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1.
Background
To determine the cause of angle-closure glaucoma in a case of posterior scleritis.Case
The patient was a 65-year-old woman with unilateral acute angle-closure glaucoma who did not respond to laser iridotomy.Observations
Slit-lamp examination demonstrated a shallow anterior chamber in the left eye. Intraocular pressure was 22?mmHg even after application of two antiglaucoma eye-drop preparations. B-scan ultrasonography demonstrated scleral thickening and choroidal detachment in the left eye. Ultrasound biomicroscopy showed a shallow anterior chamber with angle closure, annular ciliochoroidal effusion with ciliary body edema, and an anterior rotation of the ciliary body. After instillation of cycloplegics, the ciliary body and ciliary processes rotated posteriorly, resulting in the release of the pressure on the iris. These changes led to the opening of the angle and subsequent normalization of intraocular pressure. A diagnosis was made of ciliochoroidal effusion syndrome associated with posterior scleritis.Conclusions
Patients with posterior scleritis can develop ciliochoroidal effusion syndrome, which can lead to angle-closure glaucoma. The therapeutic strategy for acute angle-closure glaucoma induced by ciliochoroidal effusion syndrome differs completely from that for acute angle-closure glaucoma with pupillary block. In the case of ciliochoroidal effusion syndrome, it is important to relieve the compression of the angle by the iris by displacing the lens–iris diaphragm posteriorly by cycloplegics.?Jpn J Ophthalmol 2007;51:49–52 © Japanese Ophthalmological Society 20072.
Takashi Ono Masaharu Iida Toshihiro Sakisaka Keiichiro Minami Kazunori Miyata 《Japanese journal of ophthalmology》2018,62(2):216-220
Purpose
To evaluate the changes in corneal endothelial cell density (ECD) over a 7-year period after laser peripheral iridotomy (LPI) using argon and neodymium-doped yttrium aluminum garnet (Nd:YAG) lasers.Study design
Retrospective case series.Methods
Eyes that underwent prophylactic LPI using argon and Nd:YAG lasers were followed up for 7 years. Central corneal endothelial cells were observed by use of noncontact specular microscopy preoperatively and at 1 and 7 years postoperatively. Changes in ECD and the associations between preoperative ECD and the total energy of the Nd:YAG laser were evaluated.Results
Fifty-one eyes of 51 patients were followed up for 7 years. The ECD significantly decreased after LPI (P < 0.049), and the reduction rate at 1 year after the surgery (1.69 ± 4.80%, 95% CI: 0.34%–3.04%) was significantly higher than the annual reduction rates after 1 year (0.17 ± 0.85%/y, P = 0.036, 95% CI: -0.07% to 0.41%). No association was found between the preoperative ECD and the total laser energy.Conclusions
Long-term evaluation indicated that the reduction in ECD after argon-Nd:YAG laser LPI was present but small during the initial year and was negligible after 1 year.3.
Takahashi N Wakuta M Morishige N Chikama T Nishida T Sumii Y 《Japanese journal of ophthalmology》2007,51(3):185-190
Purpose
Diabetic complications are associated with abnormality of the basement membranes. We have developed a light-scattering detection system (LSDS) specifically for measurement of light scattering at the corneal epithelial basement membrane, and have determined the reproducibility and clinical significance of the results obtained by the LSDS in diabetic patients.Methods
Thirty nondiabetic controls and 40 diabetic subjects participated in the study. Light scattering at the corneal epithelial basement membrane was measured with the LSDS.Results
The measurement of light scattering at the corneal basement membrane was found to be reproducible. The LSDS index (mean ± SD) was 28.1 ± 4.8 in controls, 35.7 ± 6.3 in mild diabetic retinopathy subjects, and 42.7 ± 8.6 in severe diabetic retinopathy subjects. This demonstrated that the LSDS index at the corneal basement membrane is proportional to the extent of diabetic retinopathy.Conclusions
Measurement of light scattering at the corneal epithelial basement membrane is possible with the LSDS, is relatively easy to perform, and is reproducible. The LSDS may prove suitable for the early detection of diabetic ocular complications.?Jpn J Ophthalmol 2007;51:185–190 © Japanese Ophthalmological Society 20074.
Interlamellar Flap Edema Due to Steroid-Induced Ocular Hypertension After Laser In Situ Keratomileusis 总被引：1，自引：0，他引：1
Miyai T Yonemura T Nejima R Otani S Miyata K Amano S 《Japanese journal of ophthalmology》2007,51(3):228-230
Background
Several recent studies have reported post-laser in situ keratomileusis (LASIK) complications related to a steroid-induced increase in intraocular pressure, including interface fluid and elevated intraocular pressure-induced interlamellar stromal keratitis.Cases
We examined two cases of interlamellar flap edema due to steroid-induced ocular hypertension after uneventful laser in situ keratomileusis.Observations
Oral acetazolamide and discontinuance of topical steroids were effective for treating interlamellar stromal edema in both cases.Conclusion
A rise in intraocular pressure should be considered a cause of interlamellar stromal edema after LASIK.?Jpn J Ophthalmol 2007;51:228–230 © Japanese Ophthalmological Society 20075.
Purpose
To investigate the long-term clinical course of acute primary angle closure (APAC) and acute primary angle-closure glaucoma (APACG) in Japanese patients.Methods
We retrospectively reviewed our records of 66 consecutive APAC or APACG eyes observed between February 1992 and December 2003 (mean follow-up, 42.1 months). Immediately after the diagnosis, all patients had received similar medications to halt the acute attack. Subsequently, laser iridotomy or surgical peripheral iridectomy and/or laser iridoplasty were conducted. If intraocular pressure (IOP) control was poor under maximum tolerable ocular hypotensive agents, trabeculectomy with adjunctive mitomycin C (MMC) was undertaken.Results
After laser therapy, the probability of success, defined as an IOP of <21?mmHg with or without medications, was 81.2% ± 6.2%. In the ten eyes that were trabeculectomized, the probability of success based on the same criterion was 40.0% ± 29.7%. Multivariate analysis revealed that the degree of synechial angle closure (P = 0.029) and the preexistence of chronic glaucomatous optic neuropathy (P = 0.015) significantly influenced the need for subsequent filtering surgery.Conclusions
Without the intervention of filtering surgery, 84.6% of eyes with APAC or APACG maintained IOP control with or without antiglaucoma medications. However, APAC and APACG eyes that eventually received trabeculectomy were predisposed to an uncontrollable IOP, even with the intraoperative application of MMC. The severity of APAC or APACG in Japanese may be affected by an underlying creeping angle closure.?Jpn J Ophthalmol 2007;51:353–359 © Japanese Ophthalmological Society 20076.
Nishida T Chikama T Morishige N Yanai R Yamada N Saito J 《Japanese journal of ophthalmology》2007,51(6):442-447
Purpose
The loss of corneal sensation results in the development of persistent corneal epithelial defects. The combination of a substance P-derived peptide, phenylalanine -glycine-leucine-methionine (FGLM)-amide, and insulin-like growth factor 1 (IGF-1) stimulates corneal epithelial migration in vitro and corneal epithelial wound closure in vivo. The clinical efficacy of eye drops containing FGLM-amide and IGF-1 for the treatment of persistent epithelial defects in individuals with neurotrophic keratopathy was examined in a prospective open study.Methods
Eleven patients with persistent corneal epithelial defects associated with neurotrophic keratopathy were treated for up to 28 days by the administration of eye drops containing FGLM-amide and IGF-1. The course of epithelial healing was monitored by slit-lamp examination, and visual acuity was measured before and after treatment.Results
Complete epithelial resurfacing was achieved in eight of the nine (89%) cases of persistent epithelial defects in the nine patients who received the full course of treatment. Epithelial defects had completely resurfaced in two of nine (22%) and five of nine (56%) cases within 1 and 2 weeks, respectively, after treatment initiation. No adverse effects of treatment were observed in any of the 11 patients.Conclusions
Eye drops containing FGLM-amide and IGF-1 induced the rapid resurfacing of persistent epithelial defects in individuals with neurotrophic keratopathy.?Jpn J Ophthalmol 2007;51:442–447 © Japanese Ophthalmological Society 20077.
Chikamoto N Teranishi S Chikama T Nishida T Ohshima K Hatsukawa Y 《Japanese journal of ophthalmology》2007,51(6):453-455
Background
Ehlers-Danlos syndrome (EDS) is a hereditary connective tissue disorder caused by defective collagen synthesis and categorized into 11 types based on genetic mutations and clinical features.1 Its principal clinical characteristics include hyperelasticity and vulnerability of the skin and joints to laxity, and fragility of blood vessels.Case
We recently performed vitreous surgery with introduction of an artificial cornea and corneal allograft transplantation in a boy with EDS type VI, whose visual acuity had decreased rapidly because of vitreous hemorrhage.Observations
An ultrasound examination revealed posterior vitreous detachment with fresh vitreous hemorrhage. After vitrectomy with introduction of an artificial cornea and cornea allograft transplant were carried out, visual acuity improved to 0.05 and was maintained for at least 22 months.Conclusions
Abnormal collagen synthesis is thought to lead to systemic disorders such as hyperelasticity, vulnerability to skin and joint laxity, and fragile blood vessels in patients with Ehlers-Danlos syndrome.?Jpn J Ophthalmol 2007;51:453–455 © Japanese Ophthalmological Society 20078.
Background
A case of acute lymphoblastic leukemia with an initial presentation of unilateral simultaneous conjunctival, uveal, and orbital infiltration is reported.Case
A 9-year-old girl presented with mild proptosis and chemosis and total exudative retinal detachment in the right eye.Observations
B-mode ultrasonography showed diffuse uveal thickening and a retrobulbar mass. Magnetic resonance imaging scans demonstrated a well-circumscribed peribulbar orbital mass. Incisional biopsy from the conjunctiva and bone marrow sampling established the diagnosis of acute lymphoblastic leukemia L1 type.Conclusion
Blast-cell infiltration of three distinct ocular structures simultaneously in the absence of any peripheral signs is an extremely rare initial manifestation of acute lymphoblastic leukemia.?Jpn J Ophthalmol 2007;51:139–141 © Japanese Ophthalmological Society 20079.
Ito K Miura K Sugimoto K Matsunaga K Sasoh M Uji Y 《Japanese journal of ophthalmology》2007,51(1):57-59
Background
We report the use of an indocyanine green (ICG) injection during the safe removal of an overhanging filtering bleb after trabeculectomy.Case
A 63-year-old man with a history of trabeculectomy 5 years previously in his left eye complained of foreign body sensation in this eye and decreased vision from induced astigmatism. Slit-lamp examination revealed an expanding overhanging filtering bleb on the cornea.Observations
With a 30-G needle, 0.25% ICG was injected into the overhanging bleb. Use of ICG visualization of the inner space of the overhanging filtering bleb provided visualization of the border with the original bleb, allowing for safe excision of the overhanging filtering bleb without injury to the thin surface of the original bleb.Conclusion
Injection of ICG into an overhanging filtering bleb during excision can be useful in the prevention of damage to the original bleb.?Jpn J Ophthalmol 2007;51:57–59 © Japanese Ophthalmological Society 200710.
Purpose
To investigate gelatinase [matrix metalloproteinase (MMP)-2 and MMP-9] expression in the tear fluid of patients with recurrent corneal erosion (RCE).Methods
Eleven patients with RCE, three patients with traumatic corneal erosion, and 10 control individuals were enrolled in this study. Tear samples from RCE eyes were obtained once, either at the time of recurrence (onset-phase samples, seven samples), or during the remission period (remission-phase samples, four samples). Tear samples from the nonaffected fellow eyes of the RCE patients were also examined once (fellow-eye samples, ten samples from ten patients). In addition, three samples from three patients with traumatic corneal erosion and ten samples from ten control individuals were obtained as well. Tear samples were collected by a modified Schirmer test I method and analyzed by gelatin zymography.Results
Neither the active form of MMP-2 nor that of MMP-9 was detected in the samples from traumatic corneal erosion patients and control individuals. Both active MMP-2 and active MMP-9 were detected in all seven onset-phase samples. Active MMP-2 and active MMP-9 were detected in three of the four remission-phase samples. Although none of the ten fellow eyes had a history of RCE, active MMP-2 and active MMP-9 were detected in three fellow-eye samples.Conclusions
Gelatinase expression was upregulated in the tear fluid of RCE patients. The presence of gelatinase in the affected eye during the remission phase as well as in the nonaffected fellow eye indicates that gelatinase expression in the tear fluid may be related to the recurrence of corneal erosion.?Jpn J Ophthalmol 2007;51:343–346 © Japanese Ophthalmological Society 200711.
Effect of Berberine on Barrier Function in a Human Retinal Pigment Epithelial Cell Line 总被引：1，自引：0，他引：1
Cui HS Hayasaka S Zhang XY Hayasaka Y Chi ZL Zheng LS 《Japanese journal of ophthalmology》2007,51(1):64-67
Purpose
To examine the effects of berberine, an alkaloid isolated from some medicinal herbs, on the disruption of the barrier function in a human retinal pigment epithelial cell line (ARPE-19) stimulated with interleukin-1β (IL-1β).Methods
ARPE-19 cells were cultured to confluence. Berberine and IL-1β were added to the medium. Barrier functions were evaluated by measuring transepithelial electrical resistance (TER) and the permeability to horseradish peroxidase (HRP) and sodium fluorescein (SF).Results
Berberine dose-dependently inhibited decreased TER and increased the permeability to HRP and SF in the cells stimulated with IL-1β.Conclusions
Berberine dose-dependently inhibited the disruption of the barrier function in the ARPE-19 cell line induced by IL-1β.?Jpn J Ophthalmol 2007;51:64–67 © Japanese Ophthalmological Society 200712.
Visual Acuity Prognosis After Anterior Chamber Air Replacement to Prevent Pseudo-Anterior Chamber Formation After Deep Lamellar Keratoplasty 总被引：1，自引：0，他引：1
Purpose
To investigate the prognosis of patients who received anterior chamber air replacement after deep lamellar keratoplasty (DLKP) during the study period, January 1995 to April 2000.Methods
The records were studied of 47 patients (54 eyes) (60.6 ± 21.3 years of age) who underwent DLKP at Dokkyo University Hospital. Visual acuity and endothelial cell loss were assessed in patients (1) with and without Descemet's membrane perforation; (2) with and without the use of anterior chamber air replacement, and for different durations of air replacement; and (3) in the presence or absence of a pseudo-anterior chamber, and in relation to its duration if present.Results
No significant differences in relation to the above three items were found in endothelial cell loss in study years 1 to 5. Average best visual acuity was 0.61 in perforated eyes, 0.54 in unperforated eyes, 0.54 in eyes that received air replacement, and 0.57 in eyes that did not. The average best visual acuity was 0.38 in eyes with a pseudo-anterior chamber and 0.68 in eyes without one. There was a significant correlation between the duration of the pseudo-anterior chamber and loss of visual acuity.Conclusions
The prolongation of a pseudo-anterior chamber eventually impairs visual acuity, whereas anterior chamber air replacement, used to prevent the development of a pseudo-anterior chamber, causes minimal endothelial cell damage. Anterior chamber air replacement, therefore, is an effective technique by which to prevent the development of a pseudo-anterior chamber.?Jpn J Ophthalmol 2007;51:181–184 © Japanese Ophthalmological Society 200713.
Purpose
To review the surgical results and complications of trabeculectomy techniques in patients with advanced glaucoma and threatened fixation.Methods
Trabeculectomy had been carried out on 49 advanced glaucoma patients (49 eyes) using mitomycin C and postoperative laser suture lysis. The clinical records prior to and 2 months after surgery were reviewed, and the long-term surgical outcomes were determined.Results
Two months after surgery there were no eyes with fixation loss. Intraocular pressure (IOP) levels were reduced from 22.8 ± 6.0 to 11.7 ± 4.7?mmHg. Kaplan-Meier survival analysis showed that the success rate in achieving IOPs of 15?mmHg or lower 5 years after surgery was 70%. The chance of visual acuity remaining within two lines of the preoperative level was 75%. In 29 of the 49 eyes, visual acuities remained at their preoperative level at the time of the final visit, but had decreased to less than 0.1 in three eyes (cataract progression, n = 2; fixation loss, n = 1).Conclusion
The results suggest that laser suture lysis and stepwise management of IOP levels, which are performed as part of the modern postoperative management of trabeculectomy, decrease the frequency of fixation loss during the early postsurgical phase.?Jpn J Ophthalmol 2007;51:116–120 © Japanese Ophthalmological Society 200714.
Kursat Atalay Ahmet Kirgiz Kubra Serefoglu Cabuk Havva Erdogan Kaldirim 《International ophthalmology》2017,37(4):905-910
Purpose
To investigate the presence of corneal alterations in the long term among patients with primary open-angle glaucoma (POAG) after a single session of selective laser trabeculoplasty (SLT) treatment.Materials and methods
The files of the POAG patients who had been treated with SLT were evaluated retrospectively. The Pretreatment Scheimpflug corneal topographic (SCT) findings were then compared with the post-treatment findings.Results
The files of 33 patients were eligible. The changes in central corneal thickness, thinnest point of cornea, and posterior corneal asphericity at 5 and 8 mm were statistically significant (p = 0.03, 0.01, 0.02, and 0.04 respectively). On the other hand, the simulated K, anterior 3 mm K, anterior 5 mm K, posterior 3 mm K, posterior 5 mm K, anterior asphericity at 3 mm, posterior asphericity at 3 mm, and Zernike values did not change significantly following the treatment (p = 0.19, 0.08, 0.1, 0.3, 0.2, 0.75, 0.09, and 0.3 respectively).Conclusion
SLT can slightly alter pretreatment SCT findings in 3–6 months. Clinicians should wait for at least 6 months after SLT before performing any subsequent surgeries that depend on corneal parameters.15.
Purpose
To evaluate the contribution of stem cell factor (SCF) to the pathogenesis of vernal keratoconjunctivitis (VKC), we determined levels of soluble SCF in the tear fluid of VKC patients.Methods
Samples of tear fluid were obtained from 38 VKC patients and 13 normal controls after we received informed consent from each participant. In the 38 VKC patients, disease severity was mild in 13, moderate in 17, and severe in 8. The levels of soluble SCF in tear fluid were determined by enzyme immunoassay.Results
Mean ± SD SCF levels in tears were 90.3 ± 23.4?pg/ml in patients with mild VKC, 225.3 ± 101.2?pg/ml in those with moderate VKC, and 872.0 ± 313.2?pg/ml in those with severe VKC, and 68.3 ± 15.3?pg/ml in healthy controls. The increase in SCF levels in patients with moderate or severe VKC was statistically significant compared with the level in healthy controls.Conclusion
Soluble SCF may make a crucial contribution to the pathogenesis of VKC.?Jpn J Ophthalmol 2007;51:474–476 © Japanese Ophthalmological Society 200716.
Hiroko Bissen-Miyajima Manabu Hirasawa Kunihiko Nakamura Yuka Ota Keiichiro Minami 《Japanese journal of ophthalmology》2018,62(2):226-230
Purpose
To assess the safety and efficacy of femtosecond laser-assisted cataract surgery (FLACS) in Japanese eyes.Study design
Retrospective case series.Methods
The clinical records of 529 consecutive eyes of 312 Japanese patients who underwent FLACS from 2013 to 2016 were reviewed. The completion rates of anterior capsulotomy and corneal incisions using the femtosecond laser (LenSx, Alcon) and the number of attempts to achieve secure docking between the cornea and laser system were recorded. The uncorrected and corrected distance visual acuities (VAs) and uncorrected and distance-corrected near VAs 1 week postoperatively were evaluated.Results
Anterior capsulotomies were completed in 98.7% of eyes. The corneal incisions were incomplete in 8.3%, which included eyes with arcus senilis and neovascularization. The mean corneal endothelial cell reduction rate was 5.5%. Multiple docking attempts were required in 22.9% of eyes, while canthotomy was performed in two eyes. The postoperative VAs were favorable.Conclusion
FLACS was safe and reliable in Japanese eyes. Further improvements in docking are required to accommodate small corneas and narrow palpebral spaces.17.
Purpose
To investigate the feasibility of the procedure and the modifications of the corneal curvature and profile obtained with a novel technique of stromal-lentoid implantation in ex vivo human corneas.Design
Experimental ex vivo study in human corneas.Materials and methods
Twelve stromal lentoids were produced by means of hyperopic femtosecond lenticule extraction (FLEx) with the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) with a refractive power of +8.00 D and optical zone of 6.0 (six lenticules) and 5.0 mm (six lenticules), respectively. The posterior surface of these stromal lentoids presented a higher curvature with respect to the anterior surface and, therefore, the thinnest point is located at the center of the lenticule, gradually thickening towards the periphery. Another 12 corneas underwent femtosecond laser intrastromal pocket creation at a depth of 115 microns, for lenticule insertion. After intrastromal lenticule implantation the changes of corneal profiles were evaluated by means of corneal topography and anterior segment optical coherence tomography (OCT).Results
The implantations of intrastromal lenticules were successful in all cases with proper distention and centration. A mid-peripheral forward shift of the anterior corneal surface along with a thickening (greater in periphery) was induced. There was a significant flattening of anterior corneal central areas of 7.31 ± 1.52 D (p = 0.002). Diameters of the flattening area were found to be consistently correlated with the optical zone diameter of the implanted lenticules (p = 0.006). Central flattening was similar in both groups. OCT pachymetry maps showed an increase of corneal thickness consistently correlated with implanted lentoid thickness and diameter.Conclusion
The implantation of modified hyperopic-shaped intra-corneal stromal lentoid is a feasible and reproducible technique for achieving central corneal flattening while increasing thickness. Whether this procedure may be beneficial in the treatment of refractive errors or ectatic corneal disorders such as keratoconus merits further study.18.
Yamamoto Y Fukushima A Nishino K Koura Y Komatsu T Ueno H 《Japanese journal of ophthalmology》2007,51(1):60-63
Background
We present the clinical case reports of elderly Vogt-Koyanagi-Harada (VKH) disease patients, including the oldest patient at onset to date.Cases
Four patients with VKH disease, whose ages at onset were 68 to 89 years, were treated at Kochi Medical School Hospital between December 2002 and September 2004.Observations
Four elderly patients were diagnosed with VKH disease according to the International Revised Diagnostic Criteria for VKH disease. Two were treated with corticosteroid pulse therapy, but the other two could not tolerate high-dose steroid therapy and were treated with only topical corticosteroids. All had recurrences, which were treated effectively. None of these patients experienced recurrence after sunset glow fundus was observed in the follow-up period.Conclusions
VKH disease is thought to be more common in younger people, but it is not as uncommon in elderly people as is generally believed. Among elderly VKH disease patients, some cannot tolerate high-dose corticosteroid therapy, so we need to treat these patients with only topical corticosteroids.?Jpn J Ophthalmol 2007;51:60–63 © Japanese Ophthalmological Society 200719.
Purpose
To determine whether single-nucleotide polymorphisms (SNPs) within the transforming growth factor-β1 (TGF-β1) gene are associated with high myopia in Japanese. Previous studies have indicated that the gene expression products, regulators of the TGF-β1 gene, are involved in high myopia.Methods
Genomic DNA samples were obtained from 330 Japanese patients with high myopia and 330 Japanese controls without high myopia who were chosen at random. SNPs were genotyped by the TaqMan system, using primer extension and polymerase chain reaction amplification.Results
Ten SNPs were identified in the high-myopia patients and controls, with four of the ten SNPs having nonsynonymous changes. However, no statistical differences in the SNPs were detected between the high-myopia cases and the controls.Conclusions
Sequence variants of the TGF-β1 gene were not associated significantly with high myopia, and further studies are needed to identify which genes are responsible for high myopia.?Jpn J Ophthalmol 2007;51:96–99 © Japanese Ophthalmological Society 200720.
Nitta T Kase M Shinmei Y Yoshida K Chin S Ohno S 《Japanese journal of ophthalmology》2007,51(3):224-227