緑内障眼の篩状板構造解析と遺伝子解析による治療評価法の開発

2015 Fiscal Year Annual Research Report

• Project/Area Number: 25462713
• Research Institution: Kyoto University
• Principal Investigator: 赤木 忠道 京都大学, 医学(系)研究科(研究院), 講師 (30580112)
• Co-Investigator(Kenkyū-buntansha): 後藤 謙元 京都大学, 医学(系)研究科(研究院), 准教授 (20632095) ; 池田 華子 京都大学, 医学(系)研究科(研究院), 准教授 (20372162)
• Project Period (FY): 2013-04-01 – 2016-03-31
• Keywords: 緑内障 / 篩状板 / 走査型光干渉断層計 / 遺伝子

Outline of Annual Research Achievements

眼圧下降治療に伴って篩状板の形状変化が生じることを再確認できた。緑内障手術後の篩状板形状変化は、眼圧下降度、年齢、緑内障の重症度、術前の篩状板後方変位の程度と関連を認めた。しかし、今回の検討では術後の篩状板形状変化の程度と視野障害進行抑制との相関は明らかではなかった。視野障害進行抑制に対する篩状板形状変化の関与が小さい可能性以外に、視野検査というバラツキを有する自覚検査の特性上、比較的短期間の経過で有意な判定を得ることが難しいことが影響している可能性がある。
強度近視の緑内障眼では篩状板のみならず乳頭周囲の強膜にも多彩な形状変化が生じていることを明らかにした。このことは、眼圧依存性の高い眼球内の部位が症例によって異なる可能性を示唆する。ただし、それらの変化に対する遺伝的因子の関与は本研究では明らかにすることはできなかった。
原発開放隅角緑内障の感受性遺伝子としてCAV1/CAV2 (7q31.1)、CDKN2B-AS1 (9p21.3)、ABCA1 (9q31.1)などの報告があり、特にCDKN2B-ASは正常眼圧緑内障との関連性が複数の施設から示唆されている。強度近視の緑内障患者237名とコントロール276名を対象にCDKN2B-AS1の緑内障発症への関与を検討した結果、強度近視の緑内障眼に対してCDKN2B-AS1は少なくともオッズ比1.70以上の関与は無いことが確認できた。強度近視眼の緑内障は、非強度近視眼の緑内障とは発症に関与する因子が異なる可能性が考えられる。

Research Products

• [Journal Article] Glaucoma Tube Changes After Suture Lysis Assessed by High-Resolution Anterior Segment Optical Coherence Tomography (2016)
  • Author(s): Akagi T, Uji A, Yoshimura N
  • Journal Title: JAMA Ophthalmol Volume: 134(2) Pages: e153674
  • DOI: 10.1001/jamaophthalmol.2015.3674.
  • Peer Reviewed
• [Journal Article] Transient Ciliochoroidal Detachment After Ab Interno Trabeculotomy for Open-Angle Glaucoma: A Prospective Anterior-Segment Optical Coherence Tomography Study (2016)
  • Author(s): Akagi T, Nakano E, Nakanishi H, Uji A, Yoshimura N
  • Journal Title: JAMA Ophthalmol Volume: 134(3) Pages: 304-311
  • DOI: 10.1001/jamaophthalmol.2015.5765.
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Microstructure of Peripapillary Atrophy and Subsequent Visual Field Progression in Treated Primary Open-Angle Glaucoma (2016)
  • Author(s): Yamada H, Akagi T, Nakanishi H, Ikeda HO, Kimura Y, Suda K, Hasegawa T, Yoshikawa M, Iida Y, Yoshimura N
  • Journal Title: Ophthalmology Volume: 123(3) Pages: 542-551
  • DOI: 10.1016/j.ophtha.2015.10.061
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Structural dissociation of optic disc margin components with optic disc tilting: a spectral domain optical coherence tomography study (2016)
  • Author(s): Hasegawa T, Akagi T, Hangai M, Yamada H, Suda K, Kimura Y, Nakanishi H, Ikeda HO, Yoshimura N: Structural dissociation of optic disc margin components with optic disc tilting: a spectral domain optical coherence tomography study
  • Journal Title: Graefes Arch Clin Exp Ophthalmol Volume: 254(2) Pages: 343-349
  • DOI: 10.1007/s00417-015-3210-0
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Association between the CDKN2B-AS1 gene and primary open angle glaucoma with high myopia in Japanese patients (2016)
  • Author(s): Kimura Y, Akagi T, Miyake M, Yamashiro K, Yoshikawa M, Yamada H, Hasegawa T, Suda K, Nakanishi H, Ikeda HO, Gotoh N, Hangai M, Moriyama M, Ohno-Matsui K, Yoshimura N
  • Journal Title: Ophthalmic Genet Volume: 37 Pages: 242-244
  • DOI: 10.3109/13816810.2015.1020559
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] Effect of Axial Length on Macular Ganglion Cell Complex Thickness and on Early Glaucoma Diagnosis by Spectral-Domain Optical Coherence Tomography (2015)
  • Author(s): Nakanishi H, Akagi T, Hangai M, Kimura Y, Suda K, Hasegawa T, Yamada H, Yoshikawa M, Morooka S, Ikeda HO, Yoshimura N
  • Journal Title: J Glaucoma Volume: 25 Pages: e481-e490
  • Peer Reviewed
• [Journal Article] Comparison of Longitudinal Changes in Functional and Structural Measures for Evaluating Progression of Glaucomatous Optic Neuropathy (2015)
  • Author(s): Suda K, Hangai M, Akagi T, Noma H, Kimura Y, Hasegawa T, Yamada H, Yoshikawa M, Nakanishi H, Ikeda HO, Yoshimura N
  • Journal Title: Invest Ophthalmol Vis Sci Volume: 56 Pages: 5477-5484
  • DOI: 10.1167/iovs.15-16704
  • Peer Reviewed / Acknowledgement Compliant
• [Journal Article] A Case of WAGR Syndrome in Association with Developmental Glaucoma Requiring Bilateral Baerveldt Glaucoma Implants and Subsequent Tube Repositioning (2015)
  • Author(s): Akagi T, Yoshikawa M, Nakanishi H, Yoshimura N
  • Journal Title: Clin Ophthalmol Volume: 15 Pages: 1081-1084
  • DOI: 10.2147/OPTH.S80444
  • Peer Reviewed / Open Access
• [Journal Article] Microcystic Inner Nuclear Layer Changes and Retinal Nerve Fiber Layer Defects in Eyes with Glaucoma (2015)
  • Author(s): Hasegawa T, Akagi T, Yoshikawa M, Suda K, Yamada H, Kimura Y, Nakanishi H, Miyake M, Unoki N, Ikeda HO, Yoshimura N
  • Journal Title: PLoS One Volume: 10 Pages: e0130175
  • DOI: 10.1371/journal.pone.0130175
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Sensitivity and specificity for detecting early glaucoma in eyes with high myopia from normative database of macular ganglion cell complex thickness obtained from normal non-myopic or highly myopic Asian eyes (2015)
  • Author(s): Nakanishi H, Akagi T, Hangai M, Kimura Y, Suda K, Kumagai KK, Morooka S, Ikeda HO, Yoshimura N
  • Journal Title: Graefes Arch Clin Exp Ophthalmol Volume: 253 Pages: 1143-1152
  • DOI: 10.1007/s00417-015-3026-y
  • Peer Reviewed
• [Presentation] 近視および強度近視眼緑内障の構造と機能を解明する (2015)
  • Author(s): 赤木忠道
  • Organizer: 日本緑内障学会
  • Place of Presentation: 名古屋
  • Year and Date: 2015-09-11 – 2015-09-13
  • Int'l Joint Research / Invited
• [Presentation] En Face Lamina Cribrosa Geometry in Glaucoma: Color Photography, cSLO and Adaptive Optics (2015)
  • Author(s): Akagi T
  • Organizer: Asia Pacific Academy of Ophthalmology (APAO)
  • Place of Presentation: 中国広州
  • Year and Date: 2015-04-01 – 2015-04-04
  • Int'l Joint Research / Invited