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Maeda M, Ueki M, Sugiyama T, Kohmoto R, Nemoto E, Kojima S, Ikeda T. Three-Year Outcomes of Pars Plana Ahmed and Baerveldt Glaucoma Implantations for Neovascular Glaucoma in Japanese Eyes. J Glaucoma 2022; 31:462-467. [PMID: 34628430 DOI: 10.1097/ijg.0000000000001953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/30/2021] [Indexed: 11/25/2022]
Abstract
PRCIS Tube shunt implantation through the pars plana was effective for neovascular glaucoma (NVG) for at least 3 years, with few serious postoperative complications observed. PURPOSE The aim was to report 3-year outcomes of pars plana Ahmed and Baerveldt glaucoma implantation for NVG in Japanese eyes. PATIENTS AND METHODS This study examined 41 eyes of 39 patients who underwent tube shunt implantation through the pars plana with the Baerveldt glaucoma implant (BGI group, 26 eyes) or Ahmed glaucoma valve (AGV group, 15 eyes) for NVG and who were followed up for over 3 years at Osaka Medical College between January 2009 and April 2016. Outcome measures were intraocular pressure (IOP, mm Hg) at presurgery and at 6 months and 1, 2, and 3 years postoperative. Postoperative failure was defined as an IOP of >21 mm Hg or <5 mm Hg, further glaucoma surgery, or no light perception. RESULTS Mean IOPs at presurgery and at 3 years postoperative were 34.8±9.1 and 15.6±4.6 in the AGV group, and 36.9±9.2 and 12.8±5.5 in the BGI group. Mean antiglaucoma medication scores at 3 years postoperative were 1.3±1.4 in the AGV group and 0.4±0.8 in the BGI group (P=0.05). The number of eyes with a probability of failure at 6 months and at 2 and 3 years postoperative was 2, 3, and 4, respectively, in the BGI group, and 0, 1, and 2, respectively, in the AGV group. CONCLUSION Findings for NVG cases showed tube shunt implantation through the pars plana was effective. Equivalent good IOP reductions were noted in both groups, with the BGI group requiring fewer postoperative antiglaucoma medications compared with the AGV group. Furthermore, both groups exhibited few serious postoperative complications.
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Affiliation(s)
- Michiko Maeda
- Department of Ophthalmology, Osaka Medical and Pharmaceutical University, Osaka, Japan
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Tara A, Kobayashi T, Kohmoto R, Fukumoto M, Sato T, Kida T, Ooi Y, Ikeda T. A Case of Fungal Endophthalmitis Caused by Paecilomyces lilacinus that Might Have Spread from the Sclera into the Intraocular Space. Case Rep Ophthalmol 2020; 11:256-262. [PMID: 32774289 PMCID: PMC7383179 DOI: 10.1159/000508389] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 04/30/2020] [Indexed: 11/19/2022] Open
Abstract
The aim of this report was to describe a case of fungal endophthalmitis possibly caused by Paecilomyces lilacinus(PL) penetrating the sclera from a conjunctival abscess. This case study involved an 83-year-old male patient with a past history of scleral buckling, subtenon steroid injection, and cataract surgery. The vitreous opacity and a conjunctival abscess appeared in the inferonasal quadrant of his right eye at 5 months after cataract surgery. PL was isolated from a cultured conjunctival discharge specimen obtained from the patient's right eye. Although the treatment with antifungal agents relieved the conjunctival abscess, the vitreous opacity became worse. Thus, vitrectomy was subsequently performed. Intraoperative findings revealed severe vitreous opacity in the inferonasal quadrant, adjacent to the sclera at the site of the conjunctival abscess. Our findings indicate that fungal endophthalmitis appeared to have been caused by PL in the conjunctival abscess that may have penetrated the sclera and spread into the intraocular space.
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Affiliation(s)
- Akiko Tara
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | | | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Yukimasa Ooi
- Infection Control Office, Osaka Medical College, Takatsuki-City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
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Nagashima T, Kohmoto R, Fukumoto M, Oosuka S, Sato T, Kobayashi T, Kida T, Ikeda T. Ciliary body suturing using intraocular irrigation for traumatic cyclodialysis: two case reports. J Med Case Rep 2020; 14:121. [PMID: 32758276 PMCID: PMC7410159 DOI: 10.1186/s13256-020-02448-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 07/07/2020] [Indexed: 11/12/2022] Open
Abstract
Background We report two cases (two eyes) of traumatic cyclodialysis with prolonged decrease of intraocular pressure that were successfully treated with surgery by ciliary body suturing using intraocular irrigation. Case presentation This study involved a 17-year-old Japanese boy (patient 1) and a 31-year-old Japanese man (patient 2) in whom cyclodialysis was sustained in one eye after blunt-force ocular trauma from a thrown ball. Because the hypotony maculopathy in both patients did not resolve after conservative treatment, ciliary body suturing was performed. Briefly, a 25-gauge trocar intraocular irrigation needle for vitrectomy was inserted into the vitreous cavity of the injured eye. A lamellar scleral flap was then made, and an incision was created on the sclera while maintaining intraocular pressure. Next, the detached ciliary body was sutured to the sclera under direct vision. The intraocular fluid at the site of cyclodialysis was then rapidly drained from the scleral wound because of elevated intraocular pressure in the vitreous cavity, and the ciliary body was visually recognized through the scleral wound under direct vision, thus allowing a stable suture fixation of the ciliary body to the sclera. Postoperatively, the treated eye in both cases showed improvement of intraocular pressure and visual function. Conclusions The surgical method described in this report was found to be effective for draining intraocular fluid at the site of cyclodialysis and for performing a stable suture fixation of the ciliary body to the sclera through the scleral wound under direct vision, and it should be considered advantageous for avoiding intraoperative bleeding and suturing in a blinded manner.
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Affiliation(s)
- Taishi Nagashima
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Shou Oosuka
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takatoshi Kobayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
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Terubayashi Y, Morishita S, Kohmoto R, Mimura M, Fukumoto M, Sato T, Kobayashi T, Kida T, Ikeda T. Type III uveal effusion syndrome suspected to be related to pachychoroid spectrum disease: A case report. Medicine (Baltimore) 2020; 99:e21441. [PMID: 32756157 PMCID: PMC7402756 DOI: 10.1097/md.0000000000021441] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION We report a case of type III uveal effusion syndrome (UES) suspected to be related to pachychoroid spectrum disease. PATIENT CONCERNS A 42-year-old man became aware of visual field constriction and deterioration of visual acuity in his right eye. DIAGNOSIS Upon examination, a bullous non-rhegmatogenous retinal detachment was observed in the inferior 2 quadrants of the right eye fundus, and the subretinal fluid moved with postural changes. The axial length in that eye was 22.36 mm, thus indicating no nanophthalmia. Preoperative indocyanine green angiography revealed dilated choroidal vessels in the posterior pole of the right eye and mild leakage in the late phase. Optical coherence tomography examination revealed choroidal thickening in both eyes. INTERVENTIONS For treatment, we first performed sclerotomy, and the intraoperative findings showed no thickening of the sclera. Following surgery, reattachment of the retina was not achieved. OUTCOMES Thus, we next performed vitrectomy, which led to successful reattachment of the retina. LESSONS In this case, we theorize that pachychoroid spectrum disease might have been involved in the pathogenesis of type III UES.
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Nishi H, Kohmoto R, Mimura M, Fukumoto M, Sato T, Kida T, Ikeda T. Concurrent vitrectomy for persistent pupillary membrane complicated by severe myopia and vitreomacular traction syndrome: A case report. Medicine (Baltimore) 2020; 99:e20895. [PMID: 32590799 PMCID: PMC7328996 DOI: 10.1097/md.0000000000020895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION In cases of persistent pupillary membrane (PPM), the eye is usually slightly microphthalmic and emmetropia or hyperopia is often present, yet severe myopia is reportedly rare. Here we presented a case of PPM complicated by vitreomacular traction syndrome and posterior staphyloma due to severe myopia. PATIENT CONCERNS This study involved a 63-year-old female patient who had been diagnosed with bilateral PPM at a local eye clinic and who was subsequently referred to our department for a more detailed examination due to a recent decrease of visual acuity. DIAGNOSES Slit-lamp microscopy examination revealed bilateral PPM. The ocular fundus revealed peripapillary conus and myopic change in both eyes. Optical coherence tomography examination revealed no particular abnormalities in the right eye, yet did show findings indicative of vitreomacular traction syndrome in the left eye. INTERVENTIONS In both eyes, we performed surgical removal of the PPM, phacoemulsification aspiration, and intraocular lens implantation, yet in the patient's left eye, vitrectomy was also performed. OUTCOMES After surgery, the patient's visual acuity improved in both eyes. CONCLUSION The findings in this case show that when required, vitrectomy should be considered based upon the preoperative Optical coherence tomography findings for PPM.
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Kohmoto R, Sugiyama T, Ueki M, Kojima S, Maeda M, Nemoto E, Tokuoka S, Ikeda T. Correlation between laser speckle flowgraphy and optical coherence tomography angiography measurements in normal and glaucomatous eyes. Clin Ophthalmol 2019; 13:1799-1805. [PMID: 31571818 PMCID: PMC6750712 DOI: 10.2147/opth.s213031] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/13/2019] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the relationship between laser speckle flowgraphy (LSFG) and optical coherence tomography angiography (OCTA) measurements of the peripapillary retina and optic nerve head (ONH) in normal eyes and eyes with primary open-angle glaucoma (POAG). Patients and methods One eye from each of 46 normal subjects and mild and moderate/advanced POAG patients were included. ONH blood flow acquired by LSFG, circumpapillary vessel density (cpVD, a 250 μm-wide elliptical annulus around the optic disc), and intra-papillary vessel density (ipVD, a 1.5×1.5 mm scan field) acquired by OCTA were measured. Their values were compared among normal controls and patients at each stage of glaucoma using one-way ANOVA, and the correlation between measurements obtained by the two methods was examined by univariate regression analysis. Results ONH tissue blood flow, tissue mean blur rate (MBR-T), and cpVD in the outer layer of the retina significantly decreased with the progression of glaucoma stage, although the latter showed no significant difference between normal subjects and mild-stage glaucoma patients. MBR-T was significantly correlated with cpVD, but not with ipVD, in the retinal outer layer. Conclusion A correlation was found only between MBR-T and cpVD in the retinal outer layer. A difference in MBR-T, but not in cpVD, was detected between normal controls and mild glaucoma patients.
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Affiliation(s)
- Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Tetsuya Sugiyama
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Mari Ueki
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki, Japan
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Michiko Maeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Emika Nemoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Satoru Tokuoka
- Department of Ophthalmology, Hokusetsu General Hospital, Takatsuki, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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Kohmoto R, Fukumoto M, Sato T, Oosuka S, Kobayashi T, Kida T, Suzuki H, Ikeda T. Rhegmatogenous retinal detachment with a giant tear located in the intermediate periphery: Two case reports. Medicine (Baltimore) 2019; 98:e14271. [PMID: 30681627 PMCID: PMC6358349 DOI: 10.1097/md.0000000000014271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE We experienced 2 cases of retinal detachment (RD) with giant tears located in the intermediate periphery of the fundus. In this case report, we investigated the clinical characteristics in these 2 cases. PATIENT CONCERNS AND DIAGNOSES Case 1 involved a 63-year-old male, who became aware of metamorphopsia and decreased visual acuity (VA) in his left eye. Upon examination, he was diagnosed with a giant tear at the margin of the intermediate peripheral lattice degeneration. Case 2 involved a 54-year-old male, who became aware of decreased VA in his right eye. Upon examination, he was diagnosed with vitreous hemorrhage and a giant tear located in the upper intermediate periphery. In these 2 cases, there was no obvious previous or familial history. INTERVENTIONS In both cases, reattachment was achieved by performing vitrectomies. OUTCOMES These 2 cases were characterized by the refraction being close to emmetropia due to the flat corneal curvature, even though there was a long axial length and the eyeballs were spherically large. In both cases, the postoperative clinical course outcome was favorable and no complication occurred LESSONS:: Our findings indicate that intermediate peripheral giant tears may occur in spherically large eyeballs, and that vitreous surgery is effective in such cases. Since the risk of the onset of RD in the fellow eye is thought to be high, strict postoperative follow-up is necessary.
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Kimura D, Fukumoto M, Sato T, Kohmoto R, Kobayashi T, Kida T, Ikeda T. Optical coherence tomography findings of falciform retinal detachment complicated with persistent fetal vasculature. BMC Ophthalmol 2018; 18:216. [PMID: 30157795 PMCID: PMC6114698 DOI: 10.1186/s12886-018-0893-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 08/21/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Falciform retinal detachment (FRD) usually causes pronounced retinal wrinkles, and the prognosis of visual function is poor. In this present study, we report a rare case of FRD in which optical coherence tomography (OCT) findings revealed a relatively good visual function. CASE PRESENTATION This study involved a 22-year-old female who had previously been diagnosed with FRD at 2 years of age, and who presented with microphthalmus in both eyes with pronounced retinal folds from the optic disc to the inferior-temporal side. Based on the clinical findings, we diagnosed it as persistent fetal vasculature (PFV). We found the visual function in her left eye to be relatively poor, yet from 6 to 22 years of age, the corrected visual acuity in that eye remained at 0.08. Although a nystagmus was present, Goldman perimetry showed a relatively wider visual field than expected. Optical coherence tomography (OCT) findings revealed that the retinal layer structure near the FRD was relatively well maintained, except for the temporal peripheral region. CONCLUSIONS Our findings reveal that OCT examination can be considered useful for predicting the visual function in cases of FRD.
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Affiliation(s)
- Daisaku Kimura
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki-City, Osaka, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takatoshi Kobayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
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Abstract
INTRODUCTION Asteroid hyalosis (AH) is characterized by mild vitreous-body liquefaction and a reduced likelihood of posterior vitreous detachment (PVD). Here, we report the clinical features of 2 cases of macular hole (MH) in eyes with AH. The extent of retinal vitreous adhesion at the time of vitreous surgery, the presence or absence of iatrogenic retinal breaks, and the postoperative course was examined in regard to the association with AH. CASE PRESENTATION Case 1 involved a 67-year-old female with decreased visual acuity in her left eye. Although preoperative optical coherence tomography examination revealed complete PVD with operculum around the fovea central region, vitreoretinal adhesion was quite strong starting at the midperiphery of the fundus, and an iatrogenic retinal break was formed at the inferior site during vitreous surgery. Endophotocoagulation was performed, and no onset of retinal detachment (RD) postsurgery was observed. Case 2 involved a 74-year-old male with metamorphopsia in his right eye. Preoperative perifoveal PVD was observed, yet vitreoretinal adhesion was strong starting at the midperiphery of the fundus and multiple iatrogenic retinal breaks had formed on the inferior, superior, and temporal sites. Moreover, RD occurred during surgery. Endophotocoagulation and gas tamponade was performed; however, postoperative RD requiring multiple reoperations occurred. CONCLUSION As with normal MH, MH with AH is thought to be caused by perifoveal PVD, yet as the vitreoretinal adhesion was found to be quite strong starting at the midperiphery of the fundus, we decided to keep the artificial PVD within a range where adhesion was loose.
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Oosuka S, Sato T, Tajiri K, Kimura D, Takai A, Kohmoto R, Fukumoto M, Kobayashi T, Kida T, Ikeda T. A Case of a Ruptured Eyeball Caused by High-Pressure Water Jets. Ophthalmic Surg Lasers Imaging Retina 2018; 49:451-455. [DOI: 10.3928/23258160-20180601-11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 01/22/2018] [Indexed: 11/20/2022]
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Kimura D, Kobayashi T, Maruyama E, Oosuka S, Kohmoto R, Fukumoto M, Sato T, Kida T, Ikeda T. Familial exudative vitreoretinopathy complicated with full thickness macular hole: A case report. Medicine (Baltimore) 2018; 97:e11048. [PMID: 29879073 PMCID: PMC5999500 DOI: 10.1097/md.0000000000011048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RATIONALE To report a case of familial exudative vitreoretinopathy (FEVR) complicated with full-thickness macular hole (FTMH). PATIENT CONCERNS A 39-year-old male presented after becoming aware of metamorphopsia in his left eye. DIAGNOSES Fundus examination showed a retinal avascular area, retinal vascular abnormality, and yellow exudation at the peripheral retina in both eyes. Optical coherence tomography findings revealed impending MH (IMH) due to posterior vitreous detachment (PVD) in his left eye. Despite of the occurrence of spontaneous complete PVD, an FTMH developed at 4 months after the onset of IMH. INTERVENTIONS To treat the FTMH, vitreous surgery was performed. Intraoperative findings revealed that the thick posterior vitreous membrane (PVM) had no adhesions with the edge of the FTMH. However, a thin epiretinal membrane (ERM) was observed around the MH. OUTCOMES Postoperatively, the FTMH was closed, and the patient's corrected visual acuity improved from (0.4) to (0.8). LESSONS In this present case, an IMH developed via traction by a thick PVM, characteristic of FEVR, with FTMH then developing via traction by a thin ERM. Our findings reveal that it is vital to fully understand these anatomical features before performing vitreous surgery for FTMH complicated with FEVR.
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Kimura D, Sato T, Oosuka S, Kohmoto R, Fukumoto M, Mimura M, Tajiri K, Kobayashi T, Kida T, Ikeda T. Case Report of a Family Affected by Stickler Syndrome in Which Rhegmatogenous Retinal Detachment Occurred in Five Eyes of Three Siblings. Case Rep Ophthalmol 2018; 9:1-8. [PMID: 29643775 PMCID: PMC5892342 DOI: 10.1159/000485551] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/22/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose Stickler syndrome is an autosomal dominant inherited disorder that is well known to be highly associated with the development of rhegmatogenous retinal detachment. In this study, we report the case of a family affected by Stickler syndrome in which rhegmatogenous retinal detachment developed in 5 eyes of 3 siblings. Case Series For treatment, we performed vitreous surgery on 1 eye of the eldest son, and bilateral scleral buckling surgery on the 2 younger children. A good postoperative outcome was obtained on the 4 eyes that underwent scleral buckling surgery, yet the prognosis was poor on the 1 eye that underwent vitrectomy due to redetachment of the retina and corneal complication. Since vitreous surgery was quite difficult due to strong vitreoretinal adhesion, we created an artificial posterior vitreous detachment via the bimanual technique combined with encircling. For the scleral buckling surgery, broad scleral extrusion was needed to seal multiple retinal breaks. Conclusions The findings of this study showed a high prevalence of rhegmatogenous retinal detachment in a single family with Stickler syndrome. In these cases, scleral buckling surgery was effective for treating the detached retina, and some prophylactic treatment, such as laser photocoagulation to prevent the occurrence of rhegmatogenous retinal detachment, should be considered for such cases in the future.
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Affiliation(s)
- Daisaku Kimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki-City, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Shou Oosuka
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Masashi Mimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Kensuke Tajiri
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | | | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Japan
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Kimura D, Kida T, Sato T, Fukumoto M, Kohmoto R, Kojima S, Mizuno H, Sakaguchi H, Sugasawa J, Ikeda T. A Case of Retinal Detachment with Unique Optical Coherence Tomography Findings after Gamma Knife® Radiosurgery Treatment for Choroidal Melanoma. Case Rep Ophthalmol 2018; 9:17-23. [PMID: 29643777 PMCID: PMC5892324 DOI: 10.1159/000485317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Accepted: 11/15/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose To report a case of retinal detachment with unique optical coherence tomography (OCT) findings after Gamma Knife® (GK; Elekta Instrument AB, Stockholm, Sweden) treatment for choroidal melanoma (CM). Case Report A 48-year-old woman underwent GK therapy for CM in her right eye from the macula to the temporal side. While the tumor subsequently shrank, the patient developed radiation retinopathy, which was treated with laser photocoagulation. The tumor lesions later subsided; however, her visual acuity (VA) decreased 8 years after the initial treatment. Although the tumor lesions in the right eye had become scarred, a bullous retinal detachment with fixed folds occurred in the superior-nasal quadrants. OCT examination revealed a preretinal membrane, vitreoretinal traction, and an inner retinal break; however, no outer retinal break was clearly detectable. MRI scans showed no increase in tumorous lesions, and 123I-IMP SPECT imaging showed no photon accumulation. Thus, it was determined that there was no tumor activity. The corrected VA in her right eye was light perception, and it was determined that there was no indication for vitreous surgery. Conclusion In this case, an inner retinal break was formed by the vitreoretinal traction around the scarred tumor and radiation retinopathy, thus suggesting the possibility of the development of a rhegmatogenous retinal detachment presumably complicated with an outer retinal break.
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Affiliation(s)
- Daisaku Kimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Hiroshi Mizuno
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,Department of Ophthalmology, Osaka City General Hospital, Osaka, Japan
| | - Hitoshi Sakaguchi
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,Department of Ophthalmology, Osaka City General Hospital, Osaka, Japan
| | - Jun Sugasawa
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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14
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Okuda Y, Kakurai K, Sato T, Morishita S, Fukumoto M, Kohmoto R, Takagi M, Kobayashi T, Kida T, Ikeda T. Two Cases of Rhegmatogenous Retinal Detachment Associated with Asteroid Hyalosis. Case Rep Ophthalmol 2018; 9:43-48. [PMID: 29643781 PMCID: PMC5892340 DOI: 10.1159/000485888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Accepted: 11/29/2017] [Indexed: 11/23/2022] Open
Abstract
Background To report two cases of rhegmatogenous retinal detachment (RRD) associated with asteroid hyalosis (AH). Case Presentation Two patients presented with RRD originating from a flap tear. Case 1 involved a 62-year-old male who was found to have bullous RRD in his left eye originating from a flap tear. During vitreous surgery, a thick vitreous cortex was found to have strongly adhered to the entire retinal surface, from the center to the periphery. A bimanual method was then used in conjunction with the vitrectomy to create an artificial posterior vitreous detachment. After surgery, the retina was successfully reattached, and his corrected visual acuity (VA) improved. Case 2 involved a 70-year-old male who was found to have localized RRD in his left eye originating from a flap tear. During vitreous surgery, a thick vitreous cortex was found to have strongly adhered to the entire retinal surface. After surgery, the retina was successfully reattached, and his corrected VA improved. Conclusions RRD associated with AH presents with stronger vitreoretinal adhesion compared to typical RRD, thus requiring a more complicated surgical technique to properly treat the patient.
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Affiliation(s)
- Yoshitaka Okuda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Keigo Kakurai
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.,Department of Ophthalmology, Yao Tokushukai General Hospital, Yao City, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan.,Department of Ophthalmology, Osaka Kaisei Hospital, Osaka City, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Mai Takagi
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | | | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
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15
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Kohmoto R, Kobayashi T, Sato T, Kimura D, Fukumoto M, Tajiri K, Kida T, Ikeda T. A case of proliferative diabetic retinopathy in which scintillating particles appeared in the intravitreal cavity after laser photocoagulation. BMC Ophthalmol 2017; 17:254. [PMID: 29258460 PMCID: PMC5735882 DOI: 10.1186/s12886-017-0654-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/11/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To report a case of proliferative diabetic retinopathy (PDR) exhibiting the appearance of scintillating particles presumed to be crystallin inside the intravitreal cavity after laser photocoagulation. CASE PRESENTATION A 56-year-old male patient presented at our outpatient clinic after becoming aware of decreased vision in his right eye. Ocular examination performed at the patient's initial visit revealed a massive preretinal macular hemorrhage due to PDR in his right eye. Fundus fluorescein angiography revealed extensive retinal non-perfusion areas and neovascularization in both eyes. However, no opacity was observed in the intravitreal cavity of his left eye. Vitreous surgery was performed on the patient's right eye after ultrasonic phacoemulsification aspiration and intraocular lens implantation. Post surgery, the corrected VA in that eye improved from 0.1 to 1.0. In correlation with the treatment performed on the patient's right eye, we began panretinal photocoagulation on his left eye. Examination performed prior to the patient's third session of panretinal photocoagulation revealed a large number of scintillating particles in the posterior vitreous gel in front of the retina. Examination via slit-lamp microscopy revealed that the particles were of varied hues, and closely resembled a 'Christmas tree' cataract. No posterior vitreous detachment was observed, and since these particles were situated as if captured in the posterior vitreous gel, no eye-movement-associated mobility of the particles was observed. Since the cloudiness was not severe enough to interfere with photocoagulation, additional photocoagulation was performed, and the patient is currently under observation. Six months have now passed since the fourth photocoagulation procedure was performed, and there has been no change in the state of the particles. Optical coherence tomography imaging revealed no change before and after the panretinal photocoagulation. The corrected VA in his left eye has remained at 1.0 during the postoperative follow-up period. CONCLUSIONS We speculate that the production of crystallin in the retina in this case was triggered by the photocoagulation procedure performed for diabetic retinopathy.
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Affiliation(s)
- Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takatoshi Kobayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Daisaku Kimura
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki-City, Osaka, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Kensuke Tajiri
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
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16
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Kakurai K, Hayashi M, Yamada K, Ishizaki N, Yonemoto Y, Morishita S, Kohmoto R, Sato T, Kida T, Ikeda T. A case of pseudoxanthoma elasticum with proliferative diabetic retinopathy. BMC Ophthalmol 2017; 17:184. [PMID: 28978321 PMCID: PMC5628442 DOI: 10.1186/s12886-017-0569-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Accepted: 09/21/2017] [Indexed: 12/03/2022] Open
Abstract
Background To report the case of a patient with pseudoxanthoma elasticum (PXE) and proliferative diabetic retinopathy (PDR), and discuss the relationship between PXE and diabetic retinopathy (DR). Case presentation A 47-year-old man with PXE presented with angioid streaks and DR in both eyes, and bilateral panretinal photocoagulation was performed for treatment. Vitrectomy had previously been performed in his right eye for vitreous hemorrhage due to PDR. Systemic findings included multiple, discrete, symmetrical, small yellow papules bilaterally in the axilla and inguinal region. Examination on presentation showed vitreous hemorrhage in his left eye, and vitrectomy was performed for treatment. Intraoperative findings showed fibrovascular membrane around the optic disc and vascular arcade. A mottled fundus (peau d’orange appearance) associated with angioid streaks was also present, yet there was no evident choroidal neovascularization (CNV). The postoperative course was satisfactory, and corrected visual acuity improved from 0.02 to 0.7 diopters. Conclusion Despite the peau d’orange appearance in both eyes of this case, no CNV was evident. The vitreous hemorrhage was thus attributed to PDR. Moreover, we reviewed the published literature and discuss the relationship between PXE and DR.
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Affiliation(s)
- Keigo Kakurai
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.,Department of Ophthalmology, Yao Tokushukai General Hospital, Yao-City, Osaka, Japan
| | - Maiko Hayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.,Department of Ophthalmology, Hokusetsu General Hospital, Takatsuki-City, Osaka, Japan
| | - Kanako Yamada
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.,Department of Ophthalmology, Yao Tokushukai General Hospital, Yao-City, Osaka, Japan
| | - Norihiko Ishizaki
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.,Department of Ophthalmology, Yao Tokushukai General Hospital, Yao-City, Osaka, Japan
| | - Yumiko Yonemoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.,Department of Ophthalmology, Yao Tokushukai General Hospital, Yao-City, Osaka, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan.
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17
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Suzuki H, Morishita S, Kohmoto R, Fukumoto M, Sato T, Kida T, Ueki M, Oku H, Nakamura K, Ikeda T. The effect of vitreomacular adhesion in exudative age-related macular degeneration on the results of ranibizumab intravitreal injection. Clin Ophthalmol 2017; 11:1471-1475. [PMID: 28860695 PMCID: PMC5565387 DOI: 10.2147/opth.s141779] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
PURPOSE To investigate whether vitreomacular adhesion (VMA) affects the outcome of anti-vascular endothelial growth factor (VEGF) therapy for the treatment of exudative age-related macular degeneration (AMD) in Japanese patients. SUBJECTS AND METHODS Of 88 Japanese AMD patients (28 men and 60 women, mean age: 72.7±7.5 years) who underwent intravitreal injection of ranibizumab for 3 years from 2010 to 2013, this study involved 12 eyes of 12 patients (10 men and two women) in whom VMA was observed based on optical coherence tomography (OCT) findings (VMA [+] group) and 17 eyes of 16 patients (seven men and nine women, control group) in whom no VMA was observed (VMA [-] group). In all enrolled patients, ranibizumab was administered monthly for 3 months, and then administered as needed (ie, pro re nata) when deterioration was observed. The two groups were then compared in regard to changes in visual acuity (VA) and the frequency of ranibizumab administration over a 1-year period. RESULTS No significant difference was found between the two groups in regard to the transformation of the mean logarithm of the minimum angle of resolution VA change after the first visit. Over the 1-year treatment, the mean frequency of ranibizumab administration for the VMA (+) group was 5.6±2.5 times and for the VMA (-) group was 3.8±1.1 times, thus illustrating a significant difference between the two groups (Mann-Whitney's U-test: P<0.05). CONCLUSION Our findings show that the mean frequency of ranibizumab administration for the VMA (+) group was higher than that in the VMA (-) group, thus indicating that VMA might possibly be involved in the progress of AMD pathology.
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Affiliation(s)
- Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Mari Ueki
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
| | | | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka, Japan
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18
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Kimura D, Sato T, Suzuki H, Kohmoto R, Fukumoto M, Tajiri K, Kobayashi T, Kida T, Ikeda T. A Case of Rhegmatogenous Retinal Detachment at Late Stage following Endogenous Bacterial Endophthalmitis. Case Rep Ophthalmol 2017; 8:334-340. [PMID: 28690534 PMCID: PMC5498944 DOI: 10.1159/000477160] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 04/28/2017] [Indexed: 11/24/2022] Open
Abstract
Purpose To report a case of rhegmatogenous retinal detachment in the late stage, despite the fact that it had previously been halted after intravitreal injection of an antimicrobial agent against endogenous bacterial endophthalmitis (EBE). Case This study involved a 62-year-old male who had previously been diagnosed with septicemia due to liver abscess and the detection of Klebsiella pneumoniae in a culture of his liver abscess, and who underwent ophthalmic examination after his conjunctival hyperemia had failed to improve. Visual acuity could not be measured due to his general condition being poor and his declining level of consciousness. Slit lamp examination revealed bilateral iritis and cataracts, and the fundus was invisible due to vitreous opacity. Ultrasonic B-mode examination showed subretinal abscess and exudative retinal detachment, leading to the diagnosis of EBE. Vitreous injections of antibiotics were administered to both of his eyes. His right eye became affected by phthisis bulbi, but the condition in his left eye subsided, leaving a scarred lesion near the macula. However, complete retinal detachment occurred in his left eye approximately 10 months after the vitreous injection. During vitreous surgery, proliferative membrane formation was observed in the posterior pole area, and an irregular retinal break was detected in the scar margin caused by the traction of the proliferative membrane. After vitreous surgery, the retina was reattached under silicone oil. Conclusion In cases of EBE, even if the inflammation has previously subsided, strict follow-up examinations are necessary, since complications such as rhegmatogenous retinal detachment may occur at a late stage.
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Affiliation(s)
- Daisaku Kimura
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,Department of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Kensuke Tajiri
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | | | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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19
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Maeda M, Kojima S, Sugiyama T, Jin D, Takai S, Oku H, Kohmoto R, Ueki M, Ikeda T. Effects of Gelatin Hydrogel Containing Anti-Transforming Growth Factor-β Antibody in a Canine Filtration Surgery Model. Int J Mol Sci 2017; 18:ijms18050985. [PMID: 28475118 PMCID: PMC5454898 DOI: 10.3390/ijms18050985] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 04/27/2017] [Accepted: 05/02/2017] [Indexed: 11/17/2022] Open
Abstract
In this present study, we investigated the effect of a controlled release of anti-transforming growth factor β (TGF-β) antibody on intraocular pressure (IOP), bleb formation, and conjunctival scarring in a canine glaucoma filtration surgery model using gelatin hydrogel (GH). Glaucoma surgery models were made in 14 eyes of 14 beagles and divided into the following two groups: (1) subconjunctival implantation of anti-TGF-β antibody-loaded GH (GH-TGF-β group, n = 7), and (2) subconjunctival implantation of GH alone (GH group, n = 7). IOP and bleb features were then assessed in each eye at 2- and 4-weeks postoperative, followed by histological evaluation. We found that IOP was significantly reduced at 4-weeks postoperative in the two groups (p < 0.05) and that IOP in the GH-TGF-β-group eyes was significantly lower than that in the GH-group eyes (p = 0.006). In addition, the bleb score at 4-weeks postoperative was significantly higher in the GH-TGF-β group than in the GH group (p < 0.05), and the densities of fibroblasts, proliferative-cell nuclear antigen (PCNA)-positive cells, mast cells, and TGF-β-positive cells were significantly lower in the GH-TGF-β group than in the GH group. The findings of this study suggest that, compared with the GH-group eyes, implantation of anti-TGF-β antibody-loaded GH maintains IOP reduction and bleb formation by suppressing conjunctival scarring due to the proliferation of fibroblasts for a longer time period via a sustained release of anti-TGF-β antibody from GH.
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Affiliation(s)
- Michiko Maeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
| | - Shota Kojima
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
| | - Tetsuya Sugiyama
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
- Nakano Eye Clinic of Kyoto Medical Cooperative, Kyoto 604-8404, Japan.
| | - Denan Jin
- Department of Innovative Medicine, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
| | - Shinji Takai
- Department of Innovative Medicine, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
| | - Mari Ueki
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki-City, Osaka 569-8686, Japan.
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20
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Sato T, Kohmoto R, Fukumoto M, Morishita S, Kimura D, Tajiri K, Kobayashi T, Kida T, Kojima S, Ikeda T. A Case of Diabetic Macular Edema with Prominent Chorioretinal Folds. Case Rep Ophthalmol 2017; 8:163-169. [PMID: 28611649 PMCID: PMC5465737 DOI: 10.1159/000461574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 02/08/2017] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report a case of diabetic macular edema with prominent chorioretinal folds. CASE REPORT This study involved a 55-year-old male with untreated bilateral diabetic retinopathy who had undergone cataract surgery at another clinic. Following that surgery, diabetic macular edema rapidly exacerbated, accentuating marked cystoid macular edema and radial chorioretinal folds in the macula. Investigation of his medical history revealed that in addition to diabetes, he had uncontrolled hypertension and severe diabetic nephropathy. Vitreous surgery was performed on both eyes due to a resistance to a subtenon injection of triamcinolone acetonide or intravitreal injection of an antivascular endothelial growth factor agent. After surgery, the macular edema and chorioretinal folds showed a tendency towards improvement. Thereafter, kidney transplant surgery was performed for renal failure, and a mild tendency of chorioretinal folds was observed. CONCLUSION In the case presented in this study, we observed remarkable cystoid macular edema in the fovea centralis and theorize that distortion with the surrounding tissue might have occurred, thus leading to the formation of chorioretinal folds around the macula.
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Affiliation(s)
- Takaki Sato
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Ryohsuke Kohmoto
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Masanori Fukumoto
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Seita Morishita
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,bDepartment of Ophthalmology, Osaka Kaisei Hospital, Takatsuki, Japan
| | - Daisaku Kimura
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan.,cDepartment of Ophthalmology, Takatsuki Red Cross Hospital, Takatsuki, Japan
| | - Kensuke Tajiri
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | | | - Teruyo Kida
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Shota Kojima
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Tsunehiko Ikeda
- aDepartment of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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21
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Nemoto E, Morishita S, Akashi M, Kohmoto R, Fukumoto M, Suzuki H, Kobayashi T, Kida T, Sugasawa J, Ikeda T. A Case of Proliferative Retinopathy Complicated with Tuberous Sclerosis Treated by Vitreous Surgery. Case Rep Ophthalmol 2017; 7:277-283. [PMID: 28101046 PMCID: PMC5216218 DOI: 10.1159/000453391] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2016] [Accepted: 07/21/2016] [Indexed: 11/30/2022] Open
Abstract
We report a case of proliferative retinopathy complicated with retinal hamartoma in a tuberous sclerosis patient. This study involved a 16-year-old female patient who was diagnosed as having tuberous sclerosis at birth. Ophthalmic examination revealed retinal hamartoma surrounding the optic disc in both eyes. Vitreous surgery involving a vitrectomy and resection of the proliferative membranes was performed for proliferative retinopathy in her right eye. Postoperative fundus findings showed improvement and decreased exudative changes. The proliferative and exudative changes appeared to be due to the retinal hamartoma, and vitreous surgery proved effective in this case.
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Affiliation(s)
- Emika Nemoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Mari Akashi
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | | | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Jun Sugasawa
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki City, Japan
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22
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Kitagaki T, Morishita S, Kohmoto R, Fukumoto M, Suzuki H, Sato T, Kobayashi T, Kida T, Nakajima M, Ikeda T. A Case of Intraocular Erosion and Intrusion by an Arruga Suture. Case Rep Ophthalmol 2016; 7:174-8. [PMID: 27099609 PMCID: PMC4836125 DOI: 10.1159/000445317] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report a case of intraocular erosion and intrusion by an Arruga suture. CASE REPORT This study involved a 62-year-old male who had undergone scleral buckling surgery 40 or more years ago at another hospital for rhegmatogenous retinal detachment, as well as trabeculectomy 20 years ago for primary open-angle glaucoma, in his left eye at the same hospital. However, he recently became aware of blurred vision in that eye. Upon examination, iritis was observed in the anterior portion of his left eye, as well as a great number of pigment cell keratoprecipitates on the posterior surface of the cornea. In the ocular fundus, extensive atrophy of the retinal pigment epithelium and partial hyperpigmentation was observed, accompanied by subretinal strands, yet the retina remained attached. Around the entire peripheral area of the retina we observed a ring-shaped protrusion, but we also saw a shiny, filamentous material in the vitreous cavity that penetrated the sclera and choroid, completely extending from the 4- to 8-o'clock position of the scleral buckle protrusion. To treat the iritis in the patient's left eye, we began to administrate low-concentration steroid eye drops, after which the inflammation disappeared. CONCLUSION In this study, we experienced a case of intraocular erosion and intrusion by an Arruga suture, and opted to treat the patient with steroid eye drops and conservative follow-up observations unless retinal redetachment and/or vitreous hemorrhage occurs.
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Affiliation(s)
- Takakuni Kitagaki
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | | | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
| | | | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, Takatsuki, Japan
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Ueki M, Morishita S, Kohmoto R, Fukumoto M, Suzuki H, Sato T, Kobayashi T, Kida T, Oku H, Ikeda T, Shibayama Y. Comparison of histopathological findings between idiopathic and secondary epiretinal membranes. Int Ophthalmol 2016; 36:713-8. [PMID: 26857724 DOI: 10.1007/s10792-016-0194-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 01/28/2016] [Indexed: 10/22/2022]
Abstract
To evaluate the histopathological findings of idiopathic and secondary epithelial membranes (ERMs). This study involved 19 ERM cases that underwent pars plana vitrectomy (PPV). ERM specimens were obtained from each patient during PPV and immediately fixed in 10 % formalin. Paraffin sections were stained with hematoxylin eosin (HE) and immunohistochemical analysis was performed with glial fibrillary acidic protein (GFAP), Ki-67, CD34, and nestin antibodies. The 19 ERM cases included 11 idiopathic ERM cases and 8 secondary ERM cases i.e., 2 eyes that underwent PPV for retinal detachment and 6 eyes that underwent PPV for proliferative diabetic retinopathy. HE staining showed that some of the idiopathic ERM specimens consisted of internal limiting membrane. In contrast, numerous invasive cells were observed in the secondary ERM specimens compared to the idiopathic ERM specimens. Immunohistochemical analysis revealed GFAP-positive cells in 4 of the 11 idiopathic ERMs cases, yet no nestin-, Ki-67-, or CD34-positive cells in those cases. In contrast, there were 4 GFAP-positive cases, 2 Ki67-positive cases, 3 CD34-positive cases, and 7 cases including nestin-positive cells. The findings of this study indicate that there are different histological characteristics between idiopathic and secondary ERM and that mature nestin-positive cells in the retina might be related to secondary ERM formation.
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Affiliation(s)
- Mari Ueki
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Seita Morishita
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Ryohsuke Kohmoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Masanori Fukumoto
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Hiroyuki Suzuki
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Takaki Sato
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Takatoshi Kobayashi
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Teruyo Kida
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan.
| | - Hidehiro Oku
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Tsunehiko Ikeda
- Department of Ophthalmology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki-City, Osaka, 569-8686, Japan
| | - Yuro Shibayama
- Department of Pathology, Osaka Medical College, Takatsuki-City, Osaka, Japan
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