Community-Based Trial Educational Heat Disorder Program in Local Salons for Older Adults.

We investigated whether a combined program for heat disorder prevention can improve the behaviors and knowledge of heat disorder prevention in older adults participating in salons. This non-randomized parallel-group comparison study includes 59 participants from two salons. The intervention group met on alternate weeks on a salon day to watch an educational DVD and conduct hands-on education (Wet-Bulb Globe Temperature (WBGT) measurements inside and outside the meeting place). The intervention group conducted calls every other week except salon week to prevent action for heat disorder prevention information based on a leaflet and monitored WBGT in their bedrooms daily at bedtime. We assessed changes in recognition of heat disorders and prevention behavior between baseline, one and a half months after intervention, and post-season (approximately two months after baseline), using the Wilcoxon signed rank test. Recognition of heat disorder scores and preventive behavior improved from pre- to post-season in the intervention group. It was suggested that the approach toward older adults participating in salons could improve their recognition and behavior in preventing heat disorders.

[Quantification of metamorphopsia in the course of branch retinal vein occlusion with M-CHARTS].

PURPOSE: To evaluate visual function disorder in patients with branch retinal vein occlusion by quantifying the degree of metamorphopsia. DESIGN: prospective interventional case series. SUBJECTS AND METHODS: The subjects were 12 patients(12 eyes) whose fovea was involved with branch retinal vein occlusion within a month after noticing their symptoms. The best-corrected visual acuity, and vertical and horizontal metamorphopsia scores were obtained within one month, and at 3 months and 6 months after the onset of symptoms regardless of therapy. The metamorphopsia scores were measured with M-CHARTS. RESULTS: Although the average best-corrected visual acuity at 6 months was significantly better than that within a month of noticing symptoms, the average metamorphopsia scores did not improve after 6 months, and were not related to the average best-corrected visual acuity in either vertical or horizontal lines. CONCLUSIONS: The degree of metamorphopsia measured with M-CHARTS is an important parameter in addition to the best-corrected visual acuity for evaluating visual function in patients with branch retinal vein occlusion.

[Transient increased retinal hemorrhage and the retinal venous blood flow change in the course of non-ischemic central retinal vein occlusion treated with an anticoagulant].

PURPOSE: To investigate transient increased retinal hemorrhage during anticoagulant therapy and changes in the retinal venous blood flow in the course of non-ischemic central retinal vein occlusion (CRVO). METHODS: Seventeen patients(eighteen eyes) with non-ischemic CRVO were studied. The retinal vein diameter, blood velocity, and blood flow were determined by the laser Doppler method in seven patients. RESULTS: The retinal hemorrhage increased in nine eyes (50%); however, the retinal hemorrhage was transient and it finally decreased without vision loss in seven of the eyes. The retinal hemorrhage increased in the other two eyes and they became ischemic. The vessel diameter decreased and both velocity and blood flow increased in six of the seven patients two weeks after the treatment. There was no significant change in blood flow in cases which showed a transient increase in retinal hemorrhage, and they did not show a decrease in vision; however, only one eye which became ischemic showed a decrease in blood flow. CONCLUSION: We can judge whether an increase in retinal hemorrhage is transient or the clinical condition is getting worse in an early stage by measuring the retinal vein blood flow quantitatively by laser Doppler flowmetry.

[Clinical course and macular retinal circulation of macular retinal epithelium atrophy].

PURPOSE: To investigate the clinical course of age-related maculopathy that mainly consists of retinal pigment epithelial abnormality and macular retinal circulation between the affected eye and the fellow normal eye. PATIENTS AND METHODS: Seventeen patients (19 eyes) with age-related maculopathy were followed for more than two years. We investigated visual acuity, ocular fundus appearance, and fundus angiographic findings. We studied macular retinal leukocyte blood flow measured by blue field simulation in 19 patients whose fellow eye was normal. RESULTS: Age-related maculopathy in 18 eyes (95%) showed no change and choroidal neovasculation did not occur during the observation period. Male patients (88%) were more affected than female patients (12%). The visual acuity in the 18 eyes (95%) did not change. Only one case lost two lines of visual acuity, and the area of macular degeneration increased. Macular retinal leukocyte circulation expressed by the leukocyte density, and leukocyte density multiplied by the leukocyte velocity in the affected eyes deteriorated compared to the normal fellow eyes. CONCLUSION: We demonstrated that progression of age-related maculopathy is very slow, and macular retinal leukocyte circulation measured by blue field simulation may be disturbed in age-related maculopathy.

[Long-term enlargement of laser photocoagulation scars after treatment of choroidal neovascularization].

PURPOSE: To investigate long-term enlargement of laser photocoagulation scars after treatment of choroidal new vessels (CNV) in age-related macular degeneration or myopic neovascular maculopathy. OBJECTS AND METHOD: Twenty-four eyes of 24 patients aged between 45 and 77 years were treated with laser photocoagulation for juxtafoveal or extrafoveal choroidal neovascularization in Yodogawa Christian Hospital. There was no recurrence in any of the eyes and the mean follow-up period was 31.0 +/- 13.7 (mean +/- standard deviation) months (13-60 months). The laser photocoagulation scar was measured with an image analyzer immediately and once a year after the treatment. We investigated the relationship between scar expansion rate and visual axis measured by A-mode ultrasonography. RESULTS: Expansion of the coagulation scars (atrophic creep) was observed in 19 eyes (79.2%). The coagulation scar expanded with the length of the period after treatment in most of the patients. The expansion rate was significantly correlated with the length of the eye at two years after treatment in all 24 eyes and even in 21 of the eyes without high myopia (p < 0.05). A decrease in visual acuity was observed in only one eye (4.2%). Remarkable pigmentation around the scar was found in three eyes of five that did not have atrophic creep. CONCLUSION: Although atrophic creep occurs in approximately 80% of eyes after successful laser treatment, visual acuity deterioration is rarely encountered. The rate of expansion is significantly correlated with the axial length among the eyes both with and without high myopia. Heavy pigmentation around scars may be one sign which indicates a low expansion rate of atrophic creep.

Change in retinal arterial blood flow in the contralateral eye of retinal vein occlusion during glucose tolerance test.

PURPOSE: To investigate the changes in retinal blood flow (RBF) during a 75-g oral glucose tolerance test in the contralateral eye of patients with retinal branch vein occlusion (BRVO). METHODS: Seventeen patients with BRVO were included. None had a known history of diabetes mellitus. The blood velocity and vessel diameter of the upper temporal retinal artery in the contralateral eye were measured using laser Doppler velocimetry with an eye-tracking system before and 1, 2, and 3 h after oral intake of 75 g glucose. Blood sugar, systemic blood pressure, and intraocular pressure were monitored. Eleven healthy volunteers were examined similarly as control. RESULTS: Nine patients (53%) with BRVO had an abnormal pattern on the glucose tolerance test. RBF significantly increased at 1, 2, and 3 h in eight patients with normal glucose tolerance. The changes in RBF primarily resulted from changes in vessel diameter; the blood velocity did not change significantly. The nine patients with impaired glucose tolerance or diabetes mellitus had a RBF pattern that was significantly lower at 2 and 3 h than those with normal oral glucose tolerance. In the control group, all 11 volunteers showed the same increases in RBF at 2 and 3 h as the BRVO patients with a normal glucose pattern. CONCLUSION: A relatively high number of patients with BRVO had an abnormal pattern on glucose tolerance testing. Glucose intake increased RBF in BRVO patients without diabetes and in healthy volunteers. The RBF response may differ between subjects with diabetes and those without diabetes.