極早期緑内障の網膜神経線維層欠損と網膜内層の進行様式と乳頭出血の関係の解明

金沢大学附属病院【研究目的】Preperimetric glaucoma(PPG)において、スペクトラルドメインOCT(SD-OCT)の黄斑部解析とHumphrey視野10-2(HFA10-2)を2年以上経過観察を行った症例において、構造と機能の進行速度および互いの相関を検討し、極早期緑内障の構造と機能の進行について、関連因子を検討する。【研究方法】当科でPPGと診断され、網膜神経線維層欠損(RNFLD)が上下のいずれかに存在し、2年以上経過観察可能で、RS-3000(NIDEK)で9×9mmの黄斑マップ(512×128)でSSI6以上の画像が5回以上、信頼性のあるHFA10-2を5回以上測定できた21例24眼(男性6例、女性15例、平均年齢57.1±10歳)。等価球面度数-6.0D未満、眼軸長26mm以上、内眼手術既往、緑内障以外の眼疾患、視神経視路疾患の例は対象から除外した。SD-OCTはG chartの各8セクター{内周(直径1.5～3.0mm), 外周(直径3.0～6.0mm)各4象限}および上下で網膜神経線維層+網膜神経節細胞層+内網状層(GCC)の厚みを、HFA10-2はOCTに対応させ、4分割および上下について各々進行速度をトレンド解析し、対応するGCCとHFA10-2の進行速度の相関を用いて進行に関連する因子を検討した。【研究成果】下側にRNFLDが存在する(下側RNFLD)群は上側にRNFLDが存在する(上側RNFLD)群と比較して、RS-3000の外周下耳側と下方のGCCが有意に進行が速かった(p=0.016、0.013)。HFA10-2では、下側RNFLD群が上側RNFLD群と比較して、上下半視野ともに進行が速かった(p=0.002～0.032)。乳頭出血(DH)の有無別では、DH+群のほうがDH-群に比べて、上半視野の進行が速く(p=0.030)、RS-3000の外周下耳側のGCCの進行が速かった(p=0.034)。PPGにおいて下側RNFLD群は上側RNFLD群と比較して、DH+群はDH-群と比較して、黄斑部の構造と機能の進行が速い。研究課題/領域番号:16H00663, 研究期間(年度):201

極早期に障害される緑内障眼の構造的部位と視野検査点の解明

金沢大学附属病院緑内障眼で極早期に障害されやすい構造的部位と対応する視野検査点の配置を解明することを目的とする。前視野緑内障眼において構造的に障害されやすい部位を光干渉断層計を使用して明らかにし、構造的障害部位と対応する視野検査点配置を決定する。前視野緑内障眼で検査を行い、一般的に臨床で使用されている視野検査点配置との感度・特異度を検討する。さらに、視野の異常部位の場所と異常点の頻度を上視野、下視野に分けて特徴を明らかにする。研究課題/領域番号:21H04239, 研究期間:2021-04-01 – 2022-03-31出典：研究課題「極早期に障害される緑内障眼の構造的部位と視野検査点の解明」課題番号21H04239（KAKEN：科学研究費助成事業データベース（国立情報学研究所）） （https://kaken.nii.ac.jp/ja/grant/KAKENHI-PROJECT-21H04239/）を加工して作

The effect of concentric constriction of the visual field to 10 and 15 degrees on simulated motor vehicle accidents

金沢大学附属病院眼科Purpose: Traffic accidents are associated with the visual function of drivers, as well as many other factors. Driving simulator systems have the advantage of controlling for traffic- and automobile-related conditions, and using pinhole glasses can control the degree of concentric concentration of the visual field. We evaluated the effect of concentric constriction of the visual field on automobile driving, using driving simulator tests. Methods: Subjects meeting criteria for normal eyesight were included in the study. Pinhole glasses with variable aperture sizes were adjusted to mimic the conditions of concentric visual field constrictions of 10° and 15°, using a CLOCK CHART®. The test contained 8 scenarios (2 oncoming right-turning cars and 6 jump-out events from the side). Results: Eighty-eight subjects were included in the study; 37(mean age = 52.9±15.8 years) subjects were assigned to the 15° group, and 51 (mean = 48.6±15.5 years) were assigned to the 10° group. For all 8 scenarios, the number of accidents was significantly higher among pinhole wearing subjects. The average number of all types of accidents per person was significantly higher in the pinhole 10° group (4.59±1.81) than the pinhole 15° group (3.68±1.49) (P = 0.032). The number of accidents associated with jump-out scenarios, in which a vehicle approaches from the side on a straight road with a good view, was significantly higher in the pinhole 10° group than in the pinhole 15° group. Conclusions: Concentric constriction of the visual field was associated with increased number of traffic accidents. The simulation findings indicated that a visual field of 10° to 15° may be important for avoiding collisions in places where there is a straight road with a good view. © 2018 Udagawa et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited

Role of the RNA-Binding Protein Nrd1 in Stress Granule Formation and Its Implication in the Stress Response in Fission Yeast

We have previously identified the RNA recognition motif (RRM)-type RNA-binding protein Nrd1 as an important regulator of the posttranscriptional expression of myosin in fission yeast. Pmk1 MAPK-dependent phosphorylation negatively regulates the RNA-binding activity of Nrd1. Here, we report the role of Nrd1 in stress-induced RNA granules. Nrd1 can localize to poly(A)-binding protein (Pabp)-positive RNA granules in response to various stress stimuli, including heat shock, arsenite treatment, and oxidative stress. Interestingly, compared with the unphosphorylatable Nrd1, Nrd1DD (phosphorylation-mimic version of Nrd1) translocates more quickly from the cytoplasm to the stress granules in response to various stimuli; this suggests that the phosphorylation of Nrd1 by MAPK enhances its localization to stress-induced cytoplasmic granules. Nrd1 binds to Cpc2 (fission yeast RACK) in a phosphorylation-dependent manner and deletion of Cpc2 affects the formation of Nrd1-positive granules upon arsenite treatment. Moreover, the depletion of Nrd1 leads to a delay in Pabp-positive RNA granule formation, and overexpression of Nrd1 results in an increased size and number of Pabp-positive granules. Interestingly, Nrd1 deletion induced resistance to sustained stresses and enhanced sensitivity to transient stresses. In conclusion, our results indicate that Nrd1 plays a role in stress-induced granule formation, which affects stress resistance in fission yeast

The association of primary aldosteronism with glaucoma-related fundus abnormalities.

PurposeTo elucidate glaucoma-related fundus abnormalities in patients with primary aldosteronism (PA).MethodsThe study compared 272 eyes from 137 PA patients and 352 eyes from 177 control subjects selected randomly from 1173 participants of a public glaucoma screening. The presence of glaucomatous optic disc appearance (rim thinning and cup enlargement) and retinal nerve fiber layer defects (RNFLDs) was determined independently from fundus photographs. The results were compared between the PA and control groups.ResultsThere were 9 patients (6.6%) with glaucomatous optic disc abnormalities in the PA group and 10 cases (5.6%) identified in the control group (p = 0.92). RNFLDs were detected more frequently in the PA group (55 eyes, 20.2%) than in the control group (26 eyes, 7.4%; pConclusionAlthough the prevalence of glaucomatous optic disc appearance did not differ between the two groups, RNFLDs were more frequent in PA patients than in the control group. Moreover, RNFLDs with their central ends located around retinal vessels were characteristic of PA patients

The effect of concentric constriction of the visual field to 10 and 15 degrees on simulated motor vehicle accidents

Traffic accidents are associated with the visual function of drivers, as well as many other factors. Driving simulator systems have the advantage of controlling for traffic- and automobile-related conditions, and using pinhole glasses can control the degree of concentric concentration of the visual field. We evaluated the effect of concentric constriction of the visual field on automobile driving, using driving simulator tests.Subjects meeting criteria for normal eyesight were included in the study. Pinhole glasses with variable aperture sizes were adjusted to mimic the conditions of concentric visual field constrictions of 10° and 15°, using a CLOCK CHART®. The test contained 8 scenarios (2 oncoming right-turning cars and 6 jump-out events from the side).Eighty-eight subjects were included in the study; 37 (mean age = 52.9±15.8 years) subjects were assigned to the 15° group, and 51 (mean = 48.6±15.5 years) were assigned to the 10° group. For all 8 scenarios, the number of accidents was significantly higher among pinhole wearing subjects. The average number of all types of accidents per person was significantly higher in the pinhole 10° group (4.59±1.81) than the pinhole 15° group (3.68±1.49) (P = 0.032). The number of accidents associated with jump-out scenarios, in which a vehicle approaches from the side on a straight road with a good view, was significantly higher in the pinhole 10° group than in the pinhole 15° group.Concentric constriction of the visual field was associated with increased number of traffic accidents. The simulation findings indicated that a visual field of 10° to 15° may be important for avoiding collisions in places where there is a straight road with a good view

Screenshots of simulated scenarios.

<p>The main test contained 8 scenarios depicting situations such as oncoming right-turning cars (A, B) and suddenly appearing hazards from the side in front of the car (C-H) Screenshots of the 8 scenarios: A. Oncoming right-turning blue car 1. B. Oncoming right-turning blue car 2. C. White car appearing from left. D. Red car appearing from right. E. Mobility scooter appearing from left. F. Blue car appearing from left. G. Mobility scooter appearing from right. H. Blue car appearing from right.</p

Visual field constriction by pinhole glasses.

<p>Subjects with normal eyesight wore pinhole (PH) glasses with a 2 mm aperture that caused VF constriction. Of note, PH glasses with the same aperture can lead to a different level of VF constriction between individuals.</p

Comparison of collisions in each scenario for both the PH10 and PH15 groups.

<p>Comparison of collisions in each scenario for both the PH10 and PH15 groups.</p

CLOCK CHART^®.

<p>The VF constrictions of 10° and 15° were created using a pinhole with variable apertures and a CLOCK CHART^® displaying a ladybug and a caterpillar on the central 10°and 15°eccentricity, respectively.</p