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ABSTRACT: To prospectively examine changes in the central visual field (VF) in patients with advanced open-angle glaucoma (OAG) with advanced late stage after trabeculectomy for 12 months.
Prospective interventional case series.
In all, 27 eyes of 27 OAG patients at a single center with a best-corrected visual acuity (BCVA) of ≥40/200 and a mean total deviation of test locations of the 10-2 program of the Humphrey VF analyzer of ≤-20 dB preoperatively were enrolled. Intraocular pressure (IOP), VF parameters of the 10-2 program, and BCVA were examined for 12 months after trabeculectomy with mitomycin C. Slopes of VF parameters and their correlation with presumed risk factors were studied.
IOP decreased from 19.7±5.8 to 9.7±2.6 mm Hg (P<0.001) over postoperative 1 year. The slopes of all VF parameters did not significantly differ from zero (P>0.33), and none of the presumed factors significantly correlated with the slopes of those parameters (P>0.14). There were two eyes (7%) and one eye (4%) with ≥2 lines of deterioration in BCVA (decimal fraction) at 1 and 12 months, respectively, after surgery with no apparent causes.
Trabeculectomy resulted in little change in the central 10-degree VF, but significant decrease in BCVA without apparent causes might occur approximately 5% of the cases.
Eye (London, England) 04/2011; 25(7):866-71. · 1.97 Impact Factor
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M Kamio,
A Meguro,
M Ota,
N Nomura,
K Kashiwagi,
F Mabuchi,
H Iijima,
K Kawase,
T Yamamoto,
M Nakamura, [......],
T Fukuchi,
H Abe,
T Higashide,
K Sugiyama,
T Kanamoto,
Y Kiuchi,
A Iwase,
S Ohno,
H Inoko,
N Mizuki
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ABSTRACT: To investigate whether the GLC3A locus harboring the CYP1B1 gene is associated with normal tension glaucoma (NTG) in Japanese patients.
One hundred forty-two Japanese patients with NTG and 101 Japanese healthy controls were recruited. Patients exhibiting a comparatively early onset were selected as this suggests that genetic factors may show stronger involvement. Genotyping and assessment of allelic diversity was performed on 13 highly polymorphic microsatellite markers in and around the GLC3A locus.
There were decreased frequencies of the 444 allele of D2S0416i and the 258 allele of D2S0425i in cases compared to controls (P = 0.022 and P = 0.034, respectively). However, this statistical significance disappeared when corrected (Pc > 0.05). We did not find any significant association between the remaining 11 microsatellite markers, including D2S177, which may be associated with CYP1B1, and NTG (P > 0.05).
Our study showed no association between the GLCA3 locus and NTG, suggesting that the CYP1B1 gene, which is reportedly involved in a range of glaucoma phenotypes, may not be an associated factor in the pathogenesis of NTG.
Clinical ophthalmology (Auckland, N.Z.) 02/2009; 3:183-8.
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ABSTRACT: To assess the prevalence of atypical retardation pattern (ARP) in scanning laser polarimetry (SLP) with variable corneal compensation (VCC) and enhanced corneal compensation (ECC), and to evaluate the factors relating to typical scan score (TSS).
Measurements of SLP-VCC, SLP-ECC, and the Humphrey field analyzer (HFA) were performed in 105 normal subjects and 82 open-angle glaucoma (OAG) patients. ARP was defined as an SLP image with TSS<80.
Prevalence of ARP with SLP-VCC was 13.3 and 14.6% in normal and OAG eyes, respectively, and that with SLP-ECC (2.9% and 1.2%) was lower than SLP-VCC (P<0.009). TSS with SLP-VCC was significantly correlated with age (partial correlation coefficient (PCC)=-0.22, P=0.003) and refractive error (PCC=0.26, P<0.001) after adjusting for each other. TSS with SLP-ECC was significantly correlated with neither age nor refractive error (PCC=-0.02, P=0.788; PCC=0.10, P=0.177, respectively). In OAG eyes, mean deviation (MD) of HFA was significantly correlated with TSS with SLP-VCC and SLP-ECC (PCC=0.35, P=0.001; PCC=0.23, P=0.039, respectively). In SLP-VCC, MD was significantly correlated with retinal nerve fibre layer (RNFL) thickness only after excluding eyes with ARP (P<0.001).
ARP in SLP-VCC measurements was found in more than 10% of normal or glaucomatous eyes, and TSS was significantly lower in older subjects, more myopic eyes, or eyes with more advanced glaucomatous damage. The presence of ARP disturbs the accuracy of RNFL thickness measurement by SLP-VCC. In SLP-ECC measurements, prevalence of ARP was considerably lower and TSS was not affected by age or refractive error, suggesting the advantages of ECC in clinical practices.
Eye (London, England) 12/2008; 23(9):1796-801. · 1.97 Impact Factor
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ABSTRACT: A scanning laser polarimetry (GDx VCC) equips three different sized measurement circles. In eyes with peripapillary atrophy (PPA), the GDx measurement becomes inaccurate when the circle falls on PPA. The aim of this study was to evaluate performance of the three circles of GDx measurement in eyes with PPA.
Three different sized circles were compared regarding frequency of PPA, which fell on each circle in 282 open-angle glaucoma (OAG) eyes, reproducibility of GDx parameters in 24 normal and 22 OAG eyes, and ability to detect glaucoma in 50 normal and 50 OAG eyes.
PPA was observed in 230 (82%) of 282 OAG eyes. PPA fell on the small circle (default setting), medium, and large circles in 119 (43%), 38 (14%), and 12 (4%) of the 280 OAG eyes. Reproducibility of GDx parameters was not significantly different among three circles in normal eyes (P>0.05), whereas coefficients of reproducibility of TSNIT average (P=0.006) and superior average (P=0.035) were smaller in the smaller circles in OAG eyes. GDx parameters significantly correlated (P<0.001), but were significantly different (P<0.05) between the small and medium circles. The area under receiver operating characteristic curves for dividing OAG from normal eyes using GDx parameters was similar between the small and medium circles.
If the medium circles were used, obstructing influences of PPA on GDx measurement could be avoided more often in Japanese OAG eyes with similar reproducibility and comparable ability to detect glaucoma compared to those with the default small circle.
Eye 02/2008; 22(2):173-8. · 1.85 Impact Factor
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Y Mashima,
Y Suzuki,
Y Sergeev,
Y Ohtake,
T Tanino,
I Kimura,
H Miyata, M Aihara,
H Tanihara,
M Inatani,
N Azuma,
T Iwata,
M Araie
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ABSTRACT: To investigate CYP1B1 gene mutations in Japanese patients with primary congenital glaucoma (PCG).
Sixty-five unrelated Japanese patients with PCG were screened by PCR-single-strand conformational polymorphism (SSCP) analysis followed by direct sequencing. No patients were offspring of consanguineous marriages, a common occurrence among patients in previous reports. PCG haplotypes were constructed with intragenic polymorphisms in affected individuals. Three-dimensional atomic structures of human CYP1B1 and four mutant CYP1B1 sequences representing missense mutations were assembled using homology modeling and were regularized by an energy-minimization procedure.
Eleven novel mutations, including seven definite and four probable mutations, were detected in 13 (20%) of the 65 unrelated patients. Of the seven definite mutations, three were predicted to truncate the CYP1B1 open reading frame. The other four were missense mutations (Asp192Val, Ala330Phe, Val364Met, and Arg444Gln), all located in conserved core structures determining proper folding and heme-binding ability of cytochrome P450 molecules. Molecular modeling demonstrated that two of four mutations in positions 330 and 364 were structurally neutral, but Arg444Gln caused significant structural change. Of the four probable mutations, three were missense (Val198Ile, Val320Leu, and Glu499Gly); the other was a base substitution in the noncoding region of exon 1.
The 11 varied CYP1B1 mutations found in 13 unrelated Japanese patients with sporadic occurrence of PCG represent an allelic heterogeneity and may be unique to a specific population.
Investigative Ophthalmology & Visual Science 10/2001; 42(10):2211-6. · 3.60 Impact Factor
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ABSTRACT: To compare the visual field defects in the late stage of disease between normal-tension glaucoma (NTG) and primary open angle glaucoma (POAG), measurements taken with the 30-2 and 10-2 threshold program of the Humphrey Visual Field Analyzer were analysed by statistical methods including logistic discriminant analysis. Thirty-four eyes of 34 NTG cases and 63 eyes of 63 POAG cases whose mean deviation (MD) given by STATPAC was equal to or less than -15 dB were included and there was no significant difference in MD, refraction, or age between the two groups. The analyses demonstrated that the upper arcuate area was significantly more depressed in POAG and the inferior Bjerrum area was significantly more depressed in NTG eyes. It was also shown that the lower papillo-macular area was less affected in NTG than in POAG eyes.
Nippon Ganka Gakkai zasshi 11/1994; 98(10):968-73.
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ABSTRACT: We investigated the effects of long-term instillation of bunazosin hydrochloride--alpha 1 specific adrenergic antagonist--on the aqueous humor dynamics and blood-aqueous barrier in rabbit eyes. We examined intraocular pressure, aqueous flow rate, and blood-aqueous barrier permiability for albumin after four weeks application of 0.05% bunazosin. The effect of bunazosin on blood-aqueous barrier destruction by laser iridophotocoagulation was also examined. During four weeks, bunazosin reduced the intraocular pressure by 1.7 +/- 0.6 mmHg (mean +/- SEM). Continuous application of bunazosin had no significant influence on aqueous flow rate and fluorescein isothiocyanate-labeled rabbit albumin (FITC-Alb) concentration in the anterior chamber. Bunazosin had no effect on the rise of the FITC-Alb concentration after iris photocoagulation, but the intraocular pressure in bunazosin treated eyes was significantly lower than in control eyes one hour after photocoagulation.
Nippon Ganka Gakkai zasshi 07/1994; 98(6):540-4.
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ABSTRACT: The nature of intraocular pressure (IOP) in normal-tension glaucoma (NTG) has not been studied in detail, although the information on the IOP is indispensable for diagnosis and treatment of NTG.
After at least six IOP measurements at daytime clinic, diurnal IOP was measured at 10:00 AM, 12:00 noon, 2:00, 4:00, 6:00, 8:00, 10:00 PM, 12:00 midnight, and at 3:00, 6:00, 8:00, and 10:00 AM by 1-day hospitalization in 118 NTG suspects. Four subjects with peak IOPs exceeding 21 mmHg were diagnosed as primary open-angle glaucoma (POAG) whose eyes all had mean clinic IOPs above 16 mmHg. The remaining 114 patients were diagnosed as having NTG, and their right eye data were used for analysis.
The rhythmic nature of the diurnal IOP of NTG was analyzed by fitting the data to a cosine curve. In 54.4% of the eyes, the correlation between the measured IOP and the values predicted from the cosine curve was significant (r > 0.60, P < 0.05), and the equation, diurnal IOP = 13.9 + 1.7 cos 2 pi (t/24-0.40) mmHg, which was similar to that reported in normals, was obtained. Multiple regression analysis showed that the mean diurnal IOP was best predicted with the mean of the six clinic IOPs and systolic blood pressure (R2 = 0.67), and the peak diurnal IOP with the mean of six clinic IOPs (R2 = 0.50). The estimate fell within +/- 1 and +/- 2 mmHg of the actual value in 83% and 96% of the left eyes for the former and in 69% and 93% for the latter, respectively. No eyes with peak diurnal IOP exceeding 21 mmHg were overlooked with the cutoff IOP of 16 mmHg.
The mean and peak diurnal IOP could be predicted with the mean of clinic IOPs.
Ophthalmology 06/1993; 100(5):643-50. · 5.45 Impact Factor
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ABSTRACT: In 288 eyes of 114 low-tension glaucoma (LTG) patients, the mean, peak, trough and magnitude of the diurnal fluctuation of the intraocular pressure (IOP) determined over a period of 24 hours (diurnal IOP) were correlated with the IOPs recorded at the daytime office (office IOP), refraction, extent of visual field loss, age, sex, blood pressure and obesity index by the method of multivariate analysis. Only the mean office IOP was found to have a statistically significant contribution for estimating the mean, peak and trough of the diurnal IOP with the proportion (R) of 0.71 0.67 and 0.68 respectively. Furthermore, an analysis of the IOP data obtained from 118 LTG suspects using the receiver operating characteristics (ROC) curve showed that a patient whose peak diurnal IOP exceeds 21 mmHg could be detected with a sensitivity of 100% and a specificity of 46% if around-the-clock IOP measurements were carried out in patients whose mean office IOP are above 16 mmHg at least in one eye. In view of high prevalence of LTG in Japanese, estimation of mean diurnal IOP from mean office IOP and exclusion of primary open angle glaucoma using the mean office IOP of 16 mmHg as a cutoff IOP level are thought to be clinically useful.
Nippon Ganka Gakkai zasshi 09/1992; 96(8):1007-13.
