Macular Degeneration: Iida T

Iida T. · No affiliation provided · Nippon Ganka Gakkai Zasshi. · Pubmed #18949908 No free full text.

This publication has no abstract.

Iida T. · No affiliation provided · Br J Ophthalmol. · Pubmed #17372335 No free full text.

This publication has no abstract.

Gotoh N, Nakanishi H, Hayashi H, Yamada R, Otani A, Tsujikawa A, Yamashiro K, Tamura H, Saito M, Saito K, Iida T, Matsuda F, Yoshimura N. · Department of Ophthalmology, Kyoto University Graduate School of Medicine, Kyoto, Japan. · Am J Ophthalmol. · Pubmed #19268887 No free full text.

Abstract: PURPOSE: To determine the characteristics of the polymorphisms in the ARMS2 gene in Japanese patients with age-related macular degeneration (AMD) and those with polypoidal choroidal vasculopathy (PCV) and in healthy controls, and also to show possible associations of the polymorphisms with the disease. DESIGN: Case-control association study. METHODS: Fifty-six unrelated Japanese individuals with AMD, 55 with PCV, and 77 controls were studied. The most common polymorphism in the ARMS2 gene on chromosome 10 was resequenced. Association tests were performed for inferred haplotypes. RESULTS: A total of 22 polymorphisms were identified, and 13 were shared with those in White persons with AMD. The sequence of the deletion-and-insertion polymorphism, de1443ins54, a functional polymorphism causing an instability of the messenger ribonucleic acid of ARMS2 in the Japanese, did not differ from that in White persons. Among the polymorphisms seen in the White population, rs10490923 (R3H) as well as 7 other polymorphisms were not observed in the Japanese. One haplotype, which contained the T allele of the rs10490924 (A69S) and the variant of de1443ins54 polymorphism, had an odds ratio of 3.14 (P = 7.8 x 10(-6)) for AMD and 2.00 (P = .0058) for PCV. Among the 9 polymorphisms that were unique to the Japanese population, 2 had a minor allelic frequency of more than 0.05, and these 2 polymorphism were included as nonrisk haplotypes. CONCLUSIONS: The de1443ins54 polymorphism is a common variant between White and Japanese populations. It is strongly associated not only with AMD but also with PCV.

Gotoh N, Yamada R, Nakanishi H, Saito M, Iida T, Matsuda F, Yoshimura N. · Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan. · Clin Experiment Ophthalmol. · Pubmed #18939352 No free full text.

Abstract: BACKGROUND: Typical exudative age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV) are two of the major macular diseases found in Asians. Although genomic studies have shown a contribution by CFH and LOC387715/HTRA1 polymorphisms to the development of these two diseases, the correlation of the clinical phenotypes to these genotypes has not been determined in Asian patients. METHODS: The prevalence of the CFH Y402H and HTRA1 rs11200638 genotypes was determined in 116 patients with typical exudative AMD and in 204 patients with PCV. Potential correlations of these polymorphisms were tested retrospectively and cross-sectionally for bilaterality of the disease, final visual acuity and the greatest linear dimension of the choroidal neovascular (CNV) lesion. RESULTS: There was no significant difference in the incidence of CFH Y402H (P = 0.598) and HTRA1 rs11200638 (P = 0.290) between eyes with typical exudative AMD and with PCV. There was a significant association between the lesion size and HTRA1 rs11200638. For eyes with typical AMD, the size of the lesion (6363 +/- 2837 microm) was significantly larger in the high-risk homozygous group (AA), than in the low-risk homozygous group (GG) (3866 +/- 1947 microm; P = 0.0003). The same tendency was observed for the size of the lesion in PCV cases (homozygous group: 6347 +/- 2673 microm, non-risk homozygous group: 4405 +/- 2066 microm, P = 1.3 x 10(-5). CONCLUSIONS: A common genetic background may exist between typical exudative AMD and PCV patients. Among the patients with these two clinical entities, those with a homozygous HTRA1 rs11200638 risk allele had larger CNV lesions.

Saito M, Iida T, Nagayama D. · Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Japan. · Br J Ophthalmol. · Pubmed #18782798 No free full text.

Abstract: AIM: To evaluate outcomes after photodynamic therapy (PDT) with verteporfin in Japanese patients with age-related macular degeneration (AMD) or polypoidal choroidal vasculopathy (PCV) and compare results with the presence/absence of a retinal pigment epithelial detachment (PED). METHODS: We retrospectively reviewed 183 eyes with subfoveal choroidal neovascularisation secondary to AMD with more than 3 months' follow-up (range 3 to 36; mean 15.6). A serous PED developed in 44 of 183 eyes. RESULTS: A total of 124 eyes (67.8%) completed 12 months' follow-up. In 49 eyes with typical AMD, the best-corrected visual acuity (BCVA) improved a mean of 0.48 line. A significant (p<0.05 to p<0.0005) decline in VA occurred in eyes with a serous PED during any 3-month period. In 75 eyes with PCV, the BCVA at 12 months improved a mean of 1.79 lines. There was no significant difference between the BCVA in 22 eyes with a PED and 53 eyes without a PED during any 3 months. CONCLUSIONS: In eyes with typical AMD, a serous PED was associated with a significant decline in BCVA compared with eyes without a serous PED. In eyes with PCV, the visual outcomes were unaffected by a serous PED. When PDT is administered, differentiating PCV from typical AMD using indocyanine green angiography is important.

Shimura M, Nakazawa T, Yasuda K, Shiono T, Iida T, Sakamoto T, Nishida K. · Department of Ophthalmology, NTT East Japan Tohoku Hospital, Sendai, Miyagi, Japan. · Am J Ophthalmol. · Pubmed #18328456 No free full text.

Abstract: PURPOSE: To compare the effect of an intravitreal injection of bevacizumab, an anti-vascular endothelial growth factor (VEGF) antibody, with that of triamcinolone acetonide, a corticosteroid for reduction of diabetic macular edema (DME). DESIGN: Prospective, comparative interventional case series. METHODS: Twenty-eight eyes of 14 patients with bilateral DME participated in this study. In each patient, one eye received an intravitreal injection of 4 mg triamcinolone acetonide and the other eye received 1.25 mg bevacizumab. The clinical course of best-corrected visual acuity (VA) with a logarithm of the minimum angle of resolution chart and averaged foveal thickness using optical coherence tomography was monitored for up to 24 weeks after the injection. RESULTS: Before the injection, foveal thickness and VA were 522.3 +/- 91.3 microm and 0.64 +/- 0.28 microm in the triamcinolone-injected eye, and 527.6 +/- 78.8 microm and 0.61 +/- 0.18 microm in the bevacizumab-injected eye, respectively; there was no significant difference between the eyes. One week after the injection, both eyes showed significant regression of macular edema. The triamcinolone-injected eye (342.6 +/- 85.5 microm and 0.33 +/- 0.21 microm) showed significantly better results than the bevacizumab-injected eye (397.6 +/- 103.0 microm and 0.37 +/- 0.17 microm). However, both eyes showed the recurrence of macular edema with time, even at 24 weeks. Triamcinolone (410.4 +/- 82.4 microm and 0.47 +/- 0.25 microm) kept better results than bevacizumab (501.6 +/- 92.5 microm and 0.61 +/- 0.17 microm). CONCLUSIONS: With the generally used concentration, intravitreal injection of triamcinolone acetonide showed better results in reducing DME and in the improvement of VA than that of bevacizumab, suggesting that the pathogenesis of DME is not only attributable to VEGF-dependency, but is also attributable to other mechanisms suppressed by corticosteroid.

Koizumi H, Iida T, Saito M, Nagayama D, Maruko I. · Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, 960-1295, Japan. · Graefes Arch Clin Exp Ophthalmol. · Pubmed #17972093 No free full text.

Abstract: PURPOSE: To investigate the association between choroidal perfusion and retinal angiomatous proliferation (RAP). METHODS: We performed indocyanine green angiography (ICGA) on 26 eyes of 13 consecutive patients with RAP, and 17 eyes of 17 age-matched controls without age-related macular degeneration. In eyes with RAP and concurrent pigment epithelial detachments (PEDs), we evaluated ICGA images obtained after the PEDs resolved following treatment. Of the 26 eyes in the study group, five eyes with stage 3 RAP or a disciform scar and two eyes that underwent photodynamic therapy were excluded from further evaluation, leaving 19 eyes (11 eyes with stage 1 or 2 RAP and eight fellow eyes without RAP). RESULTS: Early decreased choroidal filling (EDCF) was observed in nine (81.8%) of 11 eyes with RAP and five (62.5%) of eight fellow eyes without RAP. Late decreased choroidal filling (LDCF) occurred in nine (81.8%) of 11 eyes with RAP and four (50%) of eight fellow eyes without RAP. The incidence of EDCF and LDCF was significantly higher in eyes with RAP than in the control eyes (p < 0.05, p < 0.01, respectively). CONCLUSIONS: Persistent decreased choroidal filling is common in early-stage RAP. Clinicians should be aware of this, especially when considering treatment.

Maruko I, Iida T, Saito M, Nagayama D, Saito K. · Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan. · Am J Ophthalmol. · Pubmed #17509509 No free full text.

Abstract: PURPOSE: To clarify the clinical characteristics of exudative age-related macular degeneration (AMD) in Japanese patients. DESIGN: Retrospective, observational, consecutive case series. METHODS: Two hundred and eighty-nine patients with neovascular AMD were examined. RESULTS: The authors classified the patients into three subtypes of neovascular AMD: polypoidal choroidal vasculopathy (PCV), retinal angiomatous proliferation (RAP), and typical AMD. One hundred and fifty-eight patients (54.7%) were diagnosed with PCV and 102 patients (35.3%) with typical AMD. RAP was observed in 13 patients (4.5%). In 16 patients (5.5%), one eye had PCV and the other eye had typical AMD. Most patients with PCV and typical AMD had unilateral disease (81.6% and 94.1%, respectively) with a male preponderance (77.8% and 71.6%, respectively). Nine of 13 patients with RAP were female (69.2%). Patients with RAP were older (mean, 80.3 years for men and 75.3 years for women) than patients with other subtypes. Serous and hemorrhagic pigment epithelial detachment developed in 69 patients (43.7%) with PCV, 22 patients (21.6%) with typical AMD, and nine patients (69.2%) with RAP. In the patients with unilateral disease in each subtype, large drusen in the unaffected eye were seen in 24.0% with PCV, 30.2% with typical AMD, and 77.8% with RAP. CONCLUSIONS: Neovascular AMD in Japanese patients has different demographic features compared with that in White patients. In Japanese patients, there is a preponderance of PCV, male gender, unilaterality, and absence of drusen in the second eye, with the exception of RAP.

Sekiryu T, Iida T. · Department of Ophthalmology, Fukushima Medical University School of Medicine, Fukushima, Japan. · Retina. · Pubmed #17290201 No free full text.

Abstract: PURPOSE: To observe the persistence of infrared fluorescence after indocyanine green (ICG)-assisted vitrectomy. METHODS: Eighteen consecutive patients underwent ICG-assisted vitrectomy for eyes with macular holes, epiretinal membranes, diabetic macular edema, and macular edema due to retinal vein occlusion. The internal limiting membrane was peeled after staining with 0.42% ICG solution. Postoperative observation of fundus infrared fluorescence was carried out using Heidelberg Retina Angiography (Heidelberg, Germany). RESULTS: Within a few months after surgery, intense fluorescence was observed around the macular hole and on the optic disk, photocoagulation scars, and the optic nerve fiber and was especially strong in the area along the vascular arcade. At the final visit (16-36 months after surgery), 12 (67%) of 18 eyes had infrared fluorescence that included fluorescence corresponding to the macular hole, retinal edema, and photocoagulation scars. The fluorescence over chorioretinal atrophy in a highly myopic eye disappeared compared with the area having an intact retinal pigment epithelium. CONCLUSIONS: Infrared fluorescence from ICG persists for 16 months to 36 months after ICG-assisted vitrectomy. ICG introduced directly into the vitreous cavity may remain in the eye over years. Careful long-term observation for the adverse effects of ICG is needed.

Maruko I, Iida T, Spaide RF, Kishi S. · Department of Ophthalmology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima, Japan. · Am J Ophthalmol. · Pubmed #16678528 No free full text.

Abstract: PURPOSE: To report the peripheral abnormalities seen only with indocyanine green angiography in patients with vitelliform macular dystrophy (Best disease, caused by a mutation in the bestrophin gene). DESIGN: Observational case report series. METHODS: Eight eyes of four patients, two with only a central macular lesion and two with multifocal lesions, were studied. Results of indocyanine green angiography were compared with findings from ophthalmoscopy and fluorescein angiography. RESULTS: Throughout the fundus periphery, indocyanine green angiography demonstrated a number of hyperfluorescent spots in all eight eyes. The spots were observed in the midperiphery and the periphery in areas with no abnormality visible by ophthalmoscopy or fluorescein angiography. CONCLUSIONS: Although Best disease generally causes lesions visible in the posterior pole, the extensive distribution of the hyperfluorescent spots is consistent with the wide-ranging abnormalities of the retinal pigment epithelium, Bruch membrane, and the choroid as seen histopathologically.

Sato T, Iida T, Hagimura N, Kishi S. · Department of Ophthalmology, Gunma University School of Medicine, Maebashi, Gunma, Japan. · Retina. · Pubmed #15579989 No free full text.

Abstract: PURPOSE: To correlate optical coherence tomography (OCT) with angiographic signs of choroidal neovascularization (CNV) in retinal pigment epithelial detachment (PED) associated with age-related macular degeneration (ARMD). METHODS: Prospectively, the authors performed OCT in 35 eyes of 35 patients (30 men and 5 women with a mean age of 71.6 years [range, 56-76 years]) with ARMD. All 35 eyes had CNV in the area of PED or adjacent to it, which was shown by fluorescein or indocyanine green angiography. Cross-sectional images were obtained by the OCT scanning line through the CNV and PED. RESULTS: In 10 (56%) of 18 eyes in which the CNV was at the margin of the PED, a small PED was adjacent to the central, dome-shaped PED. There was a notch between the central and small mounds of PED. In 13 (76%) of 17 eyes in which the CNV was within the PED, a notch was seen in the dome-shaped PED, resulting in a contour with 2 mounds. One of the 2 mounds contained a highly reflective mass immediately beneath the detached retinal pigment epithelium in 8 (62%) of the 13 eyes. CONCLUSION: A tomographic notch in the PED may be diagnostically important as an indication of CNV beneath the detached retinal pigment epithelium in eyes with ARMD.

Sato T, Kanda T, Iida T, Takahashi T, Kishi S, Hoshino Y. · Department of Ophthalmology, Gunma University School of Medicine, Gunma, Japan. · J Int Med Res. · Pubmed #14587307 No free full text.

Abstract: We carried out an immunohistochemical investigation of the choroidal neovascular membranes from 12 eyes surgically excised as a result of age-related macular degeneration (n = 6) or idiopathic choroidal neovascularization (n = 6). Immunohistochemical staining was performed with antibodies specific for basic transcriptional element binding protein-2, actin or smooth muscle cell 1. In all membranes, the endothelial cells and stromal components around the vessels were immunoreactive for expression of basic transcriptional element binding protein-2, while immunoreactive expression of actin and smooth muscle cell type 1 was found in the surrounding stromal cells. These results suggest that basic transcriptional element binding protein-2, a zinc finger transcription factor, may contribute to the establishment of the choroidal neovascularization observed in the pathogenesis of age-related macular degeneration and idiopathic choroidal neovascularization.

Iida T, Yannuzzi LA, Spaide RF, Borodoker N, Carvalho CA, Negrao S. · Department of Ophthalmology, Fukushima Medical University School of Medicine, Japan. · Retina. · Pubmed #12652224 No free full text.

Abstract: PURPOSE: To describe the optical coherence tomography (OCT) and fluorescein angiography findings in the macula of eyes with chronic central serous chorioretinopathy (CSC) and reduced central vision. METHODS: Using OCT, clinical examination, and fluorescein and indocyanine green (ICG) angiography, the authors examined eight eyes of seven patients with CSC, an attached macula, and reduced central vision of 20/200 or worse. All had a history of chronic CSC with resolution of the subretinal fluid in the macular area and poor vision. RESULTS: Patient ages ranged from 55 to 82 years (mean, 66 years). All eight eyes had some parafoveal, patchy RPE atrophy with corresponding transmission hyperfluorescence (window defect) on fluorescein angiography. Five eyes also had a window defect in the foveal area. With OCT, the foveal area revealed variable areas of cystoid change and atrophy in seven of the eight eyes. In four of these eyes, the cystoid changes were not seen on clinical examination or fluorescein angiography. The seven eyes with cystoid changes imaged with OCT had no intraretinal leakage of fluorescein in the foveal region. The authors categorized these eyes as having cystoid macular degeneration (CMD). One other eye had foveal thinning or atrophy without cystoid changes. CONCLUSIONS: Intraretinal cystoid spaces without intraretinal leakage, or CMD, was a common finding in eyes with chronic CSC and reduced central vision after resolution of subretinal fluid. OCT was useful to establish the presence of CMD and foveal atrophy, even when these changes were not clearly evident on clinical examination or fluorescein angiography. Chronic foveal detachment and antecedent intraretinal leakage were proposed to be the mechanisms for the development of the changes. CMD in conjunction with foveal atrophy was an important clinical finding to account for the poor visual outcome in patients with CSC.

Yannuzzi LA, Negrão S, Iida T, Carvalho C, Rodriguez-Coleman H, Slakter J, Freund KB, Sorenson J, Orlock D, Borodoker N. · LuEsther T. Mertz Retinal Research Center of Manhattan Eye, Ear and Throat Hospital, New York, New York 10021, USA. · Retina. · Pubmed #11642370 No free full text.

Abstract: BACKGROUND: It is known that choroidal neovascularization (CNV) in age-related macular degeneration (ARMD) may erode through the retinal pigment epithelium, infiltrate the neurosensory retina, and communicate with the retinal circulation in what has been referred to as a retinal-choroidal anastomosis (RCA). This is extremely common in the end stage of disciform disease. In recent years, the reverse also seems to be possible, as angiomatous proliferation originates from the retina and extends posteriorly into the subretinal space, eventually communicating in some cases with choroidal new vessels. This form of neovascular ARMD, termed retinal angiomatous proliferation (RAP) in this article, can be confused with CNV. PURPOSE: The purpose of this article is 1) to review the clinical and angiographic characteristics of a series of patients with RAP and 2) to propose a theoretical sequence of events that accounts for the neovascularized process. METHODS: In this retrospective clinical and angiographic analysis, 143 eyes with RAP (108 patients) were reviewed and classified based on their vasogenic nature and course. Clinical biomicroscopic examination, fluorescein angiography, and indocyanine green angiography were used to evaluate patients. RESULTS: The results of this series suggest that angiomatous proliferation within the retina is the first manifestation of the vasogenic process in this form of neovascular ARMD. Dilated retinal vessels and pre-, intra-, and subretinal hemorrhages and exudate evolve, surrounding the angiomatous proliferation as the process extends into the deep retina and subretinal space. One or more dilated compensatory retinal vessels perfuse and drain the neovascularization, sometimes forming a retinal-retinal anastomosis. Fluorescein angiography in these patients usually revealed indistinct staining simulating occult CNV. Indocyanine green angiography was useful to make an accurate diagnosis in most cases. It revealed a focal area of intense hyperfluorescence corresponding to the neovascularization ("hot spot") and other characteristic findings. Based on understanding of the nature and progression of the neovascularized process, patients with RAP were classified into three vasogenic stages. Stage I involved proliferation of intraretinal capillaries originating from the deep retinal complex (intraretinal neovascularization [IRN]). Stage II was determined by growth of the retinal vessels into the subretinal space (subretinal neovascularization [SRN]). Stage III occurred when CNV could clearly be determined clinically or angiographically. A vascularized pigment epithelial detachment and RCA were inconsistent features of this stage. CONCLUSIONS: Retinal angiomatous proliferation appears to be a distinct subgroup of neovascular ARMD. It may present in one of three vasogenic stages: IRN, SRN, or CNV. Whereas ICG angiography is helpful in diagnosing RAP and in documenting the stage of the neovascularized process, it is frequently difficult to determine the precise nature and location of the new vessel formation. It is important for clinicians to recognize the vasogenic potential and the associated manifestations of this peculiar form of neovascular ARMD so that a proper diagnosis can be made, and when possible, an appropriate management administered.

Iijima H, Iida T, Imai M, Gohdo T, Tsukahara S. · Department of Ophthalmology, Yamanashi Medical University, Tamaho, Japan. · Am J Ophthalmol. · Pubmed #10653408 No free full text.

Abstract: PURPOSE: To study the cross-section images of orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy and compare their protrusions quantitatively with those of serous retinal pigment epithelium detachment. METHODS: Optical coherent tomography images scanning remarkable orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy and serous retinal pigment epithelium detachment in age-related macular degeneration or central serous chorioretinopathy were prospectively recorded. The correlation between the base diameter and the height of the lesions was analyzed. RESULTS: Optical coherence tomography images show prominent anterior protrusion of the orange-red lesions. The ratio of the height to the base diameter of the orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy is 0.32+/-0.05, and it is significantly larger than lesions in eyes with serous retinal pigment epithelium detachment (0.18+/-0.05, P< .001). CONCLUSION: The orange-red lesions in eyes with idiopathic polypoidal choroidal vasculopathy have a more sharply peaked shape than serous retinal pigment epithelium detachment as a subretinal structure, suggesting polypoidal vascular lesions in eyes with idiopathic polypoidal choroidal vasculopathy are situated beneath the Bruch membrane and covered anteriorly with both the retinal pigment epithelium and the Bruch membrane.

Sekiryu T, Iida T, Kaneko H, Saito M. · No affiliation provided · Jpn J Ophthalmol. · Pubmed #18991048 No free full text.

This publication has no abstract.

Gotoh N, Yamada R, Matsuda F, Yoshimura N, Iida T. · No affiliation provided · Am J Ophthalmol. · Pubmed #18573360 No free full text.

This publication has no abstract.