[Show abstract][Hide abstract] ABSTRACT: Previous reports showed that short-term hyperglycemia protects optic nerve axons in a rat experimental hypertensive glaucoma model. In this study, we investigated whether short-term hyperglycemia prevents tumor necrosis factor (TNF)-induced optic nerve degeneration in rats and examined the role of autophagy in this axon change process. In phosphate-buffered saline (PBS)-treated rat eyes, no significant difference in axon number between the normoglycemic (NG) and streptozotocin (STZ)-induced hyperglycemic (HG) groups was seen at 2 weeks. Substantial degenerative changes in the axons were noted 2 weeks after intravitreal injection of TNF in the NG group. However, the HG group showed significant protective effects on axons against TNF-induced optic nerve degeneration compared with the NG group. This protective effect was significantly inhibited by 3-methyladenine (3-MA), an autophagy inhibitor. Immunoblot analysis showed that the LC3-II level in the optic nerve was increased in the HG group compared with the NG group. Increased p62 protein levels in the optic nerve after TNF injection was observed in the NG group, and this increase was inhibited in the HG group. Electron microscopy showed that autophagosomes were increased in optic nerve axons in the HG group. Immunohistochemical study showed that LC3 was colocalized with nerve fibers in the retina and optic nerve in both the NG and HG groups. Short-term hyperglycemia protects axons against TNF-induced optic nerve degeneration. This axonal-protective effect may be associated with autophagy machinery.
Preview · Article · Oct 2015 · Frontiers in Cellular Neuroscience
[Show abstract][Hide abstract] ABSTRACT: Purpose. To examine the efficacy of ophthalmic rebamipide suspensions on ocular surface disorders induced by antiglaucoma eye drops. Patients and Methods. Forty eyes of 40 patients receiving latanoprost (0.005%) and timolol (0.5%) were included in this randomized prospective study. The patients were randomly divided into two groups (n = 20): the rebamipide-treated group and control
group. Changes in intraocular pressure, tear film break-up time (TBUT), and corneal epithelial barrier function were evaluated at baseline, 4 weeks, and 8 weeks after rebamipide administration. Furthermore, superficial punctate keratopathy severity was evaluated by scoring the lesion area and density. Results. There was no significant difference in intraocular pressure before and after rebamipide treatment. However, corneal epithelial barrier function improved significantly 4 and 8 weeks after rebamipide treatment. TBUT was partially, but significantly, increased (P = 0.02) 8 weeks after rebamipide treatment, whereas no significant change was observed at 4 weeks. Additionally, a significant decrease in area and density of keratopathy was observed 8 weeks after rebamipide treatment but not at 4 weeks. The control group showed no significant difference compared to baseline. Conclusions. Our data suggests that rebamipide treatment may reduce the occurrence of drug-induced ocular surface disorder.
Full-text · Article · Jun 2015 · Journal of Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: PurposeThe purpose of this study was to compare 27-gauge (27G) with 25-gauge (25G) microincision vitrectomy in patients with epiretinal membrane (ERM).ParticipantsSeventy-four eyes of 66 patients undergoing 3-port pars plana vitrectomy using 27G or 25G instrumentation.Methods
Seventy-four eyes of 66 patients with ERM, who underwent 27G or 25G microincision vitrectomy were prospectively evaluated.ResultsThe mean operation time for vitrectomy was significantly longer in the 27G group than in the 25G group (9.9±3.5 vs 6.2±2.7 min, respectively, P<0.0001). No statistically significant difference was found between the two groups in terms of the mean operation time for ERM-inner limiting membrane peeling (27G vs 25G: 20.2±9.9 vs 16.1±9.3 min, P=0.14), although the time for vitreous cutting was longer in the 27G group (9.9±3.5 vs 6.2±2.7 min, respectively, P<0.0001). The flare value, intraocular pressure (IOP), and rate of hypotony 1 day after surgery did not differ between the 27G and 25G groups (flare value: 18.7 vs 17.2; IOP: 8.8 vs 9.7 mm Hg; rate of hypotony: 30 vs 35%, respectively). There was no significant difference in the surgically induced astigmatism between the two groups in the follow-up period. The mean time required for wound closure did not show a significant difference between the 27G and 25G groups (7.7 vs 8.6 weeks, respectively).Conclusion
The 27G system is as safe and useful for ERM vitrectomy as the 25G system. Based on its potential, further improvement of 27G instruments could result in greater efficiency.Eye advance online publication, 8 January 2016; doi:10.1038/eye.2015.275.
Full-text · Article · Jan 2015 · Eye (London, England)
[Show abstract][Hide abstract] ABSTRACT: The p62, also called sequestosome 1 (SQSTM1), plays a crucial role in tumor necrosis factor (TNF)-induced optic nerve degeneration. Brimonidine has been shown to have protective effects on retinal ganglion cell bodies, although its role in their axons remains to be examined. We determined whether brimonidine modulates axonal loss induced by TNF and affects the expression of p62 in the optic nerve.
Experiments were performed on adult male Wistar rats that received an intravitreal injection of 10 ng TNF alone or simultaneous injection of TNF and 2, 20, or 200 pmol of brimonidine tartrate. The expression of p62 in the optic nerve was examined by immunoblot analysis. The effects of brimonidine on axons were evaluated by counting axon numbers 2 weeks after intravitreal injection.
Intravitreal injection of brimonidine exerted substantial axonal protection against TNF-induced optic nerve degeneration. Immunoblot analysis showed that p62 was upregulated in the optic nerve after intravitreal injection of TNF, and that this increase was completely inhibited by brimonidine. Treatment with brimonidine alone also significantly decreased p62 protein levels in the optic nerve compared with the basal level.
These results suggest that the modulation of p62 levels in the optic nerve by brimonidine may be involved partly in its axonal protection.
Full-text · Article · Aug 2014 · Neuroscience Letters
[Show abstract][Hide abstract] ABSTRACT: This study aimed to investigate whether corneal nerve and corneal stem/progenitor cells are altered in insulin-like growth factor-I (IGF-I-) treated individuals with diabetes. A group consisting of db/db mice with type 2 diabetes mellitus (DM) and a wild-type group were assessed by neural and corneal stem/progenitor cell markers immunostaining and real-time PCR. Moreover, the expression of corneal nerve and stem/progenitor cell markers was examined in IGF-1-treated diabetic mice. Compared with a normal cornea, swelling and stratification of the corneal epithelium were noted in db/db mice. Beta-III tubulin immunostaining revealed that the corneal subbasal plexuses in diabetic mice were thinner with fewer branches. mRNA expression levels of Hes1, Keratin15, and p75 (corneal stem/progenitor cell markers) and the intensity and number of positive cells of Hes1 and Keratin19 immunostaining diminished in the diabetic corneas. Compared with the subbasal nerve density in the normal group, a decrease in the diabetic group was observed, whereas the corneal subbasal nerve density increased in IGF-1-treated diabetic group. The decreased expression of Hes1 and Keratin19 was prevented in IGF-1-treated diabetic group. Our data suggest that corneal nerve and stem/progenitor cells are altered in type 2 DM, and IGF-I treatment is capable of protecting against corneal damage in diabetes.
Full-text · Article · Feb 2014 · International Journal of Endocrinology
[Show abstract][Hide abstract] ABSTRACT: [Purpose] To compare measurements of anterior chamber depth (ACD) obtained by anterior segment optical coherence tomography (CASIA) and an optical device for measuring axial length (IOLMaster). [Subjects and Methods] Ninety-six eyes of 48 healthy subjects with ametropia were enrolled in this study. Their mean age was 48.0 ± 21.9 years and mean refraction was -1.8 ± 3.2 D. The IOLMaster measured axial length (AL), corneal radius of curvature (CRC), and ACD; and the CASIA measured CRC, central corneal thickness (CCT), and ACD. In 18 eyes of 9 subjects, ACD was measured in lighted and darkened rooms and under mydriasis.[Results] The mean ACD measurements by the IOLMaster and CASIA were 3.35 ± 0.40 mm and 3.46 ± 0.39 mm, respectively. The measurement by the CASIA was significantly greater (P < 0.01) and a strong correlation was observed between both measurements (r = 0.958, P < 0.01). The mean AL was 24.49 ± 1.41 mm, and a moderate correlation with ACD was seen (the IOLMaster, r = 0.446, P < 0.01; the CASIA, r = 0.402, P < 0.01). The mean CRC values were 7.76 ± 0.26 mm by the IOLMaster and 7.78 ± 0.26 mm by the CASIA. No correlation was seen between both measurements (the IOLMaster, r = -0.36, P = 0.725; the CASIA, r = -0.39, P = 0.706). The mean ACD measurements by the IOLMaster were 3.14 ± 0.70 mm in the lighted room, 3.13 ± 0.70 mm in the darkened room, and 3.26 ± 0.68 mm under mydriasis. No statistically significant difference was seen among these measurements (P < 0.01). With the CASIA, the mean ACD measurements were 3.21 ± 0.61 mm in the lighted room, 3.25 ± 0.66 mm in the darkened room, and 3.40 ± 0.61 mm under mydriasis. No statistically significant difference was seen among these measurements (P < 0.01).[Conclusion] Regarding ACD measurement, different devices might have different methods and principles for measurement. Therefore, we should understand the characteristics of the device when evaluating the measurement conditions and measurements.
[Show abstract][Hide abstract] ABSTRACT: Purpose: To evaluate whether indocyanine green (ICG)-assisted internal limiting membrane peeling affects visual outcome and macular morphologic changes in spectral-domain optical coherence tomography images after macular hole (MH) surgery. Methods: A retrospective analysis was performed of 34 eyes in 34 patients who had undergone surgical treatment for MH. Best-corrected visual acuity (BCVA) and optical coherence tomography parameters including central foveal thickness, length of the external limiting membrane (ELM) defect, and length of the inner segment and outer segment (IS/OS) defect were analyzed pre- and postoperatively. Results: The eyes were divided into 2 groups based on ICG use (ICG+/-). The changes in BCVA did not differ significantly between the 2 groups at 6 months. However, the ICG+ group had poorer changes compared with the ICG- group at 1 and 3 months (p = 0.038, p = 0.012, respectively). Central foveal thickness and ELM defect did not differ between the 2 groups at each period. The IS/OS defect in the ICG+ group was significantly greater at 1 and 3 months than that in the ICG- group (p = 0.026, p = 0.048, respectively). Conclusions: ICG staining may affect the recovery process of macular morphology and visual acuity in the first several months after MH surgery.
[Show abstract][Hide abstract] ABSTRACT: Purpose
To investigate prognostic factors for visual improvement in patients undergoing vitrectomy for epiretinal membrane (ERM) using spectral domain (SD) optical coherence tomography (OCT).
Prospective cohort study.
A total of 41 eyes of 38 patients.
A total of 41 eyes of 38 patients with idiopathic ERM underwent ERM resection. Ophthalmic evaluations included best-corrected visual acuity (BCVA) and OCT parameters before and 1, 3, and 6 months after surgery. Correlations between OCT parameters and BCVA were assessed at each time point. Correlations between postoperative BCVA and preoperative factors were evaluated, including age, preoperative BCVA, photoreceptor outer segment (PROS) length, central foveal thickness (CFT), outer foveal thickness (OFT), and outer nuclear layer thickness (ONLT). The factors influencing postoperative BCVA were evaluated using multiple regression analysis.
Main Outcome Measures
The BCVA at 6 months postoperatively.
The PROS length had the most significant correlation with BCVA at each time point (baseline: P = 0.0098, r = −0.409; 1 month: P = 0.0002, r = −0.586; 3 months: P < 0.0001, r = −0.642; 6 months: P = 0.0002, r = −0.577). The PROS length 1 month postoperatively was significantly decreased compared with that preoperatively (P = 0.0325), and the PROS length at 3 months recovered to the baseline length. Preoperative BCVA and PROS length were significantly correlated with postoperative BCVA at 6 months (P = 0.0055, r = 0.439 and P = 0.0089, r = −0.414, respectively). Other parameters, including age, CFT, OFT, and ONLT, were not significantly correlated with postoperative BCVA. Multiple regression analysis showed that preoperative PROS length yielded the highest regression coefficient with postoperative BCVA (P = 0.0363, standard regression coefficient = −0.335, overall R2 = 0.289).
Imaging of PROS length with SD-OCT was found to be a good indicator of BCVA at each time point after surgery and a predictor of postoperative BCVA in patients with idiopathic ERM. The PROS length changes after surgery may indicate surgical injury and restoration of the macular outer layer.
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
[Show abstract][Hide abstract] ABSTRACT: PURPOSE: To investigate prognostic factors for visual improvement in patients undergoing vitrectomy for epiretinal membrane (ERM) using spectral domain (SD) optical coherence tomography (OCT). DESIGN: Prospective cohort study. PARTICIPANTS: A total of 41 eyes of 38 patients. METHODS: A total of 41 eyes of 38 patients with idiopathic ERM underwent ERM resection. Ophthalmic evaluations included best-corrected visual acuity (BCVA) and OCT parameters before and 1, 3, and 6 months after surgery. Correlations between OCT parameters and BCVA were assessed at each time point. Correlations between postoperative BCVA and preoperative factors were evaluated, including age, preoperative BCVA, photoreceptor outer segment (PROS) length, central foveal thickness (CFT), outer foveal thickness (OFT), and outer nuclear layer thickness (ONLT). The factors influencing postoperative BCVA were evaluated using multiple regression analysis. MAIN OUTCOME MEASURES: The BCVA at 6 months postoperatively. RESULTS: The PROS length had the most significant correlation with BCVA at each time point (baseline: P = 0.0098, r = -0.409; 1 month: P = 0.0002, r = -0.586; 3 months: P < 0.0001, r = -0.642; 6 months: P = 0.0002, r = -0.577). The PROS length 1 month postoperatively was significantly decreased compared with that preoperatively (P = 0.0325), and the PROS length at 3 months recovered to the baseline length. Preoperative BCVA and PROS length were significantly correlated with postoperative BCVA at 6 months (P = 0.0055, r = 0.439 and P = 0.0089, r = -0.414, respectively). Other parameters, including age, CFT, OFT, and ONLT, were not significantly correlated with postoperative BCVA. Multiple regression analysis showed that preoperative PROS length yielded the highest regression coefficient with postoperative BCVA (P = 0.0363, standard regression coefficient = -0.335, overall R(2) = 0.289). CONCLUSIONS: Imaging of PROS length with SD-OCT was found to be a good indicator of BCVA at each time point after surgery and a predictor of postoperative BCVA in patients with idiopathic ERM. The PROS length changes after surgery may indicate surgical injury and restoration of the macular outer layer. FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
[Show abstract][Hide abstract] ABSTRACT: To investigate the clinical and diagnostic findings of a patient with acute hydrops using anterior segment optical coherence tomography (AS-OCT).
The AS-OCT findings of a 43-year-old patient with acute hydrops associated with keratoconus were examined. At the initial examination and during follow-up, evaluation of the anterior segment was performed.
The patient presented with decreased visual acuity, pain, and redness in the right eye. The symptoms, clinical presentation, and topographical findings of the right eye confirmed the diagnosis of acute corneal hydrops. Changes in the stroma and Descemet's membrane during the healing process of acute hydrops could be demonstrated by high-resolution AS-OCT. The use of contact lenses was improved at the last follow-up visit after 8 months and increased visual acuity to 20/20 with correction.
AS-OCT is a useful tool for studying the morphologic features of acute hydrops.
Full-text · Article · Sep 2012 · Case Reports in Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: To evaluate the effectiveness of selective laser trabeculoplasty (SLT) on steroid-induced glaucoma.
The study included 46 eyes of 41 subjects who were followed up for at least 12 months after SLT. The included 10 eyes with steroid-induced glaucoma, 16 eyes with primary open angle glaucoma (POAG), 10 eyes with pseudoexfoliation glaucoma (PEX.G) and 10 eyes with mixed glaucoma (Mixed. G). The range of the SLT laser was 360 degrees. Intraocular pressure (IOP) before and after SLT, and cumulative survival rate after SLT were determined.
Significant decreases in IOP were observed after SLT in the steroid-induced glaucoma group, the POAG group and the PEX.G group. At 12 months after SLT, preoperation IOP decreased by 35.9% (29.9 +/- 7.5 mmHg to 17.9 +/- 2.2 mmHg) in the steroid-induced glaucoma group, 13.2% (20.0 +/- 3.0 mmHg to 17.3 +/- 3.1 mmHg) in the POAG group, 10.7% (21.1 +/- 4.0 mmHg to 18.1 +/- 4.1 mmHg) in the PEX.G group and 6.9% (21.3 +/- 1.9 mmHg to 19.9 +/- 3.4 mmHg) in the Mixed.G group. Cumulative survival rates were 80%, 56.3%, 50.0%, 40.0% in the steroid-induced glaucoma, POAG, PEX.G, and Mixed. G groups, respectively, at 12 months after SLT (Logrank test, p = 0.467).
These data suggest that SLT increased IOP reduction rates for steroid-induced glaucoma more than for any other group.
No preview · Article · Aug 2012 · Nippon Ganka Gakkai zasshi
[Show abstract][Hide abstract] ABSTRACT: We report a case of a sympathetic ophthalmia that occurred after 23-gauge transconjunctival sutureless vitrectomy for a retinal detachment.
A 41-year-old Japanese woman underwent combined phacoemulsification with intraocular lens implantation and 23-gauge transconjunctival sutureless vitrectomy for a rhegmatogenous retinal detachment in the right eye. Endolaser photocoagulation and silicone oil tamponade were used to manage inferior retinal holes. Four weeks after the surgery, she returned with a 5-day history of reduced vision and metamorphopsia in her left eye. Slit-lamp examination showed a shallow anterior chamber in the right eye and moderate anterior uveitis bilaterally. Silicone oil bubbles and pigment dispersion were observed in the subconjunctival space adjacent to the right eye's superonasal sclerotomy site. Fundus examination showed multifocal serous retinal detachments in both eyes. A diagnosis of sympathetic ophthalmia was made and the patient was treated with intensive topical and systemic steroids. The subretinal fluid cleared in both eyes following treatment. Twelve months after the onset of inflammation, the patient's condition was stable on a combination of oral cyclosporine and topical steroids. Sunset glow retinal changes remain, but there has been no evidence of recurrent inflammation.
Sympathetic ophthalmia can develop after 23-gauge transconjunctival sutureless vitrectomy despite its smaller sclerotomy size. We recommend that special care should be taken to inspect for adequate closure of sclerotomy sites at the end of this operation.
Full-text · Article · Nov 2010 · Clinical Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to evaluate the intraocular gas dynamics after 23-gauge transconjunctival sutureless vitrectomy (TSV) as compared with 20-gauge pars plana vitrectomy (PPV).
A consecutive series of 290 eyes that experienced 20-gauge or 23-gauge vitrectomy with 25% sulfur hexafluoride (SF6) gas tamponade were retrospectively reviewed. Intraocular gas bubble size on postoperative Day 1 and Gas50, the interval to dissipate to a 50% gas fill, were evaluated.
The mean intraocular bubble size on postoperative Day 1 was 92.0 ± 8.3% in the 20-gauge PPV cases and 83.8 ± 13.7% in the 23-gauge TSV cases (P < 0.001). The mean Gas50 was 8.6 ± 1.6 days in the 20-gauge PPV cases and 6.6 ± 2.2 days in the 23-gauge TSV cases (P < 0.001). Thorough peripheral vitrectomy and 23-gauge TSV were significantly associated with Gas50 ≤ 4 days (odds ratio, 4.62 and 16.8; P = 0.036 and P = 0.007, respectively). Among thoroughly vitrectomized eyes, 13 eyes treated with 23-gauge PPV with intraoperative suture placement at the sclerotomy sites had gas longevity comparative to those with 20-gauge PPV.
Eyes treated with 23-gauge TSV tend to have earlier gas disappearance or incomplete gas fill. Intraoperative suture placement would be a solution.
No preview · Article · Nov 2010 · Retina (Philadelphia, Pa.)
[Show abstract][Hide abstract] ABSTRACT: To evaluate the long-term effects of photodynamic therapy (PDT) on different phenotypes of age-related macular degeneration (AMD): typical AMD (tAMD) and polypoidal choroidal vasculopathy (PCV).
A multicenter prospective study of 207 eyes of 201 patients (tAMD, 123 eyes; PCV, 84 eyes) treated with PDT. Sex, age, best-corrected visual acuity (BCVA), greatest linear dimension, and lesion type were evaluated for pretreatment factors. PDT frequency, BCVA at 30 months post-PDT, frequency of recurrence, and mean recurrence period were compared as posttreatment outcomes.
The 30 months post-PDT mean BCVA was significantly lower than the pre-PDT value in the tAMD group, but it remained unchanged in the PCV group. There was no difference in PDT frequency between the two groups. Multivariate analysis revealed that lesion type was the only predicting factor significantly associated with BCVA at 30 months post-PDT. The incidence of recurrence before 30 months post-PDT was not significantly different between the tAMD and PCV groups, whereas the mean duration of the PDT effect was significantly longer in the PCV group than in the tAMD group.
PDT may have some advantages for PCV patients, but not for tAMD patients. However, as PCV often recurred 12 months post-PDT, long-term observation after the treatment is crucial.
No preview · Article · Nov 2009 · Japanese Journal of Ophthalmology
[Show abstract][Hide abstract] ABSTRACT: We aimed to evaluate the effects of photodynamic therapy (PDT) on different phenotypes of age-related macular degenerations (AMD): typical AMD (tAMD) and polypoidal choroidal vasculopathy (PCV).
246 eyes from 242 patients (tAMD: 139, PCV: 107 eyes) were recruited. Gender, age, best-corrected visual acuity (BCVA) before treatment, greatest linear dimension before treatment, lesion phenotype and PDT frequency were evaluated for predicting the BCVA at 12 months after PDT using stepwise multiple regression analyses. Additionally, 125 eyes with tAMD and 97 eyes with PCV followed up for more than 12 months after the final PDT were compared for the recurrence period.
In the stepwise analysis, a younger age, better pretreatment BCVA, lower PDT frequency, lesions with PCV and a smaller pretreatment greatest linear dimension were all significantly beneficial for a better BCVA at 12 months after PDT. PCV showed a significantly lower PDT frequency and greater improvement in the BCVA than tAMD. The recurrence period of PCV was significantly later than that of tAMD.
The phenotype of AMD is significantly correlated with its prognosis after PDT. PCV showed a significantly better response to PDT in terms of BCVA improvement and effect durability.
[Show abstract][Hide abstract] ABSTRACT: To evaluate the effects of intravitreal injection of tissue plasminogen activator (tPA) on central retinal vein occlusion(CRVO) associated with diabetic retinopathy (DR).
A retrospective study of 42 eyes of 42 patients(mean age: 68 years, female/male = 20/22, 5 eyes associated with DR) with macular edema caused by CRVO treated with tPA. Best corrected visual acuity (BVCA or logarithm of the minimal angle of resolution: logMAR), macular thickness was mea sured by optical coherence tomography (OCT), and several variables were evaluated.
The mean logMAR and macular thickness improved significantly in the DR (-) group, but, no significant changes were observed in the DR (+) group. Post-operative posterior vitreous detachment (PVD) developed in 62% of the DR (-) group and none of the DR (+) group.
There may be no beneficial effects of intravitreal tPA on CRVO associated with diabetic retinopathy.
No preview · Article · May 2009 · Nippon Ganka Gakkai zasshi
[Show abstract][Hide abstract] ABSTRACT: We studied the suppressant effect of kallidinogenase on retinal vascular permeability and vascular endothelial growth factor (VEGF) in diabetic rats. Diabetes was induced by intravenously injecting streptozotocin (60 mg/kg body weight) dissolved in citrate buffer. Kallidinogenase (7 microg/kg/day) was injected intravenously once daily for 21 days. The retinal vascular permeability was estimated from the amount of fluorescent dye leaking into the retina after administration of fluorescein isothiocyanate-conjugated dextran. VEGF in intraocular fluids was quantified by an enzyme-linked immunosorbent assay. The amounts of nitrite and nitrate in the retina were quantified by a fluorescence method using 2,3-diaminonaphthalene. Retinal vascular permeability in the diabetic control group was about 5.5 times higher than in the normal control group (P<0.001). Kallidinogenase suppressed the increased retinal vascular permeability. In the diabetic control group, the VEGF level was three times that of the normal control group (diabetic control group, 160+/-12 pg/ml; normal control group, 54+/-9 pg/ml; P<0.001). The VEGF concentration in the kallidinogenase-treated group was 120+/-12 pg/ml (P<0.05). In the diabetic control group, the amounts of nitrite and nitrate in the retina were lower by about 2.6-fold, compared with the normal control group (P<0.05). Kallidinogenase almost normalized the decreases in nitrite and nitrate in the retina. The current study showed beneficial effects of kallidinogenase on increased retinal vascular permeability and VEGF in diabetic rats, suggesting that kallidinogenase may be effective for simple retinopathy in patients with diabetes.
No preview · Article · Mar 2009 · European journal of pharmacology
[Show abstract][Hide abstract] ABSTRACT: Background:
We described three cases of macular holes with an epiretinal membrane that developed after triamcinolone-assisted vitrectomy for proliferative diabetic retinopathy (PDR).
In case 1, vitrectomy was performed for vitreous hemorrhage and tractional retinal detachment. In case 2 and 3, vitrectomy was performed for vitreous hemorrhage. Triamcinolone acetonide was used to visualize the vitreous during surgery and the posterior vitreous cortex was completely removed. Macular hole occurred 18, 9, and 1 months after the initial vitrectomy in cases 1, 2, and 3, respectively. In all cases, additional surgery was performed and closure of the macular hole was achieved.
Macular hole with epiretinal membrane occurred after triamcinolone-assisted vitrectomy for PDR in three cases. Hole closure was achieved after additional vitreous surgery. Epiretinal membrane and macular hole might occur even in cases in which the posterior vitreous cortex has been removed completely during triamcinolone-assisted vitrectomy for PDR.
No preview · Article · Jan 2009 · Retinal Cases & Brief Reports
[Show abstract][Hide abstract] ABSTRACT: Purpose: To investigate the efficacy of intravitreal injection of triamcinolone acetonide (TA) for treatment of cystoid foveal edema (CFE) associated with Coats' disease.
Methods and Patient: A 32-year-old man with a 28-month history of Coats' disease received an intravitreal TA injection (4 mg) in the right eye.
Results: Visual acuity improved from 20/200 to 20/50, and foveal thickness decreased from 701 μm to 216 μm 45 days after treatment.
Conclusion: Intravitreal TA injection might temporarily improve visual acuity in eyes with CFE associated with Coats' disease.
No preview · Article · Dec 2008 · Retinal Cases & Brief Reports
[Show abstract][Hide abstract] ABSTRACT: To detect the prognostic factors associated with initial reattachment after primary pars plana vitrectomy (PPV) with gas tamponade for retinal detachment attributable to macular hole (MHRD).
Retrospective, multicenter, interventional case series.
This study included 49 eyes of 48 patients with MHRD in high myopia (axial length more than 28.0 mm). All eyes underwent PPV with gas tamponade. We retrospectively reviewed the medical records and performed univariate analysis to detect the presence of any difference between eyes with a successful initial reattachment and those that failed. We performed multivariate logistic regression analysis to assess the influence of each preoperative factor on initial success.
Success rate of initial reattachment was 69%. Postoperative best-corrected visual acuity (BCVA) of 34 eyes with initial success was significantly better than those of 15 eyes with initial failure (P < .05); preoperative BCVA was not significantly different (P = .43). The axial length of eyes with initial success (29.26 +/- 0.94 mm) was shorter than that of eyes with initial failure (30.04 +/- 1.49 mm) with borderline significance (P = .049). There were no significant differences noted for other factors such as use of ILM peeling (P = .43) or type of tamponade gas (P = .99). Multiple logistic regression analysis using preoperative factors indicated that only axial length was significantly associated with initial success (odds ratio, 0.49; 95% confidence interval, 0.26 to 0.93; P < .05).
Initial reattachment is important for visual prognosis, and axial length is a prognostic factor for initial reattachment after PPV with gas tamponade for MHRD in high myopia.
Full-text · Article · Jun 2008 · American Journal of Ophthalmology