| Co-Investigator(Kenkyū-buntansha) |
MAEDA Naoyuki Graduate School of Medicine, Osaka University, Lecturer, 医学系研究科, 講師 (00273623)
OHJI Masahito Graduate School of Medicine, Osaka University, Associate Professor, 医学系研究科, 講師 (90252650)
FUJIKADO Takashi Graduate School of Medicine, Osaka University, Professor, 医学系研究科, 教授 (50243233)
HAYASHI Atsushi Graduate School of Medicine, Osaka University, Assistant Professor, 医学系研究科, 助手 (20283773)
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| Research Abstract |
We have been developing the foveal translocation surgery as a surgical treatment modality for inveterate macular diseases such as age related macular disease and myopic neovascular maculopathy. In this study, we performed foveal translocation surgery with scleral shortening or total peripheral retinotomy in dog and monkey eyes and examined surgical procedures, histology, and electrophysiological responses. Also, we performed foveal translocation surgery in human with informed consent in the paper. We performed retinal translocation surgery in dog eyes with scleral shortening and found that retinal folds in the posterior retina were inevitable and that the translocated distances were about 1 disc diameter. In the histological examination, we showed that apoptosis was detected in the retina within the folds. Clinically foveal translocation surgery with scleral shortening is indicated for patients with small neovascular membranes, especially myopic neovascular maculopathy. Some patients s
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howed good visual acuity. We performed foveal translocation surgey with total peripheral retinotomy in monkey eyes and improved surgical procedures. Especially it was useful to make surgical procedures easy and shorten the time of surgery to irrigate vitreous cavity by a calcium-free irrigating solution by reducing physiological retinal attachment. Histologically the fovea of the monkey retina was examined by electron microscopy and some photoreceptor cells were found to be diminished. However, no apoptosis was detected after the surgery. Four types of electroretinograms were taken postoperatively (flash ERG, rod ERG, cone ERG, and flicker ERG). At 1 month after the surgery amplitudes of all electroretinograms were decreased, however, amplitudes of flash ERG, rod ERG, cone ERG, and flicker ERG recovered to 54%, 49%,34%, and 43% of the preoperative values. In monkey eyes the retinal attachment force was strong and retinal pigment epithelial defect was often occurred during intentional retinal detachment. Clinically 70% of the patients showed recovery or maintenance of the visual acuity by foveal translocation surgery with total peripheral retinotomy. More improvement is necessary in foveal translocation surgery, but in near future the foveal translocation surgery may be an effective treatment modality to inveterate macular diseases. Less
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