Nobuhiko Matsuo

Expression pattern of acidic and basic fibroblast growth factor genes in adult rat eyes

Although the retinal angiogenic and mitogenic factors have been identified to be acidic and basic fibroblast growth factors (aFGF and bFGF), little information has so far been available about the cells producing them and their function in retinal tissues. We found, by in situ hybridization, that the expression pattern of the aFGF gene differed remarkably from that of the bFGF gene in adult rat eyes. Our results demonstrated that the aFGF gene was produced by photoreceptor visual cells, neuronal cells in the inner nuclear layer and ganglion cells of the retina, in addition to pigment epithelial cells of the choroid, iris and ciliary body, and epithelial cells of the cornea, conjunctiva and lens, while bFGF was synthesized solely by the photoreceptor visual cells.

Feeder vessel photocoagulation of subfoveal choroidal neovascularization secondary to age-related macular degeneration

PURPOSE This study aimed to assess the feasibility of laser photocoagulation of feeder vessels of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration. PATIENTS AND METHODS Of 170 consecutive patients with subfoveal CNV secondary to age-related macular degeneration, feeder vessels were detected in 37 patients by means of indocyanine green videoangiography using a scanning laser ophthalmoscope. Dye laser photocoagulation was applied to extrafoveal feeder vessels, with the fovea spared. RESULTS Twenty-six (70%) of those 37 patients had complete resolution of exudative manifestations. Persistent or worsened manifestations were seen in 11 patients (30%) because of recurrent CNV or persistent CNV. The visual acuity improved or stabilized in 25 patients (68%). Ten patients (27%) had a final visual acuity of 20/40 or better and six patients (16%) had a final visual acuity of 20/50 to 20/100. Significant factors prognostic of the visual outcome of 20/100 or better were small CNV (2 disc areas or smaller, Fishers exact probability test, P = 0.041), the absence of white, fibrous tissue in neovascular membranes (Fishers exact probability test, P = 0.003), and the closest distance of laser burns to the center of the foveal avascular zone (Fishers exact probability test, P = 0.049). Preoperative visual acuity had a significant positive correlation with final visual acuity (Spearmans rank correlation test, P = 0.0076). CONCLUSION Feeder vessel photocoagulation should be considered as a treatment option for subfoveal CNV secondary to age-related macular degeneration, because no other treatment method has a better visual outcome.

A Proposed Mild Type of Acute Retinal Necrosis Syndrome

Six patients had peripheral to midperipheral pale yellow retinal exudates typical of acute retinal necrosis syndrome but which extended gradually to the posterior pole and remained isolated without becoming confluent. These exudates resulted in localized retinochoroidal degeneration without retinal detachment, in contrast to acute retinal necrosis syndrome. Antibody titers in aqueous humor were increased to varicella-zoster virus in some of the patients examined. The findings led us to hypothesize that this mild, self-limiting course is one of the natural developments of acute retinal necrosis syndrome, although somewhat modified by corticosteroid or acyclovir therapy, and that acute retinal necrosis syndrome consists of varying degrees of severity from mild to fulminant types.

Retinal circulation times in quantitative fluorescein angiography.

We tried to obtain an overview of the quantitative state of the retinal circulation. Optical density measurements by an image analyzer were performed on video fluorescein angiograms for the determination of dye-dilution curves. To ensure that curves with a sharp peak were obtained, 1 ml sodium fluorescein 10% was flushed with 20 ml physiological saline. From dilution curves of a retinal arteriole and the corresponding venule, various retinal circulation times, T (x) (x=1, 25, 50, 75, and 100) and Tm, were calculated. T(1) corresponds to the difference in the time of initial dye appearance; T(50), to the so-called half-maxim time difference; T(100), to the difference in the time to peak intensity; and Tm, to the mean circulation time. T(50) showed the best reproducibility when it was examined at 49 retinal regions of 10 healthy volunteers with a double video-fluorescein angiogram that was obtained within 1 min. Normal values (mean ± SD) at the temporal superior region of 37 healthy volunteers were as follows: T (1) = 0.87 ± 0.66 s, T(25)=1.52±0.48 s, T(50)=1.83±0.50 s, T(75)=2.12±0.56 s, T(t00) = 2.73±0.76 s, and Tm = 2.69±1.25 s. We believe that these values give a general overview of the quantitative state of normal retinal circulation.

Multifocal pigment epithelial damages with serous retinal detachment in systemic lupus erythematosus

We experienced 2 females with systemic lupus erythematosus (SLE) who developed serous retinal detachment in the posterior pole of both eyes in its active phase. Fluorescein angiography showed multifocal pigment epithelial damages with fluorescein leakage into the subretinal space. However, retinal hemorrhages or cotton-wool spots typical of SLE were not observed in their courses.

Expression pattern of the activin receptor type IIA gene during differentiation of chick neural tissues, muscle and skin

To elucidate target cells of activins during embryogenesis we isolated cDNAs of chick activin receptor type II (cActR‐II) and studied expression patterns of thecActR‐II gene by in situ hybridization. Transcripts ofcActR‐II were observed in neuroectoderm developing to spinal cord, brain and eyes, in surface ectoderm differentiating to epidermis, and in myotomes differentiating to muscles. The expression patterns ofcActR‐II suggest that activin and its receptor are involved in differentiation of chick neural tissues, muscle and skin after inducing the dorsal mesoderm.

Factors associated with poor visual outcome in acute retinal necrosis.

We reviewed 22 consecutive patients (26 eyes) with acute retinal necrosis to elucidate whether there was any sign at an early stage to predict poor visual outcome. Final visual acuity of the patients fell into two groups, one worse than 20/600 (15 eyes) and the other better than 20/30 (11 eyes). The patients with poor visual outcome showed diffuse retinal arteritis or arterial obliteration which was associated with reduced amplitude of electroretinographic a and b waves and elevated levels of circulating immune complex, even at an early stage when retinal exudates were still localised to the peripheral fundus. The retinal exudates in these patients extended rapidly to the posterior pole. In contrast, the patients with good visual outcome showed retinal arteritis limited within retinal exudates throughout the course. These signs at an early stage can be used as prognostic factors to manage patients with acute retinal necrosis more constructively.

Immune Complex Containing Herpesvirus Antigen in a Patient With Acute Retinal Necrosis

A 21-year-old man with acute retinal necrosis showed a marked increase in the convalescent titer to herpes simplex type 1 virus, especially in the aqueous humor obtained by anterior chamber paracentesis. Using an enzyme-linked immunosorbent assay, we tried to detect the herpesvirus antigen in the circulating immune complex obtained from this patient. The immune complex contained an antigen or antigens that reacted with antiherpes simplex type 1 antibody.

Intracellular calcium response to hydraulic pressure in human trabecular cells.

AIMS--To understand the mechanism for regulation of intraocular pressure, human trabecular cells were examined to determine whether they could respond to the change in hydraulic pressure. METHODS--Human trabecular cells were cultured from trabeculum tissue fragments excised during trabeculectomy in four eyes of three patients with primary open angle glaucoma and exposed to the change of hydraulic pressure in a tissue culture flask connected to a glass syringe. The pressure was exerted by automatic infusion of the piston of the syringe and monitored by a pressure gauge. The intracellular calcium concentration was measured in real time with a calcium binding fluorescent dye, fluo-3. RESULTS--A small number (about 10%) of cells appearing morphologically to be trabecular cells showed transient elevations or oscillations of the intracellular calcium concentration in response to the elevation of hydraulic pressure to 20-30 mm Hg, indicating that a part of the human trabecular cells could sense the change in hydraulic pressure. CONCLUSION--Some cells in the human trabecular tissue seem to sense the change in intraocular pressure and might play a role in its regulation.

Photoreceptor Outer Segments in the Aqueous Humor in Rhegmatogenous Retinal Detachment

We treated seven patients (all male, ranging in age from 11 to 31 years) with Schwartz syndrome, a combination of uveitis, high intraocular pressure, and retinal detachment with peripheral tears. The condition was resistant to corticosteroids but responded well to surgery. Puncture of the anterior chamber disclosed many outer segments of the visual cells with few inflammatory cells in the aqueous humor in all seven patients. Possibly the outer segments, flowing from the subretinal space through the peripheral retinal break into the aqueous humor, cover the trabecular meshwork and cause the decrease in the coefficient of outflow. Detection of the outer segments led us to make a definite diagnosis and institute the appropriate treatment.