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Biomedical subjects

Hiroshi Takebayashi

Publications and source records attributed to Hiroshi Takebayashi.

5 recordsLinked to original sources
PubMed2005

Relation between stage of endogenous fungal endophthalmitis and prognosis.

BACKGROUND: Although many studies have been published on the risk factors and therapies for endogenous fungal endophthalmitis (EFE), only a few have been published on the relationship between the stage of EFE at the initial examination and the prognosis. Thus, the purpose of this study was to determine the relation between the stage of EFE at the initial examination and the prognosis. METHODS: A total of 103 eyes of 58 patients (40 men, 18 women) with EFE, examined over a 20-year period (1984-2004), were studied. The severity of the EFE at the initial examination was classified into four stages. In addition, the type of fungus, general status, initial and final visual acuity, findings of the anterior and posterior segments, latent fungal infection, duration from initial symptoms to initial visit, history of intravenous hyperalimentation (IVH), results of the Candida Detection System, and beta-D-glucan levels were analyzed. RESULTS: More than 95% of the patients had some type of underlying disorder. Candida albicans was detected initially in the blood in 40 patients. The stage of the EFE advanced as the time from the initial symptoms to the beginning of therapy increased. The final visual acuity was significantly correlated with the stage of EFE at the initial examination. In 20 of 21 patients, blood beta-D-glucan was positive, and 42 patients (90%) were receiving IVH. CONCLUSIONS: Because the stage of EFE advanced with the time between the initial symptoms and the beginning of therapy, and because of the high correlation between the stage of EFE and the final visual acuity, it is very important that treatment be begun as soon as possible. Thus, in patients with visual symptoms and susceptible to opportunistic infections, an early consultation with an ophthalmologist is highly recommended.

Adolescent↗
PubMed2003

Penetrating keratoplasty surgery combined with vitrectomy after failing previous corneal surgery.

PURPOSE: The preoperative and postoperative factors influencing visual outcome were analyzed in 15 eyes of 15 patients with graft opacity after keratoplasty associated with vitreoretinal disease who underwent combined surgery of fresh corneal retransplantation and vitrectomy. MATERIALS AND METHODS: The data obtained consisted of diagnosis, preoperative visual acuity, corneal and vitreoretinal findings at the time of surgery, interval between the first visit and surgery, intraocular pressure before surgery, gonioscopic findings, results of bacterial culture of surgical specimens, surgical procedure for vitrectomy, corneal and vitreous findings after surgery, visual acuity 6 months after surgery, intraocular pressure after surgery, and additional surgical techniques. RESULTS: The cause of corneal opacity was graft rejection in all patients, who had been treated with high-dose administrations of steroids and cyclosporin. The preoperative diagnosis was proliferative vitreoretinopathy (PVR) in eight eyes and fungal endophthalmitis in seven eyes. Corneal transparency was achieved in 7 eyes (46.6%) 6 months after surgery. Vitreoretinal findings improved in 9 eyes (60%) and PVR recurred in 6 eyes (40%). Visual acuity improved in 7 eyes (46.6%), did not change in 2 eyes (13.3%), and deteriorated in 6 eyes (40%). The six eyes with decreased visual acuity developed phthisis bulbi. Preoperative intraocular pressure was 2.1 mmHg on average in the phthisis bulbi group, significantly lower than in the group with superior prognosis. Goniosynechia was noted before surgery and did not improve after surgery in all six eyes. CONCLUSIONS: The outcome was poor in eyes with goniosynechia and ocular hypotony, and combined surgery is not indicated for either anatomic or visual preservation in such cases. Care should be taken not to overlook intraocular infection in patients undergoing immunosuppressive therapy against graft rejection. The early detection of retinal detachment is also important in eyes exhibiting hypotony after surgery.

Adult↗
PubMedDate not supplied

Multifunction vitreous forceps (maculorrhexis forceps).

We developed novel multifunction vitreous forceps to decrease the frequency of forceps insertion and enable the removal of the internal limiting membrane and other intravitreal membranes for better surgical results. The basic forceps were conventional continuous curvelinear capsulorrhexis (CCC) forceps. The size of the shaft is 23G and its pointed end measures 500 microm in diameter. Additionally, there is a platform in its tip. The pointed end with platform helps to hold the membrane because the outer sheath can be moved while the tip of the forceps is fixed in position, and its pen hold type grip helps to reduce hand movement. The most advantageous thing is that the sharp point enables us to make an initial flap easily and the desired area of internal limiting membrane can be peeled off by firmly holding the platform.

Capsulorhexis↗
PubMedDate not supplied

Retinal vessel changes in a patient with primary systemic nonfamilial amyloidosis.

A case is described that demonstrates retinal vessel changes and suggests the favorable effects of hemodialysis to treat pathology in a patient with primary systemic nonfamilial amyloidosis. A 47-year-old woman diagnosed as having primary systemic nonfamilial amyloidosis at the age of 30 years had linear and dot hemorrhage, venous dilatation, and tortuosity in the right eye. Fluorescein angiography revealed low-density amorphous areas in the walls of dilated veins near the optic disc. These findings diminished with hemodialysis.

Amyloidosis↗