Clinical Characteristics of Idiopathic Orbital Inflammation Syndrome in Relation to Intraocular Pressure.

Purpose: To investigate the clinical characteristics of idiopathic orbital inflammation and changes in intraocular pressure (IOP) before and after its treatment. Patients and Methods: We retrospectively studied 20 eyes from the medical records of 19 patients who were diagnosed with idiopathic orbital inflammation between April 1, 2004, and April 30, 2019, at Toyama University Hospital. The inflammation site (type of disease), treatment provided, IOP before and after treatment, and the symptoms (proptosis, decreased ocular movements or diplopia, periorbital edema, and ocular pain) were analyzed. Results: The types of idiopathic orbital inflammation were dacryoadenitis in 14, myositis in 7, diffuse-type in 3, and posterior periscleritis in 1 case. The mean IOP after treatment was 15.4±3.9 mm Hg, which was significantly lower than the mean pretreatment IOP of 19.0±5.3 mm Hg (p = 0.009). Before treatment, all cases with the diffuse-type had high IOPs of 21 mm Hg or more. Ocular pain and eye movement disorders were present in 86% and 100% of subjects in the group with an IOP of 21 mm Hg or higher, but 38% and 31% in the group with an IOP of 20 mm Hg or lower, respectively. Conclusion: Diffuse-type of idiopathic orbital inflammation is prone to develop high IOP. Patients with idiopathic orbital inflammation and high IOP exhibit many symptoms such as decreased ocular movements, diplopia, and ocular pain.

Prognostic Factors for Postoperative Visual Acuity in Patients with Rhinogenic Optic Neuropathy.

PURPOSE: To examine the prognostic factors related to postoperative visual acuity in patients with rhinogenic optic neuropathy. STUDY DESIGN: Retrospective observational study. MATERIALS AND METHODS: We retrospectively studied the medical records for 15 eyes of 15 patients who underwent surgery for the treatment of rhinogenic optic neuropathy between 31 January 2010 and 30 April 2018 at Toyama University Hospital. The patient age, sex, preoperative and postoperative visual acuity, duration from visual deficit to surgery, use of steroids, type of rhinogenic optic neuropathy, and the part of sinus lesion were analyzed. We also examined postoperative visual acuity for patients whose preoperative visual acuity was less than light perception. RESULTS: The type of optic neuropathy was sinusitis in 7 cases, mucocele in 5 cases, and pyocele in 3 cases. Visual acuity was improved in 9 cases and deteriorated or unchanged in 6 cases. Patients in the improvement group were significantly younger than those in the nonimprovement group (p=0.01). In univariate regression analysis, preoperative visual acuity and type of optic neuropathy significantly related to postoperative visual acuity. Finally, 4 of the 15 cases (27%) had preoperative visual acuity less than light perception, but there was an improvement in postoperative visual acuity in 2 of 4 cases (50%). CONCLUSIONS: Preoperative visual acuity is the predictive factor for postoperative visual acuity in patients with rhinogenic optic neuropathy, but even if the preoperative visual acuity is less than light perception, it can be improved by surgical treatment.

The association between cone density and visual function in the macula of patients with retinitis pigmentosa.

PURPOSE: We observed cone photoreceptors by using adaptive optics (AO) fundus camera and optical coherence tomography (OCT) in patients with retinitis pigmentosa (RP) and examined the correlations between cone photoreceptors and visual function over 2 years. METHODS: Six patients with RP were studied. All patients underwent measurement using best-corrected decimal visual acuity, OCT, a Humphrey Field Analyzer with the 10-2 test grid pattern, and AO. AO images of the foveal center were obtained using an rtx1™ AO fundus camera, and cone counting was performed at 0.5 mm from the foveal center. RESULTS: AO detected a decrease of cone density over 2 years in RP patients. However, visual acuity, foveal sensitivity, and photoreceptor thickness were not changed over the 2 years. CONCLUSIONS: AO images showed a decrease in the number of foveal cone densities over 2 years in patients with RP. AO may shorten the period required to predict the RP progression rate.

Serine racemase deletion attenuates neurodegeneration and microvascular damage in diabetic retinopathy.

Diabetic retinopathy (DR) is a leading cause of blindness. DR is recognized as a microvascular disease and inner retinal neurodegeneration. In the course of retinal neurodegeneration, N-methyl-D-aspartate receptor (NMDAR)-mediated excitotoxicity is involved. Full activation of NMDAR requires binding of agonist glutamate and coagonist glycine or D-serine. D-Serine is produced from L-serine by serine racemase (SRR) and contributes to retinal neurodegeneration in rodent models of DR. However, the involvement of SRR in both neurodegeneration and microvascular damage in DR remains unclear. Here, we established diabetic model of SRR knockout (SRR-KO) and control wild-type (WT) mice by streptozotocin injection. Six months after the onset of diabetes, the number of survived retinal ganglion cells was higher in SRR-KO mice than that of WT mice. The reduction of thickness of inner retinal layer (IRL) was attenuated in SRR-KO mice than that of WT mice. Moreover, the number of damaged acellular capillaries was lower in SRR-KO mice than that of WT mice. Our results suggest the suppression of SRR activity may have protective effects in DR.

Efficacy of Intraoperative Anterior Segment Optical Coherence Tomography during Descemet's Stripping Automated Endothelial Keratoplasty.

Purpose. To examine the graft-host interface during Descemet's stripping automated endothelial keratoplasty (DSAEK) surgery with optical coherence tomography (OCT). Design. Prospective, interventional case series. Patients and Methods. Eight patients who underwent a DSAEK were included. A handheld OCT was used intraoperatively to examine the presence of interface fluid between the host cornea and the graft. Results. In 3 patients, no interface fluid was detected between the host cornea and the graft after the graft was attached by air injection. In 4 patients, interface fluid was detected after the graft was attached by air injection. The remaining interface fluid was drained through corneal stab incisions. One patient required a second surgery because the first surgery failed due to persistence of the interface fluid. All patients showed a complete attachment of the graft at one month after the DSAEK surgery. Conclusion. A handheld OCT is useful to detect the interface fluid between the host cornea and the graft during a DSAEK.

Comparison of fluctuations of intraocular pressure before and after selective laser trabeculoplasty in normal-tension glaucoma patients.

PURPOSE: The aim of this study was to examine the effects of selective laser trabeculoplasty (SLT) treatment on habitual intraocular pressure (IOP) fluctuations in patients with normal-tension glaucoma (NTG) using a SENSIMED Triggerfish contact lens sensor (CLS). MATERIALS AND METHODS: Ten patients diagnosed with NTG were enrolled in this study. All patients underwent SLT treatment. Habitual 24-hour IOP fluctuations were recorded before and after SLT. The IOP fluctuations were divided into diurnal periods and nocturnal periods and compared before and after SLT. Changes in corneal thickness and curvature were measured before and after the CLS use with anterior segment optical coherence tomography. RESULTS: The mean IOP was 13.5±2.5 mm Hg before SLT. The mean IOP at 1, 2, and 3 months after SLT was significantly decreased to 10.1±2.3 mm Hg (P=0.002), 11.2±2.7 mm Hg (P=0.0059), and 11.3±2.4 mm Hg (P=0.018), respectively. The range of IOP fluctuations over 24 hours was not significantly changed between before and after SLT treatment (P=0.77). Although the range of IOP fluctuations during the diurnal periods was not significantly changed between before and after SLT treatment (P=0.92), the range of IOP fluctuations during the nocturnal periods significantly decreased from 290±86 mVEq before SLT to 199±31 mVEq after SLT treatment (P=0.014). With respect to corneal changes, the steeper meridian decreased significantly after the CLS use (P=0.016), although other parameters showed no significant difference between before and after the CLS use. CONCLUSIONS: SLT treatment was shown to significantly lower IOP and decrease IOP fluctuations during the nocturnal periods in NTG patients. These effects might be important to prevent the progression of NTG.

Analysis of macular cone photoreceptors in a case of occult macular dystrophy.

PURPOSE: To investigate changes in cone photoreceptors with adaptive optics (AO) fundus imaging and spectral domain optical coherence tomography (SD-OCT) in a case of occult macular dystrophy (OMD). PATIENT AND METHODS: Both eyes of a 42-year-old woman diagnosed with OMD were examined. We used an AO fundus camera to obtain images of cone photoreceptors in the macula of the OMD subject and five healthy control subjects. Correlations between the AO images and the SD-OCT images were examined. Cone photoreceptors in eight areas in the macula of OMD and healthy control subjects were analyzed and compared. RESULTS: SD-OCT showed a loss of the cone outer-segment tips line outside of the fovea in both eyes of the subject with OMD. The left eye with decreased visual acuity showed a discontinuous photoreceptor inner-segment and outer-segment line and cone outer-segment tips line at the fovea in SD-OCT and loss of cone mosaics as a dark spot in the AO image. In panoramic AO images and cone-density maps, less cone density was observed in a ring-like region outside the fovea than in the peripheral retina. In most of the areas examined, the cone densities were lower in the OMD eyes than in the healthy control eyes. CONCLUSIONS: Cone densities in the macula of the OMD patient were greatly decreased. AO images were found to be useful to evaluate morphologic changes in cone photoreceptors in patients with OMD.

Near-infrared fundus autofluorescence-visualized melanin in the choroidal abnormalities of neurofibromatosis type 1.

PURPOSE: To report a series of three cases of neurofibromatosis type 1 examined by near-infrared fundus autofluorescence (NIR-AF) with a scanning laser ophthalmoscope and spectral-domain optical coherence tomography (OCT) to show the characteristics of choroidal abnormalities. METHODS: Retrospective case series. Six eyes of three patients were examined by conventional fundus examinations, near-infrared monochromatic light reflectance (NIR-R) and NIR-AF, OCT, fluorescein angiography, and indocyanine green angiography. RESULTS: All eyes showed multiple bright patchy regions in the choroid of the posterior pole with NIR-R. NIR-AF revealed high fluorescent regions of similar sizes at fundus locations identical to those shown by NIR-R. In one case, hypofluorescent regions were shown by indocyanine green angiography in the bright fluorescent region shown by NIR-AF. The other two cases showed no abnormality under conventional fundus examination or fluorescein angiography. OCT images crossing the bright patchy region showed irregular hyper-reflectivity in the choroid in two cases and hyporeflectivity in one case. CONCLUSIONS: NIR-AF demonstrated that dense melanin was included in the choroidal nodules of neurofibromatosis type 1. The choroidal nodules showed hyper- or hyporeflectivity in the choroid on OCT, which did not affect the retinal structure.

Low-temperature thermal decomposition of dioxin-like compounds in fly ash: combination of chemical analysis with in vitro bioassays (EROD and DR-CALUX).

To investigate the dechlorination of fly ash during low-temperature treatment under oxygen-deficient conditions (thermocatalyic treatment or Hagenmaier process), six fly ash samples from six different incineration plants were treated in a laboratory experiment or in the actual plant, either under ideal (400 degrees C, 120 min) or intermediate (300 degrees C, 30 min) conditions. The aim of the present study was to confirm the decrease in the I-TEQ (international toxicity equivalency) of polychlorinated dibenzo-p-dioxins/-furans (PCDD/Fs) and coplanar polychlorinated biphenyls (co-PXBs) and, also for the first time, the decrease in the sum of dioxin-like toxicity (bioassay- or bio-TEQ) of all kinds of other dioxin-like Ah receptor agonists (such as PXDD/Fs, PXBs, PXN, X = Br, F) measured by two state-of-the-art cell-based Ah receptor-dependent bioassays: H4IIE-Ethoxy-Resorufin-o-Deethylase (EROD) and H4IIE-luc/DR-Chemical Activated Luciferase expression (DR-CALUX). The treatment efficiency was calculated on the basis of the reduction in the I-TEQ and bio-TED values. For these fly ash samples, the treatment efficiency, as measured by chemical analysis, was higher than 99%, and 85%-99%, in the case of the bio-TED values, indicating that these Ah receptor binding toxic compounds were sufficiently decomposed. Bio-TEQ values for untreated fly ash samples (n = 6) were on average 1.2 times (range 0.7-1.9), for the H4IIE-EROD assay, and 2.8 times (1.1-4.9), for the DR-CALUX assay, higher than I-TEQ values measured by chemical analyses (sum of PCDD/Fs and co-PCBs). In the case of these fly ash samples treated under ideal conditions and therefore low in contaminants, the bio-TEQ values were on average 1.4 times (range 0.9-1.8), for the H4IIE-EROD assay, and 5.1 times (range 1.2-12), for the DR-CALUX assay, higher than the I-TEQ values.