Individualization of treatment therapy for diabetic macular edema by laser speckle flowgraphy

• Project/Area Number: 25462737
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Ophthalmology
• Research Institution: Tokyo Medical University
• Principal Investigator: Shimura Masahiko 東京医科大学, 医学部, 教授 (20302135)
• Co-Investigator(Kenkyū-buntansha): YASUDA Kanako 東京医科大学, 医学部, 講師 (70647461)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Project Status: Completed (Fiscal Year 2015)
• Budget Amount: ¥5,070,000 (Direct Cost: ¥3,900,000、Indirect Cost: ¥1,170,000); Fiscal Year 2015: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2014: ¥1,170,000 (Direct Cost: ¥900,000、Indirect Cost: ¥270,000); Fiscal Year 2013: ¥2,340,000 (Direct Cost: ¥1,800,000、Indirect Cost: ¥540,000)
• Keywords: 糖尿病黄斑浮腫 / 血流 / サイトカイン / 治療プロトコール / 網膜硝子体疾患 / 前房水 / 網膜血流 / 糖尿病網膜症 / 糖尿病 / 黄斑浮腫 / 加齢変化 / 眼循環圧

Outline of Final Research Achievements

The main cause of diabetic macular edema is considered to be retinal vascular deficiencies, and there are various types of treatment therapies, and also the sensitivity to each therapy is cknown to be case-dependent. In this study, using laser speckle flowgraphy, we successfully evaluate the dynamic change of blood flow volume in the retinal vessels. However, unfortunately, dynamic change of retinal blood flow volume after each treatment did not correlate with visual or morphologicl prognosis. Thus the limitation of this study with evaluation of blood flow volume was clarified. While response to anti-VEGF therapy for diabetic macular edema varies individually, and baseline humor aqueous concentrations of inflammatory cytokines reflect the number of IVR injections in the loading phase required to resolve DME.

Research Products

• [Journal Article] Reduction of the frequency of intravitreal bevacizumab by posterior subtenon injection of triamcinolone acetonide in patients with diffuse diabetic macular edema (2016)
  • Author(s): Shimura M, Yasuda K, Minezaki T, Noma H
  • Journal Title: Jpn J Ophthalmol Volume: 印刷中
  • Peer Reviewed
• [Journal Article] Role of soluble vascular endothelial growth factor receptors-1 and -2, their ligand, and other factors in branch retinal vein occlusion with macular edema. (2014)
  • Author(s): Noma, H., Mimura, T., Yasuda, K. and Shimura, M.
  • Journal Title: Invest Ophthalmol Vis Sci Volume: 55 Issue: 6 Pages: 3878-3885
  • DOI: 10.1167/iovs.14-13961
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Pulse waveform analysis of normal population using laser speckle flowgraphy. (2014)
  • Author(s): Tsuda, S., Kunikata, H., Shimura, M., Kunikata, H., Aizawa, N., Omodaka, K., Shiga, Y., Yasuda, M., Yokoyama, Y. and Nakazawa, T.
  • Journal Title: Curr Eye Res Volume: 39 Issue: 12 Pages: 1207-1215
  • DOI: 10.3109/02713683.2014.905608
  • Peer Reviewed
• [Journal Article] Vascular growth factor and its soluble receptors-1 and -2 in iris neovascularization and neovascular glaucoma. (2014)
  • Author(s): Noma, H., Mimura, T., Yasuda, K. and Shimura, M.
  • Journal Title: Ophthalmologica Volume: 232 Issue: 2 Pages: 102-109
  • DOI: 10.1159/000360303
  • Peer Reviewed
• [Journal Article] Role of inflammation in diabetic macular edema. (2014)
  • Author(s): Noma, H., Mimura, T., Yasuda, K. and Shimura, M.
  • Journal Title: Ophthalmologica Volume: 232 Issue: 3 Pages: 127-135
  • DOI: 10.1159/000364955
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Relationship of skin autofluorescence to severity of retiniopathy in type 2 diabetes (2014)
  • Author(s): Yasuda M, Shimura M, ....Yasuda K,......Nakazawa T.
  • Journal Title: Current Eye Research Volume: in press
  • Peer Reviewed
• [Journal Article] Relative flow volume, a novel blood flow index in the human retina derived from laser speckle flowgraphy (2014)
  • Author(s): Shiga T, Shimura M, ......., Nakazawa T
  • Journal Title: Investigative Ophthalmology & Visual Sciences Volume: in press
  • Peer Reviewed
• [Presentation] Vitreous concentrations of cytokines indicates visual prognosis after vitrectomy in patients with rhegmatogenous retinal detachment (2016)
  • Author(s): Shimura M, Motohashi R, Yasuda K, Noma H
  • Organizer: 2016 Annual Metting of Association for Research in Vision and Ophthalmology
  • Place of Presentation: Seatle USA
  • Year and Date: 2016-05-01
  • Int'l Joint Research
• [Presentation] Dynamic change of aqueous concentrations of cytokines and their receptors during the clinical course of ranibizumab treatment in diabetic macular edema. (2015)
  • Author(s): Masahiko Shimura
  • Organizer: Associartion for Research in Vision and Ophthalmology
  • Place of Presentation: Denver
  • Year and Date: 2015-05-02 – 2015-05-07
• [Presentation] Urrent opinion on optimal anti-VEGF for wAMD treatment (2014)
  • Author(s): Masahiko Shimura
  • Organizer: 2014 Annual Meeting of Taiwan Ophthalmological Scoiety
  • Place of Presentation: Taipei
  • Year and Date: 2014-12-13 – 2014-12-15
  • Invited
• [Presentation] Comaparative evaluation of dynamic change of aqueous concentration of VEGF receptorsa between ranibizumab and aflibercept in patients with wet AMD (2014)
  • Author(s): Masahiko Shimura
  • Organizer: American Academy of Ophthalmology 2014
  • Place of Presentation: Chicago
  • Year and Date: 2014-10-16 – 2014-10-22
• [Presentation] Efficacy and Safety of Intravitreal Aflibercept for Diabetic Macular Edema:VIVIDDME (2014)
  • Author(s): Masahiko Shimura
  • Organizer: Asia Pacific Macula Meeting 2014
  • Place of Presentation: Singapore
  • Year and Date: 2014-10-10 – 2014-10-12
  • Invited
• [Presentation] Current Treatment Approaches and Unmet medical needs in PCV among Asians (2014)
  • Author(s): Masahiko Shimura
  • Organizer: Asia Pacific Macula Meeting 2014
  • Place of Presentation: Singapore
  • Year and Date: 2014-10-10 – 2014-10-12
  • Invited
• [Presentation] Changes of Arterial and Venous Blood Flow Velocities at Retinal Bifurcations (2014)
  • Author(s): Shimura M, ......, Yasuda K, Noma H.
  • Organizer: Asscosiation for Research and Vision in Ophthalmology 2014
  • Place of Presentation: Orland FL, USA.
• [Presentation] Dynamic change of aqueous concentrations of VEGF and its soluble receptors during the treatment of aflibercept in patients with age-related macular degeneration (2014)
  • Author(s): Tanaka A, ...., Yasuda K, Noma H, Shimura M
  • Organizer: Asscosiation for Research and Vision in Ophthalmology 2014
  • Place of Presentation: Orland FL, USA
• [Presentation] 硝子体手術の功罪「黄斑浮腫」 (2014)
  • Author(s): 志村雅彦
  • Organizer: 第118回日本眼科学会
  • Place of Presentation: 東京
  • Invited