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

PURPOSE: Water inflow into the vitreous body regulated by retinal aquaporin-4 distributed within Müller cells has been observed in mice; however, the changes in this phenomenon with age remain unknown. This study aimed to evaluate whether intravenously injected H2O also flows into the vitreous body of human subjects and to investigate whether water dynamics in the human posterior eye change with age using [15O]H2O positron emission tomography (PET). METHODS: Forty-six normal adult volunteers underwent [15O]H2O PET, and the standard uptake value (SUV) in the center of the vitreous body after 1000-MBq [15O]H2O administration was assessed. The SUV was fitted to an exponential curve, and y0, the steady state of the SUV, and b, the speed of increase in the SUV, were calculated. The results for patients ranging from in age from 20 to 39, 40 to 59, and 60 to 79 years were compared using analyses of variance followed by Games to Howell tests. RESULTS: For the parameter y0, statistical analysis revealed no statistically significant differences among the three groups. For parameter b, statistical analysis revealed statistically significant differences between the 20 to 39 and 60 to 79 age groups (P = 0.000), the 40 to 59 and 60 to 79 age groups (P = 0.025), and the 20 to 39 and 40 to 59 age groups (P = 0.037). CONCLUSIONS: The present study revealed that H2O injected into the vein flows into the human vitreous body and that the speed of increase in water flow into the vitreous body decreases with aging. This study suggests that water dynamics in the posterior eye, or the retinal glymphatic pathway, change significantly with aging.

DOI： 10.1167/iovs.64.12.22

PubMed

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Publishing type：Research paper (scientific journal)   Publisher：MDPI AG  

Spasm of near reflex (SNR) involves intermittent spasm of one or more of the three near reflex components. Psychiatric disorders are one cause of SNR. We describe a patient with SNR diagnosed with autism spectrum disorder (ASD). A 36-year-old male with esotropia since childhood was referred due to headache and dizziness. The alternate prism cover test showed 30 prism diopters at both near and distant fixation. Four months after his first visit, he was diagnosed with ASD. Twenty-nine months after his first visit, he underwent strabismus surgery to treat concomitant esotropia. Postoperatively, the angle of strabismus improved but remained variable. Because the angle of strabismus varied, we suspected SNR; the diagnosis was performed after evaluating the patient’s microfluctuations in accommodation with Speedy-K. However, it was difficult to distinguish convergence spasm from concomitant esotropia in this patient because he has had a history of esotropia since childhood. In a patient with concomitant esotropia, if the symptoms are not exclusively due to strabismus, SNR should be suspected. Although the relationship between SNR and the pathology of ASD is unknown, it is possible that patients with ASD are more likely to develop SNR.

DOI： 10.3390/reports6030038

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

Abstract

Background

Posterior microphthalmos (PM) is a rare condition with poor visual prognosis even after amblyopia treatment. We report a case of PM with achievement of good visual acuity and disappearance of papillomacular retinal folds (PFs) over a period of 7 years.

Case presentation

A girl aged 3 years and 5 months was referred to our hospital, after poor visual acuity was identified at a medical checkup for 3-year-olds. She had severe spherical hyperopia: + 17.25 D in the right eye (RE) and + 18 D in the left eye (LE). Her corrected visual acuity was 20/200 in the RE and 20/250 in the LE. PFs were observed in both eyes on optical coherence tomography (OCT), and the diagnosis of PM was made based on the normal corneal diameter and anterior chamber depth. During the course of the disease, a gradual decrease in the height of the PFs was observed on OCT. The corrected visual acuity at age 10 years was 20/20 in the RE and 20/25 in the LE.

Conclusions

The visual prognosis of PM is poor, and only one case with good visual acuity has been reported in the literature. The patient in the present case not only developed good visual acuity, but also showed improvement in macular morphology, which was not noted in previous reports. Early diagnosis of PM and early amblyopia treatment is important for the visual development in PM.

DOI： 10.1186/s12886-022-02648-9

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Other Link： https://link.springer.com/article/10.1186/s12886-022-02648-9/fulltext.html

Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s10384-022-00954-9

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Other Link： https://link.springer.com/article/10.1007/s10384-022-00954-9/fulltext.html

Language：English  

The purpose of this study was to investigate the clinical characteristics of Japanese patients with optic nerve hypoplasia (ONH), with particular attention to the prevalence of brain abnormalities. We retrospectively analysed the medical charts of 16 patients who were diagnosed with ONH and who underwent magnetic resonance imaging (MRI) at Niigata University Medical and Dental Hospital. We recorded the age, sex, laterality, initial eye and visual symptoms, best-corrected visual acuity, and brain abnormalities on MRI (excluding ONH). The median age at the first visit to the Ophthalmology Clinic was 2.4 years old. Four patients were male and 12 were female. ONH was bilateral in 11 patients and unilateral in five. Best-corrected visual acuity ranged from no light perception to 20/20. Seven patients (43.8%) had brain abnormalities including agenesis of the septum pellucidum, pituitary gland hypofunction, cerebral dysplasia, and West syndrome. Five of these seven patients had general manifestations since the neonatal or infantile period. Our study revealed the prevalence of brain abnormalities associated with optic nerve hypoplasia in Japanese patients at a single institute. Because two of 11 patients had no general manifestations since the neonatal or infantile period but demonstrated brain abnormalities, MRI should be performed to investigate all patients with ONH.

DOI： 10.1080/01658107.2020.1844758

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Publishing type：Research paper (scientific journal)   Publisher：Hindawi Limited  

Many of the focal neurological symptoms associated with Alzheimer’s disease (AD) are due to synaptic loss. Glutamate chemical exchange saturation transfer (GluCEST) magnetic resonance imaging (MRI) is a candidate method to assess synaptic dysfunction. We assessed chronological changes in GluCEST in a 5xFAD mouse model of AD, comparing Glucest effects and regional cerebral blood flow (CBF). GluCEST effects and CBF in 5xFAD mice aged 1–15 months and their littermates (WT) were measured. Neurite orientation dispersion and density imaging (NODDI) MRI reflecting dendritic/axonal density was also measured and compared with GluCEST in 7-month-old mice. While regional CBF’s decrease began at 7 months, GluCEST-reduction effects preceded hypoperfusion of the temporal cortex and hippocampus. While longitudinal 5xFAD mouse measurements revealed a correlation between the regional GluCEST effects and CBF, a generalized linear mixed model revealed statistically different correlations in cortical and basal brain regions. Further, NODDI-derived neurite density correlated with GluCEST effects in the parietal cortex, but not in the hippocampus, thereby revealing regional differences in pathophysiological mechanisms. Finally, GluCEST’s effects correlated with regional synaptophysin. These results demonstrate that GluCEST can reflect subtle synaptic changes and may be a potential imaging method for AD diagnosis as well as serve as a biomarker of AD progression.

DOI： 10.1155/2020/8831936

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Other Link： http://downloads.hindawi.com/journals/cmmi/2020/8831936.xml

Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

DOI： 10.1016/j.ecns.2020.07.002

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Language：Japanese   Publisher：(公財)日本眼科学会  

目的:正常眼圧緑内障の加療中に視交叉部腫瘍の合併が明らかになった4例を提示し,腫瘍合併を疑うべき所見について検討する.症例:合併した視交叉部腫瘍は,3例は下垂体腺腫,1例は鞍結節部髄膜腫であった.いずれの症例も急速な視野障害進行と片眼もしくは両眼の視力低下を伴っていた.2例では乳頭蒼白を伴っていたが,2例ではなかった.症例1の両耳側半盲所見は,10°内視野測定で初めて検出された.結論:緑内障症例に視交叉部腫瘍合併を疑う眼科的所見として,垂直経線を境界とする視野障害,急激な視力低下・視野悪化,乳頭蒼白などが挙げられるが,進行した緑内障症例では耳側半盲所見が判別しづらいことがあり,10°内視野測定が有用な場合がある.疑われる場合には積極的に頭蓋内画像検索を行うことが勧められる.(著者抄録)

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Language：Japanese   Publisher：(一社)日本脳循環代謝学会  

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Language：English  

Matrix metalloproteinases (MMPs) damage the neurovascular unit, promote the blood-brain barrier (BBB) disruption following ischemic stroke, and play essential roles in hemorrhagic transformation (HT), which is one of the most severe side effects of thrombolytic therapy. However, no biomarkers have presently been identified that can be used to track changes in the distribution of MMPs in the brain. Here, we developed a new 19F-molecular ligand, TGF-019, for visualizing the distribution of MMPs in vivo using 19F-magnetic resonance spectroscopic imaging (19F-MRSI). We demonstrated TGF-019 has sufficient sensitivity for the specific MMPs suspected in evoking HT during ischemic stroke, i.e., MMP2, MMP9, and MMP3. We then utilized it to assess those MMPs at 22 to 24 hours after experimental focal cerebral ischemia on MMP2-null mice, as well as wild-type mice with and without the systemic administration of the recombinant tissue plasminogen activator (rt-PA). The 19F-MRSI of TGN-019-administered mice showed high signal intensity within ischemic lesions that correlated with total MMP2 and MMP9 activity, which was confirmed by zymographic analysis of ischemic tissues. Based on the results of this study, 19F-MRSI following TGN-019 administration can be used to assess potential therapeutic strategies for ischemic stroke.

DOI： 10.1155/2019/8908943

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

The blood-brain barrier (BBB), which imposes significant water permeability restriction, effectively isolates the brain from the systemic circulation. Seemingly paradoxical, the abundance of aquaporin-4 (AQP-4) on the inside of the BBB strongly indicates the presence of unique water dynamics essential for brain function. On the basis of the highly specific localization of AQP-4, namely, astrocyte end feet at the glia limitans externa and pericapillary Virchow-Robin space, we hypothesized that the AQP-4 system serves as an interstitial fluid circulator, moving interstitial fluid from the glia limitans externa to pericapillary Virchow-Robin space to ensure proper glymphatic flow draining into the cerebrospinal fluid. The hypothesis was tested directly using the AQP-4 facilitator TGN-073 developed in our laboratory, and [O]H2O JJ vicinal coupling proton exchange MRI, a method capable of tracing water molecules delivered into the blood circulation. The results unambiguously showed that facilitation of AQP-4 by TGN-073 increased turnover of interstitial fluid through the system, resulting in a significant reduction in [O]H2O contents of cortex with normal flux into the cerebrospinal fluid. The study further suggested that in addition to providing the necessary water for proper glymphatic flow, the AQP-4 system produces a water gradient within the interstitial space promoting circulation of interstitial fluid within the BBB.

DOI： 10.1097/WNR.0000000000000990

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：(公社)日本視能訓練士協会  

【目的】網膜色素変性(RP)患者の黙読能力の他覚的評価を試みた。【対象及び方法】新潟大学医歯学総合病院通院中のRP患者11名(37.4±17.6歳)と健常者(N)20名(46.9±17.2歳)。視線解析装置(Tobii Tx300)にて横書き文黙読時の平均停留時間およびsaccade時間、100文字あたりの読み時間、停留回数を算出した。また読書時のsaccadeを幅と角度の2変数から混合ガウスモデルによるクラスタ分類およびクラス分類し、その割合をχ2検定で検討した。【結果】平均停留時間はRP群256.3±41.6msec、N群215.7±24.9msec(p<0.01)、saccade時間RP群44.28±8.26msec、N群50.78±11.45msec(P=0.11)、停留回数はRP群31.1±7.9回、N群32.7±10.6回(p=0.66)、読み時間はRP群9.4±3.0sec、N群8.8±3.4sec(p=0.65)で、RP群において停留時間が延長した。各saccadeは短・長順行、逆行、行替えに分類されその構成に両群間で有意差を認めた(p=0.03)。RP群において短順行、長順行saccadeが多く、逆行saccadeが少なかった(p<0.01)。【結論】RP群は平均停留時間が延長しsaccadeパターンに変化がみられたが、読み時間は延長しなかった。今後は視野異常の重症度に着目した解析が必要である。(著者抄録)

DOI： 10.4263/jorthoptic.046F128

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Other Link： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01962&link_issn=&doc_id=20180306160031&doc_link_id=130006515549&url=http%3A%2F%2Fci.nii.ac.jp%2Fnaid%2F130006515549&type=CiNii&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00003_1.gif

Language：English  

BackgroundThe aim of the present study was to investigate maturational changes in glutamate (Glu) in the human cerebral cortex from childhood to young adulthood using 3.0-Tesla proton magnetic resonance spectroscopy (1H-MRS), which is capable of quantifying Glu in vivo.MethodsNormal volunteers comprising 11 children (aged 4-13 years) and 11 young adults (aged 18-33 years) participated in the study. Single-voxel point-resolved spectroscopy (PRESS, repetition time/echo time=2,000/80 ms) was performed on the frontal and occipital cortices, and the Glu-to-creatine ratio (Glu/Cr) and N-acetylaspartate-to-creatine ratio (NAA/Cr) were determined.ResultsIn both the frontal and occipital cortices, Glu/Cr was significantly lower during young adulthood relative to that during childhood. NAA/Cr did not differ significantly between the two age groups.ConclusionThis study has provided objective evidence that cerebral cortical Glu/Cr decreases between childhood and young adulthood. The observed decrease in Glu/Cr may reflect the simultaneous occurrence of maturational changes, such as changes in cortical microstructure and the intercellular compartmentation of Glu metabolism.

DOI： 10.1038/pr.2017.101

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

ObjectiveNeuromyelitis optica spectrum disorder (NMOsd) is an autoimmune disorder of the central nervous system characterized by aquaporin-4 (AQP4) autoantibodies. The aim of this study was to elucidate the characteristics of involvement of the anterior visual pathway (AVP) and neurodegeneration via glia-neuron interaction in NMOsd.
MethodsThirty Japanese patients with serologically verified NMOsd were assessed with a neuro-ophthalmological study. Using 27 tissue blocks from 13 other cases of NMOsd, we performed neuropathological analysis of glial and neuroaxonal involvement in the AVP.
ResultsThe AVP involvement in NMOsd was characterized by the following, compared to multiple sclerosis: (1) longitudinally extensive optic neuritis (ON); (2) more severe visual impairment and worse prognosis for ON; (3) unique AQP4 dynamics, including loss of AQP4 immunoreactivity on astrocytes with complement activation in ON lesions, loss of AQP4 immunoreactivity on Muller cells with no deposition of complement in the retinas, and densely packed AQP4 immunoreactivity on astrocytes in gliosis of secondary anterograde/retrograde degeneration in the optic nerves and retinal nerve fiber layer (RNFL); and (4) more severe neurodegeneration, including axonal accumulation of degenerative mitochondria and transient receptor potential melastatin 4 channel with complement-dependent astrocyte pathology in ON lesions, mild loss of horizontal cells, and RNFL thinning and loss of ganglion cells with abundance of AQP4(+) astrocytes, indicating secondary retrograde degeneration after ON.
InterpretationSevere and widespread neuroaxonal damage and unique dynamics of astrocytes/Muller cells with alterations of AQP4 were prominent in the AVP and may be associated with poor visual function and prognosis in NMOsd. Ann Neurol 2016;79:605-624

DOI： 10.1002/ana.24608

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Language：Japanese   Publisher：日本神経眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: To report a case of acute glaucoma due to complete ring cyst of the ciliary body.
Patients and Methods: A 33-year-old woman experienced blurred vision in her left eye. Intraocular pressure of the left eye was elevated accompanied with a very shallow anterior chamber. Anterior segment-optical coherence tomography and ultrasound biomicroscopy detected ring-shaped ciliary masses in the both eyes. Myopic change and contact between the ciliary mass and lens in the left eye suggested the presence of aqueous misdirection resulting in forward displacement of the lens-iris diaphragm. Because elevated intraocular pressure was refractory to conservative management, the left eye underwent clear lens aspiration and implantation of intraocular lens.
Results: Although the anterior chamber became deep in the left eye initially after lens extraction in conjunction with core vitrectomy, possible aqueous misdirection recurred. Second vitrectomy in the left eye together with posterior and anterior capsulotomies, to establish humoral communication between the anterior and posterior chambers, deepened the anterior chamber and lowered the intraocular pressure. The anterior chamber in the fellow right eye remained deep a year after the episode.
Conclusions: This is the first reported case of bilateral ring cysts of the ciliary body. The manifestation caused secondary glaucoma, which was resolved by lensectomy and vitrectomy.

DOI： 10.1097/IJG.0b013e31827a088c

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

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Language：Japanese   Publishing type：Research paper (international conference proceedings)  

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Language：Japanese   Publisher：眼科臨床紀要会  

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

DOI： 10.11477/mf.1410104132

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Other Link： http://search.jamas.or.jp/link/ui/2012151248

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

DOI： 10.11477/mf.1410104061

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Other Link： http://search.jamas.or.jp/link/ui/2012092785

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

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

A 68-year-old man who had received hormone therapy for prostate cancer was referred to our hospital with complaints of left visual loss. An ophthalmoscopic examination revealed, a yellowish-white, subretinal elevation in his left eye. One week later, a left exophthalmos appeared, and computed tomography and magnetic resonance imaging were conducted. The images revealed tumors in the left orbit and left middle cranial fossa. The left optic nerve was deviated by the left orbital tumor, but not directly compressed. With his past history of multiple bone metastases from prostate cancer and a finding by computed tomography of osteoblastic changes of the left anterior clinoid process of the sphenoid bone, we regarded the tumors as metastases from prostate cancer. We also regarded the subretinal elevation as a choroidal metastasis from prostate cancer. The signal intensity of the metastatic tumor was reduced in T2-weighted magnetic resonance images after radiation therapy. Although orbital and choroidal metastases from prostate cancer are rare, clinicians should not overlook these.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：INFORMA HEALTHCARE  

Recently available coronal fast magnetic resonance imaging (MRI) has very high spatial resolution with good contrast between the optic nerves and cerebrospinal fluid (CSF). The aim of this study was to evaluate the diagnostic value of coronal fast imaging in optic nerve diseases. Thirty-five patients with various Neuro-ophthalmic conditions including 9 with optic neuritis, 6 with optic atrophy, 5 with glaucoma, 4 with segmental optic nerve hypoplasia and 11 with other optic neuropathies including orbital apex syndrome were evaluated with the three-dimensional fast imaging employing steady-state acquisition (FIESTA) sequence in addition to standard MRI protocols. The optic nerve complexes were evaluated on coronal images of the orbits. Detailed demonstration of the optic nerve complex-the optic nerve, the perineural CSF space and dural sheath-could be readily obtained with FIESTA sequence. The acute phase of both optic neuritis and perineuritis showed enlargement of the perineural CSF space; the optic nerve was swollen in optic neuritis but not in perineuritis. Cases of optic atrophy and glaucoma showed perineural CSF space enlargement with normal optic sheath circumference and a thinner optic nerve, while optic nerve hypoplasia showed a smaller dural sheath circumference without perineural CSF space enlargement. In the cases of orbital apex syndrome optic nerve compression by the extraocular muscles was clearly shown. Coronal FIESTA imaging of the orbit is capable of delineating detailed structural changes in the optic nerve complex and is of diagnostic value for the differentiation of optic nerve diseases.

DOI： 10.3109/01658101003587825

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Purpose: To investigate, using optical coherence tomography (OCT), whether retinal nerve fiber layer thickness (RNFLT) is affected in amblyopic eyes. Methods: Using OCT (Stratus OCTTM [Carl Zeiss, Dublin, CA]), the RNFLT was measured in 26 patients with persistent unilateral amblyopia and in 25 patients with recovered unilateral amblyopia. The RNFLT was compared between the affected and fellow eyes in patients with persistent amblyopia and in those with recovered amblyopia, and between the amblyopic eyes of patients with persistent amblyopia and the previously amblyopic eyes of patients with recovered amblyopia. Results: In patients with persistent amblyopia and in those with recovered amblyopia, the affected eyes were significantly more hyperopic than the fellow eyes. The average (±standard deviation) RNFLT measured 105.5 ± 14.0 μm for the persistently amblyopic eyes
this value did not significantly differ from that of the fellow eyes (105.2 ± 13.0 μm) or the previously amblyopic eyes of recovered amblyopia (107.1 ± 11.7 μm). Also, logistic regression analysis adjusting for refraction showed no significant difference in the RNFLT between the persistently amblyopic eyes and the previously amblyopic eyes. Conclusions: Our results indicate that there is no significant change in the RNFLT in amblyopic eyes. © 2010 Miki et al.

DOI： 10.2147/OPTH.S13145

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Purpose: To investigate the characteristics of optic disc parameters in amblyopic eyes in which retinal involvement is uncertain. Methods: A total of 44 patients with a history of unilateral amblyopia (27 patients with persistent amblyopia and 17 patients with resolved amblyopia) were examined using the Heidelberg Retina Tomograph (HRT) II. Parameters examined included disc area, cup area, cup volume, rim area, rim volume, cup-to-disc area ratio, and mean retinal nerve fiber layer thickness. Results: In patients with persistent amblyopia, the amblyopic eyes were significantly more hyperopic than the fellow eyes. In the HRT parameters, there were no significant differences between the amblyopic and fellow eyes. In addition, after adjusting for refraction, the presence of strabismus, and the disc area, there was no significant difference in any HRT parameter between the amblyopic eyes of patients with persistent amblyopia and the previously amblyopic eyes of patients with resolved amblyopia. Conclusions: We did not find any strong evidence for the deformity of the optic disc of amblyopic eyes. © 2010 Miki et al.

DOI： 10.2147/OPTH.S13143

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：AMER ASSOC NEUROLOGICAL SURGEONS  

Object. Three-dimensional anisotropy contrast (CDAC) magnetic resonance (MR) imaging provides clear depiction of neuronal fibers. The aim of this study was to identify intracavernous cranial nerves in patients with pituitary macro-adenoma and in healthy volunteers by using 3DAC MR imaging on a 3-tesla system and to preoperatively predict cavernous sinus invasion by pituitary macroadenoma.
Methods. Thirty-three patients (cavernous sinuses in 66 sides) with pituitary macroadenomas and 25 healthy volunteers (50 sides) participated in this study. Coronal 3DAC MR images constructed from diffusion weighted images, acquired with periodically rotated overlapping parallel lines with enhanced reconstruction (PROPELLER) sequences, and T2-weighted reverse images were obtained at the same anatomical locations using a 3-tesla MR imaging system. Attempts were made to identify the cranial nerves.
Results. The oculomotor and ophthalmic/maxillary nerves were preoperatively identified in all sides (66 sides in patients and 50 sides in healthy volunteers) on 3DAC MR images. In the 33 patients, cavernous sinus invasion was revealed in 10 (12 [18.2%] of 66 sides) by intraoperative endoscopic observation. Coronal 3DAC MR images revealed that the oculomotor nerves were half surrounded with adenoma in all 12 of these sides, and the ophthalmic/maxillary nerves were half encapsulated with tumor (sensitivity/specificity: 100%/100% and 83%/100%, respectively).
Conclusions. Preoperative evaluation of pituitary macroadenomas using 3DAC PROPELLER MR imaging on a 3-tesla system is likely to be a powerful noninvasive method of detecting cavernous sinus invasion, which can potentially dominate the therapeutic strategy for these lesions.

DOI： 10.3171/JNS/2008/108/01/0037

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

A 66-year-old Japanese man had bilateral extraocular muscle swelling, followed by an obvious change in his bilateral eye position along with motility limitation over a one-year period. His right eye with high myopia and poor vision showed extreme eye deviation three times, which mimicked 'strabismus fixus' towards the upper temporal, down and lower nasal directions, although the extraocular muscle swelling was milder than that observed in his left eye. Usually cases of strabismus fixus with high myopia are irreversible and associated with an extraocular muscle path shift along with posterior eyeball prolapse from the muscle cone. However in this case, in the eye with high myopia, there was a rotation to an extreme eye position that occurred without any shift or prolapse, and which was reversible. Therefore, it is hypothesized that extreme ocular rotation due to an extraocular muscle disorder can easily occur in eyes with high myopia.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

center dot PURPOSE: The effectiveness of diffusion trace value analysis for non-invasive assessment of retinal ganglion cell (RGC) axonal degeneration at multiple anatomic levels along the human visual pathway under clinical setting was evaluated.
center dot DESIGN: Imaging study.
center dot METHODS: Ten patients with unilateral chronic optic neuropathy of varying cause and 16 age-matched normal subjects were studied. Trace, a tensor invariant that is considered to be a sensitive index for pathologic changes in axons, was analyzed at nine anatomic sites in each subject, namely, bilaterally at the level of the optic nerves, uncrossed chiasmal fibers, optic tracts and optic radiations, and crossed chiasmal fibers, using a 3.0 Tesla magnetic resonance imaging system.
center dot RESULTS: Trace values of the optic nerve and un- crossed chiasmal fibers ipsilateral to the affected eye, the crossed chiasmal fibers, and optic tracts bilaterally were significantly higher than those of the corresponding anatomic sites in normal subjects. The optic nerve and uncrossed chiasmal fibers ipsilateral to the unaffected side and optic radiations, bilaterally, had trace values which were not significantly different from the values of the corresponding anatomic levels in normal subjects. The increase in trace value in the optic nerve and uncrossed chiasmal fibers ipsilateral to the affected side was greater than those of the crossed chiasmal fibers and optic tracts.
center dot CONCLUSIONS: Findings are highly consistent with a degenerative process of RGC axons and trace values are quantitatively well correlated to predicted pathology at the given anatomical sites. Trace value measurement at multiple sites along fiber pathways appears to be a powerful addition to clinical assessment of the functionality of components of the visual pathways during various stages of a pathologic process. (Am J Ophthalmol 2006; 142:591-596. (c) 2006 by Elsevier Inc. All rights reserved.)

DOI： 10.1016/j.ajo.2006.05.042

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：医学書院  

DOI： 10.11477/mf.1410101685

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Other Link： http://search.jamas.or.jp/link/ui/2006314914

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DOI： 10.20566/18810624_23(1)_63

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We report a case of simultaneous onset of diabetic papillopathy and anterior ischemic optic neuropathy. A 60-year-old female noticed decreased left visual acuity and upon examination was found to exhibit optic disc swelling in both eyes. There was hyperemic optic disc swelling with only an enlarged blind spot in her right eye, while the left eye showed pallid swelling with a relatively lower visual field defect. Fluorescein angiography showed filling defect in the upper portion of the left disc. Because of the bilateral onset, we treated her with steroid semi-pulse therapy. After the treatment she exhibited high blood sugar and HbAIc, and subsequently, we diagnosed her as having diabetic papillopathy (DP) in the right eye and anterior ischemic optic neuropathy (AION) in the left eye. After six months, her right eye was also found to have AION. This suggests that the pathogenesis of DP and AION are similar and that DP is a mild type of AION.

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Other Link： http://search.jamas.or.jp/link/ui/2005231565

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Niigata University  

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Other Link： http://hdl.handle.net/10191/3485

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

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Other Link： http://search.jamas.or.jp/link/ui/2005231565

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

Purpose: To present a patient who has night blindness with a depolarizing pattern of ON/OFF response by electroretinography (ERG). Case: A 43-year-old woman had had night blindness and poorly corrected visual acuity since childhood. Parental consanguinity was noted. The patient had suffered from mental retardation, epilepsy, and mild cerebellar ataxia. Corrected visual acuity was 20/30 in the right eye and 20/25 in the left. Goldmann perimetry showed no scotoma but slight depression with internal isoptors. No evidence for rod activity was observed by Goldmann-Weekers adaptometry. The ocular fundi appeared normal. Methods: Conventional full-field ERGs to scotopic (dim and bright flash) and photopic (bright flash and flicker) stimuli were recorded. Photopic ERG responses to long flash stimulation (200 ms) were also examined. Results: The scotopic responses to dim flash were non-recordable, while those to bright flash were severely reduced. The photopic responses to bright flash were decreased. The amplitudes of flicker responses also were significantly decreased, and the implicit times of those responses were prolonged. Although the amplitudes of a- and d-waves to long flash stimulation were reduced, those of the b-wave were within normal range. The implicit times of a-, b- and d-waves were significantly prolonged. The patient showed a normal rise for the photopic b-wave but lacked a normal failing slope after the b-wave peak. An OFF-response late-negativity was also noted. Conclusions: The abnormal ON/OFF response found in the patient could be diagnosed as depolarizing pattern, characterized by elevation of the plateau to a positive potential above the prestimulus baseline. Since the ERG waveforms and clinical features found in our patient were different from those in previous reports, her ERG findings might reflect another retinal physiological mechanism.

DOI： 10.1007/s10633-005-3158-1

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: To present ocular fundus images in a patient with enhanced S-cone syndrome by scanning laser ophthalmoscopy. A 34-year-old Japanese woman whose parents were consanguineous showed mismatched electroretinographic responses to photopically balanced single-flash stimuli, with a larger signal to blue light than to red light. The central macula lacked a foveal reflex, and the surface was dull. Yellowish flecks and retinal pigment epithelium atrophy were evident in a ring at and around the vascular arcades. Faint black pigmentation was deposited in the mid peripheral retina.
Methods: The ocular fundus of the patient was observed by scanning laser ophthalmoscopy with the use of an argon blue laser (wavelength, 488 nm), a helium-neon laser (633 nm), and an infrared laser (780 nm).
Results: The argon blue laser showed numerous black spots of pigment, which were observed as faint pigmentation by conventional ophthalmoscopy. The spots were more enhanced with the argon blue laser than with the helium-neon laser. The white spots, which corresponded to the yellowish flecks in a ring at and around the vascular arcades, were more enhanced with the helium-neon laser than with the argon blue or infrared laser. Hypopigmentation of the retinal pigment epithelium was best shown with the infrared laser.
Conclusion: An abnormality of the retinal structure in enhanced S-cone syndrome may exist in the inner and outer retinal levels, in at least some patients.

DOI： 10.1097/00006982-200412000-00016

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

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

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PERGAMON-ELSEVIER SCIENCE LTD  

We analyzed the change in the ERG rod a-wave waveform during the course of dark adaptation in two patients with Oguchi disease. Two Japanese patients showed a homozygous arrestin 1147delA mutation. Scotopic flash ERGs were recorded after different periods of dark adaptation. ERG rod a-waves were obtained after subtraction of the cone ERG contribution. The rod a-waves were fitted with a model of the rod receptor signal. The parameters, Rm(p3) (maximum a-wave amplitude) and S (sensitivity) were calculated. Longer periods in the dark produced larger rod a-wave but only to the first flash presented. The amplitude of the response to subsequent flashes was essentially independent of the period of dark adaptation. Rm(p3) increased with advance of dark adaptation. However, S was nearly constant. Our results suggest that the cause of delayed dark adaptation is not to be sought in the activation of phototransduction process or the regeneration of rhodopsin per se but rather in the deactivation process of the phototransduction cascade. (C) 2003 Elsevier Ltd. All rights reserved.

DOI： 10.1016/j.visres.2003.06.003

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To elucidate the origin of the abnormal fundus reflex in Oguchi disease,
METHODS: The ocular fundus of a 63-year-old woman who showed a homozygous arrestin 1147delA mutation was observed by scanning laser ophthalmoscopy with the use of an argon blue laser (wavelength, 488 nm), a helium neon laser (633 nm), and an infrared laser (780 nm).
RESULTS: Diffuse, fine, white particles, which do not exist in normal subjects, were clearly demonstrated only with the helium-neon laser. After 4-hour dark adaptation, the abnormal particles disappeared, but then they reappeared gradually during 30 minutes of light adaptation, in accordance with the golden metallic reflex.
CONCLUSION: The white particles found by helium-neon laser could be the origin of the abnormal fundus reflex in Oguchi disease. (C) 2000 by Elsevier Science Inc. All rights reserved.

DOI： 10.1016/S0002-9394(00)00532-8

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

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Language：Japanese   Publisher：日本神経眼科学会  

目的:高血圧性網膜症による乳頭腫脹と鑑別を要した特発性頭蓋内圧亢進症によるうっ血乳頭の1例を報告する.症例:当科初診時42歳,女性.無治療の高血圧があり,網膜出血・軟性白斑の他に網膜趨壁を伴う旺盛な乳頭腫脹がみられ,程度が強い乳頭腫脹であることからうっ血乳頭を積極的に疑い,頭部画像検査・髄液検査を行って特発性頭蓋内圧亢進症の診断に至った.結論:本症例は診断に至るまでに高血圧性網膜症による乳頭腫脹との鑑別を要したため,特発性頭蓋内圧亢進症の診断を考える上で重要な症例であった.うっ血乳頭の診断には頭部画像検査・髄液検査を積極的に行うことが重要であることが改めて示唆された.(著者抄録)

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Language：Japanese   Publisher：金原出版(株)  

＜文献概要＞視神経炎は臨床所見から診断することができる。視神経炎の視力低下は急性〜亜急性に発症する。日本人の視神経炎症例の約6割に眼球運動痛・眼痛・眼窩痛がみられ,約5割に乳頭腫脹がみられる。発症から3週間以内に約8割の症例で視力の自然改善が始まり,ステロイドパルス療法を行うことで視力改善が始まるまでの期間が短縮する。視神経炎の診断をより強固にするにはMRIを行う。鑑別診断は前部虚血性視神経症・うっ血乳頭・圧迫性視神経症が重要である。視神経炎の治療は特に易感染性に注意しステロイドパルス療法を行う。非典型的視神経炎としての抗アクアポリン4抗体陽性視神経炎の治療はステロイドパルス療法のほかに血漿交換療法や免疫グロブリン大量静注療法が選択肢となる。

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Language：Japanese   Publisher：日本神経眼科学会  

眼球運動制限を伴う固定内斜視を呈する強度近視性斜視に対する術式として上外直筋結合術の効果は確立されている。一方、画像上眼球の筋円錐からの脱臼がみられるが眼球運動制限を伴わない強度近視性斜視に対する上外直筋結合術の効果についての報告は少ない。我々は眼球運動制限を伴わない強度近視性内斜視に対して上外直筋結合術を施行し、術後約6年間経過観察を行うことができた症例を経験した。画像上両眼に筋円錐からの脱臼がみられたが、程度のより強い右眼に上外直筋結合術を施行した。術後、内斜視は改善したが術眼が上斜視となり僚眼の下直筋後転法を施行した。経過良好だったが上外直筋結合術施行から5年後に水平性複視が増悪し、プリズム組込眼鏡装用で複視は改善した。本症例の経過と既報から眼球運動制限がなく両眼に眼球の脱臼がみられる強度近視性症例では、両眼の上外直筋結合術を計画するのが良いと考えられた。(著者抄録)

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Language：Japanese   Publisher：(一社)日本脳循環代謝学会  

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Language：Japanese   Publisher：金原出版(株)  

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Language：Japanese   Publisher：日本神経眼科学会  

抗アクアポリン4抗体陽性視神経炎は視神経脊髄炎スペクトラムに包括される疾患概念である。抗アクアポリン4抗体陽性視神経炎は視力視野障害が重篤で視機能予後が不良、再発回数が多いなどの臨床的特徴を有するとされている。現在コンセンサスを得ている視神経脊髄炎スペクトラムの急性期の視力視野障害改善のための治療方法、慢性期の再発予防のための治療方法について解説する。また、視神経脊髄炎スペクトラムの病態の解明が多くの神経免疫学的研究によって進んでいるが、それらの研究結果に基づく将来期待される視神経脊髄炎スペクトラムの治療方法について解説する。(著者抄録)

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Language：Japanese   Publisher：(株)メディカル葵出版  

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Language：Japanese   Publisher：(株)全日本病院出版会  

本稿は、以下の3つの点を述べる。1.多発性硬化症に関連した視神経炎を含む典型的視神経炎の定義を述べる。この定義は非典型的視神経炎の代表疾患である抗アクアポリン4抗体陽性視神経炎を踏まえた上でのものである。2.典型的視神経炎の診断のポイントを述べる。まず視神経炎を診断するための重要な問診事項、片側視神経炎を疑った場合に行うべきswinging flashlight testの詳細、診断を強固にするためのMRIのオーダーの詳細について述べる。さらに、典型的視神経炎を特徴づける臨床所見について述べる。3.典型的視神経炎の治療のポイントを述べる。ステロイドパルス療法の適応および具体的な方法について副作用に対する注意事項も含めて述べる。(著者抄録)

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：(株)メディカル葵出版  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：金原出版(株)  

DOI： 10.18888/ga.0000000561

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：(株)メディカ出版  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：(株)医学書院  

DOI： 10.11477/mf.1410212495

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：日本神経眼科学会  

難治性視神経症としての抗アクアポリン4(aquaporin-4:AQP4)抗体陽性視神経炎は広く臨床医に知られるようになり、抗AQP4抗体検査は外注検査で行えるようになった。抗AQP4抗体陽性視神経炎症例がより多く診断される環境が整ったようにも思えるが、抗AQP4抗体陽性視神経炎を的確に診断するには、まず視神経炎を的確に診断できなければならない。本稿では、まず臨床所見およびMRI所見から行う視神経炎の診断について述べる。さらに、neuromyelitis optica spectrum disordersの診断基準を踏まえた抗AQP4抗体陽性視神経炎の診断について述べる。最後に、抗AQP4抗体陽性視神経炎を除外した視神経炎を仮に抗AQP4抗体陰性視神経炎と定義すると、これにはさまざまな臨床的特徴を持った視神経炎が含まれるが、既報の典型的視神経炎・非典型的視神経炎の分類および近年のさまざまな視神経炎の治療トライアルの組み入れ基準から抗AQP4抗体陰性視神経炎の鑑別診断について考察する。(著者抄録)

DOI： 10.11476/shinkeiganka.34.267

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：(株)全日本病院出版会  

複視の診察ではまず問診で単眼複視でないかどうかを確認することが重要である。単眼複視はピンホールを通して見ると消失する。両眼複視であれば眼位ずれがみられる。正面視での眼位ずれを他覚的に評価する方法には、カバーテスト、カバー・アンカバーテスト、交代プリズムカバーテストなどがあり、自覚的に評価する方法にはマドックス杆による検査などがある。麻痺性斜視(≒非共同性斜視)では眼位により斜視角に変化がみられる。眼位による斜視角の変化を簡便に評価する方法として9方向眼位の評価があり、定量的に評価する方法として大型弱視鏡、Hessチャートがある。Hessチャートの結果の理解には、Heringの法則や第1偏位および第2偏位について知っておく必要がある。(著者抄録)

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Language：English   Publishing type：Book review, literature introduction, etc.   Publisher：MEDICAL ASSOC NIPPON MEDICAL SCH  

Molecular imaging implies the method capable of pictorially displaying distribution of target molecules and their relative concentration in space. In clinical medicine, where non-invasiveness is mandatory, diagnostic molecular imaging has been considered virtually identical to positron emission tomography (PET). However, there is another powerful, apparently underutilized molecular imaging, namely, proton magnetic resonance spectroscopic imaging (H-1-MRSI). The technique can detect target molecules endogenous in brain in virtue of their own specific resonance frequencies (chemical shift) and can create quantitative images of each molecule. H-1-MRSI is conventionally utilized for imaging relatively easily detectable molecules such as N-acetyl-aspartate or lactate. More recently, however, the method is extended into imaging of more challenging molecules such as glutamate or gamma-aminobutyric acid (GABA). In this small review, we summarize basic concept of H-1-MRSI and introduce an advanced technique, i.e. chemical exchange saturation transfer magnetic resonance imaging (CEST MRI), which made realistic glutamate imaging in vivo possible.

DOI： 10.1272/jnms.84.160

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Language：Japanese   Publisher：日本歯科色彩学会  

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瞳孔に至る交感神経および副交感神経の経路を理解することは眼科臨床では以下の2つの点で重要で、それぞれは全身疾患の発見につながる可能性がある。瞳孔に至る副交感神経の経路を理解することは、片側視神経障害を見逃さないために重要なRAPDを理解することに通じる。片側視神経障害の中でも視神経炎は神経学的疾患である多発性硬化症および視神経脊髄炎につながる。瞳孔に至る交感神経の経路を理解することはHorner症候群を理解することに通じる。Horner症候群の背景疾患には、胸部腫瘍、内頸動脈解離など、患者の生命に関わるものがある。(著者抄録)

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

本稿は「抗アクアポリン4抗体陽性視神経炎の臨床的特徴」と題して第53回日本神経眼科学会総会のサイエンティフィックレクチャーで講演した内容をまとめたものである。新潟大学の高木らが中心となって行った研究により、抗アクアポリン4抗体陽性視神経炎の臨床的特徴は、視機能予後不良、再発性、抗アクアポリン4抗体以外の自己抗体も陽性などであることが示された。また、著者らが中心となって行った研究により、抗アクアポリン4抗体陽性視神経炎ではステロイドパルス療法単独でも約40%の症例で矯正視力(0.5)以上の改善がみられることが示された。これらの結果から抗アクアポリン4抗体陽性視神経炎の治療は急性期の視力改善のため、また慢性期の再発予防のために、現時点におけるさまざまな治療方法から選択し組み立てる必要がある。しかし、抗アクアポリン4抗体陽性視神経炎は症例数が少なく視力経過にもバラつきがあるためにその評価は困難であり、今後もこれらの課題に神経眼科医が一丸となって取り組むべきである。(著者抄録)

DOI： 10.11476/shinkeiganka.33.118

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：(株)メディカル葵出版  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：日本神経眼科学会  

本稿は「麻痺性斜視の診断」と題して「第71回日本弱視斜視学会総会のミニシンポジウム1麻痺性斜視-診断と治療の進歩」で講演した内容をまとめたものである。麻痺性斜視の診断は、動眼神経、滑車神経、外転神経の脳神経麻痺の診断であり、それぞれの脳神経麻痺の原因検索をしなければならない。原因となり得る疾患とそれらの年代別の頻度を理解することが重要であり、またそれぞれの脳神経の解剖学的特徴を理解することが重要である。さらに動眼神経麻痺の原因となり得る脳動脈瘤、外転神経麻痺の原因となり得る脳腫瘍は患者の生命を脅かし得る疾患であり、どのテキストでも強調されている最重要事項である。これらの麻痺性斜視の診断についての基本となる事項を分かりやすく述べ理解してもらうことが本稿の目的である。麻痺性斜視の診断の応用編となる事項として、瞳孔散大を呈さない脳動脈瘤による動眼神経麻痺、両側滑車神経麻痺、軽度の外転神経麻痺と区別が困難な後天共同性内斜視、複合脳神経麻痺についても述べる。(著者抄録)

DOI： 10.11476/shinkeiganka.33.3

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：(株)メディカ出版  

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Language：Japanese   Publisher：(公社)日本放射線技術学会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：金原出版(株)  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：(株)メディカル葵出版  

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Language：Japanese   Publisher：金原出版株式会社  

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Language：Japanese  

J-GLOBAL

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)   Publisher：(公財)日本眼科学会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)  

DOI： 10.11477/mf.1410103979

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：金原出版株式会社  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：金原出版株式会社  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：金原出版株式会社  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (bulletin of university, research institution)  

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

CiNii Article

CiNii Books

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Language：Japanese   Publishing type：Article, review, commentary, editorial, etc. (scientific journal)   Publisher：日本神経眼科学会  

CiNii Article

CiNii Books

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

Web of Science

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