研究者詳細 - 坪田　一男

論文 - 坪田　一男

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Topography-guided conductive keratoplasty for keratoconus

Kato Naoko, Tsubota Kazuo

American Journal of Ophthalmology 151 （ 6 ） 2011年06月

ISSN 0002-9394

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The association between primary open-angle glaucoma and motor vehicle collisions

Tanabe Sachiko, Yuki Kenya, Ozeki Naoki, Shiba Daisuke, Abe Takayuki, Kouyama Keisuke, Tsubota Kazuo

Investigative Ophthalmology and Visual Science 52 （ 7 ） 4177 - 4181 2011年06月

ISSN 0146-0404

Purpose. To investigate and compare the prevalence of motor vehicle collisions (MVCs) in individuals with or without primary open-angle glaucoma (POAG). Methods. A total of 265 subjects were consecutively enrolled: 121 (79 men, 42 women; age, 62.1 ± 8.0 years) with POAG; and 144 (95 men, 49 women; age, 61.2 ± 7.9 years) who were free of ocular disease. Participants answered a questionnaire on MVC experience during the previous 10 years, past driving experience, and daily driving habits. The POAG group was subdivided into three groups according to disease severity (mild, moderate, or severe), to assess the relationship between POAG severity and MVC. Results. A statistically significant association between POAG severity and MVC frequency was observed; 3.5% of the controls, 0.0% of the mild POAG group, 3.9% of the moderate POAG group, and 25.0% of the severe POAG group had experienced MVCs (P = 0.007, Cochran-Armitage trend test). The severe POAG group had experienced a much higher frequency of MVCs during the surveyed period than had the control group (P < 0.010; Fisher's exact test). Logistic regression analyses to account for confounding factors (age, presence of diabetes mellitus, driving history, time spent driving per day, and best corrected visual acuity in the better or worse eye) produced consistent results. Conclusions. Advanced POAG with marked visual field defects may be a risk factor for MVCs. © 2011 The Association for Research in Vision and Ophthalmology, Inc.

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Retinal ganglion cell loss in superoxide dismutase 1 deficiency

Yuki Kenya, Ozawa Yoko, Yoshida Tetsu, Kurihara Toshihide, Hirasawa Manabu, Ozeki Naoki, Shiba Daisuke, Noda Kousuke, Ishida Susumu, Tsubota Kazuo

Investigative Ophthalmology and Visual Science 52 （ 7 ） 4143 - 4150 2011年06月

ISSN 0146-0404

Purpose. To investigate the influence of deficiency in superoxide dismutase (SOD) 1, a major antioxidative enzyme, on retinal ganglion cells (RGCs). Methods. In the SOD1 total knockout (SOD1-deficient) mice, the level of superoxide anion was measured using dihydroethidium. The number of RGCs was counted in both the retinal sections and the flat-mount retinas after retrograde labeling. Thickness of nerve fiber layer (NFL) was measured in the sections, and the amount of neurofilament protein was measured by immunoblot analysis. Pattern electroretinogram (ERG), which reflects the function of retinal ganglion cells, dark-adapted ERG, and cone ERG were performed. The intraocular pressure (IOP) was measured with an induction-impact tonometer. The levels of SOD-1 and -2 were measured by ELISA, in the serum of 47 newly diagnosed consecutive normal tension glaucoma (NTG) patients and 44 consecutive control subjects. Results. The level of superoxide anion in the RGC layer was significantly higher in 24-week-old SOD1-deficient mice than in wild-type mice. The RGC number was significantly reduced in 24-week-old SOD1-deficient mice, although they were not in 8-week-old mice. The NFL thickness and neurofilament protein were reduced in 24-week-old SOD1-deficient mice. The amplitude of pattern ERG was significantly reduced, although dark-adapted and cone ERGs showed no impairment, in 24-week-old SOD1-deficient mice. The IOP level was not changed in the SOD1-deficient mice. The serum level of SOD1, but not SOD2, was significantly lower in the NTG patients than in the healthy controls. Conclusions. SOD1 deficiency causes RGC vulnerability, which may be involved in the underlying condition of NTG. © 2011 The Association for Research in Vision and Ophthalmology, Inc.

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Age-related changes in functional visual acuity in healthy individuals

Kaido Minako, Toda Ikuko, Ishida Reiko, Konagai Mototaka, Dogru Murat, Tsubota Kazuo

Japanese Journal of Ophthalmology 55 （ 3 ） 183 - 189 2011年05月

ISSN 0021-5155

Objectives: To investigate the age-related alterations in functional visual acuity (FVA) in healthy individuals. Design: A prospective non-comparative multi-center study. Setting and participants: Fifty-four eyes of 54 normal subjects with best corrected visual acuities better than 20/20 seen at the outpatient clinics of the Department of Ophthalmology at Keio University, Minamiaoyama Eye Clinic and Ishida Eye Clinic were studied. Measurements: FVA measurements, Schirmer test, BUT, tear clearance rate and fluorescein vital staining scores were obtained. Results: Schirmer test scores, BUT values and fluorescein vital staining scores did not show significant changes (p > 0.05), but there were significant differences in tear clearance rates among the age groups (p < 0.05). Tear function index, which is a value obtained from multiplying a Schirmer test score by the tear clearance rate, also showed significant differences in the age groups (p < 0.05). The mean logMAR FVA score decreased significantly in the older groups (p < 0.05), while the mean conventional VA score did not show significant differences among the age groups. Moreover, there were significantly more eyes with lower minimum VA scores in the older age groups (p < 0.05). LogMAR minimum VA appeared to be significantly related to the tear clearance rates in subjects 60 years and older (p < 0.05). Conclusions: FVA testing seems to be a useful method of assessing the age-related decline in dynamic visual and tear functions. © 2011 Japanese Ophthalmological Society.

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Clusterin promotes corneal epithelial cell growth through upregulation of hepatocyte growth factor by mesenchymal cells in vitro

Okada Naoko, Kawakita Tetsuya, Mishima Kenji, Saito Ichiro, Miyashita Hideyuki, Yoshida Satoru, Shimmura Shigeto, Tsubota Kazuo

Investigative Ophthalmology and Visual Science 52 （ 6 ） 2905 - 2910 2011年05月

ISSN 0146-0404

PURPOSE. Although the cornea expresses high levels of clusterin (CLU), the role of CLU in the cornea is poorly understood. This study was performed to investigate the possible role of CLU in corneal epithelial homeostasis. METHODS. CLU was overexpressed in 3T3 cells by transfection of a vector encoding full-length CLU (Clu-3T3). Colony-forming efficacy (CFE) was compared in mouse corneal cell line (TKE2) and human primary corneal/limbal epithelial cells that were cocultured with Clu-3T3 and mock-3T3. To determine whether feeder cells have a contact effect, cocultures without feederepithelium contact were also performed. Neutralizing antibody against CLU was used to assess the effects of secretory CLU in TKE2 cells cocultured with Clu-3T3 cells. The expression of growth factors associated with limbal stem/progenitor cell maintenance and growth were analyzed by RT-PCR and Western blot analysis. RESULTS. TKE2 cells cocultured with Clu-3T3 feeders showed higher CFE and were larger in colony size than TKE2 cells cocultured with mock-3T3 feeders. Increased CFE of TKE2 was observed without direct contact with Clu-3T3 cells, which was significantly blocked by treatment with CLU neutralizing antibody. Clu-3T3 cells expressed higher levels of HGF than mock- 3T3 cells, which were significantly suppressed with anti-HGF neutralizing antibodies. Collectively, the promotion of colonyforming and cell proliferation by Clu-3T3 cells was partially mediated by the induction of HGF. CONCLUSIONS. Clusterin indirectly enhances the CFE of corneal/ limbal epithelial cells by inducing the production of HGF by feeder cells, suggesting a role in epithelial-mesenchymal interaction. © 2011 The Association for Research in Vision and Ophthalmology, Inc.

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Repair of blowout orbital floor fracture by periosteal suturing

Noda Mika, Noda Kousuke, Ideta Shinji, Nakamura Yasuhisa, Ishida Susumu, Inoue Makoto, Tsubota Kazuo

Clinical and Experimental Ophthalmology 39 （ 4 ） 364 - 369 2011年05月

ISSN 1442-6404

The study objective was to evaluate the outcome of a periosteal suturing technique in eyes with orbital blowout fractures. Fifteen orbital floor fractures were classified into: type 1, linear fracture; type 2, middle fracture; and type 3, posterior fracture extending two-thirds into the orbit. The feasibility of periosteal suturing without silicone plates or one of minimal size was determined. The improvement of ocular movements and surgical complications were evaluated. A complete suture of the torn periosteum without implanting a silicone plate was achieved in 2/2 (100%) type 1 cases, 5/7 (71%) type 2 cases and 0/6 (0%) type 3 cases. A partial fixation was achieved in 3/6 (50%) type 3 cases with an implantation of a silicone plate of approximate one-third of the usual size in one case. Conventional surgery with silicone plates after failed periosteal suture was required in 2/7 (29%) type 2 cases and 3/6 (50%) type 3 cases. Eye movements were improved postoperatively in all eyes, and a complete range of eye movements was achieved in 6/7 (86%) cases with complete periosteal closure, 1/3 (33%) of cases with partial closure and 2/5 (40%) cases without closure. In conclusion, periosteal suturing can minimize the need for silicone plates especially for anterior or middle orbital floor factures. © 2010 The Authors. Clinical and Experimental Ophthalmology © 2010 Royal Australian and New Zealand College of Ophthalmologists.

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Infectious keratitis outbreak after laser in situ keratomileusis at a single laser center in Japan

Yamaguchi Takefumi, Bissen-Miyajima Hiroko, Hori-Komai Yoshiko, Matsumoto Yukihiro, Ebihara Nobuyuki, Takahashi Hiroshi, Tsubota Kazuo, Shimazaki Jun

Journal of Cataract and Refractive Surgery 37 （ 5 ） 894 - 900 2011年05月

ISSN 0886-3350

Purpose: To evaluate an outbreak of infectious keratitis after laser in situ keratomileusis (LASIK) at a single laser center in Japan. Setting: Tokyo Dental College, Chiba, Japan. Design: Case series. Methods: Relevant demographic and clinical data were obtained from case records using a standardized multicenter questionnaire at 12 major hospitals. The clinical manifestations, management, and outcomes were analyzed. Results: Thirty-nine eyes of 30 patients developed infectious keratitis after LASIK at the specified clinic. Cases of infection continued to appear over a 5-month period. The most common interval between LASIK and the onset of infection was within 2 weeks (36 eyes, 92.3%). Slitlamp manifestation included granular opacity beneath flap (71.8%), multiple infiltration (66.7%), and epithelial defect (30.8%). Mycobacterium was identified as the causative organism in 9 eyes (23.1%). In most cases, topical amikacin, arbekacin, and erythromycin in addition to fourth-generation fluoroquinolones were effective. Flap amputation was necessary in 10 eyes (25.6%) of 10 patients. Decimal visual acuity at initial presentation was worse than 0.10 in 14 eyes (35.9%), 0.15 to 0.50 in 8 eyes (20.5%), and 0.60 to 0.90 in 7 eyes (17.9%) and was better than 1.00 in 10 eyes (25.6%). Final decimal visual acuity was worse than 0.10 in 2 eyes (5.1%), 0.15 to 0.50 in 5 eyes (12.8%), and 0.60 to 0.90 in 11 eyes (28.2%) and was better than 1.00 in 21 eyes (53.8%). Conclusions: Mycobacterium was identified as the causative organism of this outbreak. This study shows the possibility of an epidemic of post-LASIK infectious keratitis. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2011 ASCRS and ESCRS.

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The efficacy, sensitivity, and specificity of strip meniscometry in conjunction with tear function tests in the assessment of tear meniscus

Ibrahim Osama M A, Dogru Murat, Ward Samantha K., Matsumoto Yukihiro, Wakamatsu Tais Hitomi, Ishida Katsushi, Tsuyama Atsushi, Kojima Takashi, Shimazaki Jun, Tsubota Kazuo

Investigative Ophthalmology and Visual Science 52 （ 5 ） 2194 - 2198 2011年04月

ISSN 0146-0404

PURPOSE. To evaluate the specificity and sensitivity of strip meniscometry (SM) testing in conjunction with tear function tests in the diagnosis of dry eye (DE) disease and to investigate the effect of SM on reflex tearing. METHODS. One hundred seven left eyes of 107 patients with definite DE disease according to the Japanese DE diagnostic criteria and 68 left eyes of 68 age- and sex-matched control subjects were studied. Tear meniscus height (TMH) measurements, fluorescein tear film break-up time (FTBUT), fluorescein (F) and rose bengal (RB) staining, and Schirmer's test-1 (ST) were also performed. The assessment of reflex tearing before and after SM application was assessed with a graticule scale at the slit lamp and by optical coherence tomography. The sensitivity and specificity of SM alone and in combination with tear function tests were also sought. RESULTS. The SM scores, TMH measurements, FTBUTs, and STs were significantly lower in dry eye patients than in the controls (P < 0.001). The RB and F staining scores were significantly higher in the dry eye group than in the control group (P < 0.001). The meniscometry strips did not induce significant changes in relation to reflex tearing. SM had an acceptable sensitivity and specificity. CONCLUSIONS. SM is a swift, noninvasive, promising method of assessing tear meniscus volume. The combined SM and FTBUT examination appears to be a sensitive approach to the assessment of dry eye disease. © 2011 The Association for Research in Vision and Ophthalmology, Inc.

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Kato Naoko, Tsubota Kazuo

American Journal of Ophthalmology 151 （ 4 ） 735 - 736 2011年04月

ISSN 0002-9394

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The sparkle of the eye

Goto Eiki, Dogru Murat, Sato Enrique Adan, Matsumoto Yukihiro, Takano Yoji, Tsubota Kazuo

American Journal of Ophthalmology 151 （ 4 ） 691 - 696 2011年04月

ISSN 0002-9394

Purpose: To measure the sparkle of the human eye evaluated by the intensity of corneal light reflection in normal subjects and dry eye patients to investigate whether ocular surface wetness has an impact on the sparkle of the eye. Design Prospective case-control study. Methods We examined a consecutive series of eight dry eye patients with Sjgren syndrome (SS, 15 eyes), as well as eight normal subjects (16 eyes). The specular corneal surface light reflection was quantitatively measured with an ophthalmic slit-lamp microscope and image capturing system under fixed conditions of light source, incident angle, and detector sensitivity. The intensity of images from subjects' corneal light reflection was quantified with image analysis software along with the measurement of grade of self-reported brilliancy of the eye, corneal fluorescein staining score, tear film break-up time, and Schirmer test value. The intensity of corneal light reflection was also compared before and after dry eye treatment. Results The mean intensity of corneal light reflection was significantly lower in dry eye patients (125.0 ± 40.1) than normal subjects (167.6 ± 36.6, P = .004). Grade of self-reported brilliancy of the eye, corneal fluorescein staining scores, tear film break-up time, and Schirmer test values showed good correlation to the intensity of corneal light reflection. After punctal plug treatment, the intensity of corneal light reflection significantly increased from 125.0 ± 40.1 to 167.2 ± 45.0 (P < .0001). Conclusions The intensity of corneal light reflection representing the sparkle of the eye was significantly more intense in normal subjects compared to dry eye patients, and was increased after punctal plug treatment. The intensity of corneal light reflection appeared to correlate well with tear film stability, volume, and ocular surface desiccation. We showed that tears contributed not only to ocular surface wetness but also to the extent of the light reflection from the eye. © 2011 Elsevier Inc. All rights reserved.

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The effects of 2 week senofilcon-A silicone hydrogel contact lens daily wear on tear functions and ocular surface health status

Dogru Murat, Ward Samantha K., Wakamatsu Tais, Ibrahim Osama, Schnider Cristina, Kojima Takashi, Matsumoto Yukihiro, Ogawa Junko, Shimazaki Jun, Tsubota Kazuo

Contact Lens and Anterior Eye 34 （ 2 ） 77 - 82 2011年04月

ISSN 1367-0484

Purpose: To prospectively investigate the effects of 2 week senofilcon A contact lens (CL) daily wear on the functional visual acuity (VA), ocular surface and tear film. Methods: Seventeen right eyes of 17 senofilcon A CL wearers without any ocular or systemic diseases were examined before and 2 weeks after lens wear. Visual acuity measurements, tear evaporation rate, ELISA for tear cytokines, strip meniscometry, tear lipid layer interferometry, tear film break-up time (BUT), in vivo confocal microscopy, corneal sensitivity, ocular surface vital staining, Schirmer I test and brush cytology for MUC5AC mRNA expression were performed before and after CL wear. Results: The best corrected Landolt VA, functional VA parameters, the mean lipid layer interferometry grades, tear evaporation rates, Schirmer test values, vital staining scores and in vivo confocal microscopy parameters did not show any significant differences after 2 weeks of CL wear. The tear film BUT showed a significant decrease together with a significant down regulation of MUC5 AC mRNA expression after CL wear. A statistically significant elevation in the mean tear interleukin (IL)-6 concentration was also observed after 2 weeks of CL wear. Conclusions: Two week senofilcon A daily CL wear seems to be associated with tear instability, a decrease in MUC5AC expression, and elevation of IL-6 in tears without significant alterations in epithelial damage scores or in the morphology or density of in vivo keratoconjunctival cells and nerves. Alterations associated with long term wear and patients with dry eye disease need to be studied in future trials. © 2010 British Contact Lens Association.

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Surgical punctal occlusion with a high heat-energy releasing cautery device for severe dry eye with recurrent punctal plug extrusion

Ohba Emii, Dogru Murat, Hosaka Eri, Yamazaki Asako, Asaga Rie, Tatematsu Yukako, Ogawa Yoko, Tsubota Kazuo, Goto Eiki

American Journal of Ophthalmology 151 （ 3 ） 2011年03月

ISSN 0002-9394

• Purpose: To report the rate of recanalization and the efficacy of punctal occlusion surgery with a high heat-energy-releasing cautery device in patients with severe dry eye disease and recurrent punctal plug extrusion. • Design: Prospective, interventional case series. • Methods: Seventy puncta from 44 eyes of 28 dry eye patients underwent punctal occlusion with thermal cautery. All patients had a history of recurrent punctal plug extrusion. A high heat-energy-releasing thermal cautery device (Optemp II V; Alcon Japan) was used for punctal occlusion surgery. Symptom scores, best-corrected visual acuity, fluorescein staining score, rose bengal staining score, tear film break-up time, and Schirmer test values were compared before and 3 months after the surgery. Rate of punctal recanalization also was examined. • Results: Three months after surgical cauterization, symptom score decreased from 3.9 ± 0.23 to 0.56 ± 0.84 (P < .0001). Logarithm of the minimal angle of resolution best-corrected visual acuity improved from 0.11 ± 0.30 to 0.013 ± 0.22 (P = .003). Fluorescein staining score, rose bengal staining score, tear film break-up time, and the Schirmer test value also improved significantly after the surgery. Only 1 of 70 puncta recanalized after thermal cauterization (1.4%). • Conclusions: Punctal occlusion with the high heat-energy-releasing cautery device not only was associated with a low recanalization rate, but also with improvements in ocular surface wetness and better visual acuity. © 2011 Elsevier Inc.

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Clinical findings in a choroideremia patient who underwent vitrectomy for retinal detachment associated with macular hole

Shinoda Hajime, Koto Takashi, Fujiki Keiko, Murakami Akira, Tsubota Kazuo, Ozawa Yoko

Japanese Journal of Ophthalmology 55 （ 2 ） 169 - 171 2011年03月

ISSN 0021-5155

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The international workshop on meibomian gland dysfunction

Nichols Kelly K., Foulks Gary N., Bron Anthony J., Glasgow Ben J., Dogru Murat, Tsubota Kazuo, Lemp Michael A., Sullivan David A.

Investigative Ophthalmology and Visual Science 52 （ 4 ） 1922 - 1929 2011年03月

ISSN 0146-0404

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The international workshop on meibomian gland dysfunction

Geerling Gerd, Tauber Joseph, Baudouin Christophe, Goto Eiki, Matsumoto Yukihiro, O'Brien Terrence, Rolando Maurizio, Tsubota Kazuo, Nichols Kelly K.

Investigative Ophthalmology and Visual Science 52 （ 4 ） 2050 - 2064 2011年03月

ISSN 0146-0404

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Phakic intraocular lens for keratoconus.

Kato Naoko, Toda Ikuko, Hori-Komai Yoshiko, Sakai Chikako, Arai Hiroyuki, Tsubota Kazuo

Ophthalmology 118 （ 3 ） 2011年03月

ISSN 0161-6420

Comparison of corneal thickness and haze in DSAEK and penetrating keratoplasty

Uchino Yuichi, Shimmura Shigeto, Yamaguchi Takefumi, Kawakita Tetsuya, Matsumoto Yukihiro, Negishi Kazuno, Tsubota Kazuo

Cornea 30 （ 3 ） 287 - 290 2011年03月

ISSN 0277-3740

Purpose: To compare corneal thickness and haze in Descemet stripping automated endothelial keratoplasty (DSAEK) and penetrating keratoplasty (PK). Methods: This study included 30 consecutive patients undergoing DSAEK (18 patients) and PK (12 patients). Central corneal thickness and corneal haze were analyzed longitudinally by Pentacam (Oculus, Wetzlar, Germany) at 2 weeks, 1 month, and 3 months after grafting. Results: The mean age of patients in the DSAEK group was 71.42 ± 9.91 years (range, 55-85 years) and in the PK group was 60.58 ± 16.58 years (range, 31-81 years). Two weeks, 1 month, and 3 months after surgery, the cornea was significantly thicker in the DSAEK group compared with the PK group (P < 0.01). Two weeks, 1 month, and 3 months after the operation, the cornea had significantly more haze in the DSAEK group compared with the PK group (P < 0.05). Haze in the DSAEK group was mainly observed in the subepithelial stroma. Conclusions: DSAEK grafts were significantly thicker with increased haze for up to 3 months after surgery. Scheimpflug system is available for quantifying not only corneal thickness but also corneal haze after various keratoplasty procedures. Copyright © 2011 by Lippincott Williams & Wilkins.

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[Risk factors of severe peripheral corneal ulcers].

Suzuki Azu, Matsumoto Yukihiro, Uchino Yuichi, Kawakita Tetsuya, Shimmura Shigeto, Tsubota Kazuo

Nippon Ganka Gakkai zasshi 115 （ 2 ） 116 - 121 2011年02月

ISSN 0029-0203

To evaluate the risk factors of severe peripheral corneal ulcers. Twenty three eyes of 15 patients (9 eyes of 7 men and 14 eyes of 8 women) with severe peripheral corneal ulcers, who were treated during the past 10 years at Keio University Hospital, were reviewed about the original disease, status of ulcer, treatment, and visual prognosis. Fifteen eyes of 10 patients with Mooren's ulcer, 4 eyes of 3 patients with rheumatoid arthritis, and 4 eyes of 2 patients with Terrien corneal degeneration were included. Mooren's ulcer tends to advance widely. Systemic administration of immunosuppressive and corticosteroidal agents was required in addition to surgical treatment. Visual prognosis was poor in the Mooren's ulcer and perforated cases. Mooren's ulcer and perforated cases are risk factors in peripheral corneal ulcer.

Pharmacotherapy of dry eye

Dogru Murat, Tsubota Kazuo

Expert Opinion on Pharmacotherapy 12 （ 3 ） 325 - 334 2011年02月

ISSN 1465-6566

Introduction: Based on data from the largest studies of dry eye to date-the Women's Health Study (WHS) and the Physicians' Health Study (PHS)-and other studies, it has been estimated that about 3.23 million women and 1.68 million men, for a total of 4.91 million Americans aged ≥ 50 years, have dry eye. Tens of millions more have less severe symptoms and probably a more episodic manifestation of the disease that is notable only during contact with some adverse contributing factor(s), such as low humidity or contact lens wear. Dry eye disease is a common yet frequently under-recognized public health problem whose etiology and management challenge clinicians and researchers involved in this field. Areas covered: Advances in the understanding of the disease have been made over the past 10 years in areas of epidemiology, pathogenesis, clinical manifestation, and possible therapy. Historical aspects and recent information in relation to the use of artificial tear substitutes and anti-inflammatory agents in dry eye disease, including topical cyclosporin and corticosteroids, autologous serum, tetracyclines and systemic immunosuppressants, are covered in this review. The reader will gain insight into the recent views on the pharmacological menu of treatments for dry eyes following the recommendations of the 2007 International Dry Eye Workshop. Expert opinion: Dry eye is a visually disabling disease, the treatment of which needs tailoring according to the type and severity of dry eye disease. © 2011 Informa UK, Ltd.

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Functional visual acuity after neodymium

Wakamatsu Tais Hitomi, Yamaguchi Takefumi, Negishi Kazuno, Kaido Minako, Matsumoto Yukihiro, Ishida Reiko, Kojima Takashi, Ibrahim Osama Mohamed Aly, Saiki Megumi, Dogru Murat, Tsubota Kazuo

Journal of Cataract and Refractive Surgery 37 （ 2 ） 258 - 264 2011年02月

ISSN 0886-3350

Purpose: To evaluate the changes in functional visual acuity before and after neodymium:YAG (Nd:YAG) laser capsulotomy. Setting: Keio University Hospital, Tokyo, Japan. Design: Case series. Methods: Eyes that had previous cataract surgery with a clinical diagnosis of central posterior capsule opacity requiring Nd:YAG laser capsulotomy were evaluated. All patients had refractive error and corrected distance visual acuity (CDVA) measurements; slitlamp microscopy examinations, including posterior capsule opacification evaluation; high-contrast visual acuity measured at 5 m using a Landolt chart; 10% low-contrast visual acuity (LCVA); functional visual acuity; wavefront examination; and a Schirmer test without anesthesia. Results: The study enrolled 9 patients (4 women, 5 men; 10 eyes) with a mean age of 57.3 years ± 7.0 (SD) (range 47 to 68 years). Although there was no significant difference in CDVA before and after Nd:YAG capsulotomy, there was a significant improvement in the mean functional visual acuity, from 0.18 ± 0.11 logMAR (range -0.03 to 0.31 logMAR) to 0.08 ± 0.07 logMAR (range -0.04 to 0.18 logMAR) (P<.05). The LCVA improved significantly after Nd:YAG laser capsulotomy (P=.003). Higher-order aberrations and the root mean square of the 4th-order coefficients decreased significantly after capsulotomy, and these aberrations were significantly correlated with functional visual acuity and LCVA. Conclusion: Results indicate that measurement of functional visual acuity is useful in assessing the quality of vision in patients who have Nd:YAG laser capsulotomy after cataract surgery. Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. © 2011 ASCRS and ESCRS.

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