Among patients with familial amyloid polyneuropathy (FAP), those with transth yretin Val30Met mainly show distally predominant weakness and atrophy, whereas s ome FAP patients, including those with transthyretin Ser50...Among patients with familial amyloid polyneuropathy (FAP), those with transth yretin Val30Met mainly show distally predominant weakness and atrophy, whereas s ome FAP patients, including those with transthyretin Ser50Ile and Tyr114Cys, sho w muscle weakness and atrophy that is dominant proximally, simulating myopathy. To clarify the cause of proximally dominant muscular atrophy in patients with FA P transthyretin Ser50Ile and Tyr114Cys, we investigated the distinctive features of muscle specimens of patients with FAP, 3 of who had Val30Met, 2 Ser50Ile, an d 2 Tyr114Cys transthyretin. All specimens showed transthyretin amyloid around b lood vessels and perimysium, and neurogenic denervation patterns. The amount of amyloid around the vessels was much greater in patients with FAP Ser50Ile and Ty r114Cys than in Val30Met patients. Muscular amyloid angiopathy may contribute to motor nerve injury that, in turn, may lead to amyotropic changes in patients wi th FAP Ser50Ile and Tyr114Cys.展开更多
Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomogra...Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomography (OCT) and to investigate the relationship between postoperative VF defects and RNFL damage. Design: Retrospective interventional case series. Participants: Thirty-four eyes of 32 patients with idiopathic macular holes that underwent vitrectomy between January 2001 and March 2003 were included in this study. Eyes were divided into 3 groups according to the occurrence of postoperative VF defects and the use of indocyanine green for internal limiting membrane peeling during surgery: 11 eyes with VF defects after indocyanine green-assisted vitrectomy (group 1),9 eyes without VF defects despite the use of indocyanine green (group 2),and 14 eyes without VF defects that underwent vitrectomy without indocyanine green (group 3). Methods: Retinal nerve fiber layer thickness in each of 4 quadrants (superior,inferior,nasal,temporal)was measured with OCT. Main OutcomeMeasure: Retinal nerve fiber layer thickness around the optic disc. Results: The mean RNFL thickness in 3 of 4 quadrants (superior,nasal,inferior) in group 1 was significantly less than that in the corresponding quadrant in groups 2 and 3 (P < 0.01). In the temporal quadrant,there was a significant difference between groups 1 and 3 (P=0.02),but not between groups 1 and 2. The RNFL thickness in group 1 was significantly less in 3 quadrants in operated eyes than in fellow eyes (P< 0.05). Conclusions: The RNFL thickness was reduced in eyes with VF defects after indocyanine green-assisted vitrectomy for macular holes,suggesting that the postoperativeVF defectsmay have been caused by RNFL damage relating to the use of indocyanine green.展开更多
Purpose: To report a case of endophthalmitis after triamcinolone acetonide (TA )-assisted par plane vitrectomy (PPV). Methods: A 60-year-old Japanese man de veloped endophthalmitis after TA-assisted PPV for diabetic m...Purpose: To report a case of endophthalmitis after triamcinolone acetonide (TA )-assisted par plane vitrectomy (PPV). Methods: A 60-year-old Japanese man de veloped endophthalmitis after TA-assisted PPV for diabetic macular edema. Preop erative visual acuity was 20/200. Four days after surgery, endophthalmitis assoc iated with anterior chamber hypopyon was noticed; the patient’s vision had dete riorated to hand motion. In spite of severe cell infiltration, the ciliary injec tion and ocular pain were not significant. Results: The additional PPV with irri gation of cefazolin (40 μug/ml) and gentamicin (8 μug/ml) was performed. Endop hthalmitis resolved soon after this treatment. Staphylococcus epidermidis was de tected in the intravitreous samples. The patient’s visual acuity improved to 20 /100. Conclusion: Endophthalmitis may be a complication of TA-assisted PPV with unique signs and symptoms.展开更多
文摘Among patients with familial amyloid polyneuropathy (FAP), those with transth yretin Val30Met mainly show distally predominant weakness and atrophy, whereas s ome FAP patients, including those with transthyretin Ser50Ile and Tyr114Cys, sho w muscle weakness and atrophy that is dominant proximally, simulating myopathy. To clarify the cause of proximally dominant muscular atrophy in patients with FA P transthyretin Ser50Ile and Tyr114Cys, we investigated the distinctive features of muscle specimens of patients with FAP, 3 of who had Val30Met, 2 Ser50Ile, an d 2 Tyr114Cys transthyretin. All specimens showed transthyretin amyloid around b lood vessels and perimysium, and neurogenic denervation patterns. The amount of amyloid around the vessels was much greater in patients with FAP Ser50Ile and Ty r114Cys than in Val30Met patients. Muscular amyloid angiopathy may contribute to motor nerve injury that, in turn, may lead to amyotropic changes in patients wi th FAP Ser50Ile and Tyr114Cys.
文摘Purpose: To analyze retinal nerve fiber layer (RNFL) thickness in eyes with or without visual field (VF) defects after indocyanine green-assisted vitrectomy for idiopathic macular holes using optical coherence tomography (OCT) and to investigate the relationship between postoperative VF defects and RNFL damage. Design: Retrospective interventional case series. Participants: Thirty-four eyes of 32 patients with idiopathic macular holes that underwent vitrectomy between January 2001 and March 2003 were included in this study. Eyes were divided into 3 groups according to the occurrence of postoperative VF defects and the use of indocyanine green for internal limiting membrane peeling during surgery: 11 eyes with VF defects after indocyanine green-assisted vitrectomy (group 1),9 eyes without VF defects despite the use of indocyanine green (group 2),and 14 eyes without VF defects that underwent vitrectomy without indocyanine green (group 3). Methods: Retinal nerve fiber layer thickness in each of 4 quadrants (superior,inferior,nasal,temporal)was measured with OCT. Main OutcomeMeasure: Retinal nerve fiber layer thickness around the optic disc. Results: The mean RNFL thickness in 3 of 4 quadrants (superior,nasal,inferior) in group 1 was significantly less than that in the corresponding quadrant in groups 2 and 3 (P < 0.01). In the temporal quadrant,there was a significant difference between groups 1 and 3 (P=0.02),but not between groups 1 and 2. The RNFL thickness in group 1 was significantly less in 3 quadrants in operated eyes than in fellow eyes (P< 0.05). Conclusions: The RNFL thickness was reduced in eyes with VF defects after indocyanine green-assisted vitrectomy for macular holes,suggesting that the postoperativeVF defectsmay have been caused by RNFL damage relating to the use of indocyanine green.
文摘Purpose: To report a case of endophthalmitis after triamcinolone acetonide (TA )-assisted par plane vitrectomy (PPV). Methods: A 60-year-old Japanese man de veloped endophthalmitis after TA-assisted PPV for diabetic macular edema. Preop erative visual acuity was 20/200. Four days after surgery, endophthalmitis assoc iated with anterior chamber hypopyon was noticed; the patient’s vision had dete riorated to hand motion. In spite of severe cell infiltration, the ciliary injec tion and ocular pain were not significant. Results: The additional PPV with irri gation of cefazolin (40 μug/ml) and gentamicin (8 μug/ml) was performed. Endop hthalmitis resolved soon after this treatment. Staphylococcus epidermidis was de tected in the intravitreous samples. The patient’s visual acuity improved to 20 /100. Conclusion: Endophthalmitis may be a complication of TA-assisted PPV with unique signs and symptoms.
