Biomedical subjects
Publications and source records attributed to T Setogawa.
We examined three adult Japanese patients who had a history of decreased hepatic glucose-6-phosphatase activity. All three patients had increased bilateral subcutaneous (SC) fat in the lower eyelids and inverted eyelashes. One patient additionally showed retinal hemorrhages and microaneurysms in both fundi. The inverted eyelashes may have been related to type 1a glycogen storage disease.
Epiblepharon commonly occurs in Japanese infants and tends to disappear spontaneously with age. We examined 4449 Japanese children aged 3 months to 18 years for epiblepharon associated with inverted eyelashes touching the cornea. The condition was evident in 441 cases. We found that the incidence of epiblepharon decreased with age, but about 2% of high school students still had the condition. No sexual predilection was found. Lower eyelids were commonly involved bilaterally. Most cases of epiblepharon produced no or mild symptoms.
We used lid bracing sutures, buried sutures, and skin resection operations to correct epiblepharon in Japanese children. Epiblepharon and ocular irritation in 103 children (254 eyelids) were treated first with lid bracing sutures. Postoperatively the inversion of eyelashes resolved in 73 patients (196 eyelids). Of these 103 patients 30 (58 eyelids) developed recurrences, which included 11 who also complained of foreign body sensation and ocular pain. These 11 patients (22 eyelids) underwent a second surgical procedure (buried sutures or skin resection) before they became free of symptoms. No severe complications were noted in any of the 103 patients. We believe that lid bracing sutures correct most cases of mild epiblepharon in children and that buried sutures or skin resection are valuable for more severe conditions.
We examined biochemically sphingomyelinase activity in the bovine and human ocular tissues, using trinitrophenylaminododecanoylsphingosylphosphorylcholine as substrate. The enzyme activity in the crude extracts of neuroretina, retinal pigment epithelial cells, and optic nerve of the bovine eyes was proportional to protein concentration. The activities in these tissues were little activated with Mg2+ at pH 5.1 but was activated with Mg2+ at pH 7.5. The enzyme activity at pH 5.1 was also detected in the iris and ciliary body, neuroretina, retinal pigment epithelium and choroid, and optic nerve of the human eyes. It was highest in the macula, compared with other areas of the human ocular fundus.
We have recently treated an 8-year-old boy who had leukocoria, microcornea, cataract, and falciform retinal fold in the right eye and multiple grouped patches of pigmentation in the left retina. These were diagnosed as persistent hyperplastic primary vitreous in the right eye and congenital grouped pigmentation of the retina in the left. This patient had a different rare congenital anomaly in each eye.
We examined retrospectively 61 eyes of 61 patients with recurrent pterygia who had been treated with excision, with or without 0.02% mitomycin C instillation, 3 to 7 years after treatment. The rates of recurrence (5% to 9%) and complications in eyes that had undergone excision and mitomycin C instillation were less than those in eyes that had had excision only. These data suggest that the postoperative instillation of 0.02% mitomycin C, twice a day for five days, may be effective and safe in the treatment of recurrent pterygium.
A 24-year-old woman with systemic lupus erythematosus had decreased visual acuity, retinal cotton-wool spots, venous dilations, and multiple arteriolar occlusions around the optic disc in her left eye. The right eye showed good visual acuity and a few small retinal hemorrhages. Although abnormal serologic findings and systemic manifestations quieted with corticosteroid therapy, the retinopathy in the left eye progressed. After treatment with focal argon laser photocoagulation, progression of the retinopathy stopped.
A 70-year-old man was treated with scleral buckling surgery and photocoagulation for rhegmatogenous retinal detachment. One year later, serous choroidal detachment occurred after spontaneous expulsion of the episcleral exoplant. To our knowledge, this is an uncommon cause of choroidal detachment.
Eighty patients (99 eyes) with primary pterygia were treated with excision, with or without additional therapy, and were followed up for three to eight years after treatment. Of 29 eyes that underwent excision and postoperative instillation of 0.02% mitomycin C, there were only two recurrences. The other eyes were treated with excision only, excision and radiation, or excision and 0.04% mitomycin C. Instillation of 0.02% mitomycin C reduced the recurrence rate significantly (P less than .01). Only one of the 29 eyes (3%) treated with excision and 0.02% mitomycin C had a complication, the lowest rate of all groups postoperatively. We found the postoperative instillation of 0.02% mitomycin C, twice a day for five days, to be effective and safe in the treatment of primary pterygium.
We examined a family that had aniridia, microcornea, and spontaneously reabsorbed cataract in three members in three generations. An autosomal dominant inheritance for these features was strongly suggested. We believe that a spontaneously reabsorbed cataract is particularly unusual in association with aniridia.
We examined a Japanese family with Alport's syndrome; four members of family showed hematuria or renal failure and two had a hearing disturbance. The proband was a 5-year-old boy who had hematuria but normal renal function and yellow-white flecks in the perimacular region of both eyes.
We studied biochemically the regional distribution of N-acetyl-beta-D-glucosaminidase and alpha-L-fucosidase activities in the human retina and choroid. The N-acetyl-beta-D-glucosaminidase activity showed no regional difference. The alpha-L-fucosidase activity was higher in the macula than in other areas.
We examined spectrophotometrically the ability of drugs to bind with dopa-auto-oxidation melanin or tyrosinase-catalyzed dopa-melanin. Each drug, at 5 X 10(-5) M, was incubated at 37 degrees C for 8 h with 0.4 mg of synthetic melanins in 20 mM potassium phosphate buffer at pH 7.0 or in 20 mM acetate buffer at pH 4.8. Chloroquine, thioridazine, befunolol, pindolol, daunomycin and 5-fluorouracil bound to melanin at pH 7.0 and 4.8. Methotrexate bound to melanin at pH 4.8, but not at pH 7.0. Pilocarpine, epinephrine, acyclovir, vincristine and colchicine did not bind to dopa-auto-oxidation melanin or tyrosinase-catalyzed dopa-melanin.
We treated two patients with herpes zoster ophthalmicus in whom hyphema and hemorrhagic glaucoma occurred. Case 1 complained of facial skin eruption, and was given intravenous acyclovir for 7 days. Hyphema and high intraocular pressure occurred in the left eye 10 days after the onset of the skin eruption. Case 2 had severe pain and blisters on her face, and was given intravenous acyclovir for 7 days. An intracameral hemorrhage and glaucoma developed in the right eye 15 days after the onset of the skin lesion. Intravenous acyclovir may be necessary for longer than 7-day periods if the iridocyclitis remains.
We examined a 63-year-old woman with retinal telangiectasia, aneurysms, a ring of fatty exudate, and pigmented chorioretinal atrophic lesions in the right eye. Leber's miliary aneurysm was diagnosed, although this disorder is known to have a high incidence mainly in young boys. The pigmented chorioretinal scars appear to be sequelae of spontaneously regressing retinal lesions.
A 54-year-old man with diabetes mellitus had abnormal choroidal vessels in the right eye. Whirled tributaries, the choroidal part of the vortex vein, and the scleral canal beneath the central foveal area were visible. This is a rare case of vortex veins in the macula.
An 11-year-old Japanese girl had a greenish-gray, slightly elevated lesion at the optic disc and juxtapapillary retina of the right eye that was diagnosed as a combined hamartoma of the retina and retinal pigment epithelium. A gliotic epiretinal membrane partially covered the lesion. Tortuous retinal vessels, which leaked fluorescein dye, were noted ophthalmoscopically. The lesion remained stable during a follow-up period of 1 year. After reviewing the Japanese literature, we concluded that the combined hamartoma may not be as rare in Japan as previously thought.
We examined a 52-year-old man with bilateral symmetric lesions of the cornea and fundus. The corneal lesions were compatible with granular dystrophy, and the fundus lesions were consistent with cone dystrophy. The simultaneous occurrence of these dystrophies may be uncommon.