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Fumi Gomi

Publications and source records attributed to Fumi Gomi.

At least 19 recordsLinked to original sources
PubMed2006

Three-dimensional optical coherence tomographic findings in central serous chorioretinopathy.

PURPOSE: The purpose of this study was to evaluate three-dimensional optical coherence tomographic findings at the leakage point on fluorescein angiography in central serous chorioretinopathy (CSC) with OCT-ophthalmoscope. METHODS: Twenty-seven eyes of 26 patients (23 men, three women; mean age, 50 years; range, 30-72) diagnosed with CSC were examined with OCT-ophthalmoscope, and transverse and longitudinal images were compared with fundus and fluorescein angiography findings. RESULTS: Transverse images (C-scan) clearly showed serous retinal detachment in all eyes and irregular lesions in retinal pigment epithelium (RPE) in 26 of 27 eyes (96%). These results agreed with the location of lesions in areas of fluorescein dye leakage on fluorescein angiography. Longitudinal images (B-scan) of irregular RPE lesions in transverse images showed RPE detachment (PED) in 17 eyes (63%), small protrusion of the RPE layer in five eyes (19%), and rough RPE layer in four eyes (15%). CONCLUSIONS: OCT-ophthalmoscope detects morphologic changes easily and noninvasively at the point of dye leakage in eyes with CSC.

Adult↗
PubMed2006

Regression of iris neovascularization after intravitreal injection of bevacizumab in patients with proliferative diabetic retinopathy.

PURPOSE: To assess the short-term safety and efficacy of intravitreal injection of bevacizumab for iris neovascularization (INV). DESIGN: Noncomparative, interventional case series. METHODS: Intravitreal bevacizumab was injected in seven eyes of five patients with INV that was associated with proliferative diabetic retinopathy (PDR). The main outcome measurements were visual acuity, intraocular pressure (IOP), and regression of INV by fluorescein angiography before and one week, one month, and two months after injection. RESULTS: Regression of INV was confirmed in all eyes (100%) from one week after injection. Repeated injections stabilized the recurrence (two eyes; 29%) that was observed two months after the initial injection. The visual acuity remained stable or improved, and the intraocular pressure was controlled in six eyes (86%) throughout the follow-up period. No inflammation or complications were observed. CONCLUSIONS: Intravitreal injection of bevacizumab may be an effective and safe alternative for patients with INV that is refractory to conventional treatments.

Adult↗
PubMed2006

[Sub-Tenon's injection of triamcinolone acetonide for choroidal neovascularization].

PURPOSE: To evaluate the efficacy of sub-Tenon's injection of triamcinolone acetonide for age-related macular degeneration (AMD) and polypoidal choroidal vasculopathy (PCV). METHOD: Sub-Tenon's injection of triamcinolone acetonide was performed in patients (27 eyes) with the subfoveal choroidal neovascularization of AMD and in patients (10 eyes) with PCV, and its efficacy was evaluated. The visual acuity and the exudation from lesions evaluated by fluorescein angiography or optical coherence tomography (OCT) at three months or six months after injection were compared to the baseline values. RESULTS: Visual acuity was maintained in 23 of the 27 eyes (85.0%) with AMD and in 8 of the 10 eyes (80.0%) with PCV at three months after injection. Six months after infusion, the rate declined to 76.0% and 66.7%, respectively. Exudation from lesions had decreased in 10 eyes of 25 eyes(40.0%) with AMD and in 2 eyes of 9 eyes (22.2%) with PCV by six months after injection. Complete suppression of the lesions was observed in seven eyes (18.9%) with relatively small lesions. CONCLUSION: Sub-Tenon's injection of triamcinolone acetonide is useful as a treatment modality for AMD and PCV.

Aged↗
PubMed2005

New micro vertical scissors for the surgical ablation of retinal angiomatous proliferation.

PURPOSE: To develop new micro vertical scissors for the ablation of retinal angiomatous proliferation (RAP) to minimize possible retinal damage. DESIGN: Interventional case report. METHODS: New micro vertical scissors were developed and used for the ablation of RAP vessels. RESULTS: The length of the inner side of the tip is 180 microm, which is approximately one seventh that of regular vertical scissors. The scissors handled easily and the RAP vessels were ablated with less retinal damage compared with that associated with use of standard vertical scissors. Postoperatively, intraretinal hemorrhage was reduced and hyperfluorescence seen on indocyanine green angiography resolved. CONCLUSIONS: The new micro vertical scissors developed for the ablation of RAP vessels can be used safely and effectively during this surgical procedure.

Aged↗
PubMed2005

Potent retinal arteriolar traction as a possible cause of myopic foveoschisis.

PURPOSE: To report retinal microfold formation after vitrectomy for myopic foveoschisis (MF). DESIGN: Prospective observational study. METHODS: We observed 21 eyes of 17 patients who had undergone vitrectomy for MF with optical coherence tomography (OCT) in this institutional study. We also evaluated the three-dimensional retinal architecture using the OCT-ophthalmoscope in selected cases. Vitrectomy included core vitrectomy, vitreous cortex removal, internal limiting membrane (ILM) peeling with indocyanine green, and gas tamponade. RESULTS: Horizontal linear folds were commonly observed postoperatively. The folds, which were 1,000 to 2,000 microm superior, inferior, or both superior and inferior to the fovea, were detected only by OCT and not by conventional slit-lamp-based biomicroscopy. The microfolds were found in only five eyes (24%) 1 month postoperatively. The incidence increased over time, however, and a microfold was detected in nine eyes (43%) 3 months after surgery and in 13 (62%) 6 months after surgery. OCT-ophthalmoscope examination confirmed the location of the microfold coincided exactly with that of retinal arteriole. The presence of microfolds was not significantly related to the postoperative visual acuity. CONCLUSIONS: Retinal microfolds are common in eyes with MF after vitrectomy with ILM peeling, and they seem to be generated as the result of insufficient flexibility of the sclerotic retinal arteriole during axial length elongation in highly myopic eyes. This finding suggests that the inward tractional force on the retina along the arteriole may be closely related to the pathogenesis of vitreoretinal diseases specific to high myopia, including MF or paravascular microhole formation.

Aged↗
PubMed2005

Recurrent retinal angiomatous proliferation after surgical ablation.

PURPOSE: To report a case of retinal angiomatous proliferation (RAP) treated by ablation of the feeding and draining vessels that recurred by 6 months postoperatively. DESIGN: Interventional case report. METHODS: Images from fluorescein angiography, indocyanine green (ICG) angiography, and optical coherence tomography (OCT) were examined before and after ablation. RESULTS: The hot spot on late-phase ICG, the leakage on fluorescein angiography, the pigment epithelial detachment, and macular edema on OCT decreased postoperatively. However, a large hyperfluorescent lesion was detected on ICG 6 months postoperatively with recurrent cystoid macular edema. CONCLUSIONS: A new RAP lesion can develop even after the original lesion seemed to resolve after ablation.

Aged↗
PubMed2005

Retinal vascular microfolds in highly myopic eyes.

PURPOSE: Retinal microfolds attributable to retinal vessels were first observed after vitrectomy for myopic foveoschisis and were believed to indicate inward retinal traction, possibly leading to high myopia-specific retinal diseases. We report retinal microfolds in high myopia without vitrectomy. DESIGN: Observational case series. METHODS: This is an institutional study. Seven eyes of seven patients in which retinal microfolds were observed using optical coherence tomography (OCT) were included in the study. We used an OCT-ophthalmoscope to confirm the precise location of the microfolds. We also investigated the relationship between the presence of microfolds and subjective distortion detected by examination of the corresponding retinal area using the Amsler grid chart in three eyes. RESULTS: All microfolds detected by OCT coincided with the retinal vessels using the OCT-ophthalmoscope. The folds coincided only with the retinal arterioles in six eyes (86%) and with both arterioles and veins in one (14%). Subjective distortion was detected in the retinal area corresponding to the microfolds in two eyes (67%) but was not detected in one eye (33%). CONCLUSIONS: The incidence of retinal microfolds is 2.9%, and thus they are not uncommon in highly myopic eyes without vitrectomy. The coincident appearance of the folds and vessels suggests that inflexibility of the retinal vessels and retinal stretching attributable to ocular elongation may cause the microfolds. The presence of these microfolds indicates that inward retinal vascular traction could be common in highly myopic eyes.

Aged↗
PubMed2005

Nonvitrectomizing vitreous surgery for epiretinal membrane long-term follow-up.

PURPOSE: To report the long-term follow-up results of nonvitrectomizing vitreous surgery for idiopathic epiretinal membrane (ERM). DESIGN: Nonrandomized comparative case series. PARTICIPANTS: Thirty patients were followed up for at least 5 years after nonvitrectomizing vitreous surgery. INTERVENTION: Epiretinal membranes were peeled without infusion of balanced salt solution and removal of the vitreous. The data from the fellow eye was the control data. MAIN OUTCOME MEASURES: We examined the visual acuities (VAs), objective refractions, and slit-lamp and Scheimpflug photographs from the preoperative and the final examinations of both eyes. Quantitative assessment of the progression of nuclear sclerosis was performed by densitometry analysis using Scheimpflug photography. The recurrence rate of ERM was determined. RESULTS: The follow-up periods ranged from 60 to 102 months (mean+/-standard deviation, 72.2+/-11.0 months). The patient ages ranged from 52 to 76 years (68.8+/-6.3 years). The final VA improved or stabilized within 2 lines in 29 of 30 eyes (96.7%). No unilateral progression of nuclear sclerosis occurred in any cases. The mean preoperative and postoperative refractions without additional surgery were -0.4+/-2.9 diopters (D) and -0.2+/-3.0 D in the operated eyes, respectively, and -0.2+/-2.5 D and 0.1+/-2.4 D, respectively, in the unoperated fellow eyes. The mean differences in the refractive error between both eyes (operated eye data minus fellow eye data) were -0.2+/-0.7 D before surgery and -0.3+/-0.8 D after surgery (P = 0.319, paired t test). The mean preoperative and postoperative nuclear densities in 16 patients were 69+/-14 nuclear density units (NDUs) and 76+/-12 NDUs in the operated eyes and 71+/-14 NDUs and 78+/-14 NDUs in the fellow eyes, respectively. The mean preoperative and postoperative differences in nuclear densities in both eyes were -2+/-2 NDUs and -2+/-5 NDUs, respectively (P = 0.836, paired t test). The ERM recurred in 10 eyes (33%), and 3 eyes underwent conventional vitrectomy combined with cataract surgery. CONCLUSIONS: Unilateral nuclear sclerosis did not progress for at least 5 years after nonvitrectomizing vitreous surgery. The recurrence rate of ERM appeared to be higher than that after conventional vitreous surgery.

Aged↗
PubMed2005

Vascular endothelial growth factor reduced and connective tissue growth factor induced by triamcinolone in ARPE19 cells under oxidative stress.

PURPOSE: To investigate whether triamcinolone acetonide (TA) affects the expression of vascular endothelial growth factor (VEGF) and connective tissue growth factor (CTGF) in retinal pigment epithelial (RPE) cells exposed to oxidative stress. METHODS: TA (10 nM, 1 microM, or 100 microM) was added to ARPE19 cells exposed to oxidative stress induced by hypoxia-reoxygenation and paraquat. Cellular expression of VEGF, CTGF, and an inducer of both growth factors, transforming growth factor (TGF)-beta was investigated with real-time reverse transcription-polymerase chain reaction and Western blot analysis. Tube-forming assays were conducted with human umbilical vein endothelial cells (HUVECs) in conditioned medium from RPE cells exposed to oxidative stress, with or without TA treatment. RESULTS: Oxidative stress induced mRNA expression of VEGF, CTGF, and TGF-beta by RPE cells. TA reduced upregulation of VEGF and TGF-beta in a concentration-dependent manner. In contrast, upregulation of CTGF by oxidative stress was accelerated by TA concentrations of 10 nM and 1 muM. Tube formation by HUVECs was strongly inhibited by exposure to conditioned medium from oxidative stress-stimulated ARPE19 cells treated with 1 muM TA compared with cells not treated with TA. CONCLUSIONS: TA reduced VEGF expression and induced CTGF expression in ARPE19 cells exposed to oxidative stress, and conditioned medium from these cells inhibited tube formation by HUVECs. Because VEGF is a major cytokine involved in angiogenesis, and CTGF is a main cytokine related to fibrosis, these results suggest that changes in their expression may be important mechanisms underlying the decreased choroidal neovascularization and fibrosis after administration of TA.

Blotting, Western↗
PubMed2004

Wide-angle viewing lens for vitrectomy.

PURPOSE: To report a new wide-angle viewing contact lens for vitrectomy. DESIGN: New surgical instrument. METHODS: The new wide-angle viewing lens is made of glass and polymethyl methacrylate without a plastic rim. The diameter is reduced to 16.2 mm. In addition to a smaller diameter than the currently available lens, the new lens is partially cut to reduce the lens diameter. RESULTS: A smaller diameter makes it possible to eliminate contact between surgical instruments and the wide-angle lens. Instruments can be inserted through sclerotomies without removing the wide-angle lens. The optical properties are otherwise identical to the standard wide-angle lens. CONCLUSION: The new wide-angle viewing lens may be easier to use in vitreous surgery.

Contact Lenses↗
PubMed2004

Vitrectomy and internal limiting membrane peeling for myopic foveoschisis.

PURPOSE: Myopic foveoschisis is common in high myopia. We report results of a pilot study of vitrectomy for patients with myopic foveoschisis. DESIGN: Interventional case series. METHODS: In an institutional setting five patients with high myopia (six eyes), and who had progressive visual impairment presumably due to myopic foveoschisis were studied. No eyes had a macular hole preoperatively based on optical coherence tomography (OCT). We performed vitrectomy including vitreous cortex removal, internal limiting membrane (ILM) peeling, and gas tamponade. Patients were followed for at least 6 months. Best-corrected visual acuity (BCVA), OCT. Scanning laser ophthalmoscope (SLO) microperimetry was examined in three eyes. RESULTS: The foveal detachment resolved completely in five eyes and partially in one eye. No serious complications developed including macular hole formation or retinal detachment; BCVA improved more than two lines in all eyes (100%) 6 months postoperatively (P <.01); SLO microperimetry showed smaller scotoma compared with preoperatively and stabilized fixation. CONCLUSIONS: Vitrectomy with vitreous cortex removal, ILM peeling, and gas tamponade could be useful to treat myopic foveoschisis in highly myopic eyes. Because the natural course of the disease is not well-understood, further study should establish indications for this surgery.

Basement Membrane↗
PubMed2004

Macular translocation surgery and retinal circulation times.

PURPOSE: To quantify and compare the retinal circulation times before and after macular translocation surgery. METHODS: In nine patients undergoing macular translocation with 360-degree retinotomy, arm-retina and arteriovenous passage times were quantified from preoperative and postoperative scanning laser fluorescein angiograms. A control group of eight patients who had not undergone any intraocular surgery was also evaluated. The time that between injection into the antecubital vein and the appearance of fluorescein at two selected points on superotemporal and inferotemporal arteries near the disk provided the arm-retina time. For the arteriovenous passage time, 50% of the maximal fluorescence time difference was assessed from the intensity curves of arteries and corresponding veins at the same points for the arm-retina time. Postoperative measurements were obtained an average of 10.6 months after surgery. RESULTS: No significant difference was noted between preoperative and postoperative values of the arm-retina time (mean +/- SD: 14.41 +/- 2.73 seconds versus 14.67 +/- 3.85 seconds, respectively; P = 0.84) or that of the arteriovenous passage time (2.66 +/- 0.74 seconds versus 2.47 +/- 0.68 seconds, respectively; P = 0.37) in the study group. The arm-retina time (14.96 +/- 2.01 seconds) and arteriovenous passage time (2.44 +/- 0.68 seconds) in the control group did not differ from preoperative and postoperative arm-retina times (P = 0.65 and P = 0.85) and arteriovenous passage times (P = 0.54 and P = 0.93) in the study group. The arteriovenous passage time correlated with the degree of retinal rotation around the optic disk in the study group (r = -0.70; P = 0.04). CONCLUSION: Macular translocation surgery does not alter retinal macrocirculation in the long term.

Aged↗
PubMed2004

Evaluation of choroidal perfusion of the new central macular area by dilution analysis of indocyanine green angiography after macular translocation.

PURPOSE: To evaluate the possible long-term alterations of choroidal perfusion parameters in the new central macular area after macular translocation surgery. METHODS: Eleven subjects with subfoveal neovascular membrane secondary to age-related macular degeneration or degenerative myopia underwent indocyanine green angiography by using a scanning laser ophthalmoscope before and after macular translocation (mean, 10 months after surgery). Fluorescence intensity of the new central macular area over time was evaluated. Parameters derived from the intensity curves included 10% filling time, ascending slope, and maximal intensity of brightness. The 10% filling time reflects the rapidity of the early choroidal filling phase, whereas the slope of the filling of the curve shows the speed of blood entrance into the choroid. Maximal intensity of brightness indicates vascular density of the area. RESULTS: No statistical difference was encountered before or after macular translocation in 10% filling time (14.25 +/- 2.09 seconds versus 16.20 +/- 2.95 seconds), slope of the ascending portion of the curve (0.12 +/- 0.04 versus 0.11 +/- 0.04), and maximal intensity of brightness (0.89 +/- 0.09 versus 0.88 +/- 0.07) in the new central macular area. The rotational degree of the retina against the retinal pigment epithelium did not show any significant correlation with 10% filling time, slope, or maximal intensity of brightness. CONCLUSION: Choroidal perfusion parameters in the new foveal region do not change after macular translocation surgery.

Aged↗
PubMed2004

Nonaxoplasmic transfer of indocyanine green into the optic nerve after intravitreal application.

PURPOSE: To investigate whether indocyanine green (ICG) migrates into the optic nerve after intravitreal application in the rabbit eye. METHODS: Gas vitrectomy was performed in one eye of adult Dutch belted rabbits by pars plana injection of 0.4 ml of 100% C3F8 (n = 10). One week later, vitrectomy was performed and 0.2 ml of 0.25% ICG was instilled into the vitreous cavity of these vitrectomized eyes. After 30 seconds of ICG application, the vitreous cavity was rinsed with balanced salt solution plus. Unoperated rabbits served as controls (n = 2). Globes, optic nerves, and the entire brain were removed, and ICG fluorescence of the specimens was examined with a digital fundus camera starting from the first day to the fourth postoperative week. Other rabbit eyes (n = 2) were injected with ICG directly into the vitreous without vitrectomy, and assessed for ICG signal after 1 day of ICG application. In the second part of the experiment, four rabbit eyes were gas vitrectomized and ICG was instilled onto retina after blockage of axonal flow by vinblastine. They were evaluated on the first (n = 2) and seventh postoperative days (n = 2). RESULTS: No fluorescein was detected in the visual pathways and the brains of the control group of rabbits. The optic nerves of the ICG-instilled eyes were stained diffusely with ICG starting from the first day after surgery. ICG injected nonvitrectomized eyes showed similar ICG staining patterns when compared with vitrectomized eyes. ICG staining pattern of the optic nerve did not differ in vinblastine-pretreated eyes. Fluorescence extended along the intraorbital portion of the optic nerve but did not transport more posteriorly in all animals. At the fourth week after vitrectomy, ICG signal was still detectable, but staining was less intense. CONCLUSION: Intravitreal ICG injection results in nonaxoplasmic extension into the optic nerve in the rabbit.

Animals↗
PubMed2003

Sub-retinal hemorrhage during internal limiting membrane peeling for a macular hole.

PURPOSE: To report the occurrence of sub-retinal hemorrhage during peeling of the internal limiting membrane (ILM). CASE REPORTS: In case 1, a three-port pars plana vitrectomy was performed on a 57-year-old woman with a macular hole. Following the staining of the ILM with indocyanine green, the ILM was peeled with forceps, and a sub-retinal and vitreous hemorrhage resulted from a vein during the peeling. The bleeding was stopped by elevating the intraocular pressure. The final visual acuity was 20/30. In case 2, similar procedures were performed on a 68-year-old woman with a macular hole. A sub-retinal hemorrhage occurred while peeling the ILM. The pre-operative visual acuity was 20/300, and final visual acuity was 20/200. CONCLUSIONS: Surgeons should be aware that sub-retinal and vitreous hemorrhage can be a complication of ILM peeling.

Aged↗