Tetsuo Hida

Kyorin University, Edo, Tōkyō, Japan

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Publications (80)219 Total impact

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    ABSTRACT: To report on the clinical features of polypoidal choroidal vasculopathy (PCV) and to delineate visual outcomes in the absence of classic choroidal neovascularization (CNV). Records were retrospectively reviewed of 233 eyes of 215 patients diagnosed with 'definite' PCV using Japanese criteria. Of patients with definite PCV, 72.1% were men and 91.6% had unilateral disease. A history of systemic hypertension was elicited in 18.1% of patients, and blood pressure measurement revealed possible hypertension in 27.4% of patients. At the initial evaluation, 28.3% of eyes had classic CNV as assessed by fluorescein angiography and were treated by photodynamic therapy or other means. Of 112 eyes with active exudation but no classic CNV and no recent decreased vision, best-corrected visual acuity (BCVA) at 3 months improved by > or = 0.2 logarithm of the minimum angle of resolution (logMAR) in 17%, was unchanged in 72% and worsened by > or = 0.2 logMAR in 11%. In 67 eyes of which 1-year data were available, BCVA improved in 19%, was unchanged in 64% and worsened in 16%. The majority of PCV patients were men, with a high rate of diagnosed or suspected hypertension. More than two thirds of eyes had no evidence of classic CNV, of which 89% had stable or improved vision at 3 months without specific treatment. Of eyes followed for 12 months, 83% had stable or improved vision.
    Ophthalmologica 09/2009; 224(3):147-52. DOI:10.1159/000236040 · 1.87 Impact Factor
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    Acta ophthalmologica 07/2008; 87(2):239-40. DOI:10.1111/j.1755-3768.2008.01178.x · 2.51 Impact Factor
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    ABSTRACT: The clinical features and visual prognosis after vitrectomy for endophthalmitis which had developed after cataract surgery were compared in two groups with or without background factors, including malignant tumor, diabetes, oral steroid administration, collagen disease, dacryocystitis, and lid closure disturbance. Fifty-two patients (53 eyes) who underwent a vitrectomy for the treatment of endophthalmitis which had developed within 6 weeks after cataract surgery. They were divided into two groups according to the presence (21 eyes, group A) or absence (32 eyes, group B) of background factors, and were retrospectively compared based on their medical records. The culture-positive rate was 62% in group A and 69% in group B. The incidence of a final visual acuity of more than 20/20 was significantly lower in group A (14%) than in group B (47%, p < 0.05). Methicillin-resistant Staphylococcus aureus, alpha-hemolytic Streptococcus and Enterococcus were frequently identified in group A. Leakage from the cataract wound was found in about 80% of the patients with corneal incisions, and a wound that had not been covered by the conjunctiva was significantly more frequent as a factor in group A (group A, 13 eyes; group B, 10 eyes; p < 0.05). Postoperative endophthalmitis may have a less favorable visual prognosis in patients with background factors, so precise wound construction during cataract surgery is important in these patients.
    Nippon Ganka Gakkai zasshi 06/2008; 112(6):525-30.
  • Retina 07/2007; 27(6):807-8. DOI:10.1097/IAE.0b013e318054693c · 3.18 Impact Factor
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    ABSTRACT: To determine whether exposure of the cornea and retina of rats to flashes from a commercial photographic flash lamp is phototoxic. Sprague-Dawley rats were exposed to 10, 100, or 1,000 flashes of the OPTICAM 16M photographic flash lamp (Fujikoeki, Japan) placed 0.1, 1, or 3 m from the eyes. Corneal damage was assessed by a fluorescein staining score, and the retinal damage by eletroretinography (ERG) and histology before and 24 h after exposure. Exposure of the eyes to 1,000 flashes at 0.1 m increased the fluorescein staining score significantly (P = 0.009, the Mann-Whitney test). Scanning electron microscopy (SEM) of the cornea showed a detachment of the epithelial cells from the surface after this exposure. The amplitude of the a-wave was decreased significantly by 23.0% (P = 0.026) of the amplitude before the exposure, and the b-wave by 19.7% (P = 0.0478) following 1,000 flashes at 0.1 m but not by the other exposures. TUNEL-positive cells were present in the outer nuclear layer only after the extreme exposure, but no significant decrease in retinal thickness was seen under any condition. The fluorescein staining score and ERGs recovered to control levels within 1 week. Light exposure to a photographic flash lamp does not induce damage to the cornea and retina except when they are exposed to 1,000 flashes at 0.1 m.
    Documenta Ophthalmologica 12/2006; 113(3):155-64. DOI:10.1007/s10633-006-9024-y · 1.11 Impact Factor
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    ABSTRACT: The precise localization of aquaporin (AQP)1 and AQP4 was studied in iris and ciliary epithelial cells, in both mature and developing rats, to elucidate the molecular mechanisms underlying aqueous humor balance. Anterior segments of eyes dissected from embryonic day (E)13, E15, E18, and E20, postnatal day (P)0, P7, and P14, and postnatal week 8 rats were subjected to immunofluorescence analysis with AQP isoform-specific antibodies. In adult rat eye, AQP1 was localized to the apical and basolateral plasma membranes of iris epithelial cell layers and of anterior ciliary non-pigmented epithelial (NPE) cells. Conversely, AQP4 was localized to the basolateral plasma membrane of NPE cells in ciliary epithelium and the posterior iris. Developmentally, AQP1 was detected as early as E15 in immature iris and ciliary epithelial cells, and expression persisted throughout development up to adulthood. In contrast, AQP4 was first observed at P7 in the developing pars plicata, and the AQP4-positive area gradually spread to cover the entire pars plicata as development proceeded. These findings indicate that both AQP1 and AQP4 contribute to aqueous humor secretion in the rat eye, thereby maintaining proper intraocular pressure. Moreover, AQP appears to play a major role in aqueous humor secretion in early eye development. This study thus provides a basis for understanding the molecular mechanisms of aqueous humor secretion in pathological and physiological conditions.
    Cell and Tissue Research 08/2006; 325(1):101-9. DOI:10.1007/s00441-005-0122-z · 3.33 Impact Factor
  • Akito Hirakata, Tetsuo Hida
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    ABSTRACT: To evaluate the efficacy of vitrectomy for posterior retinoschisis (RS) or foveal detachment (FD) associated with posterior staphyloma in myopic eyes. We reviewed the records of 14 consecutive patients (53-77 years of age; 16 eyes) with progressive visual impairment as a result of myopic RS or FD. Optical coherence tomography demonstrated the presence of a variety of RS and FD characteristics. Five eyes had RS alone, and 11 eyes had RS and FD. Two eyes with RS and severe FD developed retinal detachment in conjunction with a tiny macular hole. Vitrectomy, including posterior vitreous separation in all eyes and internal limiting membrane (ILM) peeling in six eyes, had been performed. The patients were followed postoperatively for 6 to 66 months (mean, 24 months). The anatomical outcome and visual acuity were retrospectively analyzed in this study. Although the two eyes with RS and severe FD developed retinal detachment with a macular hole after an initial vitrectomy, final retinal reattachment was achieved in all 16 eyes. Visual acuity improved in nine eyes and remained unchanged in seven eyes. Vitrectomy with posterior vitreous separation is effective for reattaching the macula and preventing a deterioration of vision, although eyes with RS and severe FD may be at risk for the development of a macular hole after the initial vitrectomy.
    Japanese Journal of Ophthalmology 02/2006; 50(1):53-61. DOI:10.1007/s10384-005-0270-4 · 1.80 Impact Factor
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    ABSTRACT: The clinical presentation and electrophysiological findings are described of three consecutive cases with pericentral pigmentary retinal degeneration. The responses to bright flashes after dark adaptation showed negative waveform shape in all cases. Rod responses were strongly reduced compared with cone responses. Cone electroretinograms elicited by long-duration stimuli showed greater loss of the on-response than the off-response. The ratio of the on-response amplitude to off-response amplitude of these patients (0.52 +/- 0.12; mean +/- SD, n = 6) was significantly smaller than that of normal subject (0.83 +/- 0.21; mean +/- SD, n = 8) (Mann-Whitney U-test, P < 0.01). The electrophysiological findings of these cases suggest a greater defect of inner retinal function, especially in transmission between photoreceptors and depolarizing bipolar cells.
    Clinical and Experimental Ophthalmology 01/2006; 34(1):89-92. DOI:10.1111/j.1442-9071.2006.01127.x · 1.95 Impact Factor
  • Japanese Journal of Ophthalmology 12/2005; 49(6):539-42. DOI:10.1007/s10384-005-0241-9 · 1.80 Impact Factor
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    ABSTRACT: An optimal strategy for treating psychogenic visual disturbances in adults has not been established. We report a patient with psychogenic visual disturbances who recovered his visual acuity and showed an improvement in his reading performance after undergoing training based on a reading performance assessment. A 37-year-old man who had been diagnosed as having myopic macular degeneration was referred to our clinic. Three months after his initial diagnosis, no changes in his fundi were observed, but his visual acuity had significantly decreased and his peripheral field of vision had become severely restricted. In view of his tunnel vision, the discrepancy among the visual acuity results obtained by different test methods, the results of a reading assessment, objective eye examination data, and his behavioral patterns, we diagnosed a psychogenic visual disturbance in the patient and referred him to an ophthalmologist and a psychiatrist for follow-up care. In our low vision clinic, we assessed his visual function, including reading performance, and developed a training program including reading, writing, and computer skills. We also provided information to help the patient find a job. The training program included instructions on how to manipulate reading aids and how to select reading materials to maximize his vision; these instructions were effective. Nine months after his rapid decrease in visual acuity, the results of his visual function tests showed an improvement. The patient also became motivated to find a job. Reading assessments are a useful tool for diagnosing psychogenic visual disturbances in adults and for coping with functional vision impairment.
    Nippon Ganka Gakkai zasshi 12/2005; 109(11):761-5.
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    ABSTRACT: Recently, optical coherence tomography (OCT) analysis has contributed greatly to the detection of posterior retinoschisis associated with optic disc pits. We report an unusual case of optic disc pit maculopathy. A 37-year-old woman with a multilayered structure of posterior retinoschisis associated with a very small, shallow optic disc pit was treated. The patient came to our clinic after a few weeks of decreased vision in her right eye. Fundus examination showed a shallow macular detachment with a tiny, shallow pit at the temporal edge of the optic disc. OCT revealed an unusual multilayered structure of retinoschisis connected to the optic disc. We performed vitrectomy with induction of the posterior hyaloid separation and gas tamponade. After vitrectomy, OCT showed a marked fluid resolution in the retinoschisis, and the patient's vision improved rapidly. The multilayered separation of retinoschisis can be caused by traction of the optic disc with a tiny, shallow pit at the temporal edge of the disc.
    Japanese Journal of Ophthalmology 09/2005; 49(5):414-6. DOI:10.1007/s10384-004-0227-z · 1.80 Impact Factor
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    ABSTRACT: To evaluate the efficacy of vitrectomy and gas tamponade, without laser photocoagulation to the margin of the optic nerve, for the treatment of macular detachment associated with an optic disc pit. Noncomparative interventional case series. Eleven consecutive patients (8-47 years of age) who presented with unilateral macular detachment associated with an optic disc pit. Pars plana vitrectomy, induction of posterior vitreous detachment (PVD), and gas tamponade were performed, with postoperative facedown positioning for 1 week. The presence of a double-layer detachment consisting of an inner layer separation and an outer layer detachment was observed in 10 of 11 eyes either preoperatively or postoperatively. Patients were observed for 10 to 98 months (mean, 47) after surgery. Anatomic outcome and visual acuity were retrospectively analyzed for all eyes. Optical coherence tomography was used to observe anatomic changes in the macula in some eyes. Complete retinal reattachment was achieved in 10 of 11 eyes, although these eyes required nearly 1 year to reach this state. The one eye with persistent retinal detachment was observed to have a marked reduction of the detachment by 10 months postoperatively. No recurrences were observed. Visual acuity improvement was documented in 7 of 11 eyes. These results suggest that vitrectomy with induction of PVD and gas tamponade, without additional laser treatment, is successful in reattaching the macula and improving central vision in most patients with optic disc pit maculopathy.
    Ophthalmology 09/2005; 112(8):1430-5. DOI:10.1016/j.ophtha.2005.02.013 · 6.17 Impact Factor
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    ABSTRACT: The mechanism responsible for optic disc pit maculopathy is unclear, but abnormal vitreous structures, including the anomalous Cloquet's canal at the optic disc pit, have been suggested as important factors. We report the intraoperative and ultrastructural findings of an unusual posterior vitreous strand in the eye of an 8-year-old girl with optic disc pit maculopathy. The patient presented with decreased vision in the left eye. Examination of the left eye revealed a best-corrected visual acuity (VA) of 0.08 and a macular detachment associated with an optic disc pit. Vitrectomy was performed with the adjunctive use of triamcinolone acetonide intraoperatively. The presence of an unusual posterior hyaloid strand tightly attached to the margin of the optic disc pit was noted. An unusual movement of this strand was observed during the surgery. The strand was excised, and fluid-gas exchange was performed using gas tamponade with 20% SF(6). After 12 months, a complete macular reattachment was obtained, with the VA improving to 1.2. Electron microscopic examination of the removed strand revealed abundant thick collagen fibrils with a frame of fine fibrils. The unusual posterior vitreous strand connected to the optic disc pit may have contributed to the pathogenesis of maculopathy in this young child.
    Japanese Journal of Ophthalmology 06/2005; 49(3):264-6. DOI:10.1007/s10384-004-0185-5 · 1.80 Impact Factor
  • Retina 01/2005; 24(6):964-7. DOI:10.1097/00006982-200412000-00020 · 3.18 Impact Factor
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    ABSTRACT: To investigate the histological effect of subthreshold transpupillary thermotherapy (TTT) on the retina. We performed TTT in normal pigmented rabbit eyes using an 810-nm diode laser with spot size of 1.2 mm, power of 50 mW, and varying durations of 15, 30, or 60 seconds. Four weeks later, fluorescein angiography was performed, and the enucleated eyes were examined by means of electron microscopy and immunohistochemical staining. Funduscopy immediately and at 4 weeks showed no discernable changes at TTT sites, and fluorescein angiography at 4 weeks showed no abnormalities. However, electron microscopy showed photoreceptor and retinal pigment epithelium cell disruption, changes more prominent with longer durations of treatment. Immunohistochemical staining was positive for heat shock protein 60, heat shock protein 70, tumor necrosis factor alpha, and vascular cell adhesion molecule 1 in the photoreceptors and retinal pigment epithelium at TTT sites. Untreated control eyes showed no staining. Despite the absence of changes evident by funduscopy and fluorescein angiography, TTT resulted in dose-dependent histological changes in photoreceptors and retinal pigment epithelium. The induction of heat shock proteins, cytokines, and cell adhesion molecules may play a role in the tissue response to subthreshold TTT. Clinical Relevance Unrecognized damage to the retina and retinal pigment epithelium may contribute to visual loss in eyes that undergo subthreshold TTT.
    Archives of Ophthalmology 11/2004; 122(10):1510-5. DOI:10.1001/archopht.122.10.1510 · 4.49 Impact Factor
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    British Journal of Ophthalmology 09/2004; 88(8):1097-8. DOI:10.1136/bjo.2003.039719 · 2.81 Impact Factor
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    ABSTRACT: PurposePunctal occlusion using punctal plugs is very effective for the treatment of tear-deficient dry eye. We compared the newly marketed Flex Plug (FP, Eagle Vision Co., Ltd.) and the Eagle Plug (EP, Eagle Vision Co., Ltd.).Subjects and MethodsThe subjects were patients with severe tear-deficient dry eye who were treated in our dry eye clinic. FP plugs in 8 patients (9 eyes) and EP plugs in 29 patients (35 eyes) were compared during over 4 months of observation with regard to the time until extrusion and the possibility for re-insertion of the plugs.ResultsDuring the 4 months after insertion of the plugs, the EP plugs were extruded from 35 of 51 puncta (68.6%) and the FP plugs were extruded from 4 of 13 puncta (30.8%). In the 35 EP extrusions and in the 4 FP extrusions, re-insertion was possible. The time period until extrusion was longer for FP than for EP. In all cases, for both EP and FP, pyogenic granuloma was not observed.DiscussionThe extrusion rate for EP plugs was much greater than for FP plugs (68.6% to 30.8%). Pyogenic granuloma was not observed in any instance for both types of punctal plugs.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:139–143, 2004)PurposeTo examine the efficacy of arteriovenous adventitial sheathotomy (or arteriovenous decompression) for macular edema (ME) in branch retinal vein occlusion (BRVO).Patients and MethodsEighty-three patients (83 eyes) who had ME in BRVO for 26 weeks or less underwent pars plana vitrectomy and internal limiting membrane dissection and were followed postoperatively for more than one year. The eighty-three eyes were divided into 38 eyes with sheathotomy (sheathotomy group) and 45 eyes without sheathotomy (non-sheathotomy group). The absorption period for ME and the difference between pre- and postoperative visual acuity (VA) at one year in the two groups were compared, and statistically significant factors were extracted.ResultsThe mean absorption period for ME was 3.4 months in the sheathotomy group and 4.2 months in the non-sheathotomy group, and the mean difference between pre- and postoperative VA at one year was 0.37 and 0.28, respectively. There was no significant difference between the two groups. There was no significant factor related to the absorption period for ME, but the difference between preoperative VA and postoperative VA at one year was significant.ConclusionSheathotomy may have no additional effect on the absorption of ME or the improvement of VA after vitrectomy for BRVO.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:144–149, 2004)PurposeTo report the long-term prognosis of internal limiting membrane peeling for idiopathic epiretinal membrane.MethodsThirty-six patients (37 eyes) who underwent internal limiting membrane peeling without indocyanine green staining to treat idiopathic epiretinal membranes between February 1998 and April 2000 were followed for at least 2 years postoperatively in the Ophthalmology Department of Osaka Rosai Hospital. We checked visual acuity (VA) preoperatively and at 1, 3, 6, 12, 18, and 24 months postoperatively and evaluated the progress of visual improvement.ResultsVA improved significantly during the first year postoperatively and stabilized thereafter. The percentages of eyes that showed a VA improvement of greater than 2 lines were 49%, 57%, 65%, and 73% at 3, 6, 12, and 24 months postoperatively, respectively. About 70% of the patients achieved VA exceeding 1.0 at 2 years postoperatively. Patients older than 70 years and those with a long duration of illness were slower to improve. Epiretinal membranes recurred in 3% of the patients.ConclusionVA after internal limiting membrane peeling for idiopathic epiretinal membrane improved significantly during the first year postoperatively and the VA continued to improve thereafter. The recurrence rate was 3%. Internal limiting membrane peeling is the preferred treatment for idiopathic epiretinal membrane.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:150–156, 2004)PurposeTo compare the long-term clinical and experimental results of soft acrylic intraocular lenses (IOLs) manufactured by the lathe-cut (LC) method and by the cast-molding (CM) method.MethodsThis was a retrospective study of 20 patients (22 eyes) who were examined in a 5- and 7-year follow-up study. Sixteen eyes were implanted with polyacrylic IOLs manufactured by the LC method and 6 eyes were implanted with polyacrylic IOLs manufactured by the CM method. Postoperative measurements included best corrected visual acuity, contrast sensitivity, biomicroscopic examination, and Scheimpflug slit-lamp images to evaluate surface light scatter. Scanning electron microscopy and three-dimensional surface analysis were conducted.ResultsAt 7 years, the mean visual acuity was 1.08 0.24 (mean standard deviation) in the LC group and 1.22 0.27 in the CM group. Surface light scatter was 12.0 4.0 computer compatible tapes (CCT) in the LC group and 37.4 5.4 CCT in the CM group. Mean surface roughness was 0.70 0.07nm in the LC group and 6.16 0.97nm in the CM group.ConclusionAcrylic IOLs manufactured by the LC method are more stable in long-term use.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:157–161, 2004)BackgroundA case of Sweet syndrome mimicking orbital cellulitis is reported.CaseA 17-year-old girl presented with painful eyelid swelling, limited ocular movement in the right eye, and an increased white cell count. The patient was initially diagnosed as having infectious orbital cellulitis, but her symptoms did not improve with administration of intravenous carbanpenem and cefzon. Systemic examination revealed erythema of the extremities, and blood tests showed elevated C-reactive protein. These findings are consistent with a diagnosis of Sweet syndrome, and the patient was treated with 30mg of oral prednisone. The eyelid swelling and erythema of the extremities decreased one day after the initiation of corticosteroid therapy. Skin biopsy showed infiltration of neutrophils and histiocytes in the dermis, confirming the diagnosis of Sweet syndrome.ConclusionSweet syndrome with eyelid and orbital involvement may mimic infectious orbital cellulitis.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:162–165, 2004)BackgroundInvolvement of leukocytes in three major pathologic conditions in the retina, i.e., edema, ischemia, and angiogenesis, has recently been thoroughly investigated. The accumulated evidence will lead to an integrated understanding of the relationship between leukocytes and retinal disorders, which is required for clinical applications of new medical treatment.MethodLeukocyte roles in the retinal vascular pathology were assessed by reviewing the related literature.ResultsVascular endothelial growth factor (VEGF)-induced leukocyte adhesion to the retinal vessels was shown to result in blood-retinal barrier breakdown, and the leukocyte-mediated pathogenesis was also seen in a model of diabetic retinopathy. A possible mechanism by which retinal angiogenesis develops intravitreal proliferation instead of compensating the avascular retina is that VEGF-producing monocytes/macrophages infiltrate the vitreous with subsequent migration of retinal vascular endothelial cells. On the other hand, cytotoxic T lymphocyte-mediated apoptosis of endothelial cells appears to cause the suppression of pathological retinal angiogenesis and the formation of ischemic retinal secondary to vascular regression.ConclusionLeukocytes are considered to regulate retinal edema, ischemia, and angiogenesis.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:193–201, 2004)PurposeTo evaluate the inter-relationship among near visual acuity, eccentricity of preferred retinal locus (PRL), and choice of low vision aids for reading in patients with bilateral age-related macular degeneration (AMD).Subjects and MethodsThe preferred eye of 44 patients having bilateral disciform stage AMD was examined. The PRL was detected and its eccentricity from the fovea was measured by scanning laser ophthalmoscopic microperimetry. Magnification of a low vision aid for reading newsprint was determined by the critical print size which was calculated using the MNREAD-J. The type of preferred aid was chosen from high-plus lens glasses, magnifiers, and closed-circuit televisions. The inter-relationship among near visual acuity, eccentricity of the PRL, and magnification and type of low vision aid for reading were evaluated.ResultsThe magnification of the aid was correlated with the eccentricity of PRL in eyes with near visual acuity of 0.2 or less although no correlation was found in eyes with near visual acuity better than 0.3. High plus lens glasses were selected by patients with near visual acuity better than 0.2 and eccentricity of 2 degrees or less. Magnifiers were selected by patients with near visual acuity better than 0.1 and eccentricity of 5 degrees or less. Closed-circuit televisions were selected by patients with near visual acuity of 0.1 or less and eccentricity of 5 degrees or more.ConclusionThe eccentricity of PRL should be taken into account in determining low vision aids for reading, especially in patients with near visual acuity of 0.2 or less. Choice of the type of low vision aid depends on not only near visual acuity but also on eccentricity of PRL.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:202–206, 2004)PurposeTo evaluate the effect of substituting latanoprost (LAT) 0.005% for unoprostone (UNO) 0.12% after a trial of unilateral treatment.MethodsWe treated 30 patients with primary open-angle glaucoma (n = 8), ocular hypertension (n = 1), or normal-tension glaucoma (n = 21) with UNO for 4 weeks in one eye and then substituted LAT for UNO. Four weeks later we measured the intraocular pressure (IOP) in the ipsilateral eye.ResultsThe mean baseline IOP level was 18.6 3.8 (mean standard deviation) mmHg. The mean IOP levels (reduction rates) after UNO and LAT therapy were 16.7 3.1mmHg (16.6%) and 14.1 3.2mmHg (28.9%), respectively (p < 0.001). All patients who responded to UNO also responded to LAT; however, 55% of those who did not respond to UNO responded to LAT.ConclusionsIf LAT is substituted for UNO, it can be predicted that 63.3% of the patients will respond.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:207–212, 2004)PurposeTo analyze the retinal nerve fiber layer thickness (NFLT) as measured by optical coherence tomography (OCT) in glaucomatous eyes with hemifield defect and to evaluate the most effective parameter for the diagnosis of glaucoma with OCT.MethodsOne hundred eighty four (184) normal eyes (128 subjects) and 108 open-angle glaucomatous eyes (87 subjects) with superior or inferior hemifield defects verified by Humphrey field analyzer (HFA) were measured for NFLT with OCT. The correlations between NFLT and mean deviation on HFA were calculated. In combination with normal eye data, receiver operating characteristic curve (ROC curve) and AUC (area under the curve) of each NFLT in the affected hemifield were evaluated for the diagnosis of glaucoma.ResultsNFLT in both affected and unaffected hemifields was significantly correlated with mean deviation in HFA. An average of four 30 segments close to the temporal side in the affected hemifield (parameter A120) had the highest correlation (r = 0.571) and the highest AUC (0.948) among all parameters.ConclusionsNFLT in the unaffected visual field decreases with the progression of glaucomatous damage. We suggest that the parameter A120 is the best indication in a diagnosis of glaucoma when measuring NFLT by OCT.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:213–218, 2004)BackgroundWe report a patient with acute angle-closure glaucoma secondary to annular ciliochoroidal detachment after unsutured cataract surgery.CaseAn 82-year-old man was diagnosed with bilateral shallow central anterior chamber depth, flat peripheral anterior chamber, and elevated intraocular pressure. One day previously he had undergone uncomplicated unsutured cataract surgery in the right eye and eight days previously, in the left eye. Ultrasound biomicroscopy revealed annular ciliochoroidal detachment in both eyes. Treatment with intravenous methyl prednisolone deepened the anterior chamber and reduced intraocular pressure.ConclusionAnnular ciliochoroidal detachment may lead to anterior rotation of the ciliary body and angle-closure. This clinical entity is indistinguishable from malignant glaucoma when the fundus cannot be visualized.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:219–225, 2004)BackgroundLaser photocoagulation of papillary hemangioma in von Hippel-Lindau disease often causes visual loss. Therefore, we applied photodynamic therapy for one patient.CaseA 36-year-old male had 3.2 2.6mm capillary hemangioma of the optic disc associated with a fibrovascular membrane and exudative retinal detachment involving the whole macular area in his left eye. His visual acuity was 0.08.TreatmentTwo days after the intravenous injection of 2mg/kg of hematoporphyrin derivatives, the eye was irradiated with a dye laser of 630nm wavelength, with irradiance of 637mW/cm2 and a radiant exposure of 150–250J/cm2. The exudative retinal detachment and hemorrhage in the tumor increased from day 1, but the tumor and exudative changes began to resolve after 3 weeks. The fibrovascular membrane was removed by vitrectomy. Three years after the treatment, the tumor was completely resolved, but the patients visual acuity was 0.1 due to atrophy of the optic nerve and pigment epithelium of the macula.ConclusionAlthough further investigation on optimal radiance avoiding damage to the optic nerve is still needed, photodynamic therapy is a promising therapeutic option for papillary hemangioma.Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc 108:226–232, 2004)
    Japanese Journal of Ophthalmology 08/2004; 48(5):511-511. DOI:10.1007/s10384-004-1027-1 · 1.80 Impact Factor
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    ABSTRACT: Recent data suggest that the concentration of interleukin-10 (IL-10) is higher than that of interleukin-6 (IL-6) in the vitreous of eyes of patients with non-Hodgkin's lymphoma. In this study, we evaluated the utility of measuring intravitreal IL-10 and IL-6 concentrations in the diagnosis of intraocular lymphoma. Specimens of undiluted vitreous were collected at the time of pars plana vitrectomy and IL-10 and IL-6 concentrations were determined. Vitreous specimens were obtained from 5 patients with suspected intraocular lymphoma and 10 patients with uveitis presumed to be unrelated to a neoplasm. In all 5 patients eventually diagnosed with intraocular lymphoma, the vitreous IL-10 concentration ranged from 3,040 to 11,200 pg/ml, and was higher than the vitreous IL-6 concentration in all cases. In 9 of the 10 patients with uveitis, the vitreous IL-10 concentrations ranged from less than 2 to 97 pg/ml, with an IL-10/IL-6 ratio of less than 0.11. However, in the remaining case diagnosed as uveitis of unknown etiology, the vitreous IL-10/IL-6 ratio was greater than 1. Our data suggest that the measurement of vitreous IL-10 concentrations would aid in the diagnosis of intraocular lymphoma.
    Nippon Ganka Gakkai zasshi 07/2004; 108(6):359-67.
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    ABSTRACT: Involvement of leukocytes in three major pathologic conditions in the retina, i.e., edema, ischemia, and angiogenesis, has recently been thoroughly investigated. The accumulated evidence will lead to an integrated understanding of the relationship between leukocytes and retinal disorders, which is required for clinical applications of new medical treatment. Leukocyte roles in the retinal vascular pathology were assessed by reviewing the related literature. Vascular endothelial growth factor(VEGF)-induced leukocyte adhesion to the retinal vessels was shown to result in blood-retinal barrier breakdown, and the leukocyte-mediated pathogenesis was also seen in a model of diabetic retinopathy. A possible mechanism by which retinal angiogenesis develops intraviteral proliferation instead of compensating the avascular retina is that VEGF-producing monocytes/macrophages infiltrate the vitreous with subsequent migration of retinal vascular endothelial cells. On the other hand, cytotoxic T lymphocyte-mediated apoptosis of endothelial cells appears to cause the suppression of pathological retinal angiogenesis and the formation of ischemic retina secondary to vascular regression. Leukocytes are considered to regulate retinal edema, ischemia, and angiogenesis.
    Nippon Ganka Gakkai zasshi 05/2004; 108(4):193-201.
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    ABSTRACT: A case of Sweet syndrome mimicking orbital cellulitis is reported. A 17-year-old girl presented with painful eyelid swelling, limited ocular movement in the right eye, and an increased white cell count. The patient was initially diagnosed as having infectious orbital cellulitis, but her symptoms did not improve with administration of intravenous carbanpenem and cefzon. Systemic examination revealed erythema of the extremities, and blood tests showed elevated C-reactive protein. These findings are consistent with a diagnosis of Sweet syndrome, and the patient was treated with 30 mg of oral prednisone. The eyelid swelling and erythema of the extremities decreased one day after the initiation of corticosteroid therapy. Skin biopsy showed infiltration of neutrophils and histiocytes in the dermis, confirming the diagnosis of Sweet syndrome. Sweet syndrome with eyelid and orbital involvement may mimic infectious orbital cellulitis.
    Nippon Ganka Gakkai zasshi 04/2004; 108(3):162-5.

Publication Stats

2k Citations
219.00 Total Impact Points

Institutions

  • 1997–2009
    • Kyorin University
      • • Department of Ophthalmology
      • • Kyorin Eye Center
      • • School of Medicine
      Edo, Tōkyō, Japan
  • 1986–1992
    • Duke University Medical Center
      • Department of Ophthalmology
      Durham, North Carolina, United States
  • 1990
    • Cairo University
      • Department of Ophthalmology
      Cairo, Muhafazat al Qahirah, Egypt
  • 1984–1990
    • Keio University
      • • School of Medicine
      • • Department of Ophthalmology
      Tokyo, Tokyo-to, Japan