[The effect of d-timolol on intraocular pressure in the normal subjects].
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Humans↗
Biomedical subjects
Y Kitazawa
Publications and source records attributed to Y Kitazawa.
Retinal damage threshold of ophthalmic Q-switched Nd-YAG laser in monkey eyes.
Q-Switched Nd-YAG laser was irradiated to the ocular fundus of 24 eyes of 12 monkeys (Macaca fascicularis) using MICRORUPTOR II (LASAG AG, Thun, Switzerland) through the Goldmann type three-mirror contact lens. Multimode irradiation conditions were used; the pulse duration of 12 nanoseconds, spot size of 80 micrometers, convergence angle of 16 degrees and with various energy levels from 0.05 to 2.8 mJ. After irradiation, the fundus changes were observed by ophthalmoscopy and color fundus photography at 24 hours, 48 hours, 1, 2 and 5 weeks, and by fluorescein angiography at 24 hours, 1 and 5 weeks. Immediately after the irradiation and at 2 and 5 weeks, eyeballs were enucleated and histological observations were carried out. The fundus changes were more evident at 24 hours than at the immediate period after irradiation. At 24 hours, findings by fundus photography and fluorescein angiography were compared: both findings were in agreement. Consequently the retinal damage threshold was determined from the 24-hour findings; the threshold in ED50 was 296.3 microJ with 95% confidence limits from 249.8 to 351.1 microJ. These values corresponded to the retinal energy density of 3.5 J cm-2. Histological observations revealed that the site of damage was mainly in the retinal pigment epithelium when the irradiation was below 1.4 mJ. When the energy was increased to 1.9 mJ, the tissue damage extended to the middle layer of the neuroretina and also disruption of the Bruch's membrane occurred, leading to subretinal hemorrhage. With the energy of 2.8 mJ, destruction extended over wide areas including whole layers of the choroid and retina, leading to vitreous hemorrhage. Over the period of 5 weeks, proliferation of the retinal pigment epithelial cells took place and replaced the damaged retinal tissues.
Animals↗
[Reliability of optic disc measurement with computerized stereoscopic video image analyzer].
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Data Display↗
Surgical treatment of open-angle glaucoma.
The influence of intraocular pressure (IOP) on the visual field of glaucoma patients is discussed; the criterion level for postoperative IOP control was set at 20 mmHg. When the IOP exceeded this level for two consecutive months, the IOP control was judged to be a failure, and the surgical results were analysed by a life-table method. Argon laser trabeculoplasty (ALT) with 50 shots over 180 degrees of the angle was used routinely, because of fewer complications than with 360 degrees ALT. A second session sometimes improved the final success rate, which was about 57% in primary open-angle glaucoma and 94% in capsular glaucoma after a follow-up period of two years and two months. All patients (120 eyes) required drugs, but their use could be reduced in about 35%. The IOP distribution in successful cases showed a peak at 16 to 17 mmHg, and the IOP was 15 mmHg or less in 21%. In trabeculectomy, pretreatment with topical indomethacin and steroid drip infusion was advocated, and concentrated sodium hyaluronate was used during surgery. These procedures reduced the incidence of shallow anterior chamber and associated choroidal detachment. The final success rate was about 60% after five years of follow-up. The IOP distribution after more than two years peaked at 13 to 15 mmHg, and the IOP was 15 mmHg or less in 53%.
Biomechanical Phenomena↗
Laser therapy for glaucoma.
Three laser techniques for the treatment of glaucoma are described. The short-burn technique of argon laser iridotomy permitted perforation of the peripheral iris in one session without serious complications, thereby alleviating pupillary block in angle-closure glaucoma. The rates of successful intraocular pressure (IOP) control and visual acuity loss due to cataract progression were similar in laser iridotomy and surgical iridectomy. The tonographic outflow facility remained unchanged after argon laser iridotomy. Techniques of argon laser trabeculoplasty (ALT) to the anterior and posterior aspects of the trabecular band were evaluated. The anterior ALT gave fewer complications, but a lower IOP control rate than the posterior ALT. Posterior ALT over 180 degrees with about 50 burns gave fewer complications than treatment over 360 degrees with about 100 burns, yet the final effects in IOP control were better after the 180 degrees than after the 360 degrees treatment. Nd-YAG laser irradiation can separate dysgenetic iris insertion from the trabecular band in developmental glaucoma without serious complications. This Nd-YAG laser goniotomy may be useful for the treatment of juvenile primary developmental glaucoma.
Adolescent↗
Q-switched Nd:YAG laser for developmental glaucoma.
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Adolescent↗
Treatment of primary angle-closure glaucoma by argon laser iridotomy: a long-term follow-up.
Argon laser iridotomy was performed in a total of 140 eyes of 104 patients with primary angle-closure glaucoma. A total of 69 eyes were treated by the long-burn technique and followed for an average period of 2.7 years; 71 eyes were treated by the short-burn technique and followed for an average period of 1.7 years. The effects on the IOP control and various factors of glaucoma were similar between both techniques, and the results of iridotomy were analyzed for all eyes. The IOP was controlled at or lower than 20 mmHg in 29% without medication, in 52% with reduced or the same medication as the preoperative treatments, and in 13% with increased medication. However, in 6% the IOP could not be controlled. The incidence of IOP control by iridotomy alone was significantly higher in eyes with peripheral anterior synechia (PAS) less than half the angle circumference than in eyes with more extensive PAS. Visual acuity loss occurred in 51%, and the loss by more than three lines of the acuity chart was seen in 19%; the visual loss was thought to be due to cataract progression or development. No significant differences were found in the visual field, cup-disk ratio, the extent of PAS or tonographic C-value before and after iridotomy. The IOP control and visual acuity loss were comparable with those seen after surgical iridectomy. Because of the absence of significant complications and ease of performance, iridotomy may replace surgical iridectomy in the treatment of angle-closure glaucoma.
Aged↗
Methods of argon laser trabeculoplasty, complications and long-term follow-up of the results.
Argon laser trabeculoplasty (ALT) was performed on 125 eyes with primary open-angle glaucoma (POAG) and 32 eyes with capsular glaucoma; all eyes were surgical candidates where maximum tolerable medication had failed to control the intraocular pressure (IOP) below 20 mmHg. There were 93 eyes of men and 64 eyes of women, in the age range from 20 to 84 years. Three methods were used: Group 1, 36 eyes treated with about 100 laser shots to the trabecular pigment band over 360 degrees; Group 2, 84 eyes with about 50 shots to the pigment band over 180 degrees; and Group 3, 37 eyes with similar treatment to the anterior part of the trabecular band. The frequency of the initial IOP rise and the maximum postoperative IOP level were in the order of Groups 1, 2 and 3. Other complications, iritis, hemorrhage and peripheral anterior synechiae, were most frequent in Group 1. The success rate of the postoperative IOP control below 20 mmHg with continued medication was analyzed by the life-table method: It was 39 +/- 8% over the period averaging 39 months in Group 1, 66.5 +/- 6% over 17.3 months in Group 2, and 33.7 +/- 15% over 8.1 months in Group 3. The ALT over 180 degrees aimed at the pigment band gave better IOP control with less complications than 360 degrees ALT. The success rate in the eyes of Group 2 was 57 +/- 6% and 94 +/- 6% in POAG and capsular glaucoma, respectively. The IOP distribution after the ALT had a peak at 16-17 mmHg; the IOP was lower than 15 mmHg in about 21% of the eyes. Concurrent IOP measurement and tomography revealed that the IOP reduction after ALT was due largely to a reduction of the outflow resistance in the aqueous outflow channel.
Adult↗
Trabeculectomy: a prospective study of complications and results of long-term follow-up.
A total of 50 trabeculectomies were carried out with pre- and postoperative medications using steroids and indomethacin, and also with the use of sodium hyaluronate during surgery. The postoperative course was followed by the prospective study protocol adopted by Shirato et al and the results were compared with the Shirato series of 145 trabeculectomies where the surgery was performed without the above medications and without the use of sodium hyaluronate. The shallow anterior chamber and choroidal detachment were less frequent, and the complication-free postoperative course was more frequent in the present than in the Shirato series. The state of the intraocular pressure control of the Shirato series was analyzed by the life-table method for the follow-up period of about 5 years. The final success rate in maintaining the intraocular pressure at or below 20 mmHg after the first trabeculectomy was 60.8 +/- 7.2 (SE) % in primary open-angle glaucoma, 64.2 +/- 12.1% in primary angle-closure glaucoma and 31.1 +/- 9.9% in secondary glaucoma. There were several cases where argon laser trabeculoplasty had been carried out before trabeculectomy. The success rate in these cases appeared to be no different from the rate in the rest of the eyes. In primary open-angle glaucoma, the second surgery after failed first trabeculectomy gave a similar success rate as the first surgery, but the third surgery after two failed trabeculectomies gave a very low success rate. The intraocular pressure distribution after one year showed a frequency of visual field deterioration was high in the order of the eyes with the intraocular pressure higher than 20 mmHg, those with 15-20 mmHg and those with lower than 15 mmHg.
Actuarial Analysis↗
Metal contents in epiphytic bryophytes in Kitakyushu area.
Metal contents in epiphytic bryophytes growing at Yahata Nishi-ku, Kitakyushu City and its vicinity were measured. Measurements were made both on the contents in the plant body of a single species Clastobryella kusatsuensis and on those of the whole bryophytic community. Contents of eight elements (Fe, Zn, Mn, Cr, Pb, Ni, Cu and Cd) decrease generally with increase in distance from the center of the industrialized area. No such marked regional difference was seen in the contents of Ca and Mg. The ratios of seven kinds of elements (Fe, Mn, Cr, Pb, Ni, Cu and Cd) in bryophytes almost coincide with those in airborne particulates. It was proved that C. kusatsuensis and communities of bryophytes can be an indicator of air pollution by metals.
Air Pollutants↗
[The technic of argon laser trabeculoplasty and its results].
Argon laser trabeculoplasty (ALT) was performed on 130 eyes with primary open-angle glaucoma or capsular glaucoma. Three different methods of ALT were employed to determine if the methods itself affects the incidence of immediate postoperative rises in intraocular pressure (IOP). Thirty-five eyes received 100 burns over 360 degrees of the posterior trabecular meshwork; these were categorized as Group 1. Group 2 comprised 77 eyes given 50 burns over 180 degrees of the posterior meshwork. Group 3 consisted of 18 eyes treated with 50 burns over 180 degrees of the anterior trabecular meshwork. The duration of each burn was 0.2 s in Group 1 and 0.1 s in Groups 2 and 3. The power of each burn ranged from 700 to 1000 mW in each group. Immediate postlaser IOP rise was defined as a pressure elevation exceeding prelaser value by 5 mmHg or more. In Group 1 the incidence of IOP rise was 82%; it was 58% after the first session in Group 2, but only 22% in Group 3. A sustained, marked pressure rise was most frequently observed in Group 1 as compared with the other two groups. Other complications, including sustained iritis, peripheral anterior synechiae and hyphema, were seen most frequently in Group 1 and least frequently in Group 3. Successful control of IOP, defined as an IOP of less than 20 mmHg, was achieved in 37% in Group 1, 70% in Group 2 and 56% in Group 3. The follow-up period ranged from 1.5 to 52 months.(ABSTRACT TRUNCATED AT 250 WORDS)
Glaucoma, Open-Angle↗
Mesothelioma. Histological and electron microscopic study of human cases.
Four cases of mesothelioma were studied histologically and electron microscopically. One of them showed a pure epithelial type of the peritoneal origin, characterised by a tremendous production of hyaluronic acid. The other three tumors originated from the pleura revealed a histology of biphasic type mesothelioma, which showed an admixed tubular and fibrous pattern and consisted of small-sized cells with slight atypia. However, in some places of these tumors they showed considerable atypical features appearing like an anaplastic or squamoid carcinoma and/or spindle cell sarcoma. Hyaluronic acid was histologically demonstrated in the cytoplasmic vacuoles as well as in the luminal space surrounded by the tumor cells. Electron microscopically, varied numbers of microvilli and desmosome-like attachments were found on the surface of the tumor cells. Mitochondria were small and round. Well-developed rERs tended to encircle mitochondria and to dilate forming cisternae. Various amounts of microfilaments were found in the cytoplasm. The tumor cells which were rich in the latter two components, dilated rERs and microfilaments, resembled fibroblasts. Some tumor cells had phagosomes including dense and fine granules similar to ferritin, suggesting their phagocytotic activity. The hyaline matrix, common to the biphasic type tumor which was largely composed of dense collagenous tissues, was demonstrated to contain hyaluronic acid by histochemistry, and it was suggested that some secretory substances of the tumor cell may participate in composing the hyaline matrix to some extent.
Adult↗
[Half-circumference laser trabeculoplasty].
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Adult↗
Goniotomy with Q-switched Nd-YAG laser in juvenile developmental glaucoma: a preliminary report.
Goniotomy using Nd-YAG laser was carried out in 8 eyes of 6 cases with juvenile primary developmental glaucoma, in one eye with primary congenital glaucoma, in one eye with Axenfeld's anomaly and in one eye with Sturge-Weber syndrome. The chamber angles of these eyes showed various degrees of trabeculodysgenesis, and the laser shots placed anterior to the end of the iris insertion separated the iris tissue from the trabecular band. The angle circumference over 3 to 8.5 hours with an average of 4.8 hours could be treated by one session of the laser treatment in 8 eyes and by two sessions in 3 eyes. In cases with juvenile primary developmental glaucoma, the intraocular pressure (IOP) could be controlled below 20 mmHg with antiglaucomatous medication in 5 eyes by one session and in 2 eyes by two sessions of the laser treatment, but the IOP was not controlled in one eye. In the eye with primary congenital glaucoma aged 41 years and the eye with Sturge-Weber syndrome, the treatment failed to control the IOP. In the eye with Axenfeld's anomaly, the IOP was controlled with reduced medication. The postoperative complications embraced iritis, anterior chamber hemorrhage and IOP rise, but they left no serious consequences. Nd-YAG laser goniotomy may be useful for the treatment of juvenile primary developmental glaucoma.
Adolescent↗
Effects of laser trabeculoplasty on the human aqueous humor dynamics: a fluorophotometric study.
Thirteen eyes, seven with primary open-angle glaucoma and six with capsular glaucoma, were treated with laser trabeculoplasty (a fluorophotometric examination was performed about one week prior to it). The intraocular pressure was reduced below 20 mm Hg in eight eyes, and the second fluorophotometric examination could be carried out in six successfully treated eyes about three months later. In the six successfully treated eyes, the pre-laser trabeculoplasty examination showed the following results: IOP: 22 +/- 2 mm Hg; the cornea-aqueous transfer coefficient for fluorescein: 0.32 +/- 0.10 hour-1; and the aqueous flow rate: 1.31 +/- 0.53 microliter min-1. The post-laser trabeculoplasty examination gave the following results: IOP: 15 +/- 2 mm Hg; the cornea-aqueous transfer coefficient: 0.29 +/- 0.08 hour-1; and the aqueous flow rate: 1.23 +/- 0.41 microliter min-1. No significant difference was found in the aqueous flow rate or the cornea-aqueous transfer coefficient before and after.
Adult↗
Argon laser iridotomy and surgical iridectomy in treatment of primary angle-closure glaucoma.
In an attempt to compare surgical peripheral iridectomy and laser iridotomy with regards to the long-term control of the intraocular pressure (IOP), analyses were carried out of the clinical records of 195 eyes of 149 primary angle-closure glaucoma patients who had undergone either peripheral iridectomy or laser iridotomy and were followed up for at least one year. One hundred and ten eyes underwent peripheral iridectomy and 85 eyes had laser iridotomy. The postoperative IOP not exceeding 20 mmHg was taken as the criterion for success. The iridectomized eyes showed no significant difference from those treated with laser iridotomy in 13 clinical factors, including age at treatment, sex, type of angle-closure glaucoma, preoperative mean IOP with medication, visual field, extent of peripheral anterior synechiae (PAS) and horizontal cup/disk (C/D) ratio. The rate of successful IOP control was obtained in 76.4% of the eyes in the peripheral iridectomy group and in 75.3% of the eyes in the laser iridotomy group. It appears that laser iridotomy is just as effective as surgical iridectomy in normalizing IOP. Discriminant analysis was done to derive a discriminant function consisting of a set of factors that will prognosticate the response of primary angle-closure glaucoma either to surgical iridectomy or to laser iridotomy. Four factors were demonstrated to be significant prognosticators. They were preoperative mean IOP with medication, visual field change, C/D ratio and PAS-index, in order of statistical significance. The discriminant function yielded the discriminant efficacy of 71.2% in overall cases.
Aged↗
Prevalence of diabetes mellitus detected by 75 g GTT in Tokyo.
Oral glucose tolerance test (75 g GTT) was performed on 5,172 subjects who received physical checkups at Daiichi Survey Center from April 1981 to March 1982 and the Prevalence of diabetes in Tokyo was studied using the new diagnostic criteria of WHO (1980). The diabetic test was obtained in 3.6% of the subjects over 30 years old. Diabetic retinopathy was found in 4.3% of the diabetic cases. The prevalence of diabetes increased with fasting blood glucose (FBG) and it was considered to be adequate to set the screening point for diabetes mellitus by FBG at 100 mg/dl. 50 g GTT and 75 g were performed in 10,456 cases and 11,925 cases, respectively, and mean 1-hour and 2-hour values were compared by FBG levels. The results show that 2-hour values in 50 g GTT which correspond those of 120 mg/dl and 180 mg/dl in 75 g GTT may be 105 mg/dl and 150 mg/dl, respectively. However it is not reasonable to make the conversion by adding a certain value, because the differences varies markedly with each case.
Adult↗
Difference of glucose values due to analytical instruments, methods and samples.
This study was carried out to obtain exact blood glucose differences due to samples, analytical methods and instruments. Glucose values obtained with autoanalyzer having deproteinizing system were lower than those obtained by the instrument without deproteinizing system, but the difference was less when the analyzer had no deproteinizing procedure but a dual wave length system. The difference between Hoffman's method and glucose-oxidase method was 10 mg/dl. Plasma glucose values were higher than those of whole blood and the difference varied with glucose values.
Autoanalysis↗