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Biomedical subjects

T Fujikado

Publications and source records attributed to T Fujikado.

At least 37 records · Page 2Linked to original sources
PubMed1999

Vitrectomy for rhegmatogenous or tractional retinal detachment with familial exudative vitreoretinopathy.

OBJECTIVE: To examine the anatomic features and surgical indications of familial exudative vitreoretinopathy (FEVR) complicated with rhegmatogenous or tractional retinal detachment. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Twenty-eight eyes of 25 patients who had either clinically suspected or fully diagnosed FEVR. Of these, 25 had rhegmatogenous retinal detachment, 2 had tractional retinal detachment, and 1 had tractional retinal detachment plus vitreous hemorrhage. INTERVENTIONS: The authors carefully observed the vitreoretinal interface during surgery, studied the clinical and anatomic features of FEVR, and then evaluated the surgical results. RESULTS: The vitreoretinal adhesions were so strong in the peripheral avascular area that iatrogenic retinal breaks easily occurred in 22 of 28 eyes. In all cases, the bimanual technique with vitreous scissors and forceps was required to dissect the posterior vitreous membrane from the retinal surface. The retina was reattached in 24 of 28 cases (85.7%), and visual acuity improved in 20 eyes (71.4%). CONCLUSION: Dissection of the vitreous in the peripheral avascular area is very difficult in FEVR, and those patients for whom this procedure was not successfully performed may have a poorer prognosis.

Adolescent↗
PubMed1999

The effect of nitric oxide on the contractile tone of Müller cells.

The effect of nitric oxide (NO) on the contractile tone of Müller cells was investigated. Müller cells, isolated from the retina of chick embryos, were cultured on thin sheets of silicone. S-Nitro-N-acetyl-DL-penicillamine (SNAP), an NO donor, was applied in the presence or the absence of carboxyl phenyltetramethylimidazole oxide (C-PTIO), an NO scavenger. The contractile tone of Müller cells was assessed by the extent of wrinkles created on the silicone sheets. The change of contractile tone was evaluated quantitatively by digitizing the photograph before and after the application of SNAP. Relaxation of wrinkles was induced by SNAP. C-PTIO inhibited the SNAP-induced relaxation of wrinkles. These results suggest that NO affects the contractility of embryonic Müller cells and could thus modulate ocular development.

Animals↗
PubMed1998

Visual function after foveal translocation with scleral shortening in patients with myopic neovascular maculopathy.

PURPOSE: To document the visual outcome after successful foveal translocation with intentional retinal detachment and scleral shortening for the treatment of myopic neovascular maculopathy. METHODS: Two severely myopic patients with subfoveal neovascular membranes underwent surgical translocation of the fovea to an area of healthy retinal pigment epithelium by means of scleral shortening and intentional retinal detachment. In the postoperative period, monocular and binocular visual function were studied. RESULTS: In one patient, best-corrected visual acuity improved from 20/150 to 20/20 postoperatively. In the second patient, acuity initially improved from 20/70 to 20/30. In both patients, the fixation point shifted from the site of the neovascular membrane. Oblique astigmatism developed and was managed with hard contact lenses. Diplopia and subjective torsion occurred transiently. Micropsia occurred in one patient. Peripheral fusion assessed by Worth four-dot testing after resolution of diplopia disclosed suppression in the nondominant eye in both cases. CONCLUSIONS: Foveal translocation with intentional retinal detachment and scleral shortening was useful in improving visual acuity in two patients with myopic neovascular maculopathy. Diplopia and aniseikonia occurred but resolved over time as suppression developed. This technique is promising for patients with myopic neovascular maculopathy.

Adult↗
PubMed1998

Anatomic and functional recovery of the fovea after foveal translocation surgery without large retinotomy and simultaneous excision of a neovascular membrane.

PURPOSE: To document the anatomic and functional recovery of the fovea after foveal translocation surgery with scleral shortening and simultaneous excision of a neovascular membrane in a patient with age-related macular degeneration. METHOD: Case report. RESULTS: The visual acuity of a 54-year-old woman with age-related macular degeneration improved from 20/200 to 20/50 after excision of subretinal neovascular membrane and foveal translocation surgery in the right eye. Fixation shifted inferonasally 0.6 disk diameters, corresponding to the direction of foveal translocation, as shown by scanning laser ophthalmoscope microperimetry. Postoperative optical coherence tomography through fixation disclosed normal foveal concavity and intact retinal pigment epithelium. CONCLUSION: Anatomic and functional recovery of the fovea was confirmed in a patient with age-related macular degeneration after foveal translocation surgery with scleral shortening and simultaneous excision of a neovascular membrane.

Female↗
PubMed1998

Low response of the thyroid gland to endogenous thyrotropin increased by thyrotropin-releasing hormone in patients with euthyroid Graves' disease.

Euthyroid Graves' disease is defined as Graves' ophthalmopathy without hyperthyroidism, and the thyroid-stimulating antibody (TSAb) has been known to be a good marker for diagnosis. However, the question of why TSAb does not cause hyperthyroidism arises. To settle this, we examined thyroid responsiveness to endogenous thyrotropin (TSH) increased by thyrotropin-releasing hormone (TRH) in 23 patients with euthyroid Graves' disease. Nineteen patients (83%) had positive TSAb and 21 (91%) had at least one of the autoantibodies to the thyroid gland. Only one patient (4%) had positive thyroid-stimulation blocking antibody (TSBAb). Basal levels of free thyroxine (FT4), free triiodothyronine (FT3), and thyrotropin (TSH) in patients were not different from those in age- and sex-matched normal controls (n = 25). Response of TSH to TRH was normal; however, an increase of FT3, either absolute or as a multiple of baseline, in the TRH test in these patients (0.46+/-0.23 pg/mL, P < 0.001; 1.14+/-0.09 fold, p < 0.001) was significantly lower than that in controls (0.86+/-0.19 pg/ml; 1.26+/-0.07 fold). There was no correlation between the deltaFT3/deltaTSH ratio and TSAb activity. It is concluded that thyroid responsiveness in euthyroid Graves' disease is lower than in normal controls and this explains the euthyroid function in the patients even in the presence of TSAb.

Adolescent↗
PubMed1998

Foveal translocation: a comparison of two techniques.

Subfoveal choroidal neovascular membrane is a leading cause of legal blindness. Photocoagulation has been effective, but photocoagulation of the fovea causes a decrease in vision immediately after treatment. Surgical removal of the choroidal neovascular membrane is effective for choroidal neovascular membrane in some cases, but it restores useful vision for reading (20/40 or better) in a small number of cases of choroidal neovascular membrane not due to presumed ocular histoplasmosis syndrome. A new treatment for subfoveal choroidal neovascular membrane, foveal translocation, is an innovative procedure in which the fovea is translocated onto healthier retinal pigment epithelium. Three techniques have been developed to relocate the retina, 2 of which (retinotomy and scleral shortening) we performed in 5 cases each. Preliminary results in these 10 cases indicate that foveal translocation provides improvement of visual acuity in 40% of eyes and final visual acuities useful for reading (better than 20/40) in 20% of eyes undergoing translocation with either technique. Further study is essential to refine the amount of translocation needed and to decrease complications of the 2 techniques, including retinal detachment, proliferative vitreoretinopathy, macular pucker, corneal astigmatism, and constricted visual field.

Adult↗
PubMed1997

Exotropia secondary to vitreous hemorrhage.

BACKGROUND: Diplopia after cataract surgery has been reported by several authors, but diplopia after recovery from vitreous hemorrhage (VH) has not been described. METHODS: We examined eight patients with manifest exotropia and binocular diplopia after recovery from dense VH by vitreous surgery. VH was bilateral in three patients and unilateral in five, and lasted for an average of 7.7 years. RESULTS: Visual acuity before vitrectomy ranged from 20/200 to light perception; that after vitrectomy ranged from 20/20 to 20/60. Exotropia was present in all patients after vitrectomy. Additionally, seven out of eight patients had vertical strabismus with an average deviation of 6 prism diopters (delta). Fusion was confirmed in four patients with an average amplitude of 13 delta. Four patients underwent horizontal strabismus surgery. Fusion was present in two before strabismus surgery and in all four after surgery; however, unstable diplopia persisted in three of the four after surgery. CONCLUSION: Diplopia after vitrectomy for longstanding VH may occur due to fusion impairment comparable to that occasionally seen after surgery for traumatic cataract.

Adolescent↗
PubMed1997

Horizontal transposition of vertical rectus muscles for treatment of excyclotropia.

BACKGROUND: Horizontal transposition of the vertical rectus muscles has been performed for treatment of excyclotropia associated with congenital absence of the superior oblique, and for residual excyclotropia after the Harada-Ito operation. However, the amount of excyclotropia that can be corrected and whether this technique alters the vertical muscle balance is not well known. We report the surgical results of three patients with pure excyclotropia who underwent unilateral one-half tendon width horizontal transpositions of vertical rectus muscles. METHODS: A one-half muscle width temporal transposition of the superior rectus and nasal transposition of the inferior rectus muscles of one eye was performed in three patients with pure excyclotropia and no associated hypertropia. All three had intermittent torsional diplopia before surgery. RESULTS: Postoperatively, excyclotropia decreased significantly in all fields of gaze, with 8 degrees of reduction by synoptophore and 12.3 degrees of reduction by fundus photography on average. There was no associated vertical or horizontal deviation. All three patients reported improvements of cyclofusion. CONCLUSION: One-half muscle width temporal transposition of the superior rectus and nasal transposition of the inferior rectus muscles was effective in ameliorating excyclotropia and corrected subjective complaints without altering vertical muscle balance.

Adult↗
PubMed1997

Retinal function with lens-induced myopia compared with form-deprivation myopia in chicks.

BACKGROUND: The retina is known to be involved in the development of form-deprivation myopia (FDM); however, it is not clear whether the retinal changes that lead to lens-induced myopia (LIM) are the same as those involved in FDM. To gain insight into the retinal mechanism(s) that cause myopia, we investigated differences in the results of electroretinography (ERG) in eyes with FDM and LIM. METHODS: LIM or FDM was induced in chick eyes by placing various powers of spectacles or an occluder over the left eyes of 6-day-old chicks. After 6 days, the spectacles or occluder was removed, refraction and axial length were measured and ERG was performed. Results for eyes treated with spectacles and those treated with occluders were compared. RESULTS: Refraction and axial length changed concomitant with the power of the lens used, but components of the ERG of eyes with LIM were not related to the power of lens added. Refraction and axial lengths of eyes covered with a -16 D lens did not differ from these values in eyes covered with an occluder. The a- and b-waves were also similar for the two groups. However, oscillatory potentials decreased significantly in the chicks with FDM. CONCLUSIONS: Retinal function differs in LIM and FDM, as indicated by differences in the oscillatory potentials. This difference may stem from the fact that in FDM the retinal image is continuously defocused, whereas images are ultimately focused on the retina in LIM.

Animals↗
PubMed1997

Spontaneous disappearance of traumatic macular holes in young patients.

PURPOSE: To report the disappearance of traumatic macular hole in three eyes of three patients. METHODS: Clinical data of the patients were reviewed. RESULTS: The three patients were relatively young, ranging in age from 12 to 18 years old. In one eye of each patient, a small traumatic macular hole was observed at the first visit. Visual acuities ranged from 20/100 to 20/40. The macular holes resolved spontaneously 3 to 4 months after the trauma, and final visual acuity improved to 20/20 in all patients. CONCLUSION: Small traumatic macular holes in young patients can resolve spontaneously, and this can be associated with good visual recovery.

Accidents, Traffic↗
PubMed1997

The effect of nitric oxide synthase inhibitor on form-deprivation myopia.

PURPOSE: Form-deprivation myopia (FDM) is believed to result principally from actions of substances that modulate information processing in the retina. We used a chick model to investigate what role nitric oxide (NO), a gaseous neuromodulator, might play in the development of FDM. METHODS: We injected different concentrations of the NO synthase inhibitor N omega-nitro-L-arginine methyl ester (L-NAME) (30 ml) into the left eyes and the same volume of saline into the right eyes of 6-day-old chicks. Both eyes of most chicks were occluded for 6 days with translucent goggles. After removal of the goggles, the refraction was measured by retinoscopy and the axial lengths with an A-mode ultrasound. In some chicks we measured the concentration of NOx (nitrite and nitrate) in the retina. A few chicks, not wearing occluders after injection of L-NAME and saline, ERG and refraction, were examined 6 days after the treatment. RESULTS: In chicks that wore occluders, refractive error and axial length were significantly less affected in eyes injected with L-NAME (180, 360, or 540 mM) compared to control (right) eyes. ERG changes were reversible, except in eyes injected with the highest concentration (540 mM) of L-NAME. The eyes of chicks, injected with L-NAME and reared without occlusion, had normal refractive values. After 6 days of form deprivation, the concentration of NOx in the retina of eyes injected with L-NAME (180 mM) was significantly less than the concentration in eyes injected with saline. CONCLUSIONS: The injection of L-NAME before occlusion of developing chick eyes leads to reversible modifications in retinal function and inhibits the development of form-deprivation myopia.

Animals↗
PubMed1997

Value of thyroid stimulating antibody in the diagnosis of thyroid associated ophthalmopathy of euthyroid patients.

AIMS/BACKGROUND: Thyroid associated ophthalmopathy (TAO) of euthyroid patients is difficult to diagnose because clinical findings overlap with other conditions, and no confirmatory diagnostic tests are available. Recently, it was reported that TSH binding inhibitor immunoglobulin (TBII) and thyroid stimulating antibody (TSAb) are sensitive markers of TAO. The sensitivity of these antibodies in the detection of TAO were therefore studied to determine if they could be a useful criterion in the diagnosis of TAO of euthyroid patients. METHODS: Serum values of TBII and TSAb of 35 patients with euthyroid TAO (group A) were compared with those of 27 patients with Graves' disease and TAO (group B). The relation between the serum value of TSAb and the eye symptoms of patients with euthyroid TAO were also examined by multiple linear regression analysis. RESULTS: In group A, TBII was positive in 10 cases (28.6%) and TSAb was positive in 29 cases (82.9%). In group B, both TBII and TSAb were positive in all cases (100%). The titre of serum TBII in group A (15.6% (SD 18.0%)) was significantly lower (p < 0.0001) than in group B (57.9% (21.5%)). The titre of serum TSAb in group A (1400.9% (2163.9%)) was significantly lower (p = 0.0026) than in group B (2243.9% (1472.8%)). Among the eye findings of patients with euthyroid TAO, keratopathy was significantly (p = 0.034) related to the value of TSAb. CONCLUSION: These results suggest that the activity of TSAb is a more sensitive marker of euthyroid TAO than is TBII, and could be a useful criterion in the diagnosis of TAO of euthyroid patients.

Adolescent↗
PubMed1997

Differentiating full thickness macular holes from impending macular holes and macular pseudoholes.

AIMS: The reliability of scanning laser ophthalmoscope (SLO) microperimetry in differentiating full thickness macular holes from macular pseudoholes and impending macular holes was evaluated. METHODS: 106 eyes with the clinical diagnosis of full thickness macular holes, macular pseudoholes, and impending (stage 1) macular holes were examined for the presence of deep or relative scotoma using SLO microperimetry. The relation between these scotomas and the clinical diagnosis was studied. RESULTS: Deep and relative scotomas were detected in all 57 eyes with clinically defined full thickness macular holes. In contrast, among 49 eyes diagnosed with macular pseudoholes or impending macular holes, no deep and only one relative scotoma was observed. The sensitivity of the presence of a deep scotoma as an indicator of the clinical diagnosis of a full thickness macular hole was 100% (57 of 57), and the specificity was 100% (49 of 49). The sensitivity of the presence of a relative scotoma was 100% (57 of 57) and the specificity was 98.0% (48 of 49). CONCLUSION: With SLO microperimetry, full thickness macular holes can be precisely and objectively distinguished from other conditions that mimic macular holes.

Adult↗
PubMed1997

[Optic neuritis and measles infection].

Optic neuritis has been reported as a complication of measles encephalitis. This resembles to parainfectious optic neuritis following other virus infections. We mentioned pathology, therapy of this disease, and summarized our previous cases. Intravenous methylpredonisolone treatment is effective from our experience.

Adolescent↗
PubMed1996

A clinical evaluation of stereopsis required to see 3-D images.

Some children with esotropia who have been diagnosed as 'stereoblind' on the basis of conventional stereotests (which principally use static images with small disparity) may nevertheless enjoy stereopsis for three-dimensional (3-D) animations that use dynamic images with large disparity. The purpose of this study was to develop a new stereotest equipped with dynamic random-dot stereogram (DRDS) which has larger disparity with movement and use it with esotropic children to see if they can attain stereopsis for such images. Subjects were 17 esotropic children between 5 and 10 years old (mean age 6.8 years) who had failed to demonstrate stereopsis with the Titmus fly test. Seven children had infantile esotropia and 10 had partially accommodative esotropia. The test images were DRDS that were presented on a fluorescent screen (12 x 9 cm) viewed through a lenticular lens. The dots were displayed in circle and triangle patterns that have counterphase front-rear movement with maximum disparity of 800 s. Patients were placed with eyes at a distance of 60 cm from the screen and were instructed to point out the pattern (circle or triangle) that was produced. The average angle of strabismus was 7.7 delta by alternating prism cover test (5 m). Seven patients passed and 10 failed the DRDS test. There was no significant difference in the mean angle of strabismus or the age of examination between the two groups; however, the age at onset of strabismus was significantly higher in those who passed the DRDS test. These results suggest that the DRDS test is useful in evaluating the potential stereopsis in children with esotropia who do not pass conventional stereotests.

Accommodation, Ocular↗
PubMed1996

ERG of form deprivation myopia and drug induced ametropia in chicks.

Chick eyes occluded for various periods or treated with various concentrations of kainic acid (KA) or 2-amino-4-phosphonobutylate (APB) during development showed characteristic changes of electroretinography and of refraction. In occluded eyes, oscillatory potential amplitudes (OP-A) were reduced, even with high-intensity stimulation, in proportion to duration of occlusion, but b wave amplitude was unchanged, implying functional changes in inner layers of the deprived retina. OP-A reduction after only 1 week of occlusion and reversibility of this change might reflect retinal changes preceding axial elongation. KA was confirmed to induce myopia with axial elongation and APB to induce hyperopia with axial shortening. KA and APB both suppressed OP-A. KA reduced ON and OFF responses, but low-dose APB suppressed only ON responses. Study results suggest that myopia could be induced by changes of inner retina mediating OP attenuation and degradation of ON and OFF responses. This manuscript reports unpublished work that is not currently under consideration for publication elsewhere.

Aminobutyrates↗
PubMed1996

[Visual functional changes in idiopathic macular holes treated by vitrectomy].

We evaluated visual functional measurements, visual acuity, central retinal sensitivity in a Humphrey field analyzer, and binocular function in Stereotest, Amsler grid testing, of 51 idiopathic macular holes before and after vitrectomy. In 36 of 51 eyes (71%) where the macular hole was closed after vitrectomy, there were improvements in all visual functional measurements postoperatively. The eyes in which the macular hole was closed had significantly better visual acuity before vitrectomy than those in which the hole was not closed. In 16 of 51 eyes that had visual acuity of less than 20/200 preoperatively, central retinal sensitivity before vitrectomy was higher in the eyes where the macular hole was closed than in those in which it was not closed. These measurements are useful for evaluation of visual functional improvements after vitrectomy and can help to choose candidates for macular hole surgery.

Adult↗