Language：English   Publisher：Graefe's Archive for Clinical and Experimental Ophthalmology  

Purpose: This study aimed to evaluate the factors associated with retinal pigment epithelium (RPE) tear development in the early phase after anti-vascular endothelial growth factor (VEGF) drug initiation in eyes with neovascular age-related macular degeneration (nAMD) and retinal pigment epithelial detachment (PED). Methods: Treatment-naive eyes with nAMD and PED for which anti-VEGF drug injections had been initiated and followed up for at least 3 months after the 1st anti-VEGF drug injection, were retrospectively investigated. Baseline characteristics of the PEDs, including type, height, and area, were evaluated using fundus photographs, fluorescein angiography, and optical coherence tomography images. The association between patient age, sex, medical history, PED characteristics, and the development of RPE tears within 3 months of starting anti-VEGF therapy was examined. Results: This study included 244 eyes (230 patients; mean age 75.0 years, 159 males and 71 females). RPE tears occurred in 13 eyes (5.3%) within 3 months of the start of anti-VEGF therapy. Multivariate analysis showed an association of the development of RPE tears with PED height (every 100 µm, odds ratio [OR]: 1.50, 95% confidence interval [CI]: 1.07–2.12, p = 0.019), PED area (every 10 mm2, OR: 3.02, CI: 1.22–7.46, p = 0.016), and the presence of fibrovascular PED (OR: 59.22, CI: 4.12–850.59, p = 0.002). Eyes with cleft (the hypo-reflective space beneath the fibrovascular PED) were more likely to develop an RPE tear (p = 0.01, χ-square test). Conclusions: Fibrovascular PED, large PED area, high PED height, and the cleft finding are independent risk factors for the development of RPE tears early after the administration of anti-VEGF drugs.

DOI： 10.1007/s00417-024-06503-z

Web of Science

Scopus

PubMed

Language：English   Publisher：Retinal Cases and Brief Reports  

Purpose:The aim of this study was to demonstrate the spatial pattern of retinal pigment epithelium (RPE) tear development and progression after antivascular endothelial growth factor therapy for neovascular age-related macular degeneration.Methods:We retrospectively reviewed six eyes with neovascular age-related macular degeneration that showed RPE tears after administration of intravitreal antivascular endothelial growth factor agents and were followed up for 12 months. The patterns of RPE tear development and progression were evaluated by analyzing positional relationships among the locations of the choroidal neovascularization membrane and pigment epithelial detachment (PED) area at baseline and the tear area using spectral-domain optical coherence tomography, color photography, fluorescein angiography, and fundus autofluorescence images.Results:Pretear OCT images revealed fibrovascular PED in all eyes, one of which showed complications of hemorrhagic PED after treatment. In five eyes, RPE tears developed at the PED edge located on the opposite side of the choroidal neovascularization membrane. In the eye showing hemorrhagic PED, the RPE tear developed along the wide area of the PED edge. The torn RPE monolayer contracted toward the side of the choroidal neovascularization membrane in all eyes, and RPE loss involved the fovea in five eyes that showed significantly worse visual acuity (VA) after 12 months in comparison with the baseline value before the tear (logMAR VA; 0.3 vs. 1.29; P < 0.02).Conclusion:The location of choroidal neovascularization membrane in PED determines the spatial pattern of RPE tear development and progression and helps to predict the visual outcome after RPE tears.

DOI： 10.1097/ICB.0000000000001386

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)  

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1410215061

CiNii Research

Publisher：金原出版  

DOI： 10.18888/ga.0000003475

CiNii Research

Language：English   Publisher：Graefe's Archive for Clinical and Experimental Ophthalmology  

In the published online version of this article, the title and the text contained mistakes. The authors would like to correct “VEGF therapy” to “anti-VEGF therapy”. The correct title is shown below: Persistence of vascular empty sleeves in choroidal neovascularization after anti-VEGF therapy in both animal models and humans. The correct Purpose is shown below: This study investigated whether the proposed mechanism is involved in CNV during anti-VEGF therapy. The correct Introduction is shown below: In this study, we investigated whether the proposed mechanism of vascular regrowth is involved in CNV during anti-VEGF therapy using a mouse model and long-term clinical observations in optical coherence tomography angiography (OCTA).

DOI： 10.1007/s00417-023-06214-x

Web of Science

Scopus

PubMed

Language：English   Publisher：Journal of Clinical Medicine  

Background: Although anti-vascular endothelial growth factor (anti-VEGF) therapy is the first choice of treatment for eyes with neovascular age-related macular degeneration (AMD), it sometimes results in retinal pigment epithelium (RPE) tears. This study presents the detailed clinical characteristics of RPE tears to help predict their occurrence before anti-VEGF therapy initiation. Methods: This study retrospectively analyzed neovascular age-related macular degeneration (nAMD) patients who visited the Kyushu University Hospital and started anti-VEGF therapy between April 2013 and June 2020. Using medical records, we collected the clinical data of patients with RPE tears, including age, sex, best-corrected visual acuity (BCVA), number of anti-VEGF drug injections and the type and size of pigment epithelial detachment (PED). Results: RPE tears occurred in 16 (1.50%) eyes of 16 patients in all 1068 nAMD eyes of 987 patients. The mean age of these patients with RPE tear was 81.7 ± 8.7 years. Fifteen eyes had typical AMD and one eye had polypoidal choroidal vasculopathy. The mean number of anti-VEGF drug injections before RPE tears was 5.0 ± 5.1. All patients experienced PED before the RPE tear (hemorrhagic, 4 eyes; serous vascular, 2 eyes; fibrovascular, 10 eyes). The average PED height and area were 615.7 ± 175.3 μm and 21.0 ± 7.2 mm2, respectively. The sub-RPE cleft was observed in 10 eyes. The logMAR BCVA immediately after the RPE tear (0.73 ± 0.40) at 6 months (0.86 ± 0.51) and 12 months (0.84 ± 0.43) after the RPE tear were significantly worse than that before the RPE tear (0.58 ± 0.31; p < 0.05). The BCVA of patients with RPE tears that spread to the fovea was poorer than that of patients without RPE tears. Conclusions: In patients with nAMD, RPE tears tended to occur in typical AMD eyes with high or large PEDs, and sub-RPE clefts. The visual prognosis depended on whether the RPE tear included the fovea.

DOI： 10.3390/jcm12175496

Web of Science

Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：Graefe's Archive for Clinical and Experimental Ophthalmology  

Purpose: Choroidal neovascularization (CNV) often recurs during anti-vascular endothelial growth factor (VEGF) therapy; however, little is known about the mechanism of vascular regrowth. Vascular regrowth along the empty sleeves of basement membranes was proposed as a mechanism for recurrence after the reversal of VEGF inhibition in tumors. This study investigated whether the proposed mechanism is involved in CNV during VEGF therapy. Methods: We made two observations using a mice model, as well as patients with CNV. Laser-induced CNV mice were used to examine the vascular empty sleeves of the basement membrane and CNV with the immunohistochemistry of type IV collagen and CD31, respectively. A retrospective cohort study included 17 eyes from 17 patients with CNV treated with anti-VEGF treatment. Vascular regrowth during anti-VEGF treatment was assessed using optical coherence tomography angiography (OCTA). Results: In the CNV mouse model, the CD31+ vascular endothelium area was decreased during anti-VEGF treatment compared with the IgG control (33516.7 ± 10864.7 vs. 10745.9 ± 5755.9 μm2, P < 0.05), whereas a significant difference was not observed in the area of type IV collagen+ vascular empty sleeve after the treatment compared with the control (29135.0 ± 7432.9 vs. 24592.0 ± 5935.3 μm2, P = 0.7). The proportions of CD31+ to type IV collagen+ areas were significantly decreased after the treatment (38.7 ± 7.4% vs. 17.1 ± 5.4%, P < 0.05). In the OCTA observations, the follow-up period in the retrospective cohort study was 58.2 ± 23.4 months. CNV regrowth was observed in 682 neovessels of the 17 eyes. In group 1, CNV regression and regrowth are in the same form (129 neovessels, 18.9%). In group 2, CNV regression and regrowth are in a different form (170 neovessels, 24.9%). In group 3, CNV regrowth is with a different form without the regression (383 neovessels, 56.2%).[Figure not available: see fulltext.] Conclusions: Parts of CNV regrowth may occur along the vascular empty sleeve, which remain after anti-VEGF treatment.

DOI： 10.1007/s00417-023-06018-z

Web of Science

Scopus

PubMed

Language：English   Publisher：Journal of Clinical Medicine  

Age-related macular degeneration (AMD) causes visual impairment in individuals who are >50 years of age. However, no study has investigated AMD when using ultra-wide-field swept-source optical coherence tomography (UWF SS-OCT). We aimed to evaluate central and peripheral choroidal thicknesses using UWF SS-OCT, and to compare these across the AMD subtypes. We included 75 eyes of patients with typical AMD (tAMD), 56 with polypoidal choroidal vasculopathy (PCV), 29 with pachychoroid neovasculopathy (PNV), and 12 with retinal angiomatous proliferation (RAP). To compare choroidal thicknesses in the central and peripheral choroids, we established subfields of <3 mm, <9 mm, and 9–18 mm from the fovea. PNV patients were significantly younger than those with tAMD (p = 0.01). The choroidal thicknesses of PNV were significantly greater than that of tAMD in all subfields (p < 0.01), and choroidal thickness significantly correlated with age and axial length in all subfields (p < 0.05). Even after adjusting for age and axial length, the choroidal thickness in PNV was significantly greater than that in tAMD (p < 0.05). In addition, the ratio of the posterior <9 mm to a peripheral 9–18 mm choroidal thickness in PNV was significantly greater than that in tAMD (p < 0.01). A thickened choroid in PNV was more pronounced in the posterior choroid than in the periphery.

DOI： 10.3390/jcm12165364

Web of Science

Scopus

PubMed

Web of Science

Publisher：株式会社医学書院  

DOI： 10.11477/mf.1410214765

CiNii Research

Language：Japanese   Publisher：(株)医学書院  

＜文献概要＞目的:ポリープ状脈絡膜血管症(PCV)に対する抗血管内皮増殖因子(VEGF)薬併用光線力学的療法(PDT)後2年における治療成績の検討。対象と方法:対象は2017年8月～2019年8月に九州大学病院眼科で未治療PCVに初回からPDTと抗VEGF薬導入期3回投与(1クール)を施行し,2年以上経過観察できた20例20眼。眼底写真での新たな出血,光干渉断層計で確認された滲出性変化,および蛍光眼底造影でのポリープを認めたものを再発と定義した。治療前患者背景,治療前病巣径(GLD),治療前,1,2年後の視力,中心窩網膜厚(CRT),中心窩脈絡膜厚(CCT),dry fovea率,2年間の治療回数,再発率について,診療録をもとに後ろ向きに検討した。結果:治療前平均logMAR視力(0.23)は,1年後0.12,2年後0.14と改善し,治療前CRT(333.3±21.2μm),CCT(264.6±17.8μm)は,1年後(CRT 231.9±10.7μm,CCT 220.3±17.0μm),2年後(CRT 237.7±9.56μm,CCT 234.9±18.4μm)に減少していた(p<0.05)。1年後80%,2年後70%でdry foveaが得られていた。1年目の抗VEGF薬投与回数は導入期の3回を含めて平均4.65回±0.47回/年,2年目1.9回±0.60回/年であった。2年後の視力不良との関連因子を検討したところ,治療前視力不良,治療前GLDが大きいこと,と有意に関連があった。15例(75%)が再発し,そのうち40%が1年未満に再発していた。それらの早期再発症例の治療前平均CCT(234.9μm)は,1年以上後で再発した症例の平均CCT(314.3μm)に比べ有意に薄くなっていた。結論:PCVに対するPDT併用抗VEGF薬治療は2年後の視力,網膜形態を改善したが,症例により再発し,追加治療が必要となることが示唆された。治療前CCTが薄いと再発までの期間が短い傾向があった。

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：Ophthalmic Research  

Introduction: Drusen and pigmentary abnormality are found as the hallmark to predict progression of age-related macular degeneration (AMD). In Asian populations, exudative AMD often appears in the absence of drusen but is rather accompanied by pigmentary abnormality. Recently, shallow irregular retinal pigment epithelium (RPE) elevations (SIRE) have been shown as a sign of subclinical nonexudative macular neovascularization. In this study, we aimed to investigate the characteristics of optical coherence tomography (OCT) findings including SIRE before the appearance of exudative AMD. Methods: We retrospectively reviewed 32 cases of exudative AMD that occurred in the fellow eye within the 5-year-observation period. Color fundus photography, OCT, and fluorescein/indocyanine-green angiography at the beginning of observation and at the time when exudative AMD appeared were examined to diagnose SIRE and the subtype of exudative AMD. Results: Exudative AMD was found in 19 eyes with large drusen and 13 eyes without large drusen. Mean sub-foveal choroidal thickness without large drusen was significantly thicker than that with large drusen (336 ± 109 and 220 ± 96 μm, respectively; mean ± SD). Six eyes with pachychoroid neovasculopathy, 4 eyes with type 1 macular neovascularization, and 3 eyes with PCV had occurred in the fellow eye without large drusen. Among those, 6 eyes had been accompanied by SIRE with a greatest transverse linear dimension of 1 mm or more at the beginning of observation period. Besides, small RPE elevations with a longest diameter of less than 1 mm had been observed in other 5 eyes. Three cases of polypoidal choroidal vasculopathy had originated from small RPE elevations. Moreover, pachyvessels, choriocapillaris thinning, or choroidal hyperpermeability were observed with SIRE or small RPE elevations. Conclusions: There is a non-drusen type of exudative AMD that originates from small RPE elevations as well as SIRE.

DOI： 10.1159/000526445

Web of Science

Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：Human Molecular Genetics  

Age-related macular degeneration (AMD) and central serous chorioretinopathy (CSC) are common diseases that can cause vision loss in older and younger populations. These diseases share pathophysiological conditions derived from retinal pigment epithelium (RPE) dysfunction. Tumor necrosis factor receptor superfamily 10A (TNFRSF10A)-LOC389641 with the same lead single-nucleotide polymorphism (SNP) (rs13278062) is the only overlapped susceptibility locus found in both AMD and CSC through genome-wide association studies. This lead SNP has been reported to alter the transcriptional activity of TNFRSF10A. This study aimed to elucidate the function of TNFRSF10A in RPE degeneration using human primary RPE cells and Tnfrsf10 knockout (Tnfrsf10-/-) mice. TNFRSF10A was found to be localized in human RPE. In vitro assays revealed that a T allele of rs13278062, the risk allele for AMD and CSC, downregulated TNFRSF10A transcription in RPE, leading to decreased cell viability and increased apoptosis through protein kinase C-α (PKCA) downregulation. Treatment with phorbol 12-myristate 13-Acetate, a PKC activator, rescued the cell viability. Morphological RPE abnormality was found in the retina of Tnfrsf10-/- mice. Our data suggest that downregulation of TNFRSF10A expression inactivates PKCA signaling and causes cellular vulnerability of the RPE, which may contribute to the pathogenesis of AMD and CSC.

DOI： 10.1093/hmg/ddac020

Web of Science

Scopus

PubMed

Language：English   Publisher：Graefe's Archive for Clinical and Experimental Ophthalmology  

Purpose: This study aimed to evaluate the one-year outcomes of photodynamic therapy (PDT) as a rescue treatment for age-related macular degeneration (AMD) refractory to anti-vascular endothelial growth factor (VEGF) therapy. Methods: Patients with AMD refractory to anti-VEGF therapy, treated with “rescue-PDT” were retrospectively investigated. The time of PDT was defined as the baseline value. Baseline characteristics including sex, age, best-corrected visual acuity (BCVA), central macular thickness (CMT), and foveal choroidal thickness (FCT) were examined. The changes in BCVA, CMT, and recurrence were also assessed at the 1-year follow-up. The logMAR VA change of 0.3 or more was defined as “improved” or “declined.” Results: Twenty-three consecutive eyes (typical AMD: 10 eyes, polypoidal choroidal vasculopathy: 10 eyes, and pachychoroid neovasculopathy: 3 eyes), which underwent “rescue-PDT,” were analyzed in this study. The BCVA was improved in three patients and maintained in 20 patients at 12 months after PDT (mean BCVA change: 0.11 ± 0.19). The CMT improved in 19 patients (82.6%), and the mean CMT changed from 318.5 ± 93.7 μm to 225.9 ± 51.6 μm (p < 0.01) 12 months after PDT. “Retreatment” of anti-VEGF drug injections was considered if the retinal fluid or retinal hemorrhage recurred after PDT. The baseline FCT of the “retreatment group (15 eyes)” was significantly lower than that of the “no retreatment group (8 eyes)” (206.3 ± 50.7 μm vs 293.9 ± 85.7 μm: p = 0.033). Conclusions: PDT could be an effective treatment option for anti-VEGF refractory AMD to maintain visual acuity and control retinal fluid for up to 12 months.

DOI： 10.1007/s00417-022-05553-5

Web of Science

Scopus

PubMed

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publisher：シュプリンガー・ジャパン(株)  

網膜下血腫(SRH)移動目的に施行された硝子体切除術と網膜下組織プラスミノーゲンアクチベータ(t-PA)注入後のガス充填眼のフォローアップに用いられる超広角視野眼底自発蛍光イメージングの有用性について検討した。SRHを呈する24眼(男性12眼、女性12眼、平均76.8±9.8歳)に対して硝子体切除術と網膜下t-PA注入を行い、眼底自発蛍光像を評価してSRHの占拠率を算出した。主要評価項目は術後3日間におけるSRHの移動率、SRHの方向、術後の最良矯正視力(BCVA)とした。発症から手術施行までは平均11.5±6.6日で、13眼に対して白内障硝子体同時手術、11眼に硝子体切除を行い、術中のガス交換はSF6ガスが22眼、空気が2眼、平均観察期間は13.0±10.3ヵ月であった。網膜下黄斑血腫は24眼のうち20眼(83.3%)で下部外縁に移動しており、BCVAは術前の1.16±0.52から最終観察時に0.52±0.39と有意な改善が認められた。術後の黄斑下血腫領域は術前と比較して27.4%縮小しており、血腫占拠率は術翌日が63.5±39.7%、2日後が52.6±31.6%、3日後が61.2±40.3%となっていた。術後のガス充填眼の評価に超広角視野眼底自発蛍光イメージングは有用であることが示された。

Language：English   Publisher：Japanese Journal of Ophthalmology  

Purpose: To investigate the utility of Optos ultrawide-field fundus autofluorescence (UWF-FAF) imaging for postoperative follow-up of gas-filled eyes after vitrectomy with subretinal tissue-plasminogen activator (t-PA) injection for subretinal hemorrhage (SRH) displacement. Study design: Retrospective consecutive case series. Methods: This study included 24 eyes with SRH. Vitrectomy with subretinal t-PA injection was performed, followed by postoperative prone positioning. FAF images acquired using Optos California were examined and the SRH occupancy in the macula was calculated. The main outcome measures were displacement rate and direction of SRH for 3 days postoperatively, and postoperative best-corrected visual acuity (BCVA). Results: The postoperative BCVA ranged from improvement (23 eyes; 95.8%) to no change (one eye; 4.2%). Analysis was done using postoperative Optos FAF images for 20 eyes (83.3%). Postoperative SRH occupancy was significantly reduced, by 27.4%, compared with the preoperative occupancy (P = 0.03). A statistically significant reduction was found between the preoperative and postoperative day (POD)1 (P = 0.04), but not between POD1 and POD2 (P = 0.7), or between POD2 and POD3 (P = 1.0). Conclusion: UWF-FAF imaging is useful for postoperative follow-up of gas-filled eyes after vitrectomy with subretinal t-PA injection for SRH displacement.

DOI： 10.1007/s10384-022-00910-7

Web of Science

Scopus

PubMed

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1093/hmg/ddac020.

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1007/s00417-022-05553-5.

Language：English   Publisher：European Journal of Ophthalmology  

Purpose: To report optical coherence tomography angiography (OCTA) findings in a case of immune choroiditis following contralateral acute retinal necrosis (ARN) with choroidal neovascularization (CNV) during anti-vascular endothelial growth factor (VEGF) therapy. Case report: A 64-year-old woman with immune choroiditis following contralateral ARN and secondary CNV presented with decreased visual acuity. Fundus examination revealed macular and peripheral yellowish lesions in the right eye. Inflammatory cells were observed in the anterior chamber and the vitreous. OCT revealed retinal exudative changes and subretinal lesions suggestive of CNV. OCTA detected an abnormal vascular net in the outer retina as well as choriocapillaris, corresponding to type 2 CNV, that reduced following intravitreous anti-VEGF therapy. Two weeks after treatment, OCTA showed re-dilated choroidal neovasculature at the outer retina despite no exudative recurrence in OCT. Six weeks after treatment, OCT detected exudative changes around the neovascular lesion. Conclusion: This case discusses the use of OCTA detection of CNV in a case of immune choroiditis following contralateral ARN. During anti-VEGF therapy for inflammatory CNV-related diseases, OCTA may be useful not only for CNV detection but also for the follow-up of CNV activity.

DOI： 10.1177/1120672120977349

Web of Science

Scopus

PubMed

Language：English   Publisher：Case Reports in Ophthalmology  

Bullous retinal detachment is a rare complication in the chronic phase of central serous chorioretinopathy (CSC). Only a small subset of eyes with chronic CSC develops into the bullous variant of CSC (bCSC). In patients with bCSC, the elevated concentration of fibrin in the subretinal space leads to persistent retinal detachment and eventually, severe vision loss. We experienced a case of unilateral bCSC with a massive accumulation of subretinal fibrin. Multiple leakage points and dilated choroidal veins were also observed. The patient underwent surgical removal of subretinal fibrin and silicone oil injection followed by photodynamic therapy (PDT). After this treatment, the retina was successfully reattached, and the affected eye was free from recurrent exudative changes for more than 18 months. Massive subretinal fibrin could be surgically removed to prevent the formation of subretinal fibrosis and retinal fold, and PDT under silicone oil can control the underlying exudative changes in bCSC.

DOI： 10.1159/000524515

Web of Science

Scopus

PubMed

CiNii Research

Language：Japanese  

Language：Japanese   Publishing type：Research paper (scientific journal)  

DOI： 10.1371/journal.pone.0255213

Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Purpose: To assess the real-world 5-year treatment outcomes of ranibizumab therapy in Japanese patients with neovascular age-related macular degeneration (AMD). Methods: This was a retrospective, observational, and open-label effectiveness study that included 295 eyes. The participants were patients with treatment-naïve neovascular AMD who received intravitreal ranibizumab (IVR) monthly injection at least three times as the loading phase, followed by further injections as needed (pro re nata (PRN)) and follow-up assessments for 5 years. Outcomes were determined at least 5 years after the first ranibizumab injection. Results: Mean logMAR best-corrected visual acuity (BCVA) at baseline was 0.52. The mean BCVA significantly improved after three loading injections; however, it declined gradually. The BCVA at 1 year was significantly better than the baseline BCVA, whereas the 3-year, 4-year, and 5-year BCVA values were significantly lower than the baseline values. The average central foveal thickness improved significantly from 366 ± 125 μm to 268 ± 134 μm (p < 0.0001). Macular atrophy was significantly more likely to occur in cases with classic choroidal neovascularization (CNV) than in cases with other AMD (p = 0.01). Conclusions: IVR is well tolerated in eyes with AMD. However, a PRN regimen for AMD may have limited real-world effectiveness for long-term maintenance of improved visual acuity. Macular atrophy may occur more frequently in classic CNV. To maintain good vision, IVR treatment should be started earlier and performed continuously.

DOI： 10.1007/s00417-019-04361-8

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Purpose : To report the 2-year outcomes of intravitreal ranibizumab (IVR) for myopic choroidal neovascularization (mCNV). Cases and Methods ' Twenty-one patients with treatment-naive mCNV who visited Kyushu University Hospital from September 2013 to August 2016 underwent IVR and were followed up for 24 months or longer. Visual acuity, central retinal thickness (CRT), retinal thickness at CNV, thickness of CNV and the area of the CNV-related macular atrophy were retrospectively compared before and after IVR. CRT, retinal thickness at CNV, and thickness of CNV were evaluated with optical coherence tomography (OCT) and the area of macular atrophy was evaluated with fundus photographs. Results ! The mean age of the subjects was 68.9 years and the mean number of IVR was 5.7. Mean visual acuity significantly improved from 1 month after to 24 months after compared with baseline values (l, 3, 6, 12 months p<0.01, 18, 24 months p<0.05), but decreased gradually from 12 months. Mean CRT, retinal thickness at CNV, and thickness of CNV significantly improved at all points (p< 0.01). Mean area of macular atrophy became significantly enlarged 6 months after (p<0.0l) and expanded gradually during the observation period. Visual acuity after 2 years was correlated with visual acuity before treatment and the area of macular atrophy after 2 years. The amount of change in the macular atrophy area after 2 years was correlated with the number of IVR. Conclusion ; IVR resulted in improvement of retinal shape and regression of the CNV, but enlargement of macular atrophy was noted in the long term. There was a tendency that the area of macular atrophy became enlarged in patients who received frequent administration.

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：Japanese   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Purpose: To report a case of AIDS-related Kaposi sarcoma in the eyelid. Case: A 35-year-old man had noted a tumor in the lower eyelid since 6 months before. It gradually increased in size following transconjunctival incision and curettage. Multiple foci in the lung were detected during health check-up 4 months before. He was diagnosed with AIDS at the Department of Internal Medicine of Kyushu University. He was referred to us regarding the eyelid tumor. Findings and Clinical Course: A painful, dark red mass was present in the right lower eyelid. Another red mass was present in the left bulbar conjunctiva. The tumor in eye right eyelid was resected and proved to be Kaposi sarcoma. Metastatic lesions were present in the lung and gastrointestinal tract. He was treated with highly active antiretroviral therapy (ART) and six courses of liposomal doxorubicin. Tumors in the eyes, lung, and gastrointestinal tract disappeared 6 months after end of treatment. Conclusion: This case illustrates that a tumor in the eyelid may be initial clinical manifestation of AIDS-related Kaposi sarcoma.

Language：English   Publishing type：Research paper (scientific journal)  

Language：English   Publishing type：Research paper (scientific journal)  

Purpose: To report characteristic findings of chalazion by noncontact meibography. Cases and Method: This study was made on 67 eyes of chalazion. The series comprised 25 males and 42 females. The age ranged from 1 to 90 years, average 38 years. We used two apparatus to record and analyze the findings: a meibogram (MeiboPen) and a camera for infrared photography eliminating light of wavelength longer than 760 nm. Results: Areas of chalazion showed high infrared reflection in 25 eyes, and low reflection in 42 eyes. Low reflection was present in 44% of cases in whom chalazion persisted for less than 30 days. It was present in 84% of cases in whom chalazion persisted longer than 30 days. The difference was significant (p< 0.0001). Conclusion: Chalazion showed lower infrared reflection in meibography when the lesion persisted longer than 30 days.

Language：English   Publishing type：Research paper (scientific journal)  

Vertebrate vision is initiated by photoisomerization of the visual pigment chromophore 11-cis-retinal and is maintained by continuous regeneration of this retinoid through a series of reactions termed the retinoid cycle. However, toxic side reaction products, especially those involving reactive aldehyde groups of the photoisomerized product, all-trans-retinal, can cause severe retinal pathology. Here we lowered peak concentrations of free all-trans-retinal with primary amine-containing Food and Drug Administration (FDA)-approved drugs that did not inhibit chromophore regeneration in mouse models of retinal degeneration. Schiff base adducts between all-trans-retinal and these amines were identified by MS. Adducts were observed in mouse eyes only when an experimental drug protected the retina from degeneration in both short-term and long-term treatment experiments. This study demonstrates a molecular basis of all-trans-retinal-induced retinal pathology and identifies an assemblage of FDA-approved compounds with protective effects against this pathology in a mouse model that shows features of Stargardt's disease and age-related retinal degeneration.

DOI： 10.1038/nchembio.759

Language：English   Publishing type：Research paper (scientific journal)  

Chronic inflammation is an important component that contributes to many age-related neurodegenerative diseases, including macular degeneration. Here, we report a role for toll-like receptor 3 (TLR3) in cone-rod dystrophy (CORD) of mice lacking ATP-binding cassette transporter 4 (ABCA4) and retinol dehydrogenase 8 (RDH8), proteins critical for all-trans-retinal clearance in the retina. Increased expression of toll-like receptor-signaling elements and inflammatory changes were observed in Rdh8^-/- Abca4^-/- eyes by RNA expression analysis. Unlike 3-month-old Rdh8^-/- Abca4^-/- mice that developed CORD, 6-month-old Tlr3^-/- Rdh8^-/- Abca4^-/- mice did not evidence an abnormal retinal phenotype. Light-induced retinal degeneration in Tlr3^-/- Rdh8 ^-/- Abca4^-/- mice was milder than that in Rdh8 ^-/- Abca4^-/- mice, and a 2-fold increased TLR3 expression was detected in light-illuminated retinas of Rdh8^-/- Abca4 ^-/- mice compared with nonilluminated retinas. Poly(I-C), a TLR3 ligand, caused caspase-8-independent cellular apoptosis. Whereas poly(I-C) induced retinal cell death in Rdh8^-/- Abca4^-/- and WT mice both in vivo and ex vivo, this was not seen in mice lacking Tlr3. Far fewer invasive macrophage/microglial cells in the subretinal space and weaker activation of Muller glial cells were exhibited by Tlr3^-/- Rdh8 ^-/- Abca4^-/- mice compared with Rdh8^-/- Abca4^-/- mice at 3 and 6 months of age, indicating that loss of TLR3 inhibits local inflammation in the retina. Both poly(I-C) and endogenous products emanating from dying/dead retinal cells induced NF-κB and IRF3 activation. These findings demonstrate that endogenous products from degenerating retina stimulate TLR3 that causes cellular apoptosis and retinal inflammation and that loss of TLR3 protects mice from CORD.

DOI： 10.1074/jbc.M111.228551

Event date： 2024.3

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：神戸市   Country：Japan  

Event date： 2024.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市   Country：Japan  

Event date： 2023.12

Language：Japanese  

Venue：東京都   Country：Japan  

Event date： 2023.11

Language：Japanese  

Venue：Kanagawa   Country：Japan  

Event date： 2023.11

Language：Japanese  

Venue：横浜市   Country：Japan  

Event date： 2023.11

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：横浜市   Country：Japan  

Event date： 2023.11

Language：Japanese  

Venue：横浜市   Country：Japan  

Event date： 2023.10

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：北海道   Country：Japan  

Event date： 2023.10 - 2024.10

Language：Japanese  

Venue：東京都   Country：Japan  

Event date： 2023.9

Language：Japanese  

Venue：福岡県   Country：Japan  

Event date： 2023.8

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2023.7

Language：Japanese  

Venue：奈良県   Country：Japan  

Event date： 2023.6 - 2023.7

Language：Japanese  

Venue：北海道   Country：Japan  

Event date： 2023.6

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2023.5

Language：Japanese  

Venue：福岡県   Country：Japan  

Event date： 2023.5

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：福岡県   Country：Japan  

Event date： 2023.5

Language：Japanese  

Venue：福岡県   Country：Japan  

Event date： 2023.5

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Country：Japan  

Event date： 2023.4

Language：Japanese  

Venue：東京都   Country：Japan  

Event date： 2023.4

Language：Japanese  

Venue：東京都   Country：Japan  

Event date： 2023.4

Language：English  

Venue：New Orleans   Country：United States  

Event date： 2023.3

Language：English  

Venue：Tokyo   Country：Japan  

Event date： 2023.2

Language：Japanese  

Venue：福岡市   Country：Japan  

Event date： 2023.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡県   Country：Japan  

Event date： 2022.12

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：大阪府   Country：Japan  

Event date： 2022.12

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：大阪府   Country：Japan  

Event date： 2022.12

Language：Japanese  

Country：Japan  

Event date： 2022.10

Language：Japanese  

Venue：東京都   Country：Japan  

Event date： 2022.10

Language：Japanese  

Venue：京都府   Country：Japan  

Event date： 2022.7

Language：Japanese  

Country：Japan  

Event date： 2022.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：沖縄県   Country：Japan  

Event date： 2022.5

Language：Japanese  

Venue：大阪府   Country：Japan  

Event date： 2022.5

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese  

Country：Japan  

Event date： 2022.5

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：大阪府   Country：Japan  

Event date： 2022.5

Language：Japanese  

Venue：沖縄県   Country：Japan  

Event date： 2022.5

Language：Japanese  

Venue：沖縄県   Country：Japan  

Event date： 2022.5

Language：Japanese  

Venue：沖縄県   Country：Japan  

Event date： 2022.4

Language：Japanese  

Venue：大阪府   Country：Japan  

Event date： 2022.4

Language：Japanese  

Venue：大阪府   Country：Japan  

Event date： 2021.9

Language：Japanese  

Venue：京都府   Country：Japan  

Event date： 2020.12

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡   Country：Japan  

Event date： 2020.11

Language：Japanese  

Venue：福岡   Country：Japan  

Event date： 2020.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡   Country：Japan  

Event date： 2020.11

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：福岡   Country：Japan  

Event date： 2020.11

Language：Japanese  

Venue：福岡   Country：Japan  

Event date： 2020.10 - 2022.10

Language：Japanese  

Venue：東京   Country：Japan  

Event date： 2020.10

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：北九州市   Country：Japan  

Event date： 2020.10

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：東京   Country：Japan  

Event date： 2020.10

Language：Japanese   Presentation type：Public lecture, seminar, tutorial, course, or other speech  

Venue：福岡   Country：Japan  

Event date： 2020.9

Language：Japanese   Presentation type：Oral presentation (general)  

Country：Japan  

Event date： 2020.8

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡   Country：Japan  

Event date： 2020.8

Language：Japanese   Presentation type：Symposium, workshop panel (public)  

Venue：福岡   Country：Japan  

Event date： 2020.4

Language：Japanese  

Venue：東京   Country：Japan  

Event date： 2019.12

Language：Japanese  

Venue：長崎市   Country：Japan  

Event date： 2019.12

Language：Japanese  

Venue：長崎市   Country：Japan  

Event date： 2019.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：愛知県名古屋市   Country：Japan  

Event date： 2019.10

Language：Japanese  

Country：Japan  

Event date： 2019.10

Language：Japanese  

Venue：京都府   Country：Japan  

Event date： 2019.9

Language：Japanese  

Country：Japan  

Event date： 2019.9

Language：English  

Venue：Suzhou   Country：China  

Event date： 2019.8

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市   Country：Japan  

Event date： 2019.7

Language：Japanese  

Venue：北海道札幌市   Country：Japan  

Event date： 2019.7

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市   Country：Japan  

Event date： 2019.7

Language：Japanese  

Country：Japan  

Event date： 2019.6

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市   Country：Japan  

Event date： 2019.4 - 2019.5

Language：English  

Venue：Vancouver   Country：Canada  

Event date： 2019.4 - 2019.3

Language：Japanese  

Venue：東京   Country：Japan  

Event date： 2019.2

Language：Japanese  

Country：Japan  

Event date： 2019.2

Language：Japanese  

Country：Japan  

Event date： 2019.2

Language：Japanese  

Venue：福岡   Country：Japan  

Event date： 2019.2

Language：Japanese  

Venue：福岡   Country：Japan  

Event date： 2018.12

Language：English  

Venue：Rome   Country：Italy  

Event date： 2018.12

Language：English  

Venue：Fukuoka   Country：Japan  

Event date： 2018.12

Language：Japanese  

Venue：Fukuoka   Country：Japan  

Event date： 2018.12

Language：English  

Country：Japan  

Event date： 2018.11

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：福岡市   Country：Japan  

Event date： 2018.11

Language：English  

Venue：Fukuoka   Country：Japan  

Event date： 2018.11

Language：English  

Venue：京都府   Country：Japan  

Event date： 2018.11

Language：Japanese  

Country：Japan  

Event date： 2018.10

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京   Country：Japan  

Event date： 2018.10

Language：Japanese  

Venue：東京   Country：Japan  

Event date： 2018.9

Language：Japanese  

Venue：福岡市   Country：Japan  

Event date： 2018.7

Language：Japanese  

Venue：松本市   Country：Japan  

Event date： 2018.5

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：大分   Country：Japan  

Event date： 2018.5

Language：Japanese  

Venue：長崎   Country：Japan  

Language：Japanese  

Language：Japanese  

Language：Japanese  

Language：English  

Language：Japanese  

Language：Japanese  

Authorship：Lead author  

医学部6年生のベッドサイドラーニング

医学部５年生の教育　レポート作成