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Yasuo Tano

Publications and source records attributed to Yasuo Tano.

At least 73 records · Page 4Linked to original sources

Wide-angle viewing lens for vitrectomy.

PURPOSE: To report a new wide-angle viewing contact lens for vitrectomy. DESIGN: New surgical instrument. METHODS: The new wide-angle viewing lens is made of glass and polymethyl methacrylate without a plastic rim. The diameter is reduced to 16.2 mm. In addition to a smaller diameter than the currently available lens, the new lens is partially cut to reduce the lens diameter. RESULTS: A smaller diameter makes it possible to eliminate contact between surgical instruments and the wide-angle lens. Instruments can be inserted through sclerotomies without removing the wide-angle lens. The optical properties are otherwise identical to the standard wide-angle lens. CONCLUSION: The new wide-angle viewing lens may be easier to use in vitreous surgery.

Contact Lenses↗

Vitrectomy and internal limiting membrane peeling for myopic foveoschisis.

PURPOSE: Myopic foveoschisis is common in high myopia. We report results of a pilot study of vitrectomy for patients with myopic foveoschisis. DESIGN: Interventional case series. METHODS: In an institutional setting five patients with high myopia (six eyes), and who had progressive visual impairment presumably due to myopic foveoschisis were studied. No eyes had a macular hole preoperatively based on optical coherence tomography (OCT). We performed vitrectomy including vitreous cortex removal, internal limiting membrane (ILM) peeling, and gas tamponade. Patients were followed for at least 6 months. Best-corrected visual acuity (BCVA), OCT. Scanning laser ophthalmoscope (SLO) microperimetry was examined in three eyes. RESULTS: The foveal detachment resolved completely in five eyes and partially in one eye. No serious complications developed including macular hole formation or retinal detachment; BCVA improved more than two lines in all eyes (100%) 6 months postoperatively (P <.01); SLO microperimetry showed smaller scotoma compared with preoperatively and stabilized fixation. CONCLUSIONS: Vitrectomy with vitreous cortex removal, ILM peeling, and gas tamponade could be useful to treat myopic foveoschisis in highly myopic eyes. Because the natural course of the disease is not well-understood, further study should establish indications for this surgery.

Basement Membrane↗

Vitreoretinal surgery with slit-lamp illumination combined with a wide-angle-viewing contact lens.

PURPOSE: To evaluate the feasibility of illuminating the fundus by combining a wide-angle-viewing contact lens and slit lamp attached to a surgical microscope during retinal reattachment surgery and vitrectomy. DESIGN: An interventional study. METHODS: We combined slit-lamp illumination and a wide-angle-viewing contact lens to visualize the fundus during retinal reattachment surgery and vitrectomy. RESULTS: We clearly observed the fundus using this combination approach during conventional retinal reattachment surgery, which we completed without using an indirect ophthalmoscope. With slit-lamp illumination, the wide-angle-viewing contact lens provided a wider area of illumination than a planoconcave contact lens during vitrectomy in addition to an area of illumination as wide as that obtained using a light pipe. CONCLUSIONS: Combining slit-lamp illumination and a wide-angle-viewing contact lens seems to provide a useful alternative method for viewing the fundus during vitreoretinal surgery.

Contact Lenses↗

Retinal changes after macular translocation with 360-degree retinotomy in monkey eyes.

PURPOSE: To determine the morphologic and functional changes of the fovea and retina of monkey eyes after macular translocation with 360-degree retinotomy. DESIGN: Experimental study. METHODS: The retinas of eight monkey eyes were surgically translocated with a 360-degree retinotomy with procedures similar to those used on human eyes. At 1, 2, and 3 months after the surgery, the six eyes that had successful surgery were studied by light and transmission electron microscopy, terminal deoxynucleotidyl transferase (TdT)-dNTP terminal nick-end labeling (TUNEL) assay, and immunohistochemistry with peanut agglutinin (PNA) lectin and glial fibrillary acidic protein (GFAP). Retinal physiology was assessed by scotopic and photopic electroretinograms (ERGs). RESULTS: The fovea was successfully translocated approximately 30 to 40 degrees superiorly in six eyes. The translocated macula and fovea had a normal layered architecture with no TUNEL-positive cells, minimal misalignment of the outer segments, and strong immunoreactivity to GFAP. The mean amplitudes of the scotopic and photopic b-waves were significantly reduced at 1 month after the surgery, and there was only a slight recovery at 3 months. No significant changes were observed in the mean implicit times after the surgery. CONCLUSION: These findings indicate that macular translocation surgery with 360-degree retinotomy results in minimal morphologic alterations but significant depression of electrophysiologic function.

Animals↗

A spectrum of clinical manifestations of gelatinous drop-like corneal dystrophy in japan.

PURPOSE: Typical manifestations of gelatinous drop-like corneal dystrophy (GDLD) have been documented in past studies. In practice, however, we see few typical cases and encounter many with atypical clinical manifestations. Moreover, there have been no detailed reports about the various clinical presentations. The purpose of this study is to describe a clinical subclassification for GDLD. DESIGN: Observational case series. METHODS: A retrospective, observational case series study was conducted at a single institution, Osaka University Hospital. Examined were 18 eyes of ten patients with GDLD with no prior surgery. All were found to have M1S1 mutations. Using slit-lamp examinations we performed a phenotypic classification. RESULTS: We classified GDLD patients into four groups. They included band keratopathy type (seven eyes of four patients), stromal opacity type (five eyes of three patients), kumquat-like type (four eyes of two patients), and typical mulberry type (two eyes of two patients). CONCLUSIONS: Gelatinous drop-like corneal dystrophy is thought to be the result of mutations in M1S1; however, it has various clinical manifestations. To our knowledge, this study is the first to report the range of clinical phenotypes of GDLD in a Japanese population. As most clinicians have no criteria for diagnosing GDLD, many cases are likely to be overlooked or be mistaken for other conditions. We believe that our present classification will be useful for the diagnosis of GDLD.

Adolescent↗

Age-related changes in ocular and corneal aberrations.

PURPOSE: To compare the ocular and corneal higher-order aberrations (HA) in eyes of different ages. DESIGN: Observational cross-sectional study. METHODS: Sixty-six eyes of 66 normal subjects (age range 4-69 years; average 37.4 +/- 15.4 years) were examined. Wavefront aberrations of the whole eye (ocular) and cornea were measured for the central 4 mm using a Hartmann-Shack aberrometer. RESULTS: Ocular Coma-like aberration (r = 0.270, P =.029), Spherical-like aberration (r = 0.531, P =.001), and total HA(r = 0.431, P =.001) were significantly correlated with age, whereas the corneal aberrations were not significantly correlated. The ocular total HA aberrations increased significantly after age 50 years. CONCLUSIONS: After 50 years of age, ocular aberrations increased abruptly due to the increase of lenticular HA. Customized ablation should be carefully considered, especially in eyes of presbyopic age.

Adolescent↗

Macular translocation with chorioscleral outfolding: 2-year results.

PURPOSE: To evaluate the results of macular translocation with radial chorioscleral outfolding in patients with subfoveal choroidal neovascularization (CNV) and to identify factors associated with decreased postoperative visual acuity. DESIGN: Retrospective interventional case series. METHODS: Twenty-seven consecutive patients with surgically treated subfoveal CNV were operated on and followed for more than 2 years. Macular translocation with radial chorioscleral outfolding was performed using titanium clips. Surgical outcomes including visual acuity, foveal displacement, surgically induced astigmatism, and complications were recorded. Factors associated with decreased visual acuity postoperatively were identified by multiple logistic regression analysis. RESULTS: Foveal displacement ranged from 349 to 3391 (median, 1576) microm. Surgically induced astigmatism ranged from 0 to 3.0 (median, 0.5) diopters. Visual acuity after surgery improved in 19 of the 27 patients (70.4%; median, 5 lines), but in 14, final vision ultimately decreased from the best postoperative level. Final visual acuity improved from the preoperative level in 11 patients (40.7%), remained unchanged in seven (25.9%), and decreased in nine (33.3%). In our series, the mean preoperative vision was 20/174, the best postoperative visual acuity was 20/74, and the mean final vision was 20/167. Factors associated with a decrease in postoperative visual acuity included the postoperative enlargement of CNV. CONCLUSION: Macular translocation with radial chorioscleral outfolding improved or stabilized the vision in 66.7% of patients with subfoveal CNV over the course of more than 2 years. Closing the CNV or preventing its further growth is required to maintain a better postoperative visual acuity.

Adult↗

Posterior vitreous detachment and macular hole formation in myopic foveoschisis.

PURPOSE: To report two cases of macular hole (MH) associated with myopic foveoschisis (MF). DESIGN: Interventional case report. METHODS: Two women presented with metamorphopsia. Preoperative optical coherence tomography (OCT) showed an MH and MF. We performed vitrectomy, internal limiting membrane (ILM) peeling and gas tamponade. RESULTS: Preoperative OCT examination and intraoperative microscopic observation revealed partial posterior vitreous detachment (PVD) at the posterior retina and vitreous strands adhering to the edge of the MHs. The MF resolved in both patients, but the MHs remained open postoperatively. CONCLUSIONS: Although the contribution of tangential traction cannot be excluded, the mechanism of MH formation in eyes with MF may be anteroposterior traction via abnormal vitreofoveal adhesion resulting from partial PVD.

Aged↗

Light scattering and optical aberrations as objective parameters to predict visual deterioration in eyes with cataracts.

PURPOSE: To predict the visual deterioration of eyes with cortical (CC) or nuclear (NC) cataract from objective data on ocular higher-order aberration (HOA) and forward (FLS) and backward light scattering (BLS). SETTING: Osaka University Medical School, Osaka, Japan. METHODS: Twenty-two eyes with mild NC, 41 eyes with mild CC, and 11 normal eyes were examined. Higher-order aberrations were calculated with the Zernike polynomials up to the fourth order from the values obtained by wavefront analysis using the Hartmann-Shack aberrometer. Forward light scattering was calculated from the size of the aberrometer spot images for the central 4 mm, and backward light scattering (BLS) was calculated from the optical density of the Scheimpflug images. The relationship between the area under the log contrast sensitivity function (AULCSF) curve and HOAs, FLS, and BLS was examined. RESULTS: Area under the log contrast sensitivity function was moderately correlated with the HOAs, FLS, and BLS. Multiple linear regression analysis revealed that the AULCSF was predicted by the linear combination of these variables (R(2)=.484, P<.001). Area under the log contrast sensitivity was predicted by BLS and HOA (R(2)=.555) in the NC group and by FLS and HOAs (R(2)=.540) in the CC group. CONCLUSIONS: Loss of contrast sensitivity was predominantly due to BLS and HOA in eyes with NC and FLS and HOA in eyes with CC. Higher-order aberrations, FLS, and BLS, variables that are obtained objectively, can be used to predict quantitatively the visual deterioration in cataractous eyes.

Adult↗

Novel mutations in the arrestin gene and associated clinical features in Japanese patients with Oguchi's disease.

PURPOSE: Only 2 mutations in the arrestin gene have been previously reported to be associated with Oguchi's disease, a homozygous Asn309(1-bp del) mutation in Japanese families and a homozygous Arg193stop mutation in an Indian family. The aim of this article is to report 2 novel mutations in the arrestin gene in 2 Japanese patients with Oguchi's disease and to describe the clinical features with the mutations. DESIGN: Molecular genetic study and observational case report. PARTICIPANTS: Two unrelated Japanese patients with Oguchi's disease associated with novel arrestin mutations. METHODS: Genomic DNA was extracted from leukocytes of the peripheral blood, and exons 2 through 16 of the arrestin gene were amplified by polymerase chain reaction and directly sequenced. A complete ophthalmologic examination was performed, including best-corrected visual acuity, slit-lamp and fundus examinations, fundus photography, and electroretinography (ERG). MAIN OUTCOME MEASURES: Direct sequencing of the arrestin gene, evaluation of visual acuity, refraction, and ERG. RESULTS: Three arrestin gene mutations were identified in 2 patients. A compound heterozygous mutation, Arg175stop and Asn309(1-bp del), was identified in 1 patient with Oguchi's disease. The former mutation has not been reported, whereas the latter is known to be a frequent mutation in Oguchi's disease in Japanese families. In a second patient, another novel mutation was detected in the gene, a homozygous Arg292stop mutation. Both patients demonstrated characteristic features of Oguchi's disease, including night blindness, golden-yellow discoloration of the retina, absent rod ERG response, and "negative" type bright-flash ERG after 30 minutes of dark adaptation. CONCLUSIONS: The existence of 2 novel mutations of the arrestin gene in 2 unrelated Japanese patients strongly supports the previous data that arrestin gene mutations are associated with Oguchi's disease. All of the mutations in the arrestin gene that have been identified in Oguchi's disease are null mutations, indicating that only critical gene defects in the arrestin gene are associated with Oguchi's disease.

Adult↗

Wavefront analysis of an eye with monocular triplopia and nuclear cataract.

PURPOSE: To determine whether higher-order aberrations explain patient-reported monocular triplopia. DESIGN: Observational case report. METHOD: A patient complaining of monocular triplopia was examined with a Hartmann-Shack aberrometer to determine whether higher-order wavefront aberrations could account for the triplopia. The patient had a mild nuclear cataract; measurements were made before and after lensectomy. The retinal image was simulated using the Zernike polynomials. RESULT: Spherical aberration (-0.18 microm, 4 mm pupil) and trefoil aberration (-0.16 microm) were increased. The simulated retinal image had a triple configuration similar to the subjective image reported by the patient. After cataract surgery, the subjective triplopia disappeared; spherical, and trefoil aberrations were markedly decreased. CONCLUSION: The monocular triplopia probably stemmed from combined effects of spherical and trefoil aberrations caused by the nuclear cataract.

Adult↗

Macular translocation surgery and retinal circulation times.

PURPOSE: To quantify and compare the retinal circulation times before and after macular translocation surgery. METHODS: In nine patients undergoing macular translocation with 360-degree retinotomy, arm-retina and arteriovenous passage times were quantified from preoperative and postoperative scanning laser fluorescein angiograms. A control group of eight patients who had not undergone any intraocular surgery was also evaluated. The time that between injection into the antecubital vein and the appearance of fluorescein at two selected points on superotemporal and inferotemporal arteries near the disk provided the arm-retina time. For the arteriovenous passage time, 50% of the maximal fluorescence time difference was assessed from the intensity curves of arteries and corresponding veins at the same points for the arm-retina time. Postoperative measurements were obtained an average of 10.6 months after surgery. RESULTS: No significant difference was noted between preoperative and postoperative values of the arm-retina time (mean +/- SD: 14.41 +/- 2.73 seconds versus 14.67 +/- 3.85 seconds, respectively; P = 0.84) or that of the arteriovenous passage time (2.66 +/- 0.74 seconds versus 2.47 +/- 0.68 seconds, respectively; P = 0.37) in the study group. The arm-retina time (14.96 +/- 2.01 seconds) and arteriovenous passage time (2.44 +/- 0.68 seconds) in the control group did not differ from preoperative and postoperative arm-retina times (P = 0.65 and P = 0.85) and arteriovenous passage times (P = 0.54 and P = 0.93) in the study group. The arteriovenous passage time correlated with the degree of retinal rotation around the optic disk in the study group (r = -0.70; P = 0.04). CONCLUSION: Macular translocation surgery does not alter retinal macrocirculation in the long term.

Aged↗

Evaluation of choroidal perfusion of the new central macular area by dilution analysis of indocyanine green angiography after macular translocation.

PURPOSE: To evaluate the possible long-term alterations of choroidal perfusion parameters in the new central macular area after macular translocation surgery. METHODS: Eleven subjects with subfoveal neovascular membrane secondary to age-related macular degeneration or degenerative myopia underwent indocyanine green angiography by using a scanning laser ophthalmoscope before and after macular translocation (mean, 10 months after surgery). Fluorescence intensity of the new central macular area over time was evaluated. Parameters derived from the intensity curves included 10% filling time, ascending slope, and maximal intensity of brightness. The 10% filling time reflects the rapidity of the early choroidal filling phase, whereas the slope of the filling of the curve shows the speed of blood entrance into the choroid. Maximal intensity of brightness indicates vascular density of the area. RESULTS: No statistical difference was encountered before or after macular translocation in 10% filling time (14.25 +/- 2.09 seconds versus 16.20 +/- 2.95 seconds), slope of the ascending portion of the curve (0.12 +/- 0.04 versus 0.11 +/- 0.04), and maximal intensity of brightness (0.89 +/- 0.09 versus 0.88 +/- 0.07) in the new central macular area. The rotational degree of the retina against the retinal pigment epithelium did not show any significant correlation with 10% filling time, slope, or maximal intensity of brightness. CONCLUSION: Choroidal perfusion parameters in the new foveal region do not change after macular translocation surgery.

Aged↗

Nonaxoplasmic transfer of indocyanine green into the optic nerve after intravitreal application.

PURPOSE: To investigate whether indocyanine green (ICG) migrates into the optic nerve after intravitreal application in the rabbit eye. METHODS: Gas vitrectomy was performed in one eye of adult Dutch belted rabbits by pars plana injection of 0.4 ml of 100% C3F8 (n = 10). One week later, vitrectomy was performed and 0.2 ml of 0.25% ICG was instilled into the vitreous cavity of these vitrectomized eyes. After 30 seconds of ICG application, the vitreous cavity was rinsed with balanced salt solution plus. Unoperated rabbits served as controls (n = 2). Globes, optic nerves, and the entire brain were removed, and ICG fluorescence of the specimens was examined with a digital fundus camera starting from the first day to the fourth postoperative week. Other rabbit eyes (n = 2) were injected with ICG directly into the vitreous without vitrectomy, and assessed for ICG signal after 1 day of ICG application. In the second part of the experiment, four rabbit eyes were gas vitrectomized and ICG was instilled onto retina after blockage of axonal flow by vinblastine. They were evaluated on the first (n = 2) and seventh postoperative days (n = 2). RESULTS: No fluorescein was detected in the visual pathways and the brains of the control group of rabbits. The optic nerves of the ICG-instilled eyes were stained diffusely with ICG starting from the first day after surgery. ICG injected nonvitrectomized eyes showed similar ICG staining patterns when compared with vitrectomized eyes. ICG staining pattern of the optic nerve did not differ in vinblastine-pretreated eyes. Fluorescence extended along the intraorbital portion of the optic nerve but did not transport more posteriorly in all animals. At the fourth week after vitrectomy, ICG signal was still detectable, but staining was less intense. CONCLUSION: Intravitreal ICG injection results in nonaxoplasmic extension into the optic nerve in the rabbit.

Animals↗

Foveal sensitivity and fixation stability before and after macular translocation with 360-degree retinotomy.

PURPOSE: To evaluate the functional changes of the fovea by scanning laser ophthalmoscopy (SLO) fundus perimetry after macular translocation with 360-degree retinotomy, and to determine whether the preoperative macular function estimated by the sensitivity of the fovea and the stability of fixation can predict visual acuity after the surgery. METHODS: Macular translocation with 360-degree retinotomy and simultaneous torsional muscle surgery were performed on 25 eyes of 25 patients with choroidal neovascularization. The index of foveal sensitivity (Isens) and the index of fixation stability (Ifix) before and after surgery were calculated from the microperimetric data. The preoperative Isens and Ifix were compared with postoperative Isens and Ifix, respectively. The correlations of preoperative Isens and Ifix with the visual acuity after the translocation surgery (VApost) were calculated. RESULTS: Isens increased in 14 (56%) of 25 eyes. Ifix improved in 10 (40%) of 25 eyes. The preoperative Isens and VApost were moderately correlated (r = 0.434, P = 0.0295), while the preoperative Ifix and VApost were highly correlated (r = - 0.530, P = 0.0057). CONCLUSION: An increase in foveal sensitivity and an improvement in the fixation stability were demonstrated quantitatively by microperimetry. The preoperative foveal sensitivity and fixation stability were correlated with the postoperative visual acuity. Microperimetry using SLO can be used to investigate foveal function before and after the translocation and to predict the postoperative visual acuity.

Aged↗

Involvement of rho-kinase pathway in contractile activity of rabbit RPE cells in vivo and in vitro.

PURPOSE: Increased alpha-smooth muscle actin (alpha-SMA) expression in epiretinal membranes causes tractional retinal detachment (TRD) in proliferative vitreoretinopathy (PVR). The Rho-A/Rho-associated kinase signaling pathway is a principal mediator of contractile force generation in nonmuscle cells. In the current study, the relation between the Rho-kinase pathway and alpha-SMA expression and type I collagen gel contractile activity in retinal pigment epithelial (RPE) cells was investigated, using Y27632, a specific inhibitor of p160ROCK, and the involvement of the Rho-kinase pathway was evaluated in a rabbit PVR model with cultured RPE cells and platelet-rich plasma (PRP). METHODS: RPE cells were obtained from rabbits and cultured. The number of passages and the effect of Y27632 on alpha-SMA expression were studied by immunohistochemistry and immunoblot analysis. An in vitro type I collagen gel contraction assay and MTT assay evaluated the effect of Y27632 on RPE cell contractile force and proliferation. Cultured sixth-passage rabbit RPE cells were coinjected with PRP intravitreally, followed by 50 micro M of Y27632, injected weekly. The presence of TRD was assessed until 28 days to evaluate the effect of Y27632 in vivo. RESULTS: Expression of alpha-SMA was increased according to the passages. Y27632 suppressed alpha-SMA expression in cultured RPE cells and impaired contractile force. Y27632 did not affect the proliferative potential. Y27632 significantly (P < 0.01) reduced TRD development. CONCLUSIONS: Y27632 decreased alpha-SMA expression and the contractile force generated by RPE cells and attenuated PVR, indicating the involvement of the Rho-kinase pathway in cell-dependent collagen contraction in vitro and in vivo. The drug may affect the biological event by inhibiting alpha-SMA expression, and Y27632 could be useful for preventing PVR.

Actins↗

Electrophysiological studies of the feasibility of suprachoroidal-transretinal stimulation for artificial vision in normal and RCS rats.

PURPOSE: Assessment of a novel method of retinal stimulation, known as suprachoroidal-transretinal stimulation (STS), which was designed to minimize insult to the retina by implantation of stimulating electrodes for artificial vision. METHODS: In 17 normal hooded rats and 12 Royal College of Surgeons (RCS) rats, a small area of the retina was focally stimulated with electric currents through an anode placed on the fenestrated sclera and a cathode inserted into the vitreous chamber. Evoked potentials (EPs) in response to STS were recorded from the surface of the superior colliculus (SC) with a silver-ball electrode, and their physiological properties and localization were studied. RESULTS: In both normal and RCS rats, STS elicited triphasic EPs that were vastly diminished by changing polarity of stimulating electrodes and abolished by transecting the optic nerve. The threshold intensity (C) of the EP response to STS was approximately 7.2 +/- 2.8 nC in normal and 12.9 +/- 7.7 nC in RCS rats. The responses to minimal STS were localized in an area on the SC surface measuring 0.12 +/- 0.07 mm(2) in normal rats and 0.24 +/- 0.12 mm(2) in RCS rats. The responsive area corresponded retinotopically to the retinal region immediately beneath the anodic stimulating electrode. CONCLUSIONS: STS is less invasive in the retina than stimulation through epiretinal or subretinal implants. STS can generate focal excitation in retinal ganglion cells in normal animals and in those with degenerated photoreceptors, which suggests that this method of retinal stimulation is suitable for artificial vision.

Animals↗

[The effect of substituting latanoprost 0.005% for unoprostone 0.12%].

PURPOSE: To evaluate the effect of substituting latanoprost(LAT) 0.005% for unoprostone(UNO) 0.12% after a trial of unilateral treatment. METHODS: We treated 30 patients with primary open-angle glaucoma(n = 8), ocular hypertension (n = 1), or normal-tension glaucoma(n = 21) with UNO for 4 weeks in one eye and then substituted LAT for UNO. Four weeks later we measured the intraocular pressure(IOP) in the ipsilateral eye. RESULTS: The mean baseline IOP level was 18.6 +/- 3.8(mean +/- standard deviation) mmHg. The mean IOP levels(reduction rates) after UNO and LAT therapy were 16.7 +/- 3.1 mmHg (16.6%) and 14.1 +/- 3.2 mmHg (28.9%), respectively(p < 0.001). All patients who responded to UNO also responded to LAT; however, 55% of those who did not respond to UNO responded to LAT. CONCLUSIONS: If LAT is substituted for UNO, it can be predicted that 63.3% of the patients will respond.

Adult↗