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Influence of Myopic Disc Shape in a Classification Program of the Heidelberg Retina Tomograph
567
ABSTRACTS
Purpose: The relationship between eyeglass size and protection of the eye surface from the effects of solar ultraviolet (UV) rays was investigated. Methods: Solar UV rays irradiating the eye surface were measured on a mannequin which modeled the standard facial bone structure of a Japanese female. UV sensor chips (photo-sensitivity: 260–400 nm) were attached to the ocular surface of the lid fissure. UV measurement was done from 12:00 to 15:00 on a sunny day in March. UV intensity was measured under the following conditions: (1) with or without eyeglasses, (2) wearing sunglasses with side protectors, and (3) wearing a cap with a 7 cm brim. Eyeglasses of four frame sizes (width: 48–57 mm) were put on the mannequin. All lenses were made of plastic and coated so as to be impervious to rays shorter than 400 nm. The refractive power was 0 diopters. At the same time, UV irradiation intensity from all directions (excluding from the earth direction) was measured using a polyhedron type UV sensor with 25 sensor chips. Results: Except for eyeglasses with the smallest frame size, eyeglasses effectively reduced UV exposure to sunlight from the upper front direction. However, protection against rays from the upper temporal direction was extremely poor. Sunlight from the upper back was reflected by the posterior surface of the eyeglasses and reached the eye surface. Conclusion: The efficacy of eyeglasses against UV depends on their size. The shape of the eyeglasses and reflection from the posterior lens surface are also of great importance. Small eyeglasses and reflection from the posterior lens surface are also of great importance. Small eyeglasses do not offer ideal UV protection for the Japanese face shape. (J Jpn Ophthalmol Soc 103:379–385, 1999) Yasuo Sakamoto, Masami Kojima and Kazuyuki Sasaki Department of Ophthalmology, Kanazawa Medical University PII S0021-5155(99)00125-2
Genome Analysis With Restriction Endonucleases Recognizing 4- or 5-Base Pair Sequences of Adenovirus Type 4 Purpose: To ascertain the chronological change of subgenome types of adenovirus type 4 (Ad 4) through DNA analysis.
Materials and Methods: We evaluated sixteen Ad 4 strains from patients with acute viral conjunctivitis at four eye clinics in Sapporo, Northern Japan. Seven strains were obtained from December 1993 through March 1994 (first period). Nine strains were obtained from March through May 1995 (second period). These strains were analyzed using DNA restriction endonucleases recognizing 4 or 5-base pair sequences, Taq I and Hin I. Results: The genome type of 16 strains was Ad 4a. Seven strains in the first period showed the same subgenome type. Nine strains in the second period showed two subgenome types: five strains showing the same subgenome type as in the first period, and four showing a different subgenome type. The two subgenome types were similar in DNA pattern, suggesting that both were derivatives of a common subgenome type. All the sixteen strains were a new subgenome type which was different from those previously isolated during 1985–1989. Conclusion: The subgenome types of Ad 4 in 1993– 1995 have changed from those in 1985–1989. (J Jpn Ophthalmol Soc 103:386–391, 1999) Hikaru Kanai Department of Ophthalmology, Yokohama Minami Kyosai Hospital PII S0021-5155(99)00126-4
Influence of Myopic Disc Shape in a Classification Program of the Heidelberg Retina Tomograph Purpose: We investigated the influence of myopic disc shape on the diagnostic capability of a glaucoma diagnostic software (classification program) of the Heidelberg retina tomograph (HRT). Subjects: 66 eyes of 66 normal subjects and 78 eyes of 78 patients with open-angle glaucoma were studied. The criterion of glaucoma was a visual field defect appearing between Aulhorn classification stage II and stage V regardless of the maximum intraocular pressure value. Methods: The subjects were divided into eyes with a myopic disc and those with a non-myopic disc on the basis of stereo disc fundus photographs without considering the refractive errors. Agreement between the classification program and the clinical diagnosis was evaluated by the calculation of sensitivity, specificity, and diagnostic precision, and the influence of
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Jpn J Ophthalmol Vol 43: 565–572, 1999
the disc shape on HRT disc shape parameters was also evaluated. Results: Sensitivity, specificity, and diagnostic precision of the classification program were 83%, 95%, and 89% in the eyes with a non-myopic disc, and 71%, 96%, and 83% in the eyes with a myopic disc, respectively. Rim volume, height variation contour, mean RNFL (retinal nerve fiber layer) thickness, and RNFL cross section area were significantly larger in the eyes with a myopic disc than in those with a non-myopic disc regardless of the clinical diagnosis. Conclusion: The classification program should be modified to adjust to a myopia-like disc shape in order to improve the capability of the glaucoma predictive diagnosis. (J Jpn Ophthalmol Soc 103:392– 398, 1999) Yoshio Yamazaki,* Keiji Yoshikawa,† Shiho Kunimatsu,‡ Nobuyuki Koseki,§ Yasuyuki Suzuki,† Shun Matsumoto¶ and Makoto Araie‡ *Department of Ophthalmology, Nihon University School of Medicine; †Yoshikawa Eye Clinic; ‡Department of Ophthalmology, The University of Tokyo School of Medicine; §Eye Clinic, Tokyo Metropolitan Geriatric Hospital; ¶Eye Clinic, Tokyo Posts and Telecommunication Hospital PII S0021-5155(99)00127-6
Causes of Visual Field Defects After Vitrectomy Purpose: An inferotemporal visual field defect sometimes occurs following vitreous surgery for idiopathic macular hole. There is a possibility that this visual field defect is due to damage to the superonasal retina by fluid or air irrigation through an inferonasal infusion port. We tested this hypothesis by placing the infusion port in the inferonasal sector during vitreous surgery. Cases and Method: We performed vitreous surgery on 31 eyes with idiopathic macular hole. The infusion port was placed in the inferonasal sector. The vitreous cavity was replaced either by 20% SF6 or 12% C3F8. We did not abrade the retinal pigment epithelium within the hole. The visual field was assessed before and 1 month after surgery using a Goldmann perimeter. Findings: Three eyes developed a wedge-shaped visual field defect in the inferonasal sector. No visual field defect developed in the other 28 eyes. Conclusion: The findings show that visual field defect following surgery for idiopathic macular hole is
dependent upon the site of the infusion port. We presume that the visual field defect is consequent to retinal damage caused by the flow of air or fluid during surgery. (J Jpn Ophthalmol Soc 103:399–403, 1999) Hisashi Takenaka,* Takatoshi Maeno,* Tomiya Mano* and Hisatoshi Mitsuda† *Tane Memorial Eye Hospital, †Mitsuda Eye Clinic in Amagasaki City PII S0021-5155(99)00128-8
Hemodynamics of Prepapillary Vascular Loop in Hemi-Central Retinal Vein Occlusion Background: It has been shown, by indocyanine green (ICG) videoangiography, that the prepapillary vascular loops in chronic central retinal vein occlusion (CRVO) serve as an anastomosis between the retina and the choroidal venous systems. Similar vascular loops may develop in hemi-central retinal vein occlusion (hemi-CRVO). Cases and Methods: I performed indocyanine green and fluorescein angiography using a scanning laser ophthalmoscope in 8 eyes of 8 patients with hemiCRVO to evaluate the angioarchitecture and hemodynamics of the retinochoroidal circulation. All eyes had a prepapillary vascular loop and were identified as ischemic. The patients’ ages ranged from 28 to 77 years (mean, 57 years). The interval between onset of hemi-CRVO and angiography ranged from 2 to 42 months (mean, 13 months). Scattered laser photocoagulation had been applied to the affected area in all 8 eyes and vitreous surgery in one eye. Results: Delayed dye flow in the affected retinal veins was present in all 8 eyes. The blood in the affected retinal veins drained through the prepapillary vascular loop into the branch or trunk of the intact central retinal vein. No anastomoses were seen between the vascular loop and the choroidal veins. The prepapillary vascular loop became more dilated during follow-up in one eye. Conclusions: The prepapillary vascular loop in hemiCRVO served as a collateral from the affected into intact retinal veins and not into the choroidal venous system. (J Jpn Ophthalmol Soc 103:404–408, 1999) Kyoichi Takahashi Department of Ophthalmology, Gunma University School of Medicine PII S0021-5155(99)00129-X
ABSTRACTS
Purpose: The relationship between eyeglass size and protection of the eye surface from the effects of solar ultraviolet (UV) rays was investigated. Methods: Solar UV rays irradiating the eye surface were measured on a mannequin which modeled the standard facial bone structure of a Japanese female. UV sensor chips (photo-sensitivity: 260–400 nm) were attached to the ocular surface of the lid fissure. UV measurement was done from 12:00 to 15:00 on a sunny day in March. UV intensity was measured under the following conditions: (1) with or without eyeglasses, (2) wearing sunglasses with side protectors, and (3) wearing a cap with a 7 cm brim. Eyeglasses of four frame sizes (width: 48–57 mm) were put on the mannequin. All lenses were made of plastic and coated so as to be impervious to rays shorter than 400 nm. The refractive power was 0 diopters. At the same time, UV irradiation intensity from all directions (excluding from the earth direction) was measured using a polyhedron type UV sensor with 25 sensor chips. Results: Except for eyeglasses with the smallest frame size, eyeglasses effectively reduced UV exposure to sunlight from the upper front direction. However, protection against rays from the upper temporal direction was extremely poor. Sunlight from the upper back was reflected by the posterior surface of the eyeglasses and reached the eye surface. Conclusion: The efficacy of eyeglasses against UV depends on their size. The shape of the eyeglasses and reflection from the posterior lens surface are also of great importance. Small eyeglasses and reflection from the posterior lens surface are also of great importance. Small eyeglasses do not offer ideal UV protection for the Japanese face shape. (J Jpn Ophthalmol Soc 103:379–385, 1999) Yasuo Sakamoto, Masami Kojima and Kazuyuki Sasaki Department of Ophthalmology, Kanazawa Medical University PII S0021-5155(99)00125-2
Genome Analysis With Restriction Endonucleases Recognizing 4- or 5-Base Pair Sequences of Adenovirus Type 4 Purpose: To ascertain the chronological change of subgenome types of adenovirus type 4 (Ad 4) through DNA analysis.
Materials and Methods: We evaluated sixteen Ad 4 strains from patients with acute viral conjunctivitis at four eye clinics in Sapporo, Northern Japan. Seven strains were obtained from December 1993 through March 1994 (first period). Nine strains were obtained from March through May 1995 (second period). These strains were analyzed using DNA restriction endonucleases recognizing 4 or 5-base pair sequences, Taq I and Hin I. Results: The genome type of 16 strains was Ad 4a. Seven strains in the first period showed the same subgenome type. Nine strains in the second period showed two subgenome types: five strains showing the same subgenome type as in the first period, and four showing a different subgenome type. The two subgenome types were similar in DNA pattern, suggesting that both were derivatives of a common subgenome type. All the sixteen strains were a new subgenome type which was different from those previously isolated during 1985–1989. Conclusion: The subgenome types of Ad 4 in 1993– 1995 have changed from those in 1985–1989. (J Jpn Ophthalmol Soc 103:386–391, 1999) Hikaru Kanai Department of Ophthalmology, Yokohama Minami Kyosai Hospital PII S0021-5155(99)00126-4
Influence of Myopic Disc Shape in a Classification Program of the Heidelberg Retina Tomograph Purpose: We investigated the influence of myopic disc shape on the diagnostic capability of a glaucoma diagnostic software (classification program) of the Heidelberg retina tomograph (HRT). Subjects: 66 eyes of 66 normal subjects and 78 eyes of 78 patients with open-angle glaucoma were studied. The criterion of glaucoma was a visual field defect appearing between Aulhorn classification stage II and stage V regardless of the maximum intraocular pressure value. Methods: The subjects were divided into eyes with a myopic disc and those with a non-myopic disc on the basis of stereo disc fundus photographs without considering the refractive errors. Agreement between the classification program and the clinical diagnosis was evaluated by the calculation of sensitivity, specificity, and diagnostic precision, and the influence of
568
Jpn J Ophthalmol Vol 43: 565–572, 1999
the disc shape on HRT disc shape parameters was also evaluated. Results: Sensitivity, specificity, and diagnostic precision of the classification program were 83%, 95%, and 89% in the eyes with a non-myopic disc, and 71%, 96%, and 83% in the eyes with a myopic disc, respectively. Rim volume, height variation contour, mean RNFL (retinal nerve fiber layer) thickness, and RNFL cross section area were significantly larger in the eyes with a myopic disc than in those with a non-myopic disc regardless of the clinical diagnosis. Conclusion: The classification program should be modified to adjust to a myopia-like disc shape in order to improve the capability of the glaucoma predictive diagnosis. (J Jpn Ophthalmol Soc 103:392– 398, 1999) Yoshio Yamazaki,* Keiji Yoshikawa,† Shiho Kunimatsu,‡ Nobuyuki Koseki,§ Yasuyuki Suzuki,† Shun Matsumoto¶ and Makoto Araie‡ *Department of Ophthalmology, Nihon University School of Medicine; †Yoshikawa Eye Clinic; ‡Department of Ophthalmology, The University of Tokyo School of Medicine; §Eye Clinic, Tokyo Metropolitan Geriatric Hospital; ¶Eye Clinic, Tokyo Posts and Telecommunication Hospital PII S0021-5155(99)00127-6
Causes of Visual Field Defects After Vitrectomy Purpose: An inferotemporal visual field defect sometimes occurs following vitreous surgery for idiopathic macular hole. There is a possibility that this visual field defect is due to damage to the superonasal retina by fluid or air irrigation through an inferonasal infusion port. We tested this hypothesis by placing the infusion port in the inferonasal sector during vitreous surgery. Cases and Method: We performed vitreous surgery on 31 eyes with idiopathic macular hole. The infusion port was placed in the inferonasal sector. The vitreous cavity was replaced either by 20% SF6 or 12% C3F8. We did not abrade the retinal pigment epithelium within the hole. The visual field was assessed before and 1 month after surgery using a Goldmann perimeter. Findings: Three eyes developed a wedge-shaped visual field defect in the inferonasal sector. No visual field defect developed in the other 28 eyes. Conclusion: The findings show that visual field defect following surgery for idiopathic macular hole is
dependent upon the site of the infusion port. We presume that the visual field defect is consequent to retinal damage caused by the flow of air or fluid during surgery. (J Jpn Ophthalmol Soc 103:399–403, 1999) Hisashi Takenaka,* Takatoshi Maeno,* Tomiya Mano* and Hisatoshi Mitsuda† *Tane Memorial Eye Hospital, †Mitsuda Eye Clinic in Amagasaki City PII S0021-5155(99)00128-8
Hemodynamics of Prepapillary Vascular Loop in Hemi-Central Retinal Vein Occlusion Background: It has been shown, by indocyanine green (ICG) videoangiography, that the prepapillary vascular loops in chronic central retinal vein occlusion (CRVO) serve as an anastomosis between the retina and the choroidal venous systems. Similar vascular loops may develop in hemi-central retinal vein occlusion (hemi-CRVO). Cases and Methods: I performed indocyanine green and fluorescein angiography using a scanning laser ophthalmoscope in 8 eyes of 8 patients with hemiCRVO to evaluate the angioarchitecture and hemodynamics of the retinochoroidal circulation. All eyes had a prepapillary vascular loop and were identified as ischemic. The patients’ ages ranged from 28 to 77 years (mean, 57 years). The interval between onset of hemi-CRVO and angiography ranged from 2 to 42 months (mean, 13 months). Scattered laser photocoagulation had been applied to the affected area in all 8 eyes and vitreous surgery in one eye. Results: Delayed dye flow in the affected retinal veins was present in all 8 eyes. The blood in the affected retinal veins drained through the prepapillary vascular loop into the branch or trunk of the intact central retinal vein. No anastomoses were seen between the vascular loop and the choroidal veins. The prepapillary vascular loop became more dilated during follow-up in one eye. Conclusions: The prepapillary vascular loop in hemiCRVO served as a collateral from the affected into intact retinal veins and not into the choroidal venous system. (J Jpn Ophthalmol Soc 103:404–408, 1999) Kyoichi Takahashi Department of Ophthalmology, Gunma University School of Medicine PII S0021-5155(99)00129-X