Publications by authors named "Rumi Kawashima"

12 Publications

  • Page 1 of 1

Efficacy and safety of 5-fluorouracil in infrared monitor guided bleb revision.

BMC Ophthalmol 2021 Feb 8;21(1):75. Epub 2021 Feb 8.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Purpose: Infrared monitor-guided bleb revision (IRGBR), an alternative needling system, visualizes anterior-segment tissues around the bleb not visible during needle revision after trabeculectomy. This study determined the safety and efficiency of 5-fluorouracil (5-FU) as an adjunctive anti-metabolite in IRGBR.

Methods: We retrospectively analyzed 43 consecutive eyes (40 patients; 14 eyes, primary open-angle; 29 eyes, secondary glaucoma) treated with IRGBR for failing filtering blebs. The patients were divided into two groups. The first one had IRGBR without adjunctive 5-FU subconjunctival injection, and the second one had IRGBR with 5-FU. We performed Kaplan-Meier survival analysis using log-rank tests after 2 years of follow-up and Cox proportional hazards regression model to analyze the dependence of the survival time on predictor variables. Two failure criteria were defined as the need for additional surgery for intraocular pressure (IOP) reduction and the IOP at two consecutive follow-up visits based on definition 1, IOP ≧22 mmHg and definition 2, IOP ≧17 mmHg.

Results: Thirty eyes (29 cases) underwent IRGBR with subconjunctival 5-FU injection (group A in the second term) and 13 eyes (11 cases) without 5-FU (group B in the first term). The success rates 24 months after IRGBR were 73.3 and 23.1%, respectively, in groups A and B based on the definition 1 failure and 56.7 and 7.7% based on the definition 2 failure. Complications included transient bleb leaks (group A, 3 eyes; group B, none) and choroidal detachment (group A, 1 eye; group B, none). No use of 5-FU and IOPs ≧10 mmHg 1 week after IRGBR were significant risk factors.

Conclusions: Adjunctive 5-FU in IRGBR achieved a better success rate for failing trabeculectomy blebs.
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http://dx.doi.org/10.1186/s12886-021-01843-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869480PMC
February 2021

Complete Visual Recovery From Severe Outer Retinitis After Tonsillitis.

J Neuroophthalmol 2020 Sep 11. Epub 2020 Sep 11.

Department of Ophthalmology (RK, KM, NH, KN), Osaka University Graduate School of Medicine, Osaka, Japan; Department of Ophthalmology (KK), Kindai University Faculty of Medicine, Osaka-Sayama City, Japan; Osaka University Graduate School of Frontier Biosciences (TF), Osaka, Japan; and Integrated Frontier Research for Medical Science Division (KN), Institute for Open and Transdisciplinary Research Initiatives, Osaka University, Suita, Japan.

Background: To report a case of severe acute bilateral outer retinitis after tonsillitis and rapid morphologic and functional recovery after steroid treatment.

Methods: Observational case report.

Results: A 26-year-old woman with acute bilateral blurred vision that developed after tonsillitis underwent spectral-domain optical coherence tomography (SD-OCT) that showed photoreceptor outer segment damage. Full-field electroretinography (ERG) and multifocal ERG were nonrecordable. The patient had a remarkable anatomic and functional recovery in response to steroid treatment; however, partial damage remained around the macula on SD-OCT, and an adaptive optics imaging system showed damaged cone photoreceptors.

Conclusions: Prednisolone is an effective treatment for a disease that is believed to be due to suspicious involvement of the autoimmune system. Even severe outer retinitis can recover completely with rapid diagnosis and treatment.
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http://dx.doi.org/10.1097/WNO.0000000000001073DOI Listing
September 2020

Development of an Infrared Monitor-Guided Bleb Revision Procedure.

Case Rep Ophthalmol 2020 May-Aug;11(2):234-241. Epub 2020 Jun 25.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Suita, Japan.

The needle revision procedure to address failing filtering blebs is a blind technique that might easily damage the scleral flap, conjunctiva, and choroid. We propose a new surgical procedure, infrared monitor-guided bleb revision, to perform bleb revision minimally invasively and effectively, and demonstrate the procedure in a patient. We developed the guided procedure with the infrared monitor to observe the bleb interior with greater contrast. Under the monitor, we dissect the hard fibrotic tissue with a bleb knife and, if necessary, remove adhesions using a needle and vitreous forceps. Finally, 5-fluorouracil is injected into the subconjunctiva. We have performed bleb revisions safely with clear visualization of the scleral flap using an infrared light. In the current case, the patient had good intraocular pressure control for about 1 year. The new infrared monitor-guided bleb revision procedure facilitates successful bleb revisions without damage to the underlying structures.
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http://dx.doi.org/10.1159/000508606DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7383186PMC
June 2020

Assessment of a self-assembling peptide gel, SPG-178, in providing a clear operative field for trabeculectomy surgery for glaucoma in an animal model.

Sci Rep 2020 07 9;10(1):11326. Epub 2020 Jul 9.

Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka, 565-0871, Japan.

The presence of blood during ophthalmic surgery is problematic, as it can obstruct a surgeon's view of the operative field. This is particularly true when performing trabeculectomy surgery to enhance ocular fluid outflow and reduce intraocular pressure as a treatment for glaucoma, one of the most common vision loss conditions worldwide. In this study, we investigated the performance of a transparent, self-assembling peptide gel (SPG-178) and its ability to maintain visibility during trabeculectomy surgery. Unlike the hyaluronic acid gel commonly used in ophthalmic surgery, SPG-178 did not permit the ingress of blood into the gel itself. Rather, it forced blood to flow peripherally to the gel. Moreover, if bleeding occurred under the SPG-178 gel, perfusion with saline was able to effectively flush the blood away along the interface between the SPG-178 and the ocular tissue (in this case scleral) to clear the surgical field of view. In experimental trabeculectomy surgeries with mitomycin C used as an adjuvant, there were no differences in the postoperative recovery of intraocular pressure or bleb morphology with or without the use of SPG-178. SPG-178, therefore, when used in a gel formulation, represents a new material for use in intraocular surgery to ensure a clear operative field with likely beneficial treatment outcomes.
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http://dx.doi.org/10.1038/s41598-020-68171-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7347556PMC
July 2020

Association of the CAV1-CAV2 locus with normal-tension glaucoma in Chinese and Japanese.

Clin Exp Ophthalmol 2020 07 24;48(5):658-665. Epub 2020 Mar 24.

Department of Ophthalmology and Visual Sciences, the Chinese University of Hong Kong, Hong Kong, China.

Background: The CAV1-CAV2 locus has been associated with primary open-angle glaucoma (POAG) and intraocular pressure. However, its association with normal-tension glaucoma (NTG) was inconclusive. Therefore, we evaluated this association in Chinese and Japanese.

Methods: Two single-nucleotide polymorphisms (SNPs, rs4236601 and rs1052990) from previous genome-wide association studies of POAG were genotyped in a total of 2220 study subjects: a Hong Kong Chinese cohort of 537 NTG patients and 490 controls, a Shantou Chinese cohort of 102 NTG and 731 controls and an Osaka Japanese cohort of 153 NTG and 207 controls. Subgroup analysis by gender was conducted. Outcomes from different cohorts were combined using meta-analysis.

Results: SNP rs4236601 was significantly associated with NTG in the two Chinese cohorts (P = .0019, OR = 4.55, I = 0). In contrast, rs4236601 was monomorphic in the Osaka cohort. The association of rs1052990 was insignificant in a meta-analysis combining Chinese and Japanese cohorts (P = .81, OR = 1.05; I = 64%), and the OR tended towards opposite directions between Chinese (OR = 1.26) and Japanese (OR = 0.69). Gender-specific effects of the SNPs were not statistically significant in the logistic regression or Breslow-day tests of ORs (P > .05), although rs4236601 was significant in males (P = .0068; OR = 10.30) but not in females (P = .14; OR = 2.65) in the meta-analysis of Chinese subjects.

Conclusions: In this study, we confirmed the association of rs4236601 at the CAV1-CAV2 locus with NTG in Chinese. SNP rs4236601 is monomorphic, and rs1052990 tends towards a different direction in the Japanese cohort. Further studies are warranted to verify the ethnic difference and gender-specific effects of this locus.
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http://dx.doi.org/10.1111/ceo.13744DOI Listing
July 2020

Association of the SIX6 locus with primary open angle glaucoma in southern Chinese and Japanese.

Exp Eye Res 2019 03 23;180:129-136. Epub 2018 Dec 23.

Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China; Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong, China. Electronic address:

The purpose of the study was to evaluate the association profiles of the SIX6 locus with primary open-angle glaucoma (POAG) in southern Chinese and Japanese. In this study, we tested single marker and haplotype-based associations of 11 tagging single nucleotide polymorphisms (SNPs) covering the SIX6 locus with POAG in a Hong Kong Chinese cohort (N = 1402). A novel SNP (i.e., rs12436579) and two SNPs (i.e., rs33912345 and rs10483727) from previous genome-wide association studies were further tested in a Chinese cohort from Shantou (N = 888) and a Japanese cohort from Osaka (N = 463). Results from the three cohorts were meta-analysed using a random-effect model. We found rs12436579, which has not been previously reported, was associated with POAG in Hong Kong and Shantou Chinese (P = 4.3 × 10, OR = 0.72, I = 0). Additionally, we replicated the association of one known SNP, rs33912345 (P = 0.0061, OR = 0.69, I = 45%), with POAG in the Chinese cohorts but not in the Japanese cohort (P > 0.6). Another known SNP, rs10483727, was nominally associated with POAG in the two Chinese cohorts (P = 0.017, OR = 0.70, I = 53%). All these three SNPs were significantly associated with POAG when the three cohorts were combined in meta-analysis (P<0.005). Furthermore, two haplotypes, C-C (P = 1.13 × 10, OR = 1.41, I = 0) and A-A (P = 0.045, OR = 0.68, I = 70%), defined by rs33912345-rs12436579 were associated with POAG in Chinese but not in Japanese. In conclusion, this study confirmed the association between two GWAS SNPs in SIX6 (rs33912345 and rs10483727) and POAG. Also, a SNP, rs12436579, not associated with POAG before, was found to be associated with POAG in Chinese. Further studies are warranted to elucidate the role of this novel SNP in POAG.
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http://dx.doi.org/10.1016/j.exer.2018.12.014DOI Listing
March 2019

Contribution of Bipolar Cells of Cone ON and OFF Pathways to Electroretinograms Elicited by Ultraviolet and Middle Wavelength Stimuli.

Curr Eye Res 2019 04 4;44(4):413-422. Epub 2018 Dec 4.

a Department of Ophthalmology , Osaka University Graduate School of Medicine , Osaka , Japan.

Purpose: To determine the contribution of the ON and OFF cone bipolar cell pathways to the electroretinograms (ERGs) elicited by ultraviolet (UV) and middle wavelength light in mice.

Materials And Methods: The experiments were performed on 8- to 10-week-old C57BL/6J mice. The ERGs elicited by single-flash and flickering UV light stimuli were compared to those elicited by green light stimuli under photopic conditions. Pharmacological agents were used to selectively block the ON and OFF pathways contributing to the ERGs. Saline was used as a control. The flicker ERGs elicited by UV light were compared to the ERGs elicited by green light after the injection of the pharmacological agents to determine the contribution of the cone ON and OFF pathways to the ERGs.

Results: The photopic single-flash and flicker ERGs were more sensitive to the UV light stimuli than to those elicited by green light stimuli. The flicker ERG responses elicited by both UV and green light stimuli at stimulus frequencies lower than 15-Hz decreased after L-2-amino-4-phosphobutyric acid was injected. The ERGs elicited by UV light at 30-Hz and by green light at frequencies lower than 15-Hz decreased significantly after the intravitreal injection of cis-2, 3-piperidine-dicarboxylic acid. An analysis of the ON and OFF components of the flicker ERGs showed that there might be pharmacological differences between the UV light-sensitive responses and the green light-sensitive responses.

Conclusions: These results suggest that the UV light-sensitive cones connect to both the ON and OFF bipolar cells differently than that of the green light-sensitive cones.
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http://dx.doi.org/10.1080/02713683.2018.1549262DOI Listing
April 2019

Prevalence and Associated Factors of Segmentation Errors in the Peripapillary Retinal Nerve Fiber Layer and Macular Ganglion Cell Complex in Spectral-domain Optical Coherence Tomography Images.

J Glaucoma 2017 Nov;26(11):995-1000

Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.

Purpose: To determine the prevalence of errors in segmentation of the peripapillary retinal nerve fiber layer (RNFL) and macular ganglion cell complex (GCC) boundary in spectral-domain optical coherence tomography (SDOCT) images, and to identify factors associated with the errors.

Materials And Methods: Peripapillary RNFL circle scans and macular 3-dimensional scans of consecutive cases imaged with SDOCT (RS-3000 Advance; Nidek, Gamagori, Japan) were retrospectively reviewed by a glaucoma specialist. Images with signal strength index (SSI)<6 were excluded. Threshold for segmentation failure was determined as 15 degrees in the RNFL scans and 1/24 of the scanned area in the GCC scans. Relationships between segmentation failure and clinical factors were statistically evaluated with univariable and multivariable analyses.

Results: This retrospective cross-sectional study included 207 eyes of 117 subjects (mean age, 58.5±16.5 y). Segmentation failure was found in 20.7% of the peripapillary RNFL scans, 16.6% of the 9 mm GCC scans, and 6.9% of the 6 mm GCC scans in SDOCT images. In multivariable logistic regression analyses, low SSI, large disc area, and disease type significantly correlated with RNFL segmentation failure, whereas SSI was the only baseline factor that was significantly associated with GCC segmentation failure.

Conclusions: Although segmentation failure was common in both RNFL and GCC scans, it was less frequently observed in GCC scans. SSI, disc area, and disease type were significantly associated with segmentation failure. Predictive performance of baseline factors for failure was poor, underlining the importance of reviewing raw OCT images before using OCT parameters.
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http://dx.doi.org/10.1097/IJG.0000000000000771DOI Listing
November 2017

Treatment Outcomes and Prognostic Factors of Selective Laser Trabeculoplasty for Open-angle Glaucoma Receiving Maximal-tolerable Medical Therapy.

J Glaucoma 2016 10;25(10):785-789

The Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.

Purpose: To evaluate the efficacy of selective laser trabeculoplasty (SLT) for patients with open-angle glaucoma receiving maximal-tolerable medical therapy.

Patients And Methods: Consecutive patients with open-angle glaucoma who were followed up for at least 1 year after SLT were retrospectively evaluated. The effectiveness was assessed using Kaplan-Meier survival analysis with 2 criteria for failure: (1) intraocular pressure (IOP) equal to or more than baseline; and (2) <20% reduction from baseline, on 2 consecutive visits. Those 2 failure criteria also included loss of light perception, reoperation of SLT, and glaucoma surgery. Influence of baseline factors on success were assessed using mixed-effects Cox proportional hazard models.

Results: Seventy-five eyes [39 primary open-angle glaucoma, 23 exfoliation glaucoma, and 13 secondary open-angle glaucoma (SOAG)] of 59 patients (21 females) aged 65.5±15.9 (mean±SD) were included. Preoperative mean IOP was 23.3±6.5 mm Hg with 3.4±1.3 IOP lowering medications. The overall success ratio at the end of study period was 45.3% by criterion 1 and 14.2% by criterion 2. The success ratio by criterion 1 and 2 was 61.1% and 21.7% in primary open-angle glaucoma, 29.3% and 14.5% in exfoliation glaucoma, and 15.4% and 7.7% in SOAG, respectively. Higher preoperative IOP and diagnosis of SOAG were significantly associated with treatment failure (P<0.01 and 0.04, respectively).

Conclusions: One-year efficacy of SLT in controlling IOP was very limited in patients with maximal-tolerable medical therapy. Types of glaucoma and preoperative IOP were significant prognostic factors for treatment success.
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http://dx.doi.org/10.1097/IJG.0000000000000411DOI Listing
October 2016

Air pressure-induced iridocornea contact in a patient with primary angle closure observed with a dynamic Scheimpflug analyzer.

J Glaucoma 2015 Jun-Jul;24(5):e137-8

Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.

Purpose: To report air pressure-induced corneal deformation and iridocornea contact in eyes with primary angle closure (PAC) during intraocular pressure (IOP) measurement performed using a novel noncontact tonometer.

Methods: A single case report.

Results: We report a patient with bilateral angle closure. One eye had acute PAC and the other had PAC. The latter was evaluated by the movements of the cornea and iris during IOP measurement using a noncontact tonometer. During the examination, the corneal endothelium and the iris came into contact at the mid-peripheral pupillary area in the left eye with PAC during the corneal reaction to an air puff. In contrast, the corneal endothelium in the pupillary area did not come into contact with the iris.

Conclusions: Although we observed only 1 case and there could be limitations in its interpretation, IOP measurements using a noncontact tonometer may create mechanical stress on the corneal endothelium in eyes with PAC with a very shallow anterior chamber.
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http://dx.doi.org/10.1097/IJG.0000000000000247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4450920PMC
August 2015

Real-time polymerase chain reaction for diagnosing acyclovir-resistant herpetic keratitis based on changes in viral DNA copy number before and after treatment.

Arch Ophthalmol 2012 Nov;130(11):1462-4

Department of Ophthalmology, Ehime University School of Medicine and Department of Ophthalmology, Sumitomo Hospital, Osaka, Japan.

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http://dx.doi.org/10.1001/archophthalmol.2012.1176DOI Listing
November 2012

[Family therapy and its perspective].

Ryoikibetsu Shokogun Shirizu 2003 (38):395-8

Department of Neuropsychiatry, Sapporo Medical University.

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October 2003