[Long-term follow-up of a case of unilateral retinitis pigmentosa].

BACKGROUND: Unilateral retinitis pigmentosa is a retinal dystrophy affecting only one eye, the fellow eye being affected neither functionally nor in fundus appearance. There are relatively few cases of unilateral retinitis pigmentosa being followed for more than 5 years. CASE: An 18-year-old woman complaining of blurred vision of left eye was found to have left visual field concentric contraction. Because the right eye was unaffected electrofunctionally and in fundus appearance, there was a suspicion of unilateral retinitis pigmentosa. We tracked her for 8 years and, because the right eye remained unaffected, we diagnosed unilateral retinitis pigmentosa of left eye. CONCLUSION: We report a case of unilateral retinitis pigmentosa. It is reported that the healthy fellow eye of patients with unilateral retinitis pigmentosa developed bilateral retinitis pigmentosa after 10 years, consequently, this case needs further follow-up.

Retinal detachment because of macular hole and an additional break within the staphyloma.

PURPOSE: To report the finding of retinal detachment because of macular hole and an additional break within the posterior staphyloma. METHODS: A 63-year-old woman presented with progressive central scotoma of the right eye for 1-month duration. The fundus in the right eye showed retinal detachment that was localized within the posterior staphyloma and macular hole. An additional retinal break was observed within the staphyloma using ophthalmoscope, and optical coherence tomography confirmed that both the breaks were within the staphyloma. Macular buckling was scheduled because the two breaks were close enough to each other and the patient was unable to maintain a prone position. RESULTS: The retinal detachment was successfully reattached using macular buckling procedure. CONCLUSION: In the present case, optical coherence tomography proved to be very useful in helping to make the correct diagnosis of a full-thickness break before surgery.

Retrobulbar hemodynamic effects of nipradilol in normal and normal-tension glaucoma eyes.

Purpose. To investigate the effects of nipradilol on retrobulbar hemodynamics. Methods. We investigated normal and normal-tension glaucoma (NTG) eyes. Topical nipradilol (one eye) and placebo eye drops (fellow eye) were instilled for 1 week in volunteers. Nipradilol was also instilled in NTG patients. Ultrasound color Doppler imaging for the posterior vessels was performed before, 2 hr, 1 week (for normal), and at 4 weeks (for NTG). Results. In normal eyes, there were significant decreases in the resistance index (RI) for the temporal short posterior ciliary arteries (PCA) at 2 hr and for the ophthalmic arteries at 1 week. There were no significant changes in the placebo-treated eyes. In the NTG eyes, there was a significant decrease in the RI for the central retinal artery, nasal, and temporal PCA at 2 hr and 4 weeks. Conclusion. Short-term observations found that nipradilol increased the ocular blood flow in normal and NTG eyes.

[Case of Heerfordt's syndrome presenting polyneuropathy].

BACKGROUND: Acute presentation of sarcoidosis with the combination of uveitis, parotid gland enlargement, facial nerve palsy, and fever is called Heerfordt's syndrome. Clinically recognizable involvement of the nervous system occurs in < 10% of patients with sarcoidosis, and polyneuropathy in 24% with neurosarcoidosis. CASE: A 28-year-old woman diagnosed with Guillain-Barré syndrome was admitted and treated for a month in the Department of Neurology, Mie University hospital. Her visual acuity decreased 2 weeks after discharge. She was admitted to the Department of Ophthalmology, Mie University Hospital. She presented typical optic sarcoidosis. As she had uveitis, facial nerve palsy, parotid gland enlargement and fever in the clinical course, we diagnosed her condition as Heerfordt's syndrome. CONCLUSION: On rare occasions a Heerfordt's syndrome patient may present with Guillain-Barré-like symptoms.

[Case of systemic lupus erythematosus showing visual disturbances resulting from multiple ocular complications].

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown origins. We report a case of SLE retinopathy concurrent with macular edema and ischemic optic neuropathy. CASE: A 30-year-old women with SLE presented with sudden visual disturbances and SLE retinopathy with typical macular edema. We treated her with subconjunctival triamcinolone acetonide injections which providing a resolution of the edema within a few days, but her visual acuity did not improve. Scotoma, relative afferent papillary defect (RAPD) and optic nerve abnormality appeared on MRI during her clinical course. A diagnosis of hidden ischemic optic neuropathy was established. She was treated with corticosteroid pulse therapy and because of an antiphospholipid syndrome, antiplatelet and anticoagulation therapy were used to improve ocular circulation. Following therapy, her visual function recovered. CONCLUSION: Although the symptoms seemed complicated, circulatory insufficiency was the main cause of the complications and its improvement provided the key to the patient's recovery.

Distribution of D-aspartate-immunopositive cells in the ganglion cell layer of adult rat retina.

BACKGROUND/AIMS: D-aspartate is an important candidate for retinal neurotransmitter or neuromodulator. The purpose of this study was to investigate the cells type and distribution of the D-aspartate-immunopositive cells in the ganglion cell layer. METHODS: Wister rats were fixed by perfusion with 5% glutaraldehyde. Paraffin sections of the retina were immunohistochemically double-labeled using D-aspartate and glutamate or γ-aminobutyric acid antibodies. After labeling the whole-mount retina by D-aspartate, the cell densities of both the perivascular and nonperivascular areas in the ganglion cell layer were measured for the central, midperipheral, and peripheral zones, respectively. RESULTS: Within the paraffin section, some of the glutamate-immunoreactive cells in the ganglion cell layer were D-aspartate immunoreactive. These D-aspartate-positive cells in the ganglion cell layer were more frequently observed along the retinal vessels in the whole-mount retina. The D-aspartate-positive cell densities in the perivascular area were significantly higher than those in the nonperivascular area for the central, midperipheral, and peripheral zones (p < 0.0001). CONCLUSION: In the ganglion cell layer, the D-aspartate-immunopositive cells proved to be the ganglion cells, with their distribution found to be denser along the large retinal vessels such as the arterioles or venules.

Retinal Nerve Fiber Layer Decrease during Glycemic Control in Type 2 Diabetes.

Purpose. To assess an effect of glycemic control on retinal nerve fiber layer (RNFL) in type 2 diabetes mellitus. Methods. Thirty-eight eyes of 38 patients with type 2 diabetes undergoing blood glucose regulation were enrolled. All patients were examined at (1) initial visit, (2) 1 month, (3) 2 months, and (4) 4-month after the initial examination. On each occasion, glycosylated hemoglobin (HbA1c) levels and optical coherence tomography (OCT) scanning for RNFL thickness were evaluated. 360 degree circular OCT scans with a diameter of 3.4 mm centered on the optic disc were performed. Results. Significant RNFL decrease was seen in the superior area between initial and 4 months examination (P = .043). The relationship between the changes in HbA1c and the changes in RNFL thickness was observed in superior, temporal, and inferior area (P < .05) at 4 months. Conclusions. This study suggests that the glycemic control affects RNFL within 4 months.

[Causes of visual impairment in Mie Prefecture during a 5-year period].

PURPOSE: The purpose of this study was to determine the causes of visual impairment in Mie prefecture during a five-year period. SUBJECTS AND METHODS: The study was conducted between April 2004 and March 2009 in Mie Prefecture. 1,322 visually impaired people as defined by the Act on Welfare of Physically Disabled Persons were enrolled. We reviewed age, sex, causes of visual impairment, degree of disability and medical conditions according to their physical disability certificate. RESULTS: The four major causes of visual impairment were glaucoma (20.3%), diabetic retinopathy (18.9%), retinitis pigmentosa (12.2%), and macular degeneration (9.1%), followed by chorioretinal degeneration, stroke or brain tumor, optic atrophy, and cataract. The average ages of the four major causes were glaucoma (77.1 years), diabetic retinopathy (65.1 years), retinitis pigmentosa (62.5 years) and macular degeneration (77.7 years). CONCLUSIONS: The most common cause of visual impairment in Mie prefecture was glaucoma. The four major causes in Mie prefecture were the same as the results of the nation-wide investigation reported in 2006.

Preservation of glutamate immunoreactivity and ischemic change in photoreceptor inner segments in the retina after different protocols of perfusion fixation.

AIM: The present study investigates whether glutamate immunoreactivity (IR) in the cat outer retina, which is devoid of blood vessels, can be well preserved by perfusion fixation. METHODS: Adult cats were perfused intracardially for 1, 5, 10, 15 and 30 min with physiological saline and were subsequently perfused with a mixture of 1% glutaraldehyde and 4% formaldehyde. After the fixation, the retinas were immunocytochemically examined. RESULTS: The photoreceptor inner segments in the retina, which was perfused by saline for 1 and 5 min prior to fixation, showed no glutamate IR. However, those in the retina which was perfused by saline for 10 min showed moderate glutamate IR as found in the retina fixed by immersion. The glutamate IR in the inner segments decreased with a saline perfusion of more than 10 min. CONCLUSIONS: Perfusion fixation can well preserve glutamate IR even in the outer retina including the inner segments.

The effect of the H-1152P, a potent Rho-associated coiled coil-formed protein kinase inhibitor, in rabbit normal and ocular hypertensive eyes.

PURPOSE: We wanted to determine the intraocular pressure (IOP)-lowering effect of H-1152P by utilizing a rabbit ocular hypertension-glaucoma model and normal eyes. H-1152P is a potent, Rho-associated, coiled, coil-forming protein kinase (ROCK) inhibitor. METHODS: IOPs were monitored by a pneumatonometer in New Zealand White rabbits that were given topically administered H-1152P or vehicle alone. Animals were divided into four groups followed by topical administration of 0.1, 1.0, 10, and 28 mM H-1152P. To study the IOP-lowering effects on an elevated IOP model, a rabbit ocular hypertension model was created by water loading. All studies were carried out by monitoring of IOPs on H-1152P-administered right eyes and phosphate-buffered saline (PBS)-administered left eyes. RESULTS: In normotensive IOP rabbits, topical administration of H-1152P significantly decreased IOPs by 46.1 +/- 5.0% at 1% (28 mM) solution. This effect was dose dependent, as the maximum reduction of IOPs were observed between 60 and 90 min after topical administration (3.6 +/- 0.9 mmHg, 5.4 +/- 0.7 mmHg, 6.8 +/- 0.7 mmHg, and 7.2 +/- 1.9 mmHg at 0.1, 1.0, 10, and 28 mM H-1152P). In addition, in the rabbit ocular hypertension model, the topical administration of H-1152P (28 mM) significantly lowered IOPs starting at 30 minutes and lasting up to 300 minutes after water loading. The maximum IOP reduction, however, was observed at 90 minutes after water loading (10.6 +/- 2.3 mmHg). No serious side effects were observedin ocular tissues except for some conjunctival congestion that shortly disappeared within 3 hours. CONCLUSION: Topical administration of H-1152P potently decreased rabbit normotensive IOPs in a dose-dependent manner, and the duration of the IOP lowering was also elongated in a dose-dependent manner. In addition, H-1152P has a potent IOP-lowering effect on an ocular hypertension model. These result suggested that H-1152P could be a candidate for the next generation of glaucoma therapy.

The effect of the Rho-associated protein kinase inhibitor, HA-1077, in the rabbit ocular hypertension model induced by water loading.

PURPOSE: The aim of this study was to investigate the intraocular pressure (IOP)-lowering effect of a new anti-glaucoma drug, the Rho-associated protein kinase (ROCK) inhibitor, HA-1077, in a rabbit ocular hypertension model. METHODS: Experiments were carried out in 18 male New Zealand white rabbits, with ocular hypertension induced by water loading. Animals were divided into three groups followed by topical administration of 1 mM, 2 mM, and 3 mM HA-1077 in the left eye. As a control, phosphate buffered saline was administered in the opposite eye. RESULTS: After administration of HA-1077 eye drops, there was a significant time- and dose-dependent decrease of the IOP. While minor conjunctival injection was seen in a few cases, no abnormalities of the anterior chamber or fundus were observed. CONCLUSIONS: This is the first report of the effect of the ROCK inhibitor, HA-1077, on the IOP in an ocular hypertension model. Study results indicated that HA-1077 has a strong IOP-lowering effect.

The keratin-binding protein Albatross regulates polarization of epithelial cells.

The keratin intermediate filament network is abundant in epithelial cells, but its function in the establishment and maintenance of cell polarity is unclear. Here, we show that Albatross complexes with Par3 to regulate formation of the apical junctional complex (AJC) and maintain lateral membrane identity. In nonpolarized epithelial cells, Albatross localizes with keratin filaments, whereas in polarized epithelial cells, Albatross is primarily localized in the vicinity of the AJC. Knockdown of Albatross in polarized cells causes a disappearance of key components of the AJC at cell-cell borders and keratin filament reorganization. Lateral proteins E-cadherin and desmoglein 2 were mislocalized even on the apical side. Although Albatross promotes localization of Par3 to the AJC, Par3 and ezrin are still retained at the apical surface in Albatross knockdown cells, which retain intact microvilli. Analysis of keratin-deficient epithelial cells revealed that keratins are required to stabilize the Albatross protein, thus promoting the formation of AJC. We propose that keratins and the keratin-binding protein Albatross are important for epithelial cell polarization.

Inducible nitric oxide synthase mediates retinal DNA damage in Goto-Kakizaki rat retina.

PURPOSE: To examine the nitrosative and oxidative DNA damage induced by 8-nitroguanine and 8-hydroxy-2-deoxy guanosine (8-OHdG), and to determine the role played by inducible nitric oxide synthase (iNOS) in damage to DNA in the retina of the Goto-Kakizaki (GK) rat. METHODS: Experiments were performed on GK rats, an animal model of spontaneous type 2 diabetes without obesity or visible diabetic vascular lesions. Immunohistochemistry was used to determine the retinal distribution of 8-nitroguanine, 8-OHdG, and iNOS in GK rats and control rats. The change in the expression of 8-nitroguanine and 8-OHdG in GK rats was also determined following an intravitreal injection of 1400W, an inhibitor of iNOS activity. RESULTS: Immunohistochemical analysis showed that 8-nitroguanine and 8-OHdG were expressed strongly in the inner nuclear layer of GK retinas but only weakly in control retinas. This expression was correlated with an increase in the expression of iNOS in GK retinas, which was confirmed by the inhibition of iNOS activity by 1400W. CONCLUSION: These findings demonstrate that iNOS plays a crucial role in nitrosative and oxidative DNA damage in GK rats, suggesting a retinal neurotoxic role of nitric oxide and superoxide in diabetic retinas.

Comparison of ocular hypotensive effect and safety of brinzolamide and timolol added to latanoprost.

PURPOSE: To compare the ocular hypotensive effect and safety of brinzolamide and timolol added to latanoprost monotherapy. METHODS: In prospective randomized fashion, we evaluated the ocular hypotensive effect and safety of brinzolamide or timolol in 1 eye of 32 patients with primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension who had been treated with latanoprost for more than 1 month. Intraocular pressure (IOP), blood pressure, and pulse were measured before and at 4, 8, and 12 weeks. Corneal endothelial cell density was measured at baseline and at 12 weeks. RESULTS: The IOP was 17.8+/-1.7 mm Hg (mean+/-SD) before the addition of brinzolamide (n=15) and 15.7+/-2.1 mm Hg at 12 weeks (P<0.01). In comparison, the IOP was 18.5+/-3.7 mm Hg before the addition of timolol (n=15) and 15.8+/-3.2 mm Hg at 12 weeks (P<0.01). Both brinzolamide and timolol significantly decreased IOP at 12 weeks, by a mean of 2.0 mm Hg and mean 2.7 mm Hg, respectively, and were more effective than latanoprost alone (P<0.01), but there were no significant differences between the drugs and no significant differences in corneal endothelial cell density and blood pressure before and after addition of either drug. At 12 weeks, pulse was decreased in patients receiving timolol (P<0.01). As systemic adverse events, there was one instance of malar flushing after brinzolamide addition and episodes of chest discomfort after timolol addition in 1 patient. Ocular adverse events were slight. CONCLUSIONS: Brinzolamide and timolol added to latanoprost have similar ocular hypotensive effects and safety in primary open-angle glaucoma, normal-tension glaucoma, or ocular hypertension.

Failure of multinucleated giant cell formation in k562 cells infected with newcastle disease virus and human parainfluenza type 2 virus.

When K562 cells were infected with Newcastle disease virus (NDV) or human parainfluenza type 2 virus (hPIV-2), polykaryocyte formation could not be detected. Failure of multinucleated giant cell formation in K562 cells infected with either NDV or hPIV-2 is due to disturbance of the viral envelope-cell fusion step or to defect in the cell-cell fusion step, respectively. Especially, NDV completely replicated in K562 cells, and the hemagglutinin-neuraminidase and fusion proteins expressed on the cell surface of NDV-infected K562 cell were fully functional for fusion inducing activity. Therefore, the cell membranes of K562 cells are considered to be resistant to virus-induced cell fusion. Membrane fusion is regulated by many host factors including membrane fluidity, cytoskeletal systems, and fusion regulatory proteins system. An unknown regulatory mechanism of virus-induced cell fusion may function on the cell surface of K562 cells.

Use of indocyanine green during excision of an overhanging filtering bleb.

BACKGROUND: We report the use of an indocyanine green (ICG) injection during the safe removal of an overhanging filtering bleb after trabeculectomy. CASE: A 63-year-old man with a history of trabeculectomy 5 years previously in his left eye complained of foreign body sensation in this eye and decreased vision from induced astigmatism. Slit-lamp examination revealed an expanding overhanging filtering bleb on the cornea. OBSERVATIONS: With a 30-G needle, 0.25% ICG was injected into the overhanging bleb. Use of ICG visualization of the inner space of the overhanging filtering bleb provided visualization of the border with the original bleb, allowing for safe excision of the overhanging filtering bleb without injury to the thin surface of the original bleb. CONCLUSION: Injection of ICG into an overhanging filtering bleb during excision can be useful in the prevention of damage to the original bleb.