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WGA Rescources

Top-ten Japan Glaucoma Society Meeting
Fukuoka, Fukuoka, Japan, September 24-26, 2009

Akihiko Tawara

Akihiko Tawara


  1. A new staging system was devised based on Visual Field Index (VFI) in 574 eyes of 378 patients by calculating VFI equivalent of Mean Deviation (MD) -6dB and -12dB with Humphrey visual field analyzer, which is the gold standard of existing staging system. The results indicate that MD -6dB and -12dB were nearly equivalent to VFI 81.5% (AUC=0.978) and 59.5% (AUC=0.981) respectively, and suggest the new staging system based on VFI; early glaucoma with VFI≥82%, moderate with 60%<VFI < 82% and advanced with VFI≤60%. (Kazunori Hirasawa, Sagamihara)
  2. A multi-center study was conducted to investigate a correlation between disability of daily life and a reduction of the binocular visual field in patients with glaucoma. One hundred twenty-nine patients with advanced stages of glaucoma were enrolled for the study. A reduction in the total deviation (TD) of the 10-2 mode of Humphrey field analyzer of the patients was measured for each quadrant to assess the binocular visual field. Although the reduction of TD in the lower quadrants was smaller than that in the upper quadrants, it showed higher correlation with disability of dairy life than that in upper ones. The data imply the importance of the visual field in the lower quadrants for daily life. (Kenji Mizuki, Kasukabe)
  3. In 38 glaucomatous eyes with generalized enlargement optic disc type (GEOD), the correlation of the optic disc microcirculation evaluated by laser speckle flowgraphy (LSFG) to mean deviation (MD) of Humphrey field analyzer, average retinal nerve fiber layer thickness (avgRNFLT) by OCT, or vertical cup disc ratio (vC/D) by HRTII was investigated. The mean blur rates (MBR) of the total, tissue and vessel blood flow in the optic nerve head measured by LSFG were significantly correlated to MD, avgRNFLT, and vC/D. Especially, MBR of the tissue blood flow showed a strong correlation to the parameters for glaucoma patients with GEOD. (Naki Chiba, Sendai)
  4. The efficacy and safety of bimatoprost as replacement for latanoprost, travoprost, or tafluprost were prospectively evaluated. Subjects were 133 eyes on monotherapy of latanoprost, travoprost, or tafluprost at the baseline, with average IOP at Day 0 of 15.2±2.9mmHg. Treatments were switched to bimatoprost monotherapy, resulting in statistically significant IOP reduction after the switch, at four weeks and 12 weeks (average IOP: 14.2±2.9mmHg, 14.3±3.1mmHg respectively); however, their conjunctival hyperemia scores were significantly increased at 4 weeks and 12 weeks. There was no change in the degree of superficial punctate keratopathy. Photos of eye lid area were obtained in 60 cases, and 27 cases were positive for deepening of eyelid superior sulcus, out of which, one case terminated the bimatoprost administration. There were 10 cases out of 133 that terminated the therapy. Switching to bimatoprost is shown as an effective therapeutic option, but the explanations for the reported conjunctival hyperemia and deepening of the eyelid superior sulcus are necessary. (Jun Takayama, Tokyo)
  5. Causes that preclude patient's compliance of glaucoma-medication in 114 non-compliants were studied based on dosing time by means of taxonomies (i.e. systemic classification). Structured interviews elicited 191 unique situational problems, which were grouped into four separate and major categories: 114 patients-related factors (60.7%), 25 medication regimen factors (13.1%), 6 provider-related factors (3.2%) and 44 environmental factors (22.0%). Patient-related factors showed the highest incidence in both dosing time. Sleeping and taking a bath caused 39 patients (20.4%) to miss medication in patients with eyedrops in the evening. Therefore, each dosing time may have its own situational problems, which may be multidimensional and must be individualized for the patient. (Hiroshi Kobayashi, Shimonoseki)
  6. To assess whether the asymmetry of the ganglion cell layer (GCL) thickness was associated with glaucomatous structural abnormalities in the macula, a macular GCL symmetry index, which was defined as "Log10 (inferior GCL thickness/superior GCL thickness)", was examined using OCT. The confidential intervals of the GCL thickness symmetry index values along the vertical macular scan were computed, and then generated colored maps with 1% and 5% confidential limit curves. The mean GCL symmetry index at each 0.5-mm segment from the central fovea was calculated. Macular GCL symmetry index was compared among preperimetric and early glaucoma, and normal eyes. The GCL symmetry analysis sensitivity was 85.7% in eyes with preperimetric glaucoma and 75.0% in eyes with early glaucoma. The specificity was 100%. GCL symmetry analysis may be useful to detect preperimetric and early glaucomatous structural abnormalities in the macula. (Noriko Nakano, Kyoto) Ganglion cell thickness symmetry analysis using OCT, may be useful to detect preperimetric and early glaucomatous structural abnormalities in the macula. (Noriko Nakano, Kyoto)
  7. The effects of oral Yokukansan (YKS, TJ-54), a kind of anti-dementia drugs in traditional Chinese medicine, on the rabbit intraocular pressure (IOP) and ocular circulation were examined using an ultrasonic pulsed Doppler methods (SSA-260: Toshiba). The drug increased the blood flow velocities significantly in both short posterior ciliary and ophthalmic arteries. It also caused a significant decrease of IOP by 53.2% 6 hours after one shot administration. These results suggest that Yokukansan could be available as an anti-glaucoma agent. (Ritsuko Yamada, Yokohama)
  8. The usefulness of a newly devised tonometer, the principle of which is based on the measurement of the natural frequency of the cornea, was assessed. The vibration of the cornea was generated by the air jet that is used in a non-contact tonometry system. The natural frequency of the cornea was calculated by the vibration analysis at the cycle of optical signal strength of the reflected light from the irradiated cornea. As a result, the natural frequency of the cornea of porcine eyes was significantly correlated with the intraocular pressure regulated by a hydrostatic pressure system. The results suggest that the device could be a new tonometer that is based on the different principle from previous ones. (Kotaro Ishii, Tsukuba) The measurements of a newly devised tonometer of which the principle is based on the natural frequency of the cornea, generated by an air jet as used in non-contact tonometry, were significantly correlated with a pressure related hydrostatic pressure system. . (Kotaro Ishii, Tsukuba)
  9. To study the risk factors of iridocorneal angle closure, dark-light change of cross-sectional iris area (IA) in patient with PACG or PAC was examined using anterior OCT, and compared with that of normal control (NC). The iris section was divided in two parts, pupil-side iris (PSI) and peripheral iris (PI) by the line drawing at 500µm away from the scleral spur. The IAs in PACG and PAC were significantly reduced compared to that of in NC. In both groups, the IA of PI was significantly smaller in the dark room than in the light. Although the IA of PSI was larger in the dark room than in the light, the trend was not significantly different. A significant negative correlation was found between the Angle Opening Distance 500 and IA of PSI in the dark room in patients with PACG or PAC. The difference in behavior between PI and PSI might lead an angle closure in both PACG and PAC. (Takanori Mizoguchi, Sasebo)
  10. To investigate the effect of glaucomatous optic neuropathy (GON) on higher brain function, an ocular hypertension (OH) model was established for the first time in ferret eyes because ferrets have a binocular vision among the small animals. Cultured conjunctival cells were injected into the anterior chamber to occlude aqueous outflow pathway. Intraocular pressure of treated eyes was significantly elevated by 80% compared to that of contralateral control eyes for 44 weeks after the injection, and glaucomatous cupping of the optic disc was histologically detected. Then, 5μl of cholera toxin B with red and green fluorescent dyes was injected into the treated and control eyes, respectively. Four days after injection, flurorescent signal of the colliculus superior and lateral geniculate nucleus (LGN) was obviously deteriorated in the correspondent area projected from the treated eye. Microscopically, the flurorescent signal in LGN was deteriorated not only in the area correspondent with the treated eye but also in that with the control eye. These data indicate that secondary degeneration due to OH may affect LGN in both sides by binocular projected neuronal fibers, and suggest that ferret has a great potential to investigate GON and higher brain function by OH. (Takashi Fujishiro, Saitama)
    Secondary degeneration due to ocular hypertension may affect the lateral geniculate nucleus on both sides by binocular projected neuronal fibers, and suggest that the ferret ocular hypertension model has a great potential to investigate glaucomatous optic atrophy and higher brain function. (Takashi Fujishiro, Saitama)

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