{"title":"Multimodal Imaging of a Case of Acute Annular Outer Retinopathy.","authors":"Tetsuju Sekiryu, Hiroaki Shintake, Akihito Kasai, Akira Ojima","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background: Acute annular retinopathy (AAOR) is a rare entity showing grayish spots with annular lesions. We report the clinical characteristics of a patient with AAOR derived by using multimodal imaging including spectral-domain optical coherence tomography (OCT), fundus autofluorescence (FAF), and an adaptive optics fundus camera.\u0000Case: A 56-year-old man who had fever one month and a half before presenting. He noticed bilateral visual loss after lowering of fever.\u0000Clinical findings: Grayish white rings of different sizes were seen in the posterior fundus. Margin of the lesion showed hyperautofluorescence. OCT demonstrated an indistinct ellipsoid zone, disruption of external limiting membrane, and bulging of the retinal pigment epithelium in the annular lesions. We found hyperreflective foci in the inner retina and an indistinct interdigitation zone on the OCT images and indistinct cone mosaic patterns on the AO images at an ophthalmoscopically normal fovea in the left eye.\u0000Conclusion: Multimodal imaging showed the damage in the photoreceptors and the retinal pigment epithelium at the annular lesions. OCT and AO imaging can demonstrate abnormal findings in ophthalmoscopically normal areas in eyes with AAOR.</p>","PeriodicalId":19670,"journal":{"name":"Nippon Ganka Gakkai zasshi","volume":"120 12","pages":"837-45"},"PeriodicalIF":0.0,"publicationDate":"2016-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36373484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Histamime Receptor H4 as a New Therapeutic Target for Age-related Macular Degeneration.","authors":"Hiroki Kaneko","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Histamine receptor H4 (HRH4) is one of four known histamine receptors, among which H1 receptor is primarily involved in typeI allergic reactions and H2 receptor is generally recognized for its role in gastric acid secretion. Compared with H1 and H2, HRH4 has unique characteristics; it is expressed in neurons and vascular endothelial cells, and is reported to be deeply involved in inflammation. Therefore, we investigated whether HRH4 is expressed in choroidal neovascularization(CNV), the main cause of age-related macular degeneration, and further examined whether HRH4-targeted treatment is effective in suppressing CNV.\u0000It was determined that HRH4 was expressed in human and mouse CNV, but not in the normal state of mouse retina, retinal pigment epithelium, or choroid. Laser-induced CNV in Hrh4-deficient mice was significantly smaller compared with that in wild-type mice. Immunohistochemistry showed co-positivity of the macrophage marker F4/80 with HRH4-positive cells in laser-induced CNV. Intravitreal administration of an HRH4 antagonist reduced laser-induced CNV in wild-type mice. In addition, oral administration of an HRH4 antagonist also reduced laser-induced CNV. HRH4 antagonists had no effect on tube formation in human retinal vascular endothelial cells. We also examined retinal toxicity after HRH4 antagonist administration; no retinal degeneration was observed even when a large amount of HRH4 antagonist was injected into the mouse eyes, which was confirmed using fundus imaging, retinal histology, and electroretinography. In conclusion, HRH4 antagonist is believed to be a possible therapeutic agent that reduces CNV without causing retinal toxicity.</p>","PeriodicalId":19670,"journal":{"name":"Nippon Ganka Gakkai zasshi","volume":"120 11","pages":"747-53"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36369422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Correlation between Lamina Cribrosa Tilt, Myopia and Glaucoma Using Optical Coherence Tomography with a Wide Band Femtosecond Mode-locked Laser.","authors":"Takuhei Shoji","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Morphological features of the lamina cribrosa (LC) and optic disc may play an important role in the pathogenesis and progression of glaucoma. Optical coherence tomography (OCT) is a non-invasive optical imaging modality that allows real-time structural imaging of the fundus. We developed an OCT system using an ultra-broadband Kerr lens mode-locked Ti: Sapphire laser and a wideband spectrometer. The depth resolution into the tissue was measured as less than 2.0 μm. Advances in OCT technology have enabled detailed examinations of the deep optic nerve head (ONH), including LC. When measuring LC tilting to conduct a clinical evaluation of ONH, the termination point of Bruch's membrane, Bruch's membrane opening (BMO) is used as a reference point. The vertical and horizontal angles between BMO line and approximately the best-fitting line for the surface of the LC were measured and potential associated factors were estimated. The horizontal internal LC tilt angle was correlated with refractive errors, corresponding to myopic physiological changes, and vertical internal LC tilt was correlated with glaucoma, corresponding to glaucomatous pathological changes. These parameters have important implications for investigating the correlation between myopia, glaucoma and LC morphological features.</p>","PeriodicalId":19670,"journal":{"name":"Nippon Ganka Gakkai zasshi","volume":"120 11","pages":"764-71"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36367429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Periorbital Pilomatrixoma: a Report of a Case Difficult to Diagnose.","authors":"Yumi Okuyama, Kozue Kasai, Jun Shimazaki","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background: Pilomatrixoma is a benign tumor that arises from matrix cells of hair follicles. In ophthalmology, pilomatrixoma is relatively rare, yet there are reports on eyelid pilomatrixomas that were visible and/or palpable. Our case is the first report on pilomatrixoma that was found as a subconjunctival lesion and neither readily visible or palpable.\u0000Case: A 32-year-old woman presented with a chief complaint of conjunctival hyperemia of the left eye with sensation of foreign body. A previous doctor suspected allergic conjunctivitis, but the prescribed antihistamine treatment had failed. Physical exam revealed hyperemia localized to the left temporal bulbar conjunctiva, as well as a 5 mm-diameter hard mass located underneath the lateral palpebral conjunctiva. With a suspicion of inflammatory reaction to a foreign body, enucleation of the mass was performed by opening and detaching the conjunctiva using surgical scissors.\u0000Findings: The mass was hard, spherical and 5 mm×10 mm in size without adhesions. The pathology revealed hair follicles, basophilic cells, as well as shadow/ghost cells, which led to the definitive diagnosis of pilomatrixoma.\u0000Conclusion: Pilomatrixoma is a benign tumor that arises from matrix cells of hair follicles. This case shows that pilomatrixoma from lateral canthus can extend underneath the conjunctiva.</p>","PeriodicalId":19670,"journal":{"name":"Nippon Ganka Gakkai zasshi","volume":"120 11","pages":"791-6"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36367434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Two Cases of Conjunctival Amyloidosis Found as Ptosis.","authors":"Rei Arai, Nobuyuki Ebihara, Shigeki Tomita","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Background: Amyloidosis is a spectrum of disorders characterized by the deposition of amyloid that causes severe damage to many organ systems. However, conjunctival amyloidosis is thought to be the manifestation of a local immunologic disorder and rarely affects the organ systems. We present two cases of conjunctival amyloidosis found as unilateral ptosis at initial visit.\u0000Case 1: 43-year-old-woman presented with unilateral ptosis and discomfort for the left eye. She had been treated with topical antihistamines and corticosteroids for allergic conjunctivitis. However, as symptoms persisted she was referred to us. At initial visit, unilateral ptosis, subconjunctival hemorrhage and waxy-yellow mass were found. Incisional biopsy was performed and histpathological examination revealed amyloid in the conjunctival stroma.\u0000Case 2: 31-year-old woman presented with unilateral ptosis and discomfort of palpebral superior conjunctiva in the left eye. At initial visit, the examination of the left superior palpebral conjunctiva showed waxy-yellow mass and hemorrhage. Incisional biopsy was performed and histopathological examination revealed amyloid in the conjunctival stroma.\u0000Conclusion: Unilateral ptosis may be an indication of conjunctival amyloidosis.</p>","PeriodicalId":19670,"journal":{"name":"Nippon Ganka Gakkai zasshi","volume":"120 11","pages":"797-801"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36367435","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inhibition of Renin-Angiotensin System Prevents Neurodegeneration in a Mouse Model of Normal Tension Glaucoma.","authors":"Kentaro Semba","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Glaucoma is the leading cause of blindness in Japan, and an alternative treatment to lowering intraocular pressure (IOP) is required to manage this disease. We found that expressions of angiotensin II type 1 receptor (AT1-R) and Toll-like receptor 4 (TLR4) were increased in retinal ganglion cells (RGCs) and retinal Müller glia in normal tension glaucoma (NTG) model mouse. The orally active AT1-R antagonist candesartan suppressed TLR4 and lipopolysaccharide (LPS)-induced inducible nitric oxide synthase (iNOS) expressions, especially in retinal Müller glia. Treatment with candesartan was effective for RGC protection without affecting IOP. These results suggest that the renin-angiotensin system is involved in the innate immune responses in both neural and glial cells, and AT1-R antagonist may exert IOP-independent neuroprotective effects.</p>","PeriodicalId":19670,"journal":{"name":"Nippon Ganka Gakkai zasshi","volume":"120 11","pages":"772-82"},"PeriodicalIF":0.0,"publicationDate":"2016-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36367431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}