Norihiro Nagai, Hisashi Matsubara, Hiroto Terasaki, Takao Hirano, Aki Kato, Akiko Miki, Hiromasa Hirai, Fumiko Murao, Hiroko Imaizumi, Fumi Gomi, Yoshinori Mitamura, Nahoko Ogata, Sentaro Kusuhara, Tsutomu Yasukawa, Toshinori Murata, Taiji Sakamoto, Mineo Kondo, Hajime Shinoda and Yoko Ozawa : Extent of Complete Retinal Pigment Epithelial and Outer Retinal Atrophy with Foveal Center Involvement is Associated with Visual Acuity., Ophthalmology Science, 5, 1, 2024.
(要約)
To evaluate the OCT images of eyes with fovea-involved complete retinal pigment epithelial and outer retinal atrophy (cRORA) as well as best-corrected visual acuity (BCVA) to explore the pathogenesis of visual impairment and atrophy.Retrospective observational study.Data of eyes with cRORA associated with age-related macular degeneration with foveal center involvement were collected from 10 hospitals in Japan.Ophthalmic examination data, BCVA, and extents of retinal pigment epithelial and outer retinal atrophy (RORA), represented by choroidal hyper-transmission, and outer plexiform layer (OPL) deterioration, central retinal thickness (CRT), and central choroidal thickness (CCT) measured using built-in software on the sectional OCT images were evaluated.Relationship between BCVA and extents of RORA and OPL deterioration.Of the 64 eyes of 64 patients (mean age: 76.8 ± 9.5 years old), 38 eyes (59.4%) belonged to men. Mean BCVA was 0.602 ± 0.475 (median: 0.523; range, -0.079 to 1.523) in logarithm of the minimum angle of resolution (logMAR). Mean extent of RORA was 2921 ± 1291 (median: 3172; range: 479-5985) μm. BCVA in logMAR positively correlated with extents of RORA (P = 0.004) and OPL deterioration (P = 0.004) and negatively correlated with CRT (P = 0.022). Best-corrected visual acuity ≥0.5 was associated with extents of RORA ≥3000 μm (odds ratio [OR], 4.227; 95% confidence interval [CI], 1.440-12.408; P = 0.009) and OPL deterioration ≥1700 μm (OR, 2.984; 95% CI, 1.034-8.609; P = 0.043), and presence of complete central outer plexiform layer defect (cCOD) (OR, 12.700; 95% CI, 2.439-66.132; P = 0.003), after adjusting for age and sex. The extent of RORA ≥3000 μm was associated with BCVA ≥0.5 (OR, 4.213; 95% CI, 1.437-12.356; P = 0.009), extent of OPL deterioration ≥1700 μm (OR, 58.682; 95% CI, 6.865-501.592; P < 0.001), and presence of cCOD (OR, 4.107; 95% CI, 1.339-12.604; P = 0.014), after adjusting for age and sex. The extent of RORA positively correlated with that of OPL deterioration (P < 0.001), CRT (P = 0.001), and CCT (P = 0.041).A longer extent of cRORA in the OCT images with foveal center involvement was associated with a longer extent of OPL deterioration and the presence of cCOD and worse BCVA. Further studies focusing on OPL changes are warranted for understanding the pathogenesis of RORA and vision loss.Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
Among 408 visually impaired persons (blind group: 257, low-vision group: 151), 72.1% were under 70 years of age. The rates of neovascular glaucoma (NVG) (right eye, P = 0.041; left eye, P = 0.0031) or proliferative diabetic retinopathy (PDR) (right eye: P = 0.014, left eye: P = 0.0047) and the rate of proliferative membrane beyond half of the retinal area (right eye: P = 0.0263, left eye: P = 0.037) were significantly higher in the blind group. The direct cause of visual impairment was retinal atrophy, common in both groups. Neovascular glaucoma and diabetic macular edema were equally prevalent in the blind and low-vision groups, respectively.
Takafumi Misaki, Fumiko Murao, Kayo Shinomiya, Akihiro Tani, Masayuki Yamada and Yoshinori Mitamura : A Case of Osteopetrosis with Orbital Inflammation Secondary to Maxillary Osteomyelitis., Case Reports in Ophthalmology, 15, 1, 92-99, 2024.
(要約)
This is a rare case of maxillary osteomyelitis associated with osteopetrosis, causing orbital inflammation.
Hiroki Sano, Kazuhiko Namekata, Masanori Niki, Kentaro Senba, Fumiko Murao, Takayuki Harada and Yoshinori Mitamura : Ocular expression of cyclin-dependent kinase 5 in patients with proliferative diabetic retinopathy., Journal of Diabetes Investigation, 13, 4, 628-637, 2022.
(要約)
Inhibition of peroxisome proliferator-activated receptor gamma (PPARγ) phosphorylation mediated by cyclin-dependent kinase 5 (Cdk5) is one of the main mechanisms of action of antidiabetic drugs. In this study, we analyzed the ocular expression and activation of Cdk5 in patients with proliferative diabetic retinopathy (PDR).
Keisuke Minami, Mariko Egawa, Keisuke Kajita, Fumiko Murao and Yoshinori Mitamura : A Case of Vogt-Koyanagi-Harada Disease-Like Uveitis Induced by Nivolumab and Ipilimumab Combination Therapy., Case Reports in Ophthalmology, 12, 3, 952-960, 2021.
(要約)
Nivolumab and ipilimumab are widely used immune checkpoint inhibitors (ICPIs) for the treatment of metastatic melanoma. ICPIs cause an array of side effects called immune-related adverse events (IRAEs) due to activation of an immune response. ICPI-uveitis can cause irreversible vision loss if untreated. There are few reports of recurrent Vogt-Koyanagi-Harada (VKH) disease-like uveitis induced by nivolumab and ipilimumab. We report a case of VKH disease-like uveitis recurrence after resuming ICPIs. A 73-year-old man with advanced melanoma was referred to our clinic with visual loss 25 days after starting nivolumab/ipilimumab. His corrected visual acuity was 0.5 in the right eye and 0.02 in the left eye. Enhanced-depth imaging optical coherence tomography (EDI-OCT) showed marked choroid thickening. The patient was diagnosed with VKH disease-like uveitis due to IRAEs. Subtenon injection of triamcinolone acetonide was performed, and nivolumab/ipilimumab was suspended, but serous retinal detachment (SRD) markedly worsened and choroidal detachment appeared. With 2 courses of steroid pulse therapy and oral steroids, SRD disappeared, and corrected visual acuity recovered in both eyes. Five months after the first injection, exacerbation of melanoma was observed, and nivolumab and oral steroids were restarted. Six weeks later, an increase in choroidal thickness was observed with EDI-OCT and diagnosed as a recurrence of VKH disease-like uveitis. Monitoring for the recurrence of VKH disease-like uveitis during the administration of ICPIs, even after uveitis is treated, is essential. Assessment of choroidal thickness with EDI-OCT may be useful for detecting early signs of VKH disease-like uveitis.
Yoshinori Mitamura, Tserennadmid Enkhmaa, Hiroki Sano, Masanori Niki, Fumiko Murao, Mariko Egawa, Shozo Sonoda and Taiji Sakamoto : Changes in choroidal structure following intravitreal aflibercept therapy for retinal vein occlusion., The British journal of Ophthalmology, 105, 5, 704-710, 2021.
(要約)
RVO induces substantial oedema of the choroidal stromal area that is detectable by binarisation of EDI-OCT images. This stromal oedema likely stems from high intraocular vascular endothelial growth factor levels. Changes in choroidal structure may be used to assess severity and prognosis of RVO.
Daisuke Nagasato, Yoshinori Mitamura, Mariko Egawa, Fumiko Murao, Toshihiko Nagasawa, Natsumi Komori, Shozo Sonoda, Taiji Sakamoto and Hitoshi Tabuchi : Changes in Choroidal Component Ratio and Circulation After Coffee Intake in Healthy Subjects., Investigative Ophthalmology & Visual Science, 62, 3, 2021.
(要約)
Coffee-induced choroidal thinning may result mainly from a reduction in the choroidal vessel lumen, and this vessel lumen reduction correlated with an increased choroidal blood flow velocity after coffee intake. These coffee-induced changes in choroidal component ratio and circulation should be considered when evaluating choroids.
Daisuke Nagasato, Hitoshi Tabuchi, Hiroki Masumoto, Takanori Kusuyama, Yu Kawai, Naofumi Ishitobi, Hiroki Furukawa, Shouto Adachi, Fumiko Murao and Yoshinori Mitamura : Prediction of age and brachial-ankle pulse-wave velocity using ultra-wide-field pseudo-color images by deep learning., Scientific Reports, 10, 1, 2020.
(要約)
This study examined whether age and brachial-ankle pulse-wave velocity (baPWV) can be predicted with ultra-wide-field pseudo-color (UWPC) images using deep learning (DL). We examined 170 UWPC images of both eyes of 85 participants (40 men and 45 women, mean age: 57.5 ± 20.9 years). Three types of images were included (total, central, and peripheral) and analyzed by k-fold cross-validation (k = 5) using Visual Geometry Group-16. After bias was eliminated using the generalized linear mixed model, the standard regression coefficients (SRCs) between actual age and baPWV and predicted age and baPWV from the UWPC images by the neural network were calculated, and the prediction accuracies of the DL model for age and baPWV were examined. The SRC between actual age and predicted age by the neural network was 0.833 for all images, 0.818 for central images, and 0.649 for peripheral images (all P < 0.001) and between the actual baPWV and the predicted baPWV was 0.390 for total images, 0.419 for central images, and 0.312 for peripheral images (all P < 0.001). These results show the potential prediction capability of DL for age and vascular aging and could be useful for disease prevention and early treatment.
(キーワード)
Adult / Aged / Ankle Brachial Index / Color Perception / Deep Learning / Female / Humans / Hypertension / Male / Middle Aged / Pulse Wave Analysis
Fumiko Murao, Takamasa Kinoshita, Takashi Katome, Hiroki Sano, Masanori Niki and Yoshinori Mitamura : Suspected Gentamicin-Induced Retinal Vascular Occlusion after Vitrectomy., Case Reports in Ophthalmology, 11, 2, 473-480, 2020.
(要約)
Retinal vascular occlusion after ocular surgery is a rare but serious complication. A history of cardiovascular diseases, retrobulbar anesthesia injection, high intraocular pressure during the perioperative period, and drug toxicity have been reported as possible causative factors. We report here two cases of multiple retinal vascular occlusions after the subconjunctival injection of gentamicin at the end of uncomplicated 25-gauge vitrectomy. Case 1 was a 61-year-old man who developed a macular hole in the right eye. Phacovitrectomy with gas tamponade was performed. On postoperative day (POD) 1, dot hemorrhage was observed on the temporal side of the optic disk. On POD10, macular whitening, retinal hemorrhage, and multiple occlusion of retinal arteries and veins were observed. Case 2 was a 51-year-old woman who was diagnosed with rhegmatogenous retinal detachment in the right eye and underwent phacovitrectomy with gas tamponade. On POD3, macular whitening with cotton wool spots and retinal hemorrhage were observed with macular ischemia owing to occlusion of retinal arteries and veins. In both cases, subconjunctival injection of gentamicin given at the end of surgery was the most suspected cause of retinal vascular occlusion.
Hideki Shiihara, Shozo Sonoda, Hiroto Terasaki, Naoko Kakiuchi, Takehiro Yamashita, Eisuke Uchino, Fumiko Murao, Hiroki Sano, Yoshinori Mitamura and Taiji Sakamoto : Quantitative analyses of diameter and running pattern of choroidal vessels in central serous chorioretinopathy by en face images., Scientific Reports, 10, 1, 9591, 2020.
(要約)
This study was to investigate the choroidal vessels in eyes with central serous chorioretinopathy (CSC) quantitatively. We studied 41 CSC eyes and their fellow eyes, and 41 normal eyes of 41 age-adjusted individuals. En-face optical coherence tomography image of the top 25% slab of Haller's layer was analyze. The mean vessel area, vessel length, and vessel diameter were calculated. The running pattern of the vessels was quantified and used to determine the degree of symmetry, the "symmetry index". The vessel area of CSC eyes was not significantly different from that of fellow eyes but significantly larger than that of normal eyes. The vessel length of CSC eyes was not significantly different from fellow eyes but significantly shorter than that of normal eyes. The mean vessel diameter was larger in CSC eyes than in the fellow eyes and the normal eye. The symmetry index was not significantly different in CSC eyes from that of their fellow eyes but was smaller than that of normal eyes. The quantitative analysis showed that eyes with CSC had larger choroidal vessels and asymmetrical vessels running in Haller's layer.
Takamasa Kinoshita, Hiroko Imaizumi, Miho Shimizu, Junya Mori, Akira Hatanaka, Shuichiro Aoki, Hirotomo Miyamoto, Masanori Iwasaki, Fumiko Murao, Masanori Niki, Hiroki Sano, Shozo Sonoda, Taiji Sakamoto and Yoshinori Mitamura : Systemic and Ocular Determinants of Choroidal Structures on Optical Coherence Tomography of Eyes with Diabetes and Diabetic Retinopathy., Scientific Reports, 9, 1, 2019.
(要約)
Knowledgeof the choroidal structures in eyes with diabetes and diabetic retinopathy (DR) should provide information on the pathogenesis of DR. A prospective study was performed to determine the systemic and ocular factors that affect the choroidal structures in eyes with diabetes. Two-hundred consecutive diabetic subjects consisted of 160 treatment-naïve patients with different stages of DR and 40 patients with proliferative DR with prior panretinal photocoagulation (PRP). All underwent blood and urine tests and enhanced depth imaging optical coherence tomography (EDI-OCT). The cross-sectional EDI-OCT images of the subfoveal choroid were binarized to measure the total choroidal area (TCA), luminal area, and stromal area. Multivariate regression analyses were performed to determine the systemic and ocular factors that were significantly correlated with the choroidal structures. The subfoveal choroidal thickness, TCA, luminal area, and stromal area were larger at more advanced stage of DR, and smaller in eyes with PRP than those without (P < 0.001). The TCA and stromal area were significantly and positively correlated with the degree of albuminuria (P = 0.034, P = 0.025, respectively). The choroidal lumen and stroma may increase as the stages of DR progress and decrease after PRP. Albuminuria may be associated with the choroidal stromal edema.
Boonruang Khamsri, Fumiko Murao, Akiko Yoshida, Akiko Sakurai, Tsuneo Uchiyama, Hiroki Shirai, Yo Matsuo, Mikako Fujita and Akio Adachi : Comparative study on the structure and cytopathogenic activity of HIV Vpr/Vpx proteins, Microbes and Infection, 8, 1, 10-15, 2006.
(要約)
The three-dimensional (3-D) structure of human immunodeficiency virus type 2 (HIV-2) Vpr/Vpx was predicted by homology modeling based on the NMR structure of human immunodeficiency virus type 1 (HIV-1) Vpr. The three proteins similarly have three major amphipathic alpha-helices. In contrast to HIV-1 Vpr, Vpr/Vpx of HIV-2 have a long N-terminal loop and clustered prolines in the second half of the C-terminal loop. HIV-2 Vpx uniquely contains a long region between the second and third major helices, and bears several glycines in the first half of the C-terminal loop. Instead of the glycines, there is a group of hydrophilic amino acids and arginines in the corresponding regions of the two Vprs. To compare the cytopathogenic potentials of HIV-1 Vpr and HIV-2 Vpr/Vpx, we examined the production of luciferase as a marker of cell damage. We further analyzed the characteristics of cells transduced with vpr/vpx genes driven by an inducible promoter. The results obtained clearly show that structurally similar, but distinct, HIV Vpr/Vpx proteins are detrimental to target cells.
(キーワード)
Amino Acid Sequence / Cytopathogenic Effect, Viral / Gene Expression Regulation / Gene Products, vpr / HIV-1 / HIV-2 / HeLa Cells / Humans / Molecular Sequence Data / Protein Conformation / Sequence Alignment / Viral Regulatory and Accessory Proteins / vpr Gene Products, Human Immunodeficiency Virus
Mikako Fujita, Boonruang Khamsri, Fumiko Murao, Akiko Yoshida, Akiko Sakurai, Tsuneo Uchiyama, K Kamada, Hiroki Shirai, Yo Matsuo and Akio Adachi : Comparative study on the structure and cytopathogenic activity of HIV Vpr/Vpx proteins, 5th Awaji International Forum on Infection and Immunity, Sumoto, Japan, Sep. 2005.