Tsukihiko Ogawa

Terson syndrome: A case report suggesting the mechanism of vitreous hemorrhage

OBJECTIVE To present a patient with Terson syndrome and to propose a mechanism for vitreous hemorrhage. DESIGN Observational case report. PARTICIPANT A 50-year-old woman with subarachnoid hemorrhage and unilateral vitreous hemorrhage. METHODS Detailed examination with fluorescein angiography and funduscopy. MAIN OUTCOME MEASURES Site of dye leakage on fluorescein angiography in the eye with vitreous hemorrhage. RESULTS Fluorescein angiography showed the leakage site at the margin of the disc in the eye with vitreous hemorrhage after the vitreous hemorrhage had been removed. CONCLUSIONS The damage to peripapillary tissues demonstrated by fluorescein leakage suggests that intracranial hypertension affects peripapillary structures through the intervaginal space of the optic nerve sheath.

Manganese ad copper-zinc superoxide dismutases in the developing rat retina

To determine whether superoxide dismutases (SODs) may be connected with cellular differentiation in the retina, we studied these enzymes by immunolocalization and immunochemical quantitative analysis in developing rat retinas. Four days after birth, manganese superoxide dismutase (Mn-SOD) and copper-zinc superoxide dismutase (CuZn-SOD) immunoreactivities were observed in the neural retina but not in immature neuroblasts. In 9-day-old rats, Mn-SOD immunoreactivity was located in the ganglion cell layer, inner plexiform layer, some cells of the inner nuclear layer, outer plexiform layer, and photoreceptor inner segments differentiated from immature neuroblasts. CuZn-SOD immunoreactivity was found in the same sites except the photoreceptor inner segments. The immunohistochemical staining in 9-day-old rat retinas was the same as in adult retinas. Our quantitative analysis showed increased SODs when retinal cell differentiation ceased. Our results suggest that the concentration of SODs in retinal neuroblasts is too low that immunoreactivity of SODs cannot be visualized. When the differentiation of retinal neuroblasts progresses, SODs appear to be increased in mature retinal cells to protect them from oxidative stress induced by light exposure when the eyes are open.

Cataract induced by short-term administration of large doses of busulfan : A case report

Busulfan is a carcinostatic which is used for myelocytic leukemia. A 42-year-old Japanese woman given high doses of busulfan for a short time was referred to us because of decreased visual acuity and blurred vision in both eyes. She received 212 mg/day of busulfan for only 4 days. Ophthalmoscopic examination demonstrated a posterior polar subcapsular opacity of the lens in both eyes. Although the occurrence of cataract due to busulfan has been reported after long-term administration of busulfan, this is the first clinical case of cataract caused by high doses of busulfan for a short period. It is necessary to pay more attention to busulfan cataract.

Superoxide dismutase in senescence-accelerated mouse retina.

To examine the relationship between retinal ageing and superoxide dismutase, we studied the dismutase, with immunohistochemistry and immunoquantitative analysis, in the retina of senescence-accelerated mice P8/Ta (SAMP8/Ta) 3 and 12 months after birth. Accelerated senescence-resistant mice R1TA (SAMR1TA), which show no acceleration of senescence, were used as controls. In SAMP8/Ta, copper-zinc superoxide dismutase and manganese superoxide dismutase immunoreactivity in the photoreceptor inner segments, the outer nuclear layer and the inner nuclear layer increased earlier than in the controls. The increase in both superoxide dismutases with age occurred not only in SAMP8/Ta retinas but also in the controls. In conclusion, we propose the possibility that SAMP8/Ta undergo deterioration not only of learning and memory but also acceleration of senescence in the retina. The dismutases also appear to increase with normal ageing in the retina.

[Target intraocular pressure and risk factors for progression of visual field loss in primary open-angle glaucoma].

PURPOSE Evaluation of intraocular pressure(IOP) control below the target level stated by Iwata and study of risk factors for progression of visual field loss in primary open-angle glaucoma (POAG) despite successful reduction of IOP. SUBJECTS AND METHODS Statistical difference of visual field deterioration between 27 eyes of POAG with IOPs above target levels and 48 eyes of POAG with IOP below target levels was examined for 28.1 +/- 10.2(mean +/- standard deviation) months. The relationship between the progression of visual field loss and factors of initial visual field loss, mean IOP, variance of IOP, peripapillary atrophy (zone beta), records of glaucoma surgery, age, and sex were studied in 48 patients(48 eyes) with IOPs below target levels. RESULTS Eight of the 48 eyes(16.7%) showed progression of visual field loss with IOPs below their target levels whereas 15 of the 27 eyes(55.6%) had IOPs above their target levels(p = 0.002). The risk factors for the progression of visual field loss in POAG despite good control of IOP were severity of initial visual field loss(p = 0.003), peripapillary atrophy(p = 0.002), and male sex(p = 0.03). CONCLUSIONS The control of IOP below target level is beneficial for patients with POAG. However, the risk factors which represent circulatory damage, such as peripapillary atrophy, may have a bad influence on the continuing deterioration of visual fields in patients with severe visual field damage, independently of good control of IOP.

Improved nonpenetrating trabeculectomy with trabeculotomy.

PurposeTo examine surgical effects and complications of improved nonpenetrating trabeculectomy with trabeculotomy in glaucoma patients. MethodsGlaucoma patients in two medical institutions underwent nonpenetrating trabeculectomy with sinusotomy with or without trabeculotomy, and the results were compared retrospectively in the two groups by evaluation of final intraocular pressure, drug score, and occurrence of postsurgical complications. ResultsOf the 63 eyes of 51 patients in this study, 31 were treated with nonpenetrating trabeculectomy with sinusotomy without trabeculotomy and 32 eyes were treated with nonpenetrating trabeculectomy with sinusotomy and trabeculotomy. The mean follow-up period was 17.0 months. The clinical features in both groups were similar in terms of age, presurgical intraocular pressure (P = 0.96), and presurgical drug score. The eyes treated with nonpenetrating trabeculectomy with sinusotomy without trabeculotomy had significantly reduced intraocular pressures from 21.0 ± 4.3 (mean ± SD) to 15.8 ± 6.3 mm Hg (P = 0.0003) and drug scores from 2.4 ± 1.2 to 1.6 ± 1.1 without postsurgical complications. The eyes treated with nonpenetrating trabeculectomy with sinusotomy and trabeculotomy had significantly reduced intraocular pressures from 22.3 ± 7.5 to 12.5 ± 2.3 mm Hg (P < 0.0001) and drug scores from 2.5 ± 1.9 to 0.9 ± 1.3 without postsurgical complications. Thus, the eyes treated with nonpenetrating trabeculectomy with sinusotomy and trabeculotomy had significantly lower intraocular pressures (P = 0.016) and drug scores than did those treated with nonpenetrating trabeculectomy with sinusotomy without trabeculotomy. ConclusionThe authors obtained satisfactory results in reducing intraocular pressure by the combination of nonpenetrating trabeculectomy, sinusotomy, and trabeculotomy.

AGEING TRANSITION OF SUPEROXIDE DISMUTASE IN RAT RETINA

To examine the relationship between retinal ageing and superoxide dismutase, the distribution and expression of the dismutase was studied in the retina of 2-year-old Sprague--Dawley albino rats with immunohistochemistry and immunochemical quantitative analysis. Eight-week-old Sprague--Dawley albino rats were used as controls. In 2-year-old rats, manganese superoxide dismutase (Mn-SOD) immunoreactivities in the photoreceptor inner segments, the outer nuclear layer and the inner plexiform layer were stronger than those in 8-week-old rats. Copper--zinc superoxide dismutase (CuZn-SOD) immunoreactivities in the outer nuclear layer and inner plexiform layer of 2-year-old rats were stronger than those in 8-week-old rats. Faint CuZn-SOD immunoreactivity became visible in the photoreceptor inner segments of 2-year-old rats, whereas no CuZn-SOD immunoreactivity was observed in 8-week-old rats. Our immunochemical quantitative analysis also showed an increase in the immunoreactivities of superoxide dismutases in the sensory retina with age. The transition of the dismutases may have some relationship with retinal ageing.