Macular Degeneration: Tsukahara S

Kashiwagi K, Shibuya T, Tsukahara S. · Department of Ophthalmology, University of Yamanashi, Faculty of Medicine, Yamanashi 409-3898, Japan. · Jpn J Ophthalmol. · Pubmed #15692772 No free full text.

Abstract: PURPOSE: To determine the proportion of age-related ophthalmologic diseases discovered in a healthy Japanese adult population, as well as to evaluate the age-related changes in intraocular pressure (IOP) in this population during a 10-year period. METHODS: Ophthalmologic surveys were conducted in 1988 and 1998 at Tamaho-cho in Yamanashi Prefecture. The target population of the first survey was 1389 subjects over 40 years of age, and of these, 1250 subjects (473 men and 777 women) participated in the survey. Their mean age was 57.8 +/- 11.9 years. Of these 1250 subjects, 245 subjects participated in the second ophthalmologic survey in 1998. The cases of glaucoma or age-related ophthalmologic diseases developing over the intervening 10-year period were determined among the subjects who had been diagnosed with no ophthalmologic abnormalities in the 1988 survey. We also compared the IOP values of the 219 subjects who were diagnosed with no ophthalmologic abnormalities in either the 1988 or the 1998 survey. RESULTS: The number of cases in the 1998 survey with newly discovered ocular diseases were as follows: two cases (0.82%) of normal-tension glaucoma, two cases (0.82%) of epiretinal membrane, one case (0.41%) of age-related macular degeneration, one case (0.41%) of angle-closure glaucoma, and one case (0.41%) of branch retinal vein occlusion. The mean IOP of the 219 subjects diagnosed with no ophthalmic abnormalities in either survey was 13.88 +/- 3.04 mmHg in 1988, which declined significantly to 13.16 +/- 2.75 mmHg in 1998 (P < 0.0001). CONCLUSIONS: The 10-year follow-up of the 245 subjects participating in both surveys showed one or two de novo cases of age-related macular degeneration, epiretinal membrane, branch retinal vein occlusion, normal-tension glaucoma, or angle-closure glaucoma. IOP was found to decline significantly with age.

Tokunaga T, Kashiwagi K, Saito J, Kobayashi K, Kobori Y, Abe K, Tsukahara S. · Iida Hospital, Iida, Nagano, Japan. · Jpn J Ophthalmol. · Pubmed #12543193 No free full text.

Abstract: BACKGROUND: Although there have been reports of adverse effects after use, it is unclear whether latanoprost ophthalmic solution contributes to the development of cystoid macular edema (CME). CASE: A 71-year-old man underwent lens extraction, the insertion of an intraocular lens, and vitrectomy for elevated intraocular pressure (IOP) associated with lens subluxation in the left eye. After the surgery, antiglaucoma ophthalmic solutions controlled IOP well for over a year, maintaining good visual acuity with no abnormalities in the fundus. OBSERVATIONS: Two months after the previously prescribed antiglaucoma ophthalmic solutions were replaced by latanoprost, the patient's visual acuity decreased and CME developed. When latanoprost was replaced by other antiglaucoma ophthalmic solutions for controlling IOP, CME disappeared and visual acuity returned to the base level. CONCLUSIONS: Latanoprost may be involved in the development of CME. Patients who have undergone vitreous surgery or those with aphakia should be carefully observed for the possible development of CME associated with the use of latanoprost, even a long time after surgery.

Furuichi M, Chiba T, Abe K, Kogure S, Iijima H, Tsukahara S, Kashiwagi K. · Department of Ophthalmology, Yamanashi Medical University, Tamaho, Japan. · J Glaucoma. · Pubmed #11442189 No free full text.

Abstract: PURPOSE: To study prospectively using optical coherence tomography (OCT) whether topical latanoprost induces retinal disorders, such as cystoid macular edema, in patients with glaucoma and a normally functioning blood-ocular barrier. METHODS: Sixty-eight eyes of 38 patients with glaucoma and no history of intraocular surgery, uveitis, or laser trabeculoplasty were studied. Before initiation of latanoprost treatment and after 1, 3, and 6 months of treatment, OCT images were taken, and the following tests were performed: visual acuity examination, fundus ophthalmoscopy, intraocular pressure measurement, and fundus color photography. To evaluate retinal thickness in the fovea accurately. OCT scanning was repeated six times, and the smallest value was used as the retinal thickness in the fovea. RESULTS: Latanoprost ophthalmic solution did not influence retinal thickness in the fovea at any investigated time points compared with the time before instillation, and no changes were observed in visual acuity, ophthalmoscopic findings, and fundus photographs. The intraocular pressure was reduced significantly at all investigated time points compared with the time before instillation. CONCLUSIONS: It is unlikely that topical latanoprost induces retinal disorders, such as cystoid macular edema, in glaucomatous eyes with a normally functioning blood-ocular barrier.

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.

Hirakawa H, Iijima H, Gohdo T, Tsukahara S. · Department of Ophthalmology, Yamanashi Medical University, Tamaho, Japan. · Am J Ophthalmol. · Pubmed #10458174 No free full text.

Abstract: PURPOSE: To detect cystoid macular edema in consecutive eyes with retinitis pigmentosa by means of optical coherence tomography and to study the correlation between cross-sectional structures and angiographic findings in cystoid macular edema. METHODS: In a prospective study, cross-sectional images through the fovea were evaluated by means of optical coherence tomography in 89 phakic eyes of 46 patients with retinitis pigmentosa. Eyes showing cystoid appearance in the macula in the optical coherence tomographic images were further studied with measurement of the dimensions of cystoid lesions and with a fluorescein angiogram either at 18 minutes after dye injection or later. RESULTS: Cystoid lesions were observed in the macula in optical coherence tomographic images in 12 eyes in six (13%) of 46 patients. In these eyes, the width of total area of the cystoid lesions was positively correlated with the grade of fluorescein angiogram (Spearman rank correlation coefficient, r = .629; P = .029), but the thickness of the neurosensory retina at the center of the fovea was not. Among three variables for grading cystoid macular edema, consisting of angiographic grade, thickness of the neurosensory retina at the center of the fovea, and width of total area of the cystoid lesions, only the last measure was significantly correlated with best-corrected visual acuity (Pearson correlation coefficient, r = .693; P = .012). CONCLUSION: Cystoid macular edema in eyes with retinitis pigmentosa could easily be detected with the use of optical coherence tomography independent of the angiographic degree of dye leakage. The size of cystoid lesions demonstrated in the optical coherence tomographic images, especially the thickness of the neurosensory retina at the center of the fovea, was not necessarily correlated with the angiographic grading of dye leakage. Measurement of the width of total area of the cystoid lesions in the optical coherence tomographic images is significantly correlated with the loss of visual acuity.