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Results of Therapy for Orbital Malignant Lymphoma
319
ABSTRACTS
as the target. In Experiment 1, the subjects just fixated on the fixation point. In Experiments 2 and 3, they were required to respond to the target by pressing a button and counting the number (target discrimination task). Results: A scalp negative potential with a latency of 170–280 msec was elicited in the lateral occipital area. For each of the 3 patterns the amplitude was greater in Experiments 2 and 3 than in Experiment 1. In Experiments 2 and 3, stimuli with disparity resulted in larger amplitude than without disparity. The target stimulus also evoked larger potentials than non-target stimuli did, although no such effect was apparent in Experiment 1. Conclusion: Attention, as well as disparity, increased the VEPs amplitude, which indicates that the potential could be generated by neural activity higher than V 1 including depth perception. Moreover, the potential showed characteristics similar to attentionrelated potentials modulated by visuo-spatial attention. (J Jpn Ophthalmol Soc 104:797–804, 2000) Kunihiko Akiyama, Kazuaki Maeda, Itaru Kimura, Hisao Ohde, Yukihiko Mashima and Yoshihisa Oguchi Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan PII S0021-5155(01)00308-2
Hyperfluorescent Areas Observed in Late-phase Indocyanine Green Angiography (IA) of IA Findings in Fellow Eyes of Unilateral Age-related Macular Degeneration Purpose: To evaluate abnormal findings of indocyanine green angiography (IA), predisposing to exudative age-related macular degeneration (AMD) in fellow eyes of unilateral exudative AMD. Methods: We categorized 83 fellow eyes of unilateral exudative AMD into two groups, ie, 55 eyes with early age-related maculopathy, and 28 eyes with normal aging. We performed IA. Results: The late phase of IA demonstrated hyperfluorescent areas in 27 of the 83 fellow eyes, which included 22 of the 55 eyes with early age-related maculopathy and five eyes of 28 eyes with normal aging. The prevalence of the late-phase hyperfluorescence was statistically significant in early agerelated maculopathy. Eight of the 22 eyes with early
age-related maculopathy and one of the five eyes with normal aging progressed to exudative AMD. Conclusions: Hyperfluorescent areas observed in late-phase IA before the manifestation of exudative AMD suggested the possible presence of choroidal neovascular membrane in the subretinal pigment epithelial space. (J Jpn Ophthalmol Soc 104:805–812, 2000) Miho Haruyama and Mitsuko Yuzawa Department of Ophthalmology, Surugadai Hospital of Nihon University, Tokyo, Japan PII S0021-5155(01)00309-4
Results of Therapy for Orbital Malignant Lymphoma Purpose: To elucidate the clinical and histopathological features of orbital malignant lymphoma, and to develop a protocol for effective treatment. Materials and Methods: The present study analyzed 18 cases of orbital lymphoma which were treated at Yamagata University Hospital over the last 14 years. The tentative strategy for choosing the treatment was to treat the cases of clinical stage I (Ann Arbor criteria) with curative intent and the cases of stage II–IV with palliative intent. Results: Six patients had primary orbital lymphomas, 2 had secondary orbital lymphomas, and 10 had metastatic orbital lymphomas. Histopathologically, all the cases of primary lymphoma were of low-grade malignancy and all the cases of secondary lymphoma were of intermediate-grade malignancy. Of the metastatic lymphoma cases, 3 were of low-grade and 7 of intermediate-grade malignancy. The cases of primary lymphoma were Stage I and were treated by radiation or chemotherapy. The cases with secondary lymphoma were Stage II and were treated by both radiation and chemotherapy. The cases with metastatic lymphoma were Stage III or IV and were treated by chemotherapy and/or radiation. Control of orbital lymphoma was achieved in all 6 cases with primary lymphomas. Although the survival rate was 0% for secondary lymphomas and 50% for metastatic lymphomas, ocular complications were improved during the remainder of the patient’s life. Conclusions: All the primary orbital lymphomas were treated effectively by radiation or chemotherapy. For secondary and metastatic orbital lymphoma, our strategy for treatment was beneficial by improving ocular complications and the quality of life. (J Jpn Ophthalmol Soc 104:813–818, 2000)
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Jpn J Ophthalmol Vol 45: 317–325, 2001
Hiroshi Takamura, Kazuhito Terashima and Hidetoshi Yamashita Department of Ophthalmology, Yamagata University School of Medicine, Yamagata, Japan PII S0021-5155(01)00310-0
Clinical Features of Idiopathic Macular Holes Purpose: The purpose of this study was to evaluate the clinical features of idiopathic macular holes. Materials and Methods: The clinical features were examined in consecutive 526 eyes of 480 patients with idiopathic macular hole who underwent vitrectomy. Results: Sixty-seven percent of the patients were female. The mean onset age was 64.4 years of age and 60% of the cases were in their 60s at the time of onset. The mean refractive value was ⫺0.66 dioptor and 40% of the cases were emmetropia with a refractive value between ⫺1.0 dioptor and ⫹1.0 dioptor. The onset age was positively correlated with refractive value. The visual acuity was negatively correlated with onset age, duration after onset, and the size of the macular hole. The duration was positively correlated with onset age. The size of the macular hole was positively correlated with age and duration. The factors for good visual acuity were determined by bilaterality, youth, or small size. Also we found the factors for large size of macular holes to be female gender, long duration of the hole, being in stage 4, and low visual acuity. Conclusions: The incidence of idiopathic macular hole is seen more in eyes of patients in their 60s and in emmetropic eyes. Patients with myopic eyes tend to have younger onset. The size of the macular hole in females tends to be larger than in males. (J Jpn Ophthalmol Soc 104:819–825, 2000). Kazuyuki Kumagai,* Nobuchika Ogino,* Seiji Demizu,* Kazunari Atsumi,† Hideyuki Kurihara,‡ Masayoshi Iwaki,§ Hitoshi Ishigooka¶ and Naoko Tachi储 *Shinjo Ophthalmologic Institute; †Department of Ophthalmology Kami-iida First General Hospital; ‡ Kurihara Ophthalmologic Institute; §Department of Ophthalmology Aichi Medical University; ¶ Department of Ophthalmology Kyoto Katsura Hospital; 储Department of Ophthalmology Shinseikai Toyama Hospital, Miyazaki, Japan PII S0021-5155(01)00311-2
Clinical Evaluation of the Heidelberg Retina Tomograph II Purpose: To evaluate the usefulness of Heidelberg Retina Tomograph (HRT) II prototype, which is an easily handled model for routine optic disc examination in glaucoma clinics. Methods: Ten eyes of 10 normal volunteers and 18 eyes of 18 open-angle glaucoma patients followed at Gifu University were studied. The reproducibility of three consecutive optic disc measurements with a 15⬚ ⫻ 15⬚ field using HRT II and with a 10⬚ ⫻ 10⬚ field using HRT (version 2.01) were evaluated by the same examiner on the same day. We also examined the correlation of the main topographic parameters (disc area, cup area, cup/disc area ratio, rim area, cup volume, rim volume, cup shape measure) between HRT II and HRT. Results: The mean (⫾standard deviation) reproducibility of optic disc measurements with HRT II and HRT were 17.5 ⫾ 7.6 m and 19.3 ⫾ 9.6 m, respectively. This difference was not significant. All topographic parameters obtained from HRT II and HRT (r ⫽ 0.86–0.98, P ⬍ .01) showed statistically significant correlations with each other. Conclusions: The HRT II has high reproducibility of measurements and reliable stereometric parameters comparable to the conventional HRT. (J Jpn Ophthalmol Soc 104:826–829, 2000) Hideya Uchida,* Goji Tomita† and Yoshiaki Kitazawa* *Department of Ophthalmology, Gifu University School of Medicine;† Department of Ophthalmology, The University of Tokyo, Graduate School of Medicine, Gifu, Japan PII S0021-5155(01)00312-4
Optic Neuritis: From Diagnosis to Optic Nerve Transplantation Optic neuritis is a clinical syndrome resulting from inflammation, demyelination, or infection of the optic nerve. Its diagnosis and treatment are complicated. In 1884, Nettleship first reported 28 cases of optic neuritis whose clinical symptoms have been accepted up to the present without any change. On the other hand, the development of diagnostic procedures and steroid therapy have also altered the clinical features of optic neuritis. Among several developed diagnostic procedures, the visually evoked
ABSTRACTS
as the target. In Experiment 1, the subjects just fixated on the fixation point. In Experiments 2 and 3, they were required to respond to the target by pressing a button and counting the number (target discrimination task). Results: A scalp negative potential with a latency of 170–280 msec was elicited in the lateral occipital area. For each of the 3 patterns the amplitude was greater in Experiments 2 and 3 than in Experiment 1. In Experiments 2 and 3, stimuli with disparity resulted in larger amplitude than without disparity. The target stimulus also evoked larger potentials than non-target stimuli did, although no such effect was apparent in Experiment 1. Conclusion: Attention, as well as disparity, increased the VEPs amplitude, which indicates that the potential could be generated by neural activity higher than V 1 including depth perception. Moreover, the potential showed characteristics similar to attentionrelated potentials modulated by visuo-spatial attention. (J Jpn Ophthalmol Soc 104:797–804, 2000) Kunihiko Akiyama, Kazuaki Maeda, Itaru Kimura, Hisao Ohde, Yukihiko Mashima and Yoshihisa Oguchi Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan PII S0021-5155(01)00308-2
Hyperfluorescent Areas Observed in Late-phase Indocyanine Green Angiography (IA) of IA Findings in Fellow Eyes of Unilateral Age-related Macular Degeneration Purpose: To evaluate abnormal findings of indocyanine green angiography (IA), predisposing to exudative age-related macular degeneration (AMD) in fellow eyes of unilateral exudative AMD. Methods: We categorized 83 fellow eyes of unilateral exudative AMD into two groups, ie, 55 eyes with early age-related maculopathy, and 28 eyes with normal aging. We performed IA. Results: The late phase of IA demonstrated hyperfluorescent areas in 27 of the 83 fellow eyes, which included 22 of the 55 eyes with early age-related maculopathy and five eyes of 28 eyes with normal aging. The prevalence of the late-phase hyperfluorescence was statistically significant in early agerelated maculopathy. Eight of the 22 eyes with early
age-related maculopathy and one of the five eyes with normal aging progressed to exudative AMD. Conclusions: Hyperfluorescent areas observed in late-phase IA before the manifestation of exudative AMD suggested the possible presence of choroidal neovascular membrane in the subretinal pigment epithelial space. (J Jpn Ophthalmol Soc 104:805–812, 2000) Miho Haruyama and Mitsuko Yuzawa Department of Ophthalmology, Surugadai Hospital of Nihon University, Tokyo, Japan PII S0021-5155(01)00309-4
Results of Therapy for Orbital Malignant Lymphoma Purpose: To elucidate the clinical and histopathological features of orbital malignant lymphoma, and to develop a protocol for effective treatment. Materials and Methods: The present study analyzed 18 cases of orbital lymphoma which were treated at Yamagata University Hospital over the last 14 years. The tentative strategy for choosing the treatment was to treat the cases of clinical stage I (Ann Arbor criteria) with curative intent and the cases of stage II–IV with palliative intent. Results: Six patients had primary orbital lymphomas, 2 had secondary orbital lymphomas, and 10 had metastatic orbital lymphomas. Histopathologically, all the cases of primary lymphoma were of low-grade malignancy and all the cases of secondary lymphoma were of intermediate-grade malignancy. Of the metastatic lymphoma cases, 3 were of low-grade and 7 of intermediate-grade malignancy. The cases of primary lymphoma were Stage I and were treated by radiation or chemotherapy. The cases with secondary lymphoma were Stage II and were treated by both radiation and chemotherapy. The cases with metastatic lymphoma were Stage III or IV and were treated by chemotherapy and/or radiation. Control of orbital lymphoma was achieved in all 6 cases with primary lymphomas. Although the survival rate was 0% for secondary lymphomas and 50% for metastatic lymphomas, ocular complications were improved during the remainder of the patient’s life. Conclusions: All the primary orbital lymphomas were treated effectively by radiation or chemotherapy. For secondary and metastatic orbital lymphoma, our strategy for treatment was beneficial by improving ocular complications and the quality of life. (J Jpn Ophthalmol Soc 104:813–818, 2000)
320
Jpn J Ophthalmol Vol 45: 317–325, 2001
Hiroshi Takamura, Kazuhito Terashima and Hidetoshi Yamashita Department of Ophthalmology, Yamagata University School of Medicine, Yamagata, Japan PII S0021-5155(01)00310-0
Clinical Features of Idiopathic Macular Holes Purpose: The purpose of this study was to evaluate the clinical features of idiopathic macular holes. Materials and Methods: The clinical features were examined in consecutive 526 eyes of 480 patients with idiopathic macular hole who underwent vitrectomy. Results: Sixty-seven percent of the patients were female. The mean onset age was 64.4 years of age and 60% of the cases were in their 60s at the time of onset. The mean refractive value was ⫺0.66 dioptor and 40% of the cases were emmetropia with a refractive value between ⫺1.0 dioptor and ⫹1.0 dioptor. The onset age was positively correlated with refractive value. The visual acuity was negatively correlated with onset age, duration after onset, and the size of the macular hole. The duration was positively correlated with onset age. The size of the macular hole was positively correlated with age and duration. The factors for good visual acuity were determined by bilaterality, youth, or small size. Also we found the factors for large size of macular holes to be female gender, long duration of the hole, being in stage 4, and low visual acuity. Conclusions: The incidence of idiopathic macular hole is seen more in eyes of patients in their 60s and in emmetropic eyes. Patients with myopic eyes tend to have younger onset. The size of the macular hole in females tends to be larger than in males. (J Jpn Ophthalmol Soc 104:819–825, 2000). Kazuyuki Kumagai,* Nobuchika Ogino,* Seiji Demizu,* Kazunari Atsumi,† Hideyuki Kurihara,‡ Masayoshi Iwaki,§ Hitoshi Ishigooka¶ and Naoko Tachi储 *Shinjo Ophthalmologic Institute; †Department of Ophthalmology Kami-iida First General Hospital; ‡ Kurihara Ophthalmologic Institute; §Department of Ophthalmology Aichi Medical University; ¶ Department of Ophthalmology Kyoto Katsura Hospital; 储Department of Ophthalmology Shinseikai Toyama Hospital, Miyazaki, Japan PII S0021-5155(01)00311-2
Clinical Evaluation of the Heidelberg Retina Tomograph II Purpose: To evaluate the usefulness of Heidelberg Retina Tomograph (HRT) II prototype, which is an easily handled model for routine optic disc examination in glaucoma clinics. Methods: Ten eyes of 10 normal volunteers and 18 eyes of 18 open-angle glaucoma patients followed at Gifu University were studied. The reproducibility of three consecutive optic disc measurements with a 15⬚ ⫻ 15⬚ field using HRT II and with a 10⬚ ⫻ 10⬚ field using HRT (version 2.01) were evaluated by the same examiner on the same day. We also examined the correlation of the main topographic parameters (disc area, cup area, cup/disc area ratio, rim area, cup volume, rim volume, cup shape measure) between HRT II and HRT. Results: The mean (⫾standard deviation) reproducibility of optic disc measurements with HRT II and HRT were 17.5 ⫾ 7.6 m and 19.3 ⫾ 9.6 m, respectively. This difference was not significant. All topographic parameters obtained from HRT II and HRT (r ⫽ 0.86–0.98, P ⬍ .01) showed statistically significant correlations with each other. Conclusions: The HRT II has high reproducibility of measurements and reliable stereometric parameters comparable to the conventional HRT. (J Jpn Ophthalmol Soc 104:826–829, 2000) Hideya Uchida,* Goji Tomita† and Yoshiaki Kitazawa* *Department of Ophthalmology, Gifu University School of Medicine;† Department of Ophthalmology, The University of Tokyo, Graduate School of Medicine, Gifu, Japan PII S0021-5155(01)00312-4
Optic Neuritis: From Diagnosis to Optic Nerve Transplantation Optic neuritis is a clinical syndrome resulting from inflammation, demyelination, or infection of the optic nerve. Its diagnosis and treatment are complicated. In 1884, Nettleship first reported 28 cases of optic neuritis whose clinical symptoms have been accepted up to the present without any change. On the other hand, the development of diagnostic procedures and steroid therapy have also altered the clinical features of optic neuritis. Among several developed diagnostic procedures, the visually evoked