD in the Japanese population.
Collapse
Affiliation(s)
- Yu Fujinami-Yokokawa
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan.,Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.,Division of Public Health, Yokokawa Clinic, Suita, 564-0083, Japan
| | - Kaoru Fujinami
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan. .,Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan. .,UCL Institute of Ophthalmology, London, EC1V 9EL, UK. .,Moorfields Eye Hospital, London, EC1V 2PD, UK.
| | - Kazuki Kuniyoshi
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama, 589-8511, Japan
| | - Takaaki Hayashi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, 105-8461, Japan
| | - Shinji Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University, Tokyo, 173-8605, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Teikyo University, Tokyo, 173-8605, Japan.,Department of Ophthalmology, Saitama Medical University, Saitama, 350-0495, Japan
| | - Gavin Arno
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan.,UCL Institute of Ophthalmology, London, EC1V 9EL, UK.,Moorfields Eye Hospital, London, EC1V 2PD, UK.,North East Thames Regional Genetics Service, UCL Great Ormond Street Institute of Child Health, Great Ormond Street NHS Foundation Trust, London WC1N 1EH, London, UK
| | - Nikolas Pontikos
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan.,UCL Institute of Ophthalmology, London, EC1V 9EL, UK.,Moorfields Eye Hospital, London, EC1V 2PD, UK
| | - Lizhu Yang
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Xiao Liu
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan.,Southwest Hospital/Southwest Eye Hospital, Third Military Medical University, Chongqing, 400030, China
| | - Hiroyuki Sakuramoto
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-Sayama, 589-8511, Japan
| | - Satoshi Katagiri
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, 105-8461, Japan
| | - Kei Mizobuchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, 105-8461, Japan
| | - Taro Kominami
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, 466-8550, Japan
| | - Natsuko Nakamura
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan.,Department of Ophthalmology, The University of Tokyo, Tokyo, 113-8654, Japan
| | - Shuhei Kameya
- Department of Ophthalmology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, 270-1694, Japan
| | - Kazutoshi Yoshitake
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan
| | - Yozo Miyake
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan.,Aichi Medical University, Nagakute, 480-1195, Japan.,Kobe Eye Center, Next Vision, Kobe, 650-0047, Japan
| | - Toshihide Kurihara
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Kazuo Tsubota
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, 160-8582, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, Keio University School of Medicine, Tokyo, Japan.,Department of Healthcare Quality Assessment, University of Tokyo, Tokyo, 113-8655, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan
| | - Kazushige Tsunoda
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, 152-8902, Japan
| | | |
Collapse
|
39
|
Yoshikawa Y, Shoji T, Kanno J, Ibuki H, Weinreb RN, Araie M, Shinoda K. Glaucomatous vertical vessel density asymmetry of the temporal raphe detected with optical coherence tomography angiography. Sci Rep 2020; 10:6845. [PMID: 32322012 PMCID: PMC7176726 DOI: 10.1038/s41598-020-63931-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 08/20/2019] [Accepted: 04/08/2020] [Indexed: 11/21/2022] Open
Abstract
Changes in retinal vasculature and ocular circulation may play an important role in the glaucoma development and progression. We evaluated the vertical asymmetry across the temporal raphe of the deep retinal layer vessel density, using swept-source optical coherence tomography angiography (SS-OCTA), and its relationship with the central visual field (VF) loss. Thirty-four eyes of 27 patients with open-angle glaucoma were included. SS-OCTA macular scanning was performed within a 3 × 3 mm (300 × 300 pixels) volume, centred on the fovea. The relationships between the vertical asymmetrical deep retinal vessel density reduction (ADRVD) across the temporal raphe and various ocular parameters were analysed. Twenty-two glaucomatous eyes with ADRVDs had central VF loss. Contrarily, ADRVDs were not found in any of the 12 eyes without central VF loss. Thirteen eyes (59.1%) with central VF loss had ADRVDs topographically corresponding to the central VF loss and macular ganglion cell complex thinning. The glaucomatous eyes with ADRVDs exhibited inferior rather than superior central VF loss (P = 0.032). Thus, ADRVD specifically indicates the glaucomatous central visual loss. Further analysis of ADRVD may improve our understanding on glaucoma pathogenesis, offering new treatment insights.
Collapse
Affiliation(s)
- Yuji Yoshikawa
- Saitama Medical University, Department of Ophthalmology, Saitima, Japan
| | - Takuhei Shoji
- Saitama Medical University, Department of Ophthalmology, Saitima, Japan.
| | - Junji Kanno
- Saitama Medical University, Department of Ophthalmology, Saitima, Japan
| | - Hisashi Ibuki
- Saitama Medical University, Department of Ophthalmology, Saitima, Japan
| | - Robert N Weinreb
- Hamilton Glaucoma Center, Shiley Eye Institute, and Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA
| | - Makoto Araie
- Saitama Medical University, Department of Ophthalmology, Saitima, Japan.,Kanto Central Hospital of Mutual Aid Association of Public School Teachers, Tokyo, Japan
| | - Kei Shinoda
- Saitama Medical University, Department of Ophthalmology, Saitima, Japan
| |
Collapse
|
40
|
Shimada H, Kato K, Ishida K, Yamaguchi T, Shinoda K. Evaluation of Retinal Function and Pathology After Intravitreal Injection of Povidone-Iodine and Polyvinyl Alcohol-Iodine in Rabbits. Transl Vis Sci Technol 2020; 9:5. [PMID: 32821477 PMCID: PMC7401888 DOI: 10.1167/tvst.9.5.5] [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: 10/18/2019] [Accepted: 01/11/2020] [Indexed: 01/24/2023] Open
Abstract
Purpose This study compared intraocular toxicity of intravitreally injected povidone-iodine (PI) and polyvinyl alcohol-iodine (PAI) in rabbits. Methods In each rabbit, 0.1 mL of PI or PAI solution was injected intravitreally into one eye and saline was injected into the other. PI was tested at available iodine concentrations of 0.05%, 0.1%, 0.2%, and 0.5%, and PAI at 0.05%, 0.1%, and 0.2% (n = 6 each). Electroretinograms were recorded before injection and 1, 7, and 14 days after injection. Pathological examinations of eyeballs were performed on day 15. Results Mean b-/a-wave ratios of the electroretinograms did not change in eyes injected with 0.05%, 0.1%, or 0.2% PI (PI-0.05, PI-0.1, and PI-0.2, respectively) or in eyes injected with 0.05% or 0.1% PAI (PAI-0.05 and PAI-0.1, respectively) compared to saline-injected eyes, but was transiently impaired on day 1 in PAI-0.2 eyes. Histopathologically, no retinal abnormalities were observed in PI-0.05, PAI-0.05, or PAI-0.1 eyes. One PI-0.1 eye first showed localized inflammatory cell infiltration in the inferior retinal region. Two PI-0.2 eyes and one PAI-0.2 eye had retinal degeneration and inflammatory cell infiltration. In the PI-0.5 group, extensive inflammatory cell infiltration was observed in six eyes and inferior retinal detachment in five eyes. Conclusions PI and PAI have equivalent retinal toxicity profiles, and retinal toxicity first affects the inner retinal layer in the inferior region. The highest non-retinotoxic vitreous concentration is 0.0033% available iodine from intravitreal injection of PI or PAI containing 0.05% available iodine. Translational Relevance Low concentrations of PI or PAI can be used to wash the ocular surface during surgery or intravitreal injection to prevent endophthalmitis.
Collapse
Affiliation(s)
- Hiroyuki Shimada
- Department of Ophthalmology, Nihon University Hospital, Chiyoda-ku, Tokyo, Japan
| | - Kimiko Kato
- R&D Department, Nitten Pharmaceutical Co., Ltd., Nagoya, Aichi, Japan
| | - Kazuumi Ishida
- R&D Department, Nitten Pharmaceutical Co., Ltd., Nagoya, Aichi, Japan
| | | | - Kei Shinoda
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Iruma, Saitama, Japan
| |
Collapse
|
41
|
Chino M, Yoshikawa Y, Kanno J, Nagashima T, Sakaki Y, Katsumoto T, Shibuya M, Shoji T, Makita J, Shinoda K. Development and spontaneous closure of a secondary macular hole associated with submacular hemorrhage due to polypoidal choroidal vasculopathy: a case report. BMC Ophthalmol 2020; 20:108. [PMID: 32183733 PMCID: PMC7079491 DOI: 10.1186/s12886-020-01370-8] [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: 11/25/2019] [Accepted: 03/04/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Macular hole (MH) is a retinal break in the fovea involving partial or complete dehiscence of the neural retinal layers affecting the visual quality by decreasing visual acuity (VA) and visual deformation. We describe a case of secondary MH associated with submacular hemorrhage (SMH) due to polypoidal choroidal vasculopathy (PCV), which showed spontaneous closure. CASE PRESENTATION A 67-year-old man developed decreased VA in his right eye due to an SMH. The VA was 20/50, and monthly intravitreal injection of aflibercept was administered three times. The SMH gradually decreased, and 10 months later the external limiting membrane was found to be perforated, resulting in MH. The old clot disappeared, and the MH remained for 10 months. Twenty-three months later, serous retinal detachment (SRD) involving the macula appeared and the MH had disappeared. SRD gradually disappeared, and macular configuration recovered. VA gradually improved and became 20/20 38 months later. CONCLUSION Dynamic change of the ultrastructure in an unusual case of secondary-developed and spontaneously closed MH was clearly observed. Although the mechanism was unknown, the small diameter size and exudative PCV are thought to have contributed to the closure.
Collapse
Affiliation(s)
- Minami Chino
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Junji Kanno
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Takamitsu Nagashima
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.,Kamishirane Hospital, 2-65-1, Kamishirane, Yokohama, Kanagawa, 241-0002, Japan
| | - Yu Sakaki
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Takeshi Katsumoto
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Masayuki Shibuya
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Jun Makita
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, 38 Moro-Hongo Moroyama-machi, Iruma-gun, Saitama, 350-0495, Japan.
| |
Collapse
|
42
|
Ishikawa S, Shoji T, Yamada N, Shinoda K. Bacterial Detection Rate and Surgical Outcome in Povidone-Iodine Irrigation After Nasolacrimal Duct Intubation. Clin Ophthalmol 2020; 14:205-211. [PMID: 32158179 PMCID: PMC6986241 DOI: 10.2147/opth.s217484] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 12/20/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose In various ophthalmic surgical procedures, 0.25% povidone-iodine (PI) solution is used to prevent infections. This study examined the bacterial colonisation before and after endoscopic nasolacrimal duct intubation irrigated with PI solution and investigated the relationship between bacterial detection and surgical failure. Methods A retrospective study at Saitama Medical University Hospital. We enrolled 113 patients (33 men, 80 women) who underwent lacrimal intubation surgery between April 2016 and December 2018. Preoperatively, the lacrimal pathways were washed with normal saline solution, which was subsequently cultured. The sites of obstruction in the lacrimal pathway were endoscopically determined, perforated, and intubated. The tubes were afterward either irrigated with 0.25% PI or normal saline every 2 weeks. After 8 weeks, a piece of the removed lacrimal tube was cultured. We characterized the pre- and postoperative bacterial cultures. Results We enrolled 54 and 52 patients in PI and saline groups (mean age: 69.1±9.2 and 73.2±7.2 years), respectively. In the PI group, Staphylococcus epidermidis was less frequently detected postoperatively than preoperatively. S. oralis and Candida parapsilosis were identified more often postoperatively (P=0.02, P=0.01, respectively). The PI group had significantly lower bacterial detection rate than the saline group (P=0.01). However, the surgical failure rates did not differ between groups. In surgical failure patients, the postoperative rate of Pseudomonas aeruginosa was very high (75%). Conclusion PI reduces the bacterial detection rate but does not improve the surgical success rate. P. aeruginosa is associated with an increased risk of surgical failure.
Collapse
Affiliation(s)
- Sho Ishikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Norihiro Yamada
- Department of Ophthalmology, Yokohama City University, Kanagawa, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| |
Collapse
|
43
|
Takano S, Hanabusa A, Yoshikawa Y, Sassa K, Shimura A, Shoji T, Ohde H, Shinoda K, Yamanouchi H. Pattern Visually Evoked Potentials in Japanese Girl With Optic Neuritis and Seropositive to Anti-myelin Oligodendrocyte Glycoprotein (MOG) Antibody. Front Neurol 2020; 10:1339. [PMID: 31920953 PMCID: PMC6931555 DOI: 10.3389/fneur.2019.01339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 07/24/2019] [Accepted: 12/04/2019] [Indexed: 11/13/2022] Open
Abstract
Purpose: To describe a Japanese girl with unilateral optic neuritis who was seropositive for the anti-myelin-oligodendrocyte glycoprotein (MOG). Serial recordings of the pattern visual evoked potentials (pVEPs) were made to follow the dynamic changes of the disease activity. Observations: A 5-year-old girl developed a sudden reduction of vision and deep ocular pain in her right eye. On examination at our university hospital, the best-corrected visual acuity (BCVA) was light perception, and a swelling of the optic disc and tortuous vessels at the posterior pole of the right eye were observed. MRI demonstrated that her right optic nerve was hyperintense on short TI inversion recovery (STIR) sequence. A diagnosis of right papillitis was made, and she was treated with steroid pulse therapy followed by a gradual tapering of oral prednisolone. The visual acuity decreased to no light perception and plasmapheresis combined with high-dose intravenous immunoglobulin therapy was performed. The decimal visual acuity rapidly improved and recovered to 1.2, and no recurrence was observed for at least 1 year. On day 19, she was found to be anti-MOG antibody positive and anti-Aquaporin 4 antibody negative. pVEPs were recorded during the course of the disease process which showed the dynamic changes of the physiology of the visual pathways. The implicit times of the N75 and P100 components were prolonged in the right eye in the acute phase. The right visual acuity remained at 1.2 for at least 1 year, but the implicit times of the N75 and P100 components of the pVEPs of the right eye were still prolonged compared to left eye. Conclusion: Our findings indicate a positive relationship between the anti-MOG antibodies-positivity and the prolonged pVEPs. Further analyses of the pVEPs and other clinical findings of the optic neuritis are needed to establish the clinical significance of the anti-MOG antibodies positivity and optic neuritis for the diagnosis, treatment, and prognosis for this disease.
Collapse
Affiliation(s)
- Shunichiro Takano
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Aya Hanabusa
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Kaori Sassa
- Departments of Pediatrics, Comprehensive Epilepsy Center, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Airi Shimura
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | | | - Kei Shinoda
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Hideo Yamanouchi
- Departments of Pediatrics, Comprehensive Epilepsy Center, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| |
Collapse
|
44
|
Nishiyama Y, Yoshikawa Y, Shibuya M, Kanno J, Ozaki K, Sakaki Y, Katsumoto T, Makita J, Shoji T, Shinoda K. Macular Structure Recovery after Surgery for Optic Disc Pit Maculopathy. Case Rep Ophthalmol 2019; 10:408-414. [PMID: 31911783 DOI: 10.1159/000504619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 09/03/2019] [Accepted: 10/27/2019] [Indexed: 11/19/2022] Open
Abstract
The present report aimed to describe the macular structure's recovery process in a case of optic disc pit maculopathy (ODP-M) with outer layer hole following pars plana vitrectomy (PPV) with juxtapapillary laser treatment (JPL). We performed repeated optical coherence tomography (OCT) examinations to evaluate the macular structural changes. An 80-year-old man presented with distorted vision and decreased visual acuity (VA) in his left eye, experienced for 1 year, prior to presentation. Fundus examination and OCT showed intraretinal fluid (IRF) in the inner and outer retinal layers. Serous retinal detachment (SRD) with an outer layer hole in the macula was also evident. The IRF was connected to the optic disc; however, the SRD was isolated. Best-corrected VA was 20/100. PPV combined with JPL was performed. Posterior vitreous detachment creation and tamponade with sulfur hexafluoride was performed. Postoperatively, the inner retinal IRF at the fovea disappeared. The outer layer hole gradually closed and had completely disappeared 1 month postoperatively. After resolution of the outer layer hole, SRD reduced gradually and disappeared 8 months postoperatively, although the macular outer retinal IRF remained. The outer retinal IRF had partially resolved by the 18th postoperative month. Macular structure was completely recovered 31 months postoperatively, with an improved VA of 20/20. In conclusion, SRD might be associated with outer retinal IRF and outer layer holes. In cases of ODP-M, outer layer holes might induce optic disc-isolated SRD.
Collapse
Affiliation(s)
- Yuri Nishiyama
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yuji Yoshikawa
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Masayuki Shibuya
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Junji Kanno
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Kimitake Ozaki
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Yu Sakaki
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takeshi Katsumoto
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Jun Makita
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Faculty of Medicine, Saitama Medical University, Saitama, Japan
| |
Collapse
|
45
|
Shoji T, Kato N, Ishikawa S, Ibuki H, Yamada N, Kimura I, Shinoda K. Association between axial length and in vivo human crystalline lens biometry during accommodation: a swept-source optical coherence tomography study. Jpn J Ophthalmol 2019; 64:93-101. [DOI: 10.1007/s10384-019-00700-8] [Citation(s) in RCA: 10] [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] [Received: 08/23/2018] [Accepted: 09/05/2019] [Indexed: 12/14/2022]
|
46
|
Ishikawa S, Shoji T, Yamada N, Shinoda K. Efficacy of Strip Meniscometry for Detecting Lacrimal Obstructive Diseases Among Patients With Epiphora. Transl Vis Sci Technol 2019; 8:8. [PMID: 31737432 PMCID: PMC6855374 DOI: 10.1167/tvst.8.6.8] [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: 07/10/2019] [Accepted: 09/01/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose Strip meniscometry (SM) is a new technique for evaluating tear film volume. The aim of the present study was to evaluate the efficacy of SM in detecting lacrimal obstructive diseases (LODs) in patients with epiphora retrospectively. Methods One-hundred sixty-six patients (53 men, 113 women; mean age: 72.4 ± 8.0 years) who were referred to Saitama Medical University Hospital with epiphora as their chief complaint were enrolled; finally, 72 patients with and 89 patients without LOD were examined. We assessed tear volume using SM, tear meniscus height (TMH), tear meniscus area (TMA), and Schirmer-1 test values. Patients with LOD underwent lacrimal intubation surgery to treat their epiphora; their SM scores were assessed before and 8 weeks after surgery. Results SM, TMH, TMA, and Schirmer-1 values were significantly higher in the LOD group (10.80 ± 3.63 mm, 0.49 ± 0.24 mm, 0.06 ± 0.06 mm2, 18.46 ± 8.00 mm, respectively) than in the non-LOD group (5.44 ± 3.20 mm, 0.30 ± 0.18 mm, 0.03 ± 0.04 mm2, 11.84 ± 7.16 mm). The area under the receiver operating characteristic curve (AUC) for SM was 0.88, the sensitivity and specificity were 82% and 84%. The AUC was significantly larger for SM than for the Schirmer-1 test and TMA. The SM scores significantly improved after surgery (5.30 ± 2.20 mm) compared with those before (10.69 ± 3.20 mm). Conclusions SM was significantly better than the Schirmer-1 test, TMH, and TMA for detecting LOD and evaluating the effect of lacrimal surgery. Translational Relevance SM, widely used for dry eye, is also useful for using epiphora.
Collapse
Affiliation(s)
- Sho Ishikawa
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Takuhei Shoji
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| | - Norihiro Yamada
- Department of Ophthalmology, Yokohama City University, Kanagawa, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Saitama Medical University, Saitama, Japan
| |
Collapse
|
47
|
Mizobuchi K, Hayashi T, Katagiri S, Yoshitake K, Fujinami K, Yang L, Kuniyoshi K, Shinoda K, Machida S, Kondo M, Ueno S, Terasaki H, Matsuura T, Tsunoda K, Iwata T, Nakano T. Characterization of GUCA1A-associated dominant cone/cone-rod dystrophy: low prevalence among Japanese patients with inherited retinal dystrophies. Sci Rep 2019; 9:16851. [PMID: 31728034 PMCID: PMC6856191 DOI: 10.1038/s41598-019-52660-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Received: 08/28/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022] Open
Abstract
GUCA1A gene variants are associated with autosomal dominant (AD) cone dystrophy (COD) and cone-rod dystrophy (CORD). GUCA1A-associated AD-COD/CORD has never been reported in the Japanese population. The purpose of this study was to investigate clinical and genetic features of GUCA1A-associated AD-COD/CORD from a large Japanese cohort. We identified 8 variants [c.C50_80del (p.E17VfsX22), c.T124A (p.F42I), c.C204G (p.D68E), c.C238A (p.L80I), c.T295A (p.Y99N), c.A296C (p.Y99S), c.C451T (p.L151F), and c.A551G (p.Q184R)] in 14 families from our whole exome sequencing database composed of 1385 patients with inherited retinal diseases (IRDs) from 1192 families. Three variants (p.Y99N, p.Y99S, and p.L151F), which are located on/around EF-hand domains 3 and 4, were confirmed as "pathogenic", whereas the other five variants, which did not co-segregate with IRDs, were considered "non-pathogenic". Ophthalmic findings of 9 patients from 3 families with the pathogenic variants showed central visual impairment from early to middle-age onset and progressive macular atrophy. Electroretinography revealed severely decreased or non-recordable cone responses, whereas rod responses were highly variable, ranging from nearly normal to non-recordable. Our results indicate that the three pathogenic variants, two of which were novel, underlie AD-COD/CORD with progressive retinal atrophy, and the prevalence (0.25%, 3/1192 families) of GUCA1A-associated IRDs may be low among Japanese patients.
Collapse
Affiliation(s)
- Kei Mizobuchi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Takaaki Hayashi
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan. .,Department of Ophthalmology, Katsushika Medical Center, The Jikei University School of Medicine, Tokyo, Japan.
| | - Satoshi Katagiri
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazutoshi Yoshitake
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan
| | - Kaoru Fujinami
- Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.,UCL Institute of Ophthalmology associated with Moorfields Eye Hospital, London, UK
| | - Lizhu Yang
- Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuki Kuniyoshi
- Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Teikyo University School of Medicine, Tokyo, Japan
| | - Shigeki Machida
- Department of Ophthalmology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.,Department of Ophthalmology, Iwate Medical University School of Medicine, Iwate, Japan
| | - Mineo Kondo
- Department of Ophthalmology, Mie University Graduate School of Medicine, Mie, Japan
| | - Shinji Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Aichi, Japan
| | - Tomokazu Matsuura
- Department of Laboratory Medicine, The Jikei University School of Medicine, Tokyo, Japan
| | - Kazushige Tsunoda
- Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Tokyo Medical Center, Tokyo, Japan
| | - Tadashi Nakano
- Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan
| |
Collapse
|
48
|
Ishikawa S, Shoji T, Nishiyama Y, Shinoda K. A case with acquired lacrimal fistula due to Sjögren's syndrome. Am J Ophthalmol Case Rep 2019; 15:100526. [PMID: 31388605 PMCID: PMC6667784 DOI: 10.1016/j.ajoc.2019.100526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 10/22/2018] [Revised: 07/18/2019] [Accepted: 07/22/2019] [Indexed: 11/16/2022] Open
Abstract
Purpose To report a case with lacrimal fistula presumably associated with Sjögren's syndrome. Observations A patient with Sjögren's syndrome was referred to our hospital for fistula from the inferior lacrimal canaliculus to the palpebral conjunctiva of her left lower eyelid. She also revealed severe dry eye in both eyes. She had no history of trauma or congenital lacrimal fistula. She was administering 0.3% purified sodium hyaluronate and 3% diquafosol sodium solution 6 times a day for dry eye. The Schirmer-1 test indicated that tear secretion was 0 mm for 5 min for both eyes. She was diagnosed with Sjögren's syndrome based on increased levels of blood Sjögren's-syndrome-related antigen A and Sjögren's-syndrome-related antigen B antibodies, decreased saliva volume, and lip biopsy. We performed silicone tube intubation and patched the fistula with conjunctiva. We observed the lacrimal sac and nasolacrimal duct under lacrimal micro-endoscopy; there was no bacterial concretion, obstruction, and inflammation of lacrimal mucosa. After the operation, her symptoms improved and lacrimal perforation healed after the removal of the silicone tube. Conclusions and importance Sjögren's syndrome can cause not only corneal perforation but also mucosal perforation, which may lead to a lacrimal fistula. Sjögren's syndrome patients with severe dry eye should be managed carefully.
Collapse
Affiliation(s)
- Sho Ishikawa
- Corresponding author. Department of Ophthalmology, Saitama Medical University 38 Morohongo, Moroyama, Saitama, 350-0495, Japan.
| | | | | | | |
Collapse
|
49
|
Nakamura Y, Liu Z, Fukumoto S, Shinoda K, Sakoda A, Matsushita T, Hayashida S, Isobe N, Watanabe M, Hiwatashi A, Yamasaki R, Kira JI. Spinal cord involvement by atrophy and associations with disability are different between multiple sclerosis and neuromyelitis optica spectrum disorder. Eur J Neurol 2019; 27:92-99. [PMID: 31304648 DOI: 10.1111/ene.14038] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [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: 01/30/2019] [Accepted: 06/18/2019] [Indexed: 01/07/2023]
Abstract
BACKGROUND AND PURPOSE The cervical and thoracic cross-sectional spinal cord area (CS-SCA) in multiple sclerosis (MS) correlates with disability, whilst such a correlation remains to be established in neuromyelitis optica spectrum disorder (NMOSD). Our aim was to clarify differences between MS and NMOSD in spinal cord segments where CS-SCA is associated with disability. METHODS The CS-SCA at C2/C3, C3/C4, T8/T9 and T9/T10 vertebral disc levels was measured in 140 MS patients (111 with relapsing-remitting MS and 29 with progressive MS) and 42 NMOSD patients with anti-aquaporin-4 immunoglobulin G. Disability was evaluated by Expanded Disability Status Scale (EDSS) scores. Multivariate associations between CS-SCA and disability were assessed by stepwise forward multiple linear regression. RESULTS Thoracic CS-SCA was significantly smaller in NMOSD patients than in MS patients even after adjusting for age, sex and disease duration (P = 0.002 at T8/T9), whilst there was no difference in cervical CS-SCA between the two diseases. Cervical and thoracic CS-SCA had a negative correlation with EDSS scores in MS patients (P < 0.0001 at C3/C4 and P = 0.0002 at T8/T9) whereas only thoracic CS-SCA correlated with EDSS scores in NMOSD patients (P = 0.0006 at T8/T9). By multiple regression analyses, predictive factors for disability in MS were smaller cervical CS-SCA, progressive course, older age and a higher number of relapses, whilst those in NMOSD were smaller thoracic CS-SCA and older age. CONCLUSIONS Thoracic CS-SCA is a useful predictive marker for disability in patients with NMOSD whilst cervical CS-SCA is associated with disability in patients with MS.
Collapse
Affiliation(s)
- Y Nakamura
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Z Liu
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Fukumoto
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - K Shinoda
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Sakoda
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Matsushita
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - S Hayashida
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - N Isobe
- Department of Neurological Therapeutics, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - M Watanabe
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - A Hiwatashi
- Department of Molecular Imaging & Diagnosis, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - R Yamasaki
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - J-I Kira
- Department of Neurology, Neurological Institute, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
50
|
Terauchi G, Shinoda K, Sakai H, Kawashima M, Matsumoto CS, Mizota A, Miyake Y. Retinal function determined by flicker ERGs before and soon after intravitreal injection of anti-VEGF agents. BMC Ophthalmol 2019; 19:129. [PMID: 31208350 PMCID: PMC6580612 DOI: 10.1186/s12886-019-1129-7] [Citation(s) in RCA: 4] [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: 12/21/2018] [Accepted: 05/20/2019] [Indexed: 11/26/2022] Open
Abstract
Background To evaluate the retinal function before and soon after an intravitreal injection of an anti-vascular endothelial growth factor (anti-VEGF) agents. Methods Seventy-nine eyes of 79 patients that were treated by an intravitreal injection of an anti-VEGF agent for age-related macular degeneration (AMD), diabetic macular edema (DME), or retinal vein occlusion (RVO) with macular edema (ME) were studied. The RETeval® system was used to record 28 Hz flicker electroretinograms (ERGs) from the injected and non-injected eyes before (Phase 1, P1), within 2 h after the injection (P2), and 2 to 24 h after the injection (P3). Patients were grouped by disease or by the injected agent and compared. The significance of the changes in the implicit times and amplitudes was determined by t tests. Results The amplitudes were not significantly different at the three phases. The implicit time of the injected eye was 31.2 ± 3.2 msec at P1, and it was not significantly different at P2 (31.7 ± 3.1 msec) but it was significantly longer at P3 (32.2 ± 3.3 msec, P < 0.01, ANOVA for both). The implicit time in the non-injected fellow eye was 30.5 ± 3.3 msec at P1, and it was significantly longer at P2 (31.1 ± 3.2 msec) and phase 3 (31.3 ± 3.4 msec, P < 0.01, ANOVA for both). Conclusions The results indicate that an intravitreal anti-VEGF injection will increase the implicit times not only in the injected eye but also in the non-injected eye soon after the intravitreal injection.
Collapse
Affiliation(s)
- Gaku Terauchi
- Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Kei Shinoda
- Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan. .,Department of Ophthalmology, Saitama Medical University Faculty of Medicine, 38 Moro-hongo, Moroyama, Iruma-gun, Saitama, 350-0495, Japan.
| | - Hiroyuki Sakai
- Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Makoto Kawashima
- Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Celso Soiti Matsumoto
- Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan.,Matsumoto Eye Clinic, 50-2 Takagaki, Awa-cho, Awa-shi, Tokushima, 771-1705, Japan
| | - Atsushi Mizota
- Department of Ophthalmology, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi-ku, Tokyo, 173-8605, Japan
| | - Yozo Miyake
- Department of Ophthalmology, Aichi Medical University School of Medicine, 1-1 Yazakokarimata, Nagakute, Aichi, 480-1195, Japan
| |
Collapse
|