Birdshot Chorioretinopathy : A Case Report and a Case Study in Japanese Patients

Birdshot chorioretinopathy : 症例報告と本邦における文献的考察

There have been numerous case reports of birdshot chorioretinopathy(BC) from Europe and USA. However, only 10 cases of BC have been reported in Japan. We report the case of a Japanese patient with BC and review the clinical characteristics of BC among Japanese patients previously reported. We report the case of a 64-year-old Japanese man, who was seen at our clinic and then diagnosed as hasing BC. 20 eyes of 11 patients with BC reported in the Japanese literature previously, including our patient, were studied. Age at the initial onset, sex, ocular findings, prognosis of visual acuity and the human leucocyte antigen (HLA) were evaluated. In our case bilateral cream-colored subretinal exudates presented symmetrically and in time developed depigmented atrophic 'birdshot like' scar lesions. Ocular inflammation responded to oral prednisolone without exacerbation and good visual acuity was maintained. The age at the onset ranged from 19 to 78 years(mean 54.5), and 8 patients were women. Cystoid macular edema(CME) was found in 30% of 11 Japanese patients, and optic disc edema was seen in 50%. Final visual acuity was more than 20/40 in 75% and less than 20/200 in 12.5% of the cases. HLA-A 29, which is frequently associated with Caucasian patients, was not positive in any of the Japanese patients, and no specific locus was determined. We observed a rare case of BC. Age at initial onset, sex, and ocular findings of Japanese patients with BC were consistent with those of Europe and the US and good visual acuity was maintained in almost all cases. We suggest that the disease mechanism of BC in Japanese patients is different from that of Caucasian patients, because HLA-A 29 was negative in all Japanease patients.


Monocyte chemotactic protein-1 levels in the vitreous of patients with proliferative vitreoretinopathy.

PURPOSE: To assess the potential role of monocyte chemotactic protein-1 (MCP-1) in the pathogenesis of proliferative vitreoretinopathy (PVR) and to investigate its possible interaction with the macrophage migration inhibitory factor (MIF). METHODS: We assayed MCP-1 and MIF levels in the vitreous samples of 85 consecutive patients with PVR (29 eyes), rhegmatogenous retinal detachment (RRD; 22 eyes), and macular hole or idiopathic epimacular membrane (controls; 34 eyes), by enzyme-linked immunosorbent assay. RESULTS: Vitreous levels of MCP-1 were 1760.7 +/- 471.3 pg/mL (mean +/- SD) in PVR patients, 1200.4 +/- 579.8 pg/mL in RRD patients, and 436.3 +/- 286.1 pg/mL in the controls. Vitreous MCP-1 levels in PVR patients were significantly higher than those in RRD patients and in the controls (P <.0001, respectively). MCP-1 levels in grade C of PVR (1883.7 +/- 479.5 pg/mL) were significantly greater than those in grade D (1437.8 +/- 258.8 pg/mL) (P =.0112). Vitreous concentrations of MCP-1 had no correlation with those of MIF. CONCLUSIONS: The results indicate the possibility that MCP-1 may have a role mainly in the early stage of PVR and that the role of MCP-1 in PVR may differ from that of MIF.


Surgical Outcome of Vitrectomy with Indocyanine Green Staining and Internal Limiting Membrane Peeling for Retinal Detachment with Macular Hole

Indocyanine Green 染色による内境界膜剥離を併用した黄斑円孔網膜剥離の硝子体手術成績


Monocyte chemotactic protein-1 in the vitreous of patients with proliferative diabetic retinopathy.

PURPOSE: To investigate the correlation between monocyte chemotactic protein-1 (MCP-1) levels in the vitreous and clinical findings in eyes with proliferative diabetic retinopathy (PDR). METHODS: We assayed MCP-1 levels by ELISA in vitreous samples of 88 consecutive patients with PDR (52 eyes) and macular holes or idiopathic epimacular membrane (controls, 36 eyes). RESULTS: The level of MCP-1 in the vitreous was 2,097.5 +/- 1,099.4 pg/ml (mean +/- SD) in PDR, and 504.3 +/- 405.6 pg/ml in the controls. In PDR eyes, multivariate regression analysis revealed a significant association between MCP-1 levels in the vitreous and the degree of proliferative membrane, and a significant negative association between MCP-1 levels and the extent of preoperative retinal photocoagulation. CONCLUSION: The results suggest that MCP-1 may play a role in the development of the proliferative phase of PDR.


Surgical outcomes in juvenile retinal detachment.

PURPOSE: To evaluate retrospectively clinical features and surgical outcomes of rhegmatogenous retinal detachment in juvenile patients. METHODS: Between 1991 and 1996, 28 patients younger than 15 years of age with rhegmatogenous retinal detachment (32 eyes) underwent the first surgical procedure, scleral buckling and/or pars plana vitrectomy, at our hospital. RESULTS: The major types of juvenile detachment, in order of frequency, were idiopathic, familial exudative vitreoretinopathy, trauma, and high myopia. Proliferative vitreoretinopathy (PVR) of grade C or D was involved in 12 cases (37.5%). Among the 12 eyes with PVR, 7 attained retinal reattachment after the first surgery with scleral buckling. The overall reattachment rate was 28/32 (87.5%) after the first operation and 30/32 (93.8%) after the second operation. CONCLUSION: These findings indicate that the reattachment rate and visual prognosis can be as good in juvenile retinal detachment as in adult cases, when appropriate surgical procedures are used.


Vitrectomy for Proliferative Diabetic Retinopathy in Young Adults

若年者の増殖糖尿病網膜症に対する硝子体手術


Spontaneous closure of traumatic macular hole.


Neovascular Glaucoma after Vitrectomy for Proliferative Diabetic Retinopathy

増殖糖尿病網膜症に対する硝子体手術後の血管新生緑内障


Macrophage migration inhibitory factor levels in the vitreous of patients with proliferative diabetic retinopathy.

AIMS: To assess the potential role of macrophage migration inhibitory factor (MIF) in the pathogenesis of proliferative diabetic retinopathy (PDR). METHODS: MIF levels were assayed in the vitreous and paired serum samples of 73 consecutive patients with PDR (32 eyes) and macular hole or idiopathic epiretinal membrane (controls, 41 eyes). An enzyme linked immunosorbent assay technique was used to determine the concentrations of MIF. RESULTS: The median vitreous level of MIF was 11.93 ng/ml (range 4.16-103.85) in the patients with PDR, and 1.79 ng/ml (undetectable-8.93) in the controls. Vitreous levels in eyes with PDR were significantly greater than those in the controls (p<0.0001). Vitreous levels were significantly higher than serum levels in eyes with PDR (p=0.0026). MIF levels were significantly higher in the vitreous of PDR patients with severe fibrous proliferation than in those with slight proliferation (p<0.05). CONCLUSION: The results indicate increased levels of MIF in the vitreous of patients with PDR and a significant association between MIF levels and grades of fibrous proliferation, suggesting the possibility that MIF may play a part in the development of the proliferative phase of PDR.


Hepatocyte growth factor levels in the vitreous of patients with proliferative vitreoretinopathy.

PURPOSE: To determine whether the hepatocyte growth factor is increased in the vitreous of patients with proliferative vitreoretinopathy. METHODS: We assayed hepatocyte growth factor levels by enzyme-linked immunosorbent assay (ELISA) in vitreous samples from 65 consecutive eyes (65 patients) with proliferative vitreoretinopathy (23 eyes), rhegmatogenous retinal detachment (22 eyes), and macular hole or idiopathic epiretinal membrane (control subjects, 20 eyes) having undergone pars plana vitrectomy. RESULTS: Vitreous levels of hepatocyte growth factor were 3.94 +/- 2.29 (mean +/- SD) ng/ml in proliferative vitreoretinopathy, 2.02 +/- 0.84 ng/ml in rhegmatogenous retinal detachment, and 2.16 +/- 1.39 ng/ml in the control subjects. The vitreous levels in proliferative vitreoretinopathy were much greater than levels in rhegmatogenous retinal detachment (P =.0002) and in the control subjects (P =.0007). In proliferative vitreoretinopathy, there was a tendency toward higher levels in eyes with grade D by the Retina Society terminology. CONCLUSION: The results suggest the possibility that hepatocyte growth factor may play a role in the pathogenesis of proliferative vitreoretinopathy.


Corneal endothelial cell loss in eyes undergoing lensectomy with and without anterior lens capsule removal combined with pars plana vitrectomy and gas tamponade.

PURPOSE: To assess prospectively the comeal endothelial damage associated with pars plana vitrectomy combined with lensectomy and gas tamponade. METHODS: The corneal endothelium was examined with a specular microscope preoperatively and 6 months postoperatively in 42 eyes that underwent pars plana vitrectomy combined with total lensectomy and gas tamponade with SF6 (19 eyes) or C3F8 (23 eyes), and in 12 control eyes that underwent vitrectomy combined with anterior capsule-preserved lensectomy and gas tamponade. RESULTS: The mean +/- SD endothelial cell loss was 17.19+/-7.88% in the SF6 tamponade group, 27.54+/-10.57% in the C3F8 tamponade group, and 3.49+/-2.68% in the control group. Significant differences were found in the mean cell loss among these three groups. The degree of cell loss was significantly related to gas tamponade duration in the eyes with total lensectomy. CONCLUSION: These results suggest that ophthalmic surgeons must try to preserve the lens capsule as much as possible in vitrectomy combined with lensectomy and long-acting gas tamponade in order to prevent corneal endothelial damage.


Macular buckling combined with pars plana vitrectomy for complicated retinal detachment due to macular hole.


Macrophage migration inhibitory factor levels in the vitreous of patients with proliferative vitreoretinopathy.

PURPOSE: To assess the potential role of macrophage migration inhibitory factor (MIF) in the pathogenesis of proliferative vitreoretinopathy. METHODS: We assayed MIF levels in vitreous and paired serum samples of 74 consecutive patients with proliferative vitreoretinopathy (26 eyes), rhegmatogenous retinal detachment (22 eyes), and macular hole or idiopathic epiretinal membrane (control, 26 eyes) by enzyme-linked immunosorbent assay. RESULTS: Vitreous levels of MIF were 51.33 +/- 49.21 ng/ml (mean +/- SD) in proliferative vitreoretinopathy, 19.11 +/- 16.13 ng/ml in rhegmatogenous retinal detachment, and 2.98 +/- 2.55 ng/ml in the controls. The vitreous levels in eyes with proliferative vitreoretinopathy were significantly higher than levels in eyes with rhegmatogenous retinal detachment (P = .0005) and in the control subjects (P < .0001). The vitreous levels were significantly higher than the serum levels in proliferative vitreoretinopathy (P < .0001) and rhegmatogenous retinal detachment (P = .0019), respectively. CONCLUSIONS: The results suggest that MIF may be involved in the pathogenesis of proliferative vitreoretinopathy.


Vitrectomy for Proliferative Diabetic Retinopathy without Previous Photocoagulation

光凝固術未施行の増殖糖尿病網膜症に対する硝子体手術


Vitrectomy for Retinal Detachment Associated with Atopic Dermatitis

アトピー性皮膚炎に伴う網膜剥離に対する硝子体手術


Eales 病に対する硝子体手術


Surgical Outcomes of Vitrectomy for Retinal Detachment due to Macular Hole with Proliferative Vitreoretinopathy

増殖性硝子体網膜症を伴う黄斑円孔網膜剥離の手術成績

Acta Societatis Ophthalmologicae Japonicae


Evaluation of DK-line^【○!R】 Efficacy in Surgery for Retinal Reattachment


Corneal Endothelial Cell Damage Associated with Pars Plana Vitrectomy

硝子体手術に伴う角膜内皮障害


Vitrecomy for Rhegmatogenous Vitreous Hemorrhage

硝子体手術を施行した裂孔原性硝子体出血例


当院におけるアーメド緑内障バルブを用いた手術の報告

当院におけるアーメド緑内障バルブを用いた手術の報告

Folia japonica de ophthalmologica clinica


抗M O G抗体陽性視神経炎の臨床像の検討

抗M O G抗体陽性視神経炎の臨床像の検討


SS-OCTを用いた，健常日本人小児における脈絡膜厚の経時的変化の検討(会議録)


脈絡膜2階調化による小児遠視性不同視弱視眼の眼鏡治療前後の比較検討(会議録)

脈絡膜2階調化による小児遠視性不同視弱視眼の眼鏡治療前後の比較検討(会議録)


他科に学ぶ手術手技と知識for Neurosurgeon 眼科的手技 眼底検査と見方


Scanning laser ophthalmoscope retro-mode imaging of foveal schisis in eyes with X-linked retinoschisis.


A case of anterior ischemic optic neuropathy associated with Fabry's disease.


Sustained closure of surgically repaired macular hole after proliferative vitreoretinopathy.


Retinal detachment with macular hole following intravitreal bevacizumab in patient with severe proliferative diabetic retinopathy.


Glycated albumin induces activation of activator protein-1 in retinal glial cells.


Herpes zoster panuveitis progression despite acyclovir treatment in a patient following bone marrow transplantation.


Bacterial endophthalmitis after triamcinolone acetonide-assisted pars plana vitrectomy.


Acute annular outer retinopathy is an uncommon disorder of uncertain aetiology characterized by a unilateral visual field defect with an irregular annular band of grey-white, deep retinal opacification in a peripapillary location. Acute annular outer retinopathy is considered to be a variant of acute zonal occult outer retinopathy. The case is reported of acute annular outer retinopathy with spontaneous good visual recovery and no ophthalmoscopic sequelae.


Glial cell line-derived neurotrophic factor in the vitreous of patients with proliferative diabetic retinopathy.


Branch retinal artery occlusion associated with rupture of retinal arteriolar macroaneurysm on the optic disc.


Placenta growth factor and vascular endothelial growth factor in the vitreous of patients with proliferative vitreoretinopathy.


A case of X-linked retinoschisis diagnosed in an infant.


Vitreous levels of placenta growth factor and vascular endothelial growth factor in patients with proliferative diabetic retinopathy.


Tenascin-C levels in the vitreous of patients with proliferative diabetic retinopathy.


Ophthalmic artery occlusion following pars plana vitrectomy in a patient with Terson's syndrome.


Macular hole formation following rupture of retinal arterial macroaneurysm.