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Shiho Kunimatsu

Publications and source records attributed to Shiho Kunimatsu.

8 recordsLinked to original sources

Correlation between hemifield visual field damage and corresponding parapapillary atrophy in normal-tension glaucoma.

PURPOSE: To evaluate the correlation between the superior or inferior half area of parapapillary atrophy (PPA) and the corresponding hemifield visual field damage (VFD) in normal-tension glaucoma. DESIGN: Cross-sectional study. METHODS: patients: One hundred nine eyes of 109 consecutive patients with normal-tension glaucoma. observation procedures: Topography parameters of the optic nerve head and PPA (zone beta) area were obtained with the Heidelberg Retina Tomograph (HRT), and VFD was evaluated with the 30 to 2 program of Humphrey Field Analyzer. The HRT parameters and PPA area were determined separately in superior and inferior half regions. main outcome measures: Partial correlation coefficients of the superior and inferior areas of PPA with refractive error, axial length, HRT parameters, and corresponding hemifield VFD. RESULTS: In simple correlation analyses, significant correlation was found between the inferior PPA area and the superior hemifield VFD (Spearman rank correlation coefficient; Rs = -0.32; P < .001) but not between the superior PPA area and the inferior hemifield VFD (Rs = 0.05; P = .6). Age, refractive error, axial length, and height variation contour were associated significantly with the total, superior, and inferior areas of PPA, respectively (P < .01). Multiple regression analyses showed that the superior PPA area was associated significantly with only axial length (P < .001), and the inferior PPA area was associated significantly with the axial length and the superior hemifield VFD (P < .001). CONCLUSIONS: In patients with normal-tension glaucoma, only the inferior half area of PPA correlated significantly with glaucomatous VFD. Axial length and myopia were associated with both the superior and inferior half areas of PPA.

Cross-Sectional Studies↗

Plasma endothelin-1 level in Japanese normal tension glaucoma patients.

PURPOSE: To compare the plasma concentration of endothelin-1 (ET-1) among patients < 60 years of age with normal-tension glaucoma (NTG), primary open-angle glaucoma (POAG), and in age-matched normal participants. METHODS: Plasma concentration of ET-1 was determined in 30 NTG 18 POAG patients, and 19 age-matched normal participants using an enzyme immunoassay. RESULTS: The ET-1 level was 1.49 +/- 0.51 pg/ml in the NTG patients (49.4 +/- 8.8 years), 1.58 +/- 0.64 pg/ml in the POAG patients (44.7 +/- 10.7 years), and 1.33 +/- 0.50 pg/ml in the normal participants (49.9 +/- 5.6 years). The ET-1 levels were not significantly different among the three groups, and no significant correlation with the extent of visual field damage, intraocular pressure (IOP), refraction, or age was seen in the glaucoma patients. CONCLUSIONS: The plasma ET-1 level showed no difference among NTG patients, POAG patients, and normal participants < 60 years of age in the Japanese population.

Adult↗

Prevalence of appositional angle closure determined by ultrasonic biomicroscopy in eyes with shallow anterior chambers.

PURPOSE: To determine the prevalence of appositional angle closure in eyes with a shallow peripheral anterior chamber but no peripheral anterior synechia (PAS) in Japanese patients. DESIGN: Cross-sectional study. PARTICIPANTS: Eighty eyes of 80 consecutive patients with a shallow peripheral anterior chamber, determined using the method of van Herick, and no PAS. METHODS: The anterior chamber angle was classified according to Shaffer's grading with noncompression gonioscopy superiorly, inferiorly, temporally, and nasally. The absence of PAS was confirmed by compression gonioscopy if necessary. The presence of appositional angle closure and the trabecular-iris angle (T-I angle) was determined with ultrasound biomicroscopy in each quadrant under light and dark conditions. Factors related to appositional angle closure were studied using logistic analysis, and the covariates included gender, age, refraction, gonioscopic grading, and the quadrant of the angle measured. MAIN OUTCOME MEASURES: Gonioscopic grading of the angle width, the T-I angle, and the prevalence of appositional closure. RESULTS: The gonioscopic grading (P<0.001 in light and dark) and the T-I angle (P<0.001 in light and dark) varied significantly among the 4 quadrants. Narrower angle gradings were observed more frequently superiorly. The T-I angle was narrower superiorly (in light) and inferiorly (in dark) (P<0.001 and P = 0.040, respectively). The T-I angle was significantly narrower in dark than in light (P<0.001). The sites with the narrower gonioscopic gradings tended to have a smaller T-I angle (P<0.001 and P = 0.006 in light and dark, respectively). Appositional angle closure was found in at least 1 quadrant in 46 (57.5%) of 80 eyes in light and in 68 eyes (85%) in dark. Logistic analysis showed that gonioscopic grading and the quadrant were significantly related to the presence of appositional angle closure in light and dark (P<0.003 for both comparisons). CONCLUSIONS: Appositional angle closure was frequently observed in eyes with a shallow peripheral anterior chamber, especially under dark conditions in Japanese patients. The angle width, evaluated with conventional gonioscopic grading, and the quadrant of the angle were significantly related to the presence of appositional angle closure.

Aged↗

Frequency doubling technology and scanning laser tomography in eyes with generalized enlargement of optic disc cupping.

PURPOSE: To characterize functional and structural changes in eyes with generalized enlargement of optic disc cupping (vertical cup/disc ratio > or = 0.8), normal intraocular pressure, normal standard achromatic automated perimetry (SAP) results, and no other ophthalmoscopic findings suggesting glaucoma (large C/D eyes) using frequency doubling technology (FDT) and the Heidelberg Retina Tomograph (HRT). METHODS: This comparative observational case series included 30 large C/D eyes (30 subjects), 17 eyes (17 patients) with early-stage normal tension glaucoma with generalized enlargement of optic disc cupping (NTG eyes), and 25 eyes from 25 normal subjects (normal eyes). Results with Humphrey 30-2, FDT N-30 threshold programs, and HRT were compared among these groups. Large C/D eyes were subdivided into FDT-normal and -abnormal eyes according to the predetermined criteria and HRT parameters were compared among them. RESULTS: No significant difference was seen in HRT parameters between the large C/D and NTG eyes. In the large C/D eyes, FDT mean deviation was lower than in the normal eyes and higher than in the NTG eyes, whereas FDT pattern standard deviation was smaller than in the NTG eyes (P = 0.02-0.03). Among HRT parameters, only cup shape measure (CSM) showed significant negative correlation with FDT mean deviation in the large C/D eyes. Between FDT-normal and -abnormal subgroups, only CSM showed significant difference (P < 0.01). CONCLUSION: Frequency doubling technology showed abnormalities in large C/D eyes. Only CSM showed significant correlation with FDT result and difference between those with normal and abnormal FDT results. In management of large C/D eyes, FDT and CSM will be useful to detect functional and structural change.

Adult↗

Spontaneous posterior dislocation of intraocular lenses fixated in the capsular bag.

We report 4 cases of complete posterior dislocation of an intraocular lens (IOL) in the capsular bag occurring a mean of 5.5 years after uneventful cataract surgery. In all 4 cases, posterior chamber IOLs were fixated within the capsulorhexis. The patients experienced sudden loss of vision without an episode of trauma or ocular disease. Using a 3-port pars plana vitrectomy, the IOLs were explanted through a limbal incision and a new IOL was sutured to the ciliary sulcus. Histological examination indicated that zonular fibers were severed at the site of insertion in the capsule.

Capsulorhexis↗

Specificity and sensitivity of glaucoma detection in the Japanese population using scanning laser polarimetry.

AIMS: To investigate the usefulness of the scanning laser polarimeter (GDx; GDx Nerve Fiber Analyzer) for glaucoma detection in the Japanese population, and to investigate the difference in the thickness of retinal nerve fibre layer (RNFL) between normal tension glaucoma (NTG) and primary open angle glaucoma (POAG). METHODS: 69 eyes of 69 normal subjects and 115 eyes of 115 chronic open angle glaucoma patients (60 NTG and 55 POAG patients) were studied. The thickness of RNFL was measured with GDx. An eye was diagnosed as glaucomatous, if at least one original GDx variable showed p <5%. The difference in thickness of RNFL between the NTG and POAG groups was then investigated. RESULTS: 46 normal eyes (66.7%) were diagnosed as not glaucomatous (no variables showing p <5%), and 93 glaucomatous eyes (46 NTG and 47 POAG eyes) (80.9%) were diagnosed as glaucomatous. Actual values of average thickness, ellipse average, superior average, and superior integral were significantly lower in the POAG group than those in the NTG group. CONCLUSIONS: New variables which elucidate focal RNFL defects or early changes are needed to improve the moderate detection ability found in this present study. The pattern of the change in RNFL may differ in NTG and POAG groups.

Adult↗

[Frequency-doubling perimetry in examination of open-angle glaucoma with hemifield defect].

OBJECTIVE: To determine whether frequency-doubling perimetry (FDP) can find visual field defect of early glaucoma which can not be found by conventional perimetry. METHODS: Forty-nine eyes of 49 patients with open-angle glaucoma and hemifield defect detected by Humphery Field Analyzer (HFA) were tested by both FDP (threshold test C-20) and Heidelberg Retina Tomograph (HRT). For each hemifield, its FDP result was evaluated. According to the FDP results in intact HFA hemifields, the patients were divided into FDP normal group and FDP abnormal group. The HRT parameters of half disk corresponding to the intact HFA hemifields were compared between these two groups. RESULTS: There was a strong correlation between the mean sensitivity of FDP and mean deviation of HFA results (r = 0.58, P < 0.01). In intact HFA hemifields, 41% (20/49) of eyes showed visual loss in FDP tests, while in defective HFA hemifields, only 2% (1/49) of eyes was normal in FDP test. For the HRT parameters of half disk corresponding to the intact HFA hemifields, cup area and cup/disk area ratio were statistically bigger and rim area and rim volume were statistically smaller in FDP abnormal group than in FDP normal group. CONCLUSION: FDP is able to detect early glaucomatous visual field damage which can not be detected by HFA, but can be explained by the optic nerve glaucomatous changes in HRT parameters.

Adult↗