| Project/Area Number |
10671654
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Ophthalmology
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| Research Institution | Kyoritsu University of Pharmacy |
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Principal Investigator |
HIDA Tetsuo Kyorin Univ., School of Medicine, Prof., 医学部, 教授 (40129622)
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| Co-Investigator(Kenkyū-buntansha) |
TERAKI Yuichi Kyorin Univ., School of Medicine, Prof., 医学部, 講師 (10188667)
FUJIWARA Takaki Kyorin Univ., School of Health Sciences, Prof., 保健学部, 教授 (20096259)
SHIOHARA Tetsuo Kyorin Univ., School of Medicine, Prof., 医学部, 教授 (10118953)
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| Project Period (FY) |
1998 – 2001
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| Project Status |
Completed (Fiscal Year 2001)
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| Budget Amount *help |
¥3,400,000 (Direct Cost: ¥3,400,000)
Fiscal Year 2001: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 2000: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1999: ¥600,000 (Direct Cost: ¥600,000)
Fiscal Year 1998: ¥1,400,000 (Direct Cost: ¥1,400,000)
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| Keywords | Atopic Dermatitis / Retinal Detachment / Cataract / Vitrectomy / Lymphocyte / Smooth Muscle Actin / アポトーシス / 平衡筋アクチン / サイトカイン / IL-4 / Interferon-γ |
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| Research Abstract |
Background The prevalence of retinal detachment and cataract associated with atopic dermatitis is increasing in Japan and continues to be of great interest to cataract and vitreo-retinal surgeons. This specific type of rhegmatogenous retinal detachment affects the younger population and significantly influences their lifestyle. However, the etiology of this complications with atopic dermatitis remains unclear. The purpose of this study was to (1) conducte and analyse a retrospective multicenter study to confirm its clinical characteristics, (2) evaluate the effects of present treatments, including surgical techniques of vitrectomy, cataract surgeries. (3) examine the specimen excised during surgery, such as vitreous fluid, conjunctiva. (4) study the characteristics of patients of atopic deramatitis associated with retinal detachments.
Results : We analyzed the records 417 eyes of 348 patients operated for retinal detachments associated with atopic dermatitis. And followed up for more th
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an 6 months by vitre-retinal specialists in 33 hospitals throughout Japan. Clinical characteristics of retinal detachment previously reported, such as traumatic slapping or rubbing of the lids by patients as the most likely pathogenetic factor, and high incidence of cataract and proliferative vitreoretinopath were confirmed. The primary surgical procedure was scleral buckling in 78% of the cases and vitreous surgery in 22%, and initial and final reattachment rates were 75.3% and 92.6%, respectively. The analysis of data of vitrectomy for retinal detachment or PVR. at Kyorin Eye Center suggested that the accomplishment of induction of posterior hyaloid detachment during vitrectomy was very important factor to reattach the retina for a long period. Cataract was identified in 89% of the eyes, which could have delayed the detection of the retinal detachment. Severe reactions in the residual cortex and the lens capsule can worsen the retinal condition. Our results suggested that inhibition of cell migration at the optic edge is regulated by the degree of contact pressure between the intraocular lens optic edge and posterior capsule. A sharp capsule bend might indicate strong contact but does not in itself inhibit cell migration. We aimed to search the immunologic abnormalitoies of eyes with atopic retinal detachment, but could not detect specific cytokine from the vitreous fluid and conjunctiva in cases with retinal detachment. However, increased circulating skin homing cutaneous lymphocyte associated antigen(CLA,)+ type 2 cytokine-producing cells, and decreased CLA+ type 1 cytokine-producing cells in atopic dermatitis, and an unexpected in crease in circulating interferon gamma (IFN-γ), were found. It suggested that cytokine imbalance and cellular migration to inflammatory sites were also important compornents of atopic dermatitis. To improve the therapeutic strategies for the treatment of retinal detachment in atopic patients, we have to investigate T cell mediated allergic disorders in eyes with atopic dermatitis patients or an animal model for atopic dermatitis. Less
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