掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

DOI： 10.1007/s10384-023-01037-z

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その他リンク： https://link.springer.com/article/10.1007/s10384-023-01037-z/fulltext.html

掲載種別：研究論文（学術雑誌）   出版者・発行元：Springer Science and Business Media LLC  

Abstract

The purpose of this study was to evaluate how various parameters are related to microvasculature dropout (MvD) area measured using optical coherence tomography angiography (OCTA). We measured the area of MvD in 55 patients with primary open-angle glaucoma (POAG). Using OCTA, MvD area and peripapillary choroidal atrophy (PPA) area were assessed in a 4.5 mm × 4.5 mm region. The following were examined: circumpapillary nerve fiber layer (cpRNFL) thickness, optic disc area, optic disc cupping area, optic disc rim area, Humphrey Field Analyzer (HFA) 24/10–2 mean deviation (MD), and pattern standard deviation (PSD). The relationship between MvD area and each parameter was evaluated using Spearman’s rank correlation coefficient analysis. Mean MvD area and PPA area were 0.18 ± 0.17 mm² and 1.13 ± 0.72 mm², respectively. MvD area was significantly correlated with optic disc rim area (p = 0.0017), cpRNFL (p = 0.0027), HFA 24/10–2 MD, and PSD (p < 0.001). In eyes with POAG, MvD area indicates the severity of glaucoma, which might be associated with structural changes in the peripapillary vasculature around the optic disc.

DOI： 10.1038/s41598-023-48102-8

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その他リンク： https://www.nature.com/articles/s41598-023-48102-8

記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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掲載種別：研究論文（学術雑誌）   出版者・発行元：MDPI AG  

This study investigated the influence of asymmetric corneal hysteresis (CH) on asymmetric visual field impairment between right and left eyes in patients with primary open-angle glaucoma (POAG) without a history of intraocular surgery. CH, corneal resistance factor (CRF), and corneal compensated intraocular pressure (IOPcc) were measured using the Ocular Response Analyzer. Differences between the eyes (right eye–left eye: DIFRL) and CH-based and in target parameters (higher CH eye–lower CH eye: DIFCH) were calculated in the same patient. In 242 phakic eyes of 121 patients, older age (p < 0.001), lower CH (p = 0.001), and lower CRF (p = 0.007) were significantly associated with worse standard automated perimetry (SAP) 24-2 mean deviation (MD). The DIFsRL in axial length (p = 0.003), IOPcc (p = 0.028), and CH (p = 0.001) were significantly associated with the DIFRL in SAP24-2 MD, but not in central corneal thickness (CCT), Goldmann applanation tonometry (GAT) measurement, and CRF. When dividing the patients into two groups based on the median of the CH DIFsCH (0.46), the DIFsCH in CRF (p < 0.001), IOPcc (p < 0.001), CCT (p = 0.004), SAP24-2 MD (p < 0.001), and SAP10-2 MD (p = 0.010) were significantly different between the groups. Large inter-eye asymmetry in CH is an important explanatory factor for disease worsening in patients with POAG.

DOI： 10.3390/jcm12134514

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本眼科紀要会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

＜文献概要＞緑内障の進行を抑制し,QOLを維持,予後を改善するためには,症例ごとに適切な治療介入が重要であり,精密な診断,治療管理についての相談,手術などのためにクリニックなどの地方の医療施設から大学病院,基幹病院,専門施設への紹介が行われている.高齢化を背景に緑内障患者の治療と管理の期間は延長し,診断機器や治療法が進歩するなかで,患者について紹介元と紹介先の密な連携がより重要になっている.今回は地域,医療環境の異なる3つの大学の先生方にお集まりいただき,緑内障病診連携の現状と課題について討論いただいた.

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2021&ichushi_jid=J03471&link_issn=&doc_id=20210921300004&doc_link_id=10.34449%2FJ0024.01.62_0025-0034&url=https%3A%2F%2Fdoi.org%2F10.34449%2FJ0024.01.62_0025-0034&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: Patients with an eye disease often report nyctalopia, hemianopia, and/or photophobia. We hypothesized that such symptoms are related to the disease impacting the dynamic range of lightness perception (DRL). However, there is currently no standardized approach for measuring DRL for clinical use. We developed an efficient measurement method to estimate DRL. STUDY DESIGN: Clinical trial METHODS: Fifty-five photophobic patients with eye disease and 46 controls participated. Each participant judged the appearance of visual stimuli, a thick bar with luminance that gradually changed from maximum to minimum was displayed on uniform background. On different trials the background luminance changed pseudo-randomly between three levels. The participants repeatedly tapped a border on the bar that divided the appearance of grayish white/black and perfect white/black. We defined the DRL as the ratio between the luminance values at the tapped point of the border between gray and white/black. RESULTS: The mean DRL of the patients was approximately 15 dB, significantly smaller than that of the controls (20 dB). The center of each patient's DRL shift depending on background luminance, which we named index of contextual susceptibility (iCS), was significantly larger than controls. The DRL of retinitis pigmentosa was smaller than controls for every luminance condition. Only the iCS of glaucoma was significantly larger than controls. CONCLUSIONS: This measurement technique detects an abnormality of the DRL. The results support our hypothesis that the DRL abnormality characterizes lightness-relevant symptoms that may elucidate the causes of nyctalopia, hemeralopia, and photophobia.

DOI： 10.1007/s10384-020-00808-2

PubMed

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PRECIS: The foveal avascular zone (FAZ) in optical coherence tomography angiography is significantly correlated with retinal inner layer thickness, Humphrey field analyzer (HFA) 10-2 sensitivity threshold, and mean deviation (MD) value in open-angle glaucoma patients. PURPOSE: The purpose of this study was to measure the FAZ area using optical coherence tomography angiography and investigate its relationship with retinal inner layer thickness and visual field defects in eyes with open-angle glaucoma. PARTICIPANTS AND METHODS: A total of 52 eyes with open-angle glaucoma from 52 patients. FAZ area was measured using optical coherence tomography angiography in angio-macula mode. Thicknesses of retinal nerve fiber layer (RNFL), ganglion cell layer plus inner plexiform layer (GCL+IPL), and ganglion cell complex (GCC) were determined using a 7 mm×7 mm macular (V) map via 3D-OCT. Correlations of FAZ area with sensitivity threshold measurements, foveal threshold (FT), and MD value in the HFA10-2 visual field were analyzed for each inner retinal layer. RESULTS: FAZ area was 0.26±0.07 mm; overall mean thicknesses were 19.14±6.55 μm (RNFL), 57.34±5.93 µm (GCL+IPL), and 75.87±10.96 μm (GCC); mean FT was 35.23±3.15 dB, and sensitivity threshold was 20.81±7.22 dB in the HFA10-2 visual field. FAZ area was significantly correlated with the thickness of individual retinal layers in the entire field (RNFL, P<0.001; GCL+IPL, P<0.001; GCC, P<0.001), sensitivity threshold (P=0.01), FT (P<0.001), and MD value (P=0.011). CONCLUSION: FAZ area was significantly negatively correlated with retinal inner layer thickness, sensitivity threshold, FT, and MD value in the HFA10-2 visual field.

DOI： 10.1097/IJG.0000000000001492

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

BACKGROUND: Steep Trendelenburg position (ST) during robot-assisted radical prostatectomy (RARP) poses a risk of increase in intraocular pressure (IOP) in men receiving robot-assisted radical prostatectomy (RARP). The aim of the study was to identify clinicopathological factors associated with increased IOP during RARP. METHODS: We prospectively studied 59 consecutive prostate cancer patients without glaucoma. IOP was measured at 6 predefined time points before, during and after the operation (T1 to T6). RESULTS: Compared with T1, IOP decreased after beginning of anesthesia(T2) (by - 6.5 mmHg, p < 0.05), and increased 1 h after induction of pneumoperitoneum in the steep Trendelenburg position (ST) (T3) (+ 7.3 mmHg, p < 0.05). IOP continued to increase until the end of ST (T4) (+ 10.2 mmHg, p < 0.05), and declined when the patient was returned to supine position under general anesthesia (T5) (T1: 20.0 and T5: 20.1 mmHg, p above 0.05). The console time affected the elevation of IOP in ST; IOP elevation during ST was more prominent in men with a console time of ≥4 h (n = 39) than in those with a console time of < 4 h (n = 19) (19.8 ± 6.3 and 15.4 ± 5.8 mmHg, respectively, p < 0.05). Of the 59 patients, 29 had a high baseline IOP (20.0 mmHg or higher), and their IOP elevated during ST was also reduced at T5 (T1: 22.6 and T5: 21.7 mmHg, p above 0.05). There were no postoperative ocular complications. CONCLUSIONS: Console time of < 4 h is important to prevent extreme elevation of IOP during RARP. Without long console time, RARP may be safely performed in those with relatively high baseline IOP.

DOI： 10.1186/s12894-020-00595-5

PubMed

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記述言語：日本語   出版者・発行元：新潟医学会  

【目的】眼科健診、人間ドックで緑内障を疑われ魚沼基幹病院眼科外来を受診した患者の緑内障の有無、緑内障の病型、重症度、受診後の動向を調査した。【方法】2015年6月から2019年10月までに魚沼基幹病院眼科を初診した症例のうち、緑内障に関わる病名を付与されたものを電子カルテネットワーク上で検索し、カルテを縦覧した。眼科健診、人間ドックで緑内障を疑われ受診した症例を抽出し、眼科医による問診や細隙灯顕微鏡検査、視力、眼圧測定、眼科学的画像解析、視野検査結果から緑内障の有無、緑内障の病型、重症度、診断後の治療内容、通院継続の有無を調査した。【結果】眼科健診、人間ドックにより緑内障を疑われ初診した症例数は108例(男性51例、女性57例)だった。そのうち緑内障患者は18例、緑内障を疑う眼底所見を呈しながらも視野障害を認めない前視野緑内障と診断されたのは14例、正常範囲内と判断されたのは70例だった。緑内障と診断された症例は緑内障点眼液一剤の処方または厳重な経過観察を開始された。定期的な経過観察を指示された71症例の中で受診が途絶えた症例が12例存在した。【結論】眼科健診で緑内障を疑われて受診した症例の16.7%に緑内障を認め、検出率は既報と同等だった。経過観察を行うと緑内障患者を含めて15.5%が通院中断しており、通院継続率を向上させる取り組みが必要である。(著者抄録)

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記述言語：英語   出版者・発行元：(公財)日本眼科学会  

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記述言語：英語   出版者・発行元：(公財)日本眼科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: To estimate the central 10-degree visual field of glaucoma patients using en-face images obtained by optical coherence tomography (OCT), and to examine its usefulness. PATIENTS AND METHODS: Thirty-eight eyes of 38 patients with primary open angle glaucoma were examined. En-face images were obtained by swept-source OCT (SS-OCT). Nerve fiber bundles (NFBs) on en-face images at points corresponding to Humphrey Field Analyzer (HFA) 10-2 locations were identified with retinal ganglion cell displacement. Estimated visual fields were created based on the presence/absence of NFBs and compared to actual HFA10-2 data. κ coefficients were calculated between probability plots of visual fields and NFBs in en-face images. RESULTS: Actual HFA10-2 data and estimated visual fields based on en-face images were well matched: when the test points of <5%, <2%, and <1% of the probability plot in total deviation (TD) and pattern deviation (PD) of HFA were defined as points with visual field defects, the κ coefficients were 0.58, 0.64, and 0.66 in TD, respectively, and 0.68, 0.69, and 0.67 in PD. In eyes with spherical equivalent ≥ -6 diopters, κ coefficients for <5%, <2%, and <1% were 0.58, 0.62, and 0.63 in TD and 0.66, 0.67, and 0.65 in PD, whereas for the myopic group with spherical equivalent < -6 diopters, the values were 0.58, 0.69, and 0.71 in TD and 0.72, 0.71, and 0.71 in PD, respectively. There was no statistically significant difference in κ coefficients between highly myopic eyes and eyes that were not highly myopic. CONCLUSIONS: NFB defects in en-face images were correlated with HFA10-2 data. Using en-face images obtained by OCT, the central 10-degree visual field was estimated, and a high degree of concordance with actual HFA10-2 data was obtained. This method may be useful for detecting functional abnormalities based on structural abnormalities.

DOI： 10.1371/journal.pone.0229867

PubMed

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose: To clarify the clinical features of patients with exfoliation glaucoma (XFG) requiring surgical intervention. Study Design. Retrospective study. Methods: The study included 46 eyes from 36 XFG patients, 85 eyes from 53 primary open-angle glaucoma (POAG) patients, and 54 eyes from 35 normal-tension glaucoma (NTG) patients. Age, duration of previous glaucoma treatment, intraocular pressure, medication scores, visual function, and surgical procedure were compared among the three patient groups. Results: The XFG group had the highest mean age (XFG: 75.7 ± 8.3 years, POAG: 65.8 ± 12.8 years, and NTG: 53.3 ± 12.8 years; p < 0.001) and the shortest mean duration of previous treatment with glaucoma medication (XFG: 5.1 ± 3.5 years, POAG: 8.9 ± 6.9 years, and NTG: 8.9 ± 5.9 years; p < 0.001). Intraocular pressure and medication scores were slightly higher in the XFG group than in the POAG group, although the differences were not significant. Among XFG patients, trabeculectomy was performed in 20 eyes from 16 patients (55.6%) and trabeculotomy was performed in 16 eyes from 14 patients (44.4%). Both trabeculectomy (3 eyes) and trabeculotomy (14 eyes) were performed in combination with cataract surgery. Conclusions: The XFG patients referred to our department for initial examination were older than the POAG and NTG patients, and their duration of treatment before referral was shorter. Moreover, intraocular pressure and the eye drop medication score were higher in the XFG patients. A significantly higher percentage of XFG patients required surgical intervention compared to patients with other disease types.

DOI： 10.1155/2020/9423756

PubMed

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記述言語：日本語   出版者・発行元：(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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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）   出版者・発行元：Blackwell Publishing Ltd  

Purpose: To compare the additive effects and safety of 1% brinzolamide/0.5% timolol fixed combination (BTFC) versus the low-dose regimen of 1% dorzolamide/0.5% timolol fixed combination (DTFC) in patients with open-angle glaucoma and ocular hypertension (OAG/OH) following treatment with prostaglandin analogues (PGAs). Methods: A prospective, randomized, double-masked, multicentre, parallel-group and active-controlled study included 201 Japanese OAG/OH patients who had been treated with PGA. Efficacy was assessed as the change in intra-ocular pressure (IOP) from baseline after weeks 4 and 8. Safety was assessed with adverse event rates, ocular discomfort score, blur scale, blood pressure and heart rates, best-corrected visual acuity (BCVA) and slit lamp examinations. Results: Intra-ocular pressure (IOP) change from baseline at 9 AM/11 AM pooled over the 8 weeks was −3.3/−3.3 mmHg in the BTFC group and −2.9/−3.4 mmHg in the DTFC group, demonstrating non-inferiority of BTFC to DTFC. Ocular irritation was frequently seen in DTFC group. Although blurred vision was frequently seen in BTFC group, it was transient and blurring became the equivalent 3 min after instillation between two groups. No noteworthy issue was observed in other safety outcome. Conclusion: Non-inferiority of BTFC to DTFC in IOP reduction was demonstrated after adding onto PGA therapy in Japanese OAG/OH patients. Although the score of blurred vision was transiently higher in BTFC than DTFC, treatment difference decreased and disappeared with time. Thus, BTFC can be considered as a safe and effective agent for glaucoma treatment.

DOI： 10.1111/aos.13401

Scopus

PubMed

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記述言語：日本語   出版者・発行元：(株)メディカル葵出版  

目的:広義・原発開放隅角緑内障(POAG)眼の中心窩閾値(FT)と矯正視力との相関、Humphrey視野(HFA)10-2プログラムの傍中心窩測定点視野感度閾値(PFT)との相関について調べた。対象および方法:対象はHFA10-2測定を行ったPOAG眼103例103眼である。年齢は54.4±9.7(23〜70)歳、等価球面度数-4.5±3.9(+2.0〜14.5)ジオプトリー、病型は狭義POAG56眼、正常眼圧緑内障47眼である。FTは直近3回のHFA24/30-2もしくは10-2測定時の測定値を平均し、矯正視力(logMAR)は直近2回の測定値を平均した。FTと矯正視力の相関、またFTとHFA10-2傍中心4点の実測感度閾値(PFT)との相関を調べた。結果:FTと矯正視力は統計学的に有意に相関した(r2=0.537、p<0.001)。FTとPFTは単回帰分析では4点とも有意に相関し、その程度は耳側上方(r2=0.481、p<0.001)、耳側下方(r2=0.443、p<0.001)、鼻側下方(r2=0.210、p<0.001)、鼻側上方(r2=0.055、p=0.017)の順であった。FTとPFTの重回帰分析では、耳側上方と下方、鼻側下方の3点が有意に相関した。結論:広義POAG眼においてFTと矯正視力は有意に相関し、FT測定は広義POAG眼の矯正視力推定に有用な可能性がある。FT低下とHFA10-2における傍中心視野障害のパターンには関連があると考えられた。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01784&link_issn=&doc_id=20171201250025&doc_link_id=%2Fah9atgke%2F2017%2F003411%2F026%2F1617-1621%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah9atgke%2F2017%2F003411%2F026%2F1617-1621%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(株)メディカル葵出版  

目的:Humphrey 10-2視野(HFA10-2)における視野感度低下領域とシラスHD-OCT(カールツァイスメディテック)のganglion cell analysis(GCA)判定の相関を検討した。対象および方法:広義原発開放隅角緑内障53名53眼を対象とした後ろ向き研究。HFA10-2における測定点をGCA解析に準じて6セクターに分割し、トータル偏差で感度低下(1%以下)がみられるものを異常点とした。GCA各セクターにおける菲薄化をディビエーションマップからスコア化した(>5%、0;≦5%かつ>1%、1;≦1%、2)。半視野当たりのHFA異常点数とGCAスコア合計との相関について調べ、セクターごとの整合性についても検討した。結果:半視野当たりのHFA異常点数と対応するGCAスコアはいずれも有意な相関がみられた(上半0.74、下半0.53)。上鼻側セクターにおいて感度と特異度は高く(90%、100%)、下方および耳側セクターでは低くなる傾向があった。結論:GCA解析による判定は中心10°内視野障害を反映していると考えられる。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01784&link_issn=&doc_id=20171107230025&doc_link_id=%2Fah9atgke%2F2017%2F003410%2F026%2F1465-1469%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah9atgke%2F2017%2F003410%2F026%2F1465-1469%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：日本語   出版者・発行元：(株)メディカル葵出版  

Soemmerring輪を伴って発症した続発閉塞隅角症(以下、本症)の2例を経験した。症例1は78歳、男性。10年前に両眼に超音波水晶体乳化吸引術、眼内レンズ挿入術(以下、PEA+IOL)を受けた。左眼に浅前房と眼圧上昇(25mmHg)を生じ、細隙灯顕微鏡検査、および超音波生体顕微鏡(以下、UBM)所見から、本症と診断した。Soemmerring輪の手術的除去と周辺部前後嚢切開術を行い、前房深度は改善、隅角は開大し、眼圧は下降した。症例2は77歳、女性。11年前に左眼にPEA+IOLを受けた。左眼霧視と頭痛を主訴に受診した。左眼眼圧は77mmHgで浅前房と全周に周辺虹彩前癒着を認めた。同様に細隙灯顕微鏡検査、UBM所見から本症と診断し、Soemmerring輪の手術的除去と隅角癒着解離術を行った。術後、前房深度は改善し、眼圧は下降した。結論:まれではあるがPEA+IOL後の長期合併症の一つとしてSoemmerring輪を伴う続発閉塞隅角症がある。本症にはさまざまな隅角閉塞のメカニズムが関与している可能性が考えられる。診断にはUBMが有用で、正確に本症と診断された場合には、Soemmerring輪を手術的に除去することで眼内レンズを温存したまま治療できる可能性がある。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2017&ichushi_jid=J01784&link_issn=&doc_id=20170804240025&doc_link_id=%2Fah9atgke%2F2017%2F003407%2F024%2F1054-1059%26dl%3D0&url=http%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah9atgke%2F2017%2F003407%2F024%2F1054-1059%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

OBJECTIVES: To evaluate the vascular architecture of the radial peripapillary capillaries (RPCs) and its relation with visual function in patients with open-angle glaucoma (OAG) and normal-tension glaucoma using spectral-domain optical coherence tomography (SD-OCT) angiography. SUBJECTS AND METHODS: Clear OCT angiography images of blood vessels in the optic disc and peripapillary retina were obtained from 52 patients (52 eyes) aged 55.42±10.64 (range 28-72) years with primary OAG. The mean spherical equivalent was -3.19±2.31 diopters, and the mean deviation (MD) of the central 24/30-2 threshold test using the Humphrey Field Analyzer (HFA) was -10.47±7.99 dB. The correlations between the disappearance angle of the RPCs on OTC images, flow density (FD) and the circumpapillary retinal nerve fiber layer (cpRNFL) thickness, the angle of retinal nerve fiber layer (RNFL) defect, the MD and pattern standard deviation (PSD) values of the HFA central 24/30-2 threshold test using the Swedish interactive thresholding algorithm, the sensitivity threshold, age, corneal thickness, and refractive value were analyzed. In addition, the correlation between FD and the cpRNFL thickness was analyzed at FD measurement points. RESULTS: FD was significantly correlated with cpRNFL thickness, PSD value, MD value, and sensitivity threshold, whereas the disappearance angle of the RPCs was significantly correlated with the angle of the RNFL defect (P<0.001), MD value (P<0.01), and sensitivity threshold (P<0.01). There was a negative correlation between FD and age (P<0.05). The Pearson correlation coefficient of FD and cpRNFL thickness in the area surrounding the optic disc revealed the most significant correlation in the inferior visual field (r = 0.851, P<0.001), followed by the superior visual field (r = 0.803, P<0.001) and then the temporal visual field (r = 0.653, P<0.001). CONCLUSION: SD-OCT angiography enabled thorough observation of the RPCs. FD and the disappearance angle of the RPCs were significantly and independently correlated with glaucoma-related functional and morphological changes in the optic nerve, suggesting that these two factors are novel functional and morphological indicators of visual defects due to glaucoma.

DOI： 10.1371/journal.pone.0184301

PubMed

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記述言語：日本語   出版者・発行元：(株)メディカル葵出版  

目的:エクスプレス併用濾過手術後の角膜内皮細胞所見について検討した。対象および方法:対象はエクスプレス併用濾過手術を施行し、術後3ヵ月以上スペキュラーマイクロスコープによって角膜内皮細胞を観察できた32例37眼である。年齢は70.8±10.4歳で、病型は広義・原発開放隅角緑内障眼19例21眼(POAG群)、落屑緑内障群10例13眼(XFG群)、その他3例3眼であった。このうち眼内レンズ挿入眼は28例32眼であった。内皮細胞密度(CD)、六角形細胞出現率(6A)、変動係数(CV)の経時変化について検討した。結果:CDは術前2,292±563/mm2に対して、平均術後観察期間13.7±8.5ヵ月の最終観察時に2,059±614mm2と有意に減少した(p=0.0002)。病型別にPOAG群CDは術前2,359±487/mm2が術後最終2,244±574/mm2に対して、XFG群CDは術前2,196±671/mm2が術後最終1,808±555mm2と、XFG群で有意に大きく減少していた(p=0.037)。6A、CVでは有意な差はみられなかった。術後にCDが500以上減少した例は6眼、20%以上減少した眼は7眼であった。結論:エクスプレス併用濾過手術後に角膜内皮細胞密度が低下する可能性がある。落屑緑内障眼ではより減少する可能性がある。(著者抄録)

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

PURPOSE: We evaluated the rate of progression of total, upper, and lower visual field defects in patients with treated primary open-angle glaucoma (POAG) with high myopia (HM). SUBJECTS AND METHODS: Seventy eyes of 70 POAG patients with HM [≤-8 diopters (D)] were examined. The mean deviation (MD) slope and the upper and lower total deviation (upper TD, lower TD) slopes of the Humphrey Field Analyzer were calculated in patients with high-tension glaucoma (HTG) (>21 mmHg) versus normal-tension glaucoma (NTG) (≤21 mmHg). The mean age of all the patients (29 eyes with HTG and 41 eyes with NTG) was 48.5 ± 9.6 years. The MD slope, and upper and lower TD slopes of the HM group were compared to those of the non-HM group (NHM) (>-8 D) selected from 544 eyes in 325 age-matched POAG patients. In all, 70 eyes with HM and NHM were examined. RESULTS: The mean MD slope was -0.33 ± 0.33 dB/year in the HM, and -0.38 ± 0.49 dB/year in the NHM. There were no statistical differences between the HM and NHM (p = 0.9565). In the comparison of HTG versus NTG patients in both groups, the MD slope, and upper and lower TD slopes were similar. CONCLUSIONS: The rate of progression of total, upper, and lower visual field defects was similar among patients with HM and NHM. Although HM is a risk factor for the onset of glaucoma, HM may not be a risk factor for progression of visual field defects as assessed by the progression rate under treatment.

DOI： 10.1007/s10384-016-0427-3

PubMed

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記述言語：日本語   出版者・発行元：(株)医学書院  

目的:原発開放隅角緑内障(POAG)眼で,3種の眼圧計で眼圧を測定し,中心角膜厚と角膜生体力学特性による補正値を算出し,これと中心角膜厚と年齢の相関を検索した報告。対象と方法:POAGで通院中の218例218眼を対象とした。年齢は22〜91歳,平均72歳で,圧平眼圧計による眼圧値は8〜23mmHg,平均14.8mmHgで,屈折の等価球面度数は平均-0.51±2.4Dであった。非接触眼圧計(CT-1P)による眼圧を中心角膜厚で補正した値,非接触眼圧計(7CR)による眼圧を角膜生体力学的特性を加味して補正した値,Goldmann圧平眼圧計による眼圧を中心角膜厚で補正した値につき,年齢と中心角膜厚との相関を算出した。結果:上記3方法による眼圧値とそれを補正した計6種の測定値は,いずれも年齢と負の相関があり(p=0.001〜0.0045),中心角膜厚と正の相関があった(p=0.000〜0.007)。結論:中心角膜厚または角膜生体力学的特性により補正した眼圧値には,年齢と中心角膜厚が影響し,補正が不十分である可能性がある。(著者抄録)

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その他リンク： https://search.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2016&ichushi_jid=J01537&link_issn=&doc_id=20160310080014&doc_link_id=10.11477%2Fmf.1410211730&url=https%3A%2F%2Fdoi.org%2F10.11477%2Fmf.1410211730&type=%88%E3%8F%91.jp_%83I%81%5B%83%8B%83A%83N%83Z%83X&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00024_2.gif

記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：日本語   出版者・発行元：(公財)日本眼科学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：日本緑内障学会  

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：英語   掲載種別：研究論文（学術雑誌）  

Purpose. To evaluate the effect on intraocular pressure (IOP) of switching from latanoprost and travoprost monotherapy to timolol fixed combinations in Japanese patients with normal-tension glaucoma (NTG). Methods. 27 NTG patients (54 eyes) were compared IOP, superficial punctuate keratitis (SPK) scores, and conjunctival injection scores in eyes treated with prostaglandin (PG) or PG analog/beta-blocker (PG/b) fixed-combination 6 months after the change in therapy. Results. The mean baseline intraocular pressure was 17.4 ± 1.59 mmHg in eyes receiving PG therapy only and 17.4 ± 1.69 mmHg in eyes switched to PG/b. Switching to fixed combination therapy from PG monotherapy, the mean IOP was 13.1 ± 1.79 mmHg (P < 0.001)  (-24.71% reduction from baseline) at 6 months. The mean conjunctival injection score was 0.69 for eyes on PG monotherapy and 0.56 for eyes on fixed combination therapy (P = 0.028). The mean SPK scores were 0.46 and 0.53. This difference was not statistically significant (P = 0.463). Conclusions. Switching from PG monotherapy to PG/b fixed combination therapy for NTG resulted in a greater intraocular pressure reduction than PG alone without increasing the number of instillations.

DOI： 10.1155/2014/720385

PubMed

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記述言語：日本語   出版者・発行元：眼科臨床紀要会  

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記述言語：英語   掲載種別：研究発表ペーパー・要旨（国際会議）   出版者・発行元：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

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記述言語：日本語   出版者・発行元：(株)メディカルレビュー社  

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記述言語：日本語  

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