Study of a Cyclone Type Classifier for Separating Coarse Particles

広島大学(Hiroshima University)博士(工学)Doctor of Engineeringdoctora

Case of retinal detachment due to retinal break splitting macula vertically in a patient with cognitive disorder

We report a patient with cognitive disorder who had a rhegmatogenous retinal detachment (RRD). A 17-year-old Japanese man presented with a RRD with a vitreous hemorrhage in his right eye. An unusual vertical splitting of the macula accompanied by a giant retinal tear was observed intraoperatively. The retina was successfully reattached by pars plana vitrectomy with silicone oil tamponade and scleral buckling. Visual function appeared to have improved from the behavior of the patient. Although the precise mechanism causing the break which split the macula was not determined, self-inflicted blunt trauma to the eye was suspected

Severe macular edema induced by pioglitazone in a patient with diabetic retinopathy: a case study

We report a case of severe diabetic macular edema (DME) that developed after pioglitazone was used by a patient with proliferative diabetic retinopathy. A 30-year-old woman with poorly controlled type 2 diabetes mellitus visited our clinic in 2004. She had moderate pre-proliferative diabetic retinopathy OU. Because of the rapid progression of the diabetic retinopathy, she received pan-retinal photocoagulation in both eyes. Two weeks before using pioglitazone, her visual acuity was 0.9 OD and 0.7 OS. On October 2007, pioglitazone was prescribed by her internist because of poorly controlled blood glucose level. Two weeks later, her body weight increased, and her face became edematous. Her visual acuity decreased to 0.5 OU, and ophthlamoscopy showed severe DME in both eyes. Two weeks after stopping pioglitazone, her visual acuity improved to 0.8 OD and 0.5 OS, but the DME was still severe in the optical coherence tomographic images. Then, one half the usual dose (25 mg) of spironolactone, a diuretic, was given and her macular edema was resolved. Her final visual acuity improved to 0.9 OD and 0.7 OS. We recommend that when a patient taking pioglitazone complains of decreased vision, the physician should promptly consult an ophthalmologist

Subretinal Hemorrhage after Photodynamic Therapy for Juxtapapillary Retinal Capillary Hemangioma

A 75-year-old Japanese woman presented with a juxtapapillary retinal capillary hemangioma (RCH) in her left eye. Twelve months after the initial examination, the size of the hemangioma had increased and the exudation from the RCH involved the macula. Her best-corrected visual acuity (BCVA) had decreased from 0.8 to 0.3. A total of five intravitreal injections of bevacizumab (IVB; 1.25 mg) was given but the RCH did not respond. A photodynamic therapy (PDT) was done using multiple laser spots to avoid damaging the optic nerve head. After the first PDT, the subfoveal fluid was reduced but not completely gone. One week after the second PDT, a massive subretinal hemorrhage developed. The subretinal hemorrhage was successfully displaced by injecting intraocular sulfur hexafluoride (SF6) gas. At the 3-year follow-up examination, no subretinal hemorrhage or fluid was observed at the macula and the BCVA remained at 0.05. Our case was resistant to the combination of anti-vascular endothelial growth factor (VEGF) and PDT and had a rare massive subretinal hemorrhage. A further collection of RCH cases treated with anti-VEGF and PDT that would justify this treatment is necessary

Development of Macular Holes after Rhegmatogenous Retinal Detachment Repair in Japanese Patients

Purpose. To determine the factors associated with the development of a macular hole (MH) after successful rhegmatogenous retinal detachment (RRD) surgery. Methods. Of 1260 eyes that underwent surgery for RRD between April 2005 and March 2010 in our hospital, the medical records of 4 cases from our hospital and one case from another hospital that had undergone RRD surgery and later developed MH were reviewed. This is a retrospective study. Results. 837 eyes underwent pars plana vitrectomy (PPV) with or without scleral buckling (SB), and 423 eyes underwent SB. The four cases that developed MH had PPV alone and one case had PPV with SB. After including the results of three earlier reports, the mean interval for the MH to develop after SB alone was significantly shorter than after PPV alone or after PPV with SB. Conclusions. The SB procedures might accelerate the development of MH after RRD surgery

Relationship between chronic sclerosing dacryoadenitis with high level of IgG4 and Castleman disease

The purpose of this study is to present a case of chronic sclerosing dacryoadenitis with high level of IgG4 in a patient diagnosed earlier with Castleman disease. A 79-year-old man noticed a swelling of his lower left jaw that was first seen 8 years earlier. He was diagnosed with Castleman disease from the histopathological examination of a biopsy of the submandibular gland. Since then, the size of the gland had not changed, and he had no systemic inflammatory signs or symptoms. He developed diplopia a year earlier, and CT scans showed bilateral swelling of the lacrimal glands. He was referred to our hospital for further examinations. The patient underwent partial dacryoadenectomy. From the histopathological examinations, he was diagnosed with chronic sclerosing dacryoadenitis with high level of the serum IgG4. He underwent oral steroid therapy and the swollen lacrimal glands were significantly improved. The results suggest that there may be pathological links between IgG4-related dacryoadenitis and Castleman disease