2020 Fiscal Year Final Research Report

Aging changes of eye and general factors, living environment, and QOL

Research Project

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Project/Area Number	18K09418
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 56060:Ophthalmology-related
Research Institution	Nara Medical University
Principal Investigator	Ogata Nahoko 奈良県立医科大学, 医学部, 教授 (60204062)
Co-Investigator(Kenkyū-buntansha)	上田哲生奈良県立医科大学, 医学部, 准教授 (00364068) 吉川匡宣奈良県立医科大学, 医学部附属病院, 研究員 (20632764) 宮田季美恵奈良県立医科大学, 医学部, 助教 (40596748) 西智奈良県立医科大学, 医学部, 講師 (70571214)
Project Period (FY)	2018-04-01 – 2021-03-31
Keywords	加齢 / 白内障 / 白内障手術 / QOL / フレイル / 概日リズム / 加齢黄斑変性 / von Willebrand因子
Outline of Final Research Achievements	In this cross-sectional study of a community-based cohort, we found that circadian blood pressure variability was significantly diminished in elderly with cataracts and odds ratio (1.78) for carotid atherosclerosis was higher in the cataract group than that in the non-cataract group. These results indicated that decreased light reception by cataracts leaded to potential circadian misalignment. In the randomized study, urinary melatonin excretion 3 months after surgery was significantly higher in the cataract surgery group than in the control group. Cataract surgery may increase melatonin secretion. Mobility functions indicated by walking speed and one-leg standing times were significantly associated with visual impairment in an elderly cohort. Thus, visual impairment may advance frail conditions in elderly. We suggest the biological differences between pachychoroid neovasculopathy and age-related macular degeneration by genetic alternations in CFH and von Willebrand factor.
Free Research Field	眼科学
Academic Significance and Societal Importance of the Research Achievements	白内障は加齢に伴うほぼ必発の眼疾患であるが、白内障があると水晶体の混濁により視力が低下するだけでなく、血圧変動、頸動脈硬化の進行など全身的にも影響が大きいことを明らかにした。これは白内障により眼底へのブルーライトの到達が妨げられ概日リズムが変化したためと考えられる。白内障手術によりメラトニン分泌が増加し、概日リズムが改善すると考えられ、視力の維持によりフレイルを予防でき、白内障手術が視機能の改善だけでなく、全身的に健康維持に働くということを明らかにした。近年注目されるpachychoroid neovasculopathyと加齢黄斑変性の相違において初めて生物学的活性の違いを明らかにした。