Yoshihiko Tsuyama

Pattern visual evoked potentials in traumatic optic neuropathy

To evaluate the characteristics of pattern visual evoked potentials (PVEPs) in traumatic optic neuropathy (TON) compared with optic neuritis (ON), we retrospectively studied 47 patients with TON and 64 patients with unilateral ON. PVEPs elicited by the stimulation with 3 reversals/s were recorded in all patients. A PVEP could be recorded in 29.8% of the TON patients and 49.6% of the ON patients at their first visit. In the 14 patients with TON and recordable PVEPs, the mean amplitude ratio (affected/fellow eye) was 0.29 ± 0.03 (SE) and the mean delay of the peak latency was 17.9 ± 2.9 ms. In the 30 patients with ON and recordable PVEPs, the mean amplitude ratio was 0.48 ± 0.04 (SE) and the mean delay of the peak latency was 23.5 ± 2.5 ms. The amplitude ratio was significantly lower in patients with TON than in those with ON.

Light and electron microscopic studies on human retinal blood vessels of patients with sclerosis and hypertension

AbstractPurposeTo correlate the ophthalmoscopic and histological findings on human retinal blood vessels of patients with sclerosis and hypertension, respectively.MethodsOphthalmoscopy, light microscopy, and transmission and scanning electron microscopy with histochemical staining were performed on eyes obtained from patients with a malignant orbital tumor, with absolute glaucoma, or with hypertensive retinopathy.ResultsThe retinal arteries in aged patients with ophthalmoscopic sclerotic blood vessels had walls in which the smooth muscle cells had been replaced by collagen fibers, proteoglycan filaments, and ruthenium red-positive materials. The venous blood columns were hidden by numerous swollen nerve fibers and extending Müller cell processes. In a patient with accelerated hypertensive retinopathy, some of the muscle cells in the arteriolar walls were edematous. Focal and generalized narrowing of the retinal arteries appeared to be caused by a true functional constriction of the smooth muscle cells in the walls.ConclusionsThe ophthalmoscopic signs, such as reflection of the retinal arterial blood column and crossing phenomena, were supported by sclerotic manifestations clearly visible upon histological examination. There were some organic changes in the retinal arteries in a patient with accelerated hypertensive retinopathy, but the ophthalmoscopic narrowings appeared to result from a functional constriction of the smooth muscle cells in these vessels.

Case of POEMS Syndrome Associated with Bilateral Macular Detachment Resolved by Autologous Peripheral Blood Stem Cell Transplantation

the growth and tube formation of microvascular endothelial cells and upregulated VEGF mRNA levels via AP-1. It has been reported that the overexpression of the AP-1 gene induces severe angiogenesis in the rat brain, suggesting the involvement of AP-1 in in vivo angiogenesis. We have reported that phosphorylated c-Jun is widely expressed in the glial component of PDR ERM. In this study, c-Jun in cultured Müller cells was phosphorylated by the stimulation of glycated albumin, indicating that c-Jun is activated in glial cells under the conditions that mimic long-term hyperglycemia. Taken together, AP-1 in retinal glial cells may be involved in PDR angiogenesis by regulating the promoter activity and the expression of angiogenesis-related cytokines.

Comparison of Yatabe-Guilford personality test results in retinitis pigmentosa and glaucoma patients.

PURPOSE To determine the psychological state and personality traits of patients with retinitis pigmentosa (RP) or glaucoma so that a closer and better relationship can be developed with the patients. METHODS The Yatabe-Guilford personality test was administered to 75 RP patients and 42 glaucoma patients. The latter group included 29 cases of primary open-angle glaucoma, 6 of primary angle-closure glaucoma, and 7 of normal-tension glaucoma. The patients were being treated at the Department of Ophthalmology, Chiba University Hospital. As controls, 47 age-matched volunteers were tested. RESULTS A comparison of these three groups showed that the proportions of patients with cyclic tendency, rhathymia, and lack of cooperativeness traits were significantly higher in the RP group than in the glaucoma group. The lack of cooperativeness value was especially higher in the RP than in the glaucoma group and the control group (Fisher exact test, P <.05). On the other hand, the nervousness value was significantly higher in the glaucoma group than in the RP group and than in controls (Fisher exact test, P <.05). Factors of sex, age, type of disease, corrected visual acuity, and central visual fields did not influence the profiles of the RP and glaucoma groups. CONCLUSION RP patients had relatively well-stabilized personalities and were optimistic, while glaucoma patients tended toward nervousness in comparison with RP patients and controls.

A Case of Kearns-Shy Syndrome with Later Onset

We report a case of Kearns-Shy syndrome in a 44-year-old woman. She complained of bilateral ptosis, exotropia and gait disturbance. Diffuse chorioretinal degeneration and numerous punctate whitish spots were observed in both fundi. Eye movements were severely disturbed. An electroretinogram was almost nonrecordable, while visually evoked cortical potentials to pattern stimulation were normal. The dark adaptation curve showed an elevation of rod threshold. Besides such ophthalmological findings, muscle weakness, extinguished tendon reflex and healing difficulty were observed. Blood lactate, pyruvic acid and serum creatinine kinase were at high levels. A muscle biopsy showed ragged-red fibers and partial deficiency of cytochrome c oxidase. The patient is being treated with coenzyme Q, and we are now following up the therapeutic effects of this treatment.

Clinical profiles of patients with optic neuritis at the Ophthalmological Department of Chiba University

Objective: To determine the clinical features of 272 patients who were diagnosed with optic neuritis at an ophthalmological clinic in Japan. Methods: We reviewed the records of patients examined between January 1977 and late June 1999. Results: The ratio of women to men was 1.7 : 1. The mean age at onset was 35 years and 80.5% were unilateral. The most frequent complaint was a vision decrease in 82.4%. The disc appeared normal in 38.5%. The median visual acuity at onset was 0.1; it was 1.0 at the recovered stage. The mean time required for visual recovery was 92.3 days from the onset. The most common known cause of optic neuritis was multiple sclerosis (MS)(22.8%). The recurrence rate was 22.0% and the mean number of recurrences was 2.9. The time for the development of disc pallor was 124.8 days. Conclusions: We found no racial difference in the incidence of MS as has been reported between Caucasians and Japanese.

Histopathological study of a case with branch retinal vein occlusion

A retinal specimen from a 68-year-old patient with glaucoma and branch retinal vein occlusion was examined by light and electron microscopy. The venous and arterial lumina were filled with erythrocytes, and many erythrocytes extravasated into the venous wall. We suggest that constant rubbing of endothelial cells of the occluded vein results in damage and erythrocyte extravasation was caused by diapedesis.

[Sclerostomy with an erbium YAG laser--the relationship with pulse energy].

Purpose: To investigate the optimal pulse energy to do sclerostomy with an erbium YAG laser.Materials and Methods: The experiments were performed in enucleated porcine eyes. We changed pulse energy and examined the effects on surrounding tissue.Results: With the increase of pulse energy, the effects of the laser extended to the area surrounding the laser probe. At the threshold energy for doing full-thickness sclerostomy, the total energy was significantly higher than with higher pulse energy. And with pulse energy higher than 2 mJ, the total energy did not show any significant change. Histopathologically, the damaged area around sclerostomy became larger with the increase of pulse energy.Conclusion: The optimal energy to do full-thickness sclerostomy with this system seemed to be 2 mJ.