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Biomedical subjects

Toshihiko Matsuo

Publications and source records attributed to Toshihiko Matsuo.

At least 19 recordsLinked to original sources

Bartonella henselae bacilli detected in vitrectomy aspirates in a patient with massive vitreous opacity with total retinal detachment.

PURPOSE: To present endophthalmitis-like massive vitreous opacity as a manifestation of cat-scratch disease. METHODS: Report of a case. RESULTS: A 47-year-old man developed massive vitreous opacity and total retinal detachment in his right eye after a four-month period of uveitis, which was controlled with oral prednisolone. During the diagnostic vitrectomy, a massive fluffy white opacity adhering to the detached retina was shaved using a vitreous cutter. Further surgical procedures to reattach the retina were not pursued because of the poor state of the infected retina. Pathological examination of the vitreous aspirates revealed pleomorphic bacilli. The serological testing done at referral revealed an IgG titer positive for Bartonella henselae and culture of the vitreous proved the infection a month later. With a mixture of oral sulfamethoxazole (1600 mg daily) and trimethoprim (320 mg daily), the intraocular inflammation subsided. CONCLUSION: Rapid progression of massive vitreous opacity with total retinal detachment, mimicking endophthalmitis, can occur in cat-scratch disease.

Anti-Infective Agents↗

Intracellular calcium response and adhesiveness of chick embryonic retinal neurons to photoelectric dye-coupled polyethylene films as prototypes of retinal prostheses.

Photoelectric dyes, which absorb light and convert photon energy to electric potentials, were shown to stimulate retinal neurons in culture. One of these dyes coupled with polyethylene film surface, as a prototype of retinal prostheses, could induce intracellular calcium elevation in chick embryonic retinal tissues. In this study, we used retinal cells from chick embryos in which no photoreceptor outer segments yet developed, and assessed cell adhesiveness and response to the original and modified types of our retinal prostheses. Extruded-blown film of high density polyethylene was used as the original polyethylene film. Polyethylene film surface was modified either by coupling with type 1 collagen or by crystallization from the melt of the original polyethylene film. A photoelectric dye, 2-[2-[4-(dibutylamino)phenyl]ethenyl]-3-carboxymethylbenzothiazolium bromide, was coupled to these different types of polyethylene films through amide linkage. Retinal cells from chick embryos at the 12-day embryonic stage were cultured on the surface of dye-coupled films. The response of retinal cells to the dye-coupled films was observed by calcium imaging. Cell types, either neurons or glial cells, were detected by immunocytochemical staining and also observed by scanning electron microscopy (SEM). Intracellular calcium elevation was observed in cells, including both neurons and glial cells, on the surface of the original dye-coupled film, collagen-coated dye-coupled film, and dye-coupled recrystallized film, in contrast with no response of cells cultured on the dye-uncoupled plain film. Retinal neurons grew upon colonies of glial cells settling on the surface of all different types of the films. The number of retinal neurons on the collagen-coated dye-coupled film and dye-coupled recrystallized film was significantly larger than the number of neurons on the dye-uncoupled plain film (P = 0.0004, analysis of variance; P < 0.05, Tukey-Kramer test). With SEM, Muller cell-like large cells covered the original dye-coupled film and collagen-coated dye-coupled film, while neuron-like small cells settled directly on the dye-coupled recrystallized film and also formed large colonies on Muller-like cells. Retinal neurons and glial cells were cultured directly on the different types of dye-coupled polyethylene films. Photoelectric dye-coupled polyethylene films could be used as prototypes of retinal prostheses.

Aniline Compounds↗

Disappearance of diabetic macular hard exudates after hemodialysis introduction.

We report herein the disappearance of macular hard exudates after the introduction of hemodialysis in diabetic patients. A 62-year-old woman and a 52-year-old man with diabetes mellitus showed hard exudates in the macula of the left eyes. Both patients had previously undergone panretinal photocoagulation in both eyes. During the follow-up, hemodialysis was introduced for deteriorating chronic renal failure caused by diabetic nephropathy. Half a year later, macular hard exudates in the left eyes disappeared dramatically in both patients, but the visual acuity remained the same. No additional laser treatment was done during the observation period. Hemodialysis is considered to have accelerated the resolution of macular hard exudates in both patients. The deposition of macular hard exudates in diabetic patients is due in part to concurrent poor renal function.

Diabetes Mellitus, Type 2↗

Body sway increases immediately after strabismus surgery.

The purposes of this study were to examine whether body sway is altered immediately after strabismus surgery in children and to find preoperative clinical factors associated with body sway. In a prospective study, body sway was measured on 1-3 days before surgery and on the third day after surgery; for the measurements, computerized static stabilometry was carried out on 28 consecutive patients with strabismus (age range: 3 to 12 years old; mean: 7.4) who underwent strabismus surgery under general anesthesia. The linear length of the sway path (cm), the linear length of the sway path in a particular unit of time (cm/second), and the area of the sway path (cm2), indicative of the extent of body sway, all increased significantly among a total of 28 patients in both conditions of the patient's eyes open and closed, as well as among those in a subgroup of 16 patients with exotropia, after they had undergone strabismus surgery (p < 0.05, Wilcoxon signed ranks test). The center of pressure along the Y axis of orientation from the toe to the heel was found to deviate significantly toward the heel postoperatively, as compared with the preoperative center in the subgroup of 16 patients with exotropia (p < 0.05). Before surgery, 15 patients with no stereoacuity exhibited a greater amount of body sway when their eyes were open than did 13 patients with measurable stereoacuity (p < 0.05, Mann-Whitney U-test). In the subgroup of 16 patients with exotropia when their eyes open, 3 patients with abnormal head posture exhibited more extensive body sway than did 13 patients without abnormal head posture (p < 0.05). Body sway was found to significantly increase immediately after strabismus surgery in children with strabismus. Stereoacuity and abnormal head posture are 2 clinical factors associated with preoperative postural instability.

Child↗

Neutrophil and lymphocyte responses to oral Streptococcus in Adamantiades-Behçet's disease.

Immune reactions against microorganisms play an important pathogenic role in Adamantiades-Behçet's disease. We had previously obtained Streptococcus sanguinis (strain BD113-20), isolated from the oral cavity of patients with Adamantiades-Behçet's syndrome. To investigate the pathogenesis of this isolate, we examined neutrophil reactions and levels of cytokine production by lymphocytes after stimulation with the strain. The reactions of neutrophils were examined by chemiluminescence assay using whole blood. The amounts of interferon gamma (IFN-gamma) and interleukin (IL)-4, IL-8, IL-10 and IL-12, produced by peripheral blood mononuclear cells, were measured by ELISA. Strain BD113-20 activated neutrophils from Adamantiades-Behçet's patients and healthy volunteers, and, in addition it increased the IFN-gamma production by lymphocytes. Lymphocytes from Adamantiades-Behçet's patients showed a dominant T helper-1 immune response. Results indicated that both bacterial stimulation and host hypersensitivity might be involved in the symptoms and pathogenesis of Adamantiades-Behçet's disease.

Adult↗

Vitrectomy and silicone oil tamponade as an initial surgery for retinal detachment after acute retinal necrosis syndrome.

PURPOSE: To show the feasibility of vitrectomy and silicone oil tamponade as an initial surgical procedure for retinal detachments with multiple tears that develop after the fulminant type of acute retinal necrosis syndrome. METHODS: In a prospective noncomparative interventional case series, vitrectomy, silicone oil tamponade, and encircling scleral buckling with a solid silicone, combined with phacoemulsification and intraocular lens implantation (except for one pseudophakic patient [Case 2]), were performed in three consecutive patients during the four-year period from 1999 to 2002. These patients had developed retinal detachment with multiple retinal tears after the resolution of acute retinal necrosis syndrome. As an initial standard treatment for acute retinal necrosis syndrome, all patients received maximum-dose intravenous acyclovir (1500 mg daily) for two weeks combined with intravenous prednisolone tapered from 200 mg daily. RESULTS: Case 1 was a 65-year-old woman who developed retinal detachment 44 days after the onset of acute retinal necrosis syndrome; Case 2, a 79-year-old man, developed retinal detachment 51 days after the onset; and Case 3, a 59-year-old man, developed retinal detachment 70 days after the onset. Before surgery, all patients showed multiple tears scattered on the detached atrophic retina extending over the entire midperipheral fundus with vitreoretinal adhesions and vitreous opacity. The retina was reattached during the initial surgery. The patients showed no recurrence of retinal detachment and maintained a visual acuity of 20/200 or 20/100 during the one- to three-year follow-up period. CONCLUSIONS: Vitrectomy and silicone oil tamponade could be a treatment option as the initial surgical procedure for retinal detachments that develop after the fulminant type of acute retinal necrosis syndrome.

Aged↗

Recurrent versus non-recurrent or no eye involvement in Behcet's disease.

PURPOSE: The aim of this study was to note the clinical features of patients with Behçet's disease who did not show recurrent episodes of eye involvement during long-term follow-up. METHODS: A retrospective review was made of 70 Japanese patients with Behçet's disease who were seen during a 23-year period from 1974 to 1996 and followed for five or more years at Okayama University Hospital. The 70 patients were divided into three groups: 36 patients with recurrent episodes of eye involvement; 13 patients with non-recurrent one-time only eye involvement; and 21 patients with no eye involvement at all during a follow-up period of five or more years. Clinical features were compared between these three groups. RESULTS: Female sex (p = 0.0263, chi-square test), young age at the onset (p = 0.0322, Kruskal-Wallis test), and genital ulceration (p = 0.0003, chi-square test) were significantly associated with the non-recurrent or no eye involvement patients. CONCLUSIONS: Female patients with onset at a young age and who show the three signs of skin lesions and oral and genital ulcerations may have non-recurrent one-time only or no eye involvement at follow-up. A better visual prognosis can be expected for these patients.

Adolescent↗

Predictive factors for long-term outcome of stereoacuity in Japanese patients with pure accommodative esotropia.

PURPOSE: To find clinical factors related to the long-term outcome of stereoacuity in Japanese patients with pure accommodative esotropia, including both the refractive type and the nonrefractive type. METHODS: The medical charts of 19 Japanese patients (8 boys and 11 girls) with pure accommodative esotropia who were followed for 10 years or more at Okayama University Hospital were reviewed retrospectively. Refractive accommodative esotropia was diagnosed in 8 patients while nonrefractive accommodative esotropia was diagnosed in 11 patients. The patients were divided into two groups, based on a stereoacuity of 120 seconds of arc or better versus 240 seconds of arc or worse as measured by the TNO test at the final visit, and the clinical factors were compared between the two groups. RESULTS: Clinical factors related to a stereoacuity of 240 seconds of arc or worse at the final visit were higher accommodative convergence to accommodation (AC/A) ratios at 6 years of age (p = 0.05), larger residual esodeviations at distance under full correction with glasses at 8 years of age (p = 0.03), and larger residual esodeviations at near at 6 years of age (p = 0.01, Mann-Whitney U-test). Overall, patients with nonrefractive accommodative esotropia tended to show poor levels of stereoacuity at the final visit compared to those with refractive accommodative esotropia (p = 0.059, Fisher exact probability test). CONCLUSION: This is the first study of the long-term visual outcome in Japanese patients with pure accommodative esotropia including both refractive and nonrefractive types. To obtain better levels of stereoacuity, the residual esodeviations at near and at distance should be kept as small as possible under full correction with glasses, including bifocals, especially at the ages of 6 and 8 years.

Accommodation, Ocular↗

The prevalence of strabismus and amblyopia in Japanese elementary school children.

BACKGROUND: The purpose of this study is to elucidate the prevalence of strabismus and amblyopia in a large population of Japanese elementary school children, from Grade 1 to Grade 6, ages ranging from 6 to 12 years. The School Health Law requires that all pupils in Grade 1 to Grade 6 be examined for vision and eye problems. Visual acuity testing is done by school teachers and eye disease screening by school ophthalmologists. Pupils with suspected ocular diseases are further examined by extramural ophthalmologists and the results reported back to the schools. The schools then summarize and send uncorrected visual acuity and ocular disease incidence, together with other health statistics, to the municipal education committees. The data are forwarded to the Prefecture Governments and finally submitted to the Education Ministry of the Central Government. Both the Prefecture Governments and the Education Ministry publicize the school health statistics on their websites. The prevalence of strabismus and amblyopia remains unknown from these data because both diagnoses are included under the heading, eye diseases. METHODS: Questionnaires asking about the numbers of children with different types of strabismus and amblyopia were sent to all elementary schools in Okayama Prefecture and the results were summarized. RESULTS: The number of children covered by the return of questionnaires was 86,531 (76.4%) of 113,254 total pupils in Grade 1 to Grade 6 in Okayama Prefecture in the year 2003. The total numbers of children with strabismus and amblyopia were 1,112 (1.28%) and 125 (0.14%), respectively. The numbers of children with any type of exotropia and any type of esotropia were 602 (0.69%) and 245 (0.28%), respectively. The major types of strabismus and amblyopia were intermittent exotropia in 109 children (0.12%), accommodative esotropia in 19 children (0.02%), anisometropic amblyopia in 23 children (0.03%), and ametropic amblyopia in 12 children (0.01%). The number of children with strabismus of unknown type was 245 (0.28%) while the number of children with amblyopia of unknown type was 81 (0.09%). CONCLUSIONS: The prevalence rates of strabismus and amblyopia in this population of Japanese elementary school children were lower than those reported in Western countries. The exotropia/esotropia ratio were increased in comparison with past studies in Japan. The school eye doctors need to be more diligent in identifying and diagnosing various types of strabismus and amblyopia in order to contribute to the school vision screening program already in place in Japan

Amblyopia↗

Photoelectric dye-coupled polyethylene film as a prototype of retinal prostheses.

Photoelectric dyes, which absorb light and convert photon energy to electric potentials, have been previously shown to stimulate retinal neurons in culture. In this study, a photoelectric dye was coupled to a polyethylene film surface and tested in vitro using retinal tissues from chick embryos at the 12-day embryonic stage, at which time outer segments of retinal photoreceptor cells have not yet developed. Carboxyl moieties were introduced to a polyethylene film surface by fuming nitric acid, and then a photoelectric dye, 2-[2-[4-(dibutylamino)phenyl]ethenyl]-3-carboxymethylbenzothiazolium bromide, was coupled to the film through amide linkage. Intracellular calcium elevation was observed with Fluo-4 in retinal tissues placed on the dye-coupled polyethylene film, in contrast to retinal tissues which had no contact with the film. The response was inhibited by calcicludine, a voltage-gated calcium channel blocker, and also by extracellular calcium depletion. The photoelectric dye, coupled to the polyethylene film surface, absorbed light under a dissecting microscope and stimulated neurons in retinal tissues, showing that the dye-coupled film could be used as a prototype of retinal prostheses.

Aniline Compounds↗

ARIX and PHOX2B polymorphisms in patients with congenital superior oblique muscle palsy.

To identify ARIX gene and PHOX2B gene polymorphisms in patients with congenital superior oblique muscle palsy, 3 exons of the ARIX gene and PHOX2B gene were sequenced by genomic DNA amplification with polymerase chain reaction (PCR) and direct sequencing in 31 patients with congenital superior oblique muscle palsy and in 54 normal individuals. A family with a father and one daughter each having congenital superior oblique muscle palsy was also included in this study. Eleven patients with congenital superior oblique muscle palsy had heterozygous nucleotide changes in the ARIX gene, including 4 patients reported on previously. One patient with atrophy of the superior oblique muscle had a new change of T-4G in the promoter region of the ARIX gene. The other 6 patients had a heterozygous nucleotide change of G153A in the 5'-untranslated region (UTR) of the exon 1 of the ARIX gene. These nucleotide changes of the ARIX gene, taken together, had a significant association with congenital superior oblique muscle palsy(P = 0.0022). One patient and 5 patients had heterozygous nucleotide changes of A1106 C and A1121 C in exon 3 of the PHOX2B gene, respectively, while these changes were absent in the normal individuals. Two patients had both the G153A change in the 5'-UTR of exon 1 of the ARIX gene and the A1121 C change in exon 3 of the PHOX2B gene. In conclusion, the polymorphisms of the ARIX gene and PHOX2B gene may be genetic risk factors for the development of congenital superior oblique muscle palsy.

Adult↗

Telomere shortening in human coronary artery diseases.

BACKGROUND: Increased cell turnover in response to injury is considered to be important in the development of atherosclerotic plaques. Telomere shortening has been shown to be associated with cell turnover. We assessed the telomere length of human coronary endothelial cells to clarify whether there is a relationship between telomere shortening and coronary artery disease (CAD). METHODS AND RESULTS: Coronary endothelial cells were obtained from 11 patients with CAD who underwent autopsy and 22 patients without CAD who underwent autopsy by scraping off the luminal surface of coronary arteries. DNA extracted from the endothelial cells were blotted and hybridized with telomere-specific oligonucleotide ([TTAGGG]4). The hybridization signal intensity, which represented telomeric DNA content, was standardized with centromeric DNA content (T/C ratio) to estimate telomere length. The T/C ratios were significantly smaller (P<0.0001) in CAD patients than in age-matched non-CAD patients (CAD patients, 0.462+/-0.135; non-CAD patients, 1.002+/-0.212). In 6 individual CAD patients, the T/C ratio at the atherosclerotic lesion was significantly smaller (P<0.05) than that at the non-atherosclerotic portion. CONCLUSIONS: These findings suggest that focal replicative senescence and telomere shortening of endothelial cells may play a critical role in coronary atherogenesis and CAD.

Aged↗

Long-term follow-up results of observation or radiation for conjunctival malignant lymphoma.

PURPOSE: To elucidate the long-term prognosis of biopsy-proven malignant lymphoma of conjunctival origin after a treatment option of observation or radiation. DESIGN: Prospective noncomparative interventional case series. PARTICIPANTS: Thirteen patients with extranodal marginal zone B-cell lymphoma of mucosa-associated lymphoid tissue (MALT) of conjunctival origin. METHODS: In the 11-year period from 1992 to 2002, 13 consecutive patients (7 female and 6 male) with ages ranging from 32 to 68 years (mean, 57) who showed malignant lymphoma of conjunctival origin were enrolled in the study. Histopathological and immunohistochemical studies of biopsy specimens of the conjunctival lesions proved extranodal marginal zone B-cell lymphoma of MALT in all patients. At the initial visit, magnetic resonance imaging (MRI) showed no orbital tumors, and gallium scintigraphy demonstrated no systemic involvement. The patients chose observation or radiation after the biopsy. MAIN OUTCOME MEASURES: Clinical disappearance of the conjunctival lymphoma lesions. RESULTS: Five patients chose 30-Gy radiation to the remaining conjunctival lesions after the biopsy, whereas the other 8 patients were simply observed without administration of any medication. During the follow-up, ranging from 1 to 11 years (mean, 5.4), 7 of these 8 patients without radiation showed spontaneous regression of the conjunctival lesions 1 to 5 years after the biopsy. Yearly MRI of the orbit and gallium scintigraphy disclosed no lesions in any of the patients. CONCLUSIONS: A large fraction of patients with MALT lymphoma of conjunctival origin had spontaneous regression after the biopsy. Follow-up without radiation is an option for patients with MALT lymphoma of conjunctival origin after the pathologic diagnosis by biopsy.

Adult↗

Clinical relevance of optineurin sequence alterations in Japanese glaucoma patients.

PURPOSE: To study the clinical relevance of sequence alterations in the optineurin gene (OPTN) among Japanese patients with open-angle glaucoma, including both primary open-angle glaucoma (POAG) and normal tension glaucoma (NTG). METHODS: Genomic DNA was isolated from 83 patients with open-angle glaucoma (55 with POAG and 28 with NTG) and 58 control subjects. The 13 exons of OPTN corresponding to the coding region were amplified by polymerase chain reaction and directly sequenced. Clinical factors were compared between glaucoma patients with and without a certain nucleotide change. RESULTS: The reported heterozygous mutations, c.458G > A(Glu50Lys) in exon 4 and c.691_692insAG in exon 6, were not found in any glaucoma patients or control subjects. The reported c.603T > A(Met98Lys) in exon 5 was significantly more prevalent in the POAG (8/55, 14.5%, p=0.0147) and NTG (4/28, 14.2%, p=0.0369) patients, and even in both the POAG and NTG patients combined (12/83, 14.4%, p=0.0149, Fisher exact probability test), than in the control subjects (1/58, 1.7%). The rates of the reported c.1944G > A(Arg545Gln) in exon 16 were not significantly different between open-angle glaucoma patients (3/83, 3.6%) and control subjects (4/58, 6.8%). In addition, a heterozygous change, c.412G > A(Thr34Thr) in exon 4 was found in 18 (21.6%) open-angle glaucoma patients and seven (12.0%) control subjects. Another heterozygous change, c.457C > T(Thr49Thr), in exon 4 was found only in three POAG patients. The 18 open-angle glaucoma patients with c.412G > A showed significantly larger cup-to-disc ratios (p=0.0178, Mann-Whitney U test), significantly more deteriorated mean deviations of the visual field in the left eye at the final visit (p=0.0076), and a significantly higher rate of surgery and/or laser history (p=0.0321, Fisher exact probability test) than the 65 open-angle glaucoma patients without the nucleotide change. CONCLUSIONS: Met98Lys is a risk-associated alteration for open-angle glaucoma, including POAG and NTG, in the Japanese population as initially reported. The amino acid-preserving polymorphism, c.412G > A, may be a genetic risk factor for the progression of open- angle glaucoma in this Japanese population.

Adult↗

Prostaglandins F2alpha and E2 in aqueous humor of patients with cataract surgery.

To understand the role of prostaglandins F(2alpha) and E(2) in aqueous humor under the normal condition, their concentrations were measured by enzyme immunoassay in aqueous fluid obtained from either eye of 60 patients during cataract surgery and correlated with clinical factors as the age and intraocular pressure. The concentrations of prostaglandin F(2alpha) in the aqueous of all patients were below the level of detection. The concentrations of prostaglandin E(2) in the aqueous were below the level of detection in 37 patients while ranged from 9 to 48 pg/mL (median, 31) in 23 patients. The levels of prostaglandin E(2) did not have correlation with the age of the patients or the intraocular pressure of the eyes. In conclusions, the concentrations of prostaglandin E(2) were apparently higher than the concentrations of prostaglandin F(2alpha) in the aqueous. This study could not prove the relationship between prostaglandin levels and the intraocular pressure or the age.

Adult↗

Protein expression, genomic structure, and polymorphisms of oculomedin.

PURPOSE: To elucidate protein expression, genomic structure, and genomic polymorphisms of a novel gene, 'oculomedin', that has been cloned as a mechanical stretch-response gene from human trabecular cells in culture. METHODS: Polyclonal antibody was prepared by immunizing rabbits with a chemically synthesized 15-mer peptide of oculomedin. Protein expression was revealed by Western blot analysis after polyacrylamide gel electrophoresis of extracts of mechanically stretched trabecular cells and control trabecular cells in culture as well as retinal tissue. Protein localization was studied immunohistochemically in the human eye section. Genomic structure was determined by searching the GenBank database. Genomic polymorphisms of the coding region in 163 glaucoma patients and 50 normal subjects were detected by PCR amplification and direct sequencing. RESULTS: Western blot analysis showed that oculomedin protein was expressed only in stretched trabecular cells, not in control trabecular cells in culture. Immunohistochemically, oculomedin protein was localized to the trabecular meshwork, Schlemm's canal endothelium, retinal photoreceptor cells, and corneal and conjunctival epithelium. The oculomedin gene (OCLM) consists of two exons which are located inside an intron of a different gene of unknown function (C1orf27) on chromosome 1q25, near and telomeric to myocilin (MYOC). Two types of heterozygous nucleotide substitutions resulting in amino acid changes were found in two of 75 patients with primary open-angle glaucoma, but not at all in patients with other types of glaucoma or in normal subjects. CONCLUSIONS: Oculomedin may play a role in the function of the trabecular meshwork and also in the development of primary open-angle glaucoma.

Animals↗

Different levels of TIMPs and MMPs in human lateral and medial rectus muscle tissue excised from strabismic patients.

PURPOSE: To arrive at an understanding of the differences in gene and protein expression between human lateral and medial rectus muscle tissue excised from strabismic patients. METHODS: Resected fragments of the lateral and medial rectus muscles obtained during strabismus surgery were frozen under liquid nitrogen and pulverized by a Freezer/Mill system. Radiolabelled cDNA was synthesized from polyA+ RNA and hybridized with a gene array nylon membrane (Atlas Human 1.2 Array) to detect the difference in gene expression between the lateral and medial rectus muscles. Based on the gene array results, tissue inhibitor of metalloproteinases (TIMP)-1 and 2, matrix metalloproteinase (MMP)-2, and bone morphogenetic protein (BMP)-4 were measured in solubilized muscle tissues by enzyme immunoassay and normalized by unit length of resection. RESULTS: The resected lateral rectus muscle had significantly smaller amounts of TIMP-1, TIMP-2 and BMP-4 but larger amounts of MMP-2 compared to the medial rectus muscle (P < 0.001, Mann-Whitney U test). The amounts of TIMP-1 in the muscle when the lateral and medial rectus were combined were positively correlated with TIMP-2 and BMP-4, while the amounts of TIMP-2 positively correlated with BMP-4 (P < 0.001, Spearman rank correlation test). The amounts of BMP-4 in both muscles increased significantly with age (P = 0.0003). CONCLUSIONS: Resected tissue from the lateral and medial rectus muscles had different levels of expression of TIMP-1 and 2, MMP-2, and BMP-4. These molecular differences may underlie different characteristics of the two extraocular muscles and may also influence the process of wound healing after strabismus surgery.

Adolescent↗

Clinical correlations of aggrecan in the resected medial rectus muscle of patients with intermittent exotropia.

The purpose of this study was to elucidate the role of extracellular matrix components such as aggrecan, fibronectin, and laminin in the extraocular muscle of patients with strabismus. Resected tissues of the medial rectus muscle of 47 patients with intermittent exotropia obtained during recession-resection surgery were frozen under liquid nitrogen and pulverized by a Freezer/Mill to solubilize the tissue for enzyme immunoassay. The total amounts of aggrecan, fibronectin, and laminin in the resected tissue were correlated with clinical data of patients such as age, exodeviation, and refractive error. The amount of aggrecan decreased significantly with the advance of age (P < 0.0001, Spearman rank correlation test), while the amount of laminin or fibronectin had no correlation with age. Patients with basic type intermittent exotropia showed larger, although not significantly, amounts of aggrecan than those with convergence insufficiency type (P = 0.0538, Mann-Whitney U-test). The amount of aggrecan may be related to motor aspects of intermittent exotropia.

Adolescent↗