研究者紹介システム
| 中村 誠 |  |
| ナカムラ マコト | |
| 大学院医学研究科 医科学専攻 | |
| 教授 | |
| 医学 |
研究活動
研究分野
受賞
2011年05月 財団法人日本眼科学会, 日本眼科学会評議員会賞, 第115会日本眼科学会総会評議員会指名講演「緑内障性視神経症への挑戦．その基礎と臨床における三つの仮説の提唱
2007年04月 ロート製薬株式会社, 第12回ロート賞, 網膜内インスリン情報伝達と神経変性眼疾患との関わり
2005年09月 公益信託 須田緑内障治療研究奨励基金, 第18回須田学術奨励賞, Akt is activated via insulin / IGF-1 receptor in rat retina with episcleral vein cauterization. Brain Res 1022: 195-204, 2004
2003年03月 財団法人上原記念生命科学財団, 上原記念生命科学研究奨励, 糖尿病の実験的緑内障眼に及ぼす影響
1997年10月 日本神経眼科学会, 第９回日本神経眼科学会若手奨励賞, Evaluation of bilateral undefined optic neuropathy based on mitochondrial genetics. Neuro-opthalmology 16: 91-97, 1996
論文
This study investigated aniseikonia after reduced-fluence photodynamic therapy (RFPDT) for central serous chorioretinopathy (CSC). We examined 48 eyes of 48 patients (38 men; mean age, 49.2 ± 9.9 years) with CSC resolved after RFPDT. Horizontal and vertical aniseikonia were measured using the New Aniseikonia Test at baseline, 6 months, and 12 months after RFPDT. The maximum absolute value of the horizontal and vertical measurements indicated the aniseikonia score. The aniseikonia score was 2.2 ± 2.3 at 6 months and 2.2 ± 2.0 at 12 months after RFPDT, both of which improved significantly from the baseline score of 4.1 ± 2.9 (P < 0.05 and P < 0.01, respectively). The 12-month aniseikonia score significantly correlated with the baseline aniseikonia score (P = 0.047), outer nuclear thickness at baseline (P = 0.027) and 12 months after RFPDT (P = 0.014), baseline SRD area (P = 0.005), and ellipsoid zone disruption at 12 months after RFPDT (P = 0.021). In multivariate analysis, baseline serous retinal detachment (SRD) area (P = 0.034) was significantly associated with aniseikonia score at 12 months after RFPDT. Eyes with a larger SRD area might have higher aniseikonia scores even after SRD resolution following RFPDT.
2023年10月10日, Scientific reports, 13 (1), 17133 - 17133, 英語, 国際誌研究論文（学術雑誌）
PURPOSE: The impact of various preoperative glaucoma medications on Schlemm's canal surgery outcomes remains unclear. This study aimed to investigate the impact of preoperative glaucoma medications on the postoperative 1-year outcomes of μTLO. METHODS: We analyzed the medical records of 218 patients who underwent their first μTLO to investigate the 1-year postoperative outcomes. Cox proportional hazard regression analysis was performed with surgical failure as the dependent variable and each type of preoperative medication as the independent variable. We also compared the 1-year outcomes of μTLO between users and non-users of specific medications using propensity score matching. Surgical success was defined as a postoperative intraocular pressure ranging from 5 to 21 mmHg, a ≥20% reduction in IOP from baseline, and no additional glaucoma surgery within 1 year postoperatively. RESULTS: The Cox proportional hazard analysis showed that all drugs that do not increase the conventional outflow exhibited hazard ratios greater than 1.0, and the preoperative use of β-blockers and oral CAI was a significant surgical risk factor (hazard ratio: 2.65 and 2.45, p = 0.04 and <0.001). In the propensity score matching analysis, success rates at 1 year postoperatively were 55/85, 54/79, 60/73, and 40/76% for users/non-users of β-blockers, topical CAIs, an alpha-2 adrenergic agonist, and an oral CAI, respectively. Kaplan-Meier survival curves in these comparisons also demonstrated that preoperative β-blockers and oral CAI use were significant surgical risks (p = 0.01, <0.001). CONCLUSION: Our study suggests that preoperative medications that do not involve conventional pathway outflow have a detrimental effect on subsequent Schlemm's canal surgery outcomes.
2023年09月12日, Acta ophthalmologica, 英語, 国際誌研究論文（学術雑誌）
- 日本緑内障学会, 2023年09月, 日本緑内障学会抄録集, 34回, 160 - 160, 日本語線維柱帯切開術(眼内法)術後早期に施行された線維柱帯切除術の術後1年成績
PURPOSE: We have previously demonstrated that prolonged use of glaucoma medications was associated with a poor surgical outcome of ab interno trabeculotomy (µTLO). Given that almost all types of glaucoma eye drop either enhance the drainage through the uveoscleral pathway or reduce aqueous humor production, we hypothesized that prolonged use of these medications might cause disuse atrophy of the conventional pathway. In contrast, ripasudil increases the conventional outflow and eventually shows a favorable outcome of µTLO. This study aimed to evaluate the effect of ripasudil use on µTLO outcomes. METHOD: The medical charts of 218 patients who underwent µTLO were analyzed retrospectively. We compared the 1-year outcome between ripasudil users versus nonusers by using propensity score matching. We set the covariates as age, sex, glaucoma types, preoperative intraocular pressure (IOP), the mean deviation values of visual field tests, the presence or absence of concomitant cataract surgery, trabecular meshwork incision range, the presence or absence of any glaucoma medication except ripasudil and duration of glaucoma medical therapy. Success was defined as a postoperative IOP between 5 and 21 mmHg, a ≥ 20% IOP reduction from baseline, and no additional glaucoma surgery at postoperative 1 year. RESULT: Fifty-seven patients each were allocated to the ripasudil users or nonusers. The 1-year success rates were 74% in ripasudil users and 51% in nonusers (p = 0.01). Kaplan‒Meier survival curves also showed that the ripasudil users had a higher survival distribution (p = 0.01). CONCLUSION: The patients who took ripasudil showed a favorable 1-year outcome of µTLO.
2023年09月, Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 261 (9), 2603 - 2610, 英語, 国際誌研究論文（学術雑誌）
PURPOSE: To evaluate the reproducibility of the imo binocular random single-eye test (BRSET) and Humphrey Field Analyzer (HFA) monocular test in patients with glaucoma. STUDY DESIGN: Retrospective observational study. METHODS: We measured the visual fields (VF) of patients with glaucoma using the BRSET and HFA. All tests were repeated two months later. Mean sensitivity (MS), mean deviation (MD), sensitivity at each test location, and reliability indices were compared between the test days. Wilcoxon signed-rank test, interclass correlation coefficient (ICC), correlation coefficients, and Bland-Altman plots were generated for analysis. RESULTS: We analyzed the VFs of 46 patients with glaucoma. There were no test-retest differences for MS and MD, and ICCs were > 0.9 for MS and MD in both perimeters. Inter-test correlations for MS and MD were high. The limits of agreement (LoAs) (lower, upper limit) between test days for MS were (- 3.4, 4.0) for BRSET and (-3.3, 3.0) for HFA. The LoA for MD was (- 3.3, 3.8) for BRSET and (- 3.2, 2.9) for HFA. Sensitivity at each testing location was more variable between testing days for BRSET than for HFA. For reliability indices, LoAs between testing days were wider for BRSET than for HFA. CONCLUSION: The imo BRSET showed similar reproducibility to HFA in MS and MD. However, sensitivity at each test location varied more for BRSET than for HFA. Further studies are needed to verify the reproducibility of the imo BRSET.
2023年09月, Japanese journal of ophthalmology, 67 (5), 578 - 589, 英語, 国内誌研究論文（学術雑誌）
To evaluate the functional and anatomical effects of switching to faricimab for patients with neovascular age-related macular degeneration (nAMD) refractory to intravitreal aflibercept, this retrospective study evaluated patients with nAMD who received intravitreal injections of aflibercept (IVA) every <8 weeks and were switched to faricimab. After switching, the patients were treated with a treatment and extended regimen that started with the interval just before switching and received at least three injections. We evaluated changes in the best-corrected visual acuity (BCVA), central retinal thickness (CRT), central choroidal thickness (CCT), treatment interval, and presence of retinal fluid. Overall, 55 eyes from 55 patients were examined. After three injections of faricimab, the BCVA and CCT did not change significantly. However, the CRT decreased significantly (p < 0.05), the injection interval was significantly extended (7.5 ± 2.3 vs. 5.9 ± 1.5 weeks, p < 0.01), and the rates of the presence of intraretinal fluid and subretinal fluid decreased significantly to 16.4% and 40% of eyes, respectively (both p < 0.01). An ocular adverse event (retinal pigment epithelium tear) developed in one eye. Switching to faricimab was effective for anatomic changes. It may be an additional treatment option for some eyes refractory to IVA.
2023年08月06日, Journal of clinical medicine, 12 (15), 英語, 国際誌研究論文（学術雑誌）
To report the usefulness of intraoperative real-time adjustment of intraocular lens (IOL) tilt during the intrascleral fixation with intraoperative optical coherence tomography (iOCT) as a clinical evaluation and investigate the factors contributing to IOL tilt using iOCT as an experimental evaluation. Retrospective cohort study and experimental research. As a clinical evaluation, the medical records of 43 eyes of 41 patients who underwent intrascleral IOL fixation combined with real-time iOCT observation were retrospectively reviewed. As an experimental evaluation, in order to investigate the factors contributing to IOL tilt, the four experiments were performed using iOCT. The mean IOL tilt angle (°) at the end of surgery and 3 months after surgery were 1.81 ± 1.15 and 2.10 ± 1.66, respectively (p = 0.46). No apparent intra- or postoperative complications occurred during the follow-up period. The experimental evaluation indicated that the IOL tilt was influenced by the insertion angle of the haptic in the vertical direction. The mean IOL tilt angle (°) was 1.94 ± 0.09, 4.67 ± 0.11, 8.90 ± 0.11, and 15.78 ± 0.85 when the insertion angle of the haptic was 0°, 10°, 27.5°, and 45° in the vertical direction, respectively (p < 0.01). Clinical and experimental IOL tilt assessment using iOCT is interactively useful for better quality surgery and better postoperative outcome.
2023年07月26日, Scientific reports, 13 (1), 12065 - 12065, 英語, 国際誌研究論文（学術雑誌）
Patients with asymmetric glaucomatous optic neuropathy (GON) present a relative afferent pupillary defect (RAPD) in the eye with more advanced damage. Although useful, pupillometric RAPD quantification is not widely used as it is not portable. Whether asymmetry of the peripapillary capillary perfusion density (CPD) detected using optical coherence tomography angiography correlates with the severity of RAPD remains unknown. This study assessed RAPD in 81 patients with GON using Hitomiru, a novel hand-held infrared binocular pupillometer. The correlation and ability to detect clinical RAPD based on the swinging flash light test of two independent RAPD parameters (the maximum pupil constriction ratio and the constriction maintenance capacity ratio) were assessed. The coefficient of determination (R2) was calculated between each of the two RAPD parameters and asymmetry of the circumpapillary retinal nerve fiber layer thickness (cpRNFLT), ganglion cell layer/inner plexiform layer thickness (GCL/IPLT), and CPD. The two RAPD parameters showed a correlation coefficient of 0.86 and areas under the receiver operating characteristic (ROC) curve of 0.85-0.88, with R2 being 0.63-0.67 for the visual field, 0.35-0.45 for cpRNFLT, 0.45-0.49 for GCL/IPLT, and 0.53-0.59 for CPD asymmetry. Hitomiru has high discriminatory performance in detecting RAPD in patients with asymmetric GON. CPD asymmetry may better correlate with RAPD than cpRNFLT and GCL/IPLT asymmetry.
2023年06月08日, Journal of clinical medicine, 12 (12), 英語, 国際誌研究論文（学術雑誌）
The appropriate surgical technique to improve the closure rate of perioperative full-thickness macular hole (FTMH) secondary to submacular hemorrhage (SMH) with sub-internal limiting membrane (ILM) hemorrhage caused by retinal arterial macroaneurysm (RAM) rupture remains an unsolved clinical problem. Several ILM transplantation techniques have been attempted, but these are challenging. Our new technique can remove sub-ILM hemorrhage with the central fovea ILM intact, without peeling the ILM. The medical records of three eyes from three patients with SMH and sub-ILM hemorrhage secondary to RAM rupture were retrospectively reviewed. During the surgery, a small ILM fissure was made outside the central fovea with ILM forceps, and sub-ILM hemorrhage was washed out through it by manually spraying balanced salt solution. Sub-ILM hemorrhage removal was achieved successfully in all eyes, with no occurrences of FTMH or other complications. Best-corrected decimal visual acuity improved from 0.05 (Snellen equivalent (SE), 20/400), 0.05 (SE, 20/400), and 0.05 (SE, 20/400) preoperatively to 0.3 (SE, 20/63), 0.4 (SE, 20/50), and 0.15 (SE, 20/125) at 3 months postoperatively, respectively. This new technique may help keep the foveal ILM intact and prevent perioperative FTMH formation.
2023年05月05日, Journal of clinical medicine, 12 (9), 英語, 国際誌研究論文（学術雑誌）
PURPOSE: The aim of this study is to explore the clinical features and associated factors of intraocular inflammation (IOI) following intravitreal brolucizumab (IVBr) administration for neovascular age-related macular degeneration (nAMD). METHODS: This retrospective study included 87 eyes from 87 Japanese patients with nAMD who were followed up for 5 months after the initial administration of IVBr as switching therapy. Clinical pictures of IOI post-IVBr and changes in best corrected visual acuity (BCVA) at 5 months were evaluated between eyes with and without IOI (non-IOI). The association between IOI and baseline factors (age, sex, BCVA, hypertension, and/or arteriosclerotic changes in the fundus, subretinal hyperreflective material [SHRM], and macular atrophy) was evaluated. RESULTS: Of the 87 eyes, 18 (20.6%) developed IOI and 2 (2.3%) developed retinal artery occlusion. There were 9 (50%) cases of posterior or pan-uveitis among eyes with IOI. The mean interval from initial IVBr administration to IOI was 2 months. The mean changes in logMAR BCVA at 5 months were significantly worse in IOI eyes than in non-IOI eyes (0.09 ± 0.22 vs. - 0.01 ± 0.15, P = 0.03). There were 8 (44.4%) and 7 (10.1%) cases of macular atrophy and 11 (61.1%) and 13 (18.8%) cases of SHRM in the IOI and non-IOI groups, respectively. SHRM and macular atrophy were significantly associated with IOI (P = 0.0008 and P = 0.002, respectively). CONCLUSION: In IVBr therapy for nAMD, eyes with SHRM and/or macular atrophy should be observed more meticulously, given the increased risk of developing IOI, which is associated with insufficient BCVA gain.
2023年03月27日, Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 261 (8), 2359 - 2366, 英語, 国際誌研究論文（学術雑誌）
Background and Objectives: Faricimab is a novel bispecific antibody with Fab regions inhibiting both vascular endothelial growth factor-A and angiopoietin-2. Therefore, this study aimed to obtain short-term outcomes of intravitreal injection of faricimab (IVF) for the treatment of diabetic macular edema (DME) in daily clinical practice. Materials and Methods: A retrospective review was carried out on consecutive patients with DME who had been treated with IVF and were followed up for at least 1 month. Outcome measures included changes in logMAR best-corrected visual acuity (logMAR BCVA), central retinal thickness (CRT), number of IVF administrations, and safety. Clinical outcomes were also compared between the treatment-naïve and switch groups. Results: A total of 21 consecutive DME eyes from 19 patients were identified. The mean number of IVFs was 1.6 ± 0.8 during the mean follow-up time of 5.5 months. The overall mean logMAR BCVA following IVF was 0.236, 0.204, 0.190, and 0.224 at baseline, 1, 3, and 6 months, respectively, without a significant change from baseline to 1 month (p = 0.176) or for 6 months (p = 0.923). The overall mean CRT (μm) following IVF was 400.6, 346.6, 342.1, and 327.5 at baseline, 1, 3, and 6 months, respectively. CRT significantly decreased from baseline to 1 month (p = 0.001) but did not reach a significant level over 6 months following IVF (p = 0.070). No significant difference in BCVA or CRT was observed between the treatment-naïve and switch groups. No serious safety concerns were noted. Conclusions: IVF for the treatment of DME may preserve visual acuity and improve macular thickness without serious safety concerns in the short term in a real-world clinical setting.
2023年03月27日, Medicina (Kaunas, Lithuania), 59 (4), 英語, 国際誌研究論文（学術雑誌）
- (公財)日本眼科学会, 2023年03月, 日本眼科学会雑誌, 127 (臨増), 218 - 218, 日本語マイクロフックトラベクロトミー(μTLO)の1年後成績への術前緑内障点眼の影響
- (公財)日本眼科学会, 2023年03月, 日本眼科学会雑誌, 127 (臨増), 246 - 246, 日本語甲状腺眼症に対するステロイドパルス療法とミニパルス療法の合併症
We are pleased to bring you the 5th edition of the Glaucoma Clinical Practice Guidelines. Clinical practice guidelines are based on evidence (scientific grounds). It is a document that presents the treatment that is the most appropriate for the patient. "Glaucoma Clinical Guidelines" was first published in 2003. This was the first guideline for glaucoma treatment in Japan. The principle of glaucoma treatment is to lower intraocular pressure. Means for lowering intraocular pressure includes drugs, lasers, and surgery; Glaucoma is a disease that should be considered as a complex syndrome rather than a single condition. Therefore, the actual medical treatment is not as simple as one word. This time we set the Clinical Questionnaire with a focus on glaucoma treatment. We hope that you will take advantage of the 5th edition.
2023年03月, Japanese journal of ophthalmology, 67 (2), 189 - 254, 英語, 国内誌[査読有り][招待有り]
研究論文（学術雑誌）
PURPOSE: To compare the two-year outcome of half-time photodynamic therapy (htPDT) in chronic central serous chorioretinopathy (cCSC) with and without choroidal neovascularization (CNV). METHODS: In this retrospective study, we included 88 eyes of 88 patients with cCSC who underwent htPDT and were followed up for more than 24 months. Patients were divided into two groups with (21 eyes) or without (67 eyes) CNV before htPDT treatment. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness (SCT), and the presence of subretinal fluid (SRF) were evaluated at baseline and at 1, 3, 6, 12, and 24 months after PDT. RESULTS: A significant intergroup difference was noted in terms of age (P = 0.038). Significant improvements in the BCVA and SCT were found at all time points in eyes without CNV but only at 24 months in eyes with CNV. CRT was significantly reduced in both groups at all time points. No significant intergroup differences were noted in terms of BCVA, SCT and CRT at all time points. There were significant differences in the rate of recurrent and persistent SRF between groups (22.4% (without CNV) vs. 52.4% (with CNV), P = 0.013, and 26.9% (without CNV) vs. 57.1% (with CNV), P = 0.017, respectively). The presence of CNV was significantly associated with the recurrence and persistence of SRF after initial PDT (P = 0.007 and 0.028, respectively). Logistic regression analyses showed that the baseline BCVA, and not the presence of CNV, was significantly associated with BCVA at 24 months after initial PDT (P < 0.01). CONCLUSIONS: A htPDT for cCSC was less effective in eyes with CNV than in those without CNV regarding the recurrence and persistence of SRF. Additional treatment might be required in eyes with CNV during 24-month follow-up periods.
2023年, PloS one, 18 (5), e0284979, 英語, 国際誌研究論文（学術雑誌）
- (公社)日本眼科手術学会, 2022年12月, 眼科手術, 36 (臨増), 172 - 172, 日本語Heads-Up Surgeryにおける無彩色映像下での内境界膜の視認性
PURPOSE: To report the usefulness of a new surgical method using intraoperative optical coherence tomography that can more accurately place the buckling material for scleral buckling using a noncontact wide-angle viewing system with a cannula-based chandelier endoilluminator for the treatment of rhegmatogenous retinal detachment. METHODS: The medical records of 12 eyes of 11 patients with rhegmatogenous retinal detachment treated with scleral buckling combined with real-time intraoperative optical coherence tomography observation were retrospectively reviewed. RESULTS: Real-time observations of the positional relationship between the protrusion of buckling material and retinal breaks with intraoperative optical coherence tomography revealed that retinal breaks were not properly placed on the protrusion of the buckling material in five eyes, requiring the intraoperative repositioning of the buckling material. Eventually, the scleral buckling combined with real-time intraoperative optical coherence tomography observation yielded the initial anatomical success rates of 100% without noteworthy intraoperative or postoperative complications. CONCLUSION: This procedure is a novel approach that enables safer and more accurate placement of the buckling material and may contribute to improving the outcomes of scleral buckling in the future.
2022年12月01日, Retina (Philadelphia, Pa.), 42 (12), 2395 - 2400, 英語, 国際誌研究論文（学術雑誌）
PURPOSE: The purpose of this retrospective study was to determine the extent to which the use of antithrombotic drugs during glaucoma surgery contributes to surgical failure and postsurgical hemorrhagic complications. METHODS: Glaucoma surgeries were categorized into three groups: trabeculotomy (TLO), trabeculectomy (TLE), and long-Tube shunt surgery (Tube). At 1 year after surgery, the following criteria for surgical success were met: intraocular pressure (IOP) in the 5-21-mmHg range, IOP reduction of at least 20% from the preoperative level, and no additional glaucoma surgeries. We compared the percentages of the success rates and hemorrhagic complications between antithrombotic medication experiencers and non-experiencers. Furthermore, we adjusted the preoperative factors between the two groups using a propensity score analysis in TLO and TLE surgeries. RESULTS: A total of 910 glaucoma surgeries were included, with TLO, TLE, and Tube accounting for 353, 444, and 113 surgeries, respectively. Preoperative antithrombotic medications were administered to 149 patients in all glaucoma surgeries: 37 patients used only anticoagulants, 102 used only antiplatelets, and 10 used both. There was no significant difference in the success rates of any of the procedures. The hemorrhagic complications (hyphema and vitreous hemorrhage rate) were significantly higher in the patients who underwent TLE and Tube. The surgical success rates of TLO and TLE were not significantly different after the two groups were matched by propensity score. CONCLUSION: The perioperative use of antithrombotic drugs did not affect success for any of the procedures. However, it increased early postoperative hemorrhagic complications for TLE and Tube.
2022年11月, Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 260 (11), 3607 - 3615, 英語, 国際誌研究論文（学術雑誌）
- 眼科臨床紀要会, 2022年11月, 眼科臨床紀要, 15 (11), 762 - 763, 日本語黄斑下出血に対する組織プラスミノーゲン活性化因子併用硝子体内ガス注入の治療成績
- 日本神経眼科学会, 2022年10月, 神経眼科, 39 (増補1), 92 - 92, 日本語
- 眼科臨床紀要会, 2022年10月, 眼科臨床紀要, 15 (10), 688 - 688, 日本語ブロルシズマブ硝子体内注射後の眼内炎症の頻度と特徴
- 日本緑内障学会, 2022年09月, 日本緑内障学会抄録集, 33回, 101 - 101, 日本語線維柱帯切除術後の早期濾過胞機能不全に対するマイトマイシンC併用濾過胞再建術の術後3年成績
- 日本緑内障学会, 2022年09月, 日本緑内障学会抄録集, 33回, 146 - 146, 日本語当院で経験した虹彩分離症5症例の臨床的特徴
- 日本緑内障学会, 2022年09月, 日本緑内障学会抄録集, 33回, 154 - 154, 日本語マイクロフックトラベクロトミー(μTLO)の術成績に対する術前リパスジル点眼投与の影響
PURPOSE: This study examined the perioperative factors affecting surgical success in ab interno microhook trabeculotomy (μTLO). METHODS: A total of 146 consecutive patients who underwent μTLO were included in this retrospective study. We performed Cox proportional hazard modelling by setting surgical success at 1 year as an objective variable. The explanatory variables included age, sex, glaucoma type, preoperative intraocular pressure (IOP), glaucoma drug score, mean deviation (MD) of the Humphrey visual field test, duration of glaucoma drug use, antithrombotic drug use, combined cataract surgery, incision range and diabetes mellitus. Additionally, we performed 1:1 matching using propensity score analysis and compared the perioperative parameters between durations of glaucoma drug use of <4.5 years and ≥ 4.5 years (50 patients each). We defined surgical success as satisfaction of all three criteria: IOP 5-21 mmHg, IOP reduction of ≥20% from the preoperative IOP and no additional glaucoma surgery. RESULTS: The Cox proportional hazard model revealed that a longer duration of anti-glaucoma medication was significantly associated with surgical failure. Propensity score matching analysis showed that the <4.5-year users of anti-glaucoma drugs had significantly higher success rates than the ≥4.5-year users (72% versus 52%; p = 0.04). CONCLUSIONS: The prolonged use of multiple glaucoma drugs adversely affected the outcome of μTLO at least at 1 year postoperatively.
2022年09月, Acta ophthalmologica, 100 (6), e1209-e1215, 英語, 国際誌研究論文（学術雑誌）
PURPOSE: To compare the ability of imo binocular random single-eye test (BRSET) to detect visual field (VF) defects due to chiasmal and postchiasmal lesions (C/PCLs) with a Humphrey Field Analyzer (HFA) monocular test. STUDY DESIGN: Prospective multicenter study METHODS: This study enrolled 40 patients with C/PCLs and measured their VFs using both imo BRSET and HFA monocular test. The VFs were classified into three groups using the cluster criterion: 1) bitemporal group, 2) homonymous group, and 3) others. The agreement and correlation of VF results between imo and HFA were analyzed using the Bland-Altman plot and Spearman correlation coefficient. RESULTS: The VFs of 34 patients were analyzed and classified. There were 13 patients in the bitemporal, 6 in the homonymous, and 15 in the others group. BRSET showed a significantly shorter test duration than HFA. The imo systematically yielded a lower sensitivity than HFA. The average sensitivity at each test location correlated well between the perimeters in all groups, with the correlation coefficients ranging from 0.89 to 0.98. Bland-Altman plots showed wider limits of agreement in the affected quadrants compared to the unaffected quadrants in the bitemporal and homonymous groups. The fixation loss rate did not differ between the perimeters, but there were significant differences in the false positive and false negative rates between perimeters. CONCLUSION: BRSET detected VF defects due to C/PCLs as accurately as the HFA monocular test with a shorter test duration.
2022年09月, Japanese journal of ophthalmology, 66 (5), 413 - 424, 英語, 国内誌研究論文（学術雑誌）
PURPOSE: To identify susceptibility genes for macular neovascularization (MNV) development in central serous chorioretinopathy (CSC). DESIGN: Genome-wide survival analysis using a longitudinal cohort study. PARTICIPANTS: We included 402 and 137 patients with CSC but without MNV at their first visit from the Kyoto CSC Cohort and Kobe CSC dataset, respectively. All patients underwent detailed ophthalmologic examinations, including multimodal imaging, such as fundus autofluorescence, spectral-domain optical coherence tomography, and fluorescein angiography/indocyanine green angiography and/or optimal coherence tomography angiography. METHODS: We conducted a genome-wide survival analysis using the Kyoto CSC Cohort. We applied the Cox proportional hazard model to adjust for age, sex, and the first principal component. Single nucleotide polymorphisms (SNPs) with P-values <1.0×10-5 were carried forward to the replication in the Kobe CSC dataset. Moreover, we evaluated the contribution of previously-reported age-related macular degeneration (AMD) susceptibility loci. We used FUMA and ToppFun for the functional enrichment analysis. MAIN OUTCOME MEASURES: The association between SNPs and MNV development in patients with CSC. RESULTS: Rs370974631 near ARMS2 displayed a genome-wide significant association in the meta-analysis of discovery and replication result (hazard ratio [HR]meta = 3.63; Pmeta = 5.76×10-9). Among previously-reported AMD susceptibility loci, we additionally identified CFH rs800292 (HR = 0.39, P = 2.55×10-4), COL4A3 rs4276018 (HR = 0.26, P = 1.56×10-3), and B3GALTL rs9564692 (HR = 0.56, P = 8.30×10-3) as susceptibility loci for MNV development in CSC. The functional enrichment analysis revealed significant enrichment of eight pathways (GO:0051561, GO:0036444, GO:0008282, GO:1990246, GO:0015272, GO:0030955, GO:0031420, and GO:0005242) related to ion transport. CONCLUSIONS: ARMS2, CFH, COL4A3, and B3GALTL were identified as susceptibility genes for MNV development in CSC. The aforementioned four genes are known as susceptibility genes for AMD, whereas COL4A3 and B3GALTL were previously reported to be polypoidal choroidal vasculopathy (PCV)-specific susceptibility genes. Our findings revealed the shared genetic susceptibility between PCV and MNV secondary to CSC.
2022年09月, Ophthalmology, 129 (9), 1034 - 1042, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 眼科臨床紀要会, 2022年06月, 眼科臨床紀要, 15 (6), 418 - 418, 日本語ラニビズマブの硝子体内注射による未熟児網膜症の治療効果
PURPOSE: To describe angiographic features of a case of delayed-onset retinal vascular occlusion and intraocular inflammation (IOI) following brolucizumab intravitreal injection (IVI). OBSERVATIONS: A 75-year-old woman with advanced age-related macular degeneration (AMD) complained of persistent distorted vision despite 1 aflibercept 2-mg IVI and subsequent 1 brolucizumab 6-mg IVI. At 20 days after brolucizumab IVI, clinical examination showed no signs of IOI, her right best-corrected visual acuity (BCVA) was 1.0 (Snellen equivalent, 20/20). Simultaneous fluorescein and indocyanine green angiography (FA/IA) performed 2 days later showed no abnormalities, but she noticed floaters and decreased vision in her right eye 5-6 hours after FA/IA. At 44 days after brolucizumab IVI, her right BCVA was 0.6 (Snellen equivalent, 20/33), and clinical examination revealed mutton-fat keratic precipitates, anterior chamber cells (2+), vitreous cells, vitreous haze (1+), and sheathed retinal vessels. FA showed filling defect and vascular staining/leakage at several retinal arteries and dye leakage from optic disc edge, where IA demonstrated dye staining as well. However, there was a retinal artery occlusion site which lacks angiographic signs indicative of active retinal vasculitis. The patient was diagnosed with retinal vascular occlusion and IOI which occurred approximately 3 weeks after brolucizumab IVI. CONCLUSIONS AND IMPORTANCE: Delayed brolucizumab-associated retinal vascular occlusion and IOI can develop from a condition in which no apparent abnormal findings exist on FA/IA. Together with the fact that angiographic signs observed in this case were not severe enough to induce retinal artery occlusion, potent and prolonged vascular endothelial growth factor inhibition by brolucizumab IVI might have caused severe damage to retinal vascular endothelial cells. Then, the damage subsequently led to retinal vascular occlusions and enhanced immune reaction to brolucizumab. The latter would be enhanced through the migration of immune cells towards vitreous cavity being allowed by disrupted inner blood retinal barrier.
2022年06月, American journal of ophthalmology case reports, 26, 101521 - 101521, 英語, 国際誌- 【どう診る?視野異常】神経眼科疾患と視野
神経眼科疾患における視野障害は、障害部位によって特徴的な視野のパターンを呈する。本稿では、視路を視神経、視交叉、視索、視放線以降に分けて、部位別に視野障害の特徴を概説する。特徴的な視野障害をおさえれば、原因疾患の局在診断、早期発見、治療につなげることができ、日常診療において非常に有用である。(著者抄録)
(株)全日本病院出版会, 2022年05月, OCULISTA, (110), 43 - 48, 日本語 - (公財)日本眼科学会, 2022年03月, 日本眼科学会雑誌, 126 (臨増), 172 - 172, 日本語緑内障患者におけるアイモ両眼ランダム測定の再現性の検討
- (公財)日本眼科学会, 2022年03月, 日本眼科学会雑誌, 126 (臨増), 213 - 213, 日本語加齢黄斑変性に対するブロルシズマブ投与後の眼内炎症の臨床像と関連事前因子の検討
- (公財)日本眼科学会, 2022年03月, 日本眼科学会雑誌, 126 (臨増), 274 - 274, 日本語脈絡膜新生血管の有無による慢性中心性脈絡網膜症患者における治療成績
- (公財)日本眼科学会, 2022年03月, 日本眼科学会雑誌, 126 (臨増), 276 - 276, 日本語滲出型加齢黄斑変性に対するブロルシズマブへの切り替え効果についての検討
PURPOSE: We compared the 1-year outcomes and early surgery-related complications between 1-quadrant and 2-quadrant microhook ab interno trabeculotomy (TLO). METHODS: Medical chart extraction was performed on 47 consecutive patients with 1-quadrant incision and 37 consecutive patients with 2-quadrant incision of trabecular meshwork. Logistic regression analysis was conducted to calculate the propensity score to create a 1:1 match for a comparative analysis of 1-year postoperative success. Success was defined as postoperative intraocular pressure (IOP) between 5-21 mmHg, >20% IOP reduction from baseline, and no additional glaucoma surgery. Outcome-related covariates were age, glaucoma type, mean deviation of visual field tests, preoperative IOP, the number of preoperative glaucoma eye drops and the presence of combined cataract surgery. Thirty eyes from each group were compared. RESULTS: The median preoperative IOP was not different between the 1-quadrant and 2-quadrant groups (28.5 mmHg, quartile range 23-33.5 versus 27 mmHg, 23.3-30.0, p = 0.47). There was no difference in median postoperative IOP at 1 year (15 mmHg versus 16 mmHg, p = 0.80). The success rate was 73% in the 1-quadrant group versus 70% in the 2-quadrant group (p = 1.00). The 2-quadrant group had a significantly higher proportion of patients with transiently elevated IOP (47%) than the 1-quadrant (17%; Fisher's exact test, p = 0.02). There was no difference of hyphema formation (Fisher's exact test, p = 0.18). CONCLUSION: The 1-year success rate was not significantly different between 1- and 2-quadrant incisions of microhook TLO. However, the 2-quadrant TLO showed significantly higher proportion of post-surgical transient IOP elevation.
2021年12月, Acta ophthalmologica, 99 (8), 898 - 903, 英語, 国際誌研究論文（学術雑誌）
PURPOSE: The purpose of this study was to evaluate the 3-year surgical outcome of the sulcus fixation of Baerveldt glaucoma implant (BGI), focusing on corneal damage. METHODS: This prospective observational study included 37 patients who underwent a median of two previous glaucoma surgeries and sulcus fixation of BGI for the first time. Each patient's intraocular pressure (IOP), glaucoma drug score, corneal endothelial cell density (ECD), and logMAR-converted best-corrected visual acuity (VA) were measured preoperatively and postoperatively until 36 months after surgery. Complete success was defined as reduced IOP (5-21 mmHg and >20% rate), without corneal damage (postoperative development of decompensation, unmeasurable ECD, or reduction in ECD of >20%), without loss of light perception, and without additional surgery requirement. Qualified success was defined by excluding the corneal criteria from complete success. RESULTS: A total of 51% (19/37) patients experienced complete treatment success, whereas 86% (32/37) had qualified success. The median IOP (glaucoma drug score) decreased from 26 mmHg (5) to 15 mmHg (2) at three years postoperatively. The median postoperative ECD (reduction rate) decreased from 1838 cells/cm2 preoperatively to 1587 cells/mm2 (14%) at one year, 1358 cells/mm2 (26%) at two years, and 1228 cells/mm2 (33%) at three years postoperatively. One month after surgery, the VA was significantly reduced from preoperative values but did not decline after that. CONCLUSION: Sulcus fixation of BGI was effective for IOP reduction. However, ECD decreased over time.
2021年12月, Acta ophthalmologica, 99 (8), e1435-e1441, 英語, 国際誌研究論文（学術雑誌）
Peripherin-2 (PRPH2) is one of the causative genes of inherited retinal dystrophy. While the gene is relatively common in Caucasians, reports from Asian ethnicities are limited. In the present study, we report 40 Japanese patients from 30 families with PRPH2-associated retinal dystrophy. We identified 17 distinct pathogenic or likely pathogenic variants using next-generation sequencing. Variants p.R142W and p.V200E were relatively common in the cohort. The age of onset was generally in the 40's; however, some patients had earlier onset (age: 5 years). Visual acuity of the patients ranged from hand motion to 1.5 (Snellen equivalent 20/13). The patients showed variable phenotypes such as retinitis pigmentosa, cone-rod dystrophy, and macular dystrophy. Additionally, intrafamilial phenotypic variability was observed. Choroidal neovascularization was observed in three eyes of two patients with retinitis pigmentosa. The results demonstrate the genotypic and phenotypic variations of the disease in the Asian cohort.
2021年11月18日, Genes, 12 (11), 英語, 国際誌研究論文（学術雑誌）
PURPOSE: Cytomegalovirus (CMV)-related keratouveitis elevates intraocular pressure (IOP). Antiviral therapy does not always control IOP and some patients do not tolerate systemic antiviral therapy because of the side effects. The purpose of this study is to evaluate the clinical characteristics of patients with CMV-related keratouveitis and determine the impact of glaucoma surgeries on the postoperative antiviral therapy regimen. METHODS: We enrolled twenty-two patients with CMV-DNA-positive keratouveitis between June 2012 and July 2019 in Kobe University Hospital. The following clinical parameters were collected: gender, age, history of previous intraocular surgery, antiviral medications, visual acuity, IOP, glaucoma drug score, corneal endothelial cells density, and the mean deviation of a Humphrey visual field test at the first visit and before and 1 year after glaucoma surgery. RESULTS: All twenty-two patients started on oral and/or topical antiviral therapy. Eighteen patients needed glaucoma surgery despite their antiviral medications. Nine patients underwent trabeculotomy (TLO) and nine underwent trabeculectomy (TLE) as the first surgical intervention. Six of patients who initially underwent TLO and two of the patients who initially underwent TLE required additional TLE within 1 year. Each of the 15 patients who underwent at least 1 TLE showed a reduction in the magnitude and variation of IOP and glaucoma drug scores and 13 patients were able to discontinue antiviral therapy. For the remaining 4 patients, IOP and inflammation were controlled but with antiviral medications. CONCLUSIONS: In patients with CMV-related keratouveitis, TLE decreases and stabilizes IOP and contributes to withdrawal from antiviral medications.
2021年11月08日, BMC ophthalmology, 21 (1), 389 - 389, 英語, 国際誌研究論文（学術雑誌）
- 日本神経眼科学会, 2021年11月, 神経眼科, 38 (増補1), 72 - 72, 日本語
- 日本神経眼科学会, 2021年11月, 神経眼科, 38 (増補1), 87 - 87, 日本語
- 眼科臨床紀要会, 2021年11月, 眼科臨床紀要, 14 (11), 757 - 757, 日本語黄斑部毛細血管拡張に伴う嚢胞様黄斑浮腫に嚢胞様腔内壁切開術が奏効した1例
- 眼科臨床紀要会, 2021年11月, 眼科臨床紀要, 14 (11), 758 - 759, 日本語中心性漿液性脈絡網膜症患者における半量エネルギー光線力学的療法後低コントラスト視力
INTRODUCTION: Leber hereditary optic neuropathy (LHON) is an acute or subacute inherited optic neuropathy caused by mitochondrial mutations. More than 90% of patients with LHON have one of three point mutations (ie, G3460A, G11778A and T14484C). We previously reported that a 12-week session of skin electrical stimulation (SES) with a 2-week interval significantly improved visual acuity and field tests 1 week after the last stimulation and without adverse effects in 10 cases of LHON carrying the mt DNA G11778A mutation. In the present study, we will examine the magnitude and persistence of the efficacy and presence or absence of adverse events using SES with a more frequent stimulation protocol. METHODS AND ANALYSIS: This study will be a single-arm, open-labelled, non-randomised clinical study that analyses 15 cases of LHON with G11778A mutation. All participants will take a portable SES device home and perform SES by themselves every other day for 12 weeks. The logarithm for the minimum angle of resolution (logMAR) best-corrected visual acuity (BCVA) at 1 week after the last SES will be measured as the primary outcome. LogMAR BCVA will be measured at four and 8 weeks after the last SES treatment. The Humphrey visual field sensitivity test using size V stimulation and critical fusion frequency at 1, 4 and 8 weeks after the last SES session will be secondary outcome measurements. Slit-lamp examination, optical coherence tomography and specular microscopy will also be performed to verify the safety of SES. ETHICS AND DISSEMINATION: The protocol was approved by the Institutional Review Board at Kobe University, Japan (Approval No.C190030). This study is in progress and deserves Pre-result. All documents communicating with the ethics committee will be reposited by the researcher. Modifications to the protocol will be reviewed by the ethics committee and implemented after approval. Data monitoring will be performed by a researcher who is not involved in the study every 6 months after approval. The research summary results will be registered in the Japan Registry of Clinical Trials (jRCTs) and made available to participants in accordance with the terms described in the documents. In addition, the results of this study will be presented at domestic and international meetings and published in peer-reviewed journals within a year after data is fixed. TRIAL REGISTRATION NUMBER: jRCTs052200033.
2021年10月19日, BMJ open, 11 (10), e048814, 英語, 国際誌研究論文（学術雑誌）
- 眼科臨床紀要会, 2021年10月, 眼科臨床紀要, 14 (10), 684 - 685, 日本語裂孔原性網膜剥離に対する硝子体手術後の歪視量に寄与する周術期因子の検討
- 眼科臨床紀要会, 2021年10月, 眼科臨床紀要, 14 (10), 690 - 691, 日本語標準治療からの逸脱が糖尿病黄斑浮腫の治療効果に及ぼす影響
- (一社)日本神経免疫学会, 2021年10月, 神経免疫学, 26 (1), 132 - 132, 日本語抗MOG抗体関連疾患における画像上のくすぶり病変の意義
- (一社)日本神経免疫学会, 2021年10月, 神経免疫学, 26 (1), 132 - 132, 日本語抗MOG抗体関連疾患における画像上のくすぶり病変の意義
- 日本緑内障学会, 2021年09月, 日本緑内障学会抄録集, 32回, 136 - 136, 日本語ロングチューブシャント術後の被膜除去術の短期成績
- (一社)日本糖尿病合併症学会, 2021年09月, 糖尿病合併症, 35 (Suppl.1), 252 - 252, 日本語糖尿病黄斑浮腫におけるen face slab OCT imagingと長期視力予後
- (一社)日本神経学会, 2021年09月, 臨床神経学, 61 (Suppl.), S259 - S259, 日本語抗MOG抗体関連疾患におけるくすぶり病変は疾患活動性を反映する
- 眼科臨床紀要会, 2021年07月, 眼科臨床紀要, 14 (7), 452 - 452, 日本語視神経挫滅後のアクアポリン9ノックアウトマウスにおける網膜神経節細胞の機能低下と乳酸輸送障害の関係
目的:アイモ両眼ランダム測定の緑内障診療における有用性を検討すること.対象と方法:神戸大学附属病院眼科に通院中の緑内障患者のうち,20歳以上70歳未満,Humphrey視野計(HFA)30-2で視野障害がより進行しているほうの眼のmean deviation(MD)が-15dB以上-6dB以下の者を対象とした.同日にアイモ30-2両眼ランダム測定とHFA 30-2で測定し,2ヵ月後に再検査した.両眼ランダム測定が施行できた数を算出し,2回目のアイモとHFAの検査時間,平均感度(MS),MD,pattern standard deviation(PSD),visual field index(VFI),中心窩閾値を比較した.検査後にアンケート調査を行った.結果:登録した67例中7例で両眼ランダム測定ができなかった.アイモ両眼ランダム測定はHFAの総検査時間より25%短かった.MSと中心窩閾値は両眼ともアイモのほうが有意に小さく,MDは左眼のみHFAのほうが小さかった.PSDは両者に差はなく,VFIは右眼のみHFAのほうが大きかった.アイモとHFAのMS,MD,PSD,VFIはすべて高い相関を認めた.アンケートでアイモでの検査を希望する者は89%であった.結論:アイモ両眼ランダム測定とHFAの結果は強く相関するが,機械特性による結果の差異を認めた.アイモは検査時間が短く患者の満足度も高い一方,両眼ランダム測定ができない例も一定数存在する.(著者抄録)
(公財)日本眼科学会, 2021年05月, 日本眼科学会雑誌, 125 (5), 530 - 538, 日本語PURPOSE: To evaluate the short-term change in choroidal structure following adalimumab (ADA) treatment in refractory noninfectious uveitis. METHODS: This was a retrospective study of 33 eyes from 18 patients with refractory noninfectious uveitis. Subfoveal choroidal thickness (SFCT), the choroidal stromal index (CSI) defined as the proportion of stromal area to the total choroidal area were used as choroidal imaging parameters and were evaluated by enhanced depth imaging optical coherence tomography (EDI-OCT). The change in these parameters in the 2 months following initiation of ADA was analysed. A linear mixed-effect model was used to assess the effect of ADA treatment. RESULTS: The causes of uveitis were Vogt-Koyanagi-Harada disease (VKHD) (42.4%), presumed autoimmune retinopathy (15.2%), others (12.1%) and unclassified (30.3%). In the analysis of all eyes, the SFCT was 309.7 ± 113.1 μm at baseline, 295.7 ± 114.5 μm at 1 month and 275.2 ± 98.8 μm at 2 months after ADA initiation (P < 0.001). The CSI was 0.275 ± 0.050 at baseline, 0.273 ± 0.068 at 1 month and 0.273 ± 0.046 at 2 months (P = 0.785). In the subgroup analysis, the SFCT decreased significantly from baseline to 2 months in VKHD eyes (P = 0.007) and unclassified eyes (P = 0.034). There was no significant change in CSI in either subgroup. CONCLUSIONS: In the assessment of short-term response to ADA treatment in uveitic eyes, using EDI-OCT, the SFCT appears to be more effective as a choroidal imaging biomarker than the CSI, especially in VKHD eyes.
2021年05月, Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 259 (5), 1273 - 1280, 英語, 国際誌研究論文（学術雑誌）
To demonstrate the long-term effect of cystotomy with or without fibrinogen clot removal for treatment-resistant cystoid macular edema (CME) secondary to branch retinal vein occlusion (BRVO). Retrospective clinical study. We retrospectively analyzed medical records of 22 eyes of 22 patients with treatment-resistant CME secondary to BRVO with 12 months observation after cystotomy with or without fibrinogen clot removal. Patients included 11 women and 11 men. The mean ± SD age was 72.7 ± 10.2 years. LogMAR-converted best corrected visual acuity (BCVA) was statistically better at 12 months after surgery (0.30 ± 0.30) than preoperative BCVA (0.39 ± 0.27) (p = 0.01). The central sensitivity of microperimetry (dB) was maintained during follow-up (preoperative sensitivity: 25.4 ± 4.1, postoperative sensitivity at 12 months after the surgery: 25.9 ± 4.2, p = 0.69). Twelve months after surgery, there was a significant improvement in the central retinal thickness (CRT) on optical coherence tomography (OCT) (303.7 ± 80.1) (μm) compared with the preoperative CRT (524.2 ± 114.8) (p < 0.01). In 12 months, CME recurred in 3 of 22 eyes. The preoperative reflectivity in cystoid cavity on OCT was significantly higher in patients with fibrinogen clot removal (n = 5) than in patients without fibrinogen clot removal (n = 17) (p < 0.01). For treatment-resistant CME secondary to BRVO, Cystotomy with or without fibrinogen clot removal may be one of the treatment options.
2021年04月19日, Scientific reports, 11 (1), 8460 - 8460, 英語, 国際誌研究論文（学術雑誌）
Specific postoperative complications, such as tube exposure and conjunctival erosion, have occurred despite the favorable surgical outcomes of tube shunt surgeries for refractory glaucoma. The new autologous scleral pocket technique is performed by inserting the tube into the vitreous cavity without using a donor scleral patch. The purpose of this study was to evaluate the surgical results of Ahmed glaucoma valve (AGV) implantation using this technique for neovascular glaucoma (NVG), which is one of the representative refractory types of glaucoma. This observational retrospective case series included 15 consecutive eyes of 15 patients with NVG who had undergone AGV implantation at Kobe University between January 2018 and December 2019. The mean preoperative intraocular pressure (IOP) was 37.2 ± 13.8 mmHg and the glaucoma drug score was 4.2 ± 2.2. The mean IOP and glaucoma drug score at 1 year postoperatively decreased to 15.0 ± 4.6 mmHg and 1.3 ± 2.0, respectively (p < 0.001). No significant change in the corneal endothelial cell density following surgery was observed (p = 0.09); however, one patient required an additional trabeculectomy at 7 months postoperatively. No cases of tube exposure or conjunctival erosion were observed at 1 year postoperatively. These results indicated the effectiveness and safety of this technique in patients with NVG.
2021年04月10日, Journal of clinical medicine, 10 (8), 英語, 国際誌研究論文（学術雑誌）
This retrospective study was conducted to investigate the clinical factors associated with low-contrast visual acuity after reduced-fluence photodynamic therapy (RFPDT) in patients with resolved central serous chorioretinopathy (CSC) and good baseline visual acuity. A total of 45 eyes of 45 patients with resolved CSC at post-RFPDT and best-corrected visual acuity of >1.0 (logarithm of the minimal angle of resolution [logMAR], 0) at baseline were examined. Visual acuities of both eyes were measured at four contrast levels (100%, 25%, 12%, and 6%) at post-RFPDT. The low-contrast visual acuity (6%, 12%, and 25%) was significantly lower than the 100% contrast visual acuity in the affected eyes. Visual acuities of affected eyes were significantly worse than those of fellow eyes at any contrast levels. The degree of changes in 6% and 100% contrast visual acuities was significantly greater in affected eyes than that in fellow eyes (p < 0.05). The 6% contrast visual acuities in affected eyes at post-RFPDT were significantly associated with the symptom duration (p < 0.05). Patients with a long duration of symptoms might have disturbed low-contrast visual acuities at post-RFPDT even if their baseline visual acuities were good.
2021年03月28日, Pharmaceuticals (Basel, Switzerland), 14 (4), 英語, 国際誌研究論文（学術雑誌）
Multidrug resistance protein 4 (MRP4) is an energy-dependent membrane transporter responsible for cellular efflux of a broad range of xenobiotics and physiological substrates. In this trial, we aimed to investigate the coeffects of aging and MRP4 deficiency using gene expression microarray and morphological and electrophysiological analyses of mouse retinas. Mrp4-knockout (null) mice and wild-type (WT) mice were reared in the same conditions to 8-12 weeks (young) or 45-55 weeks (aged). Microarray analysis identified 186 differently expressed genes from the retinas of aged Mrp4-null mice as compared to aged WT mice, and subsequent gene ontology and KEGG pathway analyses showed that differently expressed genes were related to lens, eye development, vision and transcellular barrier functions that are involved in metabolic pathways or viral infection pathways. No significant change in thickness was observed for each retinal layer among young/aged WT mice and young/aged Mrp4-null mice. Moreover, immunohistochemical analyses of retinal cell type did not exhibit an overt change in the cellular morphology or distribution among the four age/genotype groups, and the electroretinogram responses showed no significant differences in the amplitude or the latency between aged WT mice and aged Mrp4-null mice. Aging would be an insufficient stress to cause some damage to the retina in the presence of MRP4 deficiency.
2021年03月15日, Antioxidants (Basel, Switzerland), 10 (3), 英語, 国際誌研究論文（学術雑誌）
- (公財)日本眼科学会, 2021年03月, 日本眼科学会雑誌, 125 (臨増), 237 - 237, 日本語マイクロフックトラベクロトミーの緑内障点眼歴による術後成績の比較
- (公財)日本眼科学会, 2021年03月, 日本眼科学会雑誌, 125 (臨増), 240 - 240, 日本語傾向スコア解析による血栓予防薬の有無に対する緑内障手術の術成功と出血合併症頻度
PURPOSE: To report the case of a patient with cystoid macular edema (CME) secondary to idiopathic macular telangiectasia (MacTel) type 1, which was successfully treated by cystotomy and en bloc removal of the fibrinogen-rich component of the cystoid lesion. PATIENTS: A 80-year-old man was referred to our department because of a visual defect in his right eye. His best corrected decimal visual acuity (BCVA) was 0.7 (Snellen equivalent [SE], 20/30). METHODS: A fundus examination revealed clustered temporal juxafoveal microaneurysms and foveal CME. The patient refused to undergo conventional treatments, including direct retinal photocoagulation for microaneurysms, intravitreal anti-vascular endothelial growth factor injection, and intravitreal triamcinolone injection. However, he provided consent to undergo cystotomy and en bloc removal of the fibrinogen-rich component of the cystoid lesion. RESULTS: His BCVA was 0.2 (SE, 20/100) just before the surgery. A 27-gauge vitrectomy with internal limiting membrane peeling was performed. Cystotomy was performed during the surgery, and the fibrinogen clot visible in the cystoid cavity was also removed. CME rapidly disappeared after the surgery. Three years postoperatively, the patient had BCVA of 0.5 (SE, 20/40) at the last medical examination, and the CME had not recurred. CONCLUSION: Cystotomy and en bloc removal of the fibrinogen-rich component of the cystoid lesion could be valid treatment options for CME secondary to MacTel type 1.
2021年01月04日, Retinal cases & brief reports, Publish Ahead of Print, 英語, 国際誌研究論文（学術雑誌）
We report a rare case of granulomatosis with polyangiitis (GPA) presenting with bilateral orbital apex syndrome (OAS). A 73-year-old woman with a history of endoscopic sinus surgery for ethmoidal sinusitis experienced a sudden decrease in visual acuity (VA) of both eyes. At the initial examination, her VA had decreased to 0.01 in the right eye and 0.03 in the left eye, and eye movement in both eyes was mildly limited in all directions. Visual field tests of both eyes showed a large central scotoma. Laboratory tests revealed an elevation of myeloperoxidase-anti-neutrophil cytoplasmic antibody. Facial computed tomography demonstrated a thickened mucosal membrane in the entire ethmoidal sinus, and the posterosuperior walls of Onodi cells filled with infiltrative lesions had thinned. Orbital magnetic resonance imaging showed severe inflammation in the orbital apex. From these clinical findings, the patient was diagnosed with GPA presenting with OAS associated with ethmoid sinusitis. Emergent endoscopic sinus surgery was performed for biopsy and debridement of the ethmoidal and sphenoid sinusitis to decompress the optic nerve. One day after endoscopic sinus surgery, the patient's VA and visual field were improved, and steroid pulse therapy was commenced postoperatively. Four days later, VA had recovered to 1.0 in both eyes, and eye movement and visual field had were improved. Although OAS is a rare manifestation, early surgical treatment should be considered when the orbital lesion presents as risk of rapid deterioration of visual function in patients with GPA.
2021年, Case reports in ophthalmology, 12 (1), 32 - 40, 英語, 国際誌PURPOSE: To investigate clinical factors contributing to metamorphopsia after 27-gauge pars plana vitrectomy (27GPPV) for primary rhegmatogenous retinal detachment (RRD) to reveal whether the proximity of the preoperative retinal detachment to the fovea is associated with postoperative metamorphopsia. METHODS: We retrospectively reviewed medical records of 77 eyes of 77 patients after 27GPPV for RRD. Patients were subdivided into three groups using optical coherence tomography findings: Group A, patients with RRD outside the vascular arcade; Group B, patients whose condition was present within the vascular arcade, but without foveal detachment; and Group C, patients with foveal detachment. RESULTS: The average metamorphopsia score (°) assessed with M-charts 12 months after surgery was 0.01 ± 0.04 in Group A (24 eyes), 0.08 ± 0.18 in Group B (20 eyes), and 0.49 ± 0.48 in Group C (33 eyes) (p<0.001). Logistic regression analysis revealed that metamorphopsia at 12 months after surgery significantly correlated with the proximity of the retinal detachment to the fovea (p = 0.007). CONCLUSION: Metamorphopsia after 27GPPV for RRD correlated with the proximity of the preoperative retinal detachment to the fovea. Attention should be paid to the possibility of postoperative metamorphopsia development when retinal detachment is present within a vascular arcade even if the fovea is not involved.
2021年, PloS one, 16 (10), e0258775, 英語, 国際誌研究論文（学術雑誌）
PURPOSE: To evaluate the efficacy and safety of intravenous "freeze-dried sulfonated human normal immunoglobulin (GGS)" in patients with steroid-resistant optic neuritis (ON). STUDY DESIGN: Multicenter, prospective, double-blind, parallel-group, randomized controlled trial. METHODS: Patients with steroid-resistant acute ON were randomly assigned to receive either intravenous GGS (GGS group) or intravenous methylprednisolone (steroid pulse [SP] group). Visual acuity (logarithm of the minimum angle of resolution [logMAR]), mean deviation (MD) value of the Humphrey Field Analyzer, and critical flicker fusion frequency were measured as efficacy endpoints; adverse events (AEs) were assessed as the safety endpoint. RESULTS: Thirty-two patients (16 patients/group) received the study drugs. The primary endpoint, change in logMAR at week 2 compared to baseline, showed no statistically significant intergroup difference. However, compared with the SP group, change in the GGS group was increasingly indicative of visual improvement, with least squares mean difference of > 0.3 logMAR. On post-hoc analyses, the percentage of patients in the GGS and SP groups with improvement by ≥ 0.3 logMAR at week 2 were 75.0% and 31.3%, respectively. Changes in MD values at week 2 compared to baseline were 9.258 ± 8.296 (mean ± standard deviation) dB and 3.175 ± 6.167 dB in the GGS and SP groups, respectively. These results showed statistically significant intergroup differences (visual acuity improvement, P = 0.032; change in MD values, P = 0.030). No clinically significant AEs were observed. CONCLUSION: Our results suggest that intravenous immunoglobulin could be a safe and efficacious therapeutic option for prompt treatment of steroid-resistant acute ON. TRIAL REGISTRATION: JapicCTI-132080.
2021年01月, Japanese journal of ophthalmology, 65 (1), 122 - 132, 英語, 国内誌研究論文（学術雑誌）
This multicenter retrospective study was conducted to evaluate the 1-year treatment outcome of photodynamic therapy (PDT) combined with anti-vascular endothelial growth factor (VEGF) therapy for pachychoroid neovasculopathy (PNV). A total of 42 eyes of 42 patients with treatment-naïve PNV who were treated with PDT combined with intravitreal injections of an anti-VEGF agent (ranibizumab or aflibercept) for 1 year. All eyes showed exudative and/or hemorrhagic changes that affected the fovea at baseline. After the initial combination therapy, subfoveal choroidal thickness (SCT) and central retinal thickness (CRT) were significantly reduced and were maintained as such for 12 months (P < 0.01 in SCT and CRT). The best-corrected visual acuity (BCVA) (0.19 ± 0.30 at baseline) significantly improved at 3 months (0.15 ± 0.29, P < 0.05) and further improved at 12 months (0.10 ± 0.30, P < 0.01) when compared to that at baseline. After the initial combination therapy, 32 eyes (76.2%) required no additional treatments for 12 months. The mean number of additional PDT and intravitreal injections of anti-VEGF agents was 0.1 ± 0.3 and 0.9 ± 1.9, respectively. Of the 42 eyes included in this study, 22 eyes (52.4%) had polypoidal lesions at baseline. No significant differences in SCT, CRT, or BCVA were observed at any time points between eyes with and without polypoidal lesions. Of 20 eyes without polypoidal lesions, only 1 eye (5.0%) needed additional treatments. PNV, especially without polypoidal lesions, can be treated effectively with PDT combined with anti-VEGF therapy with few sessions.
2021年, PloS one, 16 (3), e0248760, 英語, 国際誌研究論文（学術雑誌）
The present study aimed to identify the factors regulating aspiration rate (AR) of backflush needles and to compare those factors across various backflush needles from different manufacturers. The 27-gauge (27G), 25-gauge, and 23-gauge backflush needles from four different manufacturers, Alcon, MedOne, VitreQ, and DORC, were used for this experiment. AR was measured at four different aspiration vacuum levels: 100, 200, 400, and 650 mmHg. AR was significantly increased as the aspiration vacuum level increased when both aspirating balanced salt solution (BSS) and ethylene glycol; however, 27G products from VitreQ and MedOne were unable to aspirate ethylene glycol at the low aspiration vacuum level of 100 mmHg. When aspirating BSS at the high aspiration vacuum level of 650 mmHg, a smaller gauge number generally resulted in a significantly higher AR. AR, inner diameter, and cross-sectional area in Alcon products were significantly larger in any gauge, and the shaft length of Alcon products was significantly shorter than those of other manufacturers' products in any gauge. Cross-sectional area negatively correlated with the degree of shaft deflection (r2 = 0.21, p = 0.042). These results imply that AR differs significantly among backflush needles and among companies depending on the shaft cross-sectional area.
2020年12月08日, Scientific reports, 10 (1), 21452 - 21452, 英語, 国際誌研究論文（学術雑誌）
- (公社)日本視能訓練士協会, 2020年12月, 日本視能訓練士協会誌, 49, 246 - 246, 日本語
PURPOSE: To show surgical results of the intraoperative three-dimensional fluorescein angiography (3D-FA)-guided pars plana vitrectomy (PPV) for branch retinal vein occlusion (BRVO) with vitreous hemorrhage (VH) and neovascularization elsewhere (NVE). METHODS: The NGENUITY 3D ® visualization system was used for the digital assisted vitrectomy (DAV). 3D-FA-guided PPV was performed in three patients with BRVO with VH and NVE. PATIENTS: 3 eyes with BRVO with VH and NVE RESULTS:: In all eyes, the scatter retinal photocoagulations for nonperfusion area (NPA), depicted as hypofluorescein, and the segmentation and delamination of perivascular fibrovascular proliferative membrane, depicted as hyperfluorescein, could be safely performed on the same screen while implementing intraoperative 3D-FA. CONCLUSIONS: 3D-FA-guided PPV, a novel approach that fully utilizes the advantages of DAV, can be one of useful techniques for the treatment of BRVO with VH and NVE.
2020年11月25日, Retinal cases & brief reports, 16 (6), 802 - 805, 英語, 国際誌研究論文（学術雑誌）
Purpose. Although oral prednisolone is the first-line treatment for preventing recurrent optic neuritis (ON) after the completion of acute-phase treatment, especially anti-aquaporin 4 (AQP4) antibody-positive ON, and anti-myelin oligodendrocyte glycoprotein (MOG) antibody-positive ON, some patients experience relapses. Immunosuppressants could be effective in reducing the recurrence rate for neuromyelitis optica spectrum disorder and MOG antibody-related diseases, but there have been few studies addressing this issue focusing on the changes in ophthalmic parameters. The objective of the study was to analyze the impact of off-label uses of immunosuppressants to reduce recurrent ON. Design. Retrospective observational study, clinical case series. Methods. We reviewed the medical charts of 11 cases (22 eyes) who underwent immunosuppressive therapy in Kobe University Hospital and compared the annualized relapse rate (ARR) before and after immunosuppressive therapy. We also evaluated the dosage of prednisolone, complications of immunosuppressants, and other visual functional ophthalmologic parameters. Results. Eleven cases in total had AQP4 antibody (9 cases) and/or MOG antibody (3 cases). One case was double positive for these antibodies. Nine patients received azathioprine and two received mycophenolate mofetil as an initial immunosuppressive therapy. The median duration of immunosuppressant treatment was 2.8 years. The median ON ARR before immunosuppressive therapy was 0.33, and this decreased significantly to 0 after the therapy (
Hindawi Limited, 2020年11月17日, Journal of Ophthalmology, 2020, 1 - 6研究論文（学術雑誌）
- 日本神経眼科学会, 2020年11月, 神経眼科, 37 (増補1), 55 - 55, 日本語
- 日本神経眼科学会, 2020年11月, 神経眼科, 37 (増補1), 71 - 71, 日本語
- 日本神経眼科学会, 2020年11月, 神経眼科, 37 (増補1), 72 - 72, 日本語
- 眼科臨床紀要会, 2020年11月, 眼科臨床紀要, 13 (11), 752 - 753, 日本語視力良好なポリープ状脈絡膜血管症に対する硝子体注射併用光線力学的療法の1年経過
- 眼科臨床紀要会, 2020年11月, 眼科臨床紀要, 13 (11), 756 - 756, 日本語視力良好な中心性漿液性脈絡網膜症における治療後不等像視の関連因子についての検討
- 日本緑内障学会, 2020年10月, 日本緑内障学会抄録集, 31回, 80 - 80, 日本語サイトメガロウイルス虹彩毛様体炎続発緑内障の手術成績
- 日本緑内障学会, 2020年10月, 日本緑内障学会抄録集, 31回, 81 - 81, 日本語血栓予防薬の緑内障手術における内服状況と術後の影響
- 日本緑内障学会, 2020年10月, 日本緑内障学会抄録集, 31回, 166 - 166, 日本語緑内障眼におけるアイモ両眼ランダム測定の有用性の検討
- 日本緑内障学会, 2020年10月, 日本緑内障学会抄録集, 31回, 166 - 166, 日本語緑内障眼におけるアイモ両眼ランダム測定の中心窩感度および信頼係数の検討
Purpose: We report a case of neurosarcoidosis that presented simultaneously with oculomotor nerve palsy, contralateral abducens nerve palsy, and paresthesia of both lower limbs. Observations: A 69-year-old Japanese woman who suffered from repeated diplopia and lower-limb paresthesia was referred to our hospital. Ophthalmic findings included oculomotor nerve and contralateral abducens nerve palsies. No remarkable abnormalities were detected via enhanced brain magnetic resonance imaging (MRI), chest X-ray, and cerebrospinal fluid analysis. Chest computed tomography (CT) was performed to exclude neoplastic lesions; this revealed right hilar lymphadenopathy, and positron emission tomography MRI showed strong 18-F fluorodeoxyglucose uptake in the hilar lymph node. Biopsy of the lymph node showed non-caseating epithelioid granulomatous tissue, leading to a diagnosis of probable neurosarcoidosis. After the initiation of oral prednisolone treatment, the patient experienced complete remission without any recurrence. Conclusions and importance: When examining a patient presenting with multiple cranial neuropathies of unknown cause, neurosarcoidosis should be considered as a differential diagnosis and chest CT should be performed even when the chest X-ray and angiotensin-converting enzyme appears normal.
2020年09月, American journal of ophthalmology case reports, 19, 100796 - 100796, 英語, 国際誌BACKGROUND AND OBJECTIVES: This study aimed to compare the efficacy of fluorescein angiography (FA)-guided and indocyanine green angiography (ICGA)-guided half-time photodynamic therapy (PDT) for central serous chorioretinopathy (CSC). SUBJECTS AND METHODS: Medical records of 61 eyes of 61 CSC patients who underwent half-time PDT were retrospectively reviewed. The irradiation area was determined using information from FA or ICGA with physicians' discretion. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), subfoveal choroidal thickness (SCT), and resolution of subretinal fluid (SRF) were evaluated at baseline and 1, 3, 6, and 12 months after PDT. RESULTS: A total of 29 and 32 eyes received FA-guided PDT (irradiation area, 2898.3 ± 705.7 μm) and ICGA-guided PDT (irradiation area, 4993.8 ± 333.1 μm), respectively. A significant improvement in the mean BCVA was found at 1 month in the FA-guided group (P = 0.02), but not in the ICGA-guided group (P = 0.88). BCVA was significantly improved in both groups at 3, 6, and 12 months with no significant intergroup difference at any time points. CRT and SCT were significantly reduced in both groups at all time points with no significant intergroup differences. No significant intergroup differences were observed in the rate of recurrence and persistent SRF. However, there was a significant difference between groups in the rate of recurrence and/or persistent SRF (P = 0.04). Multivariate analysis revealed that choice of FA-guided was significantly associated with recurrence and/or persistent SRF (P = 0.04). CONCLUSION: Half-time PDT with ICGA-guided irradiation spot might be more effective than that with FA-guided in treating CSC patients in complete resolution of SRF.
2020年08月17日, Photodiagnosis and photodynamic therapy, 31, 101955 - 101955, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- S. Karger AG, 2020年08月06日, Case Reports in Ophthalmology, 11 (2), 436 - 441
研究論文（学術雑誌）
Aquaporin 9 (AQP9) is an aquaglyceroporin that can transport lactate. Accumulating evidence suggests that astrocyte-to-neuron lactate shuttle (ANLS) plays a critical role in energy metabolism in neurons, including retinal ganglion cells (RGCs). To test the hypothesis that AQP9, in concert with monocarboxylate transporters (MCTs), participates in ANLS to maintain function and survival of RGCs, Aqp9-null mice and wild-type (WT) littermates were subjected to optic nerve crush (ONC) with or without intravitreal injection of an MCT2 inhibitor. RGC density was similar between the Aqp9-null mice and WT mice without ONC, while ONC resulted in significantly more RGC density reduction in the Aqp9-null mice than in the WT mice at day 7. Positive scotopic threshold response (pSTR) amplitude values were similar between the two groups without ONC, but were significantly more reduced in the Aqp9-null mice than in the WT mice 7days after ONC. MCT2 inhibitor injection accelerated RGC death and pSTR amplitude reduction only in the WT mice with ONC. Immunolabeling revealed that both RGCs and astrocytes expressed AQP9, that ONC predominantly reduced astrocytic AQP9 expression, and that MCTs 1, 2, and 4 were co-localized with AQP9 at the ganglion cell layer. These retinal MCTs were also co-immunoprecipitated with AQP9 in the WT mice. ONC decreased the co-immunoprecipitation of MCTs 1 and 4, but did not impact co-immunoprecipitation of MCT2. Retinal glucose transporter 1 expression was increased in Aqp9-null mice. Aqp9 gene deletion reduced and increased the intraretinal L-lactate and D-glucose concentrations, respectively. Results suggest that AQP9 acts as the ANLS to maintain function and survival of RGCs.
2020年08月04日, Molecular neurobiology, 57 (11), 4530 - 4548, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
PURPOSE: To show the long-term effect of the cystotomy with or without fibrinogen clot removal for the refractory cystoid macular edema (CME) secondary to diabetic retinopathy (DR). METHODS: Retrospective analyses of the medical records of 30 eyes of 30 patients with refractory CME secondary to DR who had followed-up for 12 months after the surgery were performed. RESULTS: There were 15 men and 15 women. The mean±SD age was 68.4±7.9 years. The best corrected visual acuity (BCVA) (logMAR) at 12 months after the surgery (0.33±0.25, Snellen equivalent (SE), 20/42) was statistically better than the preoperative BCVA (0.45±0.33, SE, 20/56) (p<0.01). The central sensitivity on microperimetry (dB) was not statistically changed between preoperatively (24.0±4.9) and 12 months after the surgery (24.1±4.0) (p=0.75). The central retinal thickness (CRT) on optical coherence tomography (OCT) (μm) at 12 months after the surgery (300.3±99.0) was statistically improved compared with the preoperative CRT (565.6±198.7) (p<0.01). During the follow-up period, CME relapsed in 7 of 30 eyes. The preoperative cystoid cavity reflectivity on OCT in patients with fibrinogen clot removal (n=16) was significantly higher compared with that in patients without fibrinogen clot removal (n=14) (p<0.04). CONCLUSION: The cystotomy with or without fibrinogen clot removal may be a promising treatment option for refractory CME secondary to DR.
2020年07月21日, Retina (Philadelphia, Pa.), 41 (4), 844 - 851, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
視神経乳頭陥凹拡大や視野障害は頭蓋内疾患でもみられることが知られている。頭蓋内疾患における乳頭所見の特徴には、乳頭所見に比して視力・視野障害が強い、局所性よりびまん性の陥凹拡大が多い、蒼白部位が陥凹よりも大きい、乳頭周囲網脈絡膜萎縮や乳頭出血の頻度が少ないこと等が挙げられる。また頭蓋内疾患を疑う視野障害のパターンとしては、耳側の視野障害、視野障害が垂直経線で分かれるもの、中心・傍中心暗点、視野障害と視神経乳頭所見に対応がみられないもの等が挙げられる。そのほか、若年、頭痛・眼窩深部痛・眼球運動障害等の随伴症状、限界フリッカ値の低下や相対的求心路瞳孔障害等があるとき、眼圧コントロール良好にもかかわらず緑内障の進行が早いとき、病状の左右差が大きいときも、頭蓋内疾患の可能性を考える。緑内障診療においては、頭蓋内疾患の可能性を念頭に置いて視神経乳頭や視野の所見を注意深く観察する必要がある。(著者抄録)
(株)全日本病院出版会, 2020年06月, OCULISTA, (87), 45 - 51, 日本語目的:治療維持期の視力不良な滲出型加齢黄斑変性(nAMD)患者における視力と固視の関連について検討すること.対象と方法:治療維持期のnAMD患者のうち矯正視力が0.5以下でかつマイクロペリメーター(MP-3)を使用した固視検査が測定可能であった69例69眼を対象とした.患眼の固視(固視安定性,固視位置,中心窩・固視点間距離)を評価し,患眼視力との関連について検討した.また,患眼小数視力別の固視について層別解析を行った.最後に,患眼視力と関連する因子について多変量解析にて検討した.結果:患眼平均視力のlogarithmic minimum angle of resolution(logMAR)値は患眼の固視安定性,固視位置,中心窩・固視点間距離が不良となるほど悪化し,有意な関連を認めた(p<0.001).層別解析においては,患眼小数視力別の群間比較で,患眼固視安定性の程度の割合に有意差を認めた(p=0.015)が,中心窩に固視範囲が含まれる割合には有意差を認めなかった(p=0.404).多変量解析では,患眼視力のlogMAR値は,患眼固視安定性(p=0.015),患眼中心窩・固視点間距離(p=0.001)と有意に関連していた.結論:治療維持期の視力不良なnAMD患者において,患眼の固視安定性と中心窩・固視点間距離は患眼視力が不良となるほど悪化していた.(著者抄録)
(公財)日本眼科学会, 2020年06月, 日本眼科学会雑誌, 124 (6), 465 - 471, 日本語- (公財)日本眼科学会, 2020年06月, 日本眼科学会雑誌, 124 (6), 465 - 471, 日本語治療維持期の視力不良な滲出型加齢黄斑変性患者の固視
Leber hereditary optic neuropathy (LHON) is an intractable disease associated with mitochondrial DNA (mtDNA) mutations. In this preliminary, single-arm, prospective, open-label exploratory trial, we investigated the effectiveness and safety of skin electrical stimulation (SES) for cases of LHON harboring the mtDNA 11,778 mutation. Of the 11 enrolled patients, 10 completed six sessions of SES once every two weeks over a 10-week period. The primary outcome measure was the change in logarithm of the minimum angle of resolution (logMAR)-converted best-corrected visual acuity (BCVA) at one week after the last session of SES. The main secondary outcome measures were the logMAR BCVA at four and eight weeks and Humphrey visual field test sensitivities at one, four, and eight weeks. At all follow-up points, the logMAR BCVA had improved significantly from baseline [1.80 (1.70–1.80) at baseline, 1.75 (1.52–1.80) at one week, 1.75 (1.50–1.80) at four weeks, and 1.75 (1.52–1.80) at eight weeks; p < 0.05]. At eight weeks of follow-up, five patients showed >2-fold increase in the summed sensitivity at 52 measurement points from baseline. No adverse effects were observed. In conclusion, SES could be a viable treatment option for patients with LHON in the chronic phase harboring the mtDNA 11,778 mutation.
2020年05月06日, Journal of clinical medicine, 9 (5), 英語, 国際誌研究論文（学術雑誌）
＜文献概要＞目的:免疫健常な若年者が緑膿菌を起炎菌として,結膜炎と蜂窩織炎様の所見を呈した稀な症例の報告。症例:30歳,女性。3日前から特に誘因なく右眼痛と充血,眼脂,また眼瞼腫脹および疼痛を自覚した。近医で抗菌薬点眼および内服を処方されたのち,翌日に当院を紹介され受診した。右上眼瞼に腫脹と発赤,疼痛が著明であり,疼痛のためほぼ開瞼できなかったが,右結膜下出血と充血,眼脂を認めた。眼脂を検体として提出し,抗菌薬点眼を追加して加療した。翌日,症状はやや改善し開瞼が可能となった。球結膜の上方で円形に結膜が欠損して強膜が露出し,周辺に強い炎症所見を認めた。眼脂から緑膿菌が検出された。使用中の抗菌薬に感受性が良好であったため加療を続行し,約2週間後に結膜欠損部はほぼ被覆され,炎症所見も改善した。内科での全身検索では,特記すべき異常所見を認められなかった。結論:緑膿菌が眼表面に感染を起こす場合,コンタクトレンズの使用歴や外傷および手術歴,または免疫低下例など,何らかの既往歴を有することが一般的である。免疫学的健常者で外傷などの既往がなくとも,眼表面の緑膿菌感染を起こし,強い炎症をきたすことを本症例は示している。
(株)医学書院, 2020年05月, 臨床眼科, 74 (5), 627 - 630, 日本語PURPOSE: To show the usefulness of the intraoperative three-dimensional fluorescein angiography (3D-FA)-guided pars plana vitrectomy. METHODS: The NGENUITY 3D visualization system was used for the digital assisted vitrectomy. Three-dimensional fluorescein angiography-guided pars plana vitrectomy was performed in three patients with vitreous hemorrhage secondary to proliferative diabetic retinopathy. We investigated both whether several angiographic findings can be successfully displayed on the screen during 3D-FA and whether pars plana vitrectomy can be performed simultaneously on the same screen while implementing 3D-FA. RESULTS: In all cases, the abnormal FA findings including hypofluorescence due to non-perfusion areas, and the hyperfluorescence due to macular edema and fibrovascular proliferative membrane were successfully displayed on the screen. The segmentation and delamination of fibrovascular proliferative membrane and panretinal photocoagulation for detected non-perfusion areas were able to be performed on the same screen while implementing 3D-FA. CONCLUSION: Three-dimensional fluorescein angiography-guided pars plana vitrectomy is a novel approach that fully utilizes the advantages of digital assisted vitrectomy and a promising option for the treatment of proliferative diabetic retinopathy.
2020年04月17日, Retina (Philadelphia, Pa.), 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2020年03月, 日本眼科学会雑誌, 124 (臨増), 212 - 212, 日本語マイクロフックトラベクロトミーの切開範囲による術後短期成績の比較
- (公財)日本眼科学会, 2020年03月, 日本眼科学会雑誌, 124 (臨増), 216 - 216, 日本語傾向スコア解析による毛様溝挿入アーメド/バルベルトインプラントの術後短期成績
- (公財)日本眼科学会, 2020年03月, 日本眼科学会雑誌, 124 (臨増), 292 - 292, 日本語上皮増殖因子受容体チロシンキナーゼ阻害薬が原因と考えられる眼障害の検討
眼部帯状疱疹に高度な眼窩炎症と髄膜炎を併発し、重篤な視機能障害を残した症例を経験した。症例は72歳、女性。左眼痛と嘔気を自覚するも前医にて異常認めなかったが症状増悪し、1週間後に当科受診した。左眼瞼下垂、瞳孔不同、上眼瞼腫脹、結膜浮腫および点状角膜炎を認め、3日後に左三叉神経第一枝領域に皮疹が出現し帯状疱疹と診断された。持続する高熱と髄液検査にてウイルス性髄膜炎と診断された。アシクロビル点滴を開始し皮疹は改善したが、左視力は光覚弁に低下し、高度な眼内炎症と全眼筋麻痺を認めた。MRIでは左視神経および視神経鞘、外眼筋、強膜、眼球後方軟部組織に強い炎症性変化を認めた。ウイルス性髄膜炎による所見が改善した後、プレドニゾロン60mgからの漸減療法を開始し、左眼窩炎症は改善したが、眼球運動は部分改善にとどまり、眼瞼下垂は改善しなかった。最終的に左眼は眼球瘻に陥った。本症例は、眼症状が皮疹に先行したため、帯状疱疹の治療が遅れた。その後、抗ウイルス薬、ステロイド薬の併用療法を開始したにも関わらず、重篤な視機能障害を残した。高度な眼窩炎症を伴う眼部帯状疱疹に対しては、更に早期のステロイド大量投与が必要かもしれない。(著者抄録)
日本神経眼科学会, 2020年03月, 神経眼科, 37 (1), 38 - 44, 日本語OBJECTIVE: To evaluate the usefulness of en face slab optical coherence tomography (OCT) imaging for monitoring diabetic retinal neurodegeneration with supporting animal experimental data. RESEARCH DESIGN AND METHODS: We retrospectively examined 72 diabetic eyes over 3 years using Cirrus-HD OCT. Two-dimensional en face slab OCT images of the innermost retina were reconstructed and graded according to the ratio of dark area to total area, and relative red, green, and blue color area ratios were calculated and used as indexes for each en face slab OCT image. Values from en face OCT images were used for statistical analyses. To obtain insight into the pathogenesis of diabetic retinal neurodegeneration, we used the InsPr-Cre;Pdk1flox/flox diabetic mouse model. RESULTS: Both OCT grade and relative red color area ratio significantly increased with the advancing stage of diabetic retinopathy (p=0.018 and 0.006, respectively). After a mean follow-up period of 4.6 years, the trend was unchanged in the analyses of 42 untreated eyes (p<0.001 and 0.001, respectively). Visual acuity showed a weak but significant negative correlation with the red color ratio on en face slab OCT images, but central retinal thickness did not exhibit a clinically meaningful correlation with values obtained from en face slab OCT images. Immunohistochemical analyses of InsPr-Cre;Pdk1flox/flox diabetic mice demonstrated the loss of ganglion axon bundles and thinning of laminin without apparent retinal vascular change at the age of 20 weeks. CONCLUSIONS: En face slab OCT imaging would be a novel useful modality for the assessment of diabetic retinal neurodegeneration as it could detect subtle optical changes occurring in the innermost retina in diabetic eyes. Our animal experimental data suggest that dark areas observed on en face slab OCT images might be the impairment of the extracellular matrix as well as neurons.
2020年03月, BMJ open diabetes research & care, 8 (1), 英語, 国際誌[査読有り]
研究論文（学術雑誌）
PURPOSE: To retrospectively investigate the sensitivity and specificity of weight gain, insulin-like growth factor 1, and neonatal retinopathy of prematurity (WINROP) algorithm for the prediction of severe retinopathy of prematurity (ROP) in a Japanese population of preterm infants. The WINROP algorithm is a tool based on postnatal weight gain. STUDY DESIGN: Retrospective cohort study. METHODS: The medical records of preterm infants born between January 2011 and March 2017 were retrospectively reviewed. Infants born after 33 weeks of gestation were excluded based on the indications of the WINROP algorithm. Postnatal weight was recorded weekly on the WINROP system until postmenstrual week 36. The sensitivity and specificity of the WINROP algorithm were analyzed. RESULTS: In total, 278 infants were included in this study. Based on the WINROP algorithm 110 of these infants were predicted to be at low risk for developing severe ROP and 105 did not develop severe ROP. Based on the WINROP algorithm 168 infants were predicted to be at high risk for developing severe ROP and 27 developed severe ROP. Thus, the sensitivity of the WINROP algorithm was 84.4% and the specificity 42.7%. CONCLUSION: The WINROP algorithm could be used for preterm infants (gestational age of <28 weeks) without a complicated hospital course. Modification of the algorithm will improve its sensitivity and specificity for the Japanese population.
2020年03月, Japanese journal of ophthalmology, 64 (2), 223 - 227, 英語, 国内誌[査読有り]
研究論文（学術雑誌）
OBJECTIVES: To compare the surgical results between air and 20% sulfur hexafluoride (SF6) tamponade in 27-gauge pars plana vitrectomy (27GPPV) for rhegmatogenous retinal detachment (RRD). METHODS: A retrospective, observational, and consecutive study. All patients underwent 27GPPV for RRD were divided into two groups. Group A comprised patients who underwent 20% SF6 gas tamponade. Group B comprised patients who underwent air tamponade. The anatomical success rate, visual outcome, and the type and frequency of complications were investigated and compared between the groups. All patients were followed-up for 12 months after surgery. RESULTS: Seventy eyes were enrolled (Group A: 35 eyes, Group B: 35 eyes). Seventeen eyes in Group A and 13 eyes in Group B had RRD with superior retinal breaks, while 14 eyes in Group A and 19 eyes in Group B had RRD with inferior retinal breaks. There was no statistically difference in preoperative demographic date between the groups. The initial and final anatomical success rates were 97.1% and 100% in Group A and 94.3% and 100% in Group B, respectively. The success rates between the groups were not statistically different (p = 1). The best corrected visual acuity (BCVA) (logMAR) at 12 months after surgery was -0.02 ± 0.14 in Group A and -0.03 ± 0.27 in Group B. The BCVA between the groups was not statistically different (p = 0.27). CONCLUSIONS: The surgical results of air tamponade were not inferior to 20% SF6 tamponade in 27GPPV for RRD irrespective of retinal break locations in the present cohort.
2020年02月, Eye (London, England), 34 (2), 299 - 306, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
This retrospective study was conducted to investigate the predictive factors associated with metamorphopsia after reduced-fluence photodynamic therapy (RFPDT) in patients with central serous chorioretinopathy (CSC) with good baseline visual acuity. A total of 36 eyes of 36 consecutive patients with resolved CSC after RFPDT and best-corrected visual acuity (BCVA) better than 1.0 (logarithm of the minimal angle of resolution (logMAR) 0) at baseline were examined. Metamorphopsia was measured using M-CHARTS at 12 months after RFPDT. An average of the horizontal and vertical M-CHARTS scores was applied for defining the extent of metamorphopsia. The association between M-CHARTS score at 12 months after RFPDT and clinical parameters (age, sex, duration of symptoms, BCVA, and findings of optical coherence tomography (OCT)) was investigated at baseline or 12 months after RFPDT. The M-CHARTS score at 12 months correlated significantly with duration of symptoms (P = 0.005), baseline outer nuclear layer (ONL) thickness (P = 0.009), central foveal thickness (CFT) (P = 0.001) at 12 months, and ONL thickness (P = 0.001) at 12 months after RFPDT. In the multivariate analysis of baseline-related factors, thinner ONL thickness before RFPDT (P = 0.010) was significantly associated with large metamorphopsia at 12 months after RFPDT in CSC patients with good baseline BCVA. Baseline ONL thickness may be a useful predictive factor of metamorphopsia after RFPDT in CSC patients with good baseline BCVA.
2020年, PloS one, 15 (10), e0240557, 英語, 国際誌研究論文（学術雑誌）
- Genetic factors associated with treatment response to reduced-fluence photodynamic therapy for chronic central serous chorioretinopathy.
Purpose: Reduced-fluence photodynamic therapy (RFPDT) has proven effective for some patients with chronic central serous chorioretinopathy (cCSC). Several clinicodemographic factors influencing treatment response have been identified, but associations with genetic factors have not been examined. Therefore, we investigated the associations of single nucleotide polymorphisms (SNPs) implicated in cCSC pathogenesis with clinical outcome following RFPDT. Methods: This was a retrospective study of 87 eyes from 87 patients with cCSC who underwent RFPDT and were followed up for more than 12 months. Patients were divided into a good response group (53 patients) and a poor response group (34 patients) based on either persistence or recurrence of subretinal fluid detected with spectral domain optical coherence tomography after the first application of RFPDT. SNPs in the genes encoding age-related maculopathy susceptibility protein 2 (ARMS2, SNP rs10490924) and complement factor H (CFH, SNP rs800292) were genotyped using TaqMan technology. Results: There were no statistically significant differences in the baseline characteristics between the response groups except the degree of hyperfluorescence on indocyanine green angiography (ICGA; p = 0.011). The minor (T) allele frequency of ARMS2 (rs10490924) were statistically significantly lower in the good response group than in the poor response group (24.0% versus 41.0%, p = 0.021). Further, the good response frequency was statistically significantly lower in patients with at least one minor allele (GT or TT) compared to the homozygous major allele group (GG; p<0.05). The baseline best-corrected visual acuity (BCVA) at 12 months after RFPDT was statistically significantly better in the GG carriers than in the GT or TT carriers (p<0.01). Logistic regression analysis showed less intense hyperfluorescence on ICGA, and the T allele of ARMS2 (rs10490924) was statistically significantly associated with poor response to PDT treatment (p = 0.012, p = 0.039, respectively). Conclusions: Carriers of the ARMS2 rs10490924 minor allele (GT or TT) demonstrated a higher subretinal fluid persistence or recurrence rate and poorer visual outcome following RFPDT. In addition to the ICGA findings, genotyping of ARMS2 (rs10490924) may assist in the selection of patients with cCSC most likely to benefit from RFPDT.
2020年, Molecular vision, 26, 505 - 509, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Objective: To compare the 1-year outcomes of trabeculotomy ab externo (ab externo TLO) and trabeculotomy ab interno using a microhook (ab interno TLO) for glaucoma patients using propensity score analysis. Methods and analysis: The medical charts of 65 consecutive patients who underwent ab externo TLO and those of 69 patients who underwent ab interno TLO were reviewed. Logistic regression analysis was conducted to calculate the propensity score using 1:1 matched analysis, which indicates the likelihood of surgical success at 12 months. We set the outcome-related covariates as age, glaucoma type, mean deviation, preoperative intraocular pressure (IOP), the number of preoperative glaucoma eye drops and the presence or absence of combined cataract surgery. Fifty eyes per each surgery group were subsequently compared. Results: The mean preoperative IOP was 32.5±11.2 mm Hg in the ab externo TLO group and 28.4±7.8 mm Hg in the ab interno TLO group (p=0.08). The mean postoperative IOP at 12 months was 18.3±7.4 mm Hg in the former group and 17.8±6.3 mm Hg in the latter (p=0.91). When surgical success was defined as a postoperative IOP of between 5 and 21 mm Hg with a more than 20% IOP reduction from baseline and no additional glaucoma surgery, the rate at 12 months was 78% in the ab externo TLO group and 74% in the ab interno TLO group (p=1.00). Conclusion: The 1-year success rate was not significantly different between ab externo and ab interno TLO.
2020年, BMJ open ophthalmology, 5 (1), e000446, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
BACKGROUND/PURPOSE: To present a case report of retinal metastasis of laryngeal squamous cell carcinoma that was diagnosed by a histopathologic finding from the surgically extracted tumor tissue. METHODS: A 66-year-old man, who was suffered from the treatment-resistant laryngeal carcinoma, was referred to our department because of visual field defect in his right eye. A fundus examination revealed a parafoveal white retinal lesion, which rapidly expanded to the central fovea and decreased the visual acuity. A tissue extraction by 27G pars plana vitrectomy was performed to confirm the diagnosis. RESULTS: The abnormal retinal tissue was extracted en block through 10-mm sclerocorneal tunnel during pars plana vitrectomy. The histopathologic findings revealed that the retinal lesion was retinal metastasis of laryngeal carcinoma. CONCLUSION: We must keep in mind that retinal metastasis can be one of the differential diagnoses for white retinal lesions of unknown cause.
2020年, Retinal cases & brief reports, 14 (2), 127 - 130, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
PURPOSE: To introduce the methodology and outcomes of en bloc removal of the component of cystoid lesion during pars plana vitrectomy as a novel approach for the treatment of cystoid macular edema and show evidence that the component is an aggregation of fibrinogen by mass spectrometry analysis. METHODS: The surgical en bloc extraction of the component of cystoid lesion was performed for cystoid macular edemas secondary to diabetic retinopathy and retinal vein occlusion. Perioperative change of best-corrected decimal visual acuity, and the central retinal thickness and the continuity of subfoveal ellipsoid zone and external limiting membrane on optical coherence tomography were evaluated. Mass spectrometry was performed for the identification of protein constituting the component. RESULTS: Six eyes from six patients were included in the study. In all cases, central retinal thickness was improved after the surgery and remained stable during the follow-up period. Best-corrected decimal visual acuity and the continuity of ellipsoid zone and external limiting membrane were kept in all cases during the follow-up period. The mass spectrometry analysis disclosed that the component was composed of fibrinogen. CONCLUSION: The en block removal of the component of cystoid lesion combined with pars plana vitrectomy may be a promising option for treatment of cystoid macular edema. The component of cystoid lesion is presumably a fibrinogen aggregate.
2020年01月, Retina (Philadelphia, Pa.), 40 (1), 154 - 159, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 眼科臨床紀要会, 2019年11月, 眼科臨床紀要, 12 (11), 834 - 834, 日本語滲出型加齢黄斑変性の固視に関する検討
[査読有り]
- 眼科臨床紀要会, 2019年11月, 眼科臨床紀要, 12 (11), 834 - 834, 日本語滲出型加齢黄斑変性の固視に関する検討
[査読有り]
- 眼科臨床紀要会, 2019年11月, 眼科臨床紀要, 12 (11), 854 - 854, 日本語TREX1遺伝子変異に伴うretinal vasculopathy with cerebral leukoencephalopathyの1例
[査読有り]
- 日本視能矯正学会, 2019年11月, 日本視能矯正学会プログラム抄録集, 60回, 89 - 89, 日本語視力良好な中心性漿液性脈絡網膜症における治療後不等像視の関連因子についての検討
[査読有り]
- 日本臨床免疫学会, 2019年10月, 日本臨床免疫学会総会プログラム・抄録集, 47回, 126 - 126, 日本語非感染性ぶどう膜炎におけるアダリムマブ治療前後の鎮静化状態の達成とその臨床的意義
[査読有り]
- 眼科臨床紀要会, 2019年10月, 眼科臨床紀要, 12 (10), 769 - 769, 日本語En face slab OCT像を用いた網膜静脈分枝閉塞症の乳頭黄斑線維束障害についての検討
[査読有り]
PURPOSE: To elucidate the clinical and epidemiologic characteristics of optic neuritis in Japan. DESIGN: Multicenter cross-sectional, observational cohort study. PARTICIPANTS: A total of 531 cases of unilateral or bilateral noninfectious optic neuritis identified in 33 institutions nationwide in Japan. METHODS: Serum samples from patients with optic neuritis were tested for anti-aquaporin-4 antibodies (AQP4-Abs) and anti-myelin oligodendrocyte glycoprotein antibodies (MOG-Abs) using a cell-based assay and were correlated with the clinical findings. MAIN OUTCOME MEASURES: Antibody positivity, clinical and radiologic characteristics, and visual outcome. RESULTS: Among 531 cases of optic neuritis, 12% were AQP4-Ab positive, 10% were MOG-Ab positive, 77% were negative for both antibodies (double-negative), and 1 case was positive for both antibodies. Pretreatment visual acuity (VA) worsened to more than a median 1.0 logarithm of the minimum angle of resolution (logMAR) in all groups. After steroid pulse therapy (combined with plasmapheresis in 32% of patients in AQP4-Ab-positive group), median VA improved to 0.4 logMAR in the AQP4-Ab-positive group, 0 logMAR in the MOG-Ab-positive group, and 0.1 logMAR in the double-negative group. The AQP4-Ab-positive group showed a high proportion of females, exhibited diverse visual field abnormalities, and demonstrated concurrent spinal cord lesions on magnetic resonance imaging (MRI) in 22% of the patients. In the MOG-Ab-positive group, although posttreatment visual outcome was good, the rates of optic disc swelling and pain with eye movement were significantly higher than those in the AQP4-Ab-positive and double-negative groups. However, most cases showed isolated optic neuritis lesions on MRI. In the double-negative group, 4% of the patients had multiple sclerosis. Multivariate logistic regression analysis of all participants identified age and presence of antibodies (MOG-Ab and AQP4-Ab) as significant factors affecting visual outcome. CONCLUSIONS: The present large-scale cohort study revealed the clinicoepidemiologic features of noninfectious optic neuritis in Japan. Anti-aquaporin-4 antibody-positive optic neuritis has poor visual outcome. In contrast, MOG-Ab positive cases manifested severe clinical findings of optic neuritis before treatment, but few showed concurrent lesions in sites other than the optic nerve and generally showed good treatment response with favorable visual outcome. These findings indicate that autoantibody measurement is useful for prompt diagnosis and proper management of optic neuritis that tends to become refractory.
2019年10月, Ophthalmology, 126 (10), 1385 - 1398, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 日本緑内障学会, 2019年09月, 日本緑内障学会抄録集, 30回, 77 - 77, 日本語毛様溝挿入アーメドインプラント手術の術後短期成績
- (一社)日本糖尿病合併症学会, 2019年09月, 糖尿病合併症, 33 (Suppl.1), 270 - 270, 日本語視力良好な糖尿病黄斑浮腫に対する抗VEGF薬硝子体注射の12ヵ月治療成績
[査読有り]
PURPOSE: To determine the association of age-related maculopathy susceptibility 2 (ARMS2) gene polymorphisms with the 12-month outcomes of intravitreal aflibercept combined with photodynamic therapy (IVA+PDT) in polypoidal choroidal vasculopathy (PCV). STUDY DESIGN: Interventional cohort study. METHODS: This was a retrospective study of 48 consecutive treatment-naïve PCV patients. The patients underwent IVA+PDT as the initial therapy and were followed up for more than 12 months under a pro re nata regimen. The single nucleotide polymorphism (SNP) at rs10490924 in the ARMS2 gene was genotyped using the TaqMan assay. The clinical characteristics and outcomes of IVA+PDT were compared among the 3 genotypes at rs10490924. Multivariate regression analysis was performed to evaluate the influence of the clinical cofactors on the association of rs10490924 with the visual outcome at 12 months after the first IVA+PDT. RESULTS: No significant difference was found in the baseline characteristics among the 3 genotypes (n = 9, 23, and 16 for the GG, GT, and TT genotypes, respectively). All the patients, regardless of genotype, showed a significant improvement in vision, central retinal thickness, and subfoveal choroidal thickness at all time points measured after the initial IVA+PDT. The number of treatments was significantly smaller in the patients with the GG genotype than in those with the GT or the TT genotype. On multivariate logistic regression analysis, the number of the T allele at rs10490924 was significantly associated with the chance of retreatment after the initial IVA+PDT. CONCLUSION: The presence of the G allele at rs10490924 in the ARMS2 gene is likely associated with a lower chance of retreatment after IVA+PDT in patients with PCV.
2019年09月, Japanese journal of ophthalmology, 63 (5), 389 - 395, 英語, 国内誌[査読有り]
研究論文（学術雑誌）
BACKGROUND: Vogt-Koyanagi-Harada (VKH) disease is a T-cell-mediated autoimmune disorder characterized by bilateral granulomatous panuveitis with various systemic manifestations. Although VKH disease rarely occurs in the pediatric population, the clinical course tends to be aggressive, and the visual prognosis is worse than that in adult patients due to severe ocular complications secondary to recurrent inflammation. CASE PRESENTATION: A 3-year-old girl with probable VKH was referred to Kobe University Hospital. She had severe bilateral panuveitis with posterior synechiae of the iris, marked optic disk swelling, and serous retinal detachment in both eyes, and her best corrected visual acuities (BCVAs) were 20/200 OD and 20/125 OS. A third course of therapy was administered because serous retinal detachment remained after two courses of therapy. She was treated with three courses of high-dose intravenous corticosteroid therapy, followed by slow tapering of oral corticosteroids. Her BCVAs recovered to 20/16 OU, and relapse of ocular inflammation and side effect of treatment were not observed during the 1.5-year follow-up period. CONCLUSIONS: We experienced a pediatric patient with probable VKH disease who was treated with three courses of high-dose intravenous corticosteroid therapy. With the favorable clinical course in our patient, initial treatment with repeated high-dose intravenous corticosteroid therapy might be beneficial in pediatric VKH disease.
2019年08月13日, BMC ophthalmology, 19 (1), 179 - 179, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 日本神経眼科学会, 2019年08月, 神経眼科, 36 (増補1), 55 - 55, 日本語
- 日本神経眼科学会, 2019年08月, 神経眼科, 36 (増補1), 76 - 76, 日本語
- 日本神経眼科学会, 2019年08月, 神経眼科, 36 (増補1), 88 - 88, 日本語
- 日本神経眼科学会, 2019年08月, 神経眼科, 36 (増補1), 55 - 55, 日本語
- 眼科臨床紀要会, 2019年08月, 眼科臨床紀要, 12 (8), 648 - 648, 日本語下垂体茎断裂症候群に対するホルモン治療中に進行性の網膜変性症の合併を認めた1症例
[査読有り]
- 日本神経眼科学会, 2019年08月, 神経眼科, 36 (増補1), 55 - 55, 日本語再発性視神経炎に対する免疫抑制剤の治療効果
[査読有り]
- 日本糖尿病眼学会, 2019年07月, 日本糖尿病眼学会誌, 23, 138 - 138, 日本語糖尿病性黄斑浮腫に対するアフリベルセプト治療に影響する因子についての検討
PURPOSE: To investigate the perioperative clinical factors, which contribute to the postsurgical aqueous flare intensity (AFI) following 27-gauge pars plana vitrectomy (27GPPV) for primary rhegmatogenous retinal detachment (RRD). STUDY DESIGN: Retrospective clinical study. METHODS: We performed retrospective analyses of the medical records of 47 eyes of 47 patients with primary RRD who had undergone 27GPPV with a wide-angle viewing system. AFI was measured preoperatively and 1 week, 1 month, 3 months, 6 months, and 12 months after the surgery. RESULTS: AFI was significantly increased 1 week after the surgery (p<0.01) and then decreased overtime. At 6 months after surgery it was still statistically significantly higher than preoperative AFI (p=0.03). There was no statistical difference between preoperative AFI and that at 12 months following surgery. Multiple regression analyses revealed that the number of retinal photocoagulations and the performance of scleral indentation had significant positive correlation with AFI at 1 week, 1 month, 3 months, and 6 months, and at 1 month and 3 months after the surgery, respectively. CONCLUSION: Intraoperative retinal photocoagulation and scleral indentation are probable causes of increased AFI after 27G PPV for RRD.
2019年07月, Japanese journal of ophthalmology, 63 (4), 317 - 321, 英語, 国内誌[査読有り]
研究論文（学術雑誌）
Purpose: The present study aimed to assess the ability of en face slab images of maculae to detect residual nerve fiber bundles in eyes with advanced glaucoma. Methods: This study included 36 eyes with diffuse thinning of the ganglion cell and inner plexiform layers (GCL+IPL). Inclusion criterion was GCL+IPL thickness of <1% of the normative database level as detected using optical coherence tomography (OCT). En face slab images (50-μm thickness) were reconstructed from the macular cube scan data using advanced visualization settings. Thereafter, we assessed the agreement of the locations between hyperreflective nerve fiber bundles and normal points in the Humphrey visual field test 10-2 pattern deviation (PD) plots. Additionally, total deviation (TD) corresponding to hyperreflective and hyporeflective areas was compared. Results: Hyperreflective areas were detected in 31 out of 36 eyes; all 31 eyes exhibited at least one normal PD point despite the substantial GCL+IPL thinning in the macular region. Two eyes with abnormalities in all PD points showed no hyperreflective area. The remaining three eyes had normal PD points despite the lack of high reflectivity areas in the slab images. Therefore, 91.7% of eyes showed agreement between en face slab images and PD plots. Moreover, hyperreflective areas demonstrated significantly better TD than hyporeflective areas. Conclusions: En face slab images of maculae were able to reveal the residual nerve fiber bundles in the eyes with advanced glaucoma despite the GCL+IPL thickness in the maculae being diffusely and substantially reduced.
2019年07月01日, Investigative ophthalmology & visual science, 60 (8), 2811 - 2821, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 2019年06月, 神経眼科, 36 (2), 147 - 148, 日本語, 国内誌序論 徹底討論！Visual pathway disorder
[査読有り]
研究論文（学術雑誌）
- 2019年05月, あたらしい眼科, 36 (5), 611 - 617, 日本語, 国内誌視路疾患のOCT up-to-date
[査読有り]
研究論文（学術雑誌）
- 2019年05月, あたらしい眼科, 36 (5), 571 - 572, 日本語, 国内誌序説 神経眼科診療を楽しもう！
[査読有り]
研究論文（学術雑誌）
Purpose: The purpose of this study was to evaluate the concordance of a temporal raphe architecture estimated using optical coherence tomography (OCT) and MP-3 microperimetry. Methods: We enrolled 25 eyes with either an upper or lower glaucomatous hemifield defect, as detected on the Humphrey visual field 30-2 test. A structural temporal raphe was extrapolated from visible end points of retinal nerve fiber bundles present in a perimetrically normal hemiretina on an en face Spectralis OCT image. A functional temporal raphe was drawn as a line from the fovea to the border of at least a 10-dB difference in sensitivity, at vertically adjacent test points, with at least three consecutive pairs among 25 test points placed at 8° to 18° from the fovea (2° intervals) on the MP-3. An angle determined by the optic disc center, the fovea, and the temporal raphe line (the DFR angle) was calculated. Correlations and agreement of the OCT- and MP-3-derived DFR angles and factors affecting discordance of the two estimates were evaluated. Results: Despite no significant demographic differences, the functional DFR angle (mean ± SD, 171.8° ± 3.5°) was significantly larger than that of the structural DFR angle (166.5° ± 3.2°) in 14 eyes with upper hemifield defects and vice versa in 11 eyes with lower hemifield defects (163.4° ± 3.0° vs. 170.5° ± 3.2°). The mean deviation was significantly associated with the functional and structural DFR angle difference in eyes with only upper hemifield defects. Conclusions: The structural temporal raphe was more deviated to the perimetrically normal hemiretina side than to the functional temporal raphe, thereby suggesting that a structural change may precede a functional loss.
2019年04月01日, Investigative ophthalmology & visual science, 60 (5), 1403 - 1411, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2019年03月, 日本眼科学会雑誌, 123 (臨増), 258 - 258, 日本語マイクロパルス波経強膜毛様体光凝固術の術後短期成績
- (公財)日本眼科学会, 2019年03月, 日本眼科学会雑誌, 123 (臨増), 213 - 213, 日本語網膜静脈分枝閉塞症に伴う黄斑浮腫における網膜最内層/内層/外層障害と視力予後の評価
[査読有り]
- (公財)日本眼科学会, 2019年03月, 日本眼科学会雑誌, 123 (臨増), 216 - 216, 日本語糖尿病性黄斑浮腫に対する12ヵ月のアフリベルセプト治療成績に影響する因子の検討
[査読有り]
- (公財)日本眼科学会, 2019年03月, 日本眼科学会雑誌, 123 (臨増), 224 - 224, 日本語Vogt-小柳-原田病治療経過中の脈絡膜再肥厚と脈絡膜構造変化の検討
[査読有り]
- (公財)日本眼科学会, 2019年03月, 日本眼科学会雑誌, 123 (臨増), 273 - 273, 日本語Vogt-小柳-原田病治療前後の脈絡膜構造指標の変化と相関
[査読有り]
- (公財)日本眼科学会, 2019年03月, 日本眼科学会雑誌, 123 (臨増), 289 - 289, 日本語視力良好な中心性漿液性脈絡網膜症における治療後歪視の予測因子についての検討
[査読有り]
- 続発緑内障に対するテノン開創器を用いた線維柱帯切除術の短期成績
目的:続発緑内障に対するテノン開創器を用いた線維柱帯切除術の短期成績を調べること。対象と方法:2016年4月から2017年5月までの期間に神戸大学医学部附属病院で続発緑内障に対してテノン開創器を用いたマイトマイシンC併用線維柱帯切除術が施行された、連続11例12眼を後ろ向きに評価した。本新術式は、1)テノン開創器で強膜とテノン嚢の間に十分なスペースを確保し強膜の後方スペースに広くマイトマイシンC含有スポンジを留置する点、2)強膜フラップ後方を無縫合とする点、3)輪部結膜付近に3mm×6mmのブロッキング糸をかける点が特徴である。治療効果については、手術前後における眼圧および緑内障点眼スコアの変化および術後処置の内容で評価した。結果:続発緑内障の原因は、ブドウ膜炎続発緑内障6眼、血管新生緑内障4眼、落屑緑内障2眼であった。平均眼圧は、術前の34.8±13.8mmHgから術後12ヵ月で18.1±4.0mmHgと、有意に低下していた(p<0.001)。平均点眼スコアについても、術前の4.3±1.2から術後12ヵ月で1.1±1.5と有意に低下していた(p<0.001)。術後結膜下瘢痕に対して濾過胞再建を要した血管新生緑内障の1例を除き、術後処置(レーザー切糸、結膜縫合を含む)を必要とした症例はなかった。結論:続発緑内障に対するテノン開創器を用いた線維柱帯切除術は短期経過では有望な術式であると推測される。(著者抄録)
(公財)日本眼科学会, 2019年02月, 日本眼科学会雑誌, 123 (2), 121 - 127, 日本語, 国内誌[査読有り]
研究論文（学術雑誌）
Langerhans cell histiocytosis (LCH) is characterised by tissue destruction caused by the abnormal proliferation of pathogenic dendritic cells. We report a rare case of multi-system LCH with local invasion of the orbital apex.A 56-year-old woman suffered from a decrease of visual acuity in the left eye caused by central scotoma and the limitation of eye movement in all directions. Magnetic resonance imaging revealed an enhanced lesion in the left orbital apex, suggesting optic nerve compression. She had been diagnosed with eosinophilic granuloma 24 years previously. Two weeks after the current presentation, we admitted the patient for optic canal and orbital apex decompression and subtotal tumour resection. Histopathological analysis confirmed the diagnosis of LCH. Post-surgical treatment with low-dose cytarabine was initiated for the residual tumour. However, it was ceased because of myelosuppression-induced pyelonephritis. After surgery, the central scotoma disappeared on day 5 and eye movement palsy resolved by 6 months. After the cessation of cytarabine, she has received low-dose steroid therapy for 2 years with no recurrence. Early surgical intervention with low-dose steroid therapy can lead to recovery of visual acuity and resolve eye movement palsy in patients with lesions of the orbital apex caused by multi-system LCH.
KARGER, 2019年, CASE REPORTS IN OPHTHALMOLOGY, 10 (3), 319 - 326, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
BACKGROUND: Surgical intervention for dense vitreous hemorrhage (DVH) with unclear etiology is often delayed in favor of conservative follow-up despite possible disease progression and the availability of safe minimally invasive vitrectomy. OBJECTIVES: The aim of this study is to investigate the efficacy of early surgical intervention for DVH with unknown etiology. METHODS: Eighty-eight cases (88 eyes) of DVH with unknown origin were retrospectively reviewed. Inclusion criteria were as follows: (1) measured visual acuity (VA) of 20/200 or worse and (2) fundus invisibility requiring B-scan ultrasonography. Eyes with a history of diabetic retinopathy, recent trauma, or likely retinal detachment (RD) as revealed by B-scan ultrasonography were excluded. Outcome measures were a cause of vitreous hemorrhage and final VA following early (≤2 weeks after symptom onset) or delayed vitrectomy. RESULTS: The most frequently occurring causes of DVH were central or branch retinal vein occlusion (30 eyes, 34%) and retinal tear or RD (29 eyes, 33%). logMAR VA significantly improved after treatment (p < 0.001). Final VA was significantly higher for eyes treated within 2 weeks compared with eyes treated later than 2 weeks after symptom onset (p = 0.020). CONCLUSIONS: Surgical intervention within 2 weeks after symptom onset may prevent a lower visual outcome.
2019年, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde, 242 (4), 234 - 238, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
BACKGROUND: Invasive aspergillosis is often fatal. Here, we report a patient with invasive aspergillosis primarily involving the optic nerve diagnosed on autopsy. CASE PRESENTATION: A 77-year-old female with underlying diabetes mellitus, hyperlipidemia, and hypertension presented with disc swelling of the left eye. Although mini-pulse steroid therapy improved visual acuity (VA) of the left eye, it abruptly decreased to no light perception within a month, followed by a decrease in VA of the right eye to 0.5. At referral, VA was 0.3 in the right eye, and there was no light perception in the left eye. RESULTS: Fundus examination revealed optic disc swelling of both eyes. Goldmann perimetry showed irregular visual field defects, whereas magnetic resonance imaging (MRI), general, and cerebrospinal fluid (CSF) examinations revealed no distinct abnormalities. We suspected anterior ischemic optic neuropathy and invasive optic neuropathy. As with the left eye, steroid pulse therapy temporarily improved VA of the right eye and then decreased to 0.2. Additional anticoagulant therapy did not improve VA. Concurrent to therapy, the patient became febrile with depressed consciousness. Repeat MRI identified suspected midbrain infarction, and CSF examination indicated cerebral meningitis. In spite of administering transfusions and antibiotics, she died on hospital day 40. Autopsy revealed large amounts of Aspergillus hyphae mainly localized in the dura mater of the optic nerve and destruction of the cerebral artery wall, suggesting an etiology of subarachnoid hemorrhage. CONCLUSIONS: When examining refractory and persistent disc swelling, we should rule out fungal infections of the optic nerve.
2019年01月, Case Reports in Ophthalmology, 10 (1), 11 - 18, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
© 2019 The Author(s). Purpose: Axitinib, an orally administered vascular endothelial growth factor receptors 1, 2, and 3 inhibitor, is widely used as the second-line treatment for metastatic renal cell carcinoma. We present a case of metastatic renal cell carcinoma who developed a novel ocular adverse event, impaired retinal circulation, during axitinib therapy. Methods: This is an observational case report. Results: A 57-year-old male who had been treated with axitinib for metastatic renal cell carcinoma for 2 years presented in August 2015. He complained of sudden-onset abnormal visual field in his right eye. His right eye exhibited multiple soft exudates on fundus photography and a significant fluorescein filling delay of the retinal vessels on fluorescein angiography. His best corrected visual acuity (BCVA) was 20/20 in the right eye, and a cecocentral scotoma was detected by Goldmann perimeter. As axitinib could have been responsible for impaired retinal circulation, axitinib was terminated and switched to temsirolimus. The soft exudates gradually subsided and the patients' symptoms got better, but his right BCVA dropped to 20/63 3 months after the end of axitinib treatment with worsening of his general condition. Conclusion: Clinicians should be aware of retinal circulatory disorder that can occur in patients under axitinib treatment.
2019年01月01日, Case Reports in Ophthalmology, 10 (1), 5 - 10, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Purpose: This study aimed to evaluate the long-term efficacy and safety of infliximab (IFX) and cyclosporine (CsA) combination therapy for refractory uveoretinitis in Behçet's disease (BD). Patients and methods: The study involved a retrospective review of the medical records of 11 patients with Behçet's uveoretinitis refractory to conventional treatment who had been treated with IFX+CsA combination therapy. The frequency of ocular inflammatory attacks and a Behçet's disease ocular attack score 24 (BOS24) were used as indices for the evaluation of efficacy during each 6-month period prior to and following initiation of therapy. For the assessment of safety, adverse events (AEs) were recorded throughout the treatment period. Results: The patients had received IFX+CsA combination therapy for 5.6±2.3 years. The frequency of ocular attacks per 6-month period decreased markedly from 2.9±1.6 during the baseline period to 0.6±0.9 during months 1-6, 0.5±0.9 during months 7-12, 0.3±0.5 during months 13-18, 0.3±0.7 during months 19-24, and 0.0±0.0 thereafter (P=0.003). The BOS24 score per ocular attack significantly decreased from 5.2±2.4 during the baseline period to 1.5±2.1 during months 1-6, 1.7±3.1 during months 7-12, 1.6±2.9 during months 13-18, and 0.4±1.0 during months 19-24 (P=0.002). No serious AEs were observed, with the exception of urinary tract infection and cataract progression. Two patients exhibited transient elevation of the serum creatinine level, which was normalized following a reduction in the dose of CsA. Conclusion: For refractory Behçet's uveoretinitis, IFX+CsA combination therapy offers a promising treatment option as it appears to have an acceptable safety profile and can reduce the frequency and severity of ocular inflammatory attacks over a long period of time.
2019年, Clinical ophthalmology (Auckland, N.Z.), 13, 521 - 527, 英語, 国際誌[査読有り]
Background: Leber hereditary optic neuropathy (LHON) is a maternally inherited disease caused by three missense mutations of mitochondrial (mt) DNA, ie, m 3460 G>A, m 11778 G>A, or m 14484 T>C in the greater portion of LHON. m 11778 G>A mutation is especially observed in >90% of the cases in Japanese families. Although spontaneous remission of visual function infrequently occurs, effective treatment for LHON remains unestablished. Transcorneal electrical stimulation has been shown to be efficacious in individuals with optic neuropathy. However, due to potential risk of corneal damage, repeated treatments are not permissible. In this exploratory study, we will be conducting skin electrical stimulation (SES) as an intervention for patients with LHON having 11778 missense mutation and investigate effectiveness and safety of SES. Methods: This is a single-arm, prospective, open-label exploratory trial focused on patients with LHON having 11778 missense mutation. Eleven patients will be enrolled and receive six consecutive SES once every 2 weeks up to 10 weeks. The safety of the SES will be monitored with specular microscopy, slit-lamp biomicroscopy, fundus examinations, and the observation of facial skin. The primary outcome measure will be the averaged l ogarithm of minimum angle resolution (logMAR) converted visual acuity 1 week after the last SES. Secondary outcome measures include changes, in logMAR at 4 and 8 weeks after the last SES, such as visual field indices measured using Humphrey visual field and microperimetry-3, the thickness of peripapillary retinal fiber and macular ganglion cell complex, multifocal visual evoked potentials, critical flicker frequency, and color vision. Discussion: The results of this proposed proof-of-concept feasibility trial will help plan and execute a larger definitive trial to test SES as an effective strategy for LHON and related optic neuropathies and help establish a beneficial treatment for LHON.
2019年, Clinical ophthalmology (Auckland, N.Z.), 13, 897 - 904, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Purpose: To investigate the foveal avascular zone (FAZ) in the eyes of patients with a history of retinopathy of prematurity (ROP) using optical coherence tomography angiography (OCTA) and to identify associated clinical factors. Patients and methods: Overall, 14 children with a history of laser treatment for ROP, 17 children born prematurely without a history of ROP, and 41 age-matched children born at full-term (age range 7-14 years) were included. OCTA was conducted on an area measuring 3 × 3 mm in the central macula. The area of FAZ in the superficial layer was measured. Foveal thickness (FT), ganglion cell complex thickness, and the presence of inner retinal layer (IRL) at the fovea were evaluated. Results: There were significant differences in FT and FAZ size among patients (P < 0.001). The eyes of patients that had been treated for ROP showed the smallest FAZ and greatest FT. Univariate analyses demonstrated that the area of FAZ was not correlated with visual acuity (P=0.078) but with gestational age (GA) (P=0.001), birth weight (P=0.013), the presence of IRL (P < 0.001), and FT (P < 0.001). Multivariate regression analyses showed that the area of FAZ was significantly associated with GA, the presence of IRL, and FT (P=0.03, P=0.01, P < 0.001, respectively). Conclusion: The eyes of preterm children had small FAZ, and this reduction in area was associated with greater FT, the presence of IRL, and lower GA.
2019年, Journal of ophthalmology, 2019, 8340729 - 8340729, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
PURPOSE: This study was prospectively carried out to clarify the effectiveness of visual and anatomical outcomes under combination therapy of intravitreal aflibercept (IVA) and verteporfin photodynamic therapy (vPDT) in over 24 months. STUDY DESIGN: A single-arm prospective exploratory study. METHODS: Twenty-six eyes of 26 treatment naïve PCV patients were enrolled in this study. The primary outcome measures were the changes in best corrected visual acuity (BCVA) and the complete polyp regression rate. The secondary outcome measures included central retinal thickness assessed by optical coherence tomography. RESULTS: The patients showed significant improvement in BCVA by 0.14 logMAR units at 12 months and 0.11 logMAR units at 24 months from baseline (both p < 0.01). The mean central retinal thickness also significantly decreased at 12 months (p < 0.001) and at 24 months (p = 0.001). Complete regression of polypoidal lesions was achieved by 15 out of 20 eyes (75%) at 12 months and 11 out of 20 eyes (55%) at 24 months. The mean treatment number was 2.9 courses of IVA and 1.5 courses of vPDT and the mean retreatment free interval after initial therapy was 12.8 months during follow up of 24 months. The complete data from all predetermined examinations were observed in 17 out of 26 enrolled patients (65%) in this study. CONCLUSION: In this study, combination therapy of IVA and vPDT yielded visual and anatomical improvements in treatment-naïve PCV patients over a 24-month follow-up period.
2019年01月, Japanese journal of ophthalmology, 63 (1), 100 - 108, 英語, 国内誌[査読有り]
研究論文（学術雑誌）
- 日本神経眼科学会, 2018年11月, 神経眼科, 35 (増補1), 79 - 79, 日本語
- 眼科臨床紀要会, 2018年11月, 眼科臨床紀要, 11 (11), 838 - 839, 日本語抗血管内皮増殖因子薬硝子体内注射で治療開始した網膜静脈分枝閉塞症の治療休止割合
[査読有り]
- 日本神経眼科学会, 2018年11月, 神経眼科, 35 (増補1), 87 - 87, 日本語髄膜炎を伴う続発性眼窩炎症と強膜炎を呈した汎発性帯状疱疹の1例
[査読有り]
- (一社)日本糖尿病合併症学会, 2018年10月, 糖尿病合併症, 32 (Suppl.1), 298 - 298, 日本語糖尿病黄斑浮腫治療成績とOCT en face slab像の関係
[査読有り]
- 眼科臨床紀要会, 2018年10月, 眼科臨床紀要, 11 (10), 763 - 763, 日本語視力良好なポリープ状脈絡膜血管症への光線力学的療法単独とアフリベルセプト併用療法
[査読有り]
PURPOSE: The purpose of this study was to evaluate the surgical success of sulcus fixation of Baerveldt glaucoma implant (BGIs) in special reference to corneal damage. METHODS: This observational prospective cohort study included 24 patients who underwent a median of 3.0 previous intraocular surgeries and sulcus fixation of BGIs for the first time. The intraocular pressure (IOP), the number of ocular hypotensives used, corneal endothelial cell density (ECD), and logMAR-converted best-corrected visual acuity (VA) of each patient were measured preoperatively and postoperatively until 12 months after surgery. Surgical success was evaluated after 12 months based on the reduction of IOP (5-21 mmHg and > 20% reduction), corneal damage (postoperative development of decompensation, unmeasurable ECD, or ECD reduction of > 20%), loss of light perception, and need for additional surgeries. RESULTS: Surgical success was noted in 16 (66.7%) patients when corneal damage was included as a failure criterion, whereas surgery was successful in 21 (87.5%) patients when solely judged using IOP control similarly as previous clinical trials. The median IOP decreased from 27.5 mmHg preoperatively to 14.5 mmHg postoperatively (P < 0.0001). The number of ocular hypotensives was significantly reduced postoperatively (P < 0.0001). The median postoperative ECD reduction was only 0.15%, although ECD could not be measured during follow-up or it was significantly reduced by > 20% in six patients. VA was not significantly reduced after surgery. Adverse effects were observed in 15 patients (62.5 cumulative %). CONCLUSION: Sulcus fixation of BGIs may be effective and safe in patients with glaucomatous eyes who underwent multiple prior intraocular surgeries.
2018年10月, Graefes Arch Clin Exp Ophthalmol, 256 (10), 1953 - 1960, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 日本糖尿病眼学会, 2018年09月, 日本糖尿病眼学会誌, 22, 134 - 134, 日本語実臨床における糖尿病黄斑浮腫に対するラニビズマブ硝子体注射の12ヵ月治療成績
[査読有り]
Purpose: To report a rare case of bilateral periphlebitis associated with a pineal germinoma. Observations: A 17-year-old male teenager presented at a local clinic complaining of blurred vision in both eyes. The treating physician identified bilateral uveitis, and prescribed the patient with a local steroid treatment. However, the inflammatory findings did not improve with the treatment, and the patient was referred to our hospital for further examination. At the first visit, his best-corrected visual acuities were 0.3 for the right eye and 0.06 for the left eye; we found no inflammation in the anterior ocular segment, but observed bilateral retinal periphlebitis and a proliferative membrane from the papilla to the macula in the ocular fundus. In addition, we found a tractional serous retinal detachment in the macula. We suspected tuberculous uveitis clinically and initiated treatment with an antituberculous drug. However, the condition of the patient did not improve. Two months after our initial examination, left optic neuritis appeared, and we initiated a steroid pulse therapy. Although the periphlebitis remained, the left optic nerve findings and the visual acuity of both eyes improved. Thus, we reduced the oral steroid dose gradually. However, two months after initiating the dose reduction, the patient suffered a consciousness disturbance, and we detected a pineal tumor by magnetic resonance imaging (MRI). The patient was diagnosed as having a germ cell tumor by pathological examination and underwent radiation and chemotherapy. We noted marked improvements in both the periphlebitis findings and in the visual acuity following the treatment for the pineal tumor. Conclusions and importance: Cases of pineal tumor accompanied with retinal periphlebitis have been reported rarely. Because juvenile retinal vasculitis cases of unknown cause can be associated with pineal germinomas, we recommend brain MRI examinations for such cases.
2018年09月, American journal of ophthalmology case reports, 11, 142 - 145, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 2018年09月, 神経眼科, 35 (3号), 303 - 308, 日本語レーベル遺伝性視神経症における視標サイズに基づく中心暗点の評価
[査読有り]
研究論文（学術雑誌）
PURPOSE: To present a unique case of neuro-neutrophilic disease with inflammation and thrombosis of the superior ophthalmic vein (SOV). OBSERVATIONS: A 43-year-old Japanese man with past histories of oculomotor paralysis, auditory disorder, ischemic enteritis, and recurrent oral ulceration was referred to our hospital because of blurred vision in his right eye. Ophthalmic examination revealed decreased best corrected visual acuity and central scotoma in his right eye. Orbit magnetic resonance imaging (MRI) revealed an enlarged SOV in the right eye, with Gadolinium (Gd) enhancement in the wall of the vein but not inside the vein, indicating thrombosis. Multiple Gd-enhanced hyperintense lesions were also observed in the juxtacortical area of the brain. We diagnosed the patient with vasculitis in the right SOV that was adversely affecting the optic nerve. We ruled out systemic thrombophilia, infections, and malignancy by systemic examinations. The human leukocyte antigen (HLA) typing was Cw1-, B54-, B61-, A2-, A24-, and DR4-positive and B51-negative. We treated the patient with systemic steroid and anticoagulant therapy. After three courses of steroid pulse therapy, his symptoms and the MRI findings of the right SOV and brain improved; therefore, we decided to discontinue the anticoagulant therapy. One month after anticoagulant cessation, MRI revealed recurrence of the thrombus and enlargement of the right SOV despite the lack of vision worsening. We restarted the anticoagulant therapy while continuing the oral prednisolone treatment. At the final visit, 14 months after the onset of the disease, the patient was still receiving oral anticoagulation with warfarin potassium and prednisolone (5 mg/day). His symptoms and the right eye's visual function remained normal with a mildly enlarged SOV; there was less Gd enhancement and no brain lesions on MRI. CONCLUSIONS AND IMPORTANCE: We treated a unique case of possible neuro-neutrophilic disease that presented visual disturbances due to right SOV inflammation and thrombosis. Anticoagulation and systemic steroid therapies were required to reduce the inflammation and to prevent the recurrence of thrombosis.
2018年08月, Am J Ophthalmol Case Rep, 12, 39 - 44, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 眼科臨床紀要会, 2018年07月, 眼科臨床紀要, 11 (7), 555 - 555, 日本語緑内障眼における他覚的・自覚的機能検査結果とEn Face slab画像を用いた構造評価結果の相関性の検討
Purpose: To evaluate temporal changes in visual acuity in patients with steroid-resistant optic neuritis (ON) in neuromyelitis optica spectrum disorders (NMOSD) after apheresis. Design: Retrospective observational study, clinical case series Subjects and methods: We reviewed the medical charts of 15 eyes of 9 consecutive patients with ON in NMOSD who underwent apheresis between March 2010 and September 2017. All patients were seropositive for anti-aquaporin 4 (AQP4) antibody and resistant to steroid pulse therapy. Apheresis was performed by either simple plasma exchange or/and immune adsorption therapy. Results: Twelve eyes (80%) showed improvement with logMAR > 0.3 at 1 month after apheresis. Within 1 month after apheresis therapy, logMAR on average significantly decreased, the magnitude of change being greatest within the first week. Thereafter visual acuity became stable in 10 of the 11 eyes, until 12 months. However, two eyes (12%) showed recurrence of visual acuity reduction 3 months after the cessation of apheresis. There were a few serious complications during and after apheresis, but these were completely treatable. Conclusions: Additional apheresis therapy rapidly improves the visual acuity of steroid-resistant seropositive AQP4 ON.
Springer Tokyo, 2018年07月01日, Japanese Journal of Ophthalmology, 62 (4), 525 - 530, 英語[査読有り]
研究論文（学術雑誌）
- 2018年07月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 59 (9)The association of age-related maculopathy susceptibility 2 gene polymorphisms with the 12 months outcomes of combination therapy with intravitreal aflibercept and verteporfin photodynamic therapy for polypoidal choroidal vasculopathy
[査読有り]
研究論文（学術雑誌）
- 2018年07月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 59 (9)Structural changes in the inner retina assessed by slab en face optical coherence tomography in diabetic eyes
[査読有り]
研究論文（学術雑誌）
BACKGROUND: Recent immune therapy with checkpoint inhibitors (CPIs) has demonstrated remarkable antitumor effects on specific tumors, such as malignant lymphoma and non-small cell lung carcinoma. By contrast, CPIs cause an imbalance in the immune system, triggering a wide range of immunological side effects termed immune-related adverse effects (irAEs). Here, we report a rare case of optic neuritis and hypopituitarism during anti-programmed death-ligand 1 (PD-L1) antibody treatment. CASE PRESENTATION: A patient with non-small cell lung carcinoma received anti-PD-L1 antibody treatment every 3 weeks; however, the patient started experiencing headaches, general fatigue, anorexia, and diarrhea approximately 1 year after the initiation of the treatment. Moreover, sudden visual loss of the right eye occurred 1 week after the interruption of the anti-PD-L1 antibody treatment. MRI findings showed gadolinium enhancement in the left optic nerve, but no enlargement of the pituitary gland and stalk. Laboratory data showed decreased serum adrenocorticotropic hormone (ACTH), cortisol, and free T4 levels, and a hormone tolerance test indicated hypopituitarism, hypothyroidism, and hypoadrenocorticism. The central scotoma caused by optic neuritis completely disappeared immediately after a course of steroid pulse therapy, and no recurrence occurred up to 2 years after initiation of the steroid pulse therapy while replacement therapy for hypothyroidism and hypoadrenocorticism was continued. CONCLUSIONS: The patient presented with optic neuritis and hypopituitarism, possibly due to irAEs of the anti-PD-L1 antibody treatment. Steroid pulse therapy was effective for optic neuritis, suggesting underlying immunological mechanisms. Neurological complications including optic neuritis should be considered when examining patients with cancer undergoing CPI treatment.
2018年07月, Case Rep Ophthalmol, 9 (2), 348 - 356, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Central serous chorioretinopathy (CSC) is a common disease affecting younger people and may lead to vision loss. CSC shares phenotypic overlap with age-related macular degeneration (AMD). As recent studies have revealed a characteristic increase of choroidal thickness in CSC, we conducted a genome-wide association study on choroidal thickness in 3,418 individuals followed by TaqMan assays in 2,692 subjects, and we identified two susceptibility loci: CFH rs800292, an established AMD susceptibility polymorphism, and VIPR2 rs3793217 (P = 2.05 × 10-10 and 6.75 × 10-8, respectively). Case-control studies using patients with CSC confirmed associations between both polymorphisms and CSC (P = 5.27 × 10-5 and 5.14 × 10-5, respectively). The CFH rs800292 G allele is reportedly a risk allele for AMD, whereas the A allele conferred risk for thicker choroid and CSC development. This study not only shows that susceptibility genes for CSC could be discovered using choroidal thickness as a defining variable but also, deepens the understanding of differences between CSC and AMD pathophysiology.
2018年06月12日, Proceedings of the National Academy of Sciences of the United States of America, 115 (24), 6261 - 6266, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Purpose: To report a case of temporary bilateral corneal denting in a patient who underwent cardiovascular surgery under general anesthesia. Observations: A 71-year-old male with no history of ophthalmological disease experienced bilateral corneal denting immediately after undergoing surgery for aneurysm of the thoracic aorta under general anesthesia. Anesthesia was induced with propofol and maintained with rocuronium bromide and remifentanil hydrochloride. The initial examination revealed significant denting on the surface of both the corneas and ocular hypotension. Visual evaluation could not be performed due to the patient's low level of consciousness resulting from delayed emergence from anesthesia. After applying tropicamide and phenylephrine ophthalmic solution for fundus examination, the ocular morphology improved. Ocular pressure was normal on the day after surgery, and creasing on the surface of the corneas had disappeared. Conclusions: and Importance: We experienced a patient with bilateral corneal denting following a cardiovascular surgery under general anesthesia. The dents could be attributed to augmentation of ocular hypotension using several types of anesthesia at relatively high doses.
2018年06月, American journal of ophthalmology case reports, 10, 290 - 292, 英語, 国際誌[査読有り]
PURPOSE: The purpose of this study was to describe the initial experience, efficacy, and safety of ripasudil hydrochloride hydrate (ripasudil), a Rho-associated kinase inhibitor eye drop, for uveitic glaucoma. METHODS: In this retrospective case series, we retrieved the clinical data of 21 eyes from 19 patients with open-angle uveitic glaucoma who were treated with ripasudil at Kobe University Hospital. We analyzed the median intraocular pressure (IOP) reductions after ripasudil treatment and collected the information on the adverse events that were encountered during the course of this treatment period. RESULTS: The causes of uveitis were sarcoidosis (29%), Behçet's disease (14%), Vogt-Koyanagi-Harada disease (10%), others (15%), and unclassified (33%). Of total, 19 (90%) eyes were treated with topical, periocular, and/or systemic steroid therapies. The median number of glaucoma medications used before ripasudil treatment was 2, and the median follow-up time was 13 months. The median IOPs were 23 mmHg at baseline, 16 mmHg at 1 month, and 18 mmHg at 12 months with significant IOP reductions of - 3 mmHg at 1 month and - 2 mmHg at 12 months (P = 0.0050). Of total, 11 (52%) eyes with an IOP reduction ≥ 3 mmHg at 1 month (responders) showed a significant median IOP decrease at 12 months compared with non-responders (- 5 versus 0 mmHg, P = 0.0242). Two adverse events were observed: rashes on the back and transient conjunctival hyperemia. CONCLUSIONS: Ripasudil appears to be safe and substantially reduce IOP in eyes with uveitic glaucoma if the eye is a responder. Ripasudil could be an option for the treatment of uveitic glaucoma.
2018年04月, Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 256 (4), 809 - 814, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2018年03月, 日本眼科学会雑誌, 122 (3), 252 - 253, 日本語緑内障眼における他覚的・自覚的機能検査結果とen face slab画像を用いた構造評価結果の相関性の検討
- (公財)日本眼科学会, 2018年03月, 日本眼科学会雑誌, 122 (臨増), 166 - 166, 日本語アクアポリン9遺伝子欠損マウスにおける視神経挫滅後の網膜神経節細胞死
[査読有り]
- (公財)日本眼科学会, 2018年03月, 日本眼科学会雑誌, 122 (臨増), 176 - 176, 日本語光干渉断層計slab en face像を用いた糖尿病網膜内層構造変化の評価
[査読有り]
- (公財)日本眼科学会, 2018年03月, 日本眼科学会雑誌, 122 (臨増), 203 - 203, 日本語ポリープ状脈絡膜血管症へのアフリベルセプト併用光線力学療法後の網膜色素上皮萎縮
[査読有り]
- (公財)日本眼科学会, 2018年03月, 日本眼科学会雑誌, 122 (臨増), 246 - 246, 日本語続発緑内障に対するテノン開創器を用いた線維柱帯切除術の短期成績
[査読有り]
- 2018年03月, 平成27(2015)年度～ 平成29(2017)年度 厚生労働科学研究費補助金 疾病・障害対策研究分野 難治性疾患等政策研究（難治性疾患政策研究）総括研究報告書, 日本語
研究論文（その他学術会議資料等）
PURPOSE: To compare the postoperative anatomic success rates and the frequency of complications between prone or supine postoperative positioning after transconjunctival sutureless vitrectomy (TSV) for rhegmatogenous retinal detachment (RRD). METHODS: All patients underwent primary 27-gauge TSV for the treatment of primary RRD. Patients were divided into two groups as follows: group A was patients instructed to keep strict postoperative prone positioning for a minimum of 8 days. Group B was patients instructed to keep the prone positioning on the day of the surgery followed by supine positioning for minimum of 7 days from the day after surgery. RESULT: Sixty-two eyes were enrolled (group A: 32, group B: 30). There was no significant difference in baseline data between two groups. The initial and final anatomical success rates were 93.8% and 100% in group A and 93.3% and 100% in group B, respectively (p = 1, p = 1, respectively). Posterior synechia of the iris occurred in one eye in group A and in two eyes in group B (p = 0.61). Macular pucker and retinal fold did not occur in either group. Preoperative intraocular pressure (IOP; mmHg) was 14.5 ± 2.9 in group A and 14.5 ± 2.6 in group B (p = 0.92). Intraocular pressure (IOP) was not statistically different between the groups during the follow-up period (p = 0.36, p = 0.07, respectively). CONCLUSION: Supine positioning may be an option as a postoperative positioning after TSV and gas tamponade for the treatment of RRD.
2018年03月, Acta ophthalmologica, 96 (2), e189-e194 - e194, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Primary open-angle glaucoma (POAG) is the leading cause of irreversible blindness worldwide for which 15 disease-associated loci had been discovered. Among them, only 5 loci have been associated with POAG in Asians. We carried out a genome-wide association study and a replication study that included a total of 7378 POAG cases and 36 385 controls from a Japanese population. After combining the genome-wide association study and the two replication sets, we identified 11 POAG-associated loci, including 4 known (CDKN2B-AS1, ABCA1, SIX6 and AFAP1) and 7 novel loci (FNDC3B, ANKRD55-MAP3K1, LMX1B, LHPP, HMGA2, MEIS2 and LOXL1) at a genome-wide significance level (P < 5.0×10-8), bringing the total number of POAG-susceptibility loci to 22. The 7 novel variants were subsequently evaluated in a multiethnic population comprising non-Japanese East Asians (1008 cases, 591 controls), Europeans (5008 cases, 35 472 controls) and Africans (2341 cases, 2037 controls). The candidate genes located within the new loci were related to ocular development (LMX1B, HMGA2 and MAP3K1) and glaucoma-related phenotypes (FNDC3B, LMX1B and LOXL1). Pathway analysis suggested epidermal growth factor receptor signaling might be involved in POAG pathogenesis. Genetic correlation analysis revealed the relationships between POAG and systemic diseases, including type 2 diabetes and cardiovascular diseases. These results improve our understanding of the genetic factors that affect the risk of developing POAG and provide new insight into the genetic architecture of POAG in Asians.
2018年02月, Hum Mol Genet, 27 (8), 1486 - 1496, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Purpose: To report a case of polypoidal choroidal vasculopathy associated with optic disc coloboma. Methods: Case report. Results: A 50-year-old woman presented with optic disc coloboma and retinochoroidal coloboma associated with subretinal hemorrhage and serous retinal detachment (SRD) in her left eye. Optical coherence tomography (OCT) confirmed SRD at the macula and showed a sharply elevated retinal epithelial detachment at the choroidal excavation. OCT also revealed choroidal cavitation along the temporal side of the optic coloboma. Fluorescein angiography showed hyperfluorescent dye leakage and indocyanine green angiography revealed polypoidal lesions. We diagnosed polypoidal choroidal vasculopathy (PCV). PCV was located at the end of the choroidal cavitation. Her left eye was treated with an intraocular injection of the anti-vascular endothelial growth factor aflibercept (2 mg). Photodynamic therapy was performed using the standard protocol 1 week after the intravitreal application of aflibercept. One month after the combined treatment, OCT showed completely resolved SRD and her symptoms disappeared. Her best-corrected visual acuity remained stable and no recurrence was found during a 12-month follow-up period. Conclusion: PCV associated with optic disc coloboma has not been previously reported. The morphological abnormality of choroidal cavitation and choroidal excavation connecting with optic disc coloboma may contribute to the development of PCV in this case.
S. Karger AG, 2018年01月23日, Case Reports in Ophthalmology, 9 (1), 92 - 95, 英語[査読有り]
研究論文（学術雑誌）
Purpose Three-dimensional retinal organoids can be differentiated from embryonic stem cells/induced pluripotent stem cells (ES/iPS cells) under defined medium conditions. We modified the serum-free floating culture of embryoid body-like aggregates with quick reaggregation (SFEBq) culture procedure to obtain retinal organoids expressing more rod photoreceptors and S- and M-cone opsins. Methods Retinal organoids differentiated from mouse Nrl-eGFP iPS cells were cultured in various mediums during photoreceptor development. To promote rod photoreceptor development, organoids were maintained in media containing 9-cis retinoic acids (9cRA). To obtain retinal organoids with M-opsin expression, we cultured in medium with 1% fetal bovine serum (FBS) supplemented with T3, BMP4, and DAPT. Section immunohistochemistry was performed to visualize the expression of photoreceptor markers. Results In three-dimensional (3D) retinas exposed to 9cRA, rhodopsin was expressed earlier and S-cone opsins were suppressed. We could maintain 3D retinas up to DD 35 in culture media with 1% FBS. The 3D retinas expressed rhodopsin, S- and M-opsins, but most cone photoreceptors expressed either S- or M-opsins. Conclusion By modifying culture conditions in the SFEBq protocol, we obtained rod-dominated 3D retinas and S- and M-opsin expressing 3D retinas.
Elsevier B.V., 2018年01月22日, Biochemical and Biophysical Research Communications, 495 (4), 2595 - 2601, 英語[査読有り]
研究論文（学術雑誌）
PURPOSE: This study evaluates optical coherence tomography (OCT) findings of the macula in patients with a history of retinopathy of prematurity (ROP). METHODS: We enrolled 112 patients (age: 6-15 years) and categorized them into 3 groups: gestational age (GA) < 36 weeks with or without a history of ROP (ROP group, preterm group) and GA ≥37 weeks. We included 1 eye of each patient and measured the retinal thickness of the macula by OCT. RESULTS: The ROP group demonstrated the worst VA and the shallowest foveal depression. Furthermore, foveal depression significantly correlated with birth weight, GA, ganglion cell layer/inner plexiform layer (GCL-IPL) thickness, and a history of ROP. CONCLUSIONS: This study established a correlation of fovea formation with premature birth, damage of GCL-IPL, and a history of ROP. The retention of the inner retina possibly contributes to abnormal foveal morphology in patients with a history of ROP.
2018年, Ophthalmologica. Journal international d'ophtalmologie. International journal of ophthalmology. Zeitschrift fur Augenheilkunde, 240 (2), 106 - 110, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
Purpose: We previously reported that eyes with hypotony maculopathy (HM) after trabeculectomy (TLE) exhibited more reduction of axial length (AL) than those without HM, suggesting that inward collapse of the scleral wall may contribute to the development of HM after TLE. However, we did not evaluate change in choroidal thickness (CT), which could influence AL measures. We compared the magnitude and rate of AL and CT changes in eyes with and without HM by simultaneously measuring these parameters before and after TLE. Methods We enrolled 77 eyes of 77consecutive patients with glaucoma, who underwent TLE between March 2014 and March 2016. Intraocular pressure (IOP), central corneal thickness, keratometry, AL, and CT were measured pre- and postoperatively, up to 6 months. These biometrics were compared in eyes with and without HM. Results The 14 patients who developed HM were significantly younger than those who did not. The eyes with HM exhibited significantly reduced AL (2.8%) compared to those without HM (0.7%). There was no significant difference in CT change between the two groups. The rate of AL reduction was significantly correlated with age, postoperative IOP, and preoperative AL. Post-adjustment logistic regression analysis revealed that eyes with AL reduction rate 2% had 11.67 higher risk for developing HM (95% confidence interval, 1.28–106.6 P = 0.03). Conclusions AL reduction rates 2% were significantly associated with HM. Excessive reduction in AL, which was seen in eyes with HM, was not an artificial measure resulting from choroidal thickening but rather reflected reductions in the anterior-posterior diameter of the eyeball. Inward collapse of the scleral wall leads to redundancy of the chorioretinal tissue, contributing to the development of HM after TLE.
Public Library of Science, 2018年01月01日, PLoS ONE, 13 (1), e0191862, 英語[査読有り]
研究論文（学術雑誌）
Purpose: To assess the combined estimate of retinal ganglion cell (RGC) count developed by Medeiros et al. as a tool for diagnosis of glaucoma in Japanese patients. Study design: Cross-sectional study. Methods: Thirty-one eyes of 19 healthy controls and 106 eyes of 70 glaucoma patients underwent standard automated perimetry (SAP) and three types of spectral domain optical coherence tomography (SD-OCT) imaging using the Cirrus, RTVue, and 3D-OCT instruments. RGC counts derived from SAP and SD-OCT data were estimated using the Harwerth model (SAPrgc and OCTrgc, respectively), from which the combined RGC count estimates (CRGC) were calculated using the formula developed by Medeiros et al. Receiver operating characteristic curve (ROC) analyses were conducted for mean deviation (MD), retinal nerve fiber layer thickness (RNFLT), and CRGC. Results: The mean OCTrgc derived from the Cirrus, RTVue, and 3D-OCT instruments were 1150, 1245, and 1316 (× 1000 cells), respectively, for the control group and 463, 519, and 516 (× 1000 cells), respectively, for the patient group. SAPrgc of the controls’ group was 1526 and the patients’ group, 731 (× 1000 cells), and were consistently greater than OCTrgc in both groups (a generalized estimating equation model, p < 0.001). Partial area under the curve (pAUC) of MD was 0.178, and that of RNFLT and CRGC for the three OCT instruments were 0.185, 0.18, 0.189 and 0.196, 0.196, 0.197, respectively. CRGC had larger pAUC than MD, whereas there was no or marginal difference in pAUC between CRGC and cpRNFLT, irrespective of OCT device used or glaucoma severity. Conclusion: CRGC proved well suited to discriminate glaucoma patients from controls. However, its clinical utility did not seem to overwhelm isolated structural measures in the tested Japanese patients.
Springer Tokyo, 2018年01月01日, Japanese Journal of Ophthalmology, 62 (1), 31 - 40, 英語[査読有り]
研究論文（学術雑誌）
Aim: To compare the anatomic and visual outcomes of 25-gauge (25G), and 27-gauge (27G) transconjunctival sutureless pars plana vitrectomy (TSV) for the management of primary rhegmatogeneous retinal detachment (RRD). Design: A retrospective nonrandomized clinical trial. Methods: A retrospective comparative analysis of 62 consecutive eyes from 62 patients with 6 months of follow-up was performed. Results: Thirty-two patients underwent 25G TSV, and 30 patients underwent 27G TSV for the treatment of primary RRD. There was no significant difference in baseline demographic and preoperative ocular characteristics between the two groups. The initial and final anatomical success rates were 93.8% and 100% in 25G TSV and 96.7% and 100% in 27G TSV, respectively (p=1 and p=1, resp.). Preoperative best-corrected visual acuity (BCVA) (logMAR) was 0.44 ± 0.69 and 0.38 ± 0.61 for 25G and 27G TSV, respectively (p=0.73). The final follow-up BCVA was 0.07 ± 0.25 and -0.02 ± 0.17 for 25G and 27G TSV, respectively (p=0.16). The final BCVA was significantly better than the preoperative BCVA in both groups (p=0.02 and p=0.002, resp.). Preoperative intraocular pressure (IOP) (mmHg) was 13.0 ± 3.5 in 25G TSV and 14.3 ± 2.8 in 27G TSV (p=0.11). IOP did not statistically significantly change in both groups during the follow-up period (p=0.63 and p=0.21, resp.). Conclusion: The 27G TSV system is safe and useful for RRD treatment as 25G TSV.
2018年, Journal of ophthalmology, 2018, 7643174 - 7643174, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 2017年12月, 神経眼科, 34 (4号), 449 - 454, 日本語視神経鞘髄膜腫に対し強度変調放射線治療を施行した神経線維腫症2型の一例
[査読有り]
研究論文（学術雑誌）
- 2.0mm極小切開白内障手術における術創作成方法の違いによる術創健常性の比較検討 経結膜強角膜一面切開vs角膜切開
目的:2.0mm極小切開白内障手術(MICS)における術創の変化と術後惹起乱視(SIA)について経結膜強角膜一面切開(TSSI)と角膜切開(CCI)にて比較検討すること。対象と方法:TSSIまたはCCIで2.0mmMICSを施行した60例60眼。上記症例を無作為にTSSI群(T群)30例、CCI群(C群)30例に分け、術中の術創拡大量、術後1日、1週間での前眼部光干渉断層計(ASOCT)による術創構造、術終了時の術創ハイドレーションの有無、術前、術後1日、1週間での眼圧、術後1日、1週間でのSIAについて比較検討した。結果:平均術創拡大量(mm)はT群0.08、C群0.09であった(p=0.24、unpaired t-test)。ASOCTでの検討、眼圧(mmHg)、SIA(D)については、いずれも両群間で統計学的な有意差はなかった。T群では全例で術創ハイドレーションは不要であったが、C群では21眼で要した(p=1.79×10^-9、Fisher直接確率検定)。結論:2.0mmMICSにおいては、TSSIとCCIで比較した場合、術創の変化とSIAは有意な差はないことが示された。(著者抄録)
(株)杏林舎内「IOL&RS」編集事務局, 2017年12月, IOL & RS, 31 (4号), 617 - 622, 日本語[査読有り]
研究論文（学術雑誌）
- 眼科臨床紀要会, 2017年11月, 眼科臨床紀要, 10 (11), 946 - 947, 日本語強度近視に伴う分層黄斑円孔に対する翻転法の有無での硝子体手術成績の検討
- 眼科臨床紀要会, 2017年11月, 眼科臨床紀要, 10 (11), 932 - 932, 日本語網膜前膜術後の最高矯正視力予測因子の検討
[査読有り]
- 眼科臨床紀要会, 2017年11月, 眼科臨床紀要, 10 (11), 941 - 941, 日本語ポリープ状脈絡膜血管症に対する光線力学療法3年予後に関連する遺伝子多型の検討
[査読有り]
- 眼科臨床紀要会, 2017年11月, 眼科臨床紀要, 10 (11), 950 - 950, 日本語アキシチニブ内服中に著しい網膜循環障害をきたした1例
[査読有り]
- 日本神経眼科学会, 2017年10月, 神経眼科, 34 (増補1), 66 - 66, 日本語
- 日本神経眼科学会, 2017年10月, 神経眼科, 34 (増補1), 75 - 75, 日本語
- 日本神経眼科学会, 2017年10月, 神経眼科, 34 (増補1), 106 - 106, 日本語
- 日本神経眼科学会, 2017年10月, 神経眼科, 34 (増補1), 110 - 110, 日本語
- 日本神経眼科学会, 2017年10月, 神経眼科, 34 (増補1), 72 - 72, 日本語難治性視神経炎全国調査 2017年度結果報告
[査読有り]
- 眼科臨床紀要会, 2017年10月, 眼科臨床紀要, 10 (10), 856 - 857, 日本語網膜静脈分枝閉塞症に対するラニビズマブ硝子体注射12ヵ月後視力予後因子の検討
[査読有り]
- (一社)日本糖尿病合併症学会, 2017年10月, 糖尿病合併症, 31 (Suppl.1), 349 - 349, 日本語糖尿病性黄斑浮腫に対するアフリベルセプト治療に影響する因子についての検討
[査読有り]
- (一社)日本糖尿病合併症学会, 2017年10月, 糖尿病合併症, 31 (Suppl.1), 350 - 350, 日本語実臨床における糖尿病黄斑浮腫に対する抗VEGF薬硝子体注射の12ヵ月治療成績
[査読有り]
- 臨床報告 光線力学療法とベバシズマブ硝子体注射により長期間視力が改善した脈絡膜骨腫に続発した脈絡膜血管新生の1例
目的:脈絡膜骨腫では,約半数で脈絡膜新生血管などにより視力が低下するとされている。脈絡膜骨腫に続発した脈絡膜新生血管に対し,1回のベバシズマブ硝子体注射と光線力学療法で視力が改善し,長期に維持された症例の報告。症例:17歳の女性が2週間前からの左眼視力低下と中心暗点で紹介受診した。紹介医により左眼黄斑部に漿液性網膜剥離が指摘された。所見と経過:矯正視力は右(1.2),左(0.4)で,右眼に-5D,左眼に-6Dの近視があった。左眼後極部に境界が明瞭な黄白色の病変があった。CTで眼球後壁に石灰化があり,諸検査の結果,脈絡膜新生血管を伴う脈絡膜骨腫と診断した。ベバシズマブ硝子体注射と光線力学的療法を行い,1ヵ月後に出血は消失し,10ヵ月後に視力は(1.2)に改善した。2年後の現在,左眼の眼底病変は沈静化し,(0.8)の視力を維持している。結論:脈絡膜骨腫に続発した脈絡膜新生血管に対する1回のベバシズマブ硝子体注射と光線力学療法で,視力が改善し,以後2年間眼底病変が鎮静化している。(著者抄録)
(株)医学書院, 2017年10月, 臨床眼科, 71 (10), 1505 - 1511, 日本語[査読有り]
研究論文（学術雑誌）
Background: Leber hereditary optic neuropathy (LHON) is a maternally inherited optic neuropathy that leads to central loss of vision, predominantly in young males. Most LHON cases have one of three primary point mutations in mitochondrial DNA (mtDNA). The annual incidence and prevalence of LHON in Japan are not known. Thus, we estimated the annual incidence of molecularly confirmed LHON in Japan during 2014. Methods: Sequential questionnaires were sent to 1397 facilities, which included all of the university hospitals in Japan, and they were certified by either the Japanese Ophthalmological Society or the Japanese Neuro-Ophthalmological Society. We calculated the incidence number (Ir) as the number of patients who developed LHON in 2014 and its 95% confidence interval. Results: We received 861 responses to the first questionnaire, where 49 facilities reported 72 cases (67 were male and 5 were female) of newly developed LHON during 2014. Ir was calculated as 117, and the 95% confidence interval ranged from 81 to 153. For the second questionnaire, responses were received from 30 facilities, where the median age at onset was 38 years for males and 30 years for females, and 86.5% of cases possessed the mtDNA ND4/G11778A mutation. Conclusion: Approximately 120 cases of newly developed LHON were reported during 2014 in Japan, and 93.2% were males. (C) 2017 The Authors. Publishing services by Elsevier B.V. on behalf of The Japan Epidemiological Association.
ELSEVIER SCIENCE INC, 2017年09月, JOURNAL OF EPIDEMIOLOGY, 27 (9), 447 - 450, 英語[査読有り]
研究論文（学術雑誌）
- (一社)日本臨床免疫学会, 2017年08月, 日本臨床免疫学会会誌, 40 (4), 260 - 260, 日本語
PURPOSE: Central serous chorioretinopathy (CSC) is a common choroidal disorder which often affects the vision of young adults. Although the molecular mechanisms associated with CSC remain unknown, correlations between steroid hormone use and CSC have been suspected. We investigated the choroidal status of CSC secondary to corticosteroid use. METHODS: The records of 25 eyes of 25 consecutive acute CSC cases secondary to corticosteroid use were reviewed retrospectively. Central choroidal thickness was measured by optical coherent tomography. Choroidal vessel dilation and choroidal vascular hyperpermeability were evaluated based on indocyanine green angiography findings. The parameters related to secondary CSC were compared with those of 25 eyes of 25 cases with acute idiopathic CSC. RESULTS: The mean central choroidal thickness of secondary CSC was 294.8 ± 95.0 μm, which was significantly thinner than that of idiopathic CSC (409.4 ± 124.7 μm, P = 0.00064). The proportion of the cases exhibiting choroidal vessel dilation was not significantly different between secondary CSC (52%) and idiopathic CSC (64%). The proportion of cases showing choroidal vascular hyperpermeability was significantly smaller in secondary CSC (62%) than idiopathic CSC (92%) (P = 0.028). CONCLUSION: The choroidal status in the acute phase of secondary CSC after corticosteroid use might be different from that of idiopathic CSC, which suggests a complex mechanism for CSC.
2017年08月, Retina (Philadelphia, Pa.), 37 (8), 1562 - 1567, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- 眼科臨床紀要会, 2017年07月, 眼科臨床紀要, 10 (7), 585 - 586, 日本語下垂体腫瘍患者における光干渉断層計と静的視野検査および多局所視覚誘発電位の異常検出の一致性
- ARMS2 variants may predict the 3-year outcome of photodynamic therapy for wet age-related macular degeneration
Purpose: To determine the association of age-related maculopathy susceptibility 2 (ARMS2) gene polymorphisms with the 3-year outcomes of photodynamic therapy (PDT) in wet age-related macular degeneration (wet AMD). Methods: The single nucleotide polymorphism (SNP) at rs10490924 in the ARMS2 gene of 65 patients with wet AMD who underwent PDT was genotyped using the TaqMan assay. The clinical characteristics and the outcomes of PDT were compared among the three genotypes at rs10490924. A multivariate regression analysis was performed to evaluate the influence of the clinical cofactors on the association of rs10490924 with the visual outcome at 36 months after the first PDT. Results: A significant difference was found among the genotypes in the age and the baseline lesion size. The patients with the GG genotype showed a significant improvement in vision, and the patients with the TT genotype showed a significant worsening of vision at all time points measured after the initial PDT. In the multivariate regression analysis, the number of the G allele at rs10490924 was associated with a significantly greater improvement in the baseline bestcorrected visual acuity (BCVA) at 36 months after the first PDT. Conclusions: ARMS2 variants are likely associated with the 3-year outcomes of PDT in patients with wet AMD.
MOLECULAR VISION, 2017年07月, MOLECULAR VISION, 23, 514 - 519, 英語[査読有り]
研究論文（学術雑誌）
- 2017年06月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 58 (8)Association between CFH variants and choroidal thickness in central serous chorioretinopathy
[査読有り]
研究論文（学術雑誌）
- 日本眼科学会, 2017年05月, Nippon Ganka Gakkai zasshi, 121 (5), 431 - 5, 日本語A Case of Acquired Peripheral Retinoschisis with Retinal Detachment in Young Adult.
[査読有り]
研究論文（学術雑誌）
- 日本眼科学会, 2017年05月, 日本眼科学会雑誌, 121 (5号), 431 - 435, 日本語若年成人にみられた続発性網膜剥離を伴う後天性周辺部網膜分離症の1例
[査読有り]
研究論文（学術雑誌）
- 日本糖尿病眼学会, 2017年04月, 日本糖尿病眼学会誌, 21, 138 - 138, 日本語糖尿病黄斑浮腫に対するラニビズマブ硝子体注射の6ヵ月治療成績
[査読有り]
- 日本眼科学会, 2017年04月, 日本眼科学会雑誌, 121 (4号), 366 - 372, 日本語Icare HOMEを用いた眼圧のホームモニタリングおよび日内変動の検討
[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2017年03月, 日本眼科学会雑誌, 121 (臨増), 209 - 209, 日本語健常眼における視神経乳頭中心窩線と耳側縫線の解剖学的位置関係の検討
- (公財)日本眼科学会, 2017年03月, 日本眼科学会雑誌, 121 (臨増), 245 - 245, 日本語流出路再建術の術式別術後短期成績の比較検討
- (公財)日本眼科学会, 2017年03月, 日本眼科学会雑誌, 121 (臨増), 320 - 320, 日本語Vogt-小柳-原田病の12ヵ月治療成績と再発に関わるリスク因子の検討
[査読有り]
- (公財)日本眼科学会, 2017年03月, 日本眼科学会雑誌, 121 (臨増), 323 - 323, 日本語ぶどう膜炎に伴う高眼圧・緑内障に対する術野展開用鈎を用いた線維柱帯切除術の効果
[査読有り]
The purpose of the study was to evaluate the 1-year visual and anatomical outcomes of combination therapy with intravitreal aflibercept (IVA) and verteporfin photodynamic therapy (vPDT) for polypoidal choroidal vasculopathy (PCV), and to determine the predictors of a good visual outcome. This was a prospective case-series study. Twenty eyes from 20 treatment-na < ve PCV patients were treated with combination therapy with IVA and vPDT. Best-corrected visual acuity (BCVA) and morphological parameters including polypoidal lesions in indocyanine green angiography (ICGA) were evaluated over 12 months of follow-up. The mean logMAR BCVA was significantly improved from 0.30 at baseline to 0.20 at 3 months and 0.18 at 12 months. The mean central retinal thickness was also significantly improved at 3 months and at 12 months. In ICGA, complete regression of polypoidal lesions was found in 14 out of 20 eyes (70 %) at 3 months and in 14 out of 18 eyes (78 %) at 12 months although no ICGA were done on two eyes. In the multivariate logistic regression analyses, the baseline greatest linear dimension was found as a significant predictive factor for good visual improvement (ae 0.3 LogMAR units improvement from baseline) at 12 months. In this study, combination therapy with IVA and vPDT gave visual and anatomical improvements to treatment-na < ve PCV patients over 12 months of follow-up period.
SPRINGER, 2017年03月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 255 (3), 541 - 548, 英語[査読有り]
研究論文（学術雑誌）
Purpose An autoantibody against aquaporin-4 (AQP4 Ab) is highly specific for neuromyelitis optica spectrum disorder and plays a pathogenic role in this disease. The purpose of this study was to investigate the impact of AQP4 Ab on inner retinal structure, function, and the structure -function relationships in eyes with optic neuritis. Methods Thirty five eyes from 25 cases who had received visual function tests and RTVue optical coherence tomography (OCT) measurement at least six months after the latest episode of optic neuritis were enrolled. Patients with multiple sclerosis were excluded. AQP4 Ab was measured using a cell -based assay. Visual acuity, mean deviation (MD) of the Humphrey visual field SITA standard 30-2 tests, retinal nerve fiber layer (RNFL), ganglion cell complex (GCC) thicknesses, and other clinical variables were compared between the AQP4 Ab-positive and-negative groups. Parameters associated with visual functions were evaluated by generalized estimating equation (GEE) models. Results The AQP4 Ab-positive group (20 eyes from 12 cases) had a higher proportion of bilateral involvement and longer duration of follow-up than the AQP4 Ab-negative group (15 eyes from 13 cases). Linear mixed effect models revealed worse MD and visual acuity in AQP4 Ab-positive eyes than those in AQP4 Ab-negative eyes after adjusting for within -patient inter-eye dependence, whereas there were no differences in RNFL and GCC thickness between the two groups. In seropositive eyes, GEE regression analyses revealed that depending on age and the number of recurrences of ON episodes, OCT parameters correlated strongly with MD and more weakly with visual acuity. Conclusions Reductions in RNFL and GCC thickness were proportional to the visual field defect in eyes with AQP4 Ab but not in eyes without AQP4 Ab. The presence of AQP4 Ab probably plays a critical role in retinal ganglion cell loss in optic neuritis.
PUBLIC LIBRARY SCIENCE, 2017年02月, PLOS ONE, 12 (2), e0171880, 英語[査読有り]
研究論文（学術雑誌）
目的:糖尿病黄斑浮腫(DME)に対するranibizumab硝子体注射(IVR)単回投与後の経過に関する検討を行った。対象および方法:対象は2014年3月〜2015年4月にDMEに対してIVR 0.5mgを1回施行し、2ヵ月以上再投与なしで経過観察した連続症例22例26眼(男性17例、女性5例)。光干渉断層計にて計測した平均中心網膜厚(CRT)を、IVR投与前と投与後1、2ヵ月で比較し、その変化量を評価した。結果:平均CRTはIVR前と比較し、IVR後1ヵ月、2ヵ月では有意に減少した(各p=3.4×10^-5、2.1×10^-3)。一方、IVR後1ヵ月と2ヵ月間の平均CRTには有意差を認めなかった(p=0.10)。また、IVR前と比べて、IVR後CRTが30%以上減少した症例の割合は1ヵ月で35.7%、2ヵ月で28.6%であった。結論:DMEに対するIVR単回投与で1ヵ月後には有意なCRTの改善が得られ、2ヵ月後においても治療効果は持続した。(著者抄録)
(株)メディカル葵出版, 2017年02月, あたらしい眼科, 34 (2), 280 - 282, 日本語[査読有り]
研究論文（学術雑誌）
特発性視神経炎と分類される疾患群には，血清中に神経グリア細胞に対する特異抗体である抗アクアポリン4（AQP4）抗体や抗ミエリンオリゴデンドロサイトグリコプロテイン（MOG）抗体がみられることがある．AQP4はアストロサイト上に存在する膜タンパク質であり，その抗体は視神経や脊髄などを標的にして炎症を引き起こす．MOGは中枢神経髄鞘上に存在する分子であり，やはり視神経や脳脊髄に炎症を引き起こす．現在，日本神経眼科学会主導で，自己抗体陽性視神経炎の全国調査が行われており，特発性視神経炎が350例以上エントリーしている．その結果によると，抗AQP4抗体陽性視神経炎は特発性視神経炎の14％前後であり，中年後半の女性に多い．ステロイド治療による視力回復に乏しく，65％以上が矯正視力0.3未満である．多彩な視野障害のパターンをとり，視神経乳頭腫脹，眼球運動時痛が20％前後でみられる．抗AQP4抗体陽性視神経炎は再発することがある．一方，抗MOG抗体陽性視神経炎は，壮年男性にやや多く，ステロイド治療に速やかに反応し，良好な視力回復がえられる．視神経乳頭腫脹や眼球運動時痛が50％以上にみられる．抗MOG抗体陽性視神経炎は，抗AQP4抗体陽性視神経炎より再発しやすい傾向にある．これらの結果から，視神経炎の型を特異抗体で分類することは，予後の推定や長期の治療方針決定に有用と考えられる．
日本臨床免疫学会, 2017年, 日本臨床免疫学会会誌, 40 (4), 260b - 260b, 日本語Background: To compare the 12-month outcomes of intravitreal ranibizumab (IVR) between two angiographic subtypes of polypoidal choroidal vasculopathy (PCV). Methods: This is a retrospective cohort study of 38 treatment-naive PCV cases. Three consecutive IVR and retreatments as needed were performed. Subsequently, the PCV cases were classified into two phenotypes (18 type 1 and 20 type 2) according to the status of branching vascular network. The best-corrected visual acuity (BCVA) was evaluated in each PCV subtype up to 12 months after the initial IVR. Results: The mean BCVA was significantly improved from baseline in type 1 PCV while not in type 2 PCV. In type 2 PCV, 3 cases showed severe visual loss after 6 months from the initial IVR. The mean retreatment number was 1.9 +/- 1.7 in type 1 PCV and 1.2 +/- 1.3 in type 2 PCV. Conclusions: The outcomes of IVR may be different between two angiographic subtypes of PCV. (C) 2017 S. Karger AG, Basel
KARGER, 2017年, OPHTHALMOLOGICA, 237 (3), 123 - 127, 英語[査読有り]
研究論文（学術雑誌）
Aims. To compare the surgical outcome of pars plana vitrectomy (PPV) for full-thickness macular hole (FTMH) with and without lamellar hole-associated epiretinal proliferation (LHEP). Methods. This retrospective study included 158 eyes of 158 patients with FTMH treated with PPV. The following variables were analyzed: sex, age, preoperative best corrected visual acuity (pre-BCVA), BCVA 6 months after the surgery (6M-BCVA), the axial length of eye, the minimum diameter of FTMH, the diameter of basal side of FTMH, postoperative continuity of subfoveal ellipsoid zone (EZ) and external limiting membrane (ELM), and the preoperative presence of LHEP. Results. Twenty-eight eyes had FTMH with LHEP and 130 without LHEP. The mean +/- SD age (years) was 72.6 +/- 7.9 and 68.6 +/- 8.7, respectively (p = 0 02). 6M-BCVA was 0.38 +/- 0.30 and 0.26 +/- 0.25, respectively (p = 0 03). The diameter of basal side of FTMH (mu m) was 901.5 +/- 404.9 and 658.9 +/- 288.1, respectively (p = 0 00027). EZ was disrupted in 24 eyes and 63 eyes, respectively (p = 0 00071). ELM was disrupted in 15 eyes and 23 eyes, respectively (p = 0 00015). The FTMH diameters and the presence of LHEP were inversely correlated with the continuity of EZ and ELM. Conclusion. The preoperative appearance of LHEP could be one of the prognostic factor for the treatment of FTMH.
HINDAWI LTD, 2017年, JOURNAL OF OPHTHALMOLOGY, 英語[査読有り]
研究論文（学術雑誌）
- スリーブとインジェクターの組み合わせの違いによる白内障手術時の術創健常性の比較検討
目的:2.0mm経結膜強角膜一面切開において、スリーブとインジェクターの組み合わせの違いが術創健常性に与える影響について検討する。対象と方法:2014年7月から2015年3月の期間中の白内障手術予定症例を、眼内レンズ挿入に電動インジェクターを使い、ウルトラスリーブを装着したUSとI/Aで術操作を行う群(電U群)、電動インジェクターとナノスリーブを使う群(電N群)、手動インジェクターとナノスリーブを使う群(手N群)の3群(各40眼)にランダムに分類し、術創拡大量と前眼部光干渉断層計(OCT)での術創部所見について前向きに検討した。結果:眼内レンズ挿入直前までの術創拡大量は電U群で有意に大きく、術終了時までの術創拡大量は電N群で有意に小さかった。前眼部OCT所見は3群間で有意差はなかった。結論:スリーブとインジェクターの組み合わせの違いが術創の健常性に影響することが示唆される。(著者抄録)
(株)杏林舎内「IOL&RS」編集事務局, 2016年12月, IOL & RS, 30 (4), 552 - 557, 日本語 - (公社)日本視能訓練士協会, 2016年12月, 日本視能訓練士協会誌, 45, 346 - 346, 日本語実用視力連続3回測定における測定値変化と信頼性についての年代別検討
- 眼科臨床紀要会, 2016年11月, 眼科臨床紀要, 9 (11), 916 - 916, 日本語OCT angiographyを用いた脈絡膜新生血管検出率
[査読有り]
- 眼科臨床紀要会, 2016年11月, 眼科臨床紀要, 9 (11), 920 - 920, 日本語網膜静脈分枝閉塞症に伴う黄斑浮腫に対するラニビズマブ硝子体注射の6ヵ月治療成績
[査読有り]
- 眼科臨床紀要会, 2016年11月, 眼科臨床紀要, 9 (11), 936 - 936, 日本語近視性脈絡膜血管新生に対するビスフォスフォネート内服療法の3年経過
[査読有り]
- 眼科臨床紀要会, 2016年11月, 眼科臨床紀要, 9 (11), 947 - 947, 日本語視神経乳頭コロボーマ合併網膜剥離に対して硝子体手術を施行し形態学的改善を得た1例
[査読有り]
© 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd Purpose: To report the 5-year incidence of visual impairment after mitomycin C-augmented trabeculectomy (MMC trabeculectomy) and the risk factors for visual impairment. Methods: This is a multicentre prospective observational cohort study. Among glaucoma patients registered in the Collaborative Bleb-related Infection Incidence and Treatment Study performed in Japan, the patients with eyes meeting the following qualifications were included: eyes with primary open-angle glaucoma; eyes with primary angle-closure glaucoma; eyes with exfoliative glaucoma; eyes with ≥3/60 in blindness analysis; and eyes with ≥20/60 in low-vision analysis and visual acuity loss analysis. The patients were followed at 6-month intervals for 5 years. The entry data and follow-up data were analysed to determine the incidence of blindness (<3/60), low vision (≥3/60 and <20/60) and visual acuity loss (≥0.2 logMAR) during the follow-up period. Risk factors for visual impairment were also analysed. Results: A total of 694 eyes of 694 or 559 eyes of 559 glaucoma patients were subjected to the blindness analysis or the low-vision and visual acuity loss analysis, respectively. Visual acuity significantly deteriorated (p < 0.0001): 12.2% (95%CI: 9.8–14.7%) of the patients became blind; 12.1% (95%CI: 9.4–14.9%) were judged to have low vision at the final examination; 28.3% (95%CI: 24.5–32.0%) were judged to have visual acuity loss. Glaucoma subtypes, poor preoperative visual function and postoperative complications are the main risk factors for visual impairment. Conclusions: Visual acuity was significantly reduced after MMC trabeculectomy in 5 years, and we identified several risk factors associated with this complication.
2016年11月01日, Acta Ophthalmologica, 94 (7), e561 - e570, 英語[査読有り]
研究論文（学術雑誌）
- 日本神経眼科学会, 2016年10月, 神経眼科, 33 (増補1), 82 - 82, 日本語難治性視神経炎全国調査 計画および導入について
[査読有り]
- 日本神経眼科学会, 2016年10月, 神経眼科, 33 (増補1), 84 - 84, 日本語難治性視神経炎全国調査 中間結果報告
[査読有り]
- 日本神経眼科学会, 2016年10月, 神経眼科, 33 (増補1), 86 - 86, 日本語抗AQP4抗体陽性視神経炎に対する血液浄化療法の治療効果
[査読有り]
- (一社)日本糖尿病合併症学会, 2016年09月, 糖尿病合併症, 30 (Suppl.1), 254 - 254, 日本語実臨床における糖尿病黄斑浮腫に対するラニビズマブ硝子体注射の12ヵ月治療成績
[査読有り]
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2016年09月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 57 (12), 英語Ability of OCT angiography to detect choroidal neovascularization in retinal pigment epithelial detachment associated with chronic central serous chorioretinopathy.
[査読有り]
研究論文（学術雑誌）
- 日本眼科学会, 2016年09月, 日本眼科学会雑誌, 120 (9号), 635 - 639, 日本語Schlemm管内皮網除去と深層強膜弁切除を併施した線維柱帯切開術の術後成績
[査読有り]
研究論文（学術雑誌）
Neuromyelitis optica (NMO) is an autoimmune inflammatory disease that predominantly attacks the optic nerve and spinal cord. This study evaluated the effect of administration of human IgG (hIgG) into the caudal vein on optic nerve degeneration in a rodent model of NMO. The optic nerves were exposed to AQP4-Ab-positive sera, and the administration of intravenous immunoglobulin (IVIG) was performed immediately, at 7 days (cohort A) or at 7 days and 10 days (cohort B) after exposure to the sera. A reference group, similarly exposed to the serum, was treated with saline. Retinal ganglion cells (RGCs) labeled by the injection of Fluoro-Gold into the superior colliculus were counted in whole-mounted retina. RGCs labeled by the injection of Fluoro-Gold into the superior colliculus were counted in the whole-mounted retina. The number of RGCs 14 days after optic nerve exposure to sera from patients with NMO was 1455 +/- A 192/mm(2) (n = 7) in cohort A, 1657 +/- A 192/mm(2) (n = 4) in cohort B, and 981 +/- A 182/mm(2) (n = 10) in the saline-treated reference group (p < 0.001). Western blotting revealed that the content of neurofilament in the optic nerve of the hIgG-treated group in cohort A was significantly greater than that in the reference group (p = 0.037). IVIG administration reduced optic nerve degeneration in a rat model of NMO-optic neuritis. IVIG could be used as a treatment in the acute phase of NMO.
SPRINGER JAPAN KK, 2016年09月, JAPANESE JOURNAL OF OPHTHALMOLOGY, 60 (5), 419 - 423, 英語[査読有り]
研究論文（学術雑誌）
- Current Status of Glaucoma-related Data Management and Efforts toward Data Standardization.
Purpose: Ｗe conducted a survey to evaluate the current status of glaucoma-related medical data management and standardization, aiming to improve the development of glaucoma care and research in Japan. Materials and methods: The survey was performed as a paper-based questionnaire of 14 universities that both participate in the glaucoma-related data standardization committee, established by the Japan Glaucoma Society in 2014, and actively perform glaucoma care. Results: All enrolled university hospitals installed an electronic hospital information system and used any of three ophthalmology-limited electronic chart systems. However, only 30.8% of the hospitals established a data extraction system from an electronic medical chart system, and only 14.3% could practically apply medical data for secondary research purposes. In all, 35.7% of the hospitals operate a medical cooperation system with local medical institutions and 42.9% electronically managed medical data inside their departments. Conclusion: This survey clarified the current state of medical data management and standardization.
2016年08月, Nippon Ganka Gakkai zasshi, 120 (8), 540 - 547, 日本語, 国内誌[査読有り]
研究論文（学術雑誌）
Background: It has been hypothesized that dysfunction of the solute carrier family 1, member1 gene (SLC1A1), which encodes the glutamate aspartate transporter, may play a role in normal tension glaucoma. In this study we investigate whether SLC1A1 is associated with normal tension glaucoma in Japanese patients.Methods: A total of 292 Japanese patients with normal tension glaucoma and 500 healthy control subjects were recruited. We genotyped 12 single-nucleotide polymorphisms in SLC1A1. We also performed an imputation analysis to evaluate the potential association of un-genotyped SLC1A1 single-nucleotide polymorphisms, and 165 single-nucleotide polymorphisms were imputed.Results: We observed an increased frequency of the G allele of rs10739062 in patients compared to controls (p = 0.043, OR = 1.25). The rs10739062 polymorphism exhibited a dominant effect: individuals with genotype GG and GC showed a 1.91-fold increase in risk compared to genotype CC (p = 0.0082). However, the statistical significance disappeared after Bonferroni correction for multiple testing (pc > 0.05). We did not find any significant association between any of the remaining 176 single-nucleotide polymorphisms and disease risk.Conclusions: Our study showed a lack of association between SLC1A1 variants and normal tension glaucoma in Japanese patients, suggesting that the SLC1A1 gene does not play a critical role in the development of the disorder in this patient population. However, further genetic studies with larger sample sizes are needed to clarify whether SLC1A1 may make some contribution that affects the risk of developing normal tension glaucoma.
Taylor and Francis Ltd, 2016年04月02日, Ophthalmic Genetics, 37 (2), 194 - 200, 英語[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2016年03月, 日本眼科学会雑誌, 120 (臨増), 164 - 164, 日本語乳頭周囲網膜神経線維層厚の菲薄化の有無による極早期緑内障の層別化
- (公財)日本眼科学会, 2016年03月, 日本眼科学会雑誌, 120 (臨増), 194 - 194, 日本語視神経炎における抗AQP4抗体の構造と機能に与える影響
- (公財)日本眼科学会, 2016年03月, 日本眼科学会雑誌, 120 (臨増), 304 - 304, 日本語IcareHOMEを用いた患者による自己眼圧測定の再現性と日内変動の検討
- (公財)日本眼科学会, 2016年03月, 日本眼科学会雑誌, 120 (臨増), 280 - 280, 日本語Lamellar hole associated epiretinal proliferationの有無と全層黄斑円孔の術後成績
- (公財)日本眼科学会, 2016年03月, 日本眼科学会雑誌, 120 (臨増), 308 - 308, 日本語加齢性網膜変化におけるmultidrug resistance protein 4(Mrp4)の役割
[査読有り]
- 日本糖尿病眼学会, 2016年03月, 日本糖尿病眼学会誌, 20, 103 - 103, 日本語光干渉断層計を用いた糖尿病網膜内層の2次元的評価
[査読有り]
- 日本神経眼科学会, 2016年, 神経眼科, 33 (2), 171 - 184, 日本語
研究論文（学術雑誌）
- 2016年, 信学技報, 116 (360), 1 - 4, 日本語視機能異常に対応した病院内設備とカラーユニバーサルデザイン
研究論文（学術雑誌）
Purposes: To evaluate the effects of axial length and age on the circumpapillary retinal nerve fiber layer (cpRNFL) and the inner macular parameters measured using 3 spectral-domain optical coherence tomography (OCT) instruments. Methods: A total of 102 normal eyes (1 eye per subject) were imaged using Cirrus, RTVue, and 3D-OCT. The cpRNFL and the macular retinal nerve fiber layer (mRNFL), the ganglion cell layer+inner plexiform layer (GCLIPL), and the mRNFL+GCLIPL ganglion cell complex, GCC thicknesses were analyzed. The correlations between these values and the axial length or age were evaluated using a partial correlation analysis. These correlations were corrected using the axial length-related magnification effect. Results: All but the nasal quadrant cpRNFL thicknesses and GCC thicknesses obtained using the 3 OCT instruments were significantly correlated with age. The average cpRNFL thickness and GCC thickness measured using the Cirrus and RTVue, but not by the 3D-OCT, had a negative correlation with the axial length. The temporal quadrant cpRNFL thickness measured using the 3 instruments was positively correlated with the axial length. The magnification correction made the most correlations positive. Conclusions: The average cpRNFL and GCC thicknesses measured using these 3 instruments decreased with age. The axial length affected the cpRNFL and GCC thicknesses as measured using the Cirrus and RTVue this effect likely depended on the fundus area of analyses.
Lippincott Williams and Wilkins, 2016年, Journal of Glaucoma, 25 (4), 383 - 389, 英語[査読有り]
研究論文（学術雑誌）
Background: Cytomegalovirus (CMV) is the most common congenital infection, and chorioretinitis is the most common ophthalmic manifestation of congenital CMV infection. We experienced a unique case of CMV retinopathy showing unusual retinal vessels. Case presentation: An infant boy weighing 1860 g was born at 36 weeks. He was diagnosed with severe symptomatic congenital CMV infection, which was confirmed by positive CMV-DNA in urine and whole blood, and he was referred to our ophthalmology department on his first day of life. Ophthalmoscopic examination and fluorescein angiography revealed no chorioretinitis but major retinal vascular occlusions and arterio-venous anastomosis associated with CMV detection in the aqueous humor. These findings regressed within a week after treatment with systemic gancyclovir administration. Conclusions: To our knowledge, there are no reports of these ocular issues associated with congenital CMV infection. These findings may be useful for the early and rapid diagnosis of congenital CMV infection.
BioMed Central Ltd., 2016年, BMC Ophthalmology, 16 (1), 81, 英語[査読有り]
研究論文（学術雑誌）
- (一社)日本糖尿病合併症学会, 2015年11月, 糖尿病合併症, 29 (Suppl.1), 208 - 208, 日本語糖尿病黄斑浮腫に対するラニビズマブ硝子体注射の6ヵ月治療成績
[査読有り]
- (一社)日本糖尿病合併症学会, 2015年11月, 糖尿病合併症, 29 (Suppl.1), 221 - 221, 日本語糖尿病黄斑浮腫に対するRanibizumab 1回投与後の経過に関する検討
[査読有り]
研究論文（学術雑誌）
- 日本神経眼科学会, 2015年10月, 神経眼科, 32 (増補1), 63 - 63, 日本語レーベル遺伝性視神経症の新規発症者数に関する疫学調査
- 眼科臨床紀要会, 2015年10月, 眼科臨床紀要, 8 (10), 762 - 763, 日本語ポリープ状脈絡膜血管症に対するアフリベルセプト併用光線力学的療法の6ヵ月成績
[査読有り]
PURPOSE. Optical coherence tomography (OCT) instruments do not embed a normative database from highly myopic normal (HMN) eyes. The abilities of three OCT instruments to detect early glaucoma with high myopia were compared using the two controls with or without high myopia. METHODS. A total of 52 early glaucomatous eyes (mean deviation > -6.0 dB) with high myopia (spherical equivalent <= -6.0 diopters [HMG]), 54 HMN eyes, and 90 nonhighly myopic normal (NHMN) eyes were enrolled. Each participant was imaged using Cirrus, RTVue, and Topcon 3D OCT to evaluate the thicknesses of the circumpapillary retinal nerve fiber layer (cpRNFL), the macular retinal nerve fiber layer (mRNFL), ganglion cell layer + inner plexiform layer (GCL/IPL), and mRNFL + GCL/IPL (GCC). The covariate-adjusted areas under the receiver operating characteristic curves (AUCs) for detecting HMG were compared among the instruments and between the two normal groups (HMN or NHMN). RESULTS. Highly myopic normal eyes showed higher AUCs for the temporal quadrant cpRNFL thickness but lower AUCs for the superior and inferior RNFL thicknesses compared with NHMN. We found the AUCs for the GCC thickness showed no significant difference between the two control groups, but the GCL/IPL and mRNFL thicknesses had differences. CONCLUSIONS. The abilities of the three OCT instruments to detect early glaucomatous eyes with high myopia were different if the normal eyes were associated with high myopia or not. A normative database that includes data from patients with high myopia should be established for accurate diagnosis of glaucoma with high myopia. (www.umin.ac.jp/ctr number, UMIN000006900.)
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2015年10月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 56 (11), 6573 - 6580, 英語[査読有り]
研究論文（学術雑誌）
Purpose In previous studies, we applied receiver operating characteristic curve analysis to the signal-to-noise ratio distributions in the signal and noise windows of multifocal VEP (mfVEP) response. The areas under the curve thus obtained (SNR-AUC) were found to quantitatively detect glaucomatous visual field damage. The present study evaluated the reproducibility of SNR-AUC and the Humphrey visual field (HVF) global indices in 37 eyes with primary open angle glaucoma (POAG; POAG group) and in 30 controls (control group) within a 2-year period. Methods The HVF SITA standard 24-2 and mfVEP were recorded at three separate sessions for each individual. The intersession variability for SNR-AUC, mean deviation (MD), and pattern standard deviation (PSD) was evaluated using the repeated measures of analysis of variance and Bland-Altman plots. The logarithmically converted coefficients of variation (CV) of PSD and SNR-AUC were compared between the control and POAG groups. Linear regression analyses were performed on the logarithmic CV of SNR-AUC against the average MD, PSD, and SNR-AUC. Results SNR-AUC in the POAG group was significantly lower and its CV was greater compared with the control group (P < 0.0001). MD value recorded at the third visit had significantly improved than that at the first visit in the control group (analysis of variance, P = 0.03), whereas PSD value was significantly worse in the POAG group (P = 0.024). In the POAG group, SNR-AUC CV increased as the glaucoma stage became more advanced when evaluated by any functional parameters tested (i.e., MD, PSD, or SNR-AUC). Conclusions The SNR-AUC of mfVEP showed a high reproducibility in control group, whereas it fluctuated more in the POAG group according to the disease severity. MD in the control group and PSD in POAG group fluctuated among sessions during the 2-year period.
SPRINGER, 2015年10月, DOCUMENTA OPHTHALMOLOGICA, 131 (2), 115 - 124, 英語[査読有り]
研究論文（学術雑誌）
Background/aims Chiasmal compression affects the crossed nerve fibres originating from the nasal hemiretina, as opposed to the uncrossed fibres from the temporal hemiretina. The objectives were to evaluate circumpapillary retinal nerve fibre layer (cpRNFL) thickness by spectral-domain optical coherence tomography in eyes with band atrophy (BA) accompanying temporal hemianopia due to chiasmal damage and to estimate the distribution pattern of cpRNFL from the nasal hemiretina. Methods This cross-sectional study included 53 eyes with optic neuropathy due to chiasmal lesions and 72 normal eyes. Visual field sensitivity (VFS) was evaluated by standard automated perimetry. Eyes with abnormalities in the nasal visual hemifield were excluded. The structure-function relationships (cpRNFL thickness and VFS in the temporal hemifield) were evaluated in eyes with BA. The base levels composed of only non-neuronal elements and cpRNFL from the temporal hemiretina were estimated in the average and 12 sector-cpRNFL thicknesses using regression analysis. Results The base level in the average cpRNFL thickness was 71.2 mm in eyes with BA, which corresponded to 70% of average thickness of normal controls. However, the estimated base level of 12 sector-cpRNFL thicknesses represented the unique distribution pattern, in which base level-thickness localised at the 1 o'clock and 5 o'clock sectors was extensively reduced, with an even distribution of base levels at other sectors. Conclusions The RNFL originating from the nasal hemiretina is estimated to enter into the optic disc predominantly at the 1 o'clock and 5 o'clock angles.
BMJ PUBLISHING GROUP, 2015年10月, BRITISH JOURNAL OF OPHTHALMOLOGY, 99 (10), 1419 - 1423, 英語[査読有り]
研究論文（学術雑誌）
- 日本緑内障学会, 2015年09月, 日本緑内障学会抄録集, 26回, 100 - 100, 日本語トラベクレクトミー術後低眼圧黄斑症の発症危険因子の検討
- 日本緑内障学会, 2015年09月, 日本緑内障学会抄録集, 26回, 143 - 143, 日本語3種のSD-OCTのPre-perimetric glaucomaにおける検出力の比較について
- メディカル葵出版, 2015年09月, あたらしい眼科, 32 (9号), 1355 - 1358, 日本語強度近視として経過観察されていた完全型先天停在性夜盲の1例
[査読有り]
研究論文（学術雑誌）
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2015年06月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 56 (7), 英語Impaired axonal transport in a rodent model of optic neuritis due to NMO spectrum disorder
[査読有り]
Background: Rebamipide with mucin secretagogue activity was recently approved for the treatment of dry eye. The efficacy and safety in the treatment of rebamipide were shown in two pivotal clinical trials. It was the aim of this study to evaluate the effect of 2 % rebamipide ophthalmic suspension in patients with dry eye and analyze relevant factors for favorable effects of rebamipide in clinical practice. Methods: This was a retrospective cohort study of 48 eyes from 24 patients with dry eye treated with 2 % rebamipide ophthalmic suspension. Dry eye-related symptom score, tear film break-up time (TBUT), fluorescein ocular surface staining score (FOS) and the Schirmer test were used to collect the data from patients at baseline, and at 2, 4, 8, and 12 week visits. To determine the relevant factors, multiple regression analyses were then performed. Results: Mean dry eye-related symptom score showed a significant improvement from the baseline (14.5 points) at 2, 4, 8 and 12 weeks (9.80, 7.04, 7.04 and 7.83 points, corrected P value <0.001, respectively). Median FOS showed a significant improvement from the baseline (3.0 points) at 2, 4, 8 and 12 weeks (2.0, 2.0, 1.0 and 1.0 points, corrected P value <0.001, respectively). TBUT and Schirmer test values were not significantly improved after the treatment. For ocular symptoms, three parameters (foreign body sensation, dry eye sensation and ocular discomfort) showed significant improvements at all visits. The multiple regression analyses showed that the fluorescein conjunctiva staining score was significantly correlated with the changes of dry eye-related symptom score at 12 weeks (P value = 0.017) and dry eye-related symptom score was significantly correlated with independent variables for the changes of FOS at 12 weeks (P value = 0.0097). Conclusions: Two percent rebamipide ophthalmic suspension was an effective therapy for dry eye patients. Moreover the fluorescein conjunctiva staining score and dry eye-related symptom score might be good relevant factors for favorable effects of rebamipide.
BIOMED CENTRAL LTD, 2015年06月, BMC OPHTHALMOLOGY, 15, 58, 英語[査読有り]
研究論文（学術雑誌）
- 日本眼科学会, 2015年05月, Nippon Ganka Gakkai zasshi, 119 (5), 339 - 346, 日本語[Designation criteria for Leber's hereditary optic neuropathy].
[査読有り]
Aquaporin 9 (AQP9), an aquaglyceroporin, is not only permeable to water but also to non-charged solutes, such as lactate. Lactate can be an energy source for retinal neurons. This study aimed to evaluate the effect of the downregulation of AQP9 expression on the survival rates and reactive oxygen species accumulation in RGC-5 cells cultured in a medium containing lactate. The Live/Dead assay revealed that the cell death rate of RGC-5 cells transfected with the control siRNA (siControl) was 3.65%±0.75% in the 5-mM glucose medium. The death rate was significantly increased by five-fold in the no glucose and 10-mM d-lactate media but not in the 10-mM l-lactate medium. In comparison, the death rate of cells transfected with siRNA targeting AQP9 (siAQP9) was 8.07%±1.01% in the 5-mM glucose medium, which was significantly increased by two-fold in the other medium conditions, indicating that the downregulation of AQP9 expression eliminated the prosurvival effect of l-lactate. Few RGC-5 cells transfected with siControl showed dichlorofluorescein (DCF) fluorescence when cultured in 5-mM glucose and 10-mM l-lactate media. However, approximately 70% of those showed DCF fluorescence when cultured in the no glucose and 10-mM d-lactate media. The downregulation of AQP9 significantly increased the DCF fluorescence rate to 50.44%±6.13% in the 10-mM l-lactate medium, whereas, it did not increase the rate in the other medium conditions. These results demonstrate that AQP9 expression is required for l-lactate to maintain retinal neuronal survival.
2015年03月04日, Neuroscience letters, 589, 185 - 90, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2015年03月, 日本眼科学会雑誌, 119 (臨増), 310 - 310, 日本語非高度近視正常眼と高度近視正常眼の高度近視早期緑内障に対するOCT検出力の相違
- (公財)日本眼科学会, 2015年03月, 日本眼科学会雑誌, 119 (臨増), 316 - 316, 日本語シュレム管内皮網除去+深層強膜弁切除を併施したトラベクロトミーの術後成績
- (公財)日本眼科学会, 2015年03月, 日本眼科学会雑誌, 119 (臨増), 178 - 178, 日本語病的網膜血管新生におけるMrp4の役割
[査読有り]
- (公財)日本眼科学会, 2015年03月, 日本眼科学会雑誌, 119 (臨増), 196 - 196, 日本語続発性中心性漿液性脈絡網膜症における脈絡膜厚の検討
[査読有り]
- (公財)日本眼科学会, 2015年03月, 日本眼科学会雑誌, 119 (臨増), 245 - 245, 日本語ポリープ状脈絡膜血管症に対するアフリベルセプト併用光線力学療法の12ヵ月成績
[査読有り]
- The Japanese Neuro-Ophthalmology Society, 2015年, 神経眼科, 32 (2), 184 - 192, 日本語
Purpose: To compare the response to ranibizumab between patients with typical neovascular age-related macular degeneration (tAMD) and those with polypoidal choroidal vasculopathy (PCV), and to determine the predictors for the outcomes. Methods: Fifty-nine eyes from 59 consecutive patients (tAMD: 27 eyes, PCV: 32 eyes) were treated with three monthly ranibizumab injections followed by as-needed retreatment. Best-corrected visual acuity (BCVA) and morphological parameters were evaluated over 24 months of follow-up. Results: The mean BCVA in tAMD and PCV patients was significantly improved at 3 months (-0.22 and -0.09 logMAR units, respectively). The improvement in BCVA was sustained up to 24 months in tAMD (p = 0.01) but not in PCV patients. The significant predictor for good response to ranibizumab in tAMD patients was the improvement of BCVA at 3 months, whereas that in PCV patients was the anatomical resolution at 3 months. Conclusions: Ranibizumab is an effective therapy for tAMD and PCV over 24 months. The predictors for good outcome might be different between tAMD and PCV. (C) 2015 S. Karger AG, Basel
KARGER, 2015年, OPHTHALMOLOGICA, 234 (1), 33 - 39, 英語[査読有り]
研究論文（学術雑誌）
To compare the relationship between visual field sensitivity (VFS) and macular parameters measured using three spectral-domain optical coherence tomography (SD-OCT) instruments and to determine a base level (=floor effect) for macular parameters. We imaged 127 glaucomatous eyes (1 eye per subject) using three different OCT instruments, i.e., the Cirrus, RTVue and 3D OCT devices; 76 normal eyes were evaluated as controls using the same instruments. The thicknesses of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer+inner plexiform layer (GCL/IPL), and mRNFL+GCL/IPL (GCC) were analyzed. The VFS of the area analyzed by OCT was expressed in decibels and the 1/Lambert scale. For each parameter, the structure-function relationship and the base level were evaluated by regression analysis. The strength of the correlations between the instruments was compared by the bootstrapping method. All of the macular parameters evaluated exhibited statistically significant correlations with VFS. The average GCC measured by all three SD-OCT instruments and the average mRNFL thickness measured by the Cirrus and 3D OCT instruments had similar correlations with VFS. The average GCL/IPL thickness measured by the Cirrus OCT instrument was better correlated with VFS that was measured by the 3D OCT instrument (p = 0.031). The base level GCC thickness measured by all three instruments was approximately 65 % of that of normal eyes. The base level mRNFL thickness measured with the Cirrus and OCT instruments was 52 and 48 %, respectively, of that of normal eyes. The base level GCL/IPL thickness measured with the Cirrus and 3D instruments was 71 and 75 %, respectively, of that of normal eyes. The three SD-OCT instruments evaluated showed similar structure-function relationships in terms of GCC and mRNFL measurements. The base levels of the macular parameters determined by the three instruments differed, due, at least partly, to the scanning area defined by each instrument.
SPRINGER JAPAN KK, 2015年01月, JAPANESE JOURNAL OF OPHTHALMOLOGY, 59 (1), 55 - 64, 英語[査読有り]
研究論文（学術雑誌）
- 日本神経眼科学会, 2014年12月, 神経眼科, 31 (4), 509 - 525, 日本語
The impairment of mitochondrial function is an important pathogenic factor in glaucoma and other optic neuropathies in which retinal ganglion cell (RGC) death is the fundamental pathology. Syntaphilin was recently discovered as a docking protein that affects mitochondrial mobility. However, no reports have investigated the involvement of syntaphilin in the visual system. We investigated the expression of syntaphilin in the rat retina, optic nerve and brain. The expression of syntaphilin exhibited varying patterns in the visual system. Syntaphilin was expressed in retinal ganglion cells in the retina, in the cell bodies of neurons in the superior colliculus and was abundant in the astrocytes of rat optic nerves (similar to the findings that syntaphilin is expressed in human optic nerves). After optic nerve transection, which caused RGC death and axonal degeneration, quantitative real-time RT-PCR was used to assess changes in gene expression in the rat retina and optic nerve. Syntaphilin gene and protein expression in the optic nerve was downregulated 3 and 7 days after optic nerve transection. Our study suggests that syntaphilin expression in astrocytes at the optic nerve might be involved in axonal injury. (C) 2014 Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2014年12月, EXPERIMENTAL EYE RESEARCH, 129, 38 - 47, 英語[査読有り]
研究論文（学術雑誌）
Purpose: Our aim was to investigate the efficacy and prognostic factors of intraocular injections of bevacizumab as needed in patients with macular edema secondary to central retinal vein occlusion (CRVO). Methods: This is a retrospective study including 28 eyes of 27 consecutive patients with macular edema due to CRVO and followed for at least 6 months. The mean age of the patients was 66.3 years. The patients underwent an intravitreal injection of bevacizumab (1.25 mg) at the initial visit. Retreatments were performed when macular edema was persistent or worsened (as-needed regimen). The primary outcome measure was the mean change in best-corrected visual acuity (BCVA). The change in central retinal thickness (CRT) was evaluated as the secondary outcome. Finally, the factors useful for predicting BCVA outcome were determined. Results: The mean number of injections was 1.8 over a period of 6 months. The mean BCVA (logarithm of minimum angle of resolution) was significantly improved at 1 (-0.097), 3 (-0.14), and 6 months (-0.25) after the initial injection (P< 0.05, < 0.01, and < 0.001, respectively). The mean CRT was also improved significantly at 1 (-250.4), 3 (-150.0), and 6 months (-187.2) (P< 0.001 each). Earlier treatment and better improvement in BCVA at 1 month after the initial treatment were the prognostic factors significantly associated with better visual outcomes at 6 months (P=0.047 and 0.029, respectively). Conclusion: Intravitreal injection of bevacizumab as needed significantly improved visual acuity and macular edema in CRVO patients. Time before the treatment and early response to the treatment were important factors for the visual outcome.
Dove Medical Press Ltd, 2014年11月19日, Clinical Ophthalmology, 8, 2301 - 2305, 英語[査読有り]
研究論文（学術雑誌）
PURPOSE. To assess the diagnostic performance of the macular parameters detected by spectral-domain optical coherence tomography (SD-OCT) in band atrophy (BA) eyes. METHODS. Forty-nine BA eyes with permanent temporal hemianopia and 89 normal eyes were enrolled. Any patients who had nasal visual field loss were excluded. Each participant was imaged by three-dimensional (3D) OCT-2000, and 10 3 10 grids in the macula were automatically allocated. The thickness of the macular retinal nerve fiber layer (mRNFL), ganglion cell layer (GCL) + (GCL+inner plexiform layer [IPL]), and GCL++ (RNFL+GCL+IPL) in both nasal and temporal hemiretina was calculated and compared between the BA and normal eyes. The areas under the receiver operating characteristic curves (AUCs) in these parameters were compared between the nasal hemiretina and the temporal hemiretina. RESULTS. All the parameters in the BA eyes were significantly thinner than those in the normal eyes. The AUCs for the mRNFL, GCL+, and GCL++ thickness in the nasal hemiretina were 0.890, 0.988, and 0.981, respectively. The parameters in the nasal hemiretina showed significantly higher AUCs than those parameters in the temporal hemiretina. In the temporal hemiretina, the damaged grids in the mRNFL were located in the arcuate areas in each hemifield. CONCLUSIONS. The inner macular parameters in the nasal hemiretina exhibited high diagnostic abilities to detect BA. The GCL+ was more affected than mRNFL. The characteristic pattern of mRNFL and GCL+ thinning was implicated in the anatomical architecture regarding the nasotemporal overlap of the crossed and uncrossed fibers around the fovea. (www.umin.ac.jp/ctr number, UMIN000006900.)
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2014年07月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 55 (7), 4667 - 4672, 英語[査読有り]
研究論文（学術雑誌）
We have previously reported that the degree of signal-to-noise ratio (SNR) distribution overlaps between a signal window and a noise window in multifocal VEP (mfVEP) responses, which is determined by the area under the receiver-operating characteristic curve termed SNR-AUC, can quantitatively detect glaucomatous visual functional damage. However, the effect of high myopia on this parameter is not yet known. SNR-AUC, total deviation, and retinal sensitivity on the Humphrey visual field (HVF) test were compared among 34 eyes >-6 diopters (control) and 21 eyes a parts per thousand currency signa'6 diopters (high myopia), both of which were ophthalmoscopically normal and had a best-corrected visual acuity of 20/20. The mfVEP and HVF parameters were obtained from stimulus areas that corresponded to both HVF 24-2 and 10-2 programs. Both the HVF 24-2 total deviation and the SNR-AUC obtained from 60 sectors in high-myopia patients were significantly lower compared with controls (P = 0.045 and P = 0.003, respectively). The SNR-AUC obtained from the central 36 sectors that corresponded to the HVF 10-2 area in high-myopia patients was also significantly lower than that of the controls (P = 0.01). Multiple regression analyses demonstrated that age and refractive error were significantly associated with retinal sensitivity on the HVF 24-2 and SNR-AUC for the whole field and central field, respectively. High myopia reduces the SNR-AUC of mfVEP responses, even with refractive correction. A normative database should be separately established for high myopes to evaluate the mfVEP responses obtained from highly myopic glaucoma patients.
SPRINGER, 2014年06月, DOCUMENTA OPHTHALMOLOGICA, 128 (3), 179 - 189, 英語[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2014年05月, 日本眼科学会雑誌, 118 (5), 446 - 460, 日本語
- WILEY-BLACKWELL, 2014年05月, ACTA OPHTHALMOLOGICA, 92 (3), 243 - 248, 英語
[査読有り]
研究論文（学術雑誌）
Histones are DNA-binding proteins and are involved in chromatin remodeling and regulation of gene expression. Histones can be released after tissue injuries, and the extracellular histones cause cellular damage and organ dysfunction. Regardless of their clinical significance, the role and relevance of histones in ocular diseases are unknown. We studied the role of histones in eyes with retinal detachment (RD). Vitreous samples were collected during vitrectomy, and the concentration of histone H3 was measured by enzyme-linked immunosorbent assay. The location of the histones and related molecules was examined in a rat RD model. The release of histones and their effects on rat retinal progenitor cells R28 and ARPE-19 were evaluated in vitro. In addition, the protective role of the vitreous body against histones was tested. The intravitreal concentration of histones was higher in eyes with RD (mean, 30.9 +/- 9.8 ng/ml) than in control eyes (below the limit of detection, P<0.05). In the rat RD model, histone H3 was observed on the outer side of the detached retina and was associated with photoreceptor death. Histone H3 was released from cultured R28 by oxidative stress. Histones at a concentration 10 mu g/ml induced the production of interleukin-8 in ARPE-19 cells (2.5-fold increase, P<0.05) that was mediated through the ERK1/2- and p38 MAPK-dependent pathways and Toll-like receptor 4. Histones were toxic to cells at concentrations of >= 20 mu g/ml. Vitreous body or hyaluronan decreased toxicity of histones by inhibiting diffusion of histones. These results indicate that histones are released from retinas with RD and may modulate the subretinal microenvironment by functioning as damage-associated molecular pattern molecules, thereby inducing proinflammatory cytokines or cell toxicity. In addition, the important role of the vitreous body and hyaluronan in protecting the retina from these toxic effects is suggested.
NATURE PUBLISHING GROUP, 2014年05月, LABORATORY INVESTIGATION, 94 (5), 569 - 585, 英語[査読有り]
研究論文（学術雑誌）
To establish a rat glaucoma model with chronic intraocular pressure (IOP) elevation induced by microbeads suspended in sodium sulfate-sodium hyaluronate. Chronic elevation of IOP was induced unilaterally by injecting polystyrene microbeads, suspended in 4 % sodium sulfate and 3 % sodium hyaluronate, into the anterior chamber. The microbead suspension was injected through either the clear corneal (CC) or sclerocorneal (SC) tunnel. IOP changes were monitored up to 8 weeks after injection. The loss of retinal ganglion cells (RGCs) was assessed using fluorogold retrograde labeling of RGCs. RGC axons were evaluated by immunohistochemistry and immunoblotting. The resulting IOP elevation was maintained up to 3 weeks after the intracameral injection of microbeads through the CC route and up to 4 weeks after injection through the SC route. The density of RGCs was significantly reduced at 4 weeks after injection, with the SC route leading to more RGC loss than the CC route (p = 0.037). The neurofilament immunoreactivity and protein levels in the optic nerve were also significantly reduced at 4 weeks after injection. Some eyes in the SC route cohort received re-injection of the microbead suspension at 4 weeks after the initial injection, which led to an elevated IOP more than 8 weeks after the initial injection, and eventually a 27.5 % loss of RGC density compared with the control eyes. The intracameral injection of microbeads suspended in hyaluronate effectively produced chronic IOP elevation and subsequent RGC degeneration in rat eyes. The sclerocorneal tunnel approach yielded a longer period of IOP elevation than the clear corneal approach. Our modified microbead injection offers a reliable high-pressure glaucoma model.
SPRINGER JAPAN KK, 2014年05月, JAPANESE JOURNAL OF OPHTHALMOLOGY, 58 (3), 290 - 297, 英語[査読有り]
研究論文（学術雑誌）
To measure changes in axial length before and after trabeculectomy with noncontact, partial coherence laser interferometry and identify patient factors that lead to the development of hypotony maculopathy and axial length shortening in 25 eyes with intraocular pressure (IOP) a parts per thousand currency sign6 mmHg at 4 weeks after mitomycin C-augmented trabeculectomy. A retrospective comparative case series. Hypotony maculopathy was identified with both ophthalmoscopy and spectral-domain optical coherence tomography. Axial length and IOP were serially measured pre- and postoperatively. Logistic regression analysis was performed to identify factors associated with the presence of hypotony maculopathy at 4 weeks after trabeculectomy and multiple regression analysis to identify factors associated with axial length changes. Ten eyes exhibited hypotony maculopathy, whereas the remaining 15 did not. Patients with hypotony maculopathy were significantly younger (47.7 +/- A 6.2 years) compared with those without it (63.3 +/- A 9.6 years, P = 0.0002, unpaired t test). The percent reduction of axial length after trabeculectomy was significantly larger in the former group (5.91 +/- A 2.76 %) compared with the latter group (1.51 +/- A 0.91 %) (P = 0.0001, Mann-Whitney U test). Multivariate analyses showed that only age was associated with the presence of hypotony maculopathy, with an odds ratio of 0.82 (P = 0.0075), when age, sex, type of glaucoma, lens status, percent changes in axial length and IOP before and after trabeculectomy, and central corneal thickness were included as independent variables (R (2) = 0.543, P = 0.003). Age-dependent axial length reduction is a risk factor for the development of hypotony maculopathy after trabeculectomy.
SPRINGER JAPAN KK, 2014年05月, JAPANESE JOURNAL OF OPHTHALMOLOGY, 58 (3), 267 - 275, 英語[査読有り]
研究論文（学術雑誌）
Neuromyelitis optica (NMO) is an autoimmune inflammatory, neurodestructive disease primarily targeting the optic nerve and spinal cord. An autoantibody against water channel protein aquaporin-4 (AQP4), which is expressed at endofeet of astrocytes has been implicated in the pathogenesis of NMO. We evaluated the impact of sera of seropositive patients with NMO spectrum disorders (NMOSDs) on the rodent optic nerve and retina. Serum was obtained either from patients with seropositive NMOSD (AQP4+), seronegative patient with idiopathic optic neuritis (AQP4), and healthy volunteers (control). Anti-AQP4 antibody in a serum was measured by a previously established cell-based assay. The patients' sera were applied on the optic nerve after de-sheathed. Immunohistochemistry showed that at 7 days after the treatment, the area of the optic nerve exposed to the AQP4+ sera lost expression of both AQP4 and glial fibrillary acidic protein. Also, Human-IgG immunoreactivity and marked invasion of inflammation cells were observed in the optic nerve treated with AQP4+ serum. Immnoreactivity of neurofilament was reduced at 14 days after the treatment, not 7 days. Real-time polymerase chain reaction revealed the reduced gene expression of neurofilament in retina from the eye that was exposed to the AQP4+ sera at 14 days. Retrograde fluorogold-labeling on the retinal flatmount disclosed the significantly reduced number of retinal ganglion cells when the AQP4+ sera were applied. The present model has demonstrated that the sera from patients with seropositive NMOSDs led to the regional astrocytic degeneration and inflammatory cell invasion in the optic nerve, resulting in the ultimate loss of RGCs and their axons at areas beyond the injury site. Crown Copyright (C) 2013 Published by Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2014年02月, EXPERIMENTAL EYE RESEARCH, 119, 61 - 69, 英語[査読有り]
研究論文（学術雑誌）
- 2013年10月, 眼科手術, 26 (4号), 585 - 587, 日本語手術手技のコツ 難治性緑内障に対する羊膜を使った手術のコツ
[査読有り][招待有り]
研究論文（学術雑誌）
PURPOSE. We compared the ability of circumpapillary retinal nerve fiber layer (cpRNFL) thickness and macular parameters obtained by three spectral-domain optical coherence tomography (SD-OCT) instruments to detect glaucoma. METHODS. We enrolled 87 normal eyes and 145 glaucomatous eyes (75 early glaucomatous eyes (EGs), mean deviation > -6 dB). Each participant was imaged using Cirrus, RTVue, and 3D-OCT to evaluate the average and quadrant cpRNFL thicknesses. The macular retinal nerve fiber layer (mRNFL), ganglion cell layer plus inner plexiform layer (GCL/IPL), and mRNFL + GCL/IPL (ganglion cell complex [GCC]) thicknesses were analyzed. The areas under the receiver operating characteristic curves (AUCs) were compared among the instruments. RESULTS. These instruments revealed similar AUCs for the average cpRNFL and GCC thicknesses in EGs, and total all-stage glaucomatous eyes (TGs). RTVue showed better performance in the nasal cpRNFL thickness than Cirrus and 3D-OCT, and better performance in the temporal cpRNFL thickness than 3D-OCT in TGs. RTVue had a higher AUC for the superior GCC thickness compared to Cirrus and 3D-OCT in EGs, and TGs. Cirrus had higher AUCs for GCL/IPL parameters in TGs, and lower AUCs for the mRNFL parameters in EGs and TGs compared to 3D-OCT. CONCLUSIONS. The average cpRNFL and GCC thicknesses measured using these OCT instruments exhibited similar abilities in the diagnosis of glaucoma, and RTVue exhibited better diagnostic abilities than Cirrus and 3D-OCT for nasal cpRNFL, and superior GCC thicknesses. The diagnostic performance of Cirrus and 3D-OCT was different for GCL/IPL and mRNFL parameters. (http://www.umin.ac.jp/ctr number, UMIN000006900.)
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2013年07月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 54 (7), 4478 - 4484, 英語[査読有り]
研究論文（学術雑誌）
- 2013年06月, あたらしい眼科, 30 (6号), 761 - 768, 日本語【神経眼科Minimum Requirements】 神経眼科領域のOCT
[査読有り][招待有り]
研究論文（学術雑誌）
Purpose: To compare the relationships of parapapillary retinal nerve fibre layer (RNFL) thickness among three spectral-domain optical coherence tomography (SD-OCT) instruments with visual field sensitivity (VFS). Methods: One hundred and thirteen eyes of 113 Japanese subjects with glaucoma (mean deviation in standard automated perimetry = -8.9 +/- 6.7 dB) were imaged by Cirrus, RTVue and 3D OCT. The average hemi-superior and hemi-inferior RNFL thicknesses were obtained. In addition, the structure-function relationship using two retinotopic maps that consisted of six or nine sectors was also evaluated. Decibel (dB) scale and 1/Lamert (1/L) were used to express VFS. RNFL thickness correlation with corresponding VFS in visual field sectors was compared among the three instruments. Background RNFL thickness (non-neuronal tissue) for each instrument was estimated using a linear regression model at 1/L = 0. Results: The correlation between the average hemi-superior and hemi-inferior RNFL thickness in the three SD-OCT instruments with corresponding VFS was similar. In the analysis of retinotopic maps, 3D OCT showed a higher correlation in superotemporal sectors than RTVue, whereas RTVue had a stronger relationship in the nasal sector than Cirrus. The background RNFL thickness extrapolated was approximately 60% that of normal eyes in all the instruments. Conclusions: The three SD-OCT showed similar overall correspondence with VFS with a partially discordant retinotopic relationship. RNFL measured with any SD-OCT devices likely contains non-neuronal tissue, comprising 60% of its thickness.
WILEY-BLACKWELL, 2013年05月, ACTA OPHTHALMOLOGICA, 91 (3), E196 - E202, 英語[査読有り]
研究論文（学術雑誌）
Aquaporin 9 (AQP9), an aquaglyceroporin belonging to the AQP water channel family, is permeable not only to water but also to noncharged solutes such as lactate. In neurons, Lactate presumably acts as an energy substrate and as a source of NADH (the reduced form of nicotinamide adenine dinucleotide), a scavenger of reactive oxygen species (ROS). We previously reported that retinal ganglion cells (RGCs) express AQP9 and that elevated intraocular pressure reduces AQP9 expression and increases death of neurons in the retinal ganglion cell Layer of rodents. In the present study, we investigated the association of AQP9 expression with serum deprivation-induced death of RGC-5 cells and with death of neurons in the rat retinal ganglion cell layer after optic nerve transection (ONT). The effect of AQP9 RNA interference on serum deprivation-induced apoptosis, ROS accumulation, and the NAD(+)/NADH ratio in RGC-5 cells was examined. Both serum deprivation and ONT significantly reduced AQP9 protein expression in RGCs and increased the rate of RGC death. Retinal AQP9 gene expression also declined after ONT. Down-regulation of AQP9 significantly increased apoptosis, ROS accumulation, and the NAD(+)/NADH ratio in the RGC-5 cells. These findings suggest that AQP9 Loss adversely affects survival of RGCs, at least partly because of decreased transport of Lactate as a substrate for energy and/or ROS scavenger.
ELSEVIER SCIENCE INC, 2013年05月, AMERICAN JOURNAL OF PATHOLOGY, 182 (5), 1727 - 1739, 英語[査読有り]
研究論文（学術雑誌）
- (公財)日本眼科学会, 2013年03月, 日本眼科学会雑誌, 117 (臨増), 334 - 334, 日本語3種のSD-OCTの乳頭周囲網膜神経線維層厚と視野の相関
- 視神経疾患の新しい展開
光干渉断層計(optical coherence tomography:OCT)は眼科学に生体病理学ともいえる新しい分野を形成し,黄斑疾患や緑内障の診療に革新的な情報をもたらしている.緑内障の診断には他の視神経・視路疾患との鑑別が必要である.そこでOCTの視神経・視路疾患における有用性について検討した.次いで,視神経疾患の中で最も頻度の高い緑内障性視神経症(glaucomatous optic neuropathy:GON)の病態についてアクアポリン(aquaporin:AQP)の動態に焦点を当てて検討した.I 光干渉断層計による視神経・視路疾患の評価 交互点滅対光反射試験(swinging flashlight test)は相対的瞳孔求心路障害(relative afferent pupillary defect:RAPD)を検出する容易で敏感な他覚的検査である.片眼性視神経萎縮20症例でswinging flashlight testにおけるRAPD量とOCTで測定した網膜神経線維層厚(retinal nerve fiber layer thickness:RNFLT)の両眼間の比には有意の相関がみられた.OCTによりRAPDという両眼の視神経機能障害の差を,構造的な差として把握することができた.外傷性視神経症4例において受傷直後よりRNFLTおよび神経節細胞複合体(ganglion cell complex:GCC)の経時変化を観察した.OCTによりRNFLT,GCCは受傷後2週から20週の間に急速に減少することが分かった.視交叉症候群34眼でRNFLTを測定すると,視神経乳頭周囲の水平方向では垂直方向に比してRNFLTは有意に減少していた.このことは視交叉症候群にみられる視神経乳頭の帯状萎縮が,OCTにより量的に把握できることを示した.視索症候群でRNFLTを測定すると,患側では視神経乳頭の垂直方向の水平方向に対する菲薄化が,対側では水平方向の垂直方向に対する菲薄化が確認された.またGCCでは患側の中心窩から耳側半側の菲薄化,対側眼では鼻側半側の菲薄化を示した.これらは視索症候群における患側視神経乳頭の砂時計状萎縮,対側における帯状萎縮,また同名半盲を構造的に捉えていることを示す.OCTはこのように視神経・視路疾患の評価にも有用であったが,限界もある.視交叉症候群ではOPTvue 100とCirrusで測定したRNFLTの非薄部位はまったく逆の結果を示した.これはRTVue 100のほうがCirrusに比較して視神経乳頭鼻側の薄いRNFL評価に優れているためであった.OCTの評価には機種の特性を考慮する必要がある.II 視神経におけるアクアポリンの動態 AQPは細胞膜を水が効率よく通過できるための水チャンネルを構成する膜蛋白質である.従来,視神経にはAQP-4が発現していることが報告されていたが,AQP-4は球後の有髄神経部位にのみ発現し,視神経乳頭に発現するAQPについては不明であった.我々はラット,サル,ヒトで視神経におけるAQPの発現を検討した.無髄神経部位の前篩状板部,篩状板部ではAQP-9のみが発現し,有髄神経部位ではAQP-4とAQP-9が発現していることを認めた.これらはglial fibrillary acidic proteinと共発現したことから,アストロサイトに発現していることが分かった.ラットにおいて高眼圧眼を作製するとAQP-4の発現は変化がなかったが,AQP-9の発現は著明に減少した.この現象はサル高眼圧眼,ヒト緑内障眼でも同様であった.AQP-9は水のほか,乳酸などの溶質も輸送するアクアグリセロポリンに属する.近年,神経科学の分野ではアストロサイトから神経細胞への乳酸の輸送が神経細胞のエネルギー基質になっているというastrocyte-to-neuron lactate shuttle hypothesisが提唱されている.眼圧上昇による視神経乳頭におけるAQP-9の発現低下はGONの発症に深くかかわっている可能性がある.(著者抄録)
(公財)日本眼科学会, 2013年03月, 日本眼科学会雑誌, 117 (3), 187 - 211, 日本語[査読有り]
PURPOSE. We determined the cause of sterile endophthalmitis after intravitreal triamcinolone acetonide (IVTA). METHODS. The clinical records of 21 eyes that had sterile endophthalmitis after IVTA were reviewed. Cytologic studies were performed, and cytokine and chemokine profiles in the aqueous humor were determined. The effects of a direct contact of triamcinolone acetonide (TA) particles with cultured lens epithelial cells (B3) or retinal pigment epithelial cells (ARPE-19) on cytokine production were determined. Noncontact culture studies were performed in a Boyden chamber; 11-deoxycortisol was used for nonbioactive particles. RESULTS. Inflammation appeared one day after the IVTA, and the incidence of severe sterile endophthalmitis was 13.0% (6/46), which was reduced to 4.3% (2/47) after switching to preservative-free TA. Most cells found in the aqueous humor were granulocytes. The concentrations of IL-6 (447.8-<5000 pg/mL) and IL-8 (47.2-<5000 pg/mL) were increased significantly, but IL-1 beta, IL-10, IL-12p70, and TNF-alpha were not significantly changed. In B3 cells, the level of IL-8 increased significantly when the cells made direct contact with TA particles (1.33 times that of PBS, P < 0.05, Student's t-test), but not in noncontact cultures. Similar reaction pattern was found in ARPE-19 cells. These effects also were observed when the cells were exposed to 11-deoxycortisol. CONCLUSIONS. Sterile endophthalmitis after IVTA is characterized by an immediate granulocytic infiltration and an increase of IL6/IL-8 in the aqueous humor. Preservatives may be a factor causing this condition, and mechanical/rheologic stress by particles presumably might be a new causative factor by increasing IL-6/IL-8. (Invest Ophthalmol Vis Sci. 2013; 54:1758-1766) DOI:10.1167/iovs.12-11247
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2013年03月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 54 (3), 1758 - 1766, 英語[査読有り]
研究論文（学術雑誌）
Unilateral injury of the optic tract leads to asymmetrical optic atrophy in both eyes derived from the crossing of the nerve fibers at the chiasm. This report demonstrates unique imaging appearances of optic atrophy due to this uncommon condition detected by spectral-domain optical coherence tomography (SD-OCT). Cirrus and RTVue measurements were performed in four cases of optic tract syndrome. Circumpapillary retinal nerve fiber layer (cpRNFL) thickness was obtained from both instruments and ganglion cell complex (GCC) integrity was obtained from RTVue. The presumable reduction rates of quadrant cpRNFL thickness were calculated from the published normative database and compared between eyes with temporal hemianopia and those with nasal hemianopia. Both devices showed significant reduction of cpRNFL thickness, but did not have statistical difference in the reduction rates at temporal or nasal quadrant cpRNFL between contralateral and ipsilateral eyes to the lesion. Color-coded maps helped to visualize the unique pattern of cpRNFL and GCC thinning. SD-OCT can be used as a diagnostic tool for the optic tract syndrome.
SPRINGER, 2013年02月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 251 (2), 591 - 595, 英語[査読有り]
研究論文（学術雑誌）
- 2013年01月, 日本視能訓練士協会誌, 41, 286, 日本語3種のSD-OCTによる視神経乳頭周囲網膜神経層厚における各象限の比較
研究論文（その他学術会議資料等）
The caveolin 1 to caveolin 2 (CAV1-CAV2) gene region on chromosome 7q31 has been reported to be associated with susceptibility to primary open angle glaucoma (POAG) and normal tension glaucoma (NTG) in previous studies. We investigated whether genetic variants in the CAV1-CAV2 region are associated with NTG in Japanese patients. Two hundred and ninety-two Japanese patients with NTG and 352 Japanese healthy controls were recruited. We genotyped three single-nucleotide polymorphisms that is, rs1052990, rs4236601, and rs7795356, in the CAV1-CAV2 gene region and assessed the allelic diversity among cases and controls. The frequency of the minor allele (G) of rs1052990 was significantly decreased in NTG cases compared with controls (P=0.014, OR=0.71), whereas NTG or POAG cases had a significantly higher frequency of the allele than controls in previous studies. Conversely, rs7795356 did not show any significant association with NTG cases, and rs4236601 was monomorphic in the Japanese study population. Our findings did not correspond with previous positive results, suggesting that CAV1-CAV2 variants studied in the present study are not important risk factors for NTG susceptibility in all populations. Further studies are needed to elucidate the possible contribution of the CAV1-CAV2 region to the development of glaucoma. © 2013 Macmillan Publishers Limited All rights reserved.
Nature Publishing Group, 2013年, Eye (Basingstoke), 27 (8), 979 - 983, 英語[査読有り]
研究論文（学術雑誌）
PURPOSE. To compare the ability of circumpapillary retinal nerve fiber layer (cpRNFL) thickness and macular parameters obtained by three spectral-domain optical coherence tomography (SD-OCT) instruments to detect highly myopic glaucoma. METHODS. In this study, 84 glaucomatous eyes, 53 normal eyes with high myopia, and 86 normal eyes (not highly myopic) were enrolled. Each participant was imaged using Cirrus, RTVue, and 3D OCT to evaluate the average and quadrant cpRNFL thicknesses. The macular retinal nerve fiber layer (mRNFL), ganglion cell layer {thorn} inner plexiform layer (GCL/IPL), and mRNFL {thorn} GCL/IPL (GCC) thicknesses were analyzed. The areas under the receiver operating characteristic curves (AUCs) were compared between the instruments. In addition, the best parameters for the AUC were compared between the cpRNFL parameters and macular parameters in each instrument. RESULTS. These analyses revealed similar AUCs for the average cpRNFL and GCC thicknesses between the instruments. RTVue displayed a significantly higher AUC in the nasal cpRNFL thickness than both Cirrus (P = 0.0004) and 3D OCT (P = 0.0006). 3D OCT showed higher AUCs than Cirrus in the mRNFL parameters. There were no significant differences between the best cpRNFL parameters and macular parameters in each instrument. CONCLUSIONS. The average cpRNFL and GCC thicknesses that were measured using these OCT instruments exhibited similar abilities for diagnosing highly myopic glaucoma, and RTVue exhibited better diagnostic abilities than Cirrus and 3D OCT for nasal cpRNFL. 3D OCT had better ability than Cirrus in the mRNFL. Both cpRNFL and GCC in each instrument were comparable, and their measurements offered good ability for diagnosing glaucoma with high myopia. © 2013 The Association for Research in Vision and Ophthalmology, Inc.
2013年, Investigative Ophthalmology and Visual Science, 54 (9), 6025 - 6032, 英語[査読有り]
研究論文（学術雑誌）
Purpose. Using spectral-domain optical coherence tomography (SD-OCT), we assessed the ability of cluster analyses, based on the grid-pattern of macular parameters, to detect glaucoma. Methods. We enrolled 75 normal eyes, 64 early glaucomatous eyes (EG), and 40 preperimetric glaucomatous eyes (PPG). Each participant was imaged using 3-dimensional optical coherence tomography (3D-OCT) to examine the macular retinal nerve fiber layer (mRNFL) and the thickness of the ganglion cell layer, together with the inner plexiform layer (GCL/IPL). Diagnostic criteria based on the clustering of abnormal grids from the mRNFL and GCL/IPL measurements were applied. The sensitivity and specificity of glaucoma detection were compared between the cluster criteria (CC) and the average thickness criteria (ATC) of total and hemiretinal sectors, and the cut-off criteria were determined using receiver operating characteristic (ROC) curve analyses from our normal controls. Results. The specificity values of CC and ATC from mRNFL measurements were 97% and 100%, respectively. The sensitivity of CC was 94% for EG and 68% for PPG. The sensitivity of ATC was 81% for EG and 38% for PPG. The specificity values of CC and ATC from GCL/IPL measurements were 96% and 100%, respectively. The sensitivity values of CC and ATC were 92% for EG and 63% for PPG. The sensitivity of ATC was 84% for EG and 25% for PPG. When compared to ATC and ROC-based cut-off criteria, CC showed a higher diagnostic capability. Conclusions. Judging abnormality based on a clustering of abnormal grids from macular OCT parameters may be a reliable approach for diagnosing early glaucoma. © 2013 The Association for Research in Vision and Ophthalmology, Inc.
2013年, Investigative Ophthalmology and Visual Science, 54 (9), 6401 - 6408, 英語[査読有り]
研究論文（学術雑誌）
- Nature Publishing Group, 2013年, Eye (Basingstoke), 27 (10), 1220 - 1221, 英語
[査読有り]
研究論文（学術雑誌）
- 2012年10月, 神経眼科, 29 (増補1), 59, 日本語小脳髄膜腫により腫瘍随伴性視神経症を発症した一例
研究論文（その他学術会議資料等）
To assess the agreement and diagnostic performance between retinal nerve fiber layer (RNFL) thickness measurements obtained using the Cirrus (Carl Zeiss Meditec) and RTVue (Optovue Inc.) devices for detection of band atrophy (BA) in patients with permanent temporal hemianopia. In this retrospective study, 26 eyes with BA and 64 control eyes were enrolled. The Cirrus optic disc cube protocol and the RTVue optic nerve head map protocol were used. The Cirrus measurements were extracted and regrouped to be topographically matched with the RTVue measurements. Concordance correlation and 95 % limits of agreement were assessed. Areas under the receiver operating characteristic curves (AUC) and the Spearman's correlation coefficient between average Humphrey total deviation in the temporal hemifield and average RNFL thickness were calculated. RTVue measured consistently thicker values than Cirrus in controls, whereas in eyes with BA, nasal segment measurements from the RTVue were thinner than those obtained using the Cirrus. Each quadrant showed moderate to close agreement in controls, whereas in eyes with BA, the nasal and temporal quadrants exhibited poor agreement. The RTVue measurements demonstrated significantly higher AUCs for nasal segments just above (0.95) and below (0.96) the horizontal meridian than Cirrus measurements (0.80 and 0.66, respectively) and a significant correlation with visual field loss (r(s) = 0.46, P = 0.02 for RTVue vs. r(s) = 0.26, P = 0.22 for Cirrus). The RTVue RNFL thickness measurements in nasal sectors showed better diagnostic performance in detecting BA and higher correlations with temporal hemianopia than the Cirrus measurements.
SPRINGER, 2012年10月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 250 (10), 1499 - 1507, 英語[査読有り]
研究論文（学術雑誌）
- 2012年09月, 日本緑内障学会抄録集23回, 153, 日本語自己眼圧測定器icareONEの精度および安全性の検討
研究論文（その他学術会議資料等）
- 2012年09月, 日本緑内障学会抄録集23回, 152, 日本語視神経切断モデルにおけるsyntaphilinの変化
研究論文（その他学術会議資料等）
- 2012年09月, 日本緑内障学会抄録集23回, 116, 日本語ロジスティック回帰分析による線維柱帯切除術後の低眼圧黄斑症寄与因子の検討
研究論文（その他学術会議資料等）
- 2012年09月, 日本緑内障学会抄録集23回, 155, 日本語3種のOCTによる高度近視群、非高度近視群における緑内障検出力の比較
研究論文（その他学術会議資料等）
- AMER MEDICAL ASSOC, 2012年08月, ARCHIVES OF OPHTHALMOLOGY, 130 (8), 1067 - 1069, 英語Longitudinal Study of Retinal Nerve Fiber Layer Thickness and Ganglion Cell Complex in Traumatic Optic Neuropathy
[査読有り]
研究論文（学術雑誌）
To evaluate the effects of ocular rotation on parapapillary retinal nerve fiber layer (RNFL) thickness measured by spectral-domain optical coherence tomography (SD-OCT). Eighty-eight normal and 205 glaucomatous eyes were studied. RNFL thickness was measured by 3D OCT. Ocular rotation angle was measured from a fundus image obtained by a non-mydriatic fundus camera equipped with 3D OCT. The average, hemi-superior, and hemi-inferior RNFL thicknesses as well as those in the 4 quadrants and the 16-segmented superotemporal (ST-1) and inferotemporal (IT-4) sectors were compared both before and after correcting for ocular rotation. Receiver operating characteristic curves and the areas under the curve (AUC) for the RNFL thicknesses were calculated on the basis of the data from glaucomatous and control eyes. The relationships between RNFL thickness and retinal sensitivity in the corresponding visual field were analyzed using a Humphrey field analyzer. Correction for ocular rotation did not affect the AUCs of the hemi-superior and hemi-inferior RNFL thicknesses. RNFL thicknesses in all of the quadrants and in ST-1 and IT-4 were significantly changed by correcting for ocular rotation. The correlations between all RNFL sectors and retinal sensitivity were not changed by correcting for the ocular rotation angle. Ocular rotation compensation affected RNFL thickness measurement with 3D OCT. However, the effect was clinically negligible in the diagnosis of glaucoma.
SPRINGER TOKYO, 2012年07月, JAPANESE JOURNAL OF OPHTHALMOLOGY, 56 (4), 354 - 361, 英語[査読有り]
研究論文（学術雑誌）
Backgrounds/aims To evaluate the agreement of parapapillary retinal nerve fibre layer (RNFL) thickness among three spectral-domain optical coherence tomography (OCT) instruments. Methods Two hundred and three glaucomatous eyes and 88 normal eyes were imaged by Cirrus, RTVue and 3D OCT. The average and the four quadrant RNFL thicknesses were evaluated. Agreement among RNFL measurements was evaluated using Bland-Altman analysis and linear regression analysis. The percentage of each quadrant in the average RNFL thickness value was compared among the three instruments. Results Cirrus showed significantly smaller thickness values than RTVue (difference=8.8 mu m, p<0.0001) and 3D OCT (difference=8.1 mu m, p<0.0001). Although RNFL measurements among the instruments were highly correlated, the Bland-Altman analysis revealed proportional biases for most of the pair-wise agreements. Additionally, 3D OCT showed strong proportional biases with RTVue and 3D OCT. RTVue had a smaller occupied proportion of nasal quadrants (30.2%) and a larger proportion of inferior quadrants (32.4%) compared with Cirrus and 3D OCT. Conclusions RNFL measurements among the instruments were well correlated but had different values for thickness. The measurement circle of RTVue might be more superior-temporally located compared with the other instruments. Differences in the measurement protocols might be affected by the disagreements. These instruments should not be used interchangeably.
BMJ PUBLISHING GROUP, 2012年06月, BRITISH JOURNAL OF OPHTHALMOLOGY, 96 (6), 832 - 837, 英語[査読有り]
研究論文（学術雑誌）
- 2012年03月, 日本眼科学会雑誌, 116 (臨増), 318, 日本語緑内障における多局所視覚誘発電位と構造変化の一致性と相関
研究論文（その他学術会議資料等）
- 2012年03月, 日本眼科学会雑誌, 116 (臨増), 361, 日本語外傷性視神経症における網膜神経線維層厚およびGanglion cell complexの経時的変化
研究論文（その他学術会議資料等）
Purpose/Aim: To determine whether amniotic membrane transplantation (AMT) at trabeculectomy affects intrableb structures and which intrableb parameters are significantly correlated with the long-term intraocular pressure (IOP) control. Materials and Methods: Enrolled were 64 eyes of 56 glaucoma patients who underwent trabeculectomy without (36 eyes) or with (28 eyes) AMT. Bleb structure was evaluated by ultrasound biomicroscopy (UBM) at least one year after surgery. IOP control was defined as good when the eyes had a more than 30% decrease in the preoperative IOP and an IOP value < 18 mmHg if the preoperative IOP was higher than 21 mmHg. Logistic regression analyses were conducted to identify factors significantly associated with IOP control. Results: Intervals between surgery and the timing of the UBM examinations (median; 2.5 years) and the overall frequency of good IOP control (28/36 in the eyes without AMT and 17/28 in those with AMT; chi-square test, P = 0.2276) were similar in the two groups. The eyes with AMT had a significantly lower number of type H (high reflective) or L (low reflective) blebs and a higher number of type E (encapsulated) blebs compared to those without AMT (P < 0.0001). Among independent variables, which included age, sex, glaucoma type, lens status, the number of ocular hypotensives, and previous intraocular surgeries, only type F (flattened) bleb in eyes without AMT (P = 0.0008, odds ratio [ OR] = 0.0256) and no or limited intrableb fluid-filled space in eyes with AMT were significantly associated with poor IOP control (P = 0.0026, OR = 0.0111, and 0.0071, 0.0167, respectively). Conclusions: Intrableb structures after trabeculectomy alone versus AMT-assisted trabeculectomy were distinct. The bleb wall reflectivity in the former and the extent of the subconjunctival fluid-filled space in the latter were factors associated with long-term IOP control.
INFORMA HEALTHCARE, 2012年03月, CURRENT EYE RESEARCH, 37 (3), 239 - 250, 英語[査読有り]
研究論文（学術雑誌）
Purpose: To preliminarily test whether aquaporin (AQP)-9 is expressed in the primate and human optic nerve and whether glaucoma reduces its expression. Methods: The expression of AQP-4 and AQP-9 was immunohistochemically studied in the optic nerves of monkey eyes (an angle-laser-induced ocular hypertensive (OH) eye and a control fellow eye) and of human donor eyes (one control eye and one glaucomatous eye). Results: AQP-9 was immunoreactive throughout the entire region of the optic nerve in the monkey and human control eyes and was co-labeled with glial fibrillary acidic protein. In both the monkey OH and human glaucomatous optic nerves, the level of AQP-9 immunoreactivity was substantially reduced. AQP-4 was immunoreactive only in the retrobulbar region in both the monkey and human control optic nerves, whereas neither OH nor glaucoma affected the AQP-4 expression pattern. Conclusions: As has been shown in rats, the optic nerve head in monkeys and humans expresses AQP-9 but not AQP-4. Elevated intraocular pressure or glaucoma reduces AQP-9 expression in the optic nerve. The decrease in the astrocytic expression of AQP-9 in the optic nerve could be implicated in the development of glaucomatous optic neuropathy.
INFORMA HEALTHCARE, 2011年11月, CURRENT EYE RESEARCH, 36 (11), 1064 - 1067, 英語研究論文（学術雑誌）
To test whether multifocal visual evoked potential (mfVEP) recording using two perpendicularly placed channels, as previously reported, to measure the degree of signal-to-noise ratio (SNR) distribution overlap between a signal window and a noise window would efficiently detect and quantify glaucomatous damage. Humphrey visual field (HVF) and mfVEP were recorded from 56 patients with primary open-angle glaucoma and mean deviation less than -15 dB and 62 age-matched ophthalmologically normal individuals. Areas under the receiver-operating characteristic curve (SNR-AUC) were calculated based on the proportion of mfVEP responses that exceeded a specific SNR criterion for both windows. Abnormal sectors with an SNR deviated from the previously established norm with P<5% and 1% were counted. Diagnostic accuracy of the SNR-AUC was similar to that of the average total deviation (TD) of the HVF. The hemifield agreement to detect a defect in mfVEP and HVF was 77.1-87.3%, which was similar to previous reports using multiple channels. Correlation coefficients between SNR-AUC and average TD (0.74 in the upper hemifield and 0.65 in the lower) were significantly higher than those between the sums of abnormal locations on the mfVEP and HVF probability plots (0.27 and 0.33, respectively). Two perpendicular channels can detect and quantify functional damage due to glaucoma. The SNR-AUC may be used as a global index to quantify diffuse glaucomatous functional loss.
SPRINGER, 2011年10月, DOCUMENTA OPHTHALMOLOGICA, 123 (2), 93 - 108, 英語[査読有り]
研究論文（学術雑誌）
Diabetes pathology derives from the combination of hyperglycemia and hypoinsulinemia or insulin resistance leading to diabetic complications including diabetic neuropathy, nephropathy and retinopathy. Diabetic retinopathy is characterized by numerous retinal defects affecting the vasculature and the neuro-retina, but the relative contributions of the loss of retinal insulin signaling and hyperglycemia have never been directly compared. In this study we tested the hypothesis that increased retinal insulin signaling and glycemic normalization would exert differential effects on retinal cell survival and retinal physiology during diabetes. We have demonstrated in this study that both subconjunctival insulin administration and systemic glycemic reduction using the sodium-glucose linked transporter inhibitor phloridzin affected the regulation of retinal cell survival in diabetic rats. Both treatments partially restored the retinal insulin signaling without increasing plasma insulin levels. Retinal transcriptomic and histological analysis also clearly demonstrated that local administration of insulin and systemic glycemia normalization use different pathways to counteract the effects of diabetes on the retina. While local insulin primarily affected inflammation-associated pathways, systemic glycemic control affected pathways involved in the regulation of cell signaling and metabolism. These results suggest that hyperglycemia induces resistance to growth factor action in the retina and clearly demonstrate that both restoration of glycemic control and retinal insulin signaling can act through different pathways to both normalize diabetes-induced retinal abnormality and prevent vision loss.
PUBLIC LIBRARY SCIENCE, 2011年10月, PLOS ONE, 6 (10), 英語[査読有り]
研究論文（学術雑誌）
To determine if asymmetrical postural change-induced elevations in intraocular pressure (IOP) in eyes of patients with primary open-angle glaucoma (POAG) were associated with asymmetries in functional and structural damage. Enrolled were 132 eyes of 66 patients with POAG (male/female = 22/44, age = 55.2 +/- 13.4 years). IOP was first measured in a seated position and then in a supine position at 10-minute intervals over a 60-minute period using a TonoPen XL. The Humphrey visual field 30-2 program and a fast retinal nerve fiber layer (RNFL) thickness acquisition protocol of Stratus optical coherence tomography (OCT) were performed. Mean deviation (MD) and average total RNFL thickness were compared between eyes with the greater magnitude of postural change-induced IOP elevation (Delta IOP) and those with the smaller magnitude of Delta IOP. The MDs of the eyes with larger Delta IOP (6.21 +/- 3.18 mmHg) and smaller Delta IOP (3.02 +/- 0.37 mmHg) were -12.31 +/- 7.63 dB and -9.67 +/- 6.80 dB respectively (p = 0.0176). The average total RNFL thickness was 64.33 +/- 17.83 mu m in the former and 68.56 +/- 15.10 mu m in the latter (p = 0.049). The MDs and RNFL thickness were not significantly different between the eyes that had higher and lower IOP values measured in the seated position. In patients with asymmetrical POAG, the magnitude of IOP elevation induced by postural changes may be related to differences in the severity of both functional and structural damage between the eyes.
SPRINGER, 2011年06月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 249 (6), 879 - 885, 英語[査読有り]
研究論文（学術雑誌）
- Investigation of the association between SLC1A3 gene polymorphisms and normal tension glaucoma
Purpose: To investigate whether the solute carrier family 1, member 3 (SLC1A3) gene, which encodes the glutamate aspartate transporter, is associated with normal tension glaucoma (NTG) in Japanese patients. Methods: Two hundred and ninety-five Japanese patients with NTG and 518 Japanese healthy controls were recruited. Patients exhibiting comparatively early NTG onset were selected because early onset suggests that genetic factors may show stronger involvement. We genotyped 5 single-nucleotide polymorphisms (SNPs) in SLC1A3 and assessed the allelic and genotypic diversity among cases and controls. Results: There were no statistically significant differences in the frequency of SLC1A3 alleles and genotypes between cases and controls. Conclusions: Our study showed no association between SLC1A3 and NTG, suggesting that the SLC1A3 gene may not be an associated factor in NTG pathogenesis.
MOLECULAR VISION, 2011年03月, MOLECULAR VISION, 17 (89-90), 792 - 796, 英語研究論文（学術雑誌）
Diabetes redistributes the expression of glial aquaporin (AQP) water channels in the retina. However, it is not known whether diabetes also affects retinal AQP-0 expression. This study examined the effects of the development of diabetes on the expression of retinal AQP-0 in spontaneously diabetic Toni (SDT) rats. Male SDT rats at 10 and 40 weeks of age and age-matched male Sprague-Dawley (SD) rats were used. The localization of AQP-0 was assessed immunohistochemically using sagittal cryosections of the rats' retinas and optic nerves. Fold changes in AQP-0 gene expression relative to controls were assessed by real-time RT-PCR. All SDT rats spontaneously developed diabetes by 40 weeks of age (the mean hemoglobin (Hb) A1c levels were 2.8 +/- 0.2% and 11.2 +/- 1.0% at 10 and 40 weeks, respectively). SD rats did not develop diabetes (the HbA1c levels were 2.7 +/- 0.2% and 2.6 +/- 0.3% at 10 and 40 weeks, respectively). In the retinas of SD rats and in those of SDT rats at 10 weeks of age, immunoreactivity for AQP-0 was confined predominantly to the inner nuclear layer and to the border between the inner plexiform layer and the ganglion cell layer (GCL), where AQP-0 colocalized with protein kinase C-e. AQP-0 immunoreactivity was also observed in the GCL to a lesser degree, which colocalized with the neuronal nuclei. In the 40-week-old SDT rat retinas, additional AQP-0 immunoreactivity was observed in the GCL and colocalized with neurofilaments, indicating expression of AQP-0 in ganglion cell axons. However, the axonal AQP0 immunoreactivity was restricted to the retinal nerve fibers, whereas the optic nerve axons were devoid of AQP-0. Retinal blood vessels did not express AQP-0. AQP-0 gene expression was 3.4-fold higher in SDT rat retinas than in SD rat retinas at 40 weeks of age. AQP-0 was predominantly expressed in the bipolar cells of the non-diabetic rat retinas, whereas it was also expressed in the retinal nerve fibers of diabetic rat retinas. The disrupted water transport between astrocytes and retinal nerve fibers may be associated with the known accelerated apoptosis of retinal ganglion cells induced by diabetes. (C) 2011 Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2011年03月, EXPERIMENTAL EYE RESEARCH, 92 (3), 195 - 201, 英語研究論文（学術雑誌）
The purpose of this study was to establish optimal conditions for recording multifocal visual evoked potentials (mVEPs) in Japanese individuals, whose skull frame presumably differs from Caucasians. The scalp point that was extended from the calcarine fissure was identified using magnetic resonance imaging scans of 200 subjects. MVEPs were recorded from 56 individuals using three single channels and combinations of vertical and horizontal channels. Five electrodes were placed at the inion, 4 cm above the inion, 2.5 cm below the inion, 4 cm to the left or 4 cm to the right of the inion. The signal-to-noise ratio (SNR) was obtained by measuring the root-mean-square (RMS) amplitude of a signal window (45-150 ms) from each of 60-local responses that was divided by the average of the 60 RMS amplitudes of the noise window (325-430 ms). Receiver operating characteristic (ROC) analyses were performed based on the proportion of mVEP responses that exceeded a specific SNR criterion, calculated for both the signal window and the noise window. The position of the calcarine fissure relative to the inion was significantly lower than the value reported for Caucasians. The ROC analyses disclosed that bi-channel combinations (one vertical and one horizontal) had significantly better performance to discriminate signal from noise in 60-local mVEP responses compared to any single channel and performed similarly to the tri-channel combination. Two sets of perpendicular channels should be simultaneously used in recording mVEP responses from Japanese people, among whom skull frame characteristics differ from those observed in Caucasians.
SPRINGER, 2011年02月, DOCUMENTA OPHTHALMOLOGICA, 122 (1), 29 - 37, 英語[査読有り]
研究論文（学術雑誌）
Stromal cell-derived factor-1 (SDF-1) causes chemotaxis of CXCR4-expressing bone marrow-derived cells. SDF-1 is involved in the pathogenesis of various vascular diseases, including those of the eye. However, the role of SDF-1 in neuronal diseases is not completely understood. Here, we show higher SDF-1 levels in the vitreous humor of patients with retinal detachment (RD) compared with normal patients. SDF-1 correlated positively with the duration as well as the extent of RD. Furthermore, SDF-1 correlated significantly with levels of interleukin-6 and interleukin-8, but not with vascular endothelial growth factor. Western blot analysis results showed significant SDF-1 up-regulation in detached rat retinas compared with normal animals Immunohistochemistry data showed that SDF-1 was co-localized with the glial cells of the detached retina. SDF-1 blockade with a neutralizing antibody increased photoreceptor cell loss and macrophage accumulation in the subretinal space. The retinal precursor cell line R28 expressed CXCR4. SDF-1 rescued serum starvation-induced apoptosis in R28 cells and enhanced their ability to participate in wound closure in a scratch assay. Our results indicate a surprising, protective role for SDF-1 in RD. This effect may be mediated directly or indirectly through other cell types. (Am J Pathol 2010, 177:2268-2277 DOI: 10.2353/ajpath.2010.100134)
AMER SOC INVESTIGATIVE PATHOLOGY, INC, 2010年11月, AMERICAN JOURNAL OF PATHOLOGY, 177 (5), 2268 - 2277, 英語研究論文（学術雑誌）
PURPOSE. To investigate the effect of chronically elevated intraocular pressure (IOP) on the expression of water channel aquaporins (AQPs) 1, 4, and 9 in the optic nerve and retina in rats. METHODS. Three episcleral veins were cauterized to elevate IOP in the left eyes of Sprague-Dawley rats. IOPs were monitored with a rebound tonometer. At 2 and 4 weeks after surgery, eyeballs with the attached optic nerve were enucleated for cryosectioning with immunohistochemistry, or dissected retinas and desheathed optic nerves were subjected to gene expression analyses. RESULTS. IOP was significantly increased after surgery up to 4 weeks (P = 0.0008). In the control optic nerve, the unmyelinated portion showed only AQP9 immunoreactivity, whereas the myelinated portion expressed both AQP4 and AQP9 immunoreactivities colabeled for glial fibrillary acidic protein but not for neurofilament. In the control retina, AQP1 was expressed in the outer nuclear layer and photoreceptors, AQP4 was expressed in Muller cell endfeet, and AQP9 was expressed primarily in NeuN-positive cells in the ganglion cell layer (GCL). Elevated IOPs substantially reduced AQP9 expression in the optic nerve head (ONH) and the GCL and decreased the retinal gene expression, but not immunoreactivity, of AQP1. CONCLUSIONS. AQP9 was the only water channel expressed in the unmyelinated portion of the ONH and in the GCL whose expression was reduced after IOP elevation. Given that AQP9 presumably acts as a channel for metabolites to pass from astrocytes to neurons, the reduced expression of AQP9 at these specific sites may be implicated in the pathogenesis of glaucomatous optic neuropathy. (Invest Ophthalmol Vis Sci. 2010; 51: 4618-4626) DOI: 10.1167/iovs.09-4712
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2010年09月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 51 (9), 4618 - 4626, 英語[査読有り]
研究論文（学術雑誌）
- Genotyping HLA-DRB1 and HLA-DQB1 alleles in Japanese patients with normal tension glaucoma
Purpose: Normal tension glaucoma (NTG) is a subtype of glaucoma in which intraocular pressure is within the statistically normal range. NTG may be associated with an immune disorder. The aim of this study was to determine whether specific alleles in the human leukocyte antigen (HLA)-DRB1 and HLA-DQB1 genes correlated with NTG in Japanese patients. Methods: We genotyped the HLA-DRB1 and HLA-DQB1 alleles in 113 Japanese patients with NTG and in 184 healthy Japanese control subjects using the polymerase chain reaction-sequence-specific oligonucleotide probes (PCR-SSOP) Luminex method. We assessed the allelic diversity in patients and controls. Results: There were no statistically significant differences in the allele frequency of HLADRB1 and HLA-DQB1 between NTG patients and control subjects, and no HLA-DRB1-HLA-DQB1 haplotypes demonstrated any significant association with NTG. Conclusions: Our findings suggest that HLA-DRB1 and HLA-DQB1 polymorphisms have no significant effect on the development of NTG in Japanese patients.
MOLECULAR VISION, 2010年09月, MOLECULAR VISION, 16 (203), 1874 - 1879, 英語[査読有り]
研究論文（学術雑誌）
Purpose: Factors contributing to the development of normal tension glaucoma (NTG), degenerative optic neuropathy characterized by the progressive loss of retinal ganglion cells, optic nerve axons, and visual fields, have not been determined. To identify genetic risk factors for NTG, we performed a genome-wide association study of NTG. Design: Case-control study. Participants: The study cohort consisted of 305 Japanese patients with NTG and 355 controls. Methods: We genotyped 500 568 single-nucleotide polymorphisms (SNPs) and assessed the allelic diversity among cases and controls. Main Outcome Measures: Genotypes of 500 568 SNPs. Results: The 2 most strongly NTG-associated SNPs, rs3213787 and rs735860, are located in an intron of SRBD1 and the 3'-untranslated region of ELOVL5 (P = 2.5X10(-9), odds ratio = 2.80 and P = 4.1X10(-6), odds ratio = 1.69), respectively. Real-time quantitative reverse transcription- polymerase chain reaction assays showed significantly increased expression of each gene in the white blood cells of subjects harboring the risk allele of these SNPs. Conclusions: Our genome-wide association study identified SRBD1 and ELOVL5 as new susceptibility genes for NTG. Because SRBD1 and ELOVL5 are reportedly involved in the induction of cell growth inhibition or apoptosis, the regulation of SRBD1 and ELOVL5 cascades may play an important physiologic role in the risk of NTG development. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2010; 117: 1331-1338 (C) 2010 by the American Academy of Ophthalmology.
ELSEVIER SCIENCE INC, 2010年07月, OPHTHALMOLOGY, 117 (7), 1331 - U84, 英語[査読有り]
研究論文（学術雑誌）
- Analysis of microsatellite polymorphisms within the GLC1F locus in Japanese patients with normal tension glaucoma
Purpose: To investigate whether the GLC1F locus is associated with normal tension glaucoma (NTG) in Japanese patients. Methods: We recruited 242 unrelated Japanese subjects, including, 141 NTG patients and 101 healthy controls. The patients exhibiting a comparatively early onset were selected as they suggest that genetic factors may show stronger involvement. Genotyping and assessment of allelic diversity was performed on 11 highly polymorphic microsatellite markers in and around the GLC1F locus. Results: Individuals carrying the 163 allele of D7S1277i had a statistically significant increased risk of NTG (p=0.0013, pc=0.016, OR=2.47, 95% CI=1.42-4.30). None of the other markers identified significant loci (pc>0.05) after Bonferroni's correction. Conclusions: These findings suggested that the genes in the GLC1F locus may be associated with the pathogenesis of NTG.
MOLECULAR VISION, 2010年03月, MOLECULAR VISION, 16 (51-52), 462 - 466, 英語研究論文（学術雑誌）
- AMER MEDICAL ASSOC, 2010年01月, ARCHIVES OF OPHTHALMOLOGY, 128 (1), 139 - 141, 英語Marked Cup Reversal Presumably Associated With Scleral Biomechanics in a Case of Adult Glaucoma
[査読有り]
研究論文（学術雑誌）
Evidence is mounting that not only microangiopathy, but also neurodegenerative events occur in the retinas of humans and rodents with early diabetes. Diverse pathologies are known to alter the amount and/or location of glial expression of the water-selective channels aquaporins (AQPs) 1 and 4. However, the temporal relationships among glial activation, the altered expression of the AQP proteins and neuronal death in the retinas of diabetic animals remains to be investigated. Male spontaneously diabetic Torii (SDT) rats reportedly develop diabetes by 40 weeks of age at the latest and manifest proliferative diabetic retinopathy at 50 weeks or later. This study compared temporal changes in neuroretinal apoptosis, glial fibrillary acidic protein (GFAP) expression and the expression of AQPs 1 and 4 between SDT rat retinas and age-matched Sprague-Dawley (SD) rat retinas. Cell death was detected by terminal deoxynucleotidyl transferase-mediated deoxy-uridine triphosphate nick end-labeling on retinal flatmounts and activated caspase 3 immunofluorescence of retinal cryosections. The expression of GFAP and AQPs 1 and 4 was assessed by immunohistochemistry of cryosections and retinal flatmounts. Diabetes started to develop around 15 weeks in SDT rats. Apoptotic cells in the ganglion cell layer and the inner nuclear layer were significantly more numerous in 40-week-old SDT rat retinas than in either age-matched SD rat retinas or 10-week-old SDT rats. GFAP immunoreactivity was confined to the nerve fiber layer both in SD and SDT rats at 10 weeks, whereas it spanned the whole retina in SDT rats, but not in 5D rats, at 40 weeks. AQP1 was expressed in the outer retina, whereas AQP4 was expressed in the perivascular and end feet of Muller cells and astrocytes in the inner retina in the control SD rats and the SDT rats at 10 weeks. The perivascular AQPs shifted from AQP4 to AQP1 in 40-week-old SDT rats that exhibited marked hyperglycemia. Thus, the development of diabetes increases neuroretinal apoptosis, and this coincides with an altered expression pattern of GFAP and water-selective channels AQPs 1 and 4 in SDT rats. (C) 2009 Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2010年01月, EXPERIMENTAL EYE RESEARCH, 90 (1), 17 - 25, 英語[査読有り]
研究論文（学術雑誌）
- 日本眼科学会, 2009年12月, 日本眼科学会雑誌, 113巻, 12号, pp. 1145-1152 (12), 1145 - 1152, 日本語早発型発達緑内障の弱視化要因
[査読有り]
研究論文（学術雑誌）
- Association of toll-like receptor 2 gene polymorphisms with normal tension glaucoma
Purpose: Toll-like receptor 2 (TLR2) is a transmembrane receptor that mediates immune responses to exogenous and endogenous ligands, and interacts with heat-shock proteins, which are reportedly involved in normal tension glaucoma (NTG). We investigated whether TLR2 polymorphisms are associated with NTG. Methods: 200 Japanese patients with NTG and 128 healthy Japanese controls were recruited. We genotyped five single-nucleotide polymorphisms (SNPs) in the TLR2 gene and assessed the allele and haplotype diversities between cases and controls for all SNPs. Results: No significant differences in the frequency of TLR2 alleles and haplotypes in the NTG cases were detected, compared with the controls. Conclusions: Our study showed no evidence for an association between TLR2 polymorphisms and NTG. TLR2 polymorphisms may not play an important role in NTG pathogenesis in the Japanese population.
MOLECULAR VISION, 2009年12月, MOLECULAR VISION, 15 (306-07), 2905 - 2910, 英語[査読有り]
研究論文（学術雑誌）
To investigate whether tafluprost, which is a prostaglandin-related compound and an anti-glaucoma drug, has a direct anti-apoptotic effect in cultured retinal ganglion cells (RGCs) and rat RGCs in retinas with optic nerve crush (ONC). RGC-5 cells were induced to undergo apoptosis by a serum deprivation and by exogenous glutamate. The level of cell death with or without tafluprost was monitored by an XTT assay and by immunocytochemistry with activated caspase-3. Changes in intracellular calcium ([Ca(2+)]i) levels were measured with fluo-4 fluorescence. Rat RGCs were degenerated by ONC. After topical instillation of tafluprost for 7 and 14 days, the numbers of retrograde-labeled RGCs were counted. Retinal flatmounts were subjected to terminal dUTP nick end labeling (TUNEL) staining to detect apoptotic cells. Tafluprost dose-dependently promoted RGC-5 cell viability with an optimum concentration of 3 mu M (p = 0.006). Tafluprost significantly reduced caspase-3-positive cells and suppressed [Ca(+2)]i evoked by exogenous glutamate. The cGMP-dependent protein kinase inhibitor and KT-5823 partially blocked the rescue effect of tafluprost (p = 0.002). The survival rate of RGCs significantly increased in eyes treated with tafluprost (p = 0.01), and the prevalence of TUNEL-positive cells was significantly decreased 14 days after ONC (p < 0.001). These data suggest that tafluprost has an anti-apoptotic effect in RGCs.
SPRINGER, 2009年10月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 247 (10), 1353 - 1360, 英語[査読有り]
研究論文（学術雑誌）
- 2009年09月, 神経眼科, 26巻, 3号, pp. 307-313, 日本語興味ある経過をたどった両眼性特発性視神経炎の小児例
[査読有り]
研究論文（学術雑誌）
Objective: To evaluate which of the 3 clinically used Visual field indices including mean deviation (MD), Advanced Glaucoma Intervention Study (AGIS) score, and Collaborative Initial Glaucoma Treatment Study (CIGTS) score are best in evaluating functional damage of glaucomatous optic neuropathy. Methods: In 213 glaucomatous eyes, peripapillary retinal nerve fiber layer thickness (RNFLT) and optic disc configuration were measured with Stratus optical coherence tomography and Heidelberg Retina Tomograph-2, respectively. Visual field was measured with standard automated perimetry 30-2. Correlations of the structural parameters compared with the 3 VF indices using second polynomial regression were calculated. In addition, these correlations were analyzed among eyes of 3 different stages of glaucoma, as defined by MD score (early, MD >= - 6 dB; moderate, - 12 dB <= MD < - 6 dB; advanced, MD < - 12 dB). Results: Among structure-function relationships in all subjects, the highest correlation determination (R(2)) was MD with RNFLT ( = 0.298). CIGTS score showed better R(2) than MD or AGIS score with rim area, but these values were not higher than any R(2) with RNFLT. In analyses of 3 groups depending on MD, statistically significant structure-function correlations were observed only in patients with an advanced stage. Conclusions: No clear difference was found among MD and AGIS/CIGTS scores in expressing functional damage of glaucomatous eyes. MD is suggested to be no worse than others in monitoring glaucoma in clinical setting.
LIPPINCOTT WILLIAMS & WILKINS, 2009年06月, JOURNAL OF GLAUCOMA, 18 (5), 379 - 384, 英語[査読有り]
研究論文（学術雑誌）
We investigated whether latanoprost has a direct anti-apoptotic effect in retinal ganglion cell (RGC) line and RGCs in the rat. RGC-5 cells were induced to undergo apoptosis by serum deprivation and exogenous glutamate. The level of cell death with or without latanoprost acid was monitored by an XTT assay and by immunocytochemistry with activated caspase-3. Changes in the level of intracellular calcium ([Ca(2+)](i)) were measured with fluo-4 fluorescence. The XTT assay revealed that latanoprost acid increased RGC-5 cell viability. Latanoprost acid significantly reduced caspase-3 positive cells and suppressed [Ca(2+)](i)evoked by glutamate. 00126, a mitogen-activated protein/extracellular signal-regulated kinase 1 and 2 inhibitor, partially blocked the rescue effect of latnanoprost acid (p = 0.013). In vivo, rat RGCs were degenerated by optic nerve crush. After topical instillation of latanoprost for 7 days, RGCs labeled with fluorogold were significantly. Retinal flatmounts were subjected to terminal dUTP nick end labeling (TUNEL) staining to detect apoptotic cells. TUNEL-positive cells were significantly decreased in eyes with topically instilled latanoprost (p = 0.015). These data suggest that latanoprost has an neuroprotective ability in RGCs. (C) 2008 Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2009年03月, EXPERIMENTAL EYE RESEARCH, 88 (3), 535 - 541, 英語[査読有り]
研究論文（学術雑誌）
High-mobility group box 1 (HMGB1) protein is a multifunctional protein, which is mainly present in the nucleus and is released extracellularly by dying cells and/or activated immune cells. Although extracellular HMGB1 is thought to be a typical danger signal of tissue damage and is implicated in diverse diseases, its relevance to ocular diseases is mostly unknown. To determine whether HMGB1 contributes to the pathogenesis of retinal detachment (RD), which involves photoreceptor degeneration, we investigated the expression and release of HMGB1 both in a retinal cell death induced by excessive oxidative stress in vitro and in a rat model of RD-induced photoreceptor degeneration in vivo. In addition, we assessed the vitreous concentrations of HMGB1 and monocyte chemoattractant protein 1 (MCP-1) in human eyes with RD. We also explored the chemotactic activity of recombinant HMGB1 in a human retinal pigment epithelial (RPE) cell line. The results show that the nuclear HMGB1 in the retinal cell is augmented by death stress and upregulation appears to be required for cell survival, whereas extracellular release of HMGB1 is evident not only in retinal cell death in vitro but also in the rat model of RD in vivo. Furthermore, the vitreous level of HMGB1 is significantly increased and is correlated with that of MCP-1 in human eyes with RD. Recombinant HMGB1 induced RPE cell migration through an extracellular signal-regulated kinase-dependent mechanism in vitro. Our findings suggest that HMGB1 is a crucial nuclear protein and is released as a danger signal of retinal tissue damage. Extracellular HMGB1 might be an important mediator in RD, potentially acting as a chemotactic factor for RPE cell migration that would lead to an ocular pathological wound-healing response.
NATURE PUBLISHING GROUP, 2009年03月, LABORATORY INVESTIGATION, 89 (3), 278 - 289, 英語[査読有り]
研究論文（学術雑誌）
- 2009年, Clinical ophthalmology (Auckland, N.Z.), Vol. 3, No. , pp. 183-8, 英語Investigation of the association between the GLC3A locus and normal tension glaucoma in Japanese patients by microsatellite analysis
[査読有り]
研究論文（学術雑誌）
- Association of microsatellite polymorphisms of the GPDS1 locus with normal tension glaucoma in the Japanese population.
BACKGROUND: To investigate whether the GPDS1 locus, a potential causative locus of pigment-dispersion syndrome, is associated with normal-tension glaucoma (NTG) in Japanese patients. MATERIALS AND METHODS: We used polymerase chain reaction amplification with sequence-specific primers to analyze 20 polymorphic microsatellite markers in and around the GPDS1 locus with an automated DNA analyzer and automated fragment detection by fluorescent-based technology. The DNA samples used for these analyses were obtained from ethnicity- and gender-matched patients, including 141 Japanese patients with NTG and 101 healthy controls. Patients exhibiting a comparatively early onset were selected as this suggests that genetic factors may show stronger involvement. RESULTS: One allele of D7S2462 exhibited a frequency that was significantly decreased in NTG cases compared to controls (P = 0.0013, Pc = 0.019, OR = 0.48, 95% CI = 0.30-0.75). Alleles at another six microsatellite loci were positively or negatively associated with NTG, but these associations did not retain statistical significance after Bonferroni correction (P < 0.05, Pc > 0.05). CONCLUSION: Our study showed a significant association between the GPDS1 locus and NTG, suggesting that there may be some genetic risk factor(s) in the development of NTG.
2009年, Clinical ophthalmology (Auckland, N.Z.), 3, 307 - 12, 英語, 国際誌[査読有り]
研究論文（学術雑誌）
- AMER MEDICAL ASSOC, 2009年01月, ARCHIVES OF OPHTHALMOLOGY, 127 (1), 105 - 107, 英語Serous Macular Detachment Due to Diabetic Papillopathy Detected Using Optical Coherence Tomography
[査読有り]
研究論文（学術雑誌）
- Association of Optic Disc Configuration and Clustered Visual Field Sensitivity in Glaucomatous Eyes With Hemifield Visual Field Defects
Purpose: To compare the morphologic alterations between upper and lower sectors of the optic nerve head (ONH) in eyes with primary open-angle glaucoma (POAG) that have hemifield Visual field defects and to evaluate the correlation between this sectoral ONH damage and visual field sensitivity loss within the corresponding clustered test points of standard automated perimetry. Methods: Visual field testing with Humphrey Field Analyzer and imaging with Heidelberg Retina Tomograph (HRT) were performed in 87 eyes from 87 Japanese patients with POAG and 150 eves, from 150 normal subjects. Global and segmental HKT topographic parameters were compared among POAG patients with Superior hemifield defects, those with interior hemifield defects, and controls. The correlation between the sectoral HRT measurements and the sum of total deviation Value, ill the corresponding clustered visual field test points was analyzed in the 2 POAG groups. Results: The HRT measurements in both POAG groups were significantly different from those of controls, not only in the sectors corresponding to abnormal hemifield. but also in the sectors corresponding to the normal Visual hemifield. There was a linear correlation between the sectoral HRT parameters and clustered Visual field sensitivities in the affected hemifield areas. Conclusions: The present study indirectly supports the notion that the relationship between structural and functional damage of glaucomatous optic neuropathy is not linear when evaluated with the currently available techniques and instruments.
LIPPINCOTT WILLIAMS & WILKINS, 2009年01月, JOURNAL OF GLAUCOMA, 18 (1), 62 - 68, 英語[査読有り]
研究論文（学術雑誌）
- Regional Relationship Between Retinal Nerve Fiber Layer Thickness and Corresponding Visual Field Sensitivity in Glaucomatous Eyes
Objective: To establish the structure-function relationship between peripapillary retinal nerve fiber layer (RNFL) thickness and visual field (VF) test points in standard automated perimetry. Methods: We included 213 eyes with open-angle glaucoma and VF loss in this cross-sectional study. Correlations between individual VF sensitivity at 52 test points and peripapillary RNFL thickness divided into 16 sectors were calculated. The RNFL thickness was measured by Stratus optical coherence tomography. A new VF cluster map corresponding to RNFL sectors was generated by grouping the VF test points with the highest relation to each RNFL sector. Results: The VF sensitivity at each test point was significantly correlated with the sectoral RNFL thickness. The highest coefficient of determination (R-2) for a superotemporal RNFL sector and VF sensitivity at an inferotemporal test point (9 degrees temporal and 15 degrees inferior from the center) in standard automated perimetry was 0.500 (P <.001). Clustered VF test points most highly related to the RNFL sectors were asymmetrically located between the upper and lower hemifields. A newly developed map revealed significant structure-function relationships. Conclusions: We describe an association between VF sensitivity at test points and sectoral RNFL thickness. Nine clustered VF test points corresponding to 9 RNFL regions were demonstrated from the structure-function relationships.
AMER MEDICAL ASSOC, 2008年11月, ARCHIVES OF OPHTHALMOLOGY, 126 (11), 1500 - 1506, 英語[査読有り]
研究論文（学術雑誌）
Photoreceptor apoptosis is a critical process of retina degeneration in retinitis pigmentosa (RP), a group retinal degenerative diseases that result from rod and cone photoreceptor cell death and represent a major cause of adult blindness. We previously demonstrated the efficient prevention of photoreceptor apoptosis by intraocular gene transfer of pigment epithelium-derived factor (PEDF) in animal models of RP; however, the underlying mechanism of the neuroprotective activity of PEDF remains elusive. In this study, we show that an apoptosis-inducing factor (AIF)-related pathway is an essential target of PEDF-mediated neuroprotection. PEDF rescued serum starvation-induced apoptosis, which is mediated by AIF but not by caspases, of R28 cells derived from the rat retina by preventing translocation of AIF into the nucleus. Nuclear translocation of AIF was also observed in the apoptotic photoreceptors of Royal College of Surgeons rats, a well-known animal model of RP that carries a mutation of the Merik gene. Lentivirus-mediated retinal gene transfer of PEDF prevented the nuclear translocation of AIF in vivo, resulting in the inhibition of the apoptotic loss of their photoreceptors in association with up-regulated Bcl-2 expression, which mediates the mitochondrial release of A-IF. These findings clearly demonstrate that AIF is an essential executioner of photoreceptor apoptosis in inherited retinal degeneration and provide a therapeutic rationale for PEDF-mediated neuroprotective gene therapy for individuals with RP. (Am J Pathol 2008, 173:1326-1338; DOI: 10.2353/ajpath.2008.080466)
AMER SOC INVESTIGATIVE PATHOLOGY, INC, 2008年11月, AMERICAN JOURNAL OF PATHOLOGY, 173 (5), 1326 - 1338, 英語[査読有り]
研究論文（学術雑誌）
Background/aims: To evaluate to what extent the optic nerve head (ONH) parameters as measured with Heidelberg Retina Tomograph (HRT) differed from those measured with optical coherence tomography (OCT) in eyes with compressive optic neuropathy (CON) that had band atrophy (BA) of the optic disc. Methods: A total of 30 eyes from 19 patients with BA due to chiasmal tumour and 162 eyes from 162 normal subjects were examined with HRT and Stratus OCT using the fast optic nerve scan protocol. Parameters measured by the two devices, including the disc area, cup/disc (C/D) area ratio, cup area, cup volume, rim area and rim volume, were compared between the eyes of BA patients and controls. Bland-Altman plots were used to evaluate agreement for each parameter between OCT and HRT in both groups of eyes. Intermethod discrepancy of the measurements for each parameter was compared between the two groups of eyes. Results: Eyes with BA had smaller cup and larger rim parameters than control eyes when measured with HRT, whereas they had significantly larger cup and significantly smaller rim parameters than control eyes when measured with OCT. HRT measurements tended to be consistently lower in the C/D area ratio and cup area and higher in the rim area and rim volume than OCT measurements for both control eyes and eyes with BA. The intermethod discrepancy for all the parameters except the disc area was significantly larger in eyes with BA than in control eyes. Conclusion: The increased optic disc excavation was detected with OCT but not with HRT in CON eyes with BA of the optic disc. Thus, the distinct algorithms used by these two modalities affected the measurements of ONH parameters, particularly when assessing optic discs with temporal rim thinning.
B M J PUBLISHING GROUP, 2008年10月, BRITISH JOURNAL OF OPHTHALMOLOGY, 92 (10), 1382 - 1386, 英語[査読有り]
研究論文（学術雑誌）
PURPOSE. Toll-like receptor 4 (TLR4) is a transmembrane receptor that mediates immune responses to exogenous and endogenous ligands and interacts with heat shock proteins, which are reportedly involved in normal tension glaucoma (NTG). This study was undertaken to investigate whether TLR4 polymorphisms are associated with NTG. METHODS. Two hundred fifty Japanese patients with NTG and 318 Japanese healthy control subjects were recruited. Eight single-nucleotide polymorphisms (SNPs) in the TLR4 gene were genotyped, and allelic and phenotypic diversity was assessed between cases and control subjects. RESULTS. Strong linkage disequilibrium was observed among all SNPs (D' >= 0.85), which were located in one haplotype block. With respect to allelic diversity, the minor allele of three SNPs (rs10759930, rs1927914, and rs7037117) carried a significantly increased risk of NTG. With regard to genotypic diversity, individuals with the minor allele of six SNPs (rs10759930, rs1927914, rs1927911, rs12377632, rs2149356, and rs7037117) had a 1.47- to 1.65-fold increased risk of NTG. rs7037117, located in the 3'-untranslated region of TLR4, was most strongly associated with NTG, and when incorporated into a haplotype with rs10759930, the strongest association was detected (P = 0.0038, P(c) = 0.0095). CONCLUSIONS. Multiple SNPs in the TLR4 gene are associated with the risk of NTG. This finding suggests that the ligands and/or cytokines involved in the TLR4 signaling network may be risk factors for the development of NTG.
ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2008年10月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 49 (10), 4453 - 4457, 英語[査読有り]
研究論文（学術雑誌）
Aims: The aim of this study was to investigate the association between normal tension glaucoma and the candidate disease locus glaucoma 1, open angle, B (GLC1B) on chromosome 2. There are many reports describing the results of association or linkage studies for primary open angle glaucoma (POAG), with GLC1B as one of the loci associated with normal or moderately elevated intraocular pressure. However, there are few reports about the association of genes or defined genomic regions with normal tension glaucoma, which is the leading type of glaucoma in Japan. The GLC1B locus is hypothesized to be a causative region for normal tension glaucoma. Methods: Genomic DNA was extracted from whole blood of normal tension glaucoma (n= 143) and healthy controls (n= 103) of Japanese origin. Results: Fifteen microsatellite markers within and/or near to the GLC1B locus were genotyped, and their association with normal tension glaucoma was analysed. Two markers D2S2264 and D2S176 had significant positive associations. Conclusion: The D2S176 marker had the strongest significant association and it is located 24 kb from the nearest gene NCK2, which now becomes an important new candidate gene for future studies of its association with normal tension glaucoma.
B M J PUBLISHING GROUP, 2008年09月, BRITISH JOURNAL OF OPHTHALMOLOGY, 92 (9), 1293 - 1296, 英語[査読有り]
研究論文（学術雑誌）
Purpose To test whether Heidelberg Retina Tomograph (HRT) is applicable to assess the optic nerve head (ONH) configuration of the atrophic phase of non-glaucomatous optic neuropathy when a default set of the reference plane is used. Methods Ten eyes with non-arteritic anterior ischaemic optic neuropathy (NAION), 17 eyes with Leber's hereditary optic neuropathy (LHON), 40 eyes with compressive optic neuropathy (CON) owing to chiasmal tumour, and 241 eyes of control individuals were examined with HRT using the default reference plane. The global values of HRT parameters were evaluated among the groups of patients and controls. The sectoral measurements of the eyes with LHON and CON were compared with controls. To eliminate the influence of disc size and age on HRT measurements, eyes with disc area-and age-matched normal controls were used for comparison with eyes with NAION and LHON. Results Cup parameters in eyes with NAION were similar to those in controls. The retinal nerve fibre layer (RNFL) thickness was significantly thinner in eyes with NAION than that of controls. The eyes with LHON had significantly larger cup parameters, smaller rim volume, and thinner mean RNFL thickness than controls. Eyes with CON had significantly larger rim area and smaller cup parameters but similar RNFL thickness compared with controls. Conclusions When the default reference plane is used, HRT can measure the ONH configuration in eyes with NAION and LHON as expected. However, caution must be made to interpret the parameters obtained from the eyes with CON.
NATURE PUBLISHING GROUP, 2008年09月, EYE, 22 (9), 1154 - 1160, 英語[査読有り]
研究論文（学術雑誌）
Background To report long-term results of amniotic membrane transplantation (AMT)-assisted bleb revision for intractable late-onset bleb leak. Methods Retrospective medical record review of six consecutive patients who underwent AMT-assisted bleb revision for late-onset bleb leak at the Kobe University hospital between December 2001 and March 2004. Results The median (range) of age was 60 (20-77) years. All patients had a history of trabeculectomy with adjunctive use of 0.4 mg/ml mitomycin C. The median (range) of interval between the prior trabeculectomy and bleb leak was 15 (4-54) months. Preoperative intraocular pressure (IOP) was lower than 10 mmHg in two cases, while it was 25 mmHg or higher in three patients, who had a localized, ischemic, thin-wall leaking bleb circumscribed with extensively scarred tissue. The median (range) of follow-up after the AMT-assisted bleb revision was 49 (41-67) months. Postoperative IOP was well controlled in all patients without medication or with a maximum of three glaucoma medications. No patients presented recurrence of the bleb leak or AMT-related complications during entire follow-up. All patients showed at final visit a diffuse bleb which extended posteriorly beyond the conjunctival incision line. Conclusion AMT-assisted bleb revision successfully treated intractable late-onset bleb leak. Further comparative studies are needed to confirm the present result.
SPRINGER, 2008年04月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 246 (4), 567 - 571, 英語研究論文（学術雑誌）
Aims: To investigate the influence of age, disc size and axial length on the retinal nerve fibre layer (RNFL) thickness measurements of Heidelberg Retina Tomograph (HRT) and optical coherence tomography (OCT). Methods: A total of 162 eyes of 162 Japanese normal subjects aged between 20 and 83 were enrolled in this study. The disc area and mean RNFL thickness were measured with HRT. The disc area was also measured using the fast optic nerve scan protocol, and the average RNFL thickness was measured using the fast RNFL thickness scan mode with Stratus OCT. The correlations of age, disc area and axial length with RNFL thickness measured with HRT and OCT were analysed. The associations between axial length and disc area measured with HRT and OCT were also calculated. Results: RNFL thickness measured with the two instruments decreased with age. There was a significantly negative correlation between the mean RNFL thickness and disc area measured with HRT. The RNFL thickness measured with OCT correlated positively with the disc area measured with OCT, but not with the disc area measured with HRT. Both RNFL thickness and disc area measured with OCT were inversely correlated with axial length, whereas the two parameters measured with HRT had no association with axial length. Conclusion: In addition to the effect of ageing, the disc size affected the RNFL thickness measured with HRT, whereas the axial length influenced the RNFL thickness and disc area measured with OCT. These variables must be taken into consideration when measuring eyes with the lower or upper boundary of the normal range.
B M J PUBLISHING GROUP, 2008年02月, BRITISH JOURNAL OF OPHTHALMOLOGY, 92 (2), 186 - 190, 英語研究論文（学術雑誌）
Purpose: To investigate if nipradilol has an anti-apoptotic effect in serum-deprived RGC-5 cells and in the streptozotocin-induced diabetic rat retina. Methods: Apoptosis was quantified by activated caspase-3 immunohistochemistry or terminal dUTP nick end-labeling assay. Results: Nipradilol dose-dependently suppressed apoptosis in a protein kinase A- and G-dependent manner and counteracted glutamate-induced calcium entry in the RGC-5 cells and reduced apoptotic cells in the retinal ganglion cell layer of 4- and 12-week diabetic retinas compared to controls when instilled for 5 days. Removal of the nitric oxide moiety from nipradilol blocked these effects. Conclusions: Nipradilol protects RGCs from apoptosis induced by serum-deprivation in vitro and by diabetes in vivo. The NO-related signaling pathway mediates the anti-apoptotic ability of nipradilol.
INFORMA HEALTHCARE, 2008年, CURRENT EYE RESEARCH, 33 (8), 683 - 692, 英語[査読有り]
研究論文（学術雑誌）
Aim: The relative afferent pupillary defect (RAPD) is an important clinical sign of asymmetrical retinal ganglion cell and axonal damage. Although glaucoma essentially affects bilateral eyes, a subset of patients manifests asymmetrical glaucomatous optic neuropathy (GON), which exhibits an RPAD in the more advanced eyes. However, the degree to which axonal loss occurs before an RAPD is clinically detectable has not been substantiated. The purpose of this study is to assess the relationship between the depth of a clinically detectable RAPD and the reduction ratio of retinal nerve fiber layer (RNFL) thickness in the more advanced eyes relative to that in the contralateral less advanced eyes of patients with asymmetrical GON. Methods: Enrolled were 29 consecutive glaucoma patients with the clinically detectable RAPD. An RAPD was quantified by placing log-scaled neutral density filters over the less advanced eyes while performing the swinging flashlight test. Average RNFL thickness was determined using the Fast RNFL thickness programme of optical coherence tomography 3000. Correlation coefficient and Linear regression analyses were used in assessing the relationship between the RAPD and the ratio of RNFL thickness in the more advanced eyes relative to that in the less advanced. Results: RAPD ranged from 0.6 to 2.4 log units. The log-scaled RAPD had a statistically significantly inversed correlation with the average RNFL thickness ratio (r(s) = 20.729, p, 0.0001). Linear regression analysis found an equation that the average RNFL thickness ratio in the more affected eyes relative to that in the less advanced (%) = (0.8272-0.1696 x RAPD (log units)) 6100 (R-2 = 0.557, p, 0.0001). Conclusions: When an RAPD is clinically detected, the RNFL thickness in the more advanced eyes was in average reduced to about 73% of that in the less advanced.
B M J PUBLISHING GROUP, 2007年05月, BRITISH JOURNAL OF OPHTHALMOLOGY, 91 (5), 633 - 637, 英語[査読有り]
研究論文（学術雑誌）
Purpose: Although central corneal thickness (CCT) can be measured by several methods, interchangeability of different modalities has not been fully investigated. CCT is known to correlate with intraocular pressure (IOP). The aim of this study was to evaluate the agreement of Pentacam Scheimpflug system with noncontact specular microscopy (NCSM) and ultrasound (US) pachymetry in measuring CCT and the relation between IOP taken with Goldmann applanation tonometer (GAT) and the CCT measured with these three methods. Methods: The right eyes of 135 enrolled persons without antiglaucoma drug use (100 females and 35 males), who comprised 32 patients with primary open-angle glaucoma, 14 with ocular hypertension, 45 with primary angle-closure glaucoma, and 44 controls, were studied. Intermethod comparison of CCT was made by the 95% limits of agreement analysis according to Bland and Altman. Linear regression analysis was used to assess the relationship between IOP and CCT taken with each modality. Results: The mean CCT (+/-SD) taken with Scheimpflug, US, and NCSM was 559.49 +/- 38.44 mu m, 553.01 +/- 39.33 mu m, and 552.04 +/- 42.95 mu m, respectively. The average values of CCT taken with the three instruments were not significantly different (one-factor ANOVA; p = 0.26), although the marginal mean difference between Scheimpflug and US or NCSM was statistically significant (paired t test; p = 0.0009 and 0.005, respectively). The 95% limits of agreement were 6.47 +/- 43.21 mu m between Scheimpflug and US, 7.45 +/- 58.86 mu m between Scheimpflug and NCSM, and 0.98 +/- 51.69 mu m between US and NCSM. There was a positive association between IOP and CCT measured with US or NCSM, whereas there was no correlation between IOP and CCT measured with Scheimpflug. Conclusions: Although CCT values measured with Scheimpflug, US, and NCSM are closely similar, clinicians should keep in mind that these methods are not simply interchangeable.
TAYLOR & FRANCIS INC, 2007年02月, CURRENT EYE RESEARCH, 32 (2), 89 - 94, 英語[査読有り]
研究論文（学術雑誌）
Nitric oxide (NO) is cytoprotective to certain types of neuronal cells. The neuroprotective ability of NO in the retina was reportedly mediated by the cyclic GMP (cGMP) to protein kinase G (PKG) pathway. Cyclic AMP-responsive element binding protein (CREB) plays an essential role in the NO/cGMP/PKG-mediated survival of rat cerebellar granule cells. We tested whether CREB transduces the NO/cGMP/PKG anti-apoptotic cascade in R28 neuro-glial progenitor cells. Apoptosis was induced in R28 cells by serum deprivation for 24 h. Varying concentrations of two NO donors, sodium nitroprusside (SNP) and nipradilol, were added to medium with or without an NO scavenger, a soluble guanylyl cyclase inhibitor, or a PKG inhibitor. The cells were immunostained against activated caspase-3 and counterstained with Hoechst 33258. Apoptosis was quantified by counting activated caspase-3 positive or pyknotic cells. SNP and nipradilol rescued R28 cells from apoptosis in a dose-dependent manner, at an optimal concentration of 1.0 mu M and 10 mu M, respectively. Higher concentrations were cytotoxic. The NO scavenger and the inhibitors decreased the anti-apoptotic effect of the NO donors. Intracellular cGMP levels were increased after exposure to SNP and nipradilol. Western blotting showed that both NO donors increased CREB phosphorylation, which was blocked when pre-exposed to the inhibitors. Transfection with a dominant negative CREB construct defective of phosphorylation at Ser-133 interfered with the anti-apoptotic activity of SNP. These results indicate that CREB at least in part mediates the cGMP/PKG-dependent anti-apoptotic signal induced by NO in R28 cells. (c) 2006 Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD, 2007年01月, EXPERIMENTAL EYE RESEARCH, 84 (1), 152 - 162, 英語[査読有り]
研究論文（学術雑誌）
- Intraocular pressure lowering effect of once daily versus once weekly latanoprost instillation in the same normal individuals
This study tested whether once weekly instillation of latanoprost exerts the similar IOP lowering effect as once daily instillation in the same individuals. Latanoprost was administered on right eyes of eight healthy male volunteers once daily first for 24 days, which was followed by the 31-day washout and the subsequent once weekly instillation for another 24 days. The mean baseline IOP was 12.06 ± 1.50 (range, 10.0 to 14.0) mmHg, whereas the mean IOP during once daily treatment was 9.87 ± 1.71 mmHg, which was significantly lower than the former (p=0.025). The mean washout IOP was 12.56 ± 2.16 mmHg, which was similar to the baseline IOP. The mean IOP during once weekly instillation of latanoprost was 11.34 ± 1.51 mmHg, which was not statistically different from the washout IOP. Four of the 8 subjects showed 15% or more reduction in IOP both during once daily and once weekly instillations, two of whom were overlapped. Since the magnitude of the IOP reduction with once daily use was higher than that with once weekly use even in the responders, the current protocol of once daily instillation should be respected.
2007年, Kobe Journal of Medical Sciences, 53 (6), 297 - 304, 英語[査読有り]
研究論文（学術雑誌）
A relative afferent pupillary defect (RAPD) is known to develop only when more than 25% of retinal ganglion cells are ablated in monkeys' eyes. However, there was no prior study to estimate biometrically the degree of retinal nerve fiber layer (RNFL) thickness reduction leading to the development of RAPD in live human eyes. The purpose of this study was to examine the correlation between the amount of RNFL thickness reduction and the depth of a clinically detectable RAPD in patients with unilateral optic atrophy. Enrolled were 20 patients with optic atrophy of various etiologies. We quantified RAPD by performing the swinging flashlight test with log-scaled neutral density filters placed over the unaffected eye. Average RNFL thickness was measured by OCT3000 with the average RNFL thickness program. Linear regression analysis was used in assessing the relationship between RAPD and the ratio of affected to unaffected average RNFL thickness. The mean of average RNFL thickness was 95.6 +/- 17.3 mu m in the unaffected eyes and 50.7 +/- 19.3 mu m in the affected eyes (P < 0.001). Regression analysis between RAPD and the ratio of affected to unaffected average RNFL thickness revealed a correlation coefficient R-2=0.48 (P=0.0007). The regression line intersected the y-axis at 0.77. RAPD was not clinically detected until at least approximately 25% of the retinal nerve fibers were lost when compared with the unaffected eyes. Substantial retinal ganglion cell damage is required for the development of RAPD.
SPRINGER, 2006年11月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 244 (11), 1480 - 1484, 英語[査読有り]
研究論文（学術雑誌）
The purpose of this study was to investigate whether latanoprost, a prostaglandin F2 alpha analogue, has a direct anti-apoptotic effect both in retinal neuro-glial cells in culture and in diabetic retina. R28 cells, immortalized retinal neuroglial progenitor cells, were induced apoptosis by 24 h serum deprivation. Serum withdrawal made up to 15% of R28 cells pyknotic and activated caspase-3 immunoreactive, and latanoprost acid suppressed apoptosis with dose dependency at an optimum concentration of 1.0 mu M (P < 0.001). UO126, a mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase kinase (MEK) 1 and 2 inhibitor reversed this effect. Streptozotocin induced one- or three-month diabetic rats received balanced-salt-solution (BSS) in the left eye and latanoprost eye drops in the right for 5 days. Retinal wholemount was subjected to terminal dUTP nick end labeling (TUNEL) staining, whereas eyeballs were enucleated for cleaved caspase-3 immunofluorescence. Retinal homogenates were probed for phospho- or total p44/p42 MAPK and Akt. One- and three-month diabetic retina had 30.2 +/- 15.3 and 23.6 +/- 9.0 TUNEL positive cells per 0.5 CM, respectively, whereas control retina had few TUNEL positive cells. Latanoprost instillation significantly reduced these cells (10.0 +/- 3.1 and 11.3 +/- 3.1 cells per 0.5 cm(2) for 1 M and 3 M, respectively, P < 0.01), whereas BSS did not. Latanoprost also significantly reduced cleaved caspase-3 immunoreactive cells in ganglion cell and inner nuclear layers (P < 0.05). Latanoprost increased phosphorylated to total protein ratio of p44/p42 MAPK (P < 0.05), but not of Akt. Taken together, the present findings suggest that latanoprost rescues retinal neurons and/or glial cells from apoptosis, which is probably mediated by p44/p42 MAPK through caspase-3 inhibition. (c) 2006 Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD, 2006年11月, EXPERIMENTAL EYE RESEARCH, 83 (5), 1108 - 1117, 英語研究論文（学術雑誌）
Aims To assess the changes in macular and peripapillary retinal nerve fibre layer (RNFL) thickness in eyes with unilateral optic atrophy and to evaluate the relationship between retinal thickness and visual function. Methods Enrolled were 22 patients with unilateral optic atrophy. Macular thickness at the divided nine areas and peripapillary RNFL thickness in quadrantic sections were measured by optical coherence tomography. Thickness values in the affected eyes were compared with those in the contralateral unaffected eyes. The correlation of foveal thickness with best-corrected visual acuity (BCVA) was evaluated. The correlation between retinal thickness and the remaining visual field area circumscribed with I-4-e isopter in superior and inferior hemifield was assessed. Results Macular thinning was observed in all areas (P < 0.001 in each area) other than the fovea (P=0.068). Peripapillary RNFL thickness decreased in all quadrantic sections (P < 0.001 in each section). The affected to unaffected eye ratio of retinal thickness was more than 0.6 in each area. BCVA did not correlate with foveal thickness (correlation coefficient 0.094, P=0.668). Although not statistically significant (P=0.281, superior hemifield; P=0.053, inferior hemifield), there was a tendency that eyes with severe visual field loss show more marked retinal thinning. Conclusions Macular thinning with the preserved foveal thickness is a hallmark of eyes with optic atrophy. Together with no correlation between foveal thickness and BCVA, this finding would help in differential diagnosis of macular and optic nerve diseases.
NATURE PUBLISHING GROUP, 2006年08月, EYE, 20 (8), 882 - 887, 英語[査読有り]
研究論文（学術雑誌）
- Agreement of rebound tonometer in measuring intraocular pressure with three types of applanation tonometers
PURPOSE: To evaluate the agreement of iCare rebound tonometer in measuring intraocular pressure (IOP) with Goldmann applanation tonometer (GAT), Tonopen XL, and noncontact tonometer, and the influence of the central corneal thickness (CCT) on IOP measurements made with these four tonometers in 45 (12 control and 33 glaucomatous or ocular hypertensive) eyes. DESIGN: Clinically relevant experimental study. METHODS: Tonometer intermethod agreement was assessed by the Bland-Altman method. The relations of CCT with absolute IOP values and intertonometer differences were analyzed by linear regression. RESULTS: The mean differences (95% limits of agreement) in IOP readings between iCare and GAT, Tonopen XL, and noncontact tonometer were 1.40 +/- 4.29, 0.00 +/- 4.78, and 2.22 +/- 4.19 mm Hg, respectively. All tonometries had a marked association with CCT. As the CCT got thicker, iCare considerably overestimated GAT and Tonopen XL. CONCLUSIONS: Although influenced by CCT, iCare agrees well with applanation tonometers.
ELSEVIER SCIENCE INC, 2006年08月, AMERICAN JOURNAL OF OPHTHALMOLOGY, 142 (2), 332 - 334, 英語研究論文（学術雑誌）
- Diabetes reduces basal retinal insulin receptor signaling - Reversal with systemic and local insulin
Diabetic retinopathy is characterized by early onset of neuronal cell death. We previously showed that insulin mediates a prosurvival pathway in retinal neurons and that normal retina expresses a highly active basal insulin receptor/Akt signaling pathway that is stable throughout feeding and fasting. Using the streptozotocin-induced diabetic rat model, we tested the hypothesis that diabetes diminishes basal retinal insulin receptor signaling concomitantly with increased diabetes-induced retinal apoptosis. The expression, phosphorylation status, and/or kinase activity of the insulin receptor and downstream signaling proteins were investigated in retinas of age-matched control, diabetic, and insulin-treated diabetic rats. Four weeks of diabetes reduced basal insulin receptor kinase, insulin receptor substrate (IRS)-1/2-associated phosphatidylinositol 3-kinase, and Akt kinase activity without altering insulin receptor or IRS-1/2 expression or tyrosine phosphorylation. After 12 weeks of diabetes, constitutive insulin receptor autophosphorylation and IRS-2 expression were reduced, without changes in p42/p44 mitogen-activated protein kinase or IRS-1. Sustained systemic insulin treatment of diabetic rats prevented loss of insulin receptor and Akt kinase activity, and acute intravitreal insulin administration restored insulin receptor kinase activity. Insulin treatment restored insulin receptor-beta autophosphorylation in rat retinas maintained ex vivo, demonstrating functional receptors and suggesting loss of ligand as a cause for reduced retinal insulin receptor/Akt pathway activity. These results demonstrate that diabetes progressively impairs the constitutive retinal insulin receptor signaling pathway through Akt and suggests that loss of this survival pathway may contribute to the initial stages of diabetic retinopathy.
AMER DIABETES ASSOC, 2006年04月, DIABETES, 55 (4), 1148 - 1156, 英語[査読有り]
研究論文（学術雑誌）
- 日本眼科学会, 2006年03月, 日本眼科学会雑誌, 110巻, 3号, pp.180-187 (3), 180 - 187, 日本語緑内障眼におけるGDx-variable corneal compensation,光干渉断層計,ハイデルベルグレチナトモグラフによる解析結果ならびに視野障害に対する相関
[査読有り]
研究論文（学術雑誌）
Background: The aim was to compare the ability of confocal scanning laser ophthalmoscopy (CSLO), scanning laser polarimetry (SLP), and optical coherence tomography (OCT) to discriminate eyes with ocular hypertension (OHT), glaucoma-suspect eyes (GS) or early glaucomatous eyes (EG) from normal eyes. Methods: Ocular hypertension, GS, and EG were defined as normal disc with intraocular pressure > 21 mmHg, glaucomatous disc without visual field loss, and glaucomatous disc accompanying the early glaucomatous visual filed loss respectively. Ninety-three normal eyes, 26 OHT, 55 GS, and 67 EG were enrolled. Optic disc configuration was analyzed by CSLO (version 3.04), whereas retinal nerve fiber layer thickness was analyzed by SLP (GDx-VCC; version 5.3.2) and OCT-1 (version A6X1) in each individual. The measurements were compared in the four groups of patients. Receiver operating characteristic curve (ROC) and area under the curve (AUC) discriminating OHT, GS or EG from normal eyes were compared for the three instruments. Results: Most parameters in GS and EG eyes showed significant differences compared with normal eyes. However, there were few significant differences between normal and OHT eyes. No significant differences were observed in AUCs between SLP and OCT. In EG eyes, the greatest AUC parameter in OCT (inferior-120; 0.932) had a higher AUC than that in CSLO (vertical cup/disc ratio; 0.845; P=0.017). In GS, the greatest AUC parameter in OCT (average retinal nerve fiber layer [RNFL] thickness; 0.869; P=0.002) and SLP (nerve fiber indicator [NFI]; 0.875; P=0.002) had higher AUC than that in CSLO (vertical cup/disc ratio; 0.720). Conclusions: Three instruments were useful in identifying GS and EG eyes. For glaucomatous eyes with or without early visual field defects, SLP and OCT performed similarly or had better discriminating abilities compared with CSLO.
SPRINGER, 2006年01月, GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, 244 (1), 58 - 68, 英語研究論文（学術雑誌）
- 2005年09月, 緑内障, 15巻, 1, pp.21-23, 日本語非緑内障性視神経症による乳頭陥凹
[査読有り]
研究論文（学術雑誌）
Background: Optic tract syndrome (OTS) is characterized by incongruous homonymous hemianopia and a perpendicular pattern of bilateral optic atrophy due to the optic tract lesion. However, loss of retinal nerve fiber layer thickness (RNFLT) associated with OTS has not been quantitatively assessed. Case: A 20-year-old woman with blunt head trauma showed normal visual acuity, color vision, ocular motility, and intraocular pressure. Because of a relative afferent pupillary defect in her left eve and left-sided homonymous hemianopia, we suspected right-sided optic tract damage, although magnetic resonance imaging detected no intracranial lesion. Observations: Using optical coherence tomography (OCT), the RNFLT of this case was measured at 31 months after the trauma and compared with age-matched normal controls (n = 41). Nasal, temporal, superior, and inferior quadrant RNFLT was reduced by 22%, 21%, 5%, and 46% in the right eye and 76%, 64%, 25%, and 27% in the left eve, respectively. The reduction was > 3 x the standard deviation of the normal mean values in the nasal and temporal quadrants of the left eve and in the inferior quadrant of the right eye. Conclusions: OCT can determine the RNFLT reduction corresponding to the characteristic patterns of optic atrophy of OTS.
ELSEVIER SCIENCE INC, 2005年07月, JAPANESE JOURNAL OF OPHTHALMOLOGY, 49 (4), 294 - 296, 英語研究論文（学術雑誌）
Although glaucoma is known to alter glial reactivity, the long-term effect of elevated intraocular pressure (IOP) on glial change has not been fully elucidated. This study aimed to examine how chronically elevated IOP induced by episcleral vein cauterization (EVC) in unilateral eyes affect reactivities of astrocytes and Muller cells of rats in the treated as well as contralateral eyes over time. EVC in unilateral eyes of Sprague-Dawley rats were performed to produce chronically elevated IOP. Flat mounted retina preparations were made at several points until 6 months, which were subjected to immunostaining for glial fibrillary acidic protein (GFAP). Retinal homogenates were one- or two-dimensionally electrophoresed, followed by GFAP immunoblotting. EVC significantly increased IOPs up to 27.8 from 13.1 mmHg, which gradually decreased over time. In flat mounted retinas, astrocytes lost but Muller cells gained GFAP immunoreactivity at 3 days after cauterization. The glial changes were partially reversed over time but last even after IOP normalization. In the contralateral eyes, similar glial changes gradually appeared at 1 month after EVC and thereafter. Immunoblotting demonstrated not only molecular size shifts but also alteration of isoelectric focusing of GFAP both in treated and contralateral retina as compared with age-matched control retina. EVC led to opposite reactions in astrocytes and Muller cells in terms of GFAP immunoreactivity. Late-onset glial reactivity also occurred in the contralateral retina. (c) 2005 Elsevier Ltd. All rights reserved.
ACADEMIC PRESS LTD ELSEVIER SCIENCE LTD, 2005年07月, EXPERIMENTAL EYE RESEARCH, 81 (1), 48 - 56, 英語研究論文（学術雑誌）
- メディカル葵出版, 2005年05月, あたらしい眼科, 22巻, 5, pp.661-663 (5), 661 - 663, 日本語非緑内障性視神経症による乳頭陥凹
[査読有り]
研究論文（学術雑誌）
- 小児白内障術後の近見・遠見視力発達
小児白内障術後の近見・遠見視力発達について検討した.対象は,小児白内障手術を行った30例45眼(男児17例25眼,女児13例20眼)で,片眼は15例15眼,両眼は15例30眼であった.診療録で3歳から7歳まで6ヵ月毎の遠見視力(FV)と近見視力(NV)を片眼,両眼で比較した.その結果,各年齢時で片眼群ではFV,NVとも視力不良が多く,両眼群では良好な経過を辿る例が多かった.経過を通じ,両群ともFVとNVとの間に有意差はなかった.7歳時での視力の中間値は片側群ではFV 0.45,NV 0.35で,両眼群ではFV 1.0,NV 1.0であった.45眼中3眼(7%)でFVとNVに3段階以上の差を認め,2眼(片側群の1眼,両側群の1眼)はNVが良好で,1眼(片側群)はFVが良好であった.術後,大半の症例で調節力のないNVでもFVと同様の発達を認めたが,両者の発達に解離を認める症例も少数あり,FVとともにNVにも注意深い経過観察が必要と考えられた
眼科臨床医報会, 2005年03月, 眼科臨床医報, 99 (3), 231 - 233, 日本語[査読有り]
研究論文（学術雑誌）
- NATURE PUBLISHING GROUP, 2005年02月, EYE, 19 (2), 235 - 237, 英語
[査読有り]
研究論文（学術雑誌）
- ELSEVIER SCIENCE INC, 2005年01月, JAPANESE JOURNAL OF OPHTHALMOLOGY, 49 (1), 65 - 67, 英語Unilateral manifestation of Leber's hereditary optic neuropathy after blunt ocular
[査読有り]
研究論文（学術雑誌）
Purpose. Unoprostone isopropyl is an ocular hypotensive that was originally produced as a prostaglandin F2alpha analogue and is eventually recognized as a synthetic docosanoid. The compound is recently suggested to have potent neuroprotective ability in the retina. The purpose of this study is to test whether and how the biologically active metabolites of unoprostone isopropyl rescue retinal neuro-glial progenitor cells from apoptosis. Methods. R28 cells were deprived of serum for 24 hr with or without varying concentrations of unoprostone metabolite M1 or M2 or vehicle in the presence or absence of specific inhibitors against several types of signal transduction proteins. Immunocytochemistry against activated caspase-3 with Hoechst nuclear staining was performed. Results. Up to 15% of R28 cells became pyknotic and activated caspase-3 immunoreactive after 24-hr serum withdrawal. M1, but not M2, significantly reduced apoptotic cells in a dose-dependent fashion with a maximal effect at 100 muM (p < .0001). LY294002, the phosphatidylinositol 3-OH kinase (PI3K) inhibitor, and KT5823, the protein kinase G (PKG) inhibitor, reversed the antiapoptotic effect of M1. Conclusions. The unoprostone metabolite M1 protects retinal neuro-glial progenitor R28 cells from apoptosis induced by serum deprivation via the PI3K and PKG pathways.
SWETS ZEITLINGER PUBLISHERS, 2004年12月, CURRENT EYE RESEARCH, 29 (6), 457 - 464, 英語[査読有り]
研究論文（学術雑誌）
Objectives: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with band atrophy by use of optical coherence tomography (OCT) and to evaluate the ability of OCT to detect this characteristic pattern of RNFL loss. Design: Cross-sectional, retrospective study. Participants: Thirty-four eyes of 18 patients with bitemporal hemianopia caused by optic chiasm compression by chiasmal tumors were studied. All eyes were divided into 3 groups according to visual field loss grading after Goldmann perimetry. Interventions: Retinal nerve fiber layer thickness measurements with OCT. Main Outcome Measures: Retinal nerve fiber layer thickness around the optic disc was measured by OCT (3.4-mm diameter circle). Calculation of the changes in OCT parameters, including the horizontal (nasal + temporal quadrant RNFL thickness) and vertical values (superior + inferior quadrant RNFL thickness) was based on data from 160 normal eyes. Comparison between the 3 visual field grading groups was done with the analysis of variance test. The receiver operating characteristic (ROC) curve for the horizontal and vertical value were calculated, and the areas under the curve (AUC) were compared. Results: Retinal nerve fiber layer thickness in eyes with band atrophy decreased in all OCT parameters. The reduction rate in average and temporal RNFL thickness and horizontal value was correlated with visual field grading. The AUC of horizontal value was 0.970+/-0.011, which was significantly different from AUC of vertical value (0.903+/-0.022). Conclusions: The degree of RNFL thickness reduction correlated with that of visual field defects. Optical coherence tomography was able to identify the characteristic pattern of RNFL loss in these eyes. Ophthalmology 2004;111:2278-2283 (C) 2004 by the American Academy of Ophthalmology.
ELSEVIER SCIENCE INC, 2004年12月, OPHTHALMOLOGY, 111 (12), 2278 - 2283, 英語[査読有り]
研究論文（学術雑誌）
The Akt serine/threonine kinase mediates pro-survival signalings in retina and was reported to be activated in a response to some retinal and optic nerve injuries. Human and experimental glaucoma induce apoptosis of retinal ganglion cells (RGCs). The purpose of this study is to test whether episcleral vein cauterization (EVC) to chronically elevate intraocular pressures (IOPs) in rats increase apoptosis of RGCs and affect activation of Akt and its upstream insulin-like growth factor (IGF)-1 receptor/Insulin receptor. Three episcleral veins in left eyes of Sprague-Dawley rats were cauterized to elevate IOPs. Up to 6 months, IOPs were monitored and the retina was dissected at several time points. The numbers of terminal dUTP nick end labeling (TUNEL)-positive cells and those of RGCs labeled with fluorogold were counted in flat-mounted retina. Immunohistochemistry and immunoblotting were performed to identify cells expressing phosphorylated Akt and to quantify the phospho- to total ratios of Akt and IGF-1 receptor/insulin receptor. EVC significantly elevated ION up to 2 months, increased TUNEL-positive cells in an IOP-dependent fashion, and reduced 34.5% of RGCs at 6 months (P<0.001) compared with contralateral retinas. Phosphorylated Akt was specifically expressed in RGCs until 1 month after cauterization. Akt (P=0.036) and IGF-1 receptor/Insulin receptor (P=0.003) were transiently phosphorylated at 3 days. Intrinsic activation of the IGF-1 receptor/Insulin receptor to Akt pathway may occur in RGCs in retina with EVC. (C) 2004 Elsevier B.V. All rights reserved.
ELSEVIER SCIENCE BV, 2004年10月, BRAIN RESEARCH, 1022 (1-2), 195 - 204, 英語[査読有り]
研究論文（学術雑誌）
- 日本神経眼科学会, 2004年10月, 神経眼科, 21 (増補1), 89 - 89, 日本語相対的求心性瞳孔障害と光干渉断層計で測定した網膜神経線維層厚の関係
研究論文（国際会議プロシーディングス）
- 2004年09月, 緑内障, 14巻, 臨増, pp. 172-172, 日本語トラベクレクトミー施行後の濾過胞炎と鑑別を要したred eye症候群の一症例
研究論文（国際会議プロシーディングス）
- 2004年09月, 緑内障, 14巻, 臨増, pp. 106-106, 日本語GDx-VCC,光干渉断層計,HRTの早期緑内障診断における比較検討
研究論文（国際会議プロシーディングス）
- 2004年08月, 眼科臨床医報, 98巻, 8号, pp. 687-690, 日本語神経線維腫症に合併した先天緑内障の1例
[査読有り]
研究論文（学術雑誌）
- 2004年04月, 日本眼科学会雑誌, 108巻, 4, pp. 213-218 (4), 213 - 218, 日本語緑内障眼における上下半視野の網膜神経線維層厚の光干渉断層計による解析
研究論文（学術雑誌）
A 17-year-old girl presented with bilateral angle-closure glaucoma associated with spherophakia. A previous bilateral laser iridotomy failed to control intraocular pressure (IOP). Goniosynechialysis with lens aspiration and posterior chamber intraocular lens implantation were performed in both eyes. Peripheral iridoplasty was performed 3 days later. The postoperative IOP was controlled without medication for 12 months in the right eye and 24 months in the left eye. By restructuring the physiologic aqueous outflow route, goniosynechialysis safely and effectively treated secondary glaucoma from spherophakia.
ELSEVIER SCIENCE INC, 2004年02月, JOURNAL OF CATARACT AND REFRACTIVE SURGERY, 30 (2), 513 - 516, 英語[査読有り]
研究論文（学術雑誌）
- Diabetes has an additive effect on neural apoptosis in rat retina with chronically elevated intraocular pressure
Purpose. Diabetes mellitus (DM) is a risk factor for open-angle glaucoma, although the mechanistic interrelationship of the two is debatable. The purpose of this study is to test whether DM augments neural apoptosis in rat retina with chronically elevated intraocular pressure (IOP). Methods. Sprague-Dawley rats were made diabetic by intraperitoneal injection of streptozotocin (STZ). At one month after STZ injection, three episcleral veins in one eye were cauterized to elevate IOP Rats without STZ injection were treated likewise as diabetic controls. At 2 weeks, 1 month, and 2 months after cauterization, the retina was dissected, flat-mounted, and subjected to terminal dUTP nick end labeling (TUNEL) staining. TUNEL positive cells per unit area of the whole retina were measured. Results. DM did not affect base line IOP or augment IOP elevation due to episcleral vein cauterization. TUNEL positive cells, which primarily consisted of the neurons and glial cells in the inner retina including retinal ganglion cell (RGC), were counted consistently eight times more in the diabetic retina without IOP elevation than diabetic controls (n = 9, p < 0.001). The cauterization significantly elevated IOP up to 28.9 mmHg (p < 0.001), which was reduced over time, and substantially induced apoptosis in a IOP-dependent fashion (p < 0.001). Ocular hypertensive retinas with DM had significantly more TUNEL positive cells-than those without DM despite of the similar time course of IOP changes (p < 0.001). Conclusions. DM has an additive effect on apoptosis induction by chronic elevation of IOR Diabetes may act as a risk factor of open-angle glaucoma by increasing susceptibility of retinal cells including retinal ganglion cells to apoptosis triggered by additional stresses such as elevated IOP.
SWETS ZEITLINGER PUBLISHERS, 2004年01月, CURRENT EYE RESEARCH, 28 (1), 47 - 54, 英語[査読有り]
研究論文（学術雑誌）
- 日本神経眼科学会, 2003年12月, 神経眼科, 20 (増補1), 43 - 43, 日本語視神経疾患における乳頭周囲神経線維層厚と黄斑網膜厚の減少
[査読有り]
- 医学書院, 2003年11月, 臨床眼科, 57巻, 12号, pp. 1699-1704 (12), 1699 - 1704, 日本語晩発性濾過胞漏出に対する羊膜を用いた濾過胞再建術
[査読有り]
研究論文（学術雑誌）
Purpose: To evaluate the relationship between age and retinal nerve fiber layer (RNFL) thickness in normal subjects, as measured by optical coherence tomography (OCT). Methods: One hundred and forty-four normal subjects (144 eyes), ranging from 16 to 84 years of age, were enrolled in this cross-sectional study. The RNFL thickness was determined using OCT with three circle scans 3.4 mm in diameter. Results: The average RNFL thickness was inversely correlated with age (r = -0.348, p < 0.001). Analyzing the quadrants as a parameter, RNFL thickness in the superior, temporal and inferior quadrants also decreased with age. Using 30-degree segments, there were significant correlations between age and the RNFL thickness of temporal segments (7-11 o'clock). The average RNFL thickness had the highest correlation among all parameters (r = -0.348, p < 0.001). Regarding nasal quadrant thickness, RNFL ratios (average, superior, temporal and inferior RNFL thickness relative to the nasal quadrant thickness) were not significant-
KARGER, 2003年07月, OPHTHALMOLOGICA, 217 (4), 273 - 278, 英語[査読有り]
研究論文（学術雑誌）
- 2003年06月, 眼科臨床医報, 97巻, 6号, pp. 497-497, 日本語近視様乳頭眼の網膜神経線維層の解析 正常眼及び初期緑内障眼の比較
研究論文（国際会議プロシーディングス）
- A case of occult macular dystrophy accompanying normal-tension glaucoma
PURPOSE: To present a case of occult macular dystrophy accompanying normal-tension glaucoma. DESIGN: Observational case report. METHODS: Visual function and ophthalmoscopic and electroretinographic findings in a 56 year,old man suffering from gradually progressive photophobia and visual dysfunction were followed up over 4 years. RESULTS: Best-corrected visual acuity was below 20/200, and intraocular pressures remained in the low teens in both eyes. A wedge-shaped visual field defect in the right eye, corresponding to the enlarged disk cupping, and a relative central scotoma in the left were detected. Ophthalmoscopy and fluorescein angiography detected no apparent abnormality at the macular region in either eye. Severely attenuated multifocal electroretinographic responses were recorded from only the central areas, with normal full field responses. CONCLUSION: Clinicians must took for additional pathos logic conditions in patients with normal tension glaucoma who have unexplained central visual dysfunction. (Am J Ophthalmol 2003;135:715-717. (C) 2003 by Elsevier Inc. All rights reserved.).
ELSEVIER SCIENCE INC, 2003年05月, AMERICAN JOURNAL OF OPHTHALMOLOGY, 135 (5), 715 - 717, 英語[査読有り]
研究論文（学術雑誌）
- Evaluation of the glaucomatous damage on retinal nerve fiber layer thickness measured by optical coherence tomography
PURPOSE: To evaluate the relationship between visual field and retinal nerve fiber layer (RNFL) thickness measured by optical coherent tomography (OCT) and to assess the diagnostic ability of OCT to distinguish between early glaucomatous or glaucoma-suspect eyes from normal eyes. DESIGN: Retrospective, non-randomized, cross-sectional study. METHODS: A total of 160 eyes of 120 normal Japanese adults, 23 eyes of 16 patients with ocular hypertension, 38 eyes of 35 glaucoma-suspect patients, and 237 glaucomatous eyes of 140 glaucoma patients were enrolled in the study. The glaucoma group included 89 early glau, comatous eyes. Thickness of the RNFL around the optic disk was determined with three 3.4-mm diameter circle OCT scans. Average and segmental RNFL thickness values were compared among all groups. The correlation between mean deviation and RNFL thickness in glaucomatous eyes was also analyzed. Receiver operating characteristic (ROC) curve area was calculated to discriminate normal eyes from early glaucomatous or glaucoma suspect eyes. RESULTS: A significant relationship existed between the mean deviation and RNFL thickness in all parameters excluding the 3-o'clock area. The average RNFL thickness had the strongest correlation in all parameters (r = -0.729, P < .001). Retinal nerve fiber layer thickness at the 7-o'clock inferotemporal segment had the widest areas under the ROC curves in all parameters for early glaucomatous eyes (0.873). CONCLUSION: Measurement of RNFL thickness by OCT is useful in detecting early RNFL damage. Furthermore, OCT measurements of RNFL thickness may provide clinically relevant information in monitoring glaucomatous changes. (C) 2003 by Elsevier Science Inc. All rights reserved.
ELSEVIER SCIENCE INC, 2003年04月, AMERICAN JOURNAL OF OPHTHALMOLOGY, 135 (4), 513 - 520, 英語[査読有り]
研究論文（学術雑誌）
Purpose. The changes in short wavelength sensitive (S-) cone electroretinograms (ERGs) to ganzfeldt flash stimuli were examined in patients with Posner-Schlossman syndrome to study the differences in S-cone action in both the acute attack phase and the remission phase. Methods. Ganzfeldt colour flashes under bright white background illumination were used to elicit short wavelength (S-), and mixed long- (L) and middle- (M) wavelength sensitive cone ERGs. Three subjects with unilateral Posner-Schlossman syndrome and 18 age-matched normal controls were compared. To compare the media opacity we obtained the L,M-cone balance, namely, the log density units of the neutral density filter required to produce the L,M-cone b-wave elicited with red stimuli which is identical to those with blue stimuli. Results. Selective reduction of the S-cone ERG b-wave in acute attacks of Posner-Schlossman syndrome was found. Two of three cases showed the recovery of the S-cone b-wave with a decrease in the intraocular pressure. With regard to the implicit time, significant delay of the S-cone b-wave could not be detected in all subjects. Conclusion. Selective reduction of the S-cone component of the ERG during raised intraocular pressure was found. The S-cone pathway is thought to be more vulnerable to damage than the L,M-cone systems following elevations of intraocular pressure.
Royal College of Ophthalmologists, 2001年, Eye, 15 (2), 163 - 167, 英語[査読有り]
研究論文（学術雑誌）
PURPOSE: To report a case of zoster sine herpete with bilateral ocular involvement. METHOD: Case report. RESULTS: A 65-year-old man showed bilateral iridocyclitis with sectoral iris atrophy and elevated intraocular pressure unresponsive to steroid treatment. No cutaneous eruption was manifest on the forehead. A target region of varicella-zoster virus DNA sequence was amplified from the aqueous sample from the left eye by polymerase chain reaction. Bilateral iridocyclitis resolved promptly after initiation of systemic and topical acyclovir treatment. Secondary glaucoma was well controlled by bilateral trabeculectomy. CONCLUSIONS: Zoster sine herpete should be considered and polymerase chain reaction performed on an aqueous sample to detect varicella-zoster virus DNA for rapid diagnosis whenever anterior uveitis accompanies the characteristic iris atrophy, even in the case of bilateral involvement. © 2000 Elsevier Science Inc.
2000年, American Journal of Ophthalmology, 129 (6), 809 - 810, 英語[査読有り]
研究論文（学術雑誌）
Optic perineuritis is a rare syndrome characterized by bilateral, sometimes unilateral, optic disc swelling without a raised cerebrospinal fluid (CSF) pressure and visual dysfunction except for big blind spots, which are presumed to be an inflammation of the optic nerve sheaths. Syphilitic infection is known to be most commonly associated with optic perineuritis. We present three cases of optic perineuritis without syphilitic infection. Two of them showed disc swelling and blind spot enlargement bilaterally, which subsided in a good response to the corticosteroid therapy. In the remaining one case, the left eye exhibited disc swelling without visual disturbance as in the other cases, while anterior ischemic optic neuropathy occurred and produced the permanent visual field defect in the right eye, presumably due to the coincidental existence of optic disc hypoplasia. CSF in all cases showed normal pressure and lymphocytosis, which faded in response to the corticosteroid therapy. A lumbar puncture was a critical maneuver for the correct diagnosis. Despite the overall favorable outcome, immediate treatment should be considered for optic perineuritis patients, especially those who have a local anatomical vulnerability of the disc.
1999年, Neuro-Ophthalmology, 21 (3), 135 - 145, 英語[査読有り]
研究論文（国際会議プロシーディングス）
手術時期4歳以下の両眼性先天白内障10例,片眼性先天白内障12例,片眼性外傷性白内障3例を対象に形態覚遮断弱視の治療の実際と問題点について検討した。両眼性先天白内障症例が術後視機能,弱視治療のコンプライアンスともに最も良好であった。一方片眼性先天白内障症例は極早期手術例を除いて手術時期と術後視力に相関があり,視力不良例が多く治療に苦慮する例が多かった。外傷性白内障症例は弱視治療は良好に行えており術後視機能はほぼ良好であった。本弱視では片眼性先天白内障症例が感受性期にうけた形態覚遮断が最も大きいものと考えられるが,治療としてはできるだけ原因疾患を迅速に取り除き,固定化を防ぐことが最も重要であるため,親に対する心理的なサポートを含めた生後早期からの注意深い観察と適切な対処をすることが必要であると考えた。
JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS, 1998年11月30日, Japanese orthoptic journal, 26, 119 - 127, 日本語12歳から87歳までの低視力者38人に対して,Vixen卓上型ルーペ,強度凸レンズ眼鏡,単眼鏡(遠用),遮光眼鏡の視覚的補助具の処方を行った。処方眼鏡別に疾患,視力,年齢,視野を調べ検討した。近用の拡大鏡であるVixen卓上型ルーペと強度凸レンズ眼鏡の処方の結果を比較したところ,視力分布では明らかな違いはみられなかったが,疾患と年齢においては前者は25歳以下の患者が約半数で視神経疾患例が多かった。後者は若年者は少なく,糖尿病網膜症の患者が大部分を占めていた。単眼鏡処方では,25歳以下の患者が大部分で視神経疾患例が約半数以上であった。遮光眼鏡(RETINEX®)処方は,当然ながら網膜色素変性患者が大部分であった。低視力の患者の残存視機能を有効に活かすことは,患者のQOLを向上する上で必要であるため,様々な補助具の処方は視機能評価に携わる視能訓練士の重要な仕事になっていくと思われる。
JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS, 1998年, 日本視能訓練士協会誌, 26, 269 - 273, 日本語生後24週以内で先天白内障手術をうけた両眼性症例6例12眼,片眼性症例2例2眼の術後視力経過,立体視機能について検討した。
JAPANESE ASSOCIATION OF CERTIFIED ORTHOPTISTS, 1997年, 日本視能訓練士協会誌, 25, 139 - 143, 日本語
手術時年齢は,両眼性は平均17.3±5.5週の両眼同時手術で片眼性では3週と20週であった。術後は速やかにハードコンタクトレンズの装用を行い,また左右差が確認された症例については多くとも覚醒時間の半分までの健眼遮蔽を指示した。
術後視機能については,両眼性では全例0.6以上でうち4例7眼が1.0の視力を得ることができ立体視は4例に認められた。片眼性では1例が1.0の良好な視力が得られたが,健眼遮蔽のコンブライアンスが不十分な1例は,0.04の視力しか得られなかった。立体視は視力良好例にも獲得することができなかった。両眼性症例は視力,両眼視機能は概ね良好であったが,片眼性では両眼視機能獲得の難しさが確認された。
MISC
- (一社)日本神経学会, 2021年09月, 臨床神経学, 61 (Suppl.), S259 - S259, 日本語抗MOG抗体関連疾患におけるくすぶり病変は疾患活動性を反映する
- 日本緑内障学会, 2020年10月, 日本緑内障学会抄録集, 31回, 38 - 38, 日本語Microhook線維柱帯切開術眼内法とTrabectomeの非劣性を検討する多施設臨床研究
- 日本緑内障学会, 2019年09月, 日本緑内障学会抄録集, 30回, 47 - 47, 日本語Trabectome vs Microhook線維柱帯切開術の眼圧下降効果と安全性の多施設共同ランダム化介入非劣性検証試験
- 日本神経眼科学会, 2018年11月, 神経眼科, 35 (増補1), 84 - 84, 日本語ランゲルハンス細胞組織球症による視神経症と外転神経麻痺を来した1例
- 2018年11月, 眼科, 60 (12), 1441 - 1447, 日本語【神経眼科とOCT】 視神経炎のOCT
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2018年09月, 眼科, 60 (10号), 1195 - 1200, 日本語【主訴と所見からみた眼科 common disease】所見からみた診断の進め方 視神経 大乳頭・小乳頭
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2018年08月, あたらしい眼科, 35 (8), 1007 - 1008, 日本語序説：続発緑内障
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2018年06月, 日本医師会雑誌, 147 (特別1), S48 - S49, 日本語【わかりやすい感覚器疾患】 感覚器の構造と機能 視覚 視覚経路
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2018年06月, 臨床眼科, 72 (6号), 755 - 764, 日本語RAPD あるのか,ないのか,それが神経眼科的問題だ!
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2018年, 日本眼感染症学会・日本眼炎症学会・日本コンタクトレンズ学会総会・日本涙道・涙液学会プログラム・講演抄録集, 55th-52nd-61st-7th, 97, 日本語3歳女児に生じたVogt‐小柳‐原田病疑い症例
- (公財)日本眼科学会, 2018年01月, 日本眼科学会雑誌, 122 (1), 5 - 53, 日本語
記事・総説・解説・論説等（学術雑誌）
- 医学書院, 2017年11月, 臨床眼科, 71 (12号), 1666 - 1670, 日本語【視神経炎最前線】 レーベル遺伝性視神経症のイデベノン療法と遺伝子治療
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- メディカル葵出版, 2017年11月, あたらしい眼科, 34 (臨増), 266 - 269, 日本語【眼科救急Q&A】 救急疾患ごとの基本的な対処法 視神経 レーベル遺伝性視神経症の診断と治療について教えてください
[招待有り]
記事・総説・解説・論説等（学術雑誌）
日本神経眼科学会は，厚生労働省網脈絡膜・視神経萎縮症に関する調査研究班と合同で，レーベル遺伝性視神経症（Leber hereditary optic neuropathy：LHON）の指定難病認定を目的に，認定基準策定ならびに全国疫学調査を行った．認定基準は，特徴的な主徴候と検査所見を基にLHONを確定例，確実例，疑い例，保因者に区分した．日本眼科学会専門医制度認定施設ならびに日本神経眼科学会会員在籍施設の合計1,397施設に対して，2014年1年間に新規で発症し，ミトコンドリアDNA 3460, 11778, 14484変異のいずれかを有するLHON確定例と確実例の症例数ならびに男女の内訳をアンケート調査した．その結果，新規発症患者数は117人（95％信頼区間：81～153人）と推計された．11778変異例が86.4％，男性が90％以上を占め，ともに海外に比較し，高い割合であった．発症年齢の中央値は30歳を超えており，既報よりも高齢であった．認定基準の策定と患者数の特定は，当初の目的達成に加えて，一般眼科医の啓蒙ならびに研究者や企業の治療開発意欲の促進に資するであろう．
日本神経眼科学会, 2017年09月, 神経眼科, 34 (3号), 293 - 299, 日本語[招待有り]
記事・総説・解説・論説等（学術雑誌）
- (公財)日本眼科学会, 2017年04月, 日本眼科学会雑誌, 121 (4), 383 - 384, 日本語難治性視神経炎全国調査 中間結果報告
- (公財)日本眼科学会, 2017年03月, 日本眼科学会雑誌, 121 (臨増), 227 - 227, 日本語早発型発達緑内障における原因遺伝子の探索
- 2017年02月, Frontiers in Glaucoma, (53号), 1 - 8, 日本語目でみるシリーズ 画像でみる緑内障の病態(第8回) 前眼部画像検査による濾過胞評価
[招待有り]
記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2016年09月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 57 (12), 英語Mrp4 deficiency has no apparent effect on age-related changes of the mouse retina
研究発表ペーパー・要旨（国際会議）
- 緑内障診療データの管理と共通化の現状とデータ共通化に向けての取り組み
目的:本邦における緑内障診療データの管理・共通化の現状について調査し,今後の緑内障診療・研究の向上のための課題と方向性について明らかにすること.対象と方法:日本緑内障学会内に設置されたデータ共通化委員会に参画し,緑内障診療に積極的に取り組んでいる14大学に対して文書によってアンケート調査を行った.結果:すべての大学において病院情報システムが導入され,3社の眼科部門カルテによる診療データの電子化が行われていた.しかしながら,電子カルテから電子的な診療データ提供体制が整っていた大学は30.8%にとどまり,データの二次利用が具体的に進んでいる大学眼科は14.3%のみであった.地域医療機関との電子データによる診療連携を進めている大学眼科は35.7%であり,眼科内で診療データの電子的管理を行っていたのは42.9%にとどまっていた.結論:アンケートの結果から診療データの管理や共通化について多くの課題が明らかになった.(著者抄録)
(公財)日本眼科学会, 2016年08月, 日本眼科学会雑誌, 120 (8), 540 - 547, 日本語 - 2016年08月, Frontiers in Glaucoma, (52号), 85 - 93, 日本語目でみるシリーズ 画像でみる緑内障の病態(第7回) OCT所見による緑内障と神経眼科疾患の違い
[招待有り]
記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
- メディカル葵出版, 2016年05月, あたらしい眼科, 33 (5号), 671 - 677, 日本語【視神経炎と視神経症:全身と眼の架け橋】 レーベル遺伝性視神経症の最前線
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- カラーコンタクトレンズの色素に対するアレルギー反応が疑われた両眼角膜潰瘍の1例
目的:カラーコンタクトレンズ(CL)による両眼角膜潰瘍の報告。症例:16歳女性がカラーCLを装着したまま就寝後に両眼の眼痛,充血を自覚し,数日後に当院へ紹介となった。初診時の矯正視力は左右眼とも0.6であった。両眼の上方角膜に弓状に配列する多数の潰瘍と毛様充血を認めた。それまでの抗菌薬点眼に反応が乏しいことからCLへの炎症反応の可能性を考え,ステロイド点眼と内服を併用したところ,徐々に上皮化し視力改善が得られた。本症例ではカラーCLの角膜側に偏在した色素による直接的な障害と色素に対するアレルギー反応である可能性が推定された。結論:カラーCLによる角膜潰瘍で抗菌薬点眼の効果が乏しい場合には,ステロイド治療を検討すべきと考えられた。(著者抄録)
(株)医学書院, 2016年05月, 臨床眼科, 70 (5), 741 - 745, 日本語[査読有り]
速報，短報，研究ノート等（学術雑誌）
- 日本眼科学会, 2016年04月, 日本眼科学会雑誌, 120 (4号), 339 - 351, 日本語日本眼科学会専門医制度生涯教育講座 神経眼科疾患の光干渉断層計像
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 金原出版, 2015年12月, 眼科, 57 (13), 1653 - 1660, 日本語遺伝性視神経症 (特集 視野異常を診断する)
- 日本医師会, 2015年12月, 日本医師会雑誌, 144 (9号), 1827 - 1830, 日本語【視覚障害の早期発見と治療】 遭遇することの多い視神経疾患
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 日本緑内障学会, 2015年09月, 日本緑内障学会抄録集, 26回, 126 - 126, 日本語緑内障診療データの管理と共通化の現状とデータ共通化に向けての取り組み
- 医学書院, 2015年09月, 臨床眼科, 69 (9), 1395 - 1399, 日本語視神経乳頭腫脹を契機として発見された肺線癌の１例
[査読有り]
速報，短報，研究ノート等（学術雑誌）
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2015年06月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 56 (7), 英語The Ability of SD-OCT to Differentiate Early Glaucoma in Highly Myopia from Highly Myopic Control
研究発表ペーパー・要旨（国際会議）
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2015年06月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 56 (7), 英語The OCT findings of macula and associated factors in patients with a history of retinopathy of prematurity
研究発表ペーパー・要旨（国際会議）
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2015年06月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 56 (7), 英語The role of Mrp4 in pathological angiogenesis of the mouse retina
研究発表ペーパー・要旨（国際会議）
- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2015年06月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 56 (7), 英語Trabeculotomy with Schlemm's canal endothelium removal and deep sclerectomy
研究発表ペーパー・要旨（国際会議）
- 金原出版, 2015年06月, 眼科, 57 (7号), 937 - 942, 日本語肥厚性硬膜炎と眼症状
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- (株)じほう, 2015年06月, 調剤と情報, 21 (7), 864 - 868, 日本語【極める!副作用モニタリング】症例でわかる 実臨床で注意すべき副作用とモニタリング 眼科疾患
[招待有り]
記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
- 日本眼科学会, 2015年05月, 日本眼科学会雑誌, 119 (5号), 339 - 346, 日本語Leber遺伝性視神経症認定基準
[査読有り]
記事・総説・解説・論説等（学術雑誌）
- (公財)日本眼科学会, 2015年03月, 日本眼科学会雑誌, 119 (臨増), 213 - 213, 日本語視神経脊髄炎関連疾患における視神経炎の軸索輸送障害
- 2015年03月, 日本の眼科, 86 (3号), 275 - 276, 日本語視路疾患と光干渉断層計
[査読有り][招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2015年, 日本眼科学会雑誌, 119中心性漿液性脈絡網膜症に対する時間短縮光線力学的療法における照射径設定法の比較
- 2014年12月, あたらしい眼科, 31 (臨時増刊), 134 - 135, 日本語遺伝性視神経症に治療法があると聞いたのですが
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 金原出版, 2014年11月, 眼科, 56 (12), 1459 - 1464, 日本語電気生理学的検査(6)多局所VEP
- 先端医学社, 2014年10月, Retina Medicine, 3 (2号), 125 - 131, 日本語【進化するOCT】 視神経疾患におけるOCTのトピックス
[招待有り]
記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
- 2014年09月, Frontiers in Glaucoma, (48号), 123 - 133, 日本語緑内障診療に吹く新しい風
[招待有り]
その他
- メディカル葵出版, 2014年07月, あたらしい眼科, 31 (7号), 969 - 975, 日本語【視野検査の最前線】 視神経疾患・中枢性疾患の視野変化
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 日本眼科学会, 2014年04月, 日本眼科学会雑誌, 118 (4号), 327 - 329, 日本語非動脈炎性前部虚血性視神経症の基礎と臨床の現状と展望
[招待有り]
書評論文,書評,文献紹介等
- 2014年04月, OCULISTA, (13号), 41 - 50, 日本語【視神経症のよりよい診療】 遺伝性視神経症
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 金原出版, 2014年04月, 眼科, 56 (5号), 585 - 592, 日本語【眼と遺伝】 ミトコンドリア病
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2014年, 日本網膜硝子体学会総会プログラム・講演抄録集, 53rdポリープ状脈絡膜血管症に対するアフリベルセプト併用光線力学的療法の6ケ月成績
- 金原出版, 2013年08月, 眼科, 55 (8号), 927 - 932, 日本語【OCTのGCCマップを考える】 前部視路疾患
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- メディカル葵出版, 2013年06月30日, あたらしい眼科 = Journal of the eye, 30 (6), 761 - 768, 日本語神経眼科領域のOCT
- 2012年09月, 眼科, 54 (10号), 1534 - 1540, 日本語【眼科薬物療法】 神経眼科疾患 遺伝性視神経症
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2012年06月, あたらしい眼科, 29 (6号), 736 - 742, 日本語【神経眼科-最新の話題】 視神経炎に抗AQP4抗体を検査すべきか?治療法は変わるか?
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 緑内障研究の進歩 緑内障性視神経症への挑戦 新しい病態論の提唱と他覚的機能解析方法の改良
緑内障性視神経症は緑内障における視機能障害の本態とされる.しかし,眼圧を筆頭とするさまざまな危険因子がどのようにして緑内障性視神経症を引き起こすのか,未だ十分に解明されていない.また,視機能障害の評価に用いられる静的・動的視野検査は心理物理学に基づく自覚的検査であるため,客観的な他覚的検査法の導入が望まれてきた.本研究において我々は緑内障性視神経症の病態と他覚的視機能解析方法に関して検討を行った.アクアポリン(aquaporin:AQP)水チャンネルは,ホモないしヘテロ四量体として主に細胞膜に存在し,細胞内外への双方向性の水輸送を担っている.AQPによる水輸送は,神経細胞が活動電位を迅速に繰り返し発生させるのに不可欠である.既報の13のアイソフォームのうちAQP-4が球後視神経には発現するが,視神経乳頭部には発現していないことが知られていた.我々は,ラット視神経のアストロサイトは,無髄・有髄領域にかかわらずAQP-9を発現していることを見出した.上強膜静脈焼灼による慢性高眼圧によって,AQP-9の免疫染色性と遺伝子発現が著しく減弱したが,球後のAQP-4の発現に変化はなかった.同様の変化は,隅角レーザー誘発高眼圧サル眼やヒト緑内障眼の視神経でも確認された.さらにAQP-9は正常ラットでは網膜神経節細胞の細胞体にも発現していたが,慢性高眼圧眼ではその発現が有意に減弱していた.すなわち,慢性高眼圧は,視神経乳頭のアストロサイトと網膜神経節細胞の細胞体という,緑内障性視神経症の発症に深く関与している細胞ならびに部位におけるAQP-9の発現を減弱させていた.近年,神経科学の分野では,解糖系によりブドウ糖から代謝されて産生された乳酸がエネルギー基質としてアストロサイトから神経細胞へ供給されると考えられるようになった(astrocyte-to-neuron lactate shuttle hypothesis).AQP-9は,水以外に乳酸などの溶質も輸送するアクアグリセロポリンに属する.AQP-9のdown-regulationにより,エネルギー基質である乳酸が網膜神経節細胞とその軸索へ正常に供給されなくなることが,緑内障性視神経症の発症に関与している可能性がある.多局所視覚誘発電位(multifocal visual evoked potential:mfVEP)は一度に60ヶ所の局所網膜に対応する視覚誘発電位を記録することのできる他覚的視野検査である.同時に複数のチャンネルから記録することで,信号雑音比(signal-to-noise ratio:SNR)は向上した.しかし,これまでの研究対象はおおむね白人であったため,骨格の異なる日本人に適した記録方法はまだ確立されていなかった.200例の頭部磁気共鳴画像(magnetic resonance imaging:MRI)から鳥距溝の後頭結節に対する相対位置関係を計測したところ,白人に比べ,その相対位置関係は約1cm有意に低かった.次いで,3チャンネルからのmfVEP同時記録ならびに信号窓と雑音窓におけるSNR分布の受信者操作特性(receiver-operating characteristic:ROC)曲線解析を行った.その結果,日本人においては,後頭結節を挟む水平チャンネルと二組の垂直チャンネルのいずれかを組み合わせた2チャンネルを用いてmfVEP記録すると,ROC曲線下面積(area under the ROC curve:AUC)が最も大きくなることを見出した.次にHumphrey視野計の平均偏差が-15dB未満の初期から中期緑内障56眼ならびに正常62眼において,このSNR-AUCがHumphrey視野計のトータル偏差に対して,同等の緑内障診断能ならびに高い相関を示すことを見出した.一方,確率プロットに基づく,Humphrey視野とmfVEP間の障害部位のトポグラフィカルな一致率は中程度であった.従来検討されてきたSNRの確率プロットのクラスター判定が局所の感度低下の診断に有用であるのに対して,SNR-AUCは,平均偏差に類似した,緑内障性視神経症のびまん性機能障害を定量するグローバル・インデックスとして用いることができる可能性がある.(著者抄録)
(公財)日本眼科学会, 2012年03月, 日本眼科学会雑誌, 116 (3), 298 - 346, 日本語[査読有り][招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2012年03月, 眼科ケア, 14 (3号), 210 - 216, 日本語【22の視野異常から学ぶ 視野検査で疾患を見抜くカギ】 両耳側半盲
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2012年01月10日, 日本眼科學会雜誌, 116 (1), 36 - 41, 日本語補足資料1
- 2012年01月10日, 日本眼科學会雜誌, 116 (1), 22 - 29, 日本語緑内障の治療総論
- 2012年01月10日, 日本眼科學会雜誌, 116 (1), 19 - 21, 日本語緑内障の検査
- 2012年01月10日, 日本眼科學会雜誌, 116 (1), 30 - 35, 日本語緑内障の病型別治療
- 2012年01月10日, 日本眼科學会雜誌, 116 (1), 15 - 18, 日本語緑内障の分類
- 2012年01月10日, 日本眼科學会雜誌, 116 (1), 42 - 46, 日本語緑内障性視神経乳頭・網膜神経線維層変化判定ガイドライン
- 2010年09月, 神経眼科, 27巻, 3号, pp. 286-294, 日本語【眼底imagingと神経眼科】 眼底imagingの問題点と限界
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- 2010年07月30日, 眼科手術 = Journal of ophthalmic surgery, 23 (3), 413 - 424, 日本語トラベクレクトミー : 術中手技のポイントとバリエーション
- 2010年03月, 神経眼科, 27巻, 1号, pp. 33-40, 日本語【虚血性視神経症】 非動脈炎性虚血性視神経症と緑内障性視神経症
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記事・総説・解説・論説等（学術雑誌）
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記事・総説・解説・論説等（学術雑誌）
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記事・総説・解説・論説等（学術雑誌）
- 2009年03月, 日本の眼科, 80巻, 3号, pp. 289-292, 日本語【「眼疾患と動物モデル」をより理解するために】 緑内障研究へのマウスの応用 眼圧および網膜神経節細胞障害機序の解明を目指して 緑内障研究におけるマウスの有用性
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- 医学書院, 2008年11月, 臨床眼科, 62巻, 12号, pp. 1836-1841 (12), 1810 - 1815, 日本語【糖尿病の眼合併症】 糖尿病関連視神経症
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- 2008年09月, 眼科プラクティス, 23巻, , pp. 244-245, 日本語【眼科薬物治療A to Z】 疾患別治療戦略と処方の実際 視神経・視路疾患 Leber遺伝性視神経症
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- 2008年09月, 眼科, 50巻, 10号, pp. 1408-1409, 日本語【眼科疾患アトラス】 緑内障 頸動脈海綿静脈洞瘻
記事・総説・解説・論説等（学術雑誌）
- 2008年09月, 眼科, 50巻, 10号, pp. 1450-1450, 日本語【眼科疾患アトラス】 緑内障 視神経乳頭出血
記事・総説・解説・論説等（学術雑誌）
- 金原出版, 2008年09月, 眼科, 50巻, 10号, pp. 1451-1451 (10), 1269 - 1649, 日本語【眼科疾患アトラス】 緑内障 ラミナドットサイン
記事・総説・解説・論説等（学術雑誌）
- 2008年09月, 眼科, 50巻, 10号, pp. 1406-1406, 日本語【眼科疾患アトラス】 緑内障 Haab(ハーブ)の線条
記事・総説・解説・論説等（学術雑誌）
- 金原出版, 2008年08月, 眼科, 50巻, 8号, pp. 1031-1037 (8), 1031 - 1037, 日本語【視神経炎・視神経症アップデート】 遺伝性視神経症
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- 2008年06月, あたらしい眼科, 25巻, 6号, pp. 771-774, 日本語【緑内障点眼薬 選択のポイント】 α受容体作動薬 α1遮断薬とα2刺激薬
記事・総説・解説・論説等（学術雑誌）
- 2008年03月, 眼科プラクティス, 20巻, , pp. 260-269, 日本語【小児眼科診療】 疾患特性と診療指針 神経眼科 視神経疾患
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- 金原出版, 2008年02月, 眼科, 50巻, 2号, pp. 183-188 (2), 183 - 188, 日本語新しい緑内障点眼薬
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- AMER ACAD SLEEP MEDICINE, 2008年, SLEEP, 31, A216 - A216, 英語Anti-aquaporin 4 antibody associated symptomatic narcolepsy due to hypothalamic lesions with multiple sclerosis
研究発表ペーパー・要旨（国際会議）
- メディカル葵出版, 2007年12月, あたらしい眼科, 24巻, 12号, pp. 1553-1560 (12), 1551 - 1617, 日本語【とっても身近な神経眼科】 乳頭が腫れていたら
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- 医学書院, 2007年10月, 臨床眼科, 61巻, 11号, pp. 98-102 (11), 274 - 277, 日本語【眼科専門医に必要な「全身疾患と眼」のすべて】 神経・筋肉疾患 Leber遺伝性視神経症
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- 2007年05月, 眼科プラクティス, 15巻, , pp. 214-218, 日本語【視野】 視路疾患と視野 視索・外側膝状体・視放線疾患と視野
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- 2007年02月, 眼科インストラクションコース．視神経と視野による緑内障診断完全ﾏｽﾀｰ, 10巻, pp. 138-142, 日本語視神経乳頭形状、視神経周囲組織と視野異常の対応をどう同定するか
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- 医学書院, 2007年02月, 臨床眼科, 61巻, 2号, pp. 146-151 (2), 128 - 135, 日本語【緑内障診療の新しい展開】 眼圧の質のとらえ方
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- 2006年12月, Frontiers in Glaucoma, 7巻, 4号, pp. 169-173, 日本語緑内障手術の実践 トラベクレクトミーの実際
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- 2006年11月, 眼科プラクティス, 12巻, pp. 299-299, 日本語【眼底アトラス】 疾患アトラス 視神経 後部虚血性視神経症
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- 2006年11月, 眼科プラクティス, 12巻, pp. 314-314, 日本語【眼底アトラス】 疾患アトラス 視神経 炎性視神経萎縮・網膜性視神経萎縮
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- 2006年11月, 眼科プラクティス, 12巻, pp. 292-292, 日本語【眼底アトラス】 疾患アトラス 視神経 SSOH
記事・総説・解説・論説等（学術雑誌）
- 2006年11月, 眼科プラクティス, 12巻, pp. 308-308, 日本語【眼底アトラス】 疾患アトラス 視神経 Leber遺伝性視神経症
記事・総説・解説・論説等（学術雑誌）
- 2006年11月, 眼科プラクティス, 12巻, pp. 273-273, 日本語【眼底アトラス】 疾患アトラス 眼底疾患 網膜有髄神経線維
記事・総説・解説・論説等（学術雑誌）
- 2006年09月, あたらしい眼科, 23巻, 9号, pp. 1185-1186, 日本語緑内障セミナー 新しい眼圧計PASCAL
記事・総説・解説・論説等（学術雑誌）
- 医学書院, 2006年09月, 臨床眼科, 60巻, 9号, pp. 1557-1561 (9), 1557 - 1561, 日本語新しい眼圧計
記事・総説・解説・論説等（学術雑誌）
- 2006年09月, 眼科プラクティス, 11巻, pp. 110-112, 日本語【緑内障診療の進めかた】 病型別診断と治療 発達緑内障 早発型発達緑内障 診断と管理
記事・総説・解説・論説等（学術雑誌）
- 2006年09月, 眼科プラクティス, 11巻, pp. 285-285, 日本語【緑内障診療の進めかた】 Topics 緑内障とcomplementary medicine
記事・総説・解説・論説等（学術雑誌）
- 文光堂, 2006年09月, 眼科プラクティス, 11巻, pp. 333-333, 333 - 333, 日本語【緑内障診療の進めかた】 Topics 羊膜を用いた修復
記事・総説・解説・論説等（学術雑誌）
- 2006年09月, 眼科プラクティス, 11巻, pp. 124-124, 日本語【緑内障診療の進めかた】 One Point Advice 小児緑内障の術後視機能評価のポイント
記事・総説・解説・論説等（学術雑誌）
- 金原出版, 2006年09月, 眼科, 48巻, 10号, pp. 1347-1354 (10), 1369 - 1373, 日本語【視路疾患の診かた 検査法からみた視路疾患】 形態検査による視神経乳頭部の診かた 光干渉断層計
記事・総説・解説・論説等（学術雑誌）
- 2006年07月, あたらしい眼科, 23巻, 7号, pp. 893-894, 日本語緑内障セミナー 新しい眼圧計アイケア
記事・総説・解説・論説等（学術雑誌）
- 2006年07月, 眼科手術, 19巻, 3号, pp. 305-308, 日本語【続発緑内障の病態と治療】 真性小眼球症に関連した続発緑内障
記事・総説・解説・論説等（学術雑誌）
- 2006年04月, 眼科インストラクションコース．緑内障 細隙灯顕微鏡診断完全マスター, 7巻, pp. 124-127, 日本語眼圧測定に関連した角膜上皮障害と院内感染を防ごう！
記事・総説・解説・論説等（学術雑誌）
- 2006年03月, 日本医事新報, 4272巻, pp. 113-113, 日本語Leber病の対光反応・中心フリッカー所見
記事・総説・解説・論説等（学術雑誌）
- 医学書院, 2006年02月, 臨床眼科, 60巻, 2, pp.144-151 (2), 144 - 151, 日本語【どこまで進んだ分子病態の解明と標的治療】 緑内障性視神経症
記事・総説・解説・論説等（学術雑誌）
- 2006年01月, 眼科プラクティス, 7巻, pp. 200-203, 日本語【糖尿病眼合併症の診療指針】 その他の眼合併症 神経眼科的合併症 視神経症
記事・総説・解説・論説等（学術雑誌）
- 2005年12月, Frontiers in Glaucoma, 6巻, 4, pp.185-193, 日本語目でみるシリーズ 緑内障手術の基礎知識 トラベクレクトミーの基礎(図説)
記事・総説・解説・論説等（学術雑誌）
- じほう, 2005年10月, 調剤と情報, 11巻, 11, pp.1461-1465 (11), 1461 - 1465, 日本語この病気のココが知りたい 眼科編 緑内障
記事・総説・解説・論説等（学術雑誌）
- 2005年04月, 日本眼科学会雑誌, 109巻, 4号, pp.189-196, 日本語レーベル遺伝性視神経症の発症分子メカニズムの展望
[査読有り]
記事・総説・解説・論説等（学術雑誌）
- 2005年02月, Clinical Neuroscience, 23巻, 2号, pp. 216-218, 日本語【グリア細胞 その新しい展開】 グリア細胞と脳疾患 糖尿病網膜症
記事・総説・解説・論説等（学術雑誌）
- 2005年, Ophthalmologica. Journal International D'Ophtalmologie. International Journal Of Ophthalmology. Zeitschrift Fur Augenheilkunde, Vol. 219, No. 1, pp. 1-10, 1 - 10, 英語Diabetes mellitus as a risk factor for glaucomatous optic neuropathy
記事・総説・解説・論説等（学術雑誌）
- 2005年01月, あたらしい眼科, 21巻, 臨増, pp. 65-68, 65 - 68, 日本語【神経眼科Q&A】 視神経疾患 Leber病の原因として何を考えればいいのですか
記事・総説・解説・論説等（学術雑誌）
- 2004年08月, 眼科ケア, 6巻, 8号, pp. 782-787, 89 - 93, 日本語ロービジョンケア 残された視力をどう生かすか 視神経疾患とロービジョンケア
記事・総説・解説・論説等（学術雑誌）
- 医学書院, 2004年06月, 臨床眼科, 58巻, 6号, pp. 887-891 (6), 887 - 891, 日本語緑内障神経保護治療の展望
記事・総説・解説・論説等（学術雑誌）
- 2004年06月, 日本医事新報, 4180号, pp. 19-24, 日本語正常眼圧緑内障
記事・総説・解説・論説等（学術雑誌）
- 2003年12月, 眼科ケア, 2003年冬季増刊, pp. 206-215, 日本語【眼科疾患別パーフェクト検査マニュアル】 疾患別検査の進め方 乳幼児の視機能を把握する
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 190-190, 日本語【緑内障診療のトラブルシューティング】 手術治療 毛様体扁平部濾過手術の適応と実際
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 155-156, 日本語【緑内障診療のトラブルシューティング】 手術治療 トラベクロトミー 乳幼児の場合のポイント
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 180-181, 日本語【緑内障診療のトラブルシューティング】 手術治療 トラベクレクトミー 羊膜を使った濾過胞修復
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 162-162, 日本語【緑内障診療のトラブルシューティング】 手術治療 トラベクレクトミー 術中虹彩切開部からの出血
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 172-172, 日本語【緑内障診療のトラブルシューティング】 手術治療 トラベクレクトミー 術後,胞状脈絡膜剥離,大量脈絡膜滲出,網膜出血,中心静脈閉塞症
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 163-163, 日本語【緑内障診療のトラブルシューティング】 手術治療 トラベクレクトミー 各種結膜縫合法の実際
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 87-87, 日本語【緑内障診療のトラブルシューティング】 治療方針 病型別-水晶体関連 先天白内障術後の高眼圧
記事・総説・解説・論説等（学術雑誌）
- 2003年09月, 眼科診療プラクティス, 98巻, pp. 87-87, 日本語【緑内障診療のトラブルシューティング】 治療方針 病型別-水晶体関連 小児の球状水晶体に伴う高眼圧
記事・総説・解説・論説等（学術雑誌）
- 2003年07月, 眼科診療プラクティス, 96巻, pp. 152-158, 日本語【スタンダード眼科顕微鏡手術】 緑内障手術 トラベクロトミー
記事・総説・解説・論説等（学術雑誌）
- 2003年07月, 眼科診療プラクティス, 96巻, pp. 144-151, 日本語【スタンダード眼科顕微鏡手術】 緑内障手術 トラベクレクトミー
記事・総説・解説・論説等（学術雑誌）
- 2002年12月28日, 日本眼科紀要 = Folia ophthalmologica Japonica, 53 (12), 991 - 994, 日本語Leber遺伝性視神経症のロービジョンケア : 中高生の場合
- 2001年10月09日, 抄録集, 18, 111 - 111, 日本語神戸大学眼科における眼球運動障害症例の統計的検討
- 2000年08月28日, 日本眼科紀要 = Folia ophthalmologica Japonica, 51 (8), 734 - 738, 日本語Bipolar Occipital Straddle電極装着法を用いた Multifocal VEP 第2報 : 刺激指標のコントラストが頂点潜時と振幅に及ぼす影響
- 2000年, Eye, 14 (5), 802 - 804, 英語
速報，短報，研究ノート等（学術雑誌）
- 1999年09月28日, 日本眼科紀要 = Folia ophthalmologica Japonica, 50 (9), 715 - 720, 日本語Dynamic Strategy と Tendency Oriented Program(TOP) による閾値測定
- 1999年01月10日, 日本眼科學会雜誌, 103 (1), 48 - 55, 日本語走査型レーザー検眼鏡を用いた篩状板孔の形態
- 1998年02月10日, 日本眼科學会雜誌, 102 (2), 111 - 116, 日本語高眼圧症におけるBlue on Yellow視野計での網膜感度分布
- 1997年07月28日, 日本眼科紀要 = Folia ophthalmologica Japonica, 48 (7), 845 - 850, 日本語視神経疾患の多局所網膜電図
- 1995年10月30日, あたらしい眼科 = Journal of the eye, 12 (10), 1636 - 1638, 日本語視力改善をみた片眼性と思われる Leber 病の1例
書籍等出版物
- 共著, メディカル葵出版, 2019年11月Leber遺伝性視神経症の発症メカニズム 遺伝、症状、治療に関して教えてください / あたらしい眼科36巻 臨時増刊号
- 共著, 総合医学社, 2019年10月レーベル遺伝性視神経症 (Leber Hereditary Optic Neuropathy ; LHON) / 眼疾患アトラスシリーズ第2巻 後眼部アトラス
- 共著, メディカ出版, 2019年07月視路疾患におけるOCTの活用法 / 眼科グラフィック8巻4号 「超」入門神経眼科診療
- その他, 医学書院, 2019年04月未承認薬・適応外使用薬と研究倫理 / 緑内障道場
- その他, 南江堂, 2019年03月両耳側半盲（下垂体腺腫）/ 眼科疾患 最新の治療2019-2021
- 化学同人, 2019年, 日本語, ISBN: 9784759816297眼科疾患と薬物治 薬物治療学
- 共著, 日本神経眼科学会, 2019年Leber遺伝性視神経症の発症メカニズム / 神経眼科36巻2号 別冊
- その他, 医学書院, 2018年12月, 日本語標準眼科学第14版 / 第16章 神経眼科
教科書・概説・概論
- その他, 南江堂, 2018年05月, 日本語緑内障診療ガイドライン解説 緑内障診療テキスト / 正常眼圧緑内障
学術書
- その他, 南江堂, 2018年05月, 日本語緑内障診療ガイドライン解説 緑内障診療テキスト / 小児緑内障
学術書
- その他, 南江堂, 2018年05月, 日本語緑内障診療ガイドライン解説 緑内障診療テキスト / 原発開放隅角緑内障
学術書
- その他, 日本医事新報社, 2017年05月, 日本語1336専門家による私の治療 2017-18年度版 / 視神経萎縮
学術書
- その他, 文光堂, 2017年03月, 日本語眼底疾患パーフェクトアトラス / 視路疾患による逆行性視神経萎縮
学術書
- その他, 中山書店, 2017年02月, 日本語小児科診断・治療指針 改定第二版 / 緑内障
学術書
- その他, 医学書院, 2017年01月, 日本語今日の治療指針 2017 / 視神経炎
学術書
- その他, 文光堂, 2016年10月, 日本語前視野緑内障に向き合う / 前視野緑内障の治療の流れ（総論）
学術書
- その他, 文光堂, 2016年09月, 日本語眼科検査ガイド第二版 / 多局所視覚誘発電位
学術書
- その他, 医学書院, 2016年04月, 日本語眼科臨床エキスパート．知っておきたい神経眼科診療 / Leber遺伝性視神経症
学術書
- その他, 中山書店, 2016年03月, 日本語専門医のための眼科診療クオリファイ 30.眼の発生と解剖・機能 / 中枢神経（III～VIII）
学術書
- その他, 南江堂, 2016年02月, 日本語眼科疾患 最新の診療2016-2018 / 視神経炎
学術書
- その他, 医学書院, 2015年10月, 日本語眼科臨床エキスパート．緑内障治療のアップデート． / トラベクロトミーのコツと落とし穴
教科書・概説・概論
- その他, 医学書院, 2015年10月, 日本語眼科臨床エキスパート．緑内障治療のアップデート / 隅角癒着乖離術
教科書・概説・概論
- その他, メジカルビュー社, 2015年09月, 日本語視神経乳頭・視野でみる緑内障確定診断 / 緑内障以外の乳頭陥凹―視神経部分低形成
学術書
- その他, メジカルビュー社, 2015年09月, 日本語視神経乳頭・視野でみる緑内障確定診断 / 緑内障以外の乳頭陥凹―虚血性変化後
学術書
- その他, メジカルビュー社, 2015年09月, 日本語視神経乳頭・視野でみる緑内障確定診断 / 緑内障以外の乳頭陥凹―その他の視神経症
学術書
- その他, 医学書院, 2015年03月, 日本語今日の診断指針 / 特発性視神経炎
学術書
- その他, 医学書院, 2015年01月, 日本語今日の治療指針 / 眼外傷
学術書
- その他, メジカルビュー, 2014年11月, 日本語神経眼科診断クローズアップ / 視野ー緑内障と間違えやすい視野異常
学術書
- その他, メジカルビュー, 2014年04月, 日本語緑内障診療クローズアップ / 緑内障患者に使えない薬
学術書
- その他, メジカルビュー, 2014年04月, 日本語緑内障診療クローズアップ / 妊婦、小児への点眼薬処方
学術書
- その他, メジカルビュー, 2014年04月, 日本語緑内障診療クローズアップ / 正常眼圧緑内障 概論
学術書
- その他, 医学書院, 2014年04月, 日本語All about 原発閉塞隅角緑内障 / 眼圧測定の注意点
学術書
- その他, 医学書院, 2013年04月, 日本語All About 開放隅角緑内障 / ガイドラインに準拠した薬物治療の考え方
学術書
- その他, 中山書店, 2013年02月, 日本語専門医のための眼科診療クオリファイ16. 糖尿病眼合併症の新展開 / 糖尿病関連視神経症
学術書
- その他, 中山書店, 2012年12月, 日本語専門医のための眼科診療クオリファイ15. メデイカルオフサルモロジー 眼薬物治療のすべて / Leber 遺伝性視神経症
学術書
- その他, 中山書店, 2012年09月, 日本語最新ガイドライン準拠 小児科診断・治療指針 / 緑内障
学術書
- その他, 文光堂, 2012年, 日本語眼手術学 6.緑内障 / 結膜瘢痕化
教科書・概説・概論
- 共著, 中山書店, 2011年02月, 日本語専門医のための眼科診療クオリファイ．3 緑内障診断ガイド / 緑内障性視野異常と鑑別疾患
学術書
- 共著, 中山書店, 2011年, 日本語専門医のための眼科診療クオリファイ 7.視神経疾患のすべて / 視神経周囲炎
学術書
- 共著, 文光堂, 2011年, 日本語眼科学第二版 / 小児の緑内障
教科書・概説・概論
- 共著, シナジー, 2010年11月, 日本語眼科検査のグノーテイ・セアウトン / 視野のスコア分類は、日常診療に適用すべきなのか？
学術書
- 共著, シナジー, 2010年11月, 日本語眼科検査のグノーテイ・セアウトン / 眼圧測定の使い捨てプリズムは、何を用いても構わないのか？
学術書
- 共著, 文光堂, 2010年06月, 日本語眼のサイエンス．眼疾患の謎 / Leber遺伝性視神経症はなぜ浸透率が低いのか、どうして環境因子が関係するのか？
学術書
- 共著, 医学書院, 2010年, 日本語今日の治療指針 / 虚血性視神経症
学術書
- 共著, 医学書院, 2009年, 日本語今日の治療指針．私はこう治療している / 虚血性視神経症
学術書
- 共著, 中山書店, 2008年, 日本語眼科診療のコツと落とし穴３．検査・診断． / 画像解析装置を応用するときの注意点
学術書
- 共著, 文光堂, 2008年, 日本語眼科プラクティス23．眼科薬物治療A to Z． / Leber遺伝性視神経症
学術書
- 共著, 文光堂, 2008年, 日本語眼科プラクティス20．小児眼科診療 / 視神経疾患
学術書
- 共著, メジカルビュー社, 2008年, 日本語眼科インストラクションコース17. 眼科診療のスキルアップ / 正常眼圧緑内障の目標眼圧設定の実際は？ 設定値変化はどうするか？
学術書
- 共著, メジカルビュー社, 2008年, 日本語眼科インストラクションコース14. トラベクレクトミー完全マスター． / 術翌日の診察ではここに注意しておこう！
学術書
- 共著, 金原出版, 2008年, 日本語すぐに役立つ眼科診療の知識．臨床神経眼科学 / 同名半盲に合併したRAPD
学術書
- 共著, 金原出版, 2008年, 日本語すぐに役立つ眼科診療の知識．臨床神経眼科学 / 虚血性視神経症の治療
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 乳頭部第一次硝子体過形成遺残
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 乳頭周囲ぶどう腫
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 糖尿病と視神経萎縮
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 朝顔症候群
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 先天乳頭上膜，Bergmeister乳頭遺残
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 視神経・視路疾患．コロボーマ
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 屈折異常と視神経乳頭
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二版 / 虚血性視神経症
学術書
- 共著, 医学書院, 2007年, 日本語今日の眼疾患治療指針．第二 / 視神経萎縮
学術書
- 共著, メジカルビュー社, 2007年, 日本語眼科インストラクションコース14. トラベクレクトミー完全マスター / 術翌日の診察ではここに注意しておこう！
学術書
- 共訳, メデイカルビュー社, 2006年10月, 日本語緑内障と眼の病気 / 緑内障性障害の病因
学術書
- 共著, 中山書店, 2006年09月, 日本語緑内障３分診療を科学する！ / 前眼部の発達・構造異常を伴う緑内障
学術書
- 共訳, メディカルレビュー, 2006年, 日本語緑内障と眼の病気 / 緑内障の危険因子、緑内障性障害の病因
学術書
- 共著, 文光堂, 2006年01月, 日本語眼科プラクティス7巻 糖尿病眼合併症の診療指針 / その他の眼合併症 神経眼科的合併症 視神経症
学術書
- 共著, 文光堂, 2005年09月, 日本語眼科プラクティス5巻 これならわかる神経眼科 / 視路の異常 視神経の病変 視神経周囲炎
学術書
- 共著, 文光堂, 2005年09月, 日本語眼科プラクティス5巻 これならわかる神経眼科 / 視路の異常 視神経の病変 遺伝性視神経症
学術書
- 共著, 文光堂, 2005年09月, 日本語眼科プラクティス5巻 これならわかる神経眼科 / One Point Advice 近視眼にみられる乳頭出血
学術書
- 共著, 文光堂, 2005年09月, 日本語眼科プラクティス5巻 これならわかる神経眼科 / One Point Advice RAPDの定量とparadoxical RAPD
学術書
- 共著, 文光堂, 2005年09月, 日本語眼科プラクティス5巻 これならわかる神経眼科 / Controversy テンシロンテストvsアイスパックテスト
学術書
- 共著, 文光堂, 2005年09月, 日本語眼科プラクティス5巻 これならわかる神経眼科 / Advanced Techniques 髄液検査の有用性と意義
学術書
講演・口頭発表等
- 第58回日本網膜硝子体学会, 2019年12月06日, 日本語, 国内会議Alport症候群に伴う網膜異常に対する微小視野計（MP3）を用いた機能的評価
ポスター発表
- 第58回日本網膜硝子体学会, 2019年12月06日, 日本語, 国内会議経過中に脈絡膜変化を伴った妊娠高血圧症候群に続発した高血圧性脈絡膜症の1症例
ポスター発表
- 第58回日本網膜硝子体学会, 2019年12月06日, 日本語, 国内会議自己免疫網膜症疑い患者の臨床的特徴
ポスター発表
- 第58回日本網膜硝子体学会, 2019年12月06日, 日本語, 国内会議視力良好な中心性漿液性脈絡網膜症における治療後不等像視の関連因子についての検討
ポスター発表
- 第58回日本網膜硝子体学会, 2019年12月06日, 日本語, 国内会議視力良好なポリープ状脈絡膜血管症に対する硝子体注射併用光線力学的療法の1年経過
ポスター発表
- 第58回日本網膜硝子体学会, 2019年12月06日, 日本語, 国内会議網膜中心静脈閉塞症に対する抗VEGF薬・ステロイド・周辺網膜光凝固併用療法
ポスター発表
- 兵庫県眼科医会・2大学合同オープンカンファレンス, 2019年11月30日, 日本語, 国内会議両眼開放下視野測定により診断した片眼性心因性視覚障害の2例
口頭発表（一般）
- 兵庫県眼科医会・2大学合同オープンカンファレンス, 2019年11月30日, 日本語, 国内会議毛様溝挿入バルベルトインプラント手術の術後中長期成績
口頭発表（一般）
- 兵庫県眼科医会・2大学合同オープンカンファレンス, 2019年11月30日, 日本語, 国内会議フルコナゾール全身投与が効果不良であったCandida albicansによる真菌性眼内炎の1例
口頭発表（一般）
- 兵庫県眼科医会・2大学合同オープンカンファレンス, 2019年11月30日, 日本語, 国内会議増殖硝子体網膜症を伴った水晶体起因性眼内炎の一例
口頭発表（一般）
- 13th Asia-Pacific Vitreo-retina Society, 2019年11月22日, 英語, 国際会議Clinical factors associated with aniseikonia after reduced-fluence photodynamic therapy in central serous chorioretinopathy patients with good visual acuity.
ポスター発表
- 13th Asia-Pacific Vitreo-retina Society, 2019年11月22日, 英語, 国際会議The size of the gauge and the cross-sectional area of the shaft are factors that determine the aspiration volume of the backflush needle.
ポスター発表
- SENJU Ophthalmic Seminar in 松江, 2019年11月17日, 日本語緑内障診療におけるOCT：多事争論！
公開講演，セミナー，チュートリアル，講習，講義等
- 15th International Ocular Inflammation Society Congress, 2019年11月, 英語, 国際会議Short-term outcomes of Tenon’s capsule retractor-assisted trabeculectomy for uveitic glaucoma.
口頭発表（一般）
- 第73回日本臨床眼科学会, 2019年10月27日, 日本語, 国内会議視力良好な網膜静脈分枝閉塞症に伴う黄斑浮腫に対する抗VEGF治療成績
口頭発表（一般）
- 第73回日本臨床眼科学会, 2019年10月26日, 日本語, 国内会議中心性漿液性脈絡網膜症に対する低照射エネルギー光線力学療法の長期治療成績
ポスター発表
- 第73回日本臨床眼科学会, 2019年10月26日, 日本語, 国内会議新規ブリモニジン/チモロール配合点眼剤のチモロール対照第III相比較試験
口頭発表（一般）
- 第73回日本臨床眼科学会, 2019年10月25日, 日本語, 国内会議ぶどう膜炎における超広角眼底自発蛍光の特徴
口頭発表（一般）
- 第73回日本臨床眼科学会, 2019年10月24日, 日本語, 国内会議毛様溝挿入バルベルトインプラント手術の術後中長期成績
口頭発表（一般）
- 第73回日本臨床眼科学会, 2019年10月24日, 日本語, 国内会議緑膿菌が原因の結膜炎から結膜欠損を引き起こした免疫健常な若年例
ポスター発表
- 第73回日本臨床眼科学会, 2019年10月24日, 日本語, 国内会議卵黄様黄斑症を伴う眼内リンパ腫の臨床的特徴の検討
口頭発表（一般）
- 第73回日本臨床眼科学会, 2019年10月24日, 日本語, 国内会議インストラクションコース23 斜視・弱視・小児眼科・神経眼科 やさしい神経眼科 vol.9
口頭発表（一般）
- 第57回日本神経眼科学会総会, 2019年10月05日, 日本語, 国内会議多発血管炎性肉芽腫症に伴う副鼻腔炎により発症した両側鼻性視神経症の一例
口頭発表（一般）
- 第57回日本神経眼科学会総会, 2019年10月04日, 日本語, 国内会議抗PD-L1抗体薬により視神経炎と下垂体機能低下症を来した一例
口頭発表（一般）
- 第57回日本神経眼科学会総会, 2019年10月04日, 日本語, 国内会議再発性視神経炎に対する免疫抑制剤の治療効果
口頭発表（一般）
- 第57回日本神経眼科学会総会, 2019年10月04日, 日本語, 国内会議ランチョンセミナー1 視神経疾患と緑内障を見極める 緑内障と紛らわしい鑑別疾患
口頭発表（一般）
- 第34回日本糖尿病合併症学会・第25回日本糖尿病眼学会総会, 2019年09月28日, 日本語, 国内会議視力良好な糖尿病黄斑浮腫に対する抗VEGF薬硝子体注射の12ヵ月治療成績
口頭発表（一般）
- なんかい眼科フォーラム, 2019年09月21日, 日本語緑内障マネージメントのアップデート
公開講演，セミナー，チュートリアル，講習，講義等
- 第30回日本緑内障学会, 2019年09月07日, 日本語, 国内会議ランチョンセミナー7 緑内障トリビア3 神経眼科
口頭発表（一般）
- 第30回日本緑内障学会, 2019年09月07日, 日本語, 国内会議シンポジウム6 超高齢社会の緑内障のマネージメント 加齢変化と緑内障の関係
口頭発表（一般）
- 19th Euretina Congress, 2019年09月06日, 英語, 国際会議Effectiveness of the intentional lamellar macular hole formation for the treatment of refractory cystoid macular edema
ポスター発表
- 第30回日本緑内障学会, 2019年09月06日, 日本語, 国内会議毛様溝挿入アーメドインプラント手術の術後短期成績
口頭発表（一般）
- 第30回日本緑内障学会, 2019年09月06日, 日本語, 国内会議データ解析委員会特別セッション～研究プロジェクト支援事業～ Trabectomeに対する、microhookを用いた線維柱帯切開術眼内法の眼圧下降効果と安 全性の非劣性を検討する多施設共同ランダム化介入臨床研究
口頭発表（一般）
- 19th Euretina Congress, 2019年09月05日, 英語, 国際会議The comparison of reduced fluence photodynamic therapy with modified or conventional irradiation area for central serous chorioretinopathy.
ポスター発表
- 第77回日本眼科医会生涯教育講座 眼科における緊急疾患, 2019年08月31日, 日本語神経眼科の緊急疾患
公開講演，セミナー，チュートリアル，講習，講義等
- 第6回Tokai Ophthalmic Academy, 2019年08月18日, 日本語視路疾患診療最前線！
公開講演，セミナー，チュートリアル，講習，講義等
- 医学系女性研究者・女性医師の活躍促進のための意見交換会, 2019年07月30日, 日本語女性医師支援の歩みと課題
公開講演，セミナー，チュートリアル，講習，講義等
- 第77回日本眼科医会生涯教育講座 眼科における緊急疾患, 2019年07月20日, 日本語神経眼科の緊急疾患
公開講演，セミナー，チュートリアル，講習，講義等
- 第77回日本眼科医会生涯教育講座 眼科における緊急疾患, 2019年07月11日, 日本語神経眼科の緊急疾患
公開講演，セミナー，チュートリアル，講習，講義等
- 第56回日本眼感染症学会・第53回眼炎症学会, 2019年07月06日, 日本語, 国内会議脈絡膜網膜炎をきたした梅毒性ぶどう膜炎3例の光干渉断層計画像所見
口頭発表（一般）
- 第56回日本眼感染症学会・第53回眼炎症学会, 2019年07月05日, 日本語, 国内会議抗PD-1抗体ペムブロリズマブ投与中に網膜血管炎を発症した1例
口頭発表（一般）
- 第56回日本眼感染症学会・第53回眼炎症学会, 2019年07月05日, 日本語, 国内会議非感染性ぶどう膜炎におけるアダリムマブ治療前後の脈絡膜構造指標変化の検討
口頭発表（一般）
- Global Ocular Inflammation Workshop 2019, 2019年06月, 英語Optical coherence tomography in vitreoretinal lymphoma with or without vitelliform submaculopathy.
ポスター発表
- 第67回日本視覚電気生理学会, 2019年06月, 日本語強直性脊椎炎加療中に発症した網膜外層障害を伴うぶどう膜炎の診断に全視野網膜電図が有用であったと思われる一例
口頭発表（一般）
- 第8回日本視野画像学会学術集会, 2019年05月19日, 日本語En face slab imaging を用いた後期緑内障眼の構造と機能の解析
口頭発表（一般）
- 第8回日本視野画像学会学術集会, 2019年05月18日, 日本語シンポジウム2 視野の臨床を語る 視路疾患の視野
シンポジウム・ワークショップパネル（指名）
- ケーラボ提携講演会, 2019年05月07日, 日本語眼疾患患者のQOV評価の現状と課題
公開講演，セミナー，チュートリアル，講習，講義等
- The Association for Research in Vision and Ophthalmology, 2019年05月02日, 英語Deletion of Aqp9 in mice enhances retinal ganglion cell death after optic nerve injury.
ポスター発表
- The Association for Research in Vision and Ophthalmology, 2019年05月01日, 日本語Predictive factors for metamorphopsia after reduced-fluence photodynamic therapy.
ポスター発表
- The Association for Research in Vision and Ophthalmology, 2019年05月01日, 英語Genetic factors associated with the treatment response to reduced-flurence photodynamic therapy for chronic central serous chorioretinopathy.
ポスター発表
- The Association for Research in Vision and Ophthalmology, 2019年04月30日, 英語The relationship between structural change of distinct retinal layers and visual prognosis in patients with macular edema secondary to branchial retinal vein occlusion.
ポスター発表
- The Association for Research in Vision and Ophthalmology, 2019年04月29日, 英語Post-treatment change of choroidal structural parameters and their correlations and fluctuations in Vogt-Koyanagi-Harada disease.
ポスター発表
- The Association for Research in Vision and Ophthalmology, 2019年04月29日, 英語The relationship between the choroidal structure and choroidal thickening in Vogt-Koyanagi-Harada disease.
ポスター発表
- The Association for Research in Vision and Ophthalmology, 2019年04月28日, 英語The association of the branching vascular network area progression with the outcomes of combination therapy with intravitreal aflibercept and verteporfin photodynamic therapy for polypoidal choroidal vasculopathy
ポスター発表
- The Association for Research in Vision and Ophthalmology, 2019年, 英語Pretreatment factors in managing protocol with aflibercept in patients with diabetic macular edema.
ポスター発表
- 第123回日本眼科学会総会, 2019年04月21日, 日本語フマル酸ジメチル／モノメチルによる視神経挫滅後の網膜神経節細胞の生存促進効 果
口頭発表（一般）
- 第123回日本眼科学会総会, 2019年04月19日, 日本語前眼部OCTにより鑑別を行った結膜粘液腫の一例
ポスター発表
- 第123回日本眼科学会総会, 2019年04月19日, 日本語視力良好な中心性漿液性脈絡網膜症における治療後歪視の予測因子についての検討
ポスター発表
- 第123回日本眼科学会総会, 2019年04月19日, 日本語網膜静脈分枝閉塞症に伴う黄斑浮腫における網膜最内層／内層／外層障害と視力予後の 評価
口頭発表（一般）
- 第123回日本眼科学会総会, 2019年04月19日, 日本語Vogt-小柳-原田病治療経過中の脈絡膜再肥厚と脈絡膜構造変化の検討
口頭発表（一般）
- 第123回日本眼科学会総会, 2019年04月19日, 日本語OCTによる上方視神経部分低形成の診断の試み
ポスター発表
- 第123回日本眼科学会総会, 2019年04月19日, 日本語糖尿病性黄斑浮腫に対するアフリベルセプト治療に影響する因子についての検討
ポスター発表
- 第123回日本眼科学会総会, 2019年04月18日, 日本語マイクロパルス波経強膜毛様体光凝固の使用経験
ポスター発表
- 第123回日本眼科学会総会, 2019年04月18日, 日本語Vogt-小柳-原田病治療前後の脈絡膜構造指標の変化と相関
ポスター発表
- 第123回日本眼科学会総会, 2019年04月18日, 日本語難治性黄斑浮腫に対する嚢胞内壁穿破術の有効性
口頭発表（一般）
- 第123回日本眼科学会総会, 2019年04月18日, 日本語ポリープ状脈絡膜血管症へのaflibercept併用光線力学的療法と異常血管網の進展
ポスター発表
- World Glaucoma Congress 2019, 2019年03月29日, 英語A comparison of one-year surgical outcome between trabeculotomy ab externo and microhook ab interno trabeculotomy using the propensity score analysis.
ポスター発表
- World Glaucoma Congress 2019, 2019年03月27日, 英語Structure-function relationship in the temporal raphe region. Japan Glaucoma Society Symposium. Hot topics of imaging for glaucoma diagnosis and management.
口頭発表（一般）
- 新・眼科診療アップデートセミナー2019 in Kyoto, 2019年03月23日, 日本語視神経疾患診療アップデート
公開講演，セミナー，チュートリアル，講習，講義等
- SENJU Ophthalmic seminar in Kyoto, 2019年03月20日, 日本語神経眼科診療、知っておくべき10の知識
公開講演，セミナー，チュートリアル，講習，講義等
- SENJU 眼疾患セミナー in 金沢, 2019年03月14日, 日本語緑内障マネージメントのアップデート
公開講演，セミナー，チュートリアル，講習，講義等
- 第3回Ochanomizu Crossover Conference, 2019年03月07日, 日本語緑内障と偽緑内障の鑑別ポイント＋α
公開講演，セミナー，チュートリアル，講習，講義等
- 第38回神戸市立医療センター中央市民病院・ 神戸アイセンター病院眼科オープンカンファレンス, 2019年03月02日, 日本語続発緑内障に対するテノン開創器を用いた線維柱帯切除術の臨床経過
口頭発表（一般）
- 兵庫区眼科医会パンジーの会, 2019年02月28日, 日本語緑内障・視神経疾患患者の病診連携
公開講演，セミナー，チュートリアル，講習，講義等
- 第428回大阪眼科集談会, 2019年01月26日, 日本語, 国内会議視路疾患診療最前線！
公開講演，セミナー，チュートリアル，講習，講義等
- 第57回日本網膜硝子体学会総会, 2018年12月, 日本語, 京都, 国内会議滲出型加齢黄斑変性の固視に関する検討
口頭発表（一般）
- 第56回日本神経眼科学会総会, 2018年12月, 日本語, 神戸, 国内会議片眼の動眼神経麻痺と僚眼の外転神経麻痺を呈したサルコイドーシスの1例
口頭発表（一般）
- 第56回日本神経眼科学会総会, 2018年12月, 日本語, 神戸, 国内会議髄膜炎を伴う続発性眼窩炎症と強膜炎を呈した汎発性帯状疱疹の一例
口頭発表（一般）
- 第57回日本網膜硝子体学会総会, 2018年12月, 日本語, 京都, 国内会議ポリープ状脈絡膜血管症へのaflibercept単独療法とaflibercept併用光線力学的療法との2年経過の比較
口頭発表（一般）
- 第57回日本網膜硝子体学会総会, 2018年12月, 日本語, 京都, 国内会議OCT angiographyを用いた糖尿病網膜症発症前後の網膜微小血管及び網膜構造変化の解析
口頭発表（一般）
- 第57回日本網膜硝子体学会総会, 2018年12月, 日本語, 京都, 国内会議En face slab OCT像を用いた網膜静脈分枝閉塞症の乳頭黄斑線維束障害についての検討
口頭発表（一般）
- 第5回神戸大学眼科オープンカンファレンス, 2018年11月, 日本語, 神戸, 国内会議当院における悪性黒色腫の長期経過
口頭発表（一般）
- 第36回日本腫瘍学会, 2018年11月, 日本語, 金沢, 国内会議当院における悪性黒色腫の長期経過
口頭発表（一般）
- 第5回神戸大学眼科オープンカンファレンス, 2018年11月, 日本語, 神戸, 国内会議髄膜炎を伴う続発性眼窩炎症と強膜炎を呈した汎発性帯状疱疹の一例
口頭発表（一般）
- 第5回神戸大学眼科オープンカンファレンス, 2018年11月, 日本語, 神戸, 国内会議下垂体茎断裂症候群に対するホルモン治療中に進行性の網膜変性症の合併を認めた１症例
口頭発表（一般）
- 第5回神戸大学眼科オープンカンファレンス, 2018年11月, 日本語, 神戸, 国内会議ランゲルハンス細胞組織球症による視神経症と外転神経麻痺を来した 1 例
口頭発表（一般）
- 第5回神戸大学眼科オープンカンファレンス, 2018年11月, 日本語, 神戸, 国内会議サイトメガロウイルス虹彩炎に起因する続発性緑内障 15 例の臨床像
口頭発表（一般）
- 第72回日本臨床眼科学会, 2018年10月, 日本語, 東京, 国内会議裂孔原性網膜剥離に対する27ゲージ硝子体手術後の歪視量に寄与する周術期因子の検討
口頭発表（一般）
- 第72回日本臨床眼科学会, 2018年10月, 日本語, 東京, 国内会議糖尿病眼におけるslab en face OCT像と網膜内層厚
口頭発表（一般）
- 第33回日糖尿病合併症学会・第24回日本糖尿病眼学会総会, 2018年10月, 日本語, 東京, 国内会議糖尿病黄斑浮腫治療成績とOCT en face slab像の関係
口頭発表（一般）
- 第72回日本臨床眼科学会, 2018年10月, 日本語, 東京, 国内会議原因不明の硝子体出血眼に対する早期硝子体手術の効果
口頭発表（一般）
- 第72回日本臨床眼科学会, 2018年10月, 日本語, 東京, 国内会議マイクロフックロトミーの術後短期成績
口頭発表（一般）
- 第72回日本臨床眼科学会, 2018年10月, 日本語, 東京, 国内会議ポリープ状脈絡膜血管症に対するaflibercept併用光線力学的療法の3年経過
口頭発表（一般）
- 第72回日本臨床眼科学会, 2018年10月, 日本語, 東京, 国内会議ぶどう膜炎続発緑内障に対するテノン開創器を用いた線維柱帯切除術の短期成績
口頭発表（一般）
- 第72回日本臨床眼科学会, 2018年10月, 日本語, 東京, 国内会議Vogt-小柳-原田病治療後の脈絡膜構造変化と再発前変動の検討
口頭発表（一般）
- 日本臨床視覚電気生理学会, 2018年09月, 日本語, 浜松, 国内会議下垂体茎断裂症候群に対するホルモン治療中に進行性の網膜変性症の合併を認めた１例
口頭発表（一般）
- 第22回眼創傷治癒研究会, 2018年07月, 日本語, 奈良, 国内会議続発緑内障に対するテノン開創器を用いた線維柱帯切除術
口頭発表（一般）
- 第52回日本眼炎症学会, 2018年07月, 日本語, 東京, 国内会議神戸大学眼科における非感染性ぶどう膜炎に対するアダリムマブの使用経験
口頭発表（一般）
- フォーサム2018東京, 2018年07月, 英語, 東京, 国内会議International Distinguished Papers Symposium Characteristics of vitreous cells in uveitis on optical coherence tomography
口頭発表（一般）
- フォーサム2018東京, 2018年07月, 日本語, 東京, 国内会議3歳女児に生じたVogt-小柳-原田病疑い症例
口頭発表（一般）
- WOC, 2018年06月, 英語, バルセロナ, 国際会議Time Course of Changes in Aqueous Flare Intensity after 27-gauge pars plana Vitrectomy for Primary Rhegmatogenous Retinal Detachment
口頭発表（一般）
- WOC, 2018年06月, 英語, バルセロナ, 国際会議Prediction of severe retinopathy of prematurity with WINROP algorithm in a Japanese poplulation of preterm infants
口頭発表（一般）
- 第7回日本視野学会学術集会, 2018年05月, 日本語, 石川, 国内会議視路疾患の構造と機能を考える
口頭発表（招待・特別）
- 23rd International visual field and imaging symposium, 2018年05月, 英語, 石川, 国内会議The disc-fovea-temporal raphe angle is associated with the severity of glaucoma with a hemi-field defect.
ポスター発表
- 23rd International visual field and imaging symposium, 2018年05月, 英語, 石川, 国内会議Agreement of a nasal step border by a microperimeter with a temporal raphe by optical coherence tomography in glaucoma patients
ポスター発表
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議裂孔原性網膜剥離に対する27G硝子体手術後の前房フレア値に寄与する周術期因子の検討
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議未熟児網膜症既往眼における中心窩無血管領域と固視点安定性の関連
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議続発緑内障に対するテノン開創器を用いた線維柱帯切除術の短期成績
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議小児緑内障の治療
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議光干渉断層計slab en face像を用いた糖尿病網膜内層構造変化の評価
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議ポリープ状脈絡膜血管症へのアフリベルセプト併用光線力学療法後の網膜色素上皮萎縮
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議ポリープ状脈絡膜血管症に対する光線力学的療法及びaflibercept併用療法と脈絡膜変化
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議アクアポリン9 遺伝子欠損マウスにおける視神経挫滅後の網膜神経節細胞死
口頭発表（一般）
- ARVO, 2018年04月, 英語, ホノルル, 国際会議The impact of early vitrectomy for dense vitreous hemorrhage without a history of diabetic retinopathy
口頭発表（一般）
- ARVO, 2018年04月, 英語, ホノルル, 国際会議The association of age-related maculopathy susceptibility 2 gene polymorphisms with the 12 months outcomes of combination therapy with intravitreal aflibercept and verteporfin photodynamic therapy for polypoidal choroidal vasculopathy.
口頭発表（一般）
- ARVO, 2018年04月, 英語, ホノルル, 国際会議Structural changes in the inner retina assessed by slab en face optical coherence tomography in diabetic eyes.
口頭発表（一般）
- 第122回日本眼科学会総会, 2018年04月, 日本語, 大阪, 国内会議OCTにおける緑内障パラメーター測定値の検者内再現性と検者間一致度
口頭発表（一般）
- ARVO, 2018年04月, 英語, ホノルル, 国際会議Evaluation of vitreoretinal cellular infiltration in uveitis on optical coherence tomography.
口頭発表（一般）
- 7th A-PHPBA 29th JSHBPS, 2017年06月, 英語, The University of Tokyo, Yokohama, Japan, 国際会議The impact of pancreatic duct stent in pancreatic fistula after pancreaticoduodenentomy: multicenter large observational study by Japan-Korean project, Symposium
シンポジウム・ワークショップパネル（公募）
- 第87回福祉情報工学研究会, 2016年12月, 日本語, 電子情報通信学会 福祉情報工学研究会, 東京, 国内会議視機能異常に対応した病院内設備とカラーユニバーサルデザイン
口頭発表（一般）
- 第17回日本クリニカルパス学会, 2016年11月, 日本語, 日本クリニカルパス学会, 金沢, 国内会議患者用パスの色覚異常への配慮の調査と作成ガイドラインの提案
口頭発表（一般）
- Pediatric Academic Societies (PAS) Annual Meeting 2016, 2016年04月, 英語, Pediatric Academic Societies, Baltimore, USA, 国際会議Incidence of kernicterus in Japanese preterm infants <30 wks gestation born in 2011
ポスター発表
- The 8th Congress of Asia Pacific Vitreo-retina Society (APVRS), 2013年12月, 英語, 日本網膜硝子体学会, 名古屋, 国際会議The natural course and response to treatments in the cases with peripapillary polypoidal choroidal vasculopathy,
口頭発表（一般）
- 第61回日本臨床視覚電気生理学会, 2013年10月, 日本語, 日本臨床視覚電気生理学会, 大阪, 国内会議多局所視覚誘発電位の信号雑音比受信者操作特性曲線下面積の中期変動
口頭発表（一般）
- 第67回日本臨床眼科学会, 2013年10月, 日本語, 日本眼科学会, 横浜, 国内会議関西緑内障道場 またまた帰ってきた悩みの相談室
公開講演，セミナー，チュートリアル，講習，講義等
- 第67回日本臨床眼科学会, 2013年10月, 日本語, 日本眼科学会, 横浜, 国内会議SD-OCTによる黄斑部解析の視交叉圧迫性視神経症の検出力
口頭発表（一般）
- 第67回日本臨床眼科学会, 2013年10月, 日本語, 日本眼科学会, 横浜, 国内会議SD-OCTによる黄斑部解析での 菲薄化プロットパターンによる初期緑内障眼検出能
口頭発表（一般）
- 第24回緑内障学会, 2013年09月, 日本語, 日本緑内障学会, 東京, 国内会議徹底検証！Glaucomatous optic axonopathy．イントロダクション
[招待有り]
シンポジウム・ワークショップパネル（指名）
- 第24回緑内障学会, 2013年09月, 日本語, 日本緑内障学会, 東京, 国内会議眼軸長と年齢が SD-OCTの網膜神経線維層と黄斑部内層網膜測定に及ぼす影響
口頭発表（一般）
- 第24回緑内障学会, 2013年09月, 日本語, 日本緑内障学会, 東京, 国内会議この視野の症例は緑内障でしょうか？
公開講演，セミナー，チュートリアル，講習，講義等
- 第24回緑内障学会, 2013年09月, 日本語, 日本緑内障学会, 東京, 国内会議3種のSD-OCTの黄斑部パラメータと視野の相関
口頭発表（一般）
- 第2回日本視野学会, 2013年05月, 日本語, 日本視野学会, 東京, 国内会議シンポジウム「近視と緑内障」 高度近視のOCTと静的視野に及ぼす影響
[招待有り]
シンポジウム・ワークショップパネル（指名）
- ARVO2012, 2013年05月, 英語, The Association For Research in Vision and Ophthalmology, Seattle, USA, 国際会議Syntaphilin is expressed in astrocytes in optic nerve and is down regulated in optic nerve after axonal injury
口頭発表（一般）
- ARVO2012, 2013年05月, 英語, The Association For Research in Vision and Ophthalmology, Seattle, USA, 国際会議Impact of plasma from patients with neuromyelitis optica spectrum disorders on the optic degeneration in rats
口頭発表（一般）
- ARVO2012, 2013年05月, 英語, The Association For Research in Vision and Ophthalmology, Seattle, USA, 国際会議Comparative assessment for the ability of macular parameters and circumpapillary retinal nerve fiber layer measured by three spectral-domain optical coherence tomograpahy insrtuments to diagnose glaucoma with high myopia
口頭発表（一般）
- 第117回日本眼科学会総会, 2013年04月, 日本語, 日本眼科学会, 東京, 国内会議緑内障診療における視野の役割 光干渉断層計（OCT）との関係
口頭発表（一般）
- 第117回日本眼科学会総会, 2013年04月, 日本語, 日本眼科学会, 東京, 国内会議視神経脊髄炎関連ラット視神経炎モデルの作製
口頭発表（一般）
- 第117回日本眼科学会総会, 2013年04月, 日本語, 日本眼科学会, 東京, 国内会議マイクロビーズによる慢性高眼圧緑内障モデルの作成
口頭発表（一般）
- 第117回日本眼科学会総会, 2013年04月, 日本語, 日本眼科学会, 東京, 国内会議3種のSD-OCTの乳頭周囲網膜神経線維層と視野の相関
口頭発表（一般）
- 第36回日本眼科手術学会, 2013年01月, 日本語, 日本眼科手術学会, 福岡, 国内会議術後中後期合併症と対策I.トラベクレクトミー術後管理の実践講座
公開講演，セミナー，チュートリアル，講習，講義等
- 第36回日本眼科手術学会, 2013年01月, 日本語, 日本眼科手術学会, 国内会議トラベクレクトミー・術後早期から中期の合併症
シンポジウム・ワークショップパネル（公募）
- 第50回日本神経眼科学会, 2012年11月, 日本語, 日本神経眼科学会, 京都, 国内会議小脳髄膜腫より腫瘍随伴性視神経症を発症した1例
口頭発表（一般）
- 第50回日本神経眼科学会, 2012年11月, 日本語, 日本神経眼科学会, 京都, 国内会議視神経疾患、視覚路障害の病態解明に向けて
[招待有り]
シンポジウム・ワークショップパネル（指名）
- 第50回日本神経眼科学会, 2012年11月, 日本語, 日本神経眼科学会, 京都, 国内会議Spectral-domain OCTを用いたSSOHの網膜内構造の評価
口頭発表（一般）
- American Academy of Ophthalmology・Asia-Pacific Academy of Ophthalmology Joint Meeting Chicago 2012, 2012年11月, 英語, The Foundation of The American Academy of Ophthalmology, Chicago,USA, 国際会議Anti-aquaporin-4 antibody-positive optic neuritis
口頭発表（一般）
- 第66回日本臨床眼科学会, 2012年10月, 日本語, 日本眼科学会, 京都, 国内会議緑内障の細分化により得られるもの RCTに基づく緑内障点眼薬の使い分け
シンポジウム・ワークショップパネル（公募）
- 第60回日本臨床視覚電気生理学会, 2012年10月, 日本語, 日本臨床視覚電気生理学会, 名古屋, 国内会議多局所視覚誘発電位の受信者操作特性曲線解析に及ぼす高度近視の影響
口頭発表（一般）
- 第66回日本臨床眼科学会, 2012年10月, 日本語, 日本眼科学会, 京都, 国内会議CT時代の眼底のみかた千本ノック
公開講演，セミナー，チュートリアル，講習，講義等
- 第66回日本臨床眼科学会, 2012年10月, 日本語, 日本眼科学会, 京都, 国内会議3種の光干渉断層計で測定した高眼圧症，Pre-perimetric glaucomaにおける視神経乳頭周囲網膜神経層厚の比較
口頭発表（一般）
- 第23回日本緑内障学会, 2012年09月, 日本語, 日本緑内障学会, 金沢, 国内会議自己眼圧測定器IcareONE®の精度および安全性の検討
口頭発表（一般）
- 第23回日本緑内障学会, 2012年09月, 日本語, 日本緑内障学会, 金沢, 国内会議視神経切断モデルにおけるsyntaphilinの変化
口頭発表（一般）
- 第23回日本緑内障学会, 2012年09月, 日本語, 日本緑内障学会, 金沢, 国内会議ロジスティック回帰分析による線維柱帯切除術後の低眼圧黄斑症寄与因子の検討
口頭発表（一般）
- 第23回日本緑内障学会, 2012年09月, 日本語, 日本緑内障学会, 金沢, 国内会議3種のOCTによる高度近視群、非高度近視群における緑内障検出力の比較
口頭発表（一般）
- 第68回日本弱視斜視学会総会, 2012年06月, 日本語, 日本弱視斜視学会, 名古屋, 国内会議長期経過において形態変化を認めた網膜つた状血管腫の一例
口頭発表（一般）
- ARVO2012, 2012年05月, 英語, The Association For Research in Vision and Ophthalmology, Florida,USA, 国際会議The association of altered aquaporin 9 expression with apoptosis of retinal ganglion cells.
口頭発表（一般）
- 第116回日本眼科学会総会, 2012年04月, 日本語, 日本眼科学会, 東京, 国内会議緑内障における多局所視覚誘発電位と構造変化の一致性と相関
口頭発表（一般）
- 第116回日本眼科学会総会, 2012年04月, 日本語, 日本眼科学会, 東京, 国内会議外傷性視神経症における網膜神経線維層厚およびGanglion cell complexの経時的変化
口頭発表（一般）
- 第116回日本眼科学会総会, 2012年04月, 日本語, 日本眼科学会, 東京, 国内会議「緑内障・視神経症」緑内障薬物治療のアップデート4. 具体的戦略2: 管理中の薬物変更、手術への移行
シンポジウム・ワークショップパネル（公募）
- The 27th APAO/SOE Congress, 2012年04月, 英語, The Korean Ophthalmological Society, Busan,Korea, 国際会議Objective Functional assessment in Glaucoma
口頭発表（一般）
- 第35回日本眼科手術学会, 2012年01月, 日本語, 名古屋市立大学, 名古屋, 国内会議トラベクレクトミー術後管理の実践講座
その他
- 第49回日本神経眼科学会, 2011年11月, 日本語, 兵庫医科大学, 神戸, 国内会議二種のスペクトラル・ドメイン光干渉断層計のband atrophy検出能と一致性の検討
口頭発表（一般）
- 第65回日本臨床眼科学会, 2011年10月, 日本語, 日本大学, 東京, 国内会議日本視野研究会シンポジウム 視野を活かす、珠玉の症例集 視路疾患の局在診断と視野
口頭発表（一般）
- 第65回日本臨床眼科学会, 2011年10月, 日本語, 日本大学, 東京, 国内会議視覚経路症としての緑内障
その他
- 第65回日本臨床眼科学会, 2011年10月, 日本語, 日本大学, 東京, 国内会議関西緑内障道場：緑内障症例「なやみの相談室4」
その他
- 第65回日本臨床眼科学会, 2011年10月, 日本語, 日本大学, 東京, 国内会議3種の光干渉断層計で測定した視神経乳頭線維層の緑内障検出能の比較検討
口頭発表（一般）
- 第22回日本緑内障学会, 2011年09月, 日本語, 日本緑内障学会, 秋田, 国内会議ラット網膜神経節細胞死とアクアポリン9の発現変化の関連
口頭発表（一般）
- 第22回日本緑内障学会, 2011年09月, 日本語, 日本緑内障学会, 秋田, 国内会議トラベクレクトミーはこうするんだ 術中の秘訣2
その他
- 第22回日本緑内障学会, 2011年09月, 日本語, 日本緑内障学会, 秋田, 国内会議3種のスペクトラルドメイン光干渉断層計による視神経乳頭周囲網膜神経層厚の相関と一致性
口頭発表（一般）
- 世界緑内障会議, 2011年06月, 英語, World Glaucoma Association, パリ, フランス, 国際会議Differences in filtering bleb structure associated with long-term intraocular pressure control between trabeculectomy with and without amniotic membrane transplantation.
口頭発表（一般）
- 世界緑内障会議, 2011年06月, 英語, World Glaucoma Association, パリ, フランス, 国際会議A comparison of long-term outcomes between trabeculectomy with and without amniotic membrane transplantation for intractable glaucoma
口頭発表（一般）
- 第115回日本眼科学会総会, 2011年05月, 日本語, 日本眼科学会, 東京, 国内会議緑内障性視神経症への挑戦 その基礎と臨床における三つの仮説の提唱
[招待有り]
口頭発表（招待・特別）
- 第115回日本眼科学会総会, 2011年05月, 日本語, 日本眼科学会, 東京, 国内会議小児緑内障手術を考える
その他
- 第64回日本臨床眼科学会, 2010年11月, 日本語, 日本眼科学会, 神戸, 国内会議緑内障点眼薬と神経保護
その他
- APAO2010, 2010年09月, 英語, International Council of Ophthalmology, 北京, 中国, 国際会議The role of aquaporin in glaucomatous optic neuropathy
口頭発表（一般）
- 第66回日本弱視斜視学会総会・第35回日本小児眼科学会総会合同学会, 2010年07月, 日本語, 日本斜視弱視学会・日本小児眼科学会, 東京, 国内会議発達緑内障術後管理（視機能） 小児緑内障～治療と予後～
その他
- 第66回日本弱視斜視学会総会・第35回日本小児眼科学会総会合同学会, 2010年07月, 日本語, 日本斜視弱視学会・日本小児眼科学会, 東京, 国内会議小児緑内障難治例に対する羊膜移植併用線維柱帯切除術の術後経過について
口頭発表（一般）
- WOC2010, 2010年06月, 英語, International Council of Ophthalmology, ベルリン, ドイツ, 国際会議Elevated intraocular pressure reduces aquaporin-9 expression in rat optic nerve head and retina.
口頭発表（一般）
- 第114回日本眼科学会総会, 2010年04月, 日本語, 日本眼科学会, 名古屋, 国内会議緑内障疾患感受性遺伝子によるオーダーメイド医療の可能性と問題点
その他
- 第114回日本眼科学会総会, 2010年04月, 日本語, 日本眼科学会, 名古屋, 国内会議よくわかる!緑内障診断ｽｷﾙｱｯﾌﾟｾﾐﾅｰ 初期緑内障を探しましょう 症例が教えてくれる眼底の見方
その他
- 第60回日本臨床眼科学会, 2006年10月, 日本語, 日本臨床眼科学会, 京都, 国内会議反跳式眼圧計の圧平眼圧計に対する眼圧測定の一致性と角膜厚の及ぼす影響
口頭発表（一般）
- 第17回日本緑内障学会, 2006年09月, 日本語, 日本緑内障学会, 神戸, 国内会議正常眼におけるOCT3とHRTによる網膜神経線維層厚測定値と視神経乳頭面積、眼軸長との相関
口頭発表（一般）
- 第17回日本緑内障学会, 2006年09月, 日本語, 日本緑内障学会, 神戸, 国内会議Dynamic Contour Tonometerにより測定されたOcular Pluse Amplitudeの検討
口頭発表（一般）
- 第31回日本小児眼科学会総会, 2006年06月, 日本語, 日本小児眼科学会, 静岡, 国内会議小児optic neurooathy こぼれ話
口頭発表（一般）
- 第110回日本眼科学会総会, 2006年04月, 日本語, 日本眼科学会, 大阪, 国内会議前房深度に対する機種間中心角膜厚の一致性
口頭発表（一般）
- 第110回日本眼科学会総会, 2006年04月, 日本語, 日本眼科学会, 大阪, 国内会議自然発症糖尿病ラットに初期網膜変化
口頭発表（一般）
- 第110回日本眼科学会総会, 2006年04月, 日本語, 日本眼科学会, 大阪, 国内会議視覚の発生・再生と神経保護 網膜内インスリン/IGF-1シグナル情報伝達と神経保護作用
口頭発表（一般）
- ARVO2006, 2006年04月, 英語, Fort Lauderdale, アメリ, 国際会議Nitric oxide rescues retinal neurons from apoptosis through a cGMP / protein kinase G pathway that activates cAMP-responsive element binding protein
口頭発表（一般）
- ARVO2006, 2006年04月, 英語, Fort Lauderdale, アメリ, 国際会議Neural and Glial Change at Early Stage in Spontaneous Diabetes Torii rats
口頭発表（一般）
- ARVO2006, 2006年04月, 英語, Fort Lauderdale, アメリ, 国際会議Agreement of three types of instruments in measuring central corneal thickness and the association with the anterior depth
口頭発表（一般）
- 第12回日本糖尿病眼学会総会, 2006年03月, 日本語, 群馬大学医学部眼科学教室, 東京, 国内会議自然発症糖尿病ラット網膜のglial fibrillary acidic proteinの発現様式
口頭発表（一般）
- 第29回日本眼科手術学会, 2006年01月, 日本語, 日本眼科手術学会, 東京, 国内会議漏出濾過胞に対する羊膜併用濾過胞修復術の術後経過
口頭発表（一般）
- 第29回日本眼科手術学会, 2006年01月, 日本語, 日本眼科手術学会, 東京, 国内会議羊膜移植 疾患別治療戦略 緑内障
口頭発表（一般）
- 第28回兵庫県緑内障研究会, 2006年01月, 日本語, 兵庫県緑内障研究会, 神戸, 国内会議Rebound tonometer（アイケア）とapplanation tonometerの一致性
口頭発表（一般）
- 日本神経眼科学会, 2005年11月, 日本語, 大分, 国内会議急速に進行した両鼻側視野欠損の症例
口頭発表（一般）
- 日本神経眼科学会, 2005年11月, 日本語, 大分, 国内会議OCT3とHRTによる圧迫性視神経症眼の視神経乳頭形状比較解析
口頭発表（一般）
- 第５９回日本臨床眼科学会, 2005年10月, 日本語, 札幌, 国内会議ﾊｲﾃﾞﾙﾍﾞﾙｸﾞﾚﾃｨﾅﾄﾓｸﾞﾗﾌによる半視野欠損を有する緑内障眼の視神経頭形状解析
口頭発表（一般）
- 第５９回日本臨床眼科学会, 2005年10月, 日本語, 札幌, 国内会議正常眼に於ける連日および週一回ﾗﾀﾉﾌﾟﾛｽﾄ点眼による眼圧降下効果の比較
口頭発表（一般）
- 第５９回日本臨床眼科学会, 2005年10月, 日本語, 札幌, 国内会議強度近視性内斜視（AEHM)に対する上直筋縫縮術の4例
口頭発表（一般）
- 第５９回日本臨床眼科学会, 2005年10月, 日本語, 札幌, 国内会議関西緑内障道場 悩みの相談室 続発緑内障編
口頭発表（一般）
- 第５９回日本臨床眼科学会, 2005年10月, 日本語, 札幌, 国内会議HRTによる視神経乳頭解析、CDｘ－VCCおよびOCTによる網膜神経線維層厚と網膜感度との相関
口頭発表（一般）
- 第１６回日本緑内障学会, 2005年09月, 日本語, 神戸, 国内会議ﾚｽｷｭﾗの謎を解く 神経保護経路を探る
シンポジウム・ワークショップパネル（公募）
- 第１６回日本緑内障学会, 2005年09月, 日本語, 神戸, 国内会議網膜神経線維層厚とRAPDの関係
口頭発表（一般）
- 第１６回日本緑内障学会, 2005年09月, 日本語, 神戸, 国内会議実験的ﾗｯﾄ緑内障網膜におけるinsulin/IGF-1受容体を介したAktの活性化
シンポジウム・ワークショップパネル（公募）
- 第１６回日本緑内障学会, 2005年09月, 日本語, 神戸, 国内会議Bland and Altman plot 解析による各種中心角膜厚測定方の比較
口頭発表（一般）
- 第１０９回日本眼科学会総会, 2005年03月, 日本語, 日本眼科学会, 京都, 国内会議ﾚｰｻﾞｰ虹彩切開術の角膜内皮細胞密度に及ぼす影響
口頭発表（一般）
- 第１０９回日本眼科学会総会, 2005年03月, 日本語, 日本眼科学会, 京都, 国内会議糖尿病ﾗｯﾄの網膜神経細胞におけるﾗﾀﾉﾌﾟﾛｽﾄのｱﾎﾟﾄｰｼｽ抑制効果の検討
口頭発表（一般）
- 第２４回神戸市立中央市民病院眼科ｵｰﾌﾟﾝｶﾝﾌｧﾗﾝｽ, 2005年03月, 日本語, 神戸市立中央市民病院, 神戸, 国内会議眼瞼下垂再手術例の検討 ﾚｰｻﾞｰ虹彩切開術（L1）と水疱性角膜症（BK)
口頭発表（一般）
- 第１０９回日本眼科学会総会, 2005年03月, 日本語, 日本眼科学会, 京都, 国内会議どこまでわかってるの？神経保護と眼疾患 NOﾄﾞﾅｰの網膜神経細胞に対する抗ｱﾎﾟﾄｰｼｽ抑制効果の検討
シンポジウム・ワークショップパネル（公募）
- 第２９回角膜カンファランス・第２１回日本角膜移植学会, 2005年02月, 日本語, 日本角膜移植学会, 徳島, 国内会議予防的ｱﾙｺﾞﾝﾚｰｻﾞｰ虹彩切開術後に生じた水疱性角膜症の検討
口頭発表（一般）
- 第２８回日本眼科手術学会, 2005年01月, 日本語, 日本眼科手術学会, 大阪, 国内会議ｲﾝｽﾄﾗｸｼｮﾝｺｰｽ 羊膜移植－疾患別治療戦略－
シンポジウム・ワークショップパネル（公募）
- 第５８回日本臨床眼科学会, 2004年11月, 日本語, 日本臨床眼科学会, 東京, 国内会議関西緑内障道場 -なやみの相談室-
シンポジウム・ワークショップパネル（公募）
- 第１０６回兵庫県眼科医会学術集談会, 2004年10月, 日本語, 兵庫県眼科医会, 神戸大学, 国内会議難治な血管新生緑内障に対する羊膜移植併用経毛様体扁平部濾過手術
口頭発表（一般）
- 第４２回日本神経眼科学会総会, 2004年10月, 日本語, 日本神経眼科学会, 名古屋, 国内会議相対的求心性瞳孔障害と光干渉断層計で測定した網膜神経線維層の関係
口頭発表（一般）
- 第１５回日本緑内障学会, 2004年09月, 日本語, 日本緑内障学会, 新潟, 国内会議非緑内障性視神経症における乳頭陥凹
口頭発表（一般）
- 第１５回日本緑内障学会, 2004年09月, 日本語, 日本緑内障学会, 新潟, 国内会議R28細胞におけるニプラジロールのNO/cGMP/PKG経路による抗アポトーシス作用
口頭発表（一般）
- 第１５回日本緑内障学会, 2004年09月, 日本語, 日本緑内障学会, 新潟, 国内会議GDx-VCC, 光干渉断層計、HRTの早期緑内障診断における比較検討
口頭発表（一般）
- 第１９回日本眼内レンズ屈折矯正学会, 2004年06月, 日本語, 日本眼内レンズ屈折矯正学会, 福岡, 国内会議閉塞隅角緑内障と白内障手術
口頭発表（一般）
- 第１１０回京都眼科学会, 2004年06月, 日本語, 京都眼科学会, 京都, 国内会議難治な血管新生緑内障に対する羊膜移植併用毛様体扁平部濾過手術
口頭発表（一般）
- 第２９回日本小児眼科学会、第60回日本弱視斜視学会, 2004年06月, 日本語, 日本小児眼科学会、日本弱視斜視学会, 沖縄, 国内会議小児白内障術後の近見、遠見視力発達
口頭発表（一般）
- 第１０８回日本眼科学会総会, 2004年04月, 日本語, 日本眼科学会, 東京, 国内会議ﾌﾟﾛｽﾀｸﾞﾗﾝﾃﾞｨﾝＦ２α関連薬のＲ２８細胞に対する抗ｱﾎﾟﾄｰｼｽ作用
口頭発表（一般）
- 第１０８回日本眼科学会総会, 2004年04月, 日本語, 日本眼科学会, 東京, 国内会議糖尿病ﾗｯﾄ網膜におけるｲﾝｽﾘﾝ情報伝達傷害
口頭発表（一般）
- 第１０回日本糖尿病眼学会, 2004年03月, 日本語, 日本糖尿病眼学会, 福岡, 国内会議慢性緑内障ﾗｯﾄ網膜神経細胞死に対する糖尿病の影響
口頭発表（一般）
- 第２７回日本眼科手術学会総会, 2004年01月, 日本語, 日本眼科手術学会, 東京, 国内会議羊膜移植併用濾過手術の術後短期成績
口頭発表（一般）
- 第４１回日本神経眼科学会, 2003年12月, 日本語, 日本神経眼科学会, 京都, 国内会議視神経疾患における乳頭周囲神経線維層厚と黄斑網膜厚の減少
口頭発表（一般）
- 第４１回日本神経眼科学会, 2003年12月, 日本語, 日本神経眼科学会, 京都, 国内会議視索症候群の網膜神経線維層厚
口頭発表（一般）
- 第４１回日本神経眼科学会, 2003年12月, 日本語, 日本神経眼科学会, 京都, 国内会議Band atrophyにおけるOCTによる網膜神経線維層厚の解析
口頭発表（一般）
- 第５７回日本臨床眼科学会, 2003年10月, 日本語, 日本臨床眼科学会, 名古屋, 国内会議線維柱帯切除術の術後中期成績～輪部基底結膜切開と円蓋部基底結膜切開の比較～
口頭発表（一般）
- 第６９回日本中部眼科学会、第１００回中国四国眼科学会, 2003年10月, 日本語, 日本中部眼科学会、中国四国眼科学会, 岡山, 国内会議線維柱帯切除術の術後中期成績～輪部基底結膜切開と円蓋部基底結膜切開の比較
口頭発表（一般）
- 第１０３回兵庫県眼科医会学術集談会, 2003年10月, 日本語, 日本眼科医会, 神戸大学, 国内会議線維柱帯切開術の術後中期成績～輪部基底結膜切開と円蓋部基底結膜切開の比較～
口頭発表（一般）
- 第６９回日本中部眼科学会、第１００回中国四国眼科学会, 2003年10月, 日本語, 日本中部眼科学会、, 岡山, 国内会議正常眼圧緑内障 診断の要点
シンポジウム・ワークショップパネル（公募）
- 第６９回日本中部眼科学会、第１００回中国四国眼科学会, 2003年10月, 日本語, 日本中部眼科学会、, 岡山, 国内会議上下半視野による光干渉断層計を用いた網膜神経線維層厚の解析
口頭発表（一般）
- 第５７回日本臨床眼科学会, 2003年10月, 日本語, 日本臨床眼科学会, 名古屋, 国内会議上下半視野におけるOCTによる網膜神経線維層厚の解析
口頭発表（一般）
- 第１０３回兵庫県眼科医会学術集談会, 2003年10月, 日本語, 日本眼科医会, 神戸大学, 国内会議上下半視野におけるOCTによる網膜神経線維層厚の解析
口頭発表（一般）
- 第３９回日本眼光学学会, 2003年09月, 日本語, 日本眼光学学会, 大阪, 国内会議スリット検査をマスターする ２．緑内障
口頭発表（一般）
- 北神戸眼科カンファレンス, 2003年07月, 日本語, 北神戸眼科, 神戸, 国内会議線維柱帯切除術合併症対策
口頭発表（一般）
- 第１４回日本緑内障学会, 2003年07月, 日本語, 日本緑内障学会, 東京, 国内会議眼圧変動に伴い視神経乳頭陥凹が著明な変化を繰り返した成人症例
口頭発表（一般）
- 第１４回日本緑内障学会, 2003年07月, 日本語, 日本緑内障学会, 東京, 国内会議ラット緑内障モデル網膜内アポトーシスへの糖尿病の影響
口頭発表（一般）
- 第１４回日本緑内障学会, 2003年07月, 日本語, 日本緑内障学会, 東京, 国内会議ラット慢性緑内障モデル網膜におけるAktの発現及びリン酸化
口頭発表（一般）
- 第１４回日本緑内障学会, 2003年07月, 日本語, 日本緑内障学会, 東京, 国内会議ウノブロストンイソプロピルのR２８細胞に対する保護作用
口頭発表（一般）
- 第１０９回京都眼科学会, 2003年06月, 日本語, 京都眼科学会, 京都, 国内会議糖尿病網膜症におけるニューロン、グリア、血管内皮の異常相互作用
口頭発表（一般）
- 第５９回日本弱視斜視学会総会、第２８回日本小児眼科学会総会合同学会, 2003年06月, 日本語, 日本弱視斜視学会、日本小児眼科学会, 神戸, 国内会議先天緑内障の治療戦略 -管理と予後-
シンポジウム・ワークショップパネル（公募）
- 第５９回日本弱視斜視学会総会、第２８回日本小児眼科学会総会合同学会, 2003年06月, 日本語, 日本弱視斜視学会、日本小児眼科学会, 神戸, 国内会議神経線維腫症に合併した先天緑内障の１例
口頭発表（一般）
- 第５９回日本弱視斜視学会総会、第２８回日本小児眼科学会総会合同学会, 2003年06月, 日本語, 日本弱視斜視学会、日本小児眼科学会, 神戸, 国内会議小児先天緑内障の治療戦略
シンポジウム・ワークショップパネル（公募）
- 第１０７回日本眼科学会総会, 2003年04月, 日本語, 日本眼科学会, 福岡, 国内会議トラベルレクトミーの術後合併症対策のトライアル
シンポジウム・ワークショップパネル（公募）
- 第１０７回日本眼科学会総会, 2003年04月, 日本語, 日本眼科学会, 福岡, 国内会議トラベルレクトミーの危機管理
シンポジウム・ワークショップパネル（公募）
- 第２６回日本眼科手術学会, 2003年01月, 日本語, 日本眼科手術学会, 京都, 国内会議眼圧の変動に伴い視神経乳頭陥凹が著明に縮小/拡大した成人症例
口頭発表（一般）
所属学協会
共同研究・競争的資金等の研究課題
- 学術研究助成基金助成金, 基盤研究C, 2022年04月 - 2024年03月, 研究代表者乳酸シャトル概念に基づく網膜・視神経変性疾患の病態解明と治療法の探索
- 学術研究助成基金助成金／基盤研究(C), 2018年04月 - 2021年03月, 研究代表者
競争的資金
- 学術研究助成基金助成金／基盤研究(C), 2017年04月 - 2020年03月
競争的資金
- 学術研究助成基金助成金／基盤研究(C), 2014年04月 - 2017年03月, 研究代表者
競争的資金
- 国立大学法人筑波大学, 臨床研究等ＩＣＴ基盤構築・人工知能実装研究事業, 2017年, 研究代表者（AMED）次世代眼科医療を目指す、ICT/人工知能を活用した画像等データベースの基盤構築
競争的資金
- 学術研究助成基金助成金／基盤研究(C), 2011年, 研究代表者
競争的資金
- 科学研究費補助金／基盤研究(B), 2010年
競争的資金
- 科学研究費補助金／基盤研究(C), 2008年, 研究代表者
競争的資金
- 科学研究費補助金／基盤研究(B), 2007年
競争的資金
- 科学研究費補助金／基盤研究(B), 2005年
競争的資金
- 科学研究費補助金／基盤研究(C), 2005年, 研究代表者
競争的資金
- 文部省, 文部省科学研究費, 奨励研究A, 神戸大学, 1999年04月 - 1999年09月, 研究代表者視神経疾患における並列視覚情報処理障害様式の比較解析
- 文部省, 文部省科学研究費, 奨励研究A, 神戸大学, 1997年04月 - 1999年03月, 研究代表者遺伝伝子変異をもつレーベル病の視機能障害の特徴と発症誘発因子の解析
- 文部省, 文部省科学研究費, 奨励研究A, 神戸大学, 1996年04月 - 1997年03月, 研究代表者ミトコンドリアDNA変異をもつレーベル遺伝性視神経症症例の視機能障害の解析