研究者紹介システム
| 中西 裕子 |  |
| ナカニシ ユウコ | |
| 大学院医学研究科 医科学専攻 | |
| 准教授 | |
| 医学 |
研究活動
研究分野
受賞
1999年 日本弱視斜視学会, 廣石賞, Differential expression of immediate-early genes, c-fos and zif268, in the visual cortex of young rats: effects of a noradrenergic neurotoxin on their expression. Yamada Y, Hada Y, Imamura K, Mataga N, Watanabe Y, Yamamoto M. Neuroscience. 1999;92
国内学会・会議・シンポジウム等の賞
論文
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
- 日本緑内障学会, 2023年09月, 日本緑内障学会抄録集, 34回, 197 - 197, 日本語原発開放隅角緑内障と血清・前房水乳酸濃度の関連についての検討
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）
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）
- (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: 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）
- 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
- 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）
- 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
- (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
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）
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
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
- 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
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- (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
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. 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
- 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- (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- (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
[査読有り]
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）
- 2019年10月, 臨床眼科 増刊号 実戦 メディカル眼科治療アップデート, 73 (11), 217 - 223, 日本語動眼・滑車・外転神経麻痺
[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
- 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
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, あたらしい眼科, 36 (6), 779 - 780, 日本語緑内障セミナー 小児緑内障の分類
[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), 311 - 311, 日本語前眼部OCTにより鑑別を行った結膜粘液腫の1例
[査読有り]
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）
- 2019年, Scientific Reports, 18 (9), 14990, 英語Relationship between vision-related quality of life and central 10° of the binocular integrated visual field in advanced glaucoma
[査読有り]
研究論文（学術雑誌）
- 2019年, Investigative ophthalmology & visual science, 60 (5), 1403 - 1411, 英語Discordance of disc-fovea raphe angles determined by optical coherence tomography and MP-3 microperimetry in eyes with a glaucomatous hemifield defect
[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, 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）
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 (13), 897 - 904, 英語, 国際誌[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[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
- 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]
- 2018年10月, Graefes Arch Clin Exp Ophthalmol, 256 (10), 1953 - 1960, 英語Effectiveness and safety of sulcus fixation of Baerveldt glaucoma implants in glaucomatous eyes in patients who underwent multiple intraocular surgeries
[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）
- 2018年08月, あたらしい眼科, 35 (8号), 1057 - 1065, 日本語【続発緑内障】 続発小児緑内障
[査読有り][招待有り]
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）
- 2018年07月, 眼科臨床紀要, 11 (7号), 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
[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）
- 2018年03月, 日本眼科学会雑誌, 122 (3号), 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
[査読有り]
研究論文（学術雑誌）
- 2018年03月, 日本眼科学会雑誌, 122 (臨増), 307, 日本語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
[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）
- 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）
- 2017年11月, 眼科臨床紀要, 10 (11号), 949, 日本語未熟児網膜症既往眼における中心窩無血管体についての検討
[査読有り]
研究論文（その他学術会議資料等）
- 2017年10月, 神経眼科, 34 (増補1), 66, 日本語両視神経症の診断に苦慮し剖検にて侵襲性アスペルギルス症と診断された一例
[査読有り]
研究論文（研究会，シンポジウム資料等）
- 2017年10月, 神経眼科, 34 (増補1), 110, 日本語上眼静脈血栓性静脈炎により視力低下・視野障害を生じた一例
[査読有り]
研究論文（研究会，シンポジウム資料等）
- 2017年10月, 神経眼科, 34 (増補1), 75, 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（研究会，シンポジウム資料等）
- 2017年10月, 神経眼科, 34 (増補1), 106, 日本語ぶどう膜炎と視神経症を発症し、生検にて確定診断に至った結核性肥厚性硬膜炎の1例
[査読有り]
研究論文（研究会，シンポジウム資料等）
- 2017年07月, 眼科臨床紀要, 10 (7号), 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
[査読有り]
研究論文（学術雑誌）
- 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）
- 2017年03月, 日本眼科学会雑誌, 121 (臨増), 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
[査読有り]
研究論文（研究会，シンポジウム資料等）
- 2017年03月, 日本眼科学会雑誌, 121 (臨増), 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
[査読有り]
研究論文（研究会，シンポジウム資料等）
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）
- 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]
- 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）
- 眼科臨床紀要会, 2016年04月, 眼科臨床紀要, 9 (4), 375 - 375, 日本語All-trans retinoic acidによる偽脳腫瘍を呈した急性前骨髄性白血病の一例
[査読有り]
- (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
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）
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
- (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), 290 - 290, 日本語未熟児網膜症既往眼の黄斑部における光干渉断層計所見と関連因子の検討
[査読有り]
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）
- 日本緑内障学会, 2014年09月, 日本緑内障学会抄録集, 25回, 114 - 114, 日本語アクアポリン9は乳酸輸送を介して網膜神経節細胞の生存を制御する
[査読有り]
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）
- 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）
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）
Purpose: To evaluate the precision of the IcareONE rebound tonometer, which was developed for self-measuring intraocular pressure (IOP) and to compare IcareONE measurement with Goldmann applanation tonometry (GAT). Methods: Twenty-four healthy eyes and 81 glaucomatous eyes were enrolled. IOP measurements (three times per session) with IcareONE were made in a random order by an ophthalmologist (Icare(O)) and by the subject (Icare(S)). Intraclass correlation coefficients (CCs), kappa values and mean values of IOP were compared among the two types of Icare recordings and GAT. Bland-Altman analysis was used to assess agreement between methods. Multiple regression analysis was performed to identify the subject factors that influenced the discordant measurements between IcareONE and GAT. Results: The mean value of Icare(O) and Icare(S) measurements was 13.5 ± 5.2 and 13.5 ± 5.4 mmHg, respectively, neither of which was significantly different from GAT (13.8 ± 4.4). The intrarater CC of Icare(O) and Icare(S) was 0.968 and 0.885, respectively. The intermethod CC and weighted kappa between Icare(O) and Icare(S) were 0.907 and 0.684, respectively. All pairwise correlations between the two types of IOP measurement showed coefficients of determination > 0.8. Bland-Altman analysis did not show any proportional biases. Multiple regression analysis revealed that the differences between GAT and Icare(O) or Icare(S) were positively correlated with central corneal thickness (CCT) and negatively correlated with age. Conclusions: Intraocular pressure measurements with IcareONE by a physician and by the subject showed excellent agreement with GAT measurements IcareONE measurements between a physician and the subject had high intrarater reliability, and good agreement thicker CCT led IcareONE measurement to overestimate IOP, while higher age caused it to underestimate IOP compared with GAT. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by Blackwell Publishing Ltd.
Blackwell Publishing Ltd, 2014年, Acta Ophthalmologica, 92 (3), 243 - 248, 英語[査読有り]
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05月, 眼科臨床紀要, 6 (5号), 408, 日本語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1例
研究論文（その他学術会議資料等）
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）
- 2013年03月, Frontiers in Glaucoma, (45号), 33 - 35, 日本語小児緑内障 小児緑内障における治療とその選択
研究論文（研究会，シンポジウム資料等）
- 2013年03月, 日本眼科学会雑誌, 117 (臨増), 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
研究論文（その他学術会議資料等）
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）
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）
- 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, 53, 日本語小児緑内障 小児緑内障における治療とその選択
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, 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, 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）
PURPOSE: Sweet's syndrome (SS) is a skin disorder clinically characterized by fever, neutrophilia, and painful edematous plaques that occasionally causes posterior uveitis. We present two cases of SS with panuveitis resembling Behçet's disease (BD). SUBJECTS: Two patients with panuveitis associated with SS. OBSERVATIONS: The patient in case 1 was a 57-year-old Japanese man who developed acute severe iritis with hypopyon in the left eye. Fluorescein angiography (FA) performed 1 month after treatment showed findings observed in posterior uveitis: dye leakage from the optic disc and a petaloid pattern of hyperfluorescence in the macular region. The patient in case 2 was a 64-year-old Japanese man who complained of blurred vision in his left eye. Faint flare and occasional cells were present in the left anterior chamber, 2+ cells in the anterior vitreous, and 2+ vitreous opacification in the left eye. FA demonstrated dye leakage from the optic disc and peripheral capillary vessels in both eyes. Both patients were diagnosed as having SS on the basis of fever, neutrophilia, elevated C-reactive protein, and skin biopsy results of neutrophilic infiltration without vasculitis. CONCLUSIONS: Differentiation of SS from BD based on the ocular manifestations is difficult. Ophthalmologists should bear in mind that SS can exhibit panuveitis resembling BD.
2012年05月, Japanese journal of ophthalmology, 56 (3), 268 - 72, 英語, 国内誌[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), 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）
- 2011年10月, 神経眼科, 28巻, 増補1, pp. 80-80, 日本語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
研究論文（国際会議プロシーディングス）
- 2011年09月, 日本緑内障学会抄録集22回, 巻, , pp. 99-99, 日本語乳頭周囲網膜神経線維層厚における眼球回旋の影響
研究論文（国際会議プロシーディングス）
- 2011年09月, 日本緑内障学会抄録集22回, 巻, , pp. 126-126, 日本語眼内レンズ嚢内固定眼に生じた色素緑内障の一例
研究論文（国際会議プロシーディングス）
- 2011年09月, 日本緑内障学会抄録集22回, 巻, , pp. 95-95, 日本語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
研究論文（国際会議プロシーディングス）
- 2011年06月, 眼科, 53巻, 6号, pp. 830-830, 日本語当院における視神経鞘髄膜腫の検討
研究論文（国際会議プロシーディングス）
- 2011年06月, 眼科臨床紀要, 4巻, 6号, pp. 583-584, 日本語多チャンネル多局所視覚誘発電位と視野の緑内障眼における構造変化との関連
研究論文（国際会議プロシーディングス）
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）
- 2011年05月, 眼科臨床紀要, 4巻, 5号, pp. 472-472, 日本語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
研究論文（国際会議プロシーディングス）
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）
- 2010年11月, 神経眼科, 27巻, 増補1, pp. 86-86, 日本語性ホルモン薬の長期内服が誘引と思われる脳静脈洞血栓症の1例
研究論文（国際会議プロシーディングス）
- 2010年10月, 日本眼科学会雑誌, 114巻, 10号, pp. 891-891, 日本語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
研究論文（国際会議プロシーディングス）
- 2010年10月, 眼科臨床紀要, 3巻, 10号, pp. 1021-1021, 日本語Melanoma-Associated Retinopathyの1例
研究論文（国際会議プロシーディングス）
- 2010年07月, 眼科臨床紀要, 3巻, 7号, pp. 701-702, 日本語日本人の正常眼における多チャンネル多局所視覚誘発電位の検討
研究論文（国際会議プロシーディングス）
- 2010年03月, 日本眼科学会雑誌, 114巻, 臨増, pp. 335-335, 日本語多チャンネル多局所視覚誘発電位による緑内障検出能の検討
研究論文（国際会議プロシーディングス）
- 2009年11月, 日本緑内障学会抄録集20回, 巻, , pp. 142-142, 日本語内境界膜剥離併用硝子体手術がラタノプロストによる黄斑浮腫のトリガーとなった正常眼圧緑内障の一例
研究論文（国際会議プロシーディングス）
- 2009年06月, 眼科臨床紀要, 2巻, 6号, pp. 564-564, 日本語小児白内障術後無水晶体眼における中心角膜厚の検討
研究論文（国際会議プロシーディングス）
- 2009年03月, 日本眼科学会雑誌, 113巻, 臨増, pp. 276-276, 日本語ディスポーザブルプリズムによるゴールドマン圧平眼圧計の測定値評価
研究論文（国際会議プロシーディングス）
- 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）
- 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）
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 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）
- 2008年03月, 眼科臨床紀要, 1巻, 3号, pp. 270-271, 日本語異なる手術術式を選択した高度近視に伴う進行性内斜視の母子例
研究論文（国際会議プロシーディングス）
- 2008年01月, Journal Of Neurochemistry, Vol. 105, No. 4, pp. 1187-97, 英語Oxidized low density lipoproteins induce a pathologic response by retinal pigmented epithelial cells
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）
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）
- 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, 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）
- 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]
- 日本神経眼科学会, 2003年12月, 神経眼科, 20 (増補1), 47 - 47, 日本語Band atrophyにおけるOCTによる網膜神経線維層厚の解析
[査読有り]
- 日本神経眼科学会, 2003年12月, 神経眼科, 20 (増補1), 79 - 79, 日本語視索症候群の網膜神経線維層厚
[査読有り]
- 2003年02月, 眼科臨床医報, 97巻, 2号, pp. 132-132, 日本語動脈瘤性骨嚢胞の1例
研究論文（国際会議プロシーディングス）
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）
MISC
- 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
- 2017年10月, OCULISTA, (55号), 55 - 65, 日本語【緑内障診療に役立つ検査ノウハウ】 ゴールドマン視野計
記事・総説・解説・論説等（商業誌、新聞、ウェブメディア）
- 2015年12月, 眼科, 57 (13), 1653 - 1660, 日本語視野異常を診断する 4. 遺伝性視神経症
[招待有り]
記事・総説・解説・論説等（学術雑誌）
- 2015年10月, 臨床眼科, 69 (11号), 307 - 311, 日本語【緑内障なんでも質問箱-エキスパートに聞いたら最新エビデンスをもとにズバリと答えてくれた!】 治療編 手術 濾過手術 羊膜を用いたトラベクレクトミーのメリット・デメリット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）
- 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Trabeculotomy with Schlemm's canal endothelium removal and deep sclerectomy
研究発表ペーパー・要旨（国際会議）
- 2014年10月, 眼科ケア, 16 (10号), 924 - 930, 日本語【エキスパートからノウハウを学ぶ!弱視・斜視スペシャルノート[疾患と治療編]】 弱視の治療
記事・総説・解説・論説等（学術雑誌）
- 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, 日本語記事・総説・解説・論説等（学術雑誌）
- 2012年10月, 眼科, 54 (11号), 1654 - 1658, 日本語緑内障3分診療を科学する! 乳頭の脆弱性 血管系と「100日」
記事・総説・解説・論説等（学術雑誌）
- 2012年09月, Frontiers in Glaucoma, (44号), 109 - 116, 日本語目でみるシリーズ 続・読影シリーズ(第5回) 紛らわしい例(その2) 眼底の異常(血管異常を含む)を伴う例
記事・総説・解説・論説等（学術雑誌）
- 2012年09月, Frontiers in Glaucoma, (44号), 126 - 134, 日本語災害時における緑内障診療
その他
- 2012年08月, 眼科ケア, 14 (8号), 704 - 708, 日本語【基礎知識がバッチリ!実践でそのまま役立つ斜視・弱視の原因、検査、治療】 病気について知ろう 弱視ってどんな病気?
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）
- 日本青年心理学会, 2012年, 青年心理学研究, 24 (1), 54 - 59, 日本語「大学生の心理的自立の要因ならびに適応との関連」へのコメントに対するリプライ
- 2011年06月, あたらしい眼科, 28巻, 6号, pp. 827-828, 日本語緑内障セミナー 羊膜移植併用緑内障手術
記事・総説・解説・論説等（学術雑誌）
The purpose of this study was to organize and define the concept of psychological independence in university students, and to examine its correlations with several influential factors and psychological adjustment. Psychological independence was defined as "exercising emotional, cognitive, and behavioral control over one's life, and being responsible for one's own behavior". The participants were 329 university students, who filled out a questionnaire. As the result of a factor analysis, psychological independence was distilled into 5 factors, namely "building self, "emotional control", "self-determination and responsibility", "positive attitude to life", and "unattained individuality". The results of a multiple regression analysis suggested: 1) psychological independence was significantly correlated with basic trust in both genders; 2) psychological independence in females was correlated positively with distant associations with friends; 3) emotional support from fathers was correlated negatively with psychological independence in females, whereas emotional support from mothers was positively correlated; and 4) in males there was little correlation between psychological independence and interpersonal factors. Another multiple regression analysis suggested that psychological independence was correlated with maladjustment, besides adjustment. The limitations and implications are discussed.
日本青年心理学会, 2011年, 青年心理学研究 = The Japanese journal of adlescent psychology, 23 (1), 1 - 18, 日本語- 2011年01月, 小児科診療, 74巻, 1号, pp. 68-74, 日本語【不定愁訴の子どもを診るために】 症状に応じたアプローチ 目が見えない(視覚障害)
その他
- 2010年07月, 眼科ケア, 12巻, 7号, pp. 654-662, 日本語【覚えておきたい! 眼圧検査で異常値が出る原因】 高眼圧の原因
その他
- 2009年12月, Frontiers in Glaucoma, 10巻, 3号, pp. 101-105, 日本語目で見るシリーズ 読影シリーズ まぎらわしい例(その2) 血管異常を含む眼底異常に伴う例
記事・総説・解説・論説等（学術雑誌）
- 2008年12月, 小児看護, 31巻, 13号, pp. 1734-1739, 日本語【目の病気における看護ケアのポイント 入院治療を要する重症眼疾患を対象に】 知っておきたい知識 先天性眼疾患 先天白内障、発達緑内障、眼瞼下垂
その他
- 2007年06月, 眼科ケア, 巻, 2007夏季増刊, pp. 210-225, 日本語【患児と親へのよりよい対応のために子どもの目の病気とケア】 実践編 子どもの検査をマスターしよう 形態評価
その他
- 2007年02月, 眼科ケア, 9巻, 2号, pp. 154-164, 日本語【緑内障の患者説明 正しい知識を伝えるための3ステップ】 疾患・検査・治療についての正しい知識を身に付ける! 緑内障ではこんな治療を行う
その他
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PURPOSE: To evaluate whether an index based on hole configuration can be used to predict visual outcome in eyes with idiopathic macular holes. DESIGN: Prospective interventional case series. METHODS: Thirty five eyes of 32 patients with idiom pathic stage 2 or 3 macular hole were enrolled in this study. The best-corrected visual acuity (BCVA), cross, sectional image of the macular hole by optical coherence tomography (OCT), and retinal thickness in the central ( < 1000 mum), inner (1000 to 2220 mum), and outer ring areas (2220 to 3450 mum) as defined by the OCT retinal mapping program were evaluated preoperatively and at 1, 3, 6, and 12 months postoperatively. The change in retinal thickness of the inner ring area at the 6,month postoperative period was used to evaluate the degree of preoperative retinal deformation. The macular hole index (MHI) (ratio of hole height to base diameter of hole) was calculated and correlated with minimum diameter of hole, base diameter of hole, the postoperative decrease in macular thickness, and the postoperative BCVA. The postoperative BCVA was further evaluated in two patient-matched groups. RESULTS: Retinal thickness values in the inner ring rea were decreased at the 1-month postoperative period. MHI significantly correlated with the postoperative de crease in macular thickness in the inner ring area at 6 months (correlation coefficient = -0.632, P = .030, Spearman analysis) and with the postoperative BCVA (P = .013, multiple regression analysis). Postoperative BCVA in the MHI greater than or equal to 0.5 group was better than that in the MHI < 0.5 group (P = .032, Mann,Whitney test). CONCLUSIONS: The MHI is a ratio easily calculated from OCT transverse images of the macular area. The MHI represents the preoperative configuration of a macular hole and is a prognostic factor for visual outcome. (C) 2004 by Elsevier Inc. All rights reserved.
ELSEVIER SCIENCE INC, 2004年11月, AMERICAN JOURNAL OF OPHTHALMOLOGY, 138 (5), 709 - 716, 英語- ASSOC RESEARCH VISION OPHTHALMOLOGY INC, 2004年04月, INVESTIGATIVE OPHTHALMOLOGY & VISUAL SCIENCE, 45, U405 - U405, 英語Evaluation of successful macular hole surgery by multifocal electroretinography
研究発表ペーパー・要旨（国際会議）
- 2004年, 臨床眼科, 58巻, 2, pp. 125-129, 日本語小学校低学年児童の近視
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. 76-101, 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 緑内障の検査
その他
書籍等出版物
- 脳眼動静脈つた状血管腫症（Wyburn-Mason症候群）, 総合医学社, 2019年10月, 日本語, ISBN: 9784883786862眼疾患アトラスシリーズ第2巻 後眼部アトラス
学術書
- 神経線維腫症（von Recklinghausen病）, 総合医学社, 2019年10月, 日本語, ISBN: 9784883786862眼疾患アトラスシリーズ第2巻 後眼部アトラス
学術書
- 部分調節性内斜視, 総合医学社, 2019年10月, 日本語, ISBN: 9784883786879眼疾患アトラスシリーズ第3巻 外眼部アトラス
学術書
- その他, 文光堂, 2016年09月, 日本語眼科検査ガイド第2版 / 9．視野検査 10)神経眼科疾患の視野検査 ４．中心フリッカー値
学術書
- その他, 文光堂, 2016年09月, 日本語眼科検査ガイド第2版 / 5．眼位・眼球運動検査 1)眼位検査 ４．固視検査
学術書
- その他, 文光堂, 2016年09月, 日本語眼科検査ガイド第2版 / 5．眼位・眼球運動検査 1)眼位検査 ３．単眼性眼位検査
学術書
- その他, 文光堂, 2016年09月, 日本語眼科検査ガイド第2版 / 5．眼位・眼球運動検査 1)眼位検査 ２．眼位定量検査
学術書
- その他, 文光堂, 2016年09月, 日本語眼科検査ガイド第2版 / 5．眼位・眼球運動検査 1)眼位検査 １．眼位定性検査
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シリーズ 緑内障治療のアップデート / 発達緑内障、小児続発緑内障
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シリーズ 緑内障治療のアップデート / 難治例の攻略法 小児緑内障
学術書
- その他, 文光堂, 2012年01月, 日本語眼手術学 緑内障 / 小児の緑内障濾過手術
学術書
- その他, 文光堂, 2012年01月, 日本語眼手術学 緑内障 / 小児の流出路再建術
学術書
- 共著, 文光堂, 2008年09月, 日本語眼科プラクティス / 【眼科薬物治療A to Z】 副作用と毒性 乳幼児・小児への投与時の注意点
学術書
- 共著, 文光堂, 2008年03月, 日本語眼科プラクティス / 【小児眼科診療】 疾患特性と診療指針 緑内障 発達緑内障
学術書
- 共著, メディカルレビュー社, 2007年12月, 日本語Frontiers in Glaucoma 8巻4号 Page200-201 / 緑内障とは 眼の構造・機能
学術書
- 共著, 文光堂, 2006年09月, 日本語眼科プラクティス / 【緑内障診療の進めかた】 基礎知識 無作為化比較試験から得たエビデンス EGPS
学術書
- 共著, 金原出版, 2003年04月, 日本語小児眼科・診療の最前線 / 大脳皮質一次視覚野の可塑性
学術書
- 共著, 先端技術研究所, 2003年, 日本語先端医療シリーズ23眼科 眼科の最新医療 / 白内障手術の進歩 ８ 小児ＩＯＬ
学術書
- 共著, 先端医療技術研究所, 2003年, 日本語先端医療シリーズ23眼科 眼科の最新医療 / 白内障手術の進歩 ８ 小児ＩＯＬ
学術書
- 共著, メディカ出版, 2003年, 日本語眼科ケア2003冬季増刊 眼科疾患別パーフェクトマニュアル / 緑内障検査
学術書
- 共著, メディカ出版, 2003年, 日本語改訂第３版眼科ナースのための知識と実際 / 小児眼疾患と看護
学術書
講演・口頭発表等
- 東灘区眼科講演＆甲南医療センター眼科 病診連携の会, 2019年12月14日, 日本語, 国内会議緑内障手術 ～神戸大学における現状と課題～
公開講演，セミナー，チュートリアル，講習，講義等
- 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
ポスター発表
- 第57回日本神経眼科学会総会, 2019年10月04日, 日本語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30回日本緑内障学会, 2019年09月06日, 日本語, 国内会議教育講演2【緑内障病型ごとのアプローチ】小児緑内障へのアプローチ
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4回 瓜坊の会, 2019年05月17日, 日本語, 国内会議小児眼科 Q&A
公開講演，セミナー，チュートリアル，講習，講義等
- 第123回日本眼科学会総会, 2019年04月18日, 日本語, 国内会議OCTによる上方視神経部分低形成の診断の試み
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, 国内会議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）
- 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）
- 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Spectral-domain OCTを用いたSSOHの網膜内構造の評価
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, 国内会議小児緑内障における治療とその選択
シンポジウム・ワークショップパネル（公募）
- 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）
- 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3分診療を科学する！」視神経乳頭の脆弱性：血管系と「100日」
公開講演，セミナー，チュートリアル，講習，講義等
- The 27th APAO/SOE Congress, 2012年04月, 英語, The Korean Ophthalmological Society, Busan,Korea, 国際会議Differential diagnosis of pediatric glaucoma
口頭発表（一般）
- 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21回日本緑内障学会, 2010年09月, 日本語, 日本緑内障学会, 福岡, 国内会議補助材料（薬剤）を利用した緑内障手術 羊膜移植を用いた緑内障手術
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）
- 21st EORTH-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics, 2009年11月, 英語, AACR, Boston, 米国, 国際会議A phase I study of sorafenib (BAY 43-9006) in combination with S-1 plus cisplatin in patients with advanced gastric cancer.
ポスター発表
- 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）