Hirokazu Sakaguchi | Osaka University (original) (raw)

Papers by Hirokazu Sakaguchi

Research paper thumbnail of Long – term results of intravitreal bevacizumab (Avastin) injection for choroidal neovascularisation secondary to angioid streaks

Acta Ophthalmologica, 2011

Purpose To evaluate the efficacy of long term intravitreal bevacizumab (Avastin) treatment for ch... more Purpose To evaluate the efficacy of long term intravitreal bevacizumab (Avastin) treatment for choroidal neovascularisation (CNV) associated with angioid streaks.Methods 65 year old woman with bilateral active CNV secondary to angioid streaks was treated since October 2006. Photodynamic therapy (PDT) was used for primary treatment, after – intravitreal bevacizumab (1,25mg) was injected 20 times in each eye, average 1,4 months interval was between each session. Treatment efficacy assesment based on VA (visual acuity) (Snellen chart), fluorescence angiography (FA) and optical coherence tomography (OCT) was performed pre‐ and post‐ treatment before and after each injection.Results The follow‐up of the patient lasts for 55 months. BCVA (best corrected visual acuity) of both eyes before treatment was 0,6. The patient received 3 PDT with verteporfin (Visudyne) into left eye and later 40 intravitreal bevacizumab injections (20 into each eye) for 41 months. During the whole follow‐up BCVA o...

Research paper thumbnail of A novel , less-invasive treatment option for rhegmatogenous retinal detachment and vitreoretinal interface pathologies

S cleral buckling is a common surgical procedure for repairing uncomplicated rhegmatogenous retin... more S cleral buckling is a common surgical procedure for repairing uncomplicated rhegmatogenous retinal detachment (RRD). The basis of therapy is to form a chorioretinal adhesion around the retinal break in conjunction with releasing the vitreoretinal traction force by the use of the scleral buckle, thus preventing access of intravitreal fluid to the subretinal space via retinal breaks.1,2 Although scleral buckling can be indicated for most primary RRDs, it may result in some vision-threatening complications due to the direct depression of the sclera with the buckle and/or the size and location of buckle placement, such as mechanical ocular motility disturbance secondary to an extraocular muscle imbalance, corneal contour changes, and chorioretinal circulatory disturbances.3-5 Because the therapeutic concept of scleral buckling is to bring retina into contact with treated choroid around retinal tears, the sclera itself may not necessarily be involved in the indentation. Based on this id...

Research paper thumbnail of Predictors of postoperative bleeding after vitrectomy for vitreous hemorrhage in patients with diabetic retinopathy

Journal of Diabetes Investigation, 2018

Aims/Introduction: To clarify the association between perioperative variables and postoperative b... more Aims/Introduction: To clarify the association between perioperative variables and postoperative bleeding in pars plana vitrectomy for vitreous hemorrhage in diabetic retinopathy. Materials and Methods: The present retrospective study enrolled 72 eyes of 64 patients who were admitted to Osaka University Hospital between April 2010 and March 2014, and underwent vitrectomy for vitreous hemorrhage as a result of diabetic retinopathy. Results: Postoperative bleeding developed in 12 eyes. Using binomial logistic regression analysis, we found that the duration of operation was the only significant variable associated with postoperative bleeding within 12 weeks after vitrectomy. Furthermore, Poisson regression analysis identified fasting blood glucose just before vitrectomy, no treatment with antiplatelet drugs and treatment with antihypertensive drugs, as well as duration of operation, to be significantly associated with the frequency of bleeding within 52 weeks after vitrectomy. Conclusions: Long duration of operation can be used to predict bleeding within both 12 and 52 weeks after vitrectomy. In addition, fasting blood glucose just before vitrectomy, no treatment with antiplatelet drugs and treatment with antihypertensive drugs might be risk factors for postoperative bleeding up to 1 year after vitrectomy.

Research paper thumbnail of Association between choriocapillaris flow deficit and choroidal neovascularization activity in eyes with myopic choroidal neovascularization

Scientific Reports, 2021

Although choriocapillaris flow deficit (CFD) around choroidal neovascularization (CNV) is less as... more Although choriocapillaris flow deficit (CFD) around choroidal neovascularization (CNV) is less associated with CNV activity in myopic eyes, no reports are investigating its size as an indicator of CNV activity. We investigated the relationship between CFD and high myopia-related CNV. In this retrospective, observational study, patients underwent optical coherence tomography angiography (OCTA) with split-spectrum amplitude-decorrelation angiography for diagnosing pathological myopic CNV (mCNV); CFD features around CNV margins were evaluated. Of the 33 eyes (30 patients), 11 (33.3%) had active mCNV, and 22 (66.7%) had inactive CNV. Six eyes (18.2%) were treatment-naïve, while the remainder previously underwent anti-vascular endothelial growth factor therapy. On OCTA, blood flow signals were detected in CNV in the outer retinal layer in 28 (84.8%) eyes, including all active cases (11 cases) and 17 (77.3%) of 22 inactive cases. CNV flow signal size correlated significantly with activity...

Research paper thumbnail of Long-term outcomes of intravitreal activated protein C injection for ischemic central retinal vein occlusion: an extension trial

Graefe's Archive for Clinical and Experimental Ophthalmology, 2021

Purpose Our previous 1-year pilot study evaluated the efficacy of intravitreally injected activat... more Purpose Our previous 1-year pilot study evaluated the efficacy of intravitreally injected activated protein C (APC) in 10 eyes with ischemic central retinal vein occlusion (CRVO). The reperfusion of the areas of retinal nonperfusion (RNP) exceeded 50% of the baseline in five (50%) eyes 1 year after the APC injection. The current study evaluated the long-term efficacy and safety of intravitreal APC. Methods The 10 eyes in the pilot study were included in this study. Other treatments were administered at the physicians’ discretion after the pilot study. We evaluated visual acuity (VA), central retinal thickness (CRT) and perfusion status, and adverse events and severity over the long term. Results The median follow-up was 60 months (range, 48–68 months). Compared with baseline, the post-treatment VA improved significantly (P < 0.001) from 1.39 to 1.06 logarithm of the minimum angle of resolution. The CRT improved significantly (P < 0.001) from 1090 to 195 μm at the last visit. T...

Research paper thumbnail of A Strategy for Personalized Treatment of iPS-Retinal Immune Rejections Assessed in Cynomolgus Monkey Models

International Journal of Molecular Sciences, 2020

Recently, we successfully transplanted an autograft, or major histocompatibility complex (MHC)-ma... more Recently, we successfully transplanted an autograft, or major histocompatibility complex (MHC)-matched allografts, from induced-pluripotent-stem-cell-derived retinal pigment epithelial (iPSC-RPE) cells in patients with age-related macular degeneration. However, there was an issue regarding immune rejection after transplantation. In this study, we established a preoperational in vitro “drug–lymphocytes–grafts immune reaction (Drug-LGIR)” test to determine the medication for immune rejection using host immunocompetent cells (lymphocytes) and transplant cells (target iPSC-RPE cells) together with different medications. The adequacy of the test was assessed by in vivo transplantation in monkey models together with medication based on in vitro data. In the results of Drug-LGIR tests, some drugs exhibited significant suppression of RPE cell-related allogeneic reactions, while other drugs did not, and the efficacy of each drug differed among the recipient monkeys. Based on the results of D...

Research paper thumbnail of Observation of treated iris neovascularization by swept-source-based en-face anterior-segment optical coherence tomography angiography

Scientific Reports, 2019

We evaluated regression of iris neovascularization (INV) using en-face anterior-segment optical c... more We evaluated regression of iris neovascularization (INV) using en-face anterior-segment optical coherence tomography angiography (AS-OCTA) after anti-vascular endothelial growth factor (VEGF) therapy. Seven consecutive eyes with INV were examined before and after anti-VEGF therapy, and all AS-OCTA scans were obtained using a swept-source OCTA system with an anterior-segment lens adapter. Slit-lamp microscopy photography and anterior indocyanine green angiography also were performed. Quantitative analyses of the vascular density, vascular lacunarity, and fractal dimension on AS-OCTA images were performed. AS-OCTA visualized the INV as signals around the pupillary margin, which corresponded to the vasculature confirmed by slit-lamp microscopy. After anti-VEGF drug injection, regression of INV was observed by AS-OCTA in all eyes (100%). The vascular density decreased and vascular lacunarity increased significantly after anti-VEGF therapy. This pilot study demonstrated the ability of AS...

Research paper thumbnail of Cross-Sectional Imaging Analysis of Epiretinal Membrane Involvement in Unilateral Open-Angle Glaucoma Severity

Investigative Opthalmology & Visual Science, 2018

PURPOSE. To determine the relevance of epiretinal membranes (ERMs) in primary open-angle glaucoma... more PURPOSE. To determine the relevance of epiretinal membranes (ERMs) in primary open-angle glaucoma (POAG) and potential risk for glaucoma severity. METHODS. Sixty eyes of 30 patients with POAG who had a unilateral ERM were analyzed; 60 nonglaucomatous eyes of 30 patients with a unilateral ERM also were recruited in this institutional cross-sectional study. Patients underwent swept-source (SS) optical coherence tomography (OCT) imaging and visual field testing. Intraindividual differences in the SS-OCT retinal nerve fiber layer (RNFL) disc cupping area measurements and visual field outcomes were analyzed in the two groups. RESULTS. In patients with POAG, the mean circumpapillary RNFL thickness in the eyes with an ERM was 75.6 6 16.5 lm superiorly and 71.8 6 26.0 inferiorly compared with the fellow eyes without an ERM (87.2 6 23.6 lm, P ¼ 0.0061 and 81.3 6 27.7 lm, P ¼ 0.034, respectively). The areas of disc cupping and cup-to-disc ratio seen on OCT horizontal and vertical B-scans were larger in eyes with an ERM than in the fellow eyes without ERM (P ¼ 0.0004 and P ¼ 0.0011, respectively). The average mean deviations were À11.6 6 7.5 dB in the ERM group and À8.19 6 6.4 dB in the group with no ERM (P ¼ 0.029). Eyes with an ERM received more antiglaucoma eye drops (P ¼ 0.018). Those differences were not seen between eyes with an ERM or fellow eyes in patients without glaucoma. CONCLUSIONS. The presence of an ERM can be a potential risk factor for unilateral severity in eyes with POAG.

Research paper thumbnail of Neural retina-specific Aldh1a1 controls dorsal choroidal vascular development via Sox9 expression in retinal pigment epithelial cells

eLife, Jan 3, 2018

VEGF secreted from retinal pigment epithelial (RPE) cells is responsible for the choroidal vascul... more VEGF secreted from retinal pigment epithelial (RPE) cells is responsible for the choroidal vascular development; however, the molecular regulatory mechanism is unclear. We found that mice showed choroidal hypoplasia with insufficient vascularization in the dorsal region, although Aldh1a1, an enzyme that synthesizes retinoic acids (RAs), is expressed in the dorsal neural retina, not in the RPE/choroid complex. The level of VEGF in the RPE/choroid was significantly decreased in mice, and RA-dependent enhancement of VEGF was observed in primary RPE cells. An RA-deficient diet resulted in dorsal choroidal hypoplasia, and simple RA treatment of pregnant females suppressed choroid hypoplasia in their offspring. We also found downregulation of Sox9 in the dorsal neural retina and RPE of mice and RPE-specific disruption of Sox9 phenocopied choroidal development. These results suggest that RAs produced by Aldh1a1 in the neural retina directs dorsal choroidal vascular development via Sox9 upr...

Research paper thumbnail of Retinal Microvasculature and Visual Acuity in Eyes With Branch Retinal Vein Occlusion: Imaging Analysis by Optical Coherence Tomography Angiography

Investigative Opthalmology & Visual Science, 2017

PURPOSE. To investigate microvascular changes in the superficial capillary plexus (SCP) and deep ... more PURPOSE. To investigate microvascular changes in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in eyes with resolved branch retinal vein occlusion (BRVO) and their association with best-corrected visual acuity (BCVA). METHODS. Eighty-five eyes (82 consecutive patients) with BRVO after resolution of the macular edema were retrospectively evaluated. All patients underwent optical coherence tomography angiography (OCTA) for assessment of microvascular changes, including capillary telangiectasia, microaneurysm, and disruption of the foveal avascular zone (FAZ). The areas of vascular perfusion and FAZ in the SCP and DCP were quantitatively evaluated. Best-corrected visual acuity was measured on the same day as OCTA examination. The correlation between BCVA and OCTA findings was assessed. RESULTS. In eyes with resolved BRVO, the mean vascular perfusion areas in the SCP and DCP within a 3 3 3-mm area were 3.75 6 0.49 and 3.80 6 0.55 mm 2 , respectively. The mean FAZ areas of the SCP and DCP were 0.57 6 0.36 and 0.76 6 0.38 mm 2 , respectively. Better BCVA was significantly associated with a larger vascular perfusion area in the SCP (P < 0.001) and DCP (P < 0.001), and a smaller FAZ area in the SCP (P ¼ 0.025) and DCP (P ¼ 0.017). Stepwise multiple regression analysis revealed that the vascular perfusion area in the DCP was the most important parameter significantly correlated with BCVA (R 2 ¼ 0.33, P < 0.001). CONCLUSIONS. Preservation of the deep retinal vasculature is crucial for better visual function in BRVO.

Research paper thumbnail of A Self-Assembling Peptide Gel as a Vitreous Substitute: A Rabbit Study

Investigative Opthalmology & Visual Science, 2017

PURPOSE. To evaluate a self-assembling peptide gel as a potential vitreous substitute. METHODS. P... more PURPOSE. To evaluate a self-assembling peptide gel as a potential vitreous substitute. METHODS. PanaceaGel SPG-178, a self-assembling peptide gel, was diluted with distilled water and a balanced salt solution to achieve a final peptide concentration of 0.1%. The gel's refractive index, visible light transmission rate, and rheologic properties were investigated. The gel's biocompatibility was evaluated by examining the cellular viability (live and dead staining) and proliferation rate (alamarBlue assay). A 25-G pars plana vitrectomy was performed on the right eye of 21 New Zealand white rabbits. The gel was then injected into the vitreous cavity of 15 eyes. Six eyes were injected with a balanced salt solution (BSS) and served as controls. Toxicity was examined using electroretinography and histologic analysis after the injection of the gel. RESULTS. The gel's physical properties closely resembled those of human vitreous. The gel showed no apparent toxicity. When the gel was injected into the vitreous cavity, fragmentation was not observed. Additionally, the gel remained transparent in the vitreous cavity and no complications were observed for 3 months after the injection. Electroretinography and histology confirmed the gel's biocompatibility. CONCLUSIONS. This diluted self-assembling peptide gel could be provide a promising vitreous substitute.

Research paper thumbnail of Electrical stimulation method for vision improvement

Research paper thumbnail of Visual Sensation by Electrical Stimulation Using a New Direct Optic Nerve Electrode Device

Research paper thumbnail of An Angiogenic Role for Adrenomedullin in Choroidal Neovascularization

PLoS ONE, 2013

Purpose: Adrenomedullin (ADM) has been shown to take part in physiological and pathological angio... more Purpose: Adrenomedullin (ADM) has been shown to take part in physiological and pathological angiogenesis. The purpose of this study was to investigate whether ADM signaling is involved in choroidal neovascularization (CNV) using a mouse model. Methods and Results: CNV was induced by laser photocoagulation in 8-week-old C57BL/6 mice. ADM mRNA expression significantly increased following treatment, peaking 4 days thereafter. The expression of ADM receptor (ADM-R) components (CRLR, RAMP2 and RAMP 3) was higher in CD31 + CD45 2 endothelial cells (ECs) than CD31 2 CD45 2 non-ECs. Inflammatory stimulation upregulated the expression of ADM not only in cell lines but also in cells in primary cultures of the choroid/retinal pigment epithelium complex. Supernatants from TNFa-treated macrophage cell lines potentiated the proliferation of ECs and this was partially suppressed by an ADM antagonist, ADM (22-52). Intravitreous injection of ADM (22-52) or ADM neutralizing monoclonal antibody (mAb) after laser treatment significantly reduced the size of CNV compared with vehicle-treated controls (p,0.01). Conclusions: ADM signaling is involved in laser-induced CNV formation, because both an ADM antagonist and ADM mAb significantly inhibited it. Suppression of ADM signaling might be a valuable alternative treatment for CNV associated with age-related macular degeneration.

Research paper thumbnail of Adaptive Optics Fundus Camera to Examine Localized Changes in the Photoreceptor Layer of the Fovea

Ophthalmology, 2008

To examine highly localized photoreceptor disruptions in the fovea by a high-resolution adaptive ... more To examine highly localized photoreceptor disruptions in the fovea by a high-resolution adaptive optics (AO) fundus camera combined with Fourier-domain optical coherence tomography (FD OCT). Design: Observational case series. Participants: Three eyes of 3 patients who showed dark foveal spots by slit-lamp biomicroscopy. Methods: Three patients who reported metamorphopsia but showed no changes in the retina in conventional fundus photographs were examined. High-resolution retinal images were obtained with the AO fundus camera and by FD OCT. The images were compared with the findings obtained by standard clinical tests, including Amsler charts and fluorescein angiography (FA). Main Outcome Measures: Quantitative measurements of the area of photoreceptor disruption. Results: Slit-lamp biomicroscopy revealed an irregularly shaped dark spot in the fovea centralis but no changes in FA in the 3 cases. The photoreceptor mosaic was absent in a highly localized area of the fovea in the images obtained by the AO fundus camera, and the photoreceptor outer segment was absent or disturbed at the corresponding area by FD OCT in all 3 cases. The horizontal and vertical sizes of the area of disturbance of the photoreceptor mosaic in the AO images in the 3 eyes were 400ϫ200 m, 300ϫ120 m, and 300ϫ200 m. These sizes were comparable to the photoreceptor outer segment disturbances in the OCT images which were 330ϫ150 m, 280ϫ100 m, 200ϫ150 m, respectively. Conclusions: Localized OS disturbances were able to be detected in eyes with a dark foveal spot by AO fundus camera 2-dimensionally and by FD OCT axially. The good correspondence of the sizes of the area of photoreceptor disturbances obtained by AO images to those by FD OCT images indicate that the AO images can be used to evaluate and follow the 2-dimensional area of focal changes of the photoreceptors in the fovea quantitatively. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

Research paper thumbnail of Intravitreal Bevacizumab to Treat Iris Neovascularization and Neovascular Glaucoma Secondary to Ischemic Retinal Diseases in 41 Consecutive Cases

Ophthalmology, 2008

To evaluate the biologic efficacy of intravitreal bevacizumab (IVB) for iris neovascularization (... more To evaluate the biologic efficacy of intravitreal bevacizumab (IVB) for iris neovascularization (INV) or neovascular glaucoma (NVG) in patients with ischemic retinal disorders. Design: Retrospective, consecutive, interventional case series. Participants: Thirty patients (41 eyes) with INV or NVG secondary to ischemic retinal disorders. Methods: Patients received IVB (1 mg) as the initial treatment for INV or NVG and were followed up for at least 6 months. Ophthalmic evaluations included measurement of visual acuity and intraocular pressure (IOP), a complete ophthalmic examination, and fluorescein angiography. Patients were divided into 3 subgroups: INV without elevated IOP (INV group), NVG with an open angle (O-NVG group), and NVG with angle closure (C-NVG group) for outcomes analysis. Main Outcome Measures: The controllability of IOP by IVB, incidence of recurrence, and requirement for surgery to treat NVG. Results: No significant ocular or systemic adverse events developed during follow-up (range, 6-22 months; mean, 13.3 months). The mean IOP levels were 14.7, 31.2, and 44.9 mmHg at baseline in the INV, O-NVG, and C-NVG groups, respectively. In the INV group (9 eyes), the INV regressed or resolved after 1 injection. Iris neovascularization recurred in 4 eyes by 6 months and stabilized after repeated injections without IOP elevation. In the O-NVG group (17 eyes), rapid neovascular regression with successful IOP normalization (Յ21 mmHg) occurred in 12 eyes (71%) within 1 week after 1 injection. Five (29%) of the 17 eyes required surgery by 6 months despite repeated IVB injections, and a total of 7 eyes (41%) underwent surgery during follow-up. In the C-NVG group (15 eyes), IVB caused INV resolution but failed to lower the IOP. Fourteen (93%) of 15 eyes required surgery by 2 months after initial IVB and achieved IOP stabilization. The mean interval between IVB and surgery was significantly shorter in the C-NVG group than in the O-NVG group (PϽ0.001). Conclusions: Intravitreal bevacizumab is well tolerated, effectively stabilized INV activity, and controlled IOP in patients with INV alone and early-stage NVG without angle closure. In advanced NVG, IVB cannot control IOP but may be used adjunctively to improve subsequent surgical results. Further evaluation in controlled randomized studies is warranted.

Research paper thumbnail of Evidence That Light Modulates Protein Nitration in Rat Retina

Molecular & Cellular Proteomics, 2002

Research paper thumbnail of Chronic Implantation of Newly Developed Suprachoroidal-Transretinal Stimulation Prosthesis in Dogs

Investigative Ophthalmology & Visual Science, 2011

PURPOSE. To investigate the feasibility of implanting a newly developed suprachoroidal-transretin... more PURPOSE. To investigate the feasibility of implanting a newly developed suprachoroidal-transretinal stimulation (STS) prosthesis in dogs and to determine its biocompatibility and stability over a 3-month period. METHODS. The STS prosthesis system consisted of an array of 49 electrodes (nine were active), an intravitreal return electrode, and an extraocular microstimulator. The 49-electrode array was implanted into a scleral pocket of each of three healthy beagle dogs. Color fundus photography, fluorescein angiography, electroretinography, and functional testing of the STS system were performed postoperatively. The dogs were euthanatized 3 months after the implantation, and the retinas were evaluated histologically. RESULTS. All the prostheses were successfully implanted without complications, and no serious complications occurred during the 3-month postoperative period. The fixation of the implant was stable throughout the experimental period. Fluorescein angiography showed that the entire retina, including the area on the electrode array, remained well perfused without intraocular inflammation. Electroretinograms recorded from the eyes with the prosthesis did not differ significantly from those recorded from control eyes. Functional testing of the STS system showed that this system performed well for the 3-month experimental period. Histologic evaluations showed good preservation of the retina over the electrode array. CONCLUSIONS. Implantation of a newly developed STS retinal prosthesis into a scleral pocket of beagle dogs is surgically feasible and can be performed without significant damage to the retina or the animal. The biocompatibility and stability of the system were good for the 3-month observation period.

Research paper thumbnail of Testing of Semichronically Implanted Retinal Prosthesis by Suprachoroidal-Transretinal Stimulation in Patients with Retinitis Pigmentosa

Investigative Opthalmology & Visual Science, 2011

PURPOSE. To examine the safety and effectiveness of a retinal prosthesis that is implanted semich... more PURPOSE. To examine the safety and effectiveness of a retinal prosthesis that is implanted semichronically in two patients with advanced retinitis pigmentosa (RP). METHODS. Two eyes of two patients with advanced RP had a retinal prosthesis implanted in a sclera pocket of one eye. The visual acuity of both eyes before the implantation was bare light perception. Phosphenes were elicited by suprachoroidaltransretinal stimulation (STS). The internal devices of the STS were implanted under the skin on the temporal side of the head, and the 49 electrode-array was implanted in the scleral pocket of one eye. Biphasic electrical pulses (duration, 0.5 ms; frequency, 20 Hz) were delivered through nine active electrodes. The threshold current was determined by currents Յ1 mA. Behavioral tasks were used to determine the functioning of the prosthesis. RESULTS. The surgery was completed without a retinal detachment and retinal/vitreous hemorrhage. The implanted STS system remained functional for the 4-week test period. Phosphenes were elicited by currents delivered through six electrodes in Patient 1 and through four electrodes in Patient 2. The success of discriminating two bars was better than the chance level in both patients. In Patient 2, the success of a grasping task was better than the chance level, and the success rate of identifying a white bar on a touch panel increased with repeated testing. CONCLUSIONS. Semichronic implantation of a microelectrode-STS system showed that it was safe and remained functional for at least 4 weeks in two patients with advanced RP. (www.umin. ac.jp/ctr number, R000002690.

Research paper thumbnail of Effect of Cataract in Evaluation of Macular Pigment Optical Density by Autofluorescence Spectrometry

Investigative Ophthalmology & Visual Science, 2010

PURPOSE. To assess the effect of cataract on the evaluation of macular pigment optical density (M... more PURPOSE. To assess the effect of cataract on the evaluation of macular pigment optical density (MPOD) in aged patients. METHODS. MPOD was prospectively measured using autofluorescence spectrometry before and after cataract surgery. The Lens Opacities Classification System III was used to grade the cataracts at baseline. RESULTS. Forty-five eyes of 41 subjects, who had no ocular disorders or fundus autofluorescence abnormalities except for age-related nuclear cataract, were included. Preoperative MPOD was 0.350 Ϯ 0.117 density unit (DU). Regression analysis showed that a higher nuclear color score correlated with lower MPOD (t ϭ Ϫ2.90, P ϭ 0.0063). The preoperative MPOD prediction formula was MPOD ϭ 0.545 Ϫ 0.069 ϫ nuclear color score. A higher nuclear color score correlated significantly with failure to measure the MPOD (2 ϭ 5.08, P ϭ 0.0242). The mean postoperative MPOD was 0.600 DU (95% confidence interval [CI], 0.562-0.637), which was significantly (P Ͻ 0.0001) higher than the preoperative level of 0.350 DU (95% CI, 0.313-0.388). Regression analysis showed that higher preoperative MPOD correlated with higher postoperative MPOD (t ϭ 2.91, P ϭ 0.0061). CONCLUSIONS. Cataract, especially its nuclear component, affects MPOD measured by autofluorescence spectrometry. Care should be taken when using this method in eyes with agerelated macular maculopathy and age-related macular degeneration and in older patients who may develop these diseases.

Research paper thumbnail of Long – term results of intravitreal bevacizumab (Avastin) injection for choroidal neovascularisation secondary to angioid streaks

Acta Ophthalmologica, 2011

Purpose To evaluate the efficacy of long term intravitreal bevacizumab (Avastin) treatment for ch... more Purpose To evaluate the efficacy of long term intravitreal bevacizumab (Avastin) treatment for choroidal neovascularisation (CNV) associated with angioid streaks.Methods 65 year old woman with bilateral active CNV secondary to angioid streaks was treated since October 2006. Photodynamic therapy (PDT) was used for primary treatment, after – intravitreal bevacizumab (1,25mg) was injected 20 times in each eye, average 1,4 months interval was between each session. Treatment efficacy assesment based on VA (visual acuity) (Snellen chart), fluorescence angiography (FA) and optical coherence tomography (OCT) was performed pre‐ and post‐ treatment before and after each injection.Results The follow‐up of the patient lasts for 55 months. BCVA (best corrected visual acuity) of both eyes before treatment was 0,6. The patient received 3 PDT with verteporfin (Visudyne) into left eye and later 40 intravitreal bevacizumab injections (20 into each eye) for 41 months. During the whole follow‐up BCVA o...

Research paper thumbnail of A novel , less-invasive treatment option for rhegmatogenous retinal detachment and vitreoretinal interface pathologies

S cleral buckling is a common surgical procedure for repairing uncomplicated rhegmatogenous retin... more S cleral buckling is a common surgical procedure for repairing uncomplicated rhegmatogenous retinal detachment (RRD). The basis of therapy is to form a chorioretinal adhesion around the retinal break in conjunction with releasing the vitreoretinal traction force by the use of the scleral buckle, thus preventing access of intravitreal fluid to the subretinal space via retinal breaks.1,2 Although scleral buckling can be indicated for most primary RRDs, it may result in some vision-threatening complications due to the direct depression of the sclera with the buckle and/or the size and location of buckle placement, such as mechanical ocular motility disturbance secondary to an extraocular muscle imbalance, corneal contour changes, and chorioretinal circulatory disturbances.3-5 Because the therapeutic concept of scleral buckling is to bring retina into contact with treated choroid around retinal tears, the sclera itself may not necessarily be involved in the indentation. Based on this id...

Research paper thumbnail of Predictors of postoperative bleeding after vitrectomy for vitreous hemorrhage in patients with diabetic retinopathy

Journal of Diabetes Investigation, 2018

Aims/Introduction: To clarify the association between perioperative variables and postoperative b... more Aims/Introduction: To clarify the association between perioperative variables and postoperative bleeding in pars plana vitrectomy for vitreous hemorrhage in diabetic retinopathy. Materials and Methods: The present retrospective study enrolled 72 eyes of 64 patients who were admitted to Osaka University Hospital between April 2010 and March 2014, and underwent vitrectomy for vitreous hemorrhage as a result of diabetic retinopathy. Results: Postoperative bleeding developed in 12 eyes. Using binomial logistic regression analysis, we found that the duration of operation was the only significant variable associated with postoperative bleeding within 12 weeks after vitrectomy. Furthermore, Poisson regression analysis identified fasting blood glucose just before vitrectomy, no treatment with antiplatelet drugs and treatment with antihypertensive drugs, as well as duration of operation, to be significantly associated with the frequency of bleeding within 52 weeks after vitrectomy. Conclusions: Long duration of operation can be used to predict bleeding within both 12 and 52 weeks after vitrectomy. In addition, fasting blood glucose just before vitrectomy, no treatment with antiplatelet drugs and treatment with antihypertensive drugs might be risk factors for postoperative bleeding up to 1 year after vitrectomy.

Research paper thumbnail of Association between choriocapillaris flow deficit and choroidal neovascularization activity in eyes with myopic choroidal neovascularization

Scientific Reports, 2021

Although choriocapillaris flow deficit (CFD) around choroidal neovascularization (CNV) is less as... more Although choriocapillaris flow deficit (CFD) around choroidal neovascularization (CNV) is less associated with CNV activity in myopic eyes, no reports are investigating its size as an indicator of CNV activity. We investigated the relationship between CFD and high myopia-related CNV. In this retrospective, observational study, patients underwent optical coherence tomography angiography (OCTA) with split-spectrum amplitude-decorrelation angiography for diagnosing pathological myopic CNV (mCNV); CFD features around CNV margins were evaluated. Of the 33 eyes (30 patients), 11 (33.3%) had active mCNV, and 22 (66.7%) had inactive CNV. Six eyes (18.2%) were treatment-naïve, while the remainder previously underwent anti-vascular endothelial growth factor therapy. On OCTA, blood flow signals were detected in CNV in the outer retinal layer in 28 (84.8%) eyes, including all active cases (11 cases) and 17 (77.3%) of 22 inactive cases. CNV flow signal size correlated significantly with activity...

Research paper thumbnail of Long-term outcomes of intravitreal activated protein C injection for ischemic central retinal vein occlusion: an extension trial

Graefe's Archive for Clinical and Experimental Ophthalmology, 2021

Purpose Our previous 1-year pilot study evaluated the efficacy of intravitreally injected activat... more Purpose Our previous 1-year pilot study evaluated the efficacy of intravitreally injected activated protein C (APC) in 10 eyes with ischemic central retinal vein occlusion (CRVO). The reperfusion of the areas of retinal nonperfusion (RNP) exceeded 50% of the baseline in five (50%) eyes 1 year after the APC injection. The current study evaluated the long-term efficacy and safety of intravitreal APC. Methods The 10 eyes in the pilot study were included in this study. Other treatments were administered at the physicians’ discretion after the pilot study. We evaluated visual acuity (VA), central retinal thickness (CRT) and perfusion status, and adverse events and severity over the long term. Results The median follow-up was 60 months (range, 48–68 months). Compared with baseline, the post-treatment VA improved significantly (P < 0.001) from 1.39 to 1.06 logarithm of the minimum angle of resolution. The CRT improved significantly (P < 0.001) from 1090 to 195 μm at the last visit. T...

Research paper thumbnail of A Strategy for Personalized Treatment of iPS-Retinal Immune Rejections Assessed in Cynomolgus Monkey Models

International Journal of Molecular Sciences, 2020

Recently, we successfully transplanted an autograft, or major histocompatibility complex (MHC)-ma... more Recently, we successfully transplanted an autograft, or major histocompatibility complex (MHC)-matched allografts, from induced-pluripotent-stem-cell-derived retinal pigment epithelial (iPSC-RPE) cells in patients with age-related macular degeneration. However, there was an issue regarding immune rejection after transplantation. In this study, we established a preoperational in vitro “drug–lymphocytes–grafts immune reaction (Drug-LGIR)” test to determine the medication for immune rejection using host immunocompetent cells (lymphocytes) and transplant cells (target iPSC-RPE cells) together with different medications. The adequacy of the test was assessed by in vivo transplantation in monkey models together with medication based on in vitro data. In the results of Drug-LGIR tests, some drugs exhibited significant suppression of RPE cell-related allogeneic reactions, while other drugs did not, and the efficacy of each drug differed among the recipient monkeys. Based on the results of D...

Research paper thumbnail of Observation of treated iris neovascularization by swept-source-based en-face anterior-segment optical coherence tomography angiography

Scientific Reports, 2019

We evaluated regression of iris neovascularization (INV) using en-face anterior-segment optical c... more We evaluated regression of iris neovascularization (INV) using en-face anterior-segment optical coherence tomography angiography (AS-OCTA) after anti-vascular endothelial growth factor (VEGF) therapy. Seven consecutive eyes with INV were examined before and after anti-VEGF therapy, and all AS-OCTA scans were obtained using a swept-source OCTA system with an anterior-segment lens adapter. Slit-lamp microscopy photography and anterior indocyanine green angiography also were performed. Quantitative analyses of the vascular density, vascular lacunarity, and fractal dimension on AS-OCTA images were performed. AS-OCTA visualized the INV as signals around the pupillary margin, which corresponded to the vasculature confirmed by slit-lamp microscopy. After anti-VEGF drug injection, regression of INV was observed by AS-OCTA in all eyes (100%). The vascular density decreased and vascular lacunarity increased significantly after anti-VEGF therapy. This pilot study demonstrated the ability of AS...

Research paper thumbnail of Cross-Sectional Imaging Analysis of Epiretinal Membrane Involvement in Unilateral Open-Angle Glaucoma Severity

Investigative Opthalmology & Visual Science, 2018

PURPOSE. To determine the relevance of epiretinal membranes (ERMs) in primary open-angle glaucoma... more PURPOSE. To determine the relevance of epiretinal membranes (ERMs) in primary open-angle glaucoma (POAG) and potential risk for glaucoma severity. METHODS. Sixty eyes of 30 patients with POAG who had a unilateral ERM were analyzed; 60 nonglaucomatous eyes of 30 patients with a unilateral ERM also were recruited in this institutional cross-sectional study. Patients underwent swept-source (SS) optical coherence tomography (OCT) imaging and visual field testing. Intraindividual differences in the SS-OCT retinal nerve fiber layer (RNFL) disc cupping area measurements and visual field outcomes were analyzed in the two groups. RESULTS. In patients with POAG, the mean circumpapillary RNFL thickness in the eyes with an ERM was 75.6 6 16.5 lm superiorly and 71.8 6 26.0 inferiorly compared with the fellow eyes without an ERM (87.2 6 23.6 lm, P ¼ 0.0061 and 81.3 6 27.7 lm, P ¼ 0.034, respectively). The areas of disc cupping and cup-to-disc ratio seen on OCT horizontal and vertical B-scans were larger in eyes with an ERM than in the fellow eyes without ERM (P ¼ 0.0004 and P ¼ 0.0011, respectively). The average mean deviations were À11.6 6 7.5 dB in the ERM group and À8.19 6 6.4 dB in the group with no ERM (P ¼ 0.029). Eyes with an ERM received more antiglaucoma eye drops (P ¼ 0.018). Those differences were not seen between eyes with an ERM or fellow eyes in patients without glaucoma. CONCLUSIONS. The presence of an ERM can be a potential risk factor for unilateral severity in eyes with POAG.

Research paper thumbnail of Neural retina-specific Aldh1a1 controls dorsal choroidal vascular development via Sox9 expression in retinal pigment epithelial cells

eLife, Jan 3, 2018

VEGF secreted from retinal pigment epithelial (RPE) cells is responsible for the choroidal vascul... more VEGF secreted from retinal pigment epithelial (RPE) cells is responsible for the choroidal vascular development; however, the molecular regulatory mechanism is unclear. We found that mice showed choroidal hypoplasia with insufficient vascularization in the dorsal region, although Aldh1a1, an enzyme that synthesizes retinoic acids (RAs), is expressed in the dorsal neural retina, not in the RPE/choroid complex. The level of VEGF in the RPE/choroid was significantly decreased in mice, and RA-dependent enhancement of VEGF was observed in primary RPE cells. An RA-deficient diet resulted in dorsal choroidal hypoplasia, and simple RA treatment of pregnant females suppressed choroid hypoplasia in their offspring. We also found downregulation of Sox9 in the dorsal neural retina and RPE of mice and RPE-specific disruption of Sox9 phenocopied choroidal development. These results suggest that RAs produced by Aldh1a1 in the neural retina directs dorsal choroidal vascular development via Sox9 upr...

Research paper thumbnail of Retinal Microvasculature and Visual Acuity in Eyes With Branch Retinal Vein Occlusion: Imaging Analysis by Optical Coherence Tomography Angiography

Investigative Opthalmology & Visual Science, 2017

PURPOSE. To investigate microvascular changes in the superficial capillary plexus (SCP) and deep ... more PURPOSE. To investigate microvascular changes in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) in eyes with resolved branch retinal vein occlusion (BRVO) and their association with best-corrected visual acuity (BCVA). METHODS. Eighty-five eyes (82 consecutive patients) with BRVO after resolution of the macular edema were retrospectively evaluated. All patients underwent optical coherence tomography angiography (OCTA) for assessment of microvascular changes, including capillary telangiectasia, microaneurysm, and disruption of the foveal avascular zone (FAZ). The areas of vascular perfusion and FAZ in the SCP and DCP were quantitatively evaluated. Best-corrected visual acuity was measured on the same day as OCTA examination. The correlation between BCVA and OCTA findings was assessed. RESULTS. In eyes with resolved BRVO, the mean vascular perfusion areas in the SCP and DCP within a 3 3 3-mm area were 3.75 6 0.49 and 3.80 6 0.55 mm 2 , respectively. The mean FAZ areas of the SCP and DCP were 0.57 6 0.36 and 0.76 6 0.38 mm 2 , respectively. Better BCVA was significantly associated with a larger vascular perfusion area in the SCP (P < 0.001) and DCP (P < 0.001), and a smaller FAZ area in the SCP (P ¼ 0.025) and DCP (P ¼ 0.017). Stepwise multiple regression analysis revealed that the vascular perfusion area in the DCP was the most important parameter significantly correlated with BCVA (R 2 ¼ 0.33, P < 0.001). CONCLUSIONS. Preservation of the deep retinal vasculature is crucial for better visual function in BRVO.

Research paper thumbnail of A Self-Assembling Peptide Gel as a Vitreous Substitute: A Rabbit Study

Investigative Opthalmology & Visual Science, 2017

PURPOSE. To evaluate a self-assembling peptide gel as a potential vitreous substitute. METHODS. P... more PURPOSE. To evaluate a self-assembling peptide gel as a potential vitreous substitute. METHODS. PanaceaGel SPG-178, a self-assembling peptide gel, was diluted with distilled water and a balanced salt solution to achieve a final peptide concentration of 0.1%. The gel's refractive index, visible light transmission rate, and rheologic properties were investigated. The gel's biocompatibility was evaluated by examining the cellular viability (live and dead staining) and proliferation rate (alamarBlue assay). A 25-G pars plana vitrectomy was performed on the right eye of 21 New Zealand white rabbits. The gel was then injected into the vitreous cavity of 15 eyes. Six eyes were injected with a balanced salt solution (BSS) and served as controls. Toxicity was examined using electroretinography and histologic analysis after the injection of the gel. RESULTS. The gel's physical properties closely resembled those of human vitreous. The gel showed no apparent toxicity. When the gel was injected into the vitreous cavity, fragmentation was not observed. Additionally, the gel remained transparent in the vitreous cavity and no complications were observed for 3 months after the injection. Electroretinography and histology confirmed the gel's biocompatibility. CONCLUSIONS. This diluted self-assembling peptide gel could be provide a promising vitreous substitute.

Research paper thumbnail of Electrical stimulation method for vision improvement

Research paper thumbnail of Visual Sensation by Electrical Stimulation Using a New Direct Optic Nerve Electrode Device

Research paper thumbnail of An Angiogenic Role for Adrenomedullin in Choroidal Neovascularization

PLoS ONE, 2013

Purpose: Adrenomedullin (ADM) has been shown to take part in physiological and pathological angio... more Purpose: Adrenomedullin (ADM) has been shown to take part in physiological and pathological angiogenesis. The purpose of this study was to investigate whether ADM signaling is involved in choroidal neovascularization (CNV) using a mouse model. Methods and Results: CNV was induced by laser photocoagulation in 8-week-old C57BL/6 mice. ADM mRNA expression significantly increased following treatment, peaking 4 days thereafter. The expression of ADM receptor (ADM-R) components (CRLR, RAMP2 and RAMP 3) was higher in CD31 + CD45 2 endothelial cells (ECs) than CD31 2 CD45 2 non-ECs. Inflammatory stimulation upregulated the expression of ADM not only in cell lines but also in cells in primary cultures of the choroid/retinal pigment epithelium complex. Supernatants from TNFa-treated macrophage cell lines potentiated the proliferation of ECs and this was partially suppressed by an ADM antagonist, ADM (22-52). Intravitreous injection of ADM (22-52) or ADM neutralizing monoclonal antibody (mAb) after laser treatment significantly reduced the size of CNV compared with vehicle-treated controls (p,0.01). Conclusions: ADM signaling is involved in laser-induced CNV formation, because both an ADM antagonist and ADM mAb significantly inhibited it. Suppression of ADM signaling might be a valuable alternative treatment for CNV associated with age-related macular degeneration.

Research paper thumbnail of Adaptive Optics Fundus Camera to Examine Localized Changes in the Photoreceptor Layer of the Fovea

Ophthalmology, 2008

To examine highly localized photoreceptor disruptions in the fovea by a high-resolution adaptive ... more To examine highly localized photoreceptor disruptions in the fovea by a high-resolution adaptive optics (AO) fundus camera combined with Fourier-domain optical coherence tomography (FD OCT). Design: Observational case series. Participants: Three eyes of 3 patients who showed dark foveal spots by slit-lamp biomicroscopy. Methods: Three patients who reported metamorphopsia but showed no changes in the retina in conventional fundus photographs were examined. High-resolution retinal images were obtained with the AO fundus camera and by FD OCT. The images were compared with the findings obtained by standard clinical tests, including Amsler charts and fluorescein angiography (FA). Main Outcome Measures: Quantitative measurements of the area of photoreceptor disruption. Results: Slit-lamp biomicroscopy revealed an irregularly shaped dark spot in the fovea centralis but no changes in FA in the 3 cases. The photoreceptor mosaic was absent in a highly localized area of the fovea in the images obtained by the AO fundus camera, and the photoreceptor outer segment was absent or disturbed at the corresponding area by FD OCT in all 3 cases. The horizontal and vertical sizes of the area of disturbance of the photoreceptor mosaic in the AO images in the 3 eyes were 400ϫ200 m, 300ϫ120 m, and 300ϫ200 m. These sizes were comparable to the photoreceptor outer segment disturbances in the OCT images which were 330ϫ150 m, 280ϫ100 m, 200ϫ150 m, respectively. Conclusions: Localized OS disturbances were able to be detected in eyes with a dark foveal spot by AO fundus camera 2-dimensionally and by FD OCT axially. The good correspondence of the sizes of the area of photoreceptor disturbances obtained by AO images to those by FD OCT images indicate that the AO images can be used to evaluate and follow the 2-dimensional area of focal changes of the photoreceptors in the fovea quantitatively. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references.

Research paper thumbnail of Intravitreal Bevacizumab to Treat Iris Neovascularization and Neovascular Glaucoma Secondary to Ischemic Retinal Diseases in 41 Consecutive Cases

Ophthalmology, 2008

To evaluate the biologic efficacy of intravitreal bevacizumab (IVB) for iris neovascularization (... more To evaluate the biologic efficacy of intravitreal bevacizumab (IVB) for iris neovascularization (INV) or neovascular glaucoma (NVG) in patients with ischemic retinal disorders. Design: Retrospective, consecutive, interventional case series. Participants: Thirty patients (41 eyes) with INV or NVG secondary to ischemic retinal disorders. Methods: Patients received IVB (1 mg) as the initial treatment for INV or NVG and were followed up for at least 6 months. Ophthalmic evaluations included measurement of visual acuity and intraocular pressure (IOP), a complete ophthalmic examination, and fluorescein angiography. Patients were divided into 3 subgroups: INV without elevated IOP (INV group), NVG with an open angle (O-NVG group), and NVG with angle closure (C-NVG group) for outcomes analysis. Main Outcome Measures: The controllability of IOP by IVB, incidence of recurrence, and requirement for surgery to treat NVG. Results: No significant ocular or systemic adverse events developed during follow-up (range, 6-22 months; mean, 13.3 months). The mean IOP levels were 14.7, 31.2, and 44.9 mmHg at baseline in the INV, O-NVG, and C-NVG groups, respectively. In the INV group (9 eyes), the INV regressed or resolved after 1 injection. Iris neovascularization recurred in 4 eyes by 6 months and stabilized after repeated injections without IOP elevation. In the O-NVG group (17 eyes), rapid neovascular regression with successful IOP normalization (Յ21 mmHg) occurred in 12 eyes (71%) within 1 week after 1 injection. Five (29%) of the 17 eyes required surgery by 6 months despite repeated IVB injections, and a total of 7 eyes (41%) underwent surgery during follow-up. In the C-NVG group (15 eyes), IVB caused INV resolution but failed to lower the IOP. Fourteen (93%) of 15 eyes required surgery by 2 months after initial IVB and achieved IOP stabilization. The mean interval between IVB and surgery was significantly shorter in the C-NVG group than in the O-NVG group (PϽ0.001). Conclusions: Intravitreal bevacizumab is well tolerated, effectively stabilized INV activity, and controlled IOP in patients with INV alone and early-stage NVG without angle closure. In advanced NVG, IVB cannot control IOP but may be used adjunctively to improve subsequent surgical results. Further evaluation in controlled randomized studies is warranted.

Research paper thumbnail of Evidence That Light Modulates Protein Nitration in Rat Retina

Molecular & Cellular Proteomics, 2002

Research paper thumbnail of Chronic Implantation of Newly Developed Suprachoroidal-Transretinal Stimulation Prosthesis in Dogs

Investigative Ophthalmology & Visual Science, 2011

PURPOSE. To investigate the feasibility of implanting a newly developed suprachoroidal-transretin... more PURPOSE. To investigate the feasibility of implanting a newly developed suprachoroidal-transretinal stimulation (STS) prosthesis in dogs and to determine its biocompatibility and stability over a 3-month period. METHODS. The STS prosthesis system consisted of an array of 49 electrodes (nine were active), an intravitreal return electrode, and an extraocular microstimulator. The 49-electrode array was implanted into a scleral pocket of each of three healthy beagle dogs. Color fundus photography, fluorescein angiography, electroretinography, and functional testing of the STS system were performed postoperatively. The dogs were euthanatized 3 months after the implantation, and the retinas were evaluated histologically. RESULTS. All the prostheses were successfully implanted without complications, and no serious complications occurred during the 3-month postoperative period. The fixation of the implant was stable throughout the experimental period. Fluorescein angiography showed that the entire retina, including the area on the electrode array, remained well perfused without intraocular inflammation. Electroretinograms recorded from the eyes with the prosthesis did not differ significantly from those recorded from control eyes. Functional testing of the STS system showed that this system performed well for the 3-month experimental period. Histologic evaluations showed good preservation of the retina over the electrode array. CONCLUSIONS. Implantation of a newly developed STS retinal prosthesis into a scleral pocket of beagle dogs is surgically feasible and can be performed without significant damage to the retina or the animal. The biocompatibility and stability of the system were good for the 3-month observation period.

Research paper thumbnail of Testing of Semichronically Implanted Retinal Prosthesis by Suprachoroidal-Transretinal Stimulation in Patients with Retinitis Pigmentosa

Investigative Opthalmology & Visual Science, 2011

PURPOSE. To examine the safety and effectiveness of a retinal prosthesis that is implanted semich... more PURPOSE. To examine the safety and effectiveness of a retinal prosthesis that is implanted semichronically in two patients with advanced retinitis pigmentosa (RP). METHODS. Two eyes of two patients with advanced RP had a retinal prosthesis implanted in a sclera pocket of one eye. The visual acuity of both eyes before the implantation was bare light perception. Phosphenes were elicited by suprachoroidaltransretinal stimulation (STS). The internal devices of the STS were implanted under the skin on the temporal side of the head, and the 49 electrode-array was implanted in the scleral pocket of one eye. Biphasic electrical pulses (duration, 0.5 ms; frequency, 20 Hz) were delivered through nine active electrodes. The threshold current was determined by currents Յ1 mA. Behavioral tasks were used to determine the functioning of the prosthesis. RESULTS. The surgery was completed without a retinal detachment and retinal/vitreous hemorrhage. The implanted STS system remained functional for the 4-week test period. Phosphenes were elicited by currents delivered through six electrodes in Patient 1 and through four electrodes in Patient 2. The success of discriminating two bars was better than the chance level in both patients. In Patient 2, the success of a grasping task was better than the chance level, and the success rate of identifying a white bar on a touch panel increased with repeated testing. CONCLUSIONS. Semichronic implantation of a microelectrode-STS system showed that it was safe and remained functional for at least 4 weeks in two patients with advanced RP. (www.umin. ac.jp/ctr number, R000002690.

Research paper thumbnail of Effect of Cataract in Evaluation of Macular Pigment Optical Density by Autofluorescence Spectrometry

Investigative Ophthalmology & Visual Science, 2010

PURPOSE. To assess the effect of cataract on the evaluation of macular pigment optical density (M... more PURPOSE. To assess the effect of cataract on the evaluation of macular pigment optical density (MPOD) in aged patients. METHODS. MPOD was prospectively measured using autofluorescence spectrometry before and after cataract surgery. The Lens Opacities Classification System III was used to grade the cataracts at baseline. RESULTS. Forty-five eyes of 41 subjects, who had no ocular disorders or fundus autofluorescence abnormalities except for age-related nuclear cataract, were included. Preoperative MPOD was 0.350 Ϯ 0.117 density unit (DU). Regression analysis showed that a higher nuclear color score correlated with lower MPOD (t ϭ Ϫ2.90, P ϭ 0.0063). The preoperative MPOD prediction formula was MPOD ϭ 0.545 Ϫ 0.069 ϫ nuclear color score. A higher nuclear color score correlated significantly with failure to measure the MPOD (2 ϭ 5.08, P ϭ 0.0242). The mean postoperative MPOD was 0.600 DU (95% confidence interval [CI], 0.562-0.637), which was significantly (P Ͻ 0.0001) higher than the preoperative level of 0.350 DU (95% CI, 0.313-0.388). Regression analysis showed that higher preoperative MPOD correlated with higher postoperative MPOD (t ϭ 2.91, P ϭ 0.0061). CONCLUSIONS. Cataract, especially its nuclear component, affects MPOD measured by autofluorescence spectrometry. Care should be taken when using this method in eyes with agerelated macular maculopathy and age-related macular degeneration and in older patients who may develop these diseases.