2002 Fiscal Year Annual Research Report

硝子体の病態生理と新しい治療法

Research Project

Project/Area Number	14370557
Research Institution	Nagoya University
Principal Investigator	寺崎浩子名古屋大学, 大学院・医学系研究科, 教授 (40207478)
Co-Investigator(Kenkyū-buntansha)	近藤峰生名古屋大学, 医学部附属病院, 講師 (80303642) 中村誠名古屋大学, 大学院・医学系研究科, 講師 (60283438) 三宅養三名古屋大学, 大学院・医学系研究科, 教授 (30166136)
Keywords	網膜硝子体手術 / 網膜電図 / 黄斑円孔 / 加齢黄斑変性 / 黄斑上膜 / 光干渉断層計 / プラスミン / 内境界膜
Research Abstract	本年度では、硝子体の質的、構造的異常と黄斑疾患の相互関係では、無/偽水晶体眼に発生する嚢胞様黄斑浮腫の汎網膜機能障害を証明し、硝子体の病態が黄斑部疾患に関わっていることを証明した(AJO,2003 in press)。特発性黄斑円孔では中心窩の硝子体の接着強度によりその形成、進行過程が異なることを証明した(AJO,2003 in press)。硝子体手術による黄斑機能の回復を検討し、黄斑上膜(IOVS,2003 in press)、脈絡膜新生血管(IOVS,2002)、糖尿病黄斑浮腫(Ophthalmic Res,2003 in press)、偽黄斑円孔(AJO,2003 in press)では主に網膜厚の変化による形態の改善がもたらす効果であることがわかった。一方、硝子体を網膜表面からより完全に除去するための内境界膜剥離や複雑な手技を含む全周網膜切開黄斑移動術などでは手術侵襲などにより形態と比べて機能回復は遅延し((Ophthalmology, submitted, IOVS, submitted)、虚血性疾患(糖尿病黄斑浮腫(IOVS, submitted)、未熟児網膜症など)では網膜機能回復に限界があることがわかった。そこで新しい治療法として酵素を用いた硝子体切除を臨床的に可能にした。市販のプラスミンを注入した家兎眼での組織学的、形態、機能的解析ではその功罪に濃度依存性がみられた。臨床治験委員会の許可とともに書面による説明と患者の承諾を得て後部硝子体剥離(PVD)のない黄斑浮腫、特発性黄斑円孔、黄斑上膜に自己血清プラスミンを用いた硝子体手術を行い、後部硝子体網膜境界面でのプラスミンの効果は人眼内境界膜の電子顕微鏡的検討により明らかになった(Ophthalmology, submitted)。

Research Products
(19 results)

All Other

All Publications (19 results)

[Publications] Terasaki H, Miyake Y, Niwa T, Kikuchi M, Suzuki T, Kondo M: "Focal macular electroretinogram before and after removal of choroidal neovascular lesions"Invest Ophthalmol Vis Sci. 43. 1540-1545 (2002)
[Publications] Kondo M, Sieving PA: "Post-photoreceptoral activity dominates primate photopic 32-Hz ERG for sine-, square-, and pulsed stimuli"Invest Ophthalmol Vis Sci. 43. 2500-2507 (2002)
[Publications] Fukui T, Miyake Y. et al.: "ABCA4 gene mutations in Japanese patients with stargardt disease and retinitis pigmentosa"Invest Ophthalmol Vis Sci. 43. 2819-2824 (2002)
[Publications] Hirai T, Ito Y, Arai M, Ota Y, Kojima T, Sato M, Miyake Y: "Loss of stereopsis with optic chiasmal lesions and stereoscopic tests as a differential test"Ophthalmology. 109. 1692-1702 (2002)
[Publications] Nakamura M, Hotta Y, Piao CH, Kondo M, Terasaki H, Miyake Y: "Enhanced S-cone syndrome with subfoveal neovascularization"Am J Ophthalmol. 133. 575-577 (2002)
[Publications] Nakamura M, Ito S, Terasaki H, Miyake Y: "Incomplete congenital stationary night blindness associated with symmetrical retinal atrophy"Am J Ophthalmol. 134. 463-465 (2002)
[Publications] Sato M, Terasaki H, Amano E, Okamoto Y, Miyake Y: "Ultrasound biomicroscopic findings in Hallermann-Streiff Syndrome"Jpn J Ophthalmol. 46. 451-454 (2002)
[Publications] Niwa T, Terasaki H, Kondo M, Piao CH, Suzuki T, Miyake Y: "Function and morphology of macula before and after removal of an idiopathic epiretinal membrane"Invest Ophthalmol Vis Sci. (in press). (2003)
[Publications] Sato M, Terasaki H, Ogino N, Okamoto Y, Amano E, Ukai K, Hirai T: "Strabological findings following macular translocation surgery With 360-degree retinotomy"Invest Ophthalmol Vis Sci. (in press). (2003)
[Publications] Terasaki H, Miyake K, Miyake Y: "Reduced oscillatory potentials of the full-field electroretinogram of eyes with aphakic or pseudophakic cystoid macular edema"Am J Ophthalmol. (in press). (2003)
[Publications] Suzuki T, Terasaki H, Niwa T, Mori M, Kondo M, Miyake Y: "Optical coherence tomography and focal macular electroretinogram in eyes with epiretinal membrane and macular pseudohole"Am J Ophthalmol. (in press). (2003)
[Publications] Kondo M, Ito Y, Ueno S, Piao CH, Terasaki H, Miyake Y: "Foveal thickness in occult macular dystrophy"Am J Ophthalmol. (in press). (2003)
[Publications] Hotta K, Nakamura M, Kondo M, Ito T, Terasaki H, Miyake Y, Hida T: "Macular dystrophy in a Japanese family with fundus albipunctatus"Am J Ophthalmol. (in press). (2003)
[Publications] Ito Y, Terasaki H, Suzuki T, Kojima T, Mori M, Ishikawa K, Miyake Y: "Mapping posterior vitreous detachment by optical coherence tomography in eyes with idiopathic macular hole"Am J Ophthalmol. (in press). (2003)
[Publications] Mori M, Terasaki H, Ito Y, Horio N, Niwa H, Suzuki T, Miyake Y: "Foveal shape after idiopathic macular hole surgery with and without internal limiting membrane removal"Retina. (in press). (2003)
[Publications] Terasaki H, Hirose T: "Late-onest retinal detachment associated with regressed retinopathy"Jpn J Ophthalmol. (in press). (2003)
[Publications] Marmor M, Hood DC, Keating M, Kondo M, Seeliger M, Miyake Y: "Guidelines for basic multifocal electroretinography (mfERG)"Doc Ophthalmol. (in press). (2003)
[Publications] Nakamura M, Skalet J, Miyake Y: "RDH5 gene mutations and electroretinogram in fundus albipunctatus with or without macular dystrophy"DOC Ophthalmol. (in press). (2003)
[Publications] Kojima T, Terasaki H, Nomura H, Suzuki T, Mori M, Ito Y, Miyake Y.: "Vitrectomy for Diabetic Macular Edema : Effect of Glycemic Control (HbAlc), Renal Function (Creatinine) and other Local Factors"Ophthalmic Res.. (in press). (2003)

2002 Fiscal Year Annual Research Report

硝子体の病態生理と新しい治療法

Principal Investigator

寺崎 浩子 名古屋大学, 大学院・医学系研究科, 教授 (40207478)

Research Products

[Publications] Terasaki H, Miyake Y, Niwa T, Kikuchi M, Suzuki T, Kondo M: "Focal macular electroretinogram before and after removal of choroidal neovascular lesions"Invest Ophthalmol Vis Sci. 43. 1540-1545 (2002)

[Publications] Kondo M, Sieving PA: "Post-photoreceptoral activity dominates primate photopic 32-Hz ERG for sine-, square-, and pulsed stimuli"Invest Ophthalmol Vis Sci. 43. 2500-2507 (2002)

[Publications] Fukui T, Miyake Y. et al.: "ABCA4 gene mutations in Japanese patients with stargardt disease and retinitis pigmentosa"Invest Ophthalmol Vis Sci. 43. 2819-2824 (2002)

[Publications] Hirai T, Ito Y, Arai M, Ota Y, Kojima T, Sato M, Miyake Y: "Loss of stereopsis with optic chiasmal lesions and stereoscopic tests as a differential test"Ophthalmology. 109. 1692-1702 (2002)

[Publications] Nakamura M, Hotta Y, Piao CH, Kondo M, Terasaki H, Miyake Y: "Enhanced S-cone syndrome with subfoveal neovascularization"Am J Ophthalmol. 133. 575-577 (2002)

[Publications] Nakamura M, Ito S, Terasaki H, Miyake Y: "Incomplete congenital stationary night blindness associated with symmetrical retinal atrophy"Am J Ophthalmol. 134. 463-465 (2002)

[Publications] Sato M, Terasaki H, Amano E, Okamoto Y, Miyake Y: "Ultrasound biomicroscopic findings in Hallermann-Streiff Syndrome"Jpn J Ophthalmol. 46. 451-454 (2002)

[Publications] Niwa T, Terasaki H, Kondo M, Piao CH, Suzuki T, Miyake Y: "Function and morphology of macula before and after removal of an idiopathic epiretinal membrane"Invest Ophthalmol Vis Sci. (in press). (2003)

[Publications] Sato M, Terasaki H, Ogino N, Okamoto Y, Amano E, Ukai K, Hirai T: "Strabological findings following macular translocation surgery With 360-degree retinotomy"Invest Ophthalmol Vis Sci. (in press). (2003)

[Publications] Terasaki H, Miyake K, Miyake Y: "Reduced oscillatory potentials of the full-field electroretinogram of eyes with aphakic or pseudophakic cystoid macular edema"Am J Ophthalmol. (in press). (2003)

[Publications] Suzuki T, Terasaki H, Niwa T, Mori M, Kondo M, Miyake Y: "Optical coherence tomography and focal macular electroretinogram in eyes with epiretinal membrane and macular pseudohole"Am J Ophthalmol. (in press). (2003)

[Publications] Kondo M, Ito Y, Ueno S, Piao CH, Terasaki H, Miyake Y: "Foveal thickness in occult macular dystrophy"Am J Ophthalmol. (in press). (2003)

[Publications] Hotta K, Nakamura M, Kondo M, Ito T, Terasaki H, Miyake Y, Hida T: "Macular dystrophy in a Japanese family with fundus albipunctatus"Am J Ophthalmol. (in press). (2003)

[Publications] Ito Y, Terasaki H, Suzuki T, Kojima T, Mori M, Ishikawa K, Miyake Y: "Mapping posterior vitreous detachment by optical coherence tomography in eyes with idiopathic macular hole"Am J Ophthalmol. (in press). (2003)

[Publications] Mori M, Terasaki H, Ito Y, Horio N, Niwa H, Suzuki T, Miyake Y: "Foveal shape after idiopathic macular hole surgery with and without internal limiting membrane removal"Retina. (in press). (2003)

[Publications] Terasaki H, Hirose T: "Late-onest retinal detachment associated with regressed retinopathy"Jpn J Ophthalmol. (in press). (2003)

[Publications] Marmor M, Hood DC, Keating M, Kondo M, Seeliger M, Miyake Y: "Guidelines for basic multifocal electroretinography (mfERG)"Doc Ophthalmol. (in press). (2003)

[Publications] Nakamura M, Skalet J, Miyake Y: "RDH5 gene mutations and electroretinogram in fundus albipunctatus with or without macular dystrophy"DOC Ophthalmol. (in press). (2003)

[Publications] Kojima T, Terasaki H, Nomura H, Suzuki T, Mori M, Ito Y, Miyake Y.: "Vitrectomy for Diabetic Macular Edema : Effect of Glycemic Control (HbAlc), Renal Function (Creatinine) and other Local Factors"Ophthalmic Res.. (in press). (2003)

寺崎浩子名古屋大学, 大学院・医学系研究科, 教授 (40207478)