Noriko Abematsu

Optic disc swelling in Vogt-Koyanagi-Harada disease.

PURPOSE This retrospective observational study was designed to evaluate the frequency of, and the factors associated with, optic disc swelling in Vogt-Koyanagi-Harada disease (VKH). METHODS A retrospective observational study was conducted. We analyzed 116 eyes of 58 patients with VKH. Demographic and clinical differences between patients with and without disc swelling were analyzed. RESULTS Thirty-two eyes (27.6%) of 16 VKH patients had disc swelling. The mean age of the patients with disc swelling was higher than that of those without disc swelling (58.9 vs. 41.4, P = 0.0001). The disc-macula distance to disc diameter (DM/DD) ratio of the eyes with disc swelling was higher than that of those without disc swelling (2.81 vs. 2.59, P = 0.0007). The cup to disc (C/D) ratio of the eyes with disc swelling was smaller than that of those without disc swelling (0.18 vs. 0.32, P = 0.000001). The intraocular pressure was lower (P = 0.0084), and the refractive error was larger (P = 0.019), in eyes with disc swelling than in those without. There was no significant association between the presence of disc swelling and the range of retinal detachment, cerebrospinal fluid cell count, recurrence rate of VKH, or the incidence of sunset glow fundus. Among the eyes with disc swelling, 13 eyes of 7 patients had visual field defects even after the inflammation subsided, and these patients were older, had a higher DM/DD ratio, and had a smaller C/D ratio than those without visual field defects. CONCLUSIONS The occurrence of disc swelling in VKH was significantly correlated with age and disc morphology, rather than the severity of inflammation. Some VKH patients with disc swelling develop visual field defects from optic disc involvement.

Predictable signs of benign course of polypoidal choroidal vasculopathy: based upon the long-term observation of non-treated eyes

Purpose:  To find predictable signs of benign polypoidal choroidal vasculopathy (PCV).

Nasal and independent polypoidal lesions in polypoidal choroidal vasculopathy

BackgroundPolypoidal vessels in polypoidal choroidal vasculopathy (PCV) are known to occur frequently in the macular and peripapillary regions. The aim of this study is to describe patients with polypoidal vessels that are nasal to the optic disc, being independent of macular polypoidal lesions.MethodsA 75-year-old man and a 65-year-old man with polypoidal vessels in the macula of both eyes were followed up through routine examinations including indocyanine green angiography and optical coherence tomography.ResultsA polypoidal vessel located 1.5 disc diameters to the nasal margin of the disc was found in the right eye during the first examination in one case, and in the other case it developed during the follow-up period, after successful treatment using photodynamic therapy for the polypoidal lesion in the macula of the left eye. Indocyanine green angiography disclosed no continuity between the polypoidal vessels nasal to the disc and the polypoidal vessels in the macula region in either case. The nasal polypoidal vessels were not associated with exudative changes in either case, and the vessel in one case disappeared spontaneously without any treatment.ConclusionsThe findings of this study demonstrate that PCV could involve regions outside the macula and occur in multiple areas independently. The results also indicate the dynamic nature and transitory appearance of polypoidal vessels. Polypoidal vessels nasal to the disc might be overlooked, especially in cases that are not associated with exudative changes, and careful examination might disclose more subclinical nasal polypoidal vessels. Further detailed examination would be helpful to gain a better understanding of the pathogenesis of PCV.

Systemic diseases in patients with HTLV-1-associated uveitis

Background Human T-lymphotropic virus type 1 (HTLV-1) carriers may develop severe systemic diseases, such as adult T cell leukaemia (ATL) or HTLV-1-associated myelopathy/tropical spastic paraparesis (HAM/TSP). This study aims to investigate systemic diseases of HTLV-1 carriers who had developed HTLV-1-associated uveitis (HAU). Methods We investigated the occurrence of systemic diseases in 200 patients with HAU by performing a retrospective investigation of their medical records and examining the results of a postal survey. Results The mean age of HAU onset was 49 years, and the total person-years from HAU onset was 1627. There were two cases of ATL. Of these, one was diagnosed with smouldering ATL at the time of HAU onset and the other developed acute-type ATL 4 years after HAU onset. There were 26 cases of HAM/TSP; of these, HAM/TSP occurred first in 13 cases and HAU occurred first in 11 cases. The interval between the onset of HAM/TSP and HAU ranged from 6 months to 6 years, with no significant difference observed based on whether HAM/TSP or HAU occurred first. Hyperthyroidism was noted in 45 cases and preceded onset in all cases. HAU onset occurred after starting thiamazole treatment, and in two cases HAU recurred each time thiamazole treatment was restarted. Conclusion HTLV-1 carriers with HAU may develop HAM/TSP more frequently than general carriers. HTLV-1 carriers undergoing treatment for hyperthyroidism may be prone to developing HAU.

Non‐rhegmatogenous retinal detachment associated with hair‐like object in vitreous: a case report

Hiroto Terasaki*MD PhD Kumiko Nakao* MD PhD Kazuki Fujiwara* MD Tsubasa Hiraki MD Wakako Shirasawa* MD Noriko Abematsu* MD Suguru Yonezawa MD PhD Taiji Sakamoto* MD PhD Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan Department of Human Pathology, Field of OncologyKagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan E-mail: tsakamot@m3.kufm.kagoshima-u.ac.jp