Pathological clarification and development of novel treatment in neovascular age-related macular degeneration using adaptive-optics optical coherence tomography

2021 Fiscal Year Research-status Report

• Project/Area Number: 21K09716
• Research Institution: Kyoto University
• Principal Investigator: 宮田 学 京都大学, 医学研究科, 講師 (00548505)
• Co-Investigator(Kenkyū-buntansha): 村岡 勇貴 京都大学, 医学研究科, 助教 (00739089) ; 大音 壮太郎 京都大学, 医学研究科, 講師 (10511850) ; 池田 華子 京都大学, 医学研究科, 特定准教授 (20372162) ; 三宅 正裕 京都大学, 医学研究科, 特定講師 (90812793)
• Project Period (FY): 2021-04-01 – 2024-03-31
• Keywords: 滲出型加齢黄斑変性 / イメージング / 網膜色素上皮裂孔 / 黄斑下出血

Outline of Annual Research Achievements

本年度は主に滲出型加齢黄斑変性に併発する視機能に影響を与える重要な合併症である網膜色素上皮裂孔と黄斑下出血のイメージング研究を進めた。まず、網膜色素上皮裂孔は網膜色素上皮の一部に裂孔が生じて、出血をきたしたり、将来的には網膜萎縮につながったりすることがある。黄斑部に生じると、視力が落ちると言われているが、原因についてはよくわかっていない。そこで最新のイメージング機器であるswept-source optical coherence tomography angiography画像を、抗VEGF治療前に撮影し、種々のパラメータを解析し、治療後に網膜色素上皮裂孔が生じた群と生じなかった群で比較した。網膜色素上皮裂孔が生じたのは1年間で5.3%（8眼/152眼）であり、生じたものの方が、網膜色素上皮剥離の面積が広く、丈が高く、網膜色素上皮剥離面積に対する脈絡膜新生血管面積の割合が小さかった。次に、黄斑下出血は急激に視力が低下し、治療は黄斑部から出血を移動させることである。治療にはガス硝子体注射単独や、最近では組織プラスミノゲンアクチベータを網膜下に注入したりする手術がある。前者は低侵襲であるが、移動しない症例もある。そこで、黄斑下出血をきたし、SF6ガスを硝子体腔に注射して治療した症例で、黄斑部からの出血の移動性に関連するパラメータをoptical coherence tomographyを用いて調べた。出血の硝子体腔に対するコントラストの比（contrast to noise ratio; CNR）が高いことが出血移動の程度に最も関連があることがわかった。このCNRを考慮すれば、低侵襲のSF6ガスだけでも出血を黄斑外へ移動する可能性が高い症例を事前に認識することが可能となった。

Current Status of Research Progress

2: Research has progressed on the whole more than it was originally planned.

Reason

イメージング研究が進んでいるから。

Strategy for Future Research Activity

このままイメージングを用いて多角的に滲出型加齢黄斑変性の病態把握に努める。

Causes of Carryover

COVID-19の影響で学会がweb開催となり、旅費がかからなかったため。

Research Products

• [Journal Article] CONTRAST-TO-NOISE RATIO IS A USEFUL PREDICTOR OF EARLY DISPLACEMENT OF LARGE SUBMACULAR HEMORRHAGE BY INTRAVITREAL SF6 GAS INJECTION (2022)
  • Author(s): Ura Sawako、Miyata Manabu、Ooto Sotaro、Yasuhara Satoshi、Tamura Hiroshi、Ueda-Arakawa Naoko、Muraoka Yuki、Miyake Masahiro、Takahashi Ayako、Wakazono Tomotaka、Uji Akihito、Yamashiro Kenji、Tsujikawa Akitaka
  • Journal Title: Retina Volume: 42 Pages: 661～668
  • DOI: 10.1097/IAE.0000000000003360
  • Peer Reviewed
• [Journal Article] Pachychoroid‐phenotype effects on 5‐year visual outcomes of anti‐VEGF monotherapy in polypoidal choroidal vasculopathy (2022)
  • Author(s): Shimizu Yuichiro、Miyata Manabu、Ooto Sotaro、Miyake Masahiro、Mori Yuki、Tamura Hiroshi、Ueda‐Arakawa Naoko、Uji Akihito、Muraoka Yuki、Takahashi Ayako、Wakazono Tomotaka、Yamashiro Kenji、Hata Masayuki、Tsujikawa Akitaka
  • Journal Title: Acta Ophthalmologica Volume: 100 Pages: e943-e949
  • DOI: 10.1111/aos.15015
  • Peer Reviewed
• [Journal Article] Unilateral transient high myopization after pediatric strabismus surgery: Observation by anterior segment optical coherence tomography (2022)
  • Author(s): Yoshimura Akihito、Miyata Manabu、Muraoka Yuki、Kawai Kentaro、Tsujikawa Akitaka
  • Journal Title: American Journal of Ophthalmology Case Reports Volume: 25 Pages: 101421～101421
  • DOI: 10.1016/j.ajoc.2022.101421
  • Peer Reviewed / Open Access
• [Journal Article] Rescue photodynamic therapy for age-related macular degeneration refractory to anti-vascular endothelial growth factor monotherapy (2022)
  • Author(s): Yoshida Miyo、Oishi Akio、Miyake Masahiro、Ooto Sotaro、Tamura Hiroshi、Miyata Manabu、Takahashi Ayako、Hata Masayuki、Yamashiro Kenji、Tsujikawa Akitaka
  • Journal Title: Photodiagnosis and Photodynamic Therapy Volume: 38 Pages: 102745～102745
  • DOI: 10.1016/j.pdpdt.2022.102745
  • Peer Reviewed
• [Journal Article] Evaluation of outer nuclear layer overshadowed by retinal vessels in retinitis pigmentosa (2022)
  • Author(s): Otsuka Yuki、Oishi Akio、Miyata Manabu、Uji Akihito、Oishi Maho、Hasegawa Tomoko、Numa Shogo、Ikeda Hanako Ohashi、Tsujikawa Akitaka
  • Journal Title: Eye Volume: 36 Pages: 1042～1049
  • DOI: 10.1038/s41433-021-01578-y
  • Peer Reviewed
• [Journal Article] PREDICTORS OF RETINAL PIGMENT EPITHELIUM TEAR DEVELOPMENT AFTER TREATMENT FOR NEOVASCULAR AGE-RELATED MACULAR DEGENERATION USING SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY (2022)
  • Author(s): Yasuhara Satoshi、Miyata Manabu、Ooto Sotaro、Tamura Hiroshi、Ueda-Arakawa Naoko、Uji Akihito、Muraoka Yuki、Miyake Masahiro、Takahashi Ayako、Wakazono Tomotaka、Yamashiro Kenji、Tsujikawa Akitaka
  • Journal Title: Retina Volume: Publish Ahead of Print Pages: -
  • DOI: 10.1097/IAE.0000000000003426
  • Peer Reviewed
• [Journal Article] Three-dimensional locations of ruptured retinal arterial macroaneurysms and their associations with the visual prognosis (2022)
  • Author(s): Sakaguchi Saori、Muraoka Yuki、Kadomoto Shin、Ooto Sotaro、Murakami Tomoaki、Nishigori Naomi、Ishikura Masaharu、Miyake Masahiro、Miyata Manabu、Uji Akihito、Tsujikawa Akitaka
  • Journal Title: Scientific Reports Volume: 12 Pages: -
  • DOI: 10.1038/s41598-021-04500-4
  • Peer Reviewed
• [Journal Article] Influence of vitreomacular interface score on treatment outcomes of anti-VEGF therapy for neovascular age-related macular degeneration (2021)
  • Author(s): Miyata Manabu、Ooto Sotaro、Yamashiro Kenji、Tamura Hiroshi、Uji Akihito、Miyake Masahiro、Muraoka Yuki、Takahashi Ayako、Tsujikawa Akitaka
  • Journal Title: International Journal of Retina and Vitreous Volume: 7 Pages: -
  • DOI: 10.1186/s40942-021-00342-4
  • Peer Reviewed
• [Journal Article] Retinal artery tortuosity in Marfan’s syndrome (2021)
  • Author(s): Miyata Manabu、Ooto Sotaro、Uji Akihito、Tsujikawa Akitaka
  • Journal Title: QJM: An International Journal of Medicine Volume: 114 Pages: 601～602
  • DOI: 10.1093/qjmed/hcab079
  • Peer Reviewed
• [Journal Article] Long-Term Visual Outcome in Inferior Posterior Staphyloma and Efficacy of Treatment for Complicated Choroidal Neovascularization (2021)
  • Author(s): Doi Ayaka、Miyata Manabu、Ooto Sotaro、Tamura Hiroshi、Ueda-Arakawa Naoko、Uji Akihito、Muraoka Yuki、Miyake Masahiro、Takahashi Ayako、Wakazono Tomotaka、Yamashiro Kenji、Tsujikawa Akitaka
  • Journal Title: American Journal of Ophthalmology Volume: 229 Pages: 152～159
  • DOI: 10.1016/j.ajo.2021.02.034
  • Peer Reviewed
• [Journal Article] Association between the number of visual fields and the accuracy of future prediction in eyes with retinitis pigmentosa (2021)
  • Author(s): Asaoka Ryo、Oishi Akio、Fujino Yuri、Murata Hiroshi、Azuma Keiko、Miyata Manabu、Obata Ryo、Inoue Tatsuya
  • Journal Title: BMJ Open Ophthalmology Volume: 6 Pages: e000900～e000900
  • DOI: 10.1136/bmjophth-2021-000900
  • Peer Reviewed
• [Journal Article] Prevention of Image Quality Degradation in Wider Field Optical Coherence Tomography Angiography Images Via Image Averaging (2021)
  • Author(s): Kawai Kentaro、Uji Akihito、Miyazawa Takafumi、Yamada Tatsuya、Amano Yuri、Miyagi Sonoka、Seo Ryangha、Miyata Manabu、Kadomoto Shin、Tsujikawa Akitaka
  • Journal Title: Translational Vision Science & Technology Volume: 10 Pages: 16～16
  • DOI: 10.1167/tvst.10.13.16
  • Peer Reviewed
• [Journal Article] Detecting Progression of Retinitis Pigmentosa Using the Binomial Pointwise Linear Regression Method (2021)
  • Author(s): Asano Shotaro、Oishi Akio、Asaoka Ryo、Fujino Yuri、Murata Hiroshi、Azuma Keiko、Miyata Manabu、Obata Ryo、Inoue Tatsuya
  • Journal Title: Translational Vision Science & Technology Volume: 10 Pages: 15～15
  • DOI: 10.1167/tvst.10.13.15
  • Peer Reviewed
• [Journal Article] Detection Sensitivity of Retinitis Pigmentosa Progression Using Static Perimetry and Optical Coherence Tomography (2021)
  • Author(s): Hasegawa Tomoko、Oishi Akio、Ikeda Hanako Ohashi、Numa Shogo、Miyata Manabu、Otsuka Yuki、Oishi Maho、Tsujikawa Akitaka
  • Journal Title: Translational Vision Science & Technology Volume: 10 Pages: 31～31
  • DOI: 10.1167/tvst.10.8.31
  • Peer Reviewed
• [Journal Article] Development and validation of a visual field cluster in retinitis pigmentosa (2021)
  • Author(s): Omoto Takashi、Oishi Akio、Asaoka Ryo、Fujino Yuri、Murata Hiroshi、Azuma Keiko、Miyata Manabu、Obata Ryo、Inoue Tatsuya
  • Journal Title: Scientific Reports Volume: 11 Pages: -
  • DOI: 10.1038/s41598-021-89233-0
  • Peer Reviewed
• [Journal Article] Effects of Intravitreous Aflibercept Injection in Pachychoroid Neovasculopathy: Comparison with Typical Neovascular Age-Related Macular Degeneration (2021)
  • Author(s): Elfandi Sufian、Ooto Sotaro、Miyata Manabu、Ueda-Arakawa Naoko、Subhi Yousif、Yamashiro Kenji、Tamura Hiroshi、Oishi Akio、Hata Masayuki、Yoshimura Nagahisa、Tsujikawa Akitaka
  • Journal Title: Clinical Ophthalmology Volume: Volume 15 Pages: 1539～1549
  • DOI: 10.2147/OPTH.S285257
  • Peer Reviewed
• [Journal Article] A novel dextrin produced by the enzymatic reaction of 6-α-glucosyltransferase. I. The effect of nonreducing ends of glucose with by α-1,6 bonds on the retrogradation inhibition of high molecular weight dextrin (2021)
  • Author(s): Yasuda Akiko、Miyata Manabu、Sano Osamu、Sogo Tatsufumi、Kishishita Seiichiro、Yamamoto Takuo、Aga Hajime、Yamamoto Koryu
  • Journal Title: Bioscience, Biotechnology, and Biochemistry Volume: 85 Pages: 1737～1745
  • DOI: 10.1093/bbb/zbab062
  • Peer Reviewed
• [Journal Article] Clinical Characteristics, Differential Diagnosis and Genetic Analysis of Concentric Retinitis Pigmentosa (2021)
  • Author(s): Nakahara Mei、Oishi Akio、Miyata Manabu、Ikeda Hanako Ohashi、Hasegawa Tomoko、Numa Shogo、Otsuka Yuki、Oishi Maho、Matsuda Fumihiko、Tsujikawa Akitaka
  • Journal Title: Life Volume: 11 Pages: 260～260
  • DOI: 10.3390/life11030260
  • Peer Reviewed
• [Journal Article] Genotype and Long-term Clinical Course of Bietti Crystalline Dystrophy in Korean and Japanese Patients (2021)
  • Author(s): Murakami Yusuke、Koyanagi Yoshito、Fukushima Masatoshi、Yoshimura Marika、Fujiwara Kohta、Akiyama Masato、Momozawa Yukihide、Ueno Shinji、Terasaki Hiroko、Oishi Akio、Miyata Manabu、et al.
  • Journal Title: Ophthalmology Retina Volume: 5 Pages: 1269～1279
  • DOI: 10.1016/j.oret.2021.02.009
  • Peer Reviewed / Int'l Joint Research
• [Journal Article] IMAGE EVALUATION OF ARTIFICIAL INTELLIGENCE?SUPPORTED OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY IMAGING USING OCT-A1 DEVICE IN DIABETIC RETINOPATHY (2021)
  • Author(s): Kawai Kentaro、Uji Akihito、Murakami Tomoaki、Kadomoto Shin、Oritani Yasuyuki、Dodo Yoko、Muraoka Yuki、Akagi Tadamichi、Miyata Manabu、Tsujikawa Akitaka
  • Journal Title: Retina Volume: 41 Pages: 1730～1738
  • DOI: 10.1097/IAE.0000000000003101
  • Peer Reviewed
• [Journal Article] Clinical and Genetic Characteristics of Pachydrusen in Eyes with Central Serous Chorioretinopathy and General Japanese Individuals (2021)
  • Author(s): Takahashi Ayako、Hosoda Yoshikatsu、Miyake Masahiro、Miyata Manabu、Oishi Akio、Tamura Hitoshi、Ooto Sotaro、Yamashiro Kenji、Tabara Yasuharu、Matsuda Fumihiko、Tsujikawa Akitaka
  • Journal Title: Ophthalmology Retina Volume: 5 Pages: 910～917
  • DOI: 10.1016/j.oret.2020.12.004
  • Peer Reviewed
• [Presentation] Predictors of retinal pigment epithelium tear development after treatment for neovascular age-related macular degeneration using swept source optical coherence tomography angiography (2021)
  • Author(s): Yasuhara S, Miyata M, Ooto S, Tamura H, Ueda-Arakawa N, Uji A, Muraoka Y, Miyake M, Takahashi A, Wakazono T, Yamashiro K, Tsujikawa A
  • Organizer: ARVO
  • Int'l Joint Research
• [Presentation] 下方後部ぶどう腫における網膜滲出性変化が長期視力経過に与える影響と視力予測因子の検討 (2021)
  • Author(s): 土井綾香、宮田 学、大音壮太郎、田村 寛、上田奈央子、宇治彰人、村岡勇貴、三宅正裕、高橋綾子、若園知尊、山城健児、辻川明孝
  • Organizer: 第3回近視学会
• [Presentation] 滲出型加齢黄斑変性に対するアフリベルセプト硝子体注射7年成績 (2021)
  • Author(s): 濵 佑樹、宮田 学、大音壮太郎、田村 寛、上田奈央子、村岡勇貴、三宅正裕、高橋綾子、若園知尊 、宇治彰人、山城健児、辻川明孝
  • Organizer: 第72回京都大学眼科同窓会学会
• [Presentation] SF6ガス硝子体注射による大量黄斑下血腫の早期移動に影響を与える因子 (2021)
  • Author(s): 浦 佐和子、宮田 学、大音壮太郎、安原聡志、田村 寛、上田奈央子、村岡勇貴、三宅正裕、高橋綾子、若園知尊、宇治彰人、山城健児、辻川明孝
  • Organizer: 第72回京都大学眼科同窓会学会