岩橋 千春 (イワハシ チハル)

  • 医学科 医学部講師
Last Updated :2024/03/24

コミュニケーション情報 byコメンテータガイド

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    ぶどう膜炎、黄斑疾患の治療に携わっています。

研究者情報

学位

  • 博士(2016年04月 大阪大学)

ホームページURL

J-Global ID

現在の研究分野(キーワード)

    ぶどう膜炎、黄斑疾患の治療に携わっています。

研究分野

  • その他 / その他

研究活動情報

論文

  • Chiharu Iwahashi; Masuo Sakamoto; Nobuyuki Ohguro; Shunji Kusaka
    JAMA Ophthalmology 2023年10月 
    This case report describes the use of tirabrutinib to treat 2 individuals with vitreoretinal lymphoma.
  • Kengadhevi Yogeswaran; João M Furtado; Bahram Bodaghi; Janet M Matthews; International Ocular Toxoplasmosis; Study Group; Justine R Smith
    Br J Ophthalmol . 107 7 973 - 979 2023年07月 [査読有り]
  • Chiharu Iwahashi; Itsuka Matsushita; Kazuki Kuniyoshi; Hiroyuki Kondo; Shunji Kusaka
    Retina (Philadelphia, Pa.) 43 7 e43-e44  2023年07月
  • 大久保 麻希; 坂本 万寿夫; 岩橋 千春; 日下 俊次
    あたらしい眼科 40 3 389 - 394 (株)メディカル葵出版 2023年03月 
    目的:Vogt-小柳-原田病(以下,原田病)類似の眼病変で発症したメトトレキサート(MTX)関連リンパ増殖性疾患(MTX-LPD)の症例を報告する.症例:68歳,男性.両眼視力低下と眼瞼腫脹を自覚し眼科受診,初診時視力は右眼(0.15),左眼(0.2),両眼結膜浮腫,前房内炎症,脈絡膜肥厚,右眼漿液性網膜剥離を認めた.同時期より間欠性の発熱や頸部リンパ節腫脹などがみられたこと,血清sIL-2R 36,478U/ml,前房水IL-10/IL-6>1より,リンパ腫病変を疑い頸部リンパ節生検を施行した.びまん性大細胞型B細胞性リンパ腫であり,また,3年前に発症した関節リウマチに対して3ヵ月前よりMTXの内服が開始されていたことより,MTX-LPDと診断した.MTX休薬を行うも全身症状が悪化したため,初診2週間後よりR-CHOP療法を施行,治療開始4週間後には両眼とも視力(0.9)となり,眼炎症所見は速やかに改善した.しかし,4ヵ月後に中枢神経病変を認め,R-MPV療法を施行するも中枢神経病変増悪のため発症7ヵ月後に死亡した.経過中,眼所見の再発はみられなかった.結論:MTX-LPDに原田病類似の眼所見を伴う可能性がある.(著者抄録)
  • Chiharu Iwahashi; Tetsu Itami; Masuo Sakamoto; Shunji Kusaka
    Ocular immunology and inflammation 1 - 4 2023年02月 
    PURPOSE: To report a case of bilateral retinal vasculitis successfully managed with adalimumab in a patient with synovitis, acne, pustulosis, hyperostosis, and osteitis (SAPHO) syndrome. CASE REPORT: SAPHO syndrome was diagnosed in a 48-year-old female with bilateral blurred vision refractory to steroid eye drops. A preliminary ophthalmic examination revealed bilateral intermediate uveitis with vitreous opacity, and fluorescein angiography (FA) revealed dye leakage from peripheral retinal vessels. Because oral antirheumatic drugs were ineffective in treating her osteitis, her internist prescribed adalimumab, which resulted in rapid normalization of C-reactive protein and improvement of osteitis. Following treatment with adalimumab for 5 months, FA revealed significant improvement of retinal vasculitis. This is the first report on the use of adalimumab for retinal vasculitis associated with SAPHO syndrome. CONCLUSION: We described a rare case of retinal vasculitis associated with SAPHO syndrome. Adalimumab treatment was effective in treating both osteitis and retinal vasculitis.
  • Ashish Sharma; Mineo Kondo; Chiharu Iwahashi; Nikulaa Parachuri; Nilesh Kumar; Francesco Bandello; Anat Loewenstein; Baruch D Kuppermann
    Eye (London, England) 37 2 200 - 202 2023年02月
  • Chiharu Iwahashi; Tomoki Kurihara; Kazuki Kuniyoshi; Shunji Kusaka
    International journal of molecular sciences 24 3 2023年01月 
    This study evaluated the long-term visual outcomes of patients in whom at least one eye underwent successful lens-sparing vitrectomy (LSV) for stage 4A retinopathy of prematurity (ROP). A retrospective chart review was conducted using the data of 61 eyes of 42 patients with a minimum 4-year follow-up after successful LSV, with or without anti-vascular endothelial growth factor (VEGF) therapy, and whose best-corrected visual acuity (BCVA) was measurable using Landolt rings at the final visit. The mean age at the final follow-up was 10.1 ± 3.3 years. Before LSV, all eyes underwent laser ablation therapy. Twenty eyes (32.8%) with high vascular activity received anti-VEGF therapy before LSV. The mean decimal BCVA at the final follow-up was 0.23 ± 0.26 (range: hand motion to 1.2). Twenty-three eyes (54.1%) had a decimal BCVA of ≥0.4. Among 49 phakic eyes at the final examination, the mean refractive error was -10.1 ± 5.0 D, with 37 eyes (75.5%) having high myopia (>-6.0 D). No significant differences were observed in terms of decimal BCVA and refractive errors between eyes with and without anti-VEGF therapy. Approximately half of the patients had a decimal BCVA of ≥0.4, despite myopic refraction after successful LSV for stage 4A ROP. LSV for stage 4A ROP seemed to be associated with good visual function, despite myopic refraction.
  • Chiharu Iwahashi; Itsuka Matsushita; Kazuki Kuniyoshi; Hiroyuki Kondo; Shunji Kusaka
    Retina 43 1 64 - 71 2023年01月
  • Nimesh A. Patel; Luis A. Acaba-Berrocal; Sandra Hoyek; Kenneth C. Fan; Maria Ana Martinez-Castellanos; Caroline R. Baumal; C. Armitage Harper; Audina M. Berrocal; Wu Wei-Chi; Rand Spencer; Shunji Kusaka; Polly Quiram; Jose Asilis; Michael P. Blair; Swati Agarwal; Anna Ells; Cagri G. Besirli; Irena Tsui; Thomas C. Lee; Aaron Nagiel; Andrés Kychenthal; Jessica Kovarik; Anton Orlin; Janet Alexander; Vaidehi S. Dedania; Sengul Ozdek; Michel J. Shami; Cornelius Regan; Shilpa Desai; Moran Roni Levin; Deborah Y. Chong; Mrinali Gupta; Adam Pflugrath; Ashkan Abbey; Christopher G. Fuller; Lori E. Coors; Nicolas Yannuzzi; Catherine Negron; Hasenin Al-khersan; Paul Runge; Huseyin Baran Ozdemir; Tugce Kucukbalci; Chiharu Iwahashi; Mark Solinski; David Sutter; Jonathan Sears; Christine Sonnie; David Portney; Jake Duker; Tamara Lenis; Andreas Di-Luciano; Pablo Chamartin; Nikisha Kothari; Grecia Yael Ortiz-Ramirez; Gabriela Patricia Amadeo Oreggioni; Ameay V. Naravane; Peter J. Belin; Nahomy Ledesma Vicioso; Demetrios Vavvas; M. Elizabeth Hartnett; Robinson V.P. Chan; Eric Nudleman; Darius M. Moshfeghi; Atchara Amphornphruet; Michael Chiang; Michael J. Shapiro
    Ophthalmology 129 12 1380 - 1388 2022年12月
  • Yuta Yasaka; Eiichi Hasegawa; Hiroshi Keino; Yoshihiko Usui; Kazuichi Maruyama; Yuki Yamamoto; Toshikatsu Kaburaki; Daiju Iwata; Masaru Takeuchi; Sentaro Kusuhara; Hiroshi Takase; Kenji Nagata; Ryoji Yanai; Yutaka Kaneko; Chiharu Iwahashi; Atsuki Fukushima; Nobuyuki Ohguro; Koh-Hei Sonoda
    Japanese journal of ophthalmology 67 1 1 - 8 2022年11月 
    PURPOSE: To report the characteristics of a case series of ocular inflammatory events following COVID-19 vaccination in Japan. STUDY DESIGN: Retrospective multicenter study METHODS: In this retrospective multicenter survey, a questionnaire was sent to 16 Japanese hospitals that had uveitis specialty clinics. Information on patients who developed ocular inflammatory events within 14 days of COVID-19 vaccination between February 2021 and December 2021 was collected. RESULTS: Thirty-seven patients were diagnosed with ocular inflammatory events following COVID-19 vaccination. The mean age was 53.4 ± 16.4 years (range, 26-86 years), and the mean time to onset after vaccination was 6.3 ± 4.2 days (range, 1-14 days). Vogt-Koyanagi-Harada disease (VKH) was the most common event (n = 17 patients, 46%), followed by anterior uveitis (n = 6), infectious uveitis (n = 3), acute zonal occult outer retinopathy (AZOOR) (n = 2), sarcoidosis-associated uveitis (n = 1), acute posterior multifocal placoid pigment epitheliopathy (APMPPE) (n = 1), optic neuritis (n = 1), multiple evanescent white dot syndrome (MEWDS) (n = 1), Posner-Schlossman syndrome (n = 1), and unclassified uveitis (n = 4). Twenty-eight cases occurred after BNT162b2 vaccination (Pfizer-BioNTech) and 8 after mRNA-1273 vaccination (Moderna), whilst 1 patient had no information about vaccine type. CONCLUSIONS: COVID-19 vaccination can be related to various types of ocular inflammatory events. When we encounter patients with ocular inflammatory disease, we should consider that it may be an adverse effect of COVID-19 vaccination.
  • Fukutaro Mano; Chiharu Iwahashi; Kazuki Kuniyoshi; Shunji Kusaka
    Retina Publish Ahead of Print 10 1950 - 1957 2022年08月
  • 祖父江 茜; 岩橋 千春; 濱野 結貴; 梅本 弓夏; 春田 真実; 南 高正; 眞下 永; 大黒 伸行
    臨床眼科 76 7 976 - 982 (株)医学書院 2022年07月 
    <文献概要>目的:抗菌薬治療で良好な経過をたどった急性網膜内層炎の2例の報告。症例:症例1は79歳,女性。右眼の飛蚊症を自覚し,近医で前房炎症,硝子体混濁を指摘され,ステロイド点眼を開始されるも右眼の眼底出血と軟性白斑が出現したため,当院へ紹介となった。右眼の矯正視力0.6,眼底にびまん性硝子体混濁,網膜白色病巣,出血を認め,光干渉断層計(OCT)で白斑部位に一致して網膜内層病変を認めた。1ヵ月のミノサイクリン200mg/日の内服により白斑は消失し,視力は0.9まで改善した。症例2は60歳,男性。前医で右眼の前房炎症,両眼の網膜動脈分枝閉塞症,両眼の網膜白色病巣,さらに蛍光眼底造影検査で右眼の網膜血管炎を指摘され,精査加療目的で当院へ紹介となった。矯正視力は右1.2,左0.8であった。症例1と同様に,OCTで左眼の黄斑近傍の白斑部位に一致して網膜内層病変を認めた。デキサメタゾン結膜下注射およびミノサイクリン200mg/日とクラリスロマイシン400mg/日の内服により,2ヵ月半で炎症は消失し,両眼とも1.2まで視力改善を得た。結論:網膜内層に白色病巣を伴うぶどう膜炎に対して抗菌薬治療が奏効する可能性がある。
  • 治療抵抗性の点状脈絡膜内層症に伴う脈絡膜新生血管に対してアダリムマブを投与した一例
    祖父江 茜; 岩橋 千春; 大黒 伸行
    眼科臨床紀要 15 6 384 - 388 眼科臨床紀要会 2022年06月 
    背景:点状脈絡膜内層症punctate inner choroidopathy(PIC)に伴う脈絡膜新生血管choroidal neovascularization(CNV)に対する抗血管内皮増殖因子vascular endothelial growth factor(VEGF)治療の有効性が報告されている。今回、抗VEGF治療に抵抗性でCNVの活動性の再燃を繰り返すPICに対してアダリムマブを短期投与した症例を報告する。症例:40歳女性。PICに伴う左眼のCNVに対しアフリベルセプト硝子体内投与intravitreal aflibercept(IVA)を、右眼の黄斑浮腫に対しトリアムシノロンTenon嚢下注射を施行し、プレドニゾロン5mgの内服を開始したが、内服開始から1年間で右眼4回、左眼3回、IVAの追加投与を必要とした。ステロイド内服下でも活動性が続くため、アダリムマブを導入した。導入後6ヵ月で右眼に2回のCNVの活動性の再燃を認め、患者が中断を希望したことから投与終了となった。現在IVAとステロイド内服により加療中である。結論:アダリムマブの短期投与でPICに伴うCNVの活動性の再燃を抑制することは困難であった。(著者抄録)
  • 柴田 藍; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 岩橋 千春; 大黒 伸行
    あたらしい眼科 39 5 677 - 681 (株)メディカル葵出版 2022年05月 
    目的:後天性眼トキソプラズマ症(OT)の臨床的特徴と再発因子を検討すること。方法および対象:後天性OT10例10眼を診療録から後ろ向きに調査した。再発の有無・回数、治療薬・投与期間、再発危険因子を検討した。結果:非再発群5例、再発群5例であった。初期治療はスピラマイシン酢酸エステル(SPM)とプレドニゾロン(PSL)の併用が7例(うち再発群4例)、SPMとPSLとST合剤の併用が2例(うち再発群1例)、SPM単独が非再発群1例であった。再発回数は1回が3例、3回が1例、4回が1例で、初発病巣に対し10回、再発病巣に対し10回、計20回の治療が行われていた。SPMの各投与期間は投与なしが1回、短期間投与(60日以内)が5回、中期間投与(61~180日間)が8回、長期間投与(181日以上)が6回であった。短期投与の5回では全例内服終了後に再発したが、60日以上投与の14回では再発は4回のみであった(p=0.01)。結論:SPMの短期投与は後天性OT再発危険因子である可能性がある。(著者抄録)
  • 柴田 藍; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 岩橋 千春; 大黒 伸行
    あたらしい眼科 39 5 677 - 681 (株)メディカル葵出版 2022年05月 
    目的:後天性眼トキソプラズマ症(OT)の臨床的特徴と再発因子を検討すること。方法および対象:後天性OT10例10眼を診療録から後ろ向きに調査した。再発の有無・回数、治療薬・投与期間、再発危険因子を検討した。結果:非再発群5例、再発群5例であった。初期治療はスピラマイシン酢酸エステル(SPM)とプレドニゾロン(PSL)の併用が7例(うち再発群4例)、SPMとPSLとST合剤の併用が2例(うち再発群1例)、SPM単独が非再発群1例であった。再発回数は1回が3例、3回が1例、4回が1例で、初発病巣に対し10回、再発病巣に対し10回、計20回の治療が行われていた。SPMの各投与期間は投与なしが1回、短期間投与(60日以内)が5回、中期間投与(61〜180日間)が8回、長期間投与(181日以上)が6回であった。短期投与の5回では全例内服終了後に再発したが、60日以上投与の14回では再発は4回のみであった(p=0.01)。結論:SPMの短期投与は後天性OT再発危険因子である可能性がある。(著者抄録)
  • Koichi Nishida; Takeshi Morimoto; Shigenobu Suzuki; Chiharu Iwahashi; Hisanori Imai; Kazuki Kuniyoshi; Shunji Kusaka
    American journal of ophthalmology case reports 25 101367 - 101367 2022年03月 
    PURPOSE: To report the outcomes of two only seeing eyes of two cases with retinoblastoma in which vitrectomy was performed to treat vitreous hemorrhage or rhegmatogenous retinal detachment after treatment for retinoblastoma. OBSERVATIONS: Case 1 was an 8-month-old girl whose bilateral retinoblastoma (group D, OU) was treated by chemotherapy and focal ablation therapy. As the tumor size increased, enucleation was required in the right eye. At 4 years of age, about 1 year after the last treatment for retinoblastoma, lens-sparing vitrectomy was performed for dense, nonclearing vitreous hemorrhage, which had occurred 6 months previously. No recurrence of the tumor was found, and the patient's visual acuity improved to 0.9 postoperatively. Case 2 was a 4-month-old boy who was diagnosed with bilateral retinoblastoma (group D, OD; group C, OS) and underwent treatment, including systemic and local chemotherapy and proton beam therapy. Because large, regressed tumor masses were present in the posterior pole of the right eye, the left eye was the only seeing eye. At the age of 1 year 7 months, retinal detachment developed in the left eye 1 month after cryotherapy was performed for tumor recurrence. Although a scleral buckling procedure without drainage was performed, the retina was not reattached. The retina was reattached after vitrectomy with melphalan irrigation and silicone oil tamponade. However, recurrence was noted 6 months after the operation, and enucleation was required. CONCLUSION AND IMPORTANCE: Vitrectomy appears to be beneficial for the treatment of vision-threatening complications after retinoblastoma treatment. However, vitrectomy may be associated with the potential spread of tumor cells and/or tumor recurrence and therefore should be reserved as the last treatment modality for only seeing eyes. Careful postoperative follow-up is mandatory.
  • Chiori Kondo; Chiharu Iwahashi; Shoko Utamura; Kazuki Kuniyoshi; Yuhei Konishi; Norihisa Wada; Ryo Kawasaki; Shunji Kusaka
    Frontiers in pediatrics 10 785292 - 785292 2022年 
    Background: We investigated the incidence and clinical characteristics of eyes showing retinal detachment (RD) after anti-vascular endothelial growth factor (VEGF) for retinopathy of prematurity (ROP). Methods: A retrospective chart review of 76 consecutive eyes of 45 patients (18 girls and 27 boys) with stage 3 ROP who received anti-VEGF therapy between January 2012 and August 2020 with a minimum follow-up of 6 months was conducted. Eyes were divided into two groups: the vitrectomy (V) group that required vitrectomy for RD after anti-VEGF therapy and the non-vitrectomy (non-V) group that did not require vitrectomy. Data were collected from patient charts, including sex, postmenstrual age (PMA) at birth, birth weight, PMA at anti-VEGF therapy, comorbidities, reactivation, examination interval, and subsequent vitrectomies. Results: The median PMA at birth was 24.7 (range, 22.1-29.3) weeks. Twenty-seven eyes (35.1%) exhibited ROP reactivation at 6.4 ± 3.1 weeks after anti-VEGF therapy. The V group included six eyes of five patients, all of whom exhibited reactivation and developed RD 10.1 ± 6.5 weeks after anti-VEGF therapy. The types of RD were conventional (classic) in two eyes and circumferential (unique to RD after anti-VEGF) in four eyes. Three eyes required repeated vitrectomy. All eyes, except one eye in the V group, achieved retinal attachment at the last examination. The non-V group included 70 eyes of 40 patients, of which 21 exhibited reactivation and were treated successfully with laser (17 eyes) or second anti-VEGF (4 eyes). The proportion of eyes with plus disease was significantly higher in the V group (50.0%) than in the non-V group (10.0%) (P = 0.035). V group included 3 of 22 eyes (13.6%) in which the interval between the last examination and the diagnosis of reactivation was <1 week and 3 of 5 eyes (60.0%) in which the interval was more than 1 week (P = 0.024). The two groups showed no significant differences in the other factors. Conclusion: Approximately 8% of eyes developed RD about 10 weeks after anti-VEGF therapy for ROP. Eyes with history of plus disease should be carefully monitored at appropriate intervals after anti-VEGF therapy for ROP.
  • Kazuichi Maruyama; Chiharu Iwahashi; Noriyasu Hashida; Nobuyuki Ohguro; Kohji Nishida
    Japanese journal of ophthalmology 66 2 142 - 150 2021年12月 
    PURPOSE: To investigate diffuse large B-cell lymphoma lesions with central nervous system (CNS) involvement in patients with vitreoretinal lymphoma (VRL) during long-term clinical courses. STUDY DESIGN: Multicenter, retrospective, and observational research. METHODS: Seventy-one patients participated in this study, 45 were newly diagnosed VRL patients with CNS involvement initially or during follow-up of at least 12 months. We identified the CNS lesions in the patients that had VRL and investigated whether the onset sites of the CNS lesions were associated with the VRL lesions or optic pathways. RESULTS: There were 42 patients with bilateral ocular lesions; 29 had unilateral lesions; 26 had incidental CNS lymphomas. Twenty patients developed recurrent CNS lymphoma 1-73 months after VRL diagnosis; 25 patients had no CNS lesions during the follow-up period. Most CNS lesions were in forebrain-originating tissues (95 lesions/total 124 CNS lesions total), followed by hindbrain-originating tissues, especially the cerebellum. Sixty-seven lesions were found in the non-optic pathway or non-visual cortex. CONCLUSION: Over 60% of the VRL patients had CNS lesions. CNS involvement was not associated with the optic pathway or visual cortex, suggesting that clinicians should carefully examine CNS lesions occurring in both forebrain- and hindbrain-originating tissues during a patient's clinical course. Moreover, the CNS lymphomas that manifest as VRL show multifocal tumor development.
  • Chika Tanaka; Chiharu Iwahashi; Yuki Komuku; Kenta Hozumi; Keiichi Mitarai; Fumi Gomi
    Japanese journal of ophthalmology 65 6 761 - 768 2021年08月 
    PURPOSE: To investigate the clinical characteristics of central serous chorioretinopathy (CSC) with age. STUDY DESIGN: Retrospective, cross-sectional study. METHODS: One-hundred and forty-seven CSC patients were classified into three age groups (aged <50 years (younger group; n=53), 50-70 years (middle group; n=68), and >70 years (senior group; n=26)) and the characteristics were compared. Bilateral ophthalmic evaluation included the best corrected visual acuity (BCVA), spherical equivalents, fundus examination, fundus autofluorescence, optical coherence tomography (OCT), fluorescein angiography (FA), and indocyanine green angiography. RESULTS: The male/female ratio became lower at more advanced ages (P=0.011). Bilateral macular abnormalities were observed more frequently in the senior group than the other groups (p=0.018) and multiple drusen were characteristic in the senior group (p<0.0001). The more advanced age groups displayed a worse BCVA (P=0.002). The rate of eyes with flat retinal pigment epithelium (RPE) elevation on OCT was significantly higher in the middle group than the other groups (P=0.024). The mean subfoveal choroidal thickness (SCT) was thickest in the younger group (P<0.0001). Unifocal leakage on FA and choroidal vascular hyperpermeability were mostly found in eyes of the younger group (P<0.001,P=0.020). CONCLUSION: CSC cases in those aged >70 years were associated with an increased proportion of women and having bilateral macular abnormalities, multiple drusen, and multifocal leakage sites. The BCVA and the SCT decreased with age. Patients with CSC aged 50-70 years had the highest rate of flat RPE elevation on OCT. These characteristics need to be considered to make an accurate diagnosis, particularly in elderly patients.
  • Chiharu Iwahashi; Shoko Utamura; Kazuki Kuniyoshi; Koji Sugioka; Yuhei Konishi; Norihisa Wada; Shunji Kusaka
    Retina (Philadelphia, Pa.) 41 11 2261 - 2268 2021年05月 
    PURPOSE: To investigate the efficacy and risk factors of intravitreal anti-vascular endothelial growth factor injection (anti-VEGF therapy) for retinopathy of prematurity (ROP). METHODS: We retrospectively reviewed 80 consecutive eyes of 43 patients with type 1 ROP or worse who received anti-VEGF therapy during January 2012-February 2018. Patients were divided into those who were injected with 0.25 mg bevacizumab (IVB group, 37 eyes) and 0.25 mg ranibizumab (IVR group, 43 eyes). Serum VEGF concentrations of 18 patients were measured before and after IVR. RESULTS: Anti-VEGF therapy reduced ROP activity in all eyes; however, 14 eyes (17.5%) exhibited reactivation. The reactivation rates of the IVB and IVR groups were 13.5% and 20.9%, respectively (p = 0.556). Multivariate logistic regression analysis showed that postmenstrual age (PMA) ≤35 weeks at anti-VEGF therapy (p = 0.014) and aggressive posterior ROP (p = 0.044) were significantly associated with reactivation. Serum VEGF was significantly suppressed at days 1 (p < 0.001) and 7 (p = 0.012) after IVR and returned to preinjection level by day 14 (p = 0.210). CONCLUSIONS: Both IVR and IVB seemed effective in reducing ROP activity. Reactivation after anti-VEGF therapy may be associated with younger PMA at anti-VEGF therapy and aggressive posterior ROP.
  • 多田 明日美; 岩橋 千春; 中井 慶; 南場 研一; 岡田 アナベルあやめ; 慶野 博; 高瀬 博; 福田 祥子; 後藤 浩; 臼井 嘉彦; 蕪城 俊克; 水木 信久; 安積 淳; 園田 康平; 武田 篤信; 大黒 伸行
    日本眼科学会雑誌 125 4 415 - 424 (公財)日本眼科学会 2021年04月 
    目的:日本における結核性ぶどう膜炎の臨床像と治療内容を明らかにすること.対象と方法:多施設後ろ向き研究にて2001年1月〜2012年12月の間に結核性ぶどう膜炎と診断された130例192眼の年齢,性別,臨床所見,結核菌感染の検査法,治療について検討した.結果:130例中,男性78例(60%),女性52例(40%)で,年齢は48.5±16.7:20〜88歳(平均値±標準偏差:範囲)であった.192眼中,11眼(5.7%)が前部ぶどう膜炎,92眼(47.9%)が後部ぶどう膜炎,88眼(45.8%)が汎ぶどう膜炎であった.眼所見では網膜血管炎142眼(74.0%),硝子体混濁89眼(46.4%),前房炎症88眼(45.8%),網膜滲出斑73眼(38.0%)であった.結核菌感染検査ではツベルクリン反応123例(94.6%),インターフェロン-γ遊離試験(IGRA)83例(63.8%)の順に実施率が高く,陽性率はそれぞれ95.2%,75.9%であった.108例(83.1%)で抗結核薬が投与され,うち41例(38.0%)で副腎皮質ステロイド内服が併用された.全身結核病変を合併していた症例は14例(10.8%)であった.結論:結核性ぶどう膜炎で多い臨床像は網膜血管炎,硝子体混濁であった.全身結核病変を合併していた症例は1割と少なく,臨床像が多彩な結核性ぶどう膜炎の診断にはツベルクリン反応やIGRAが重要であると考えられた.(著者抄録)
  • Chiharu Iwahashi; Kuniko Tachibana; Tomoyuki Oga; Chiori Kondo; Kazuki Kuniyoshi; Shunji Kusaka
    Ophthalmology. Retina 5 11 1139 - 1145 2021年01月 
    PURPOSE: To determine the incidence and factors associated with lens opacity after lens-sparing vitrectomy (LSV) for retinopathy of prematurity (ROP). DESIGN: Retrospective comparative case series. PARTICIPANTS: Among the 141 eyes of 94 patients who received LSV for ROP between 2006 and 2019, 108 eyes of 71 patients with minimum follow-up of 12 months after LSV were investigated. METHODS: Data were collected from patients' charts, including sex, gestational age at birth, birth weight, stage of ROP, postmenstrual age (PMA) at LSV, surgical procedure, preoperative injection of anti-vascular endothelial growth factor (anti-VEGF), subsequent retinal surgeries, and lensectomy during the follow-up. MAIN OUTCOME MEASURES: Lens status at last visit, incidence and timing of lensectomy, risk factors for lens opacity requiring lensectomy. RESULTS: Stages of ROP at LSV were 4A, 4B, and 5 in 92, 13, and 3 eyes, respectively. The median PMA at LSV was 40.6 weeks. Thirty-two eyes received anti-VEGF therapy prior to LSV. Lens opacity was found in 17 eyes (15.7%), of which 10 eyes (9.3%) underwent lensectomy. The period between LSV and lensectomy ranged from 21 days to 131.9 months (median: 21.1 months). Eleven other eyes (10.2%) underwent lensectomy as part of a reoperation for worsening of ROP. A total of 80 eyes (74.1%) preserved clear lenses at the latest follow-up examination after surgery (median: 6.8 years; range: 1-14 years). The Kaplan-Meier estimate showed that the proportion of patients with phakia at 5 and 10 years was 92.4% and 89.0%, respectively. Multivariate Cox regression analysis revealed that eyes with the use of tamponade at LSV (p = 0.005; odds ratio: 25.68; confidence interval: 4.187-157.5) and young PMA at LSV (p = 0.033; odds ratio: 1.047; confidence interval: 1.012-1.099) were significantly associated with lens opacity requiring lensectomy. However, anti-VEGF therapy was not associated with lens opacity requiring lensectomy. CONCLUSIONS: Nearly 10% of eyes required lensectomy due to lens opacity after LSV for ROP. The development of lens opacity requiring lensectomy appears to be associated with the use of tamponade and young PMA at LSV.
  • Chiharu Iwahashi; Hiroshi Eguchi; Fumika Hotta; Mayu Uezumi; Miki Sawa; Masatomo Kimura; Takashi Yaguchi; Shunji Kusaka
    BMC infectious diseases 20 1 566 - 566 2020年08月 
    BACKGROUND: Subtenon injection of triamcinolone acetonide (STTA) has been widely adopted in the clinical setting of ophthalmology and its infectious complications are rare. However, orbital abscess following STTA has been reported in seven cases. Furthermore, although eye infections due to Exophiala species are uncommon, there have been 19 cases to date. E. jeanselmei, E. phaeomuriformis, E. werneckii, and E. dermatitidis have been reported to cause human eye infections; however, to the best of our knowledge, orbital abscess caused by E. dermatitidis has not yet been reported. We describe the first documented case of fungal orbital abscess caused by E. dermatitidis following STTA. We also review the related literature of orbital abscess following STTA, as well as eye infections caused by the four Exophiala species. CASE PRESENTATION: The patient was a 69-year-old Japanese woman with diabetic mellitus. She had a macular oedema in her right eye, which occurred secondary to branch retinal vein occlusion. An orbital abscess caused by E. dermatitidis occurred 4 months after the second STTA for the macular oedema, which was successfully treated by a surgical debridement and systemic administration of voriconazole. CONCLUSIONS: Our findings in the patient and from our literature survey caution ophthalmologists to the fact that STTA can cause fungal orbital infections, especially in diabetic patients. Furthermore, surgical treatment is one of the most important risk factors.
  • 河 共美; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 岩橋 千春; 大黒 伸行
    日本眼科学会雑誌 124 5 424 - 431 (公財)日本眼科学会 2020年05月 
    目的:非感染性ぶどう膜炎に対するアダリムマブの治療成績を検討し,無効例・奏効例の臨床的特徴を分析する.対象と方法:2017年1月1日から2018年12月31日までに地域医療機能推進機構大阪病院を受診し,アダリムマブを6ヵ月以上投与できた非感染性ぶどう膜炎25例44眼について,年齢,性別,原因疾患や罹患期間,導入時から6ヵ月後にかけての眼内炎症の変化や,プレドニゾロンおよびその他の併用治療の変化を後ろ向きに検討し,無効例と奏効例の2群に分類した.奏効例の判定基準はいずれかに改善がみられ,悪化する項目がないものである.結果:25例中20例(80%)でアダリムマブは奏効した.導入6ヵ月後に視力(p=0.03)および前房炎症(p=0.0006)が有意に改善したが,硝子体混濁や網膜浮腫は改善しなかった.単変量回帰分析の結果,アダリムマブの無効にはプレドニゾロン以外の併用薬がないこと(p=0.01)や,長期の罹患期間(p=0.02)が有意に関連した.年齢やプレドニゾロンの投与量はアダリムマブの有効性に関連しなかった.結論:アダリムマブは80%で非感染性ぶどう膜炎に有効であるが,プレドニン単独治療例,長期経過例では奏効しない可能性がある.(著者抄録)
  • Yuki Komuku; Chiharu Iwahashi; Fumi Gomi
    Japanese journal of ophthalmology 64 3 265 - 270 2020年05月 
    PURPOSE: To evaluate the 24-month effectiveness of polypoidal lesion-selective photodynamic therapy (PDT) combined with antivascular endothelial growth factor (VEGF) therapy for polypoidal choroidal vasculopathy (PCV) with branching vascular networks (BVNs) involving the fovea with 1 or more polyps. STUDY DESIGN: A retrospective case series. PATIENTS AND METHODS: Twenty-six eyes from 25 PCV patients treated with polypoidal lesion-selective PDT combined with aflibercept were included in the study. The main outcome measure was change in best-corrected visual acuity (BCVA), and the secondary outcome measures were changes in central retinal thickness and subfoveal choroidal thickness on optical coherence tomography (OCT), status of exudation at 24 months, and number of additional treatments. RESULTS: Fourteen eyes of 14 patients showed treatment-naïve PCV, and 12 eyes of 11 patients were switched from anti-VEGF monotherapy. The baseline mean logMAR BCVA was 0.43, and this had increased significantly, by 0.31, at 24 months (P = .034). The mean central retinal thickness (CRT) and central choroidal thickness (CCT) were significantly lower at all time points than those at baseline. The mean number of additional injections of aflibercept was 3.1 (range, 0-9), and that of additional PDT treatments was 0.5 (range, 0-2). CONCLUSION: Polypoidal lesion-selective PDT with aflibercept was effective for relatively large, fovea-involved PCV, with significant visual improvement at 24 months.
  • 超広角眼底撮影が有用であったChronic retinal necrosisの1例
    梅本 弓夏; 岩橋 千春; 梅村 享平; 河 共美; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 大黒 伸行
    眼科臨床紀要 13 4 242 - 245 眼科臨床紀要会 2020年04月 
    背景:chronic retinal necrosis(CRN)は2013年にSchneiderらによって提唱された疾患概念である。今回我々は超広角眼底撮影が診断に有用であったCRNの1例を経験したので報告する。症例:66歳男性。肺がん治療歴がある。左眼視力低下で受診。左眼矯正視力は0.3、眼圧は40mmHg、前眼部炎症、隅角・虹彩の新生血管、眼底周辺部に顆粒状壊死病巣がみられた。前房水PCRで、サイトメガロウイルス(CMV)陽性であった。超広角眼底カメラを用いたフルオレセイン眼底造影検査で広範囲の無灌流領域を認め、CRNと診断した。無灌流領域に対して抗VEGF薬硝子体内投与および網膜光凝固を、CMVに対しガンシクロビルの硝子体内投与を施行し、1年半は網膜炎の安定が得られた。その後、肺がん再発の治療のために免疫チェックポイント阻害薬を投与された後から網膜炎が再燃し硝子体出血を発症した。結論:CRNの診断に超広角眼底撮影が有用であった。CRNは免疫療法を契機に悪化することがあるので、注意を要する。(著者抄録)
  • Fumihiro Kubota; Tetsuyuki Suetsugu; Aki Kato; Fumi Gomi; Seiji Takagi; Takamasa Kinoshita; Hiroto Ishikawa; Yoshinori Mitamura; Mineo Kondo; Chiharu Iwahashi; Soichiro Kuwayama; Yasuo Kurimoto; Yuichiro Ogura; Tsutomu Yasukawa
    American journal of ophthalmology 207 313 - 318 2019年11月 [査読有り]
     
    PURPOSE: This study evaluated the long-term visual prognosis of a serous retinal detachment (SRD) secondary to tilted disc syndrome with or without an SRD at the final visit and the interventions. DESIGN: A retrospective, observational case series. METHODS: This was a multicenter study with an enrollment of 48 eyes of 41 treatment-naïve patients (14 men, 27 women) in whom tilted disc syndrome-related SRD was diagnosed at the first visit. Investigators at each institution decided whether to observe the patients without interventions or to treat with intravitreous injections of antivascular endothelial growth factor agents, photodynamic therapy, or both therapies combined. The patients were followed for at least 12 months. Main outcome measurements were changes in best-corrected visual acuity (BCVA) and central retinal thickness (CRT) from baseline. RESULTS: Analyses of all eyes showed improvement from baseline when BCVA was measured (P < 0.0001), although last BCVA was similar to BCVA at baseline (P = 0.46). CRT significantly improved from that at baseline at the final visit (P < 0.0001). When eyes with or without SRD at the final visit were analyzed, baseline BCVAs (P = 0.22) were similar, whereas BCVA (P = 0.05) and last BCVA (P = 0.005) were significantly better in eyes without SRD. When eyes with or without the interventions were analyzed, baseline (P = 0.70), best (P = 0.99), and last (P = 0.70) BCVAs were similar. Last CRT significantly decreased from baseline CRT in eyes that had undergone interventions (P < 0.0001). CONCLUSIONS: The visual prognosis of SRD secondary to tilted disc syndrome was better when SRD resolved but was not influenced by the treatments.
  • 岩橋 千春; 河 共美; 春田 真実; 南 高正; 冨田 有輝; 眞下 永; 下條 裕史; 狩野 廉; 大黒 伸行
    臨床眼科 73 4 457 - 462 (株)医学書院 2019年04月 
    <文献概要>目的:ぶどう膜炎に伴う続発緑内障(UG)に対するブリモニジン(Bm)点眼の短期的な眼圧下降効果の報告。対象と方法:2012年5月〜2018年1月の間に地域医療機能推進機構大阪病院でBm点眼を使用したUG 341例のうち,Bm点眼追加以外に治療内容を変更しなかった,追加前眼圧22mmHg以上のUG 38例43眼(男性21例,女性17例,平均年齢53.1±17.1歳)を対象とした。白内障手術を除く内眼手術の既往症例,6ヵ月以内の白内障手術・ステロイド注射施行例,ポスナーシュロスマン症候群の症例は除外した。投与前併用薬,投与前と投与後1ヵ月の眼圧,隅角所見などについて後ろ向きに検討した。結果:投与前平均眼圧は28.1±5.7mmHgであった。投与前の眼圧下降薬の平均薬剤スコアは1.9±0.8(0〜5)であり,眼圧下降薬としてβ遮断薬と炭酸脱水酵素阻害薬の合剤のみが処方されていた症例が28眼(65.1%)であった。1ヵ月以内に治療効果不十分のために他治療を追加した症例は5眼(11.6%)であり,4眼はステロイド点眼の減量,1眼は選択的レーザー線維柱帯形成術により眼圧下降が得られた。残る38眼の投与1ヵ月後平均眼圧は20.5±7.0mmHgであり,Bm点眼の単独追加により平均6.5±7.7mmHgの眼圧下降が得られた。投与前に比して30%以上の眼圧下降を得られた症例は17眼(39.5%)であった。Bm点眼によると思われる眼所見の悪化はなかった。結論:Bm点眼は,少なくとも短期的には約4割の症例で30%以上の眼圧下降が得られた。
  • Takashi Araki; Hiroto Ishikawa; Chiharu Iwahashi; Masanori Niki; Yoshinori Mitamura; Masahiko Sugimoto; Mineo Kondo; Takamasa Kinoshita; Tomo Nishi; Tetsuo Ueda; Aki Kato; Tsutomu Yasukawa; Yoshihiro Takamura; Fumi Gomi
    PloS one 14 2 e0213110 - e0213110 2019年 [査読有り]
     
    We investigated the rates of the use of steroids in Japanese central serous chorioretinopathy (CSC) cases and differences in the characteristics of CSC with and without steroids. A total of 538 eyes of 477 patients diagnosed with CSC, with 3 months or more of follow-up between April 2013 and June 2017 at 8 institutions. Patients with CSC with more than 3 months of follow-up were identified by OCT and fluorescein angiography at 8 institutions. Data collected included patient demographics, history of corticosteroid medication and smoking, spherical errors, findings of angiography, subfoveal choroidal thickness, and changes through the follow-up period. Differences in these findings were analyzed in cases with and without corticosteroid treatment. Among the 477 patients (344 men,133 women), 74 (15.5%) (39 men, 35 women) underwent current or prior steroid treatment. Cases with steroids were higher age (p = 0.0403) and showed no male prevalence, more bilateral involvement (p < 0.0001), and the affected eyes had multiple pigment epithelial detachment (p <0.0001), more fluorescein leakage sites (p < 0.0001), greater choroidal thickness (p = 0.0287) and a higher recurrence rate (p = 0.0412). Steroids can cause severer CSC through an effect on choroidal vessels and an impairment of retinal pigment epithelium.
  • Ikeda M; Iwahashi C; Hirai T; Hattori K; Mitarai K
    Case reports in ophthalmology 10 1 89 - 94 2019年01月 [査読有り]
     
    We report a case of eosinophilic chronic rhinosinusitis (ECRS) associated with choroidal folds and ocular motility disorder. A 50-year-old male with rhinosinusitis and bronchial asthma presented with anorthopia of the lower visual field and ocular motility disorder of the left eye. Dilated fundus examination and optical coherence tomography (OCT) revealed wavy choroidal folds in the upper retina. An emergent computed tomography (CT) showed sinusitis, a partial defect of the superior wall of the orbit on the left side, and deformation of the left eye. Based on the clinical findings, the patient was diagnosed with sinusitis complicated by ocular motility disorder. Endoscopic sinus surgery (ESS) was performed. A histopathological examination of the excised polyps showed extensive eosinophil invasion. According to the clinical findings of the nasal polyps, CT images, and peripheral blood tests, he was diagnosed as ECRS. One month after ESS, both ocular movement and anorthopia were improved. The choroidal folds observed using OCT disappeared 2 months after ESS. Although ECRS is rarely associated with ocular complications, bone involvement in sinusitis may result in deformation of the eyeball leading to choroidal folds and ocular motility disorder.
  • Chiharu Iwahashi; Hikari Ono; Mami Haruta; Takamasa Minami; Hisashi Mashimo; Hiroshi Shimojo; Nobuyuki Ohguro
    BMJ open ophthalmology 4 1 e000250  2019年 [査読有り]
     
    Objective: To report four cases of new onset or exacerbation of uveitis following administration of infliximab. Methods: This retrospective observational case series includes four patients who developed new onset or exacerbation of uveitis paradoxically during infliximab treatment. Results: Four patients were assessed, including three women, with a mean age of 33 (14-84) years. Infliximab was introduced for the treatment of scleritis associated with rheumatoid arthritis (two cases), chronic anterior uveitis associated with juvenile idiopathic arthritis (JIA) (one case) and Crohn's disease (one case). Anterior scleritis associated with rheumatoid arthritis successfully improved following infliximab administration; however, macular oedema or dense vitritis paradoxically developed in two cases. In one case, infliximab was switched to tocilizumab. In another case, infliximab was discontinued, and additional corticosteroids and immunosuppressive medications were added. In one patient with JIA, new-onset macular oedema and exacerbation of anterior uveitis were observed during infliximab treatment, so the patient was switched to adalimumab. In the patient with Crohn's disease treated with infliximab, severe vasculitis and macular oedema occurred, requiring intravitreal triamcinolone injection. The patient was switched to adalimumab. Given that these reactions were paradoxical effects of infliximab, infliximab treatment was discontinued in all cases, and additional corticosteroids or immunosuppressive medications were added. All cases remained free of ocular inflammation at the last visit. Conclusion: Uveitis rarely occurs de novo or is exacerbated during infliximab treatment. Cessation of infliximab led to resolution of this paradoxical adverse effect.
  • 福富 啓; 岩橋 千春; 吉岡 茉衣子; 小野 ひかり; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 大黒 伸行
    日本眼科学会雑誌 122 8 559 - 564 日本眼科学会 2018年08月 
    目的:眼内原発中枢神経悪性リンパ腫の診断における硝子体中サイトカイン測定および細胞診の有効性を検討する。対象と方法:対象は2010年12月から2017年3月迄に地域医療機能推進機構大阪病院眼科を受診し、眼内原発リンパ腫に合致する眼所見を有した症例のうち、経過中に脳内病変を発症し、かつ全身化学療法施行後に脳内病巣の消失を得たことから眼内原発中枢神経悪性リンパ腫との診断に至った18眼。硝子体中のサイトカイン比がinterleukin(IL)-10/IL-6>1であること、細胞診検査でclassIV以上であることを陽性として生検陽性率を検討した。次いで、臨床像や生検前の副腎皮質ステロイド加療の有無が生検結果に影響するかについて検討した。また、IL-10の実測値が補助診断の指標となりうるかについても検討を加えた。結果:サイトカイン比は55.6%、細胞診は33.3%が陽性であった。一方、サイトカイン比と細胞診がともに陰性の症例は22.2%であった。サイトカイン比あるいは細胞診が陽性であった症例は副腎皮質ステロイド加療歴がない7眼中の7眼、および副腎皮質ステロイド加療歴がある11眼中の7眼であり、有意差はないが副腎皮質ステロイド加療歴がない群で陽性率が高かった。またIL-10実測値が50pg/mL以上の症例は66.7%であった。結論:約8割の症例はサイトカイン比、細胞診の検査結果より診断可能であった。一方で、サイトカイン比、細胞診だけでは診断できない眼内原発リンパ腫が約2割に存在した。(著者抄録)
  • 小野 ひかり; 吉岡 茉依子; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 岩橋 千春; 大黒 伸行
    臨床眼科 72 6 795 - 801 (株)医学書院 2018年06月 
    <文献概要>目的:既存治療に抵抗を示す難治性非感染性ぶどう膜炎に対するアダリムマブ(ADA)の効果について検討する。対象と方法:地域医療機能推進機構大阪病院で2017年1〜8月にADAを導入した難治性非感染性ぶどう膜炎17例を対象とし,治療効果と安全性について検討した。眼所見の改善の有無,併用薬の減量の有無により,著効・有効・無効の3つに分類し効果を評価した。また,副作用についても調べた。結果:著効10例,有効5例,無効2例であった。ベーチェット病,若年性特発性関節炎,原因不明の汎ぶどう膜炎の全例を含む10例で眼所見の改善および併用薬の減量が可能であり,著効と評価した。びまん性網脈絡膜炎の全例を含む5例では併用薬を減量できたが,眼所見の改善は認めず,有効と評価した。無効と評価した2例では,副作用のためプレドニゾロン(PSL)を減量できなかった。導入後の平均視力は導入前より有意に改善した。17例中PSLを使用した15例全例でADA導入後のPSL内服量は10mg未満となった。副作用は3例(注射部位反応1例,好酸球増加2例)認めた。結論:既存治療に抵抗性を示す非感染性ぶどう膜炎に対し,ADA投与は有効であり,併用PSL投与量は全例で10mg未満に減量可能であった。
  • Teiko Saito; Nobuyuki Ohguro; Chiharu Iwahashi; Noriyasu Hashida
    Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 254 12 2319 - 2326 2016年12月 [査読有り]
     
    BACKGROUND: Primary vitreoretinal lymphoma (PVRL), a subset of primary central nervous system lymphoma (PCNSL), is a high-grade malignant tumor that shows various chorioretinal findings. Optical coherence tomography (OCT) is useful for detecting these lesions, and various abnormalities on OCT images have been reported. The purpose of this report was to investigate retrospectively the OCT manifestations of various disease stages and compare the manifestations of pretreatment, recurrent, and chronic cases. METHODS: We reviewed the medical charts and OCT images of 38 consecutive cases with PVRL. When abnormalities were detected on OCT images, the patients were classified based on the treatment of the primary disease: pretreatment if not treated, recurrent if treated previously, and chronic when chronic changes. RESULTS: Twenty-six eyes (20 cases) had abnormalities in the post-pole OCT images, i.e., 16 eyes (12 cases) were in the pretreatment group, seven eyes (five cases) were in the recurrent group, and five eyes (five cases) were in the chronic group. Two eyes (two cases) had abnormalities on OCT in the pretreatment and recurrent or chronic stages. The pretreatment and recurrent groups had subretinal or retinal pigment epithelium (RPE) level abnormalities more often than intraretinal changes. Twelve of 16 pretreated eyes and all seven eyes with recurrent disease had subretinal or RPE level abnormalities. One pretreatment case and three recurrent cases had atypical OCT manifestations of intraretinal (round lesions) or epiretinal changes (villous-shaped lesions). CONCLUSIONS: Although pretreatment cases and recurrent cases showed similar OCT abnormalities and the specific changes in the various disease stages were unclarified, collecting OCT data from various disease stages will facilitate detection of typical OCT changes of PVRL and lead to early diagnosis and treatment.
  • Chiharu Iwahashi; Minoru Fujimoto; Shintaro Nomura; Satoshi Serada; Kei Nakai; Nobuyuki Ohguro; Kohji Nishida; Tetsuji Naka
    Experimental eye research 140 53 - 64 2015年11月 [査読有り]
     
    Recently, a number of biologics have been used in the treatment of autoimmune diseases. However, in the treatment of severe autoimmune uveitis, only TNF-alpha inhibitors are preferably used and the effect of other biologics such as interleukin-6 (IL-6) signaling blockade or cytotoxic T-lymphocyte antigen-4-immunoglobulin fusion protein (CTLA4-Ig) has not been well studied. Previously, we reported that IL-6 blockade effectively suppresses the development of experimental autoimmune uveitis (EAU), a mouse model for uveitis, by inhibiting Th17 cell development. In this study, we investigated the effect of CTLA4-Ig on EAU development and compared it with the effect of anti-IL-6 receptor monoclonal antibody (MR16-1). C57BL/6J mice were immunized with interphotoreceptor retinoid-binding protein (IRBP) and treated once with CTLA4-Ig or MR16-1. Both CTLA4-Ig and MR16-1 administered in the induction phase (the same day as immunization) significantly reduced the clinical and histopathological scores of EAU. Fluorescence-activated cell sorting studies using draining lymph node (LN) cells from EAU mice 10 days after immunization showed that CTLA4-Ig can suppress early T-helper cell activation. CTLA4-Ig administered in the effector phase of the disease (one week after immunization), when IRBP-reactive T cells have been primed, also significantly reduced the clinical and histopathological scores of EAU. In contrast, MR16-1 administered in the effector phase did not ameliorate EAU. To investigate the differences between these biologics in the effector phase, in vitro restimulation analysis of LN cells obtained from EAU mice one week after immunization was performed and revealed that CTLA4-Ig, but not MR16-1, added to culture media could inhibit the proliferation of IRBP-specific CD4(+) T cells which possessed capacities of producing IFN-gamma and/or IL-17. Collectively, CTLA4-Ig ameliorated EAU through preventing initial T-cell activation in the induction phase and suppressing proliferation of IRBP-specific T cells in the effector phase. Blockade of IL-6 signaling did not have such inhibitory effects after T-cell priming. CTLA4-Ig may have therapeutic effects on human chronic uveitis.
  • Kotaro Tsuboi; Kei Nakai; Chiharu Iwahashi; Fumi Gomi; Yasushi Ikuno; Kohji Nishida
    Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie 253 6 959 - 64 2015年06月 [査読有り]
     
    PURPOSE: To characterize patients with Vogt-Koyanagi-Harada (VKH) disease with choroidal folds (CFs) and determine how the foveal choroidal thickness changes after initial treatment using high-penetration optical coherence tomography (HP-OCT). METHODS: In this retrospective observational study, we analyzed 42 eyes of 21 patients with new-onset VKH disease to determine the demographic and clinical differences between patients with and without CFs. RESULTS: Twenty-four eyes (57.1 %) of 13 patients with VKH disease had CFs. The mean age (p = 0.0009) of patients with CFs was significantly higher than that of those without CFs (49.1 vs 39.4 years respectively). The frequency of disc swelling (p = 0.0001) was significantly higher in eyes with CFs than in those without CFs (95.8 % vs 38.9 %). The choroidal thickness at the first visit (p = 0.0011) was significantly greater in eyes with CFs than in those without CFs (794 ± 144 μm vs 649 ± 113 μm). The choroid 6 months after the initial treatment (p = 0.0118) was significantly thinner in eyes with CFs than in those without CFs (270 ± 92 μm vs 340 ± 80 μm). The frequency of sunset glow fundus at 6 months (p = 0.0334) in eyes with CFs was significantly higher than in those without CFs (62.5 % vs 27.8 %). CONCLUSION: The development of CFs in patients with VKH disease was significantly correlated with age, disc swelling, and choroidal thickness. The eyes with CFs frequently developed a sunset glow fundus. The findings suggested that patients with CFs might have severe and longstanding inflammation of the choroidal tissues.
  • Chiharu Iwahashi; Kensuke Okuno; Noriyasu Hashida; Kei Nakai; Nobuyuki Ohguro; Kohji Nishida
    Japanese journal of ophthalmology 59 3 157 - 63 2015年05月 [査読有り]
     
    PURPOSE: Our aim was to determine the recurrence rate of inflammation in Vogt-Koyanagi-Harada (VKH) disease and to describe its clinical features. METHODS: We retrospectively evaluated patients diagnosed as having VKH disease with exudative retinal detachment at the Osaka University Hospital or the Japanese Community Healthcare Organization, Osaka Hospital, between 1998 and 2012. All patients received high-dose corticosteroid therapy as the initial treatment and were followed for at least 6 months. Demographic data, including age, sex, visual acuity (VA) levels at initial presentation and at 1 year after initial therapy, treatment received, and recurrent episodes were reviewed. RESULTS: Fifty-five consecutive patients with VKH disease were identified (36 women; mean age 38.6 ± 10.4 years). Fourteen patients (25.5 %) had recurrent inflammation, which manifested as posterior uveitis in eight and as anterior uveitis in six of the patients. Recurrent posterior segment inflammation was more likely to develop in patients whose VA at initial presentation was poor (P = 0.039) and in whom orally administered corticosteroid was tapered rapidly (to 30 mg within 3 weeks or less, to 20 mg within 2 months or less, and to 10 mg within 3 months or less) (P = 0.006, P = 0.066, and P = 0.041, respectively). CONCLUSIONS: About 25 % of patients with VKH disease had recurrent inflammation. Poor initial VA and rapid tapering of the corticosteroid were associated with posterior recurrence.
  • Yuki Komuku; Chiharu Iwahashi; Shinsaku Yano; Chika Tanaka; Tomoya Nakagawa; Fumi Gomi
    Case Reports in Ophthalmology 6 3 488 - 494 2015年 [査読有り]
     
    Vogt-Koyanagi-Harada (VKH) disease and central serous chorioretinopathy (CSC) develop serous retinal detachment however, the treatment of each disease is totally different. Steroids treat VKH but worsen CSC therefore, it is important to distinguish these diseases. Here, we report a case with CSC which was diagnosed by en face optical coherence tomography (OCT) imaging during the course of VKH disease. A 50-year-old man was referred with blurring of vision in his right eye. Fundus examination showed bilateral optic disc swelling and macular fluid in the right eye. OCT showed thick choroid, and en face OCT images depicted blurry choroid without clear delineation of choroidal vessels. Combined with angiography findings, this patient was diagnosed with VKH disease and treated with steroids. Promptly, fundus abnormalities resolved with the reduction of the choroidal thickness and the choroidal vessels became visible on the en face images. During the tapering of the steroid, serous macular detachment in the right eye recurred several times. Steroid treatment was effective at first however, at the fourth appearance of submacular fluid, the patient did not respond. At that time, the choroidal vessels on the en face OCT images were clear, which significantly differed from the images at the time of recurrence of VKH. Angiography also suggested CSC-like leakage. The tapering of the steroids was effective in resolving the fluid. Secondary CSC may develop in the eye with VKH after steroid treatment. En face OCT observation of the choroid may be helpful to distinguish each condition.
  • Chiharu Iwahashi-Shima; Tatsuhiko Sato; Hajime Bando; Toshihide Ikeda; Kazuyuki Emi
    Clinical Ophthalmology 7 2043 - 2049 2013年10月 [査読有り]
     
    Background: The purpose of this study was to evaluate the outcome of 25-gauge vitrec-tomy for repair of rhegmatogenous retinal detachment (RRD) complicated by proliferative vitreoretinopathy (PVR). Methods: Twenty-seven eyes of 27 patients who had undergone 25-gauge vitrectomy for grade C PVR were investigated retrospectively. The surgical procedures, anatomic success, and best-corrected visual acuity were assessed. Results: The mean number of operations was 1.4 (range 1-4). During the 25-gauge vitrectomy, 20-gauge instruments were needed in eleven eyes (40.7%) to remove resilient fibrous preretinal membranes, to extract subretinal proliferations, or to remove or infuse silicone oil. The retina was reattached in 21 eyes (77.8%) after the initial vitrectomy and in 25 eyes (92.6%) at the final examination. The mean best-corrected visual acuity in logarithm of the minimal angle of resolution units was 1.36 ± 0.81 before vitrectomy and 0.79 ± 0.71 at one month, 0.73 ± 0.72 at 3 months, 0.73 ± 0.75 at 6 months, and 0.75 ± 0.78 at 12 months after vitrectomy. The best-corrected visual acuities were significantly improved compared with the preoperative ones at all postoperative assessments (P,0.001). Conclusion: Twenty-five gauge vitrectomy is a relatively safe and efficacious method of treating RRD with PVR, although combined use of 20-gauge instruments may be needed for certain surgical procedures. © 2013 Iwahashi-Shima et al.
  • Chiharu Iwahashi-Shima; Atsushi Azumi; Nobuyuki Ohguro; Annabelle A. Okada; Toshikatsu Kaburaki; Hiroshi Goto; Koh-Hei Sonoda; Kenichi Namba; Nobuhisa Mizuki; Manabu Mochizuki
    JAPANESE JOURNAL OF OPHTHALMOLOGY 57 1 98 - 103 2013年01月 [査読有り]
     
    To examine the factors associated with anatomic and visual outcomes in Japanese patients with acute retinal necrosis (ARN). One hundred four patients with ARN who were followed for more than 1 year at nine referral centers were reviewed. Retinal involvement at initial presentation was classified into four groups: zone 1 (posterior pole, n = 22), zone 2 (midperiphery, n = 54), zone 3 (periphery, n = 25), and unknown (n = 3). Forty-eight eyes underwent prophylactic vitrectomy before development of retinal detachment (vitrectomy group); 56 eyes were treated conventionally without prophylactic vitrectomy (observation group). The retina was attached in 28 of 48 eyes (58.3 %) in the vitrectomy group and 42 of 56 eyes (75.0 %) in the observation group at the final visit (P = 0.071). At 1 year, 56 eyes (53.8 %) had a best-corrected visual acuity (BCVA) of 20/200 or worse. Multivariate logistic regression analyses identified zone 1 disease (odds ratio = 4.983) and optic nerve involvement (odds ratio = 5.084) as significantly associated with BCVA of 20/200 or worse. Among the zone 3 eyes, significantly (P = 0.012) more eyes in the observation group than in the vitrectomy group had an attached retina. Prophylactic vitrectomy did not improve the final BCVA in any eyes. Zone 3 eyes had better outcomes without prophylactic vitrectomy.
  • Chiharu Iwahashi-Shima; Atsuya Miki; Toshimitsu Hamasaki; Yasumasa Otori; Kenji Matsushita; Yoshiaki Kiuchi; Morio Okada; Shunji Kusaka
    RETINA-THE JOURNAL OF RETINAL AND VITREOUS DISEASES 32 8 1636 - 1642 2012年09月 [査読有り]
     
    Purpose: To determine the incidence and risk factors for delayed-onset intraocular pressure (IOP) elevations after vitrectomy for Stages 4 and 5 retinopathy of prematurity and, in addition, to determine the results of treating the IOP elevations. Methods: Fifty-five consecutive eyes with successful retinal reattachment and at least 24 months of follow-up after vitrectomy were studied. The ophthalmic examinations included slit-lamp biomicroscopy, wide-field digital retinal imaging, and IOP measurements. Eyes were classified into 2 groups: eyes with a postoperative IOP elevation to >= 21 mmHg and eyes whose IOP was always <21 mmHg. Results: Eight eyes (14.5%) developed an IOP elevation to >= 21 mmHg from 2 months to 4 months (median: 2.5 months) after the vitrectomy. In two of these eyes, the IOP was controlled with antiglaucoma medications. In the other six eyes, trabeculotomy for eyes with open angles and trabeculectomy or goniosynechialysis for eyes with closed angles were performed. The IOPs were successfully controlled after an average of 1.5 glaucoma surgeries. Multivariate logistic regression analyses identified that a young gestational age (odds ratio = 1.147, 95% confidence interval: 1.024-1.346) and lensectomy (odds ratio = 8.795, 95% confidence interval: 1.262-183.3) were significantly associated with the IOP elevation. Conclusion: Delayed-onset IOP elevation after vitrectomy for retinopathy of prematurity occurs in 14.5% of the eyes, and it is significantly associated with a young gestational age and presence of lensectomy.
  • 岩橋 千春; 大黒 伸行
    日本サルコイドーシス/肉芽腫性疾患学会雑誌 32 1 71 - 77 日本サルコイドーシス 2012年09月 
    サルコイドーシスの国際的な診断基準は確立されておらず,2006年に眼サルコイドーシスの国際基準案(東京基準)が提唱されたが,この診断基準の妥当性の評価はあまり行われていない.今回,我が国10大学で組織診断された眼サルコイドーシス287症例を対象とし,後ろ向きに東京基準について検討した.東京基準の眼所見の項目は視神経乳頭肉芽腫/脈絡膜肉芽腫を除いては半数以上で陽性であり,約85%が3項目以上を満たしていた.全身所見の項目については,両側肺門リンパ節腫脹を認めた症例が70%以上を占めていた.肝酵素の上昇は2%に認められたにすぎなかった.全例で生検未施行と仮定した場合,Presumed Ocular Sarcoidosisの基準を満たす症例は71%であったのに対し,Probable Ocular Sarcoidosisは5%であり,再考を要すると思われた.東京基準案は一部の項目を除いてはおおむね臨床を反映していると考えられるが,国際基準としての妥当性の評価のためには,前向きで国際的な今後の検討を要する.(著者抄録)
  • Tatsuhiko Sato; Kosaku Sawada; Chiharu Iwahashi-Shima; Hajime Bando; Toshihide Ikeda; Kazuyuki Emi
    ANNALS ACADEMY OF MEDICINE SINGAPORE 41 7 294 - 299 2012年07月 [査読有り]
     
    Introduction: This study aims to compare the long-term efficacy of 25-gauge vitrectomy to that of intravitreal bevacizumab (IVB) for the treatment of macular edema (ME) secondary to branch retinal vein occlusion (BRVO). Materials and Methods: The medical records of 46 eyes of 46 consecutive patients were reviewed. Twenty-seven eyes underwent 25-gauge vitrectomy (VIT Group) and 19 eyes received 1.25 mg of IVB (IVB Group). The best-corrected visual acuities (BCVAs) in logarithm of minimum angle resolution units and central macular thicknesses (CMTs) were evaluated before and 3, 6, and 12 months after the initial treatment. Results: There was no significant difference in the pre-treatment BCVA and CMT between the 2 groups. In the VIT Group, the preoperative BCVA was 0.59 and the CMT was 587.3 mu m and the BCVA was 0.35 and the CMT was 286.6 mu m, 12 months after the vitrectomy. Both values were significantly (P<0.05) better at 12 months than the preoperative values. In the IVB Group, the average number of IVB was 2.4 during the 1-year period. The BCVA was 0.69 and the CMT was 590.9 mu m before the IVB, and the BCVA was 0.36 and the CMT was 360.1 pm, 12 months after the initial IVB. The improvements of these 2 parameters were significant (P<0.05) at 12 months after the initial IVB. The differences in the BCVA and CMT at 12 months between the 2 groups were not significant. Conclusion: These results suggest that the 25-gauge vitrectomy and IVB have similar effects in improving the BCVA and CMT in eyes with ME secondary to BRVO. However, IVB often required several injections to preserve the improvement.
  • Nakashima H; Emi K; Sato T; Iwahashi-Shima C; Bando H; Ikeda T
    Nippon Ganka Gakkai zasshi 116 6 560 - 567 日本眼科学会 2012年06月 [査読有り]
  • Tatsuhiko Sato; Kazuko Wada; Hitomi Arahori; Noriyuki Kuno; Kenji Imoto; Chiharu Iwahashi-Shima; Shunji Kusaka
    AMERICAN JOURNAL OF OPHTHALMOLOGY 153 2 327 - 333 2012年02月 [査読有り]
     
    PURPOSE: To determine the serum concentrations of bevacizumab and vascular endothelial growth factor (VEGF) in infants with retinopathy of prematurity (ROP) who received intravitreal bevacizumab; and to determine whether the changes in the serum concentration of bevacizumab were significantly correlated with the serum concentration of VEGF after intravitreal bevacizumab. DESIGN: Case series. METHODS: Eleven infants (4 girls and 7 boys) with ROP were studied. They received 0.25 mg or 0.5 mg of intravitreal bevacizumab to either 1 eye (unilateral cases) or both eyes (bilateral cases) with vascularly active ROP. Serum samples were collected before and 1 day, 1 week, and 2 weeks after the intravitreal bevacizumab. The serum concentrations of bevacizumab and VEGF were measured by enzyme-linked immunosorbent assay, and the correlation in the serum levels between the 2 was determined. RESULTS: The serum concentration of bevacizumab before and 1 day, 1week, and 2 weeks after a total of 0.5 mg of intravitreal bevacizumab was 0 ng/mL, 195 +/- 324 ng/mL, 946 +/- 680 ng/mL, and 1214 +/- 351 ng/mL, respectively. The serum bevacizumab level before and 1 day and 1 week after a total 1.0 mg of intravitreal bevacizumab was 0 ng/mL, 248 +/- 174 ng/mL, and 548 +/- 89 ng/mL, respectively. The serum concentration of VEGF before and 1 day, 1 week, and 2 weeks after a total of 0.5 mg intravitreal bevacizumab was 1628 +/- 929 pg/mL, 427 +/- 140 pg/mL, 246 +/- 110 pg/mL, and 269 +/- 157 pg/mL, respectively. There was a significant negative correlation (r = -0.575, P = .0125) between the serum concentration of bevacizumab and VEGF when a total of 0.25 mg or 0.5 mg of bevacizumab was injected. CONCLUSIONS: These results indicate that bevacizumab can escape from the eye into the systemic circulation and reduce the serum level of VEGF in infants with ROP. Continued extensive evaluations of infants are warranted for possible effects after intravitreal bevacizumab in ROP patients. (Am J Ophthalmol 2012;153:327-333. (C) 2012 by Elsevier Inc. All rights reserved.)
  • Tatsuhiko Sato; Chiharu Shima; Shunji Kusaka
    AMERICAN JOURNAL OF OPHTHALMOLOGY 151 2 353 - 357 2011年02月 [査読有り]
     
    PURPOSE: To determine the vitreous levels of angiopoietin (Ang)-1 and Ang-2 in eyes with retinopathy of prematurity (ROP), and to determine the correlation between the 2 levels. DESIGN: Retrospective case-control study. " METHODS: Forty-eight eyes with stage 4 ROP were studied. Six eyes with congenital cataract were used as controls. The ROP eyes were classified by the vascular activity into highly (n = 22), moderately (n = 15), and mildly (n = 11) Vascular-active ROP. Eyes with highly vascular-active ROP initially received 0.5 mg of intravitreal bevacizumab (IVB) and underwent vitrectomy within 1 week. The others underwent vitrectomy without IVB. Vitreous samples were collected at the beginning of vitrectomy, and the vitreous levels of Angs were measured by enzyme-linked immunosorbent assay. RESULTS: The mean concentrations of Ang-1 and Ang-2 were 201.9 and 7832.1 pg/mL in highly vascularactive ROP eyes, 216.1 and 7731.2 pg/mL in moderately vascular-active ROP eyes, 533.8 and 1685.9 pg/mL in mildly vascular-active ROP eyes, and 0 and 41.5 pg/mL in control eyes. The vitreous Ang-1 level was significantly higher (P < .05) in highly, moderately, and mildly vascular-active ROP eyes than in control eyes. The vitreous Ang-2 level was significantly higher (P < .05) in highly and moderately vascular-active ROP eyes than in control eyes. There was a significant negative correlation (r = -0.406; P = .040) between the Ang-1 and Ang-2 levels in moderately and mildly vascular-active ROP eyes. " CONCLUSIONS: The balance of Ang-1 and Ang-2 in the vitreous may be important in the pathogenesis of ROP. (Am J Op hthalmol 2011;151:353-357. (C) 2011 by Elsevier Inc. All rights reserved.)
  • Chiharu Shima; Fumi Gomi; Miki Sawa; Hirokazu Sakaguchi; Motokazu Tsujikawa; Yasuo Tano
    GRAEFES ARCHIVE FOR CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY 247 7 899 - 906 2009年07月 [査読有り]
     
    To evaluate the efficacy of combined photodynamic therapy (PDT) and intravitreal bevacizumab injection in eyes with a serous pigment epithelial detachment (PED) associated with age-related macular degeneration (AMD). Twenty-two eyes with a serous PED exceeding two disc areas associated with AMD with choroidal vascular abnormalities [choroidal neovascularization (n = 10), polypoidal choroidal vasculopathy (n = 9), and retinal angiomatous proliferation (n = 3)] received combined PDT and intravitreal bevacizumab, and were followed about every 6 weeks for more than 1 year. Additional treatments were given for residual or recurrent lesions. The main outcome measures were changes in the PED height measured by optical coherence tomography, and the best-corrected visual acuity. After one treatment, the PED resolved in 12 eyes (55%) and the PED decreased in ten eyes (45%). There was no recurrence in eight (36%) eyes; however, PED recurred in 14 eyes. At 1 year, the average PED height decreased to 413 microns from the baseline 751 microns (p < 0.001). Twenty eyes (91%) had improved or stabilized vision; two eyes had decreased vision due to a retinal pigment epithelial tear and subretinal hemorrhage. Combined PDT and intravitreal bevacizumab may decrease the PED height and stabilize visual acuity at 1 year.
  • Yusuke Oshima; Chiharu Shima; Taku Wakabayashi; Shunji Kusaka; Fumio Shiraga; Masahito Ohji; Yasuo Tano
    OPHTHALMOLOGY 116 5 927 - 938 2009年05月 [査読有り]
     
    Purpose: To investigate the feasibility and efficacy of microincision vitrectomy surgery (MIVS) combined with intravitreal bevacizumab (IVB) as a surgical adjunct for treating traction retinal detachment (TRD) secondary to severe proliferative diabetic retinopathy (PDR). Design: Retrospective, comparative, consecutive, interventional case series. Participants: Seventy-one eyes of 59 consecutive patients who underwent primary vitrectomy for diabetic TRD and were followed up for more than 6 months after surgery. Methods: Eyes that received IVB (1 mg) as a preoperative adjunct followed by MIVS (IVB/MIVS group) from November 2005 through December 2007 were compared with eyes that underwent conventional 20-gauge pars plana vitrectomy (20-g PPV group) from September 2003 through October 2005. Main Outcome Measures: Primary and ultimate anatomic success, intraoperative and postoperative complications, and final visual success with at least 6 months of follow-up. Results: This series included 38 eyes (33 patients) in the IVB/MIVS group and 33 eyes (26 patients) in the 20-g PPV group. The primary and ultimate anatomic success rates (95% vs. 91% and 100% in both groups, respectively) and the mean visual acuity changes did not differ significantly between groups; the surgical time and intraoperative bleeding in the IVB/MIVS group decreased significantly compared with the 20-g PPV group (P<0.001). The rate of visual improvement of 3 lines or more at the 6-month follow-up was 68% in the IVB/MIVS group and 49% in the 20-g PPV group, respectively. Progression of the preexisting TRD after IVB occurred in 7 eyes (18%). Absence of previous laser photocoagulation (P = 0.025) and the presence of a ring-shaped fibrovascular membrane (P = 0.013) were relevant findings in eyes with these IVB-induced complications. Conclusions: Intravitreal bevacizumab plus MIVS offers comparable anatomic success compared with conventional 20-gauge PPV in patients with TRD resulting from severe PDR. This technique shortens the surgical time with fewer intraoperative complications and favorable visual recovery. However, caution should be taken because of rapid progression of the preexisting TRD after IVB in some patients. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2009;116:927-938 (C) 2009 by the American Academy of Ophthalmology.
  • Ryo Inoue; Yoshitsugu Saishin; Chiharu Shima; Hiroshi Yoshikawa; Nobuyuki Ohguro; Yasuo Tano
    JAPANESE JOURNAL OF OPHTHALMOLOGY 53 3 271 - 273 2009年05月 [査読有り]
  • Chiharu Shima; Shunji Kusaka; Hiroyuki Kondo; Haruyuki Hasebe; Takashi Fujikado; Yasuo Tano
    ARCHIVES OF OPHTHALMOLOGY 127 4 579 - 580 2009年04月 [査読有り]
  • Chiharu Shima; Hirokazu Sakaguchi; Fumi Gomi; Motohiro Kamei; Yasushi Ikuno; Yusuke Oshima; Miki Sawa; Motokazu Tsujikawa; Shunji Kusaka; Yasuo Tano
    ACTA OPHTHALMOLOGICA 86 4 372 - 376 2008年06月 [査読有り]
     
    Purpose: To report complications in patients after intravitreal injection of bevacizumab to treat ocular diseases associated with vascular endothelial growth factor. Methods: We retrospectively reviewed the systemic and ocular complications that developed within 2 months of each intravitreal injection of bevacizumab in 707 patients (1300 injections) with intraocular neovascularization or macular oedema. Results: Nine ocular (1.27%) and eight systemic (1.13%) complications occurred in 707 patients. The ocular complications included corneal abrasion (n = 2), chemosis (n = 2), lens injury (n = 1), ocular inflammation (n = 2), retinal pigment epithelial tear (n = 1) and acute vision loss (n = 1). The systemic complications included cerebral infarction (n = 1), elevation of systolic blood pressure (n = 2), facial skin redness (n = 1), itchy diffuse rash (n = 1) and menstrual irregularities (n = 3). Conclusion: Intravitreal injection of bevacizumab may cause systemic or ocular complications. Caution is advised when considering intravitreal injection of this drug.
  • Tomoyuki Inoue; Yusuke Oshima; Chiharu Shima; Yuichi Hori; Naoyuki Maeda; Yasuo Tano
    JOURNAL OF CATARACT AND REFRACTIVE SURGERY 34 6 892 - 896 2008年06月 [査読有り]
     
    We describe a technique that uses chandelier illumination during Descemet-stripping automated endothelial keratoplasty (DSAEK) in severe bullous keratopathy. A 25-gauge or 27-gauge chandelier illumination fiber inserted through the corneal side port serves as sclera-scattering illumination from the sclerocorneal margin and endoillumination from the anterior chamber and provides excellent visibility for Descemet stripping and intraocular manipulation without obstruction by a hazy cornea. In cases complicated by dense cataract, the chandelier fiber can be inserted trans-conjunctivally into the pars plana, providing sufficient retroillumination to perform phacoemulsification with intraocular lens implantation combined with Descemet stripping for a DSAEK triple procedure. Because of the powerful illumination and hands-free nature of the chandelier fiber, Descemet membrane can be visualized clearly and stripped as 1 sheet without inadvertent complications. This new technique is safe and might encourage surgeons to perform DSAEK in challenging cases.
  • Yusuke Oshima; Chiharu Shima; Naoyuki Maeda; Yasuo Tano
    JOURNAL OF CATARACT AND REFRACTIVE SURGERY 33 12 2018 - 2022 2007年12月 [査読有り]
     
    We describe a technique that uses 25-gauge transconjunctival chandelier endoillumination in combination with a torsional oscillation system for cataract surgery in cases with severe bullous keratopathy. Because of the hands-free and self-retaining nature of the chandelier fiber, continuous curvilinear capsulorhexis and subsequent bimanual intraocular manipulation can be performed easily. Torsional oscillation efficiently emulsifies lens particles along with the fluidics, preventing posterior capsule rupture and endothelial cell damage. After the chandelier fiber is removed at the end of surgery, the 25-gauge incision self-seals. This technique is safe and visualization during cataract surgery in patients with severe corneal opacities.
  • Chiharu Shima; Yasumasa Otori; Atsuya Miki; Yasuo Tano
    JAPANESE JOURNAL OF OPHTHALMOLOGY 51 5 390 - 391 2007年09月 [査読有り]

書籍

  • 眼疾患アトラスシリーズ 後眼部アトラス
    (担当:範囲:関節・リウマチ性疾患によるぶどう膜炎、真菌性眼内炎)総合医学社 2019年10月
  • 眼科診療ビジュアルラーニング 眼炎症
    (担当:範囲:突発性の炎症/Behcet病)中山書店 2018年02月
  • 眼科診療マイスター 処置と手術手技
    (担当:範囲:ぶどう膜炎の手術治療)メジカルビュー社 2017年03月
  • 眼科診療マイスター 診断と治療
    (担当:範囲:ぶどう膜炎 薬物治療(ステロイド以外))メジカルビュー社 2017年01月
  • 今日の眼疾患 治療指針
    (担当:範囲:血液検査)医学書院 2016年10月
  • 知っているようで知らない新しい糖尿病網膜症診療
    (担当:範囲:手厚く治す糖尿病黄斑浮腫(DME)至れり尽くせりのマネージメント)メジカルビュー社 2016年09月
  • 一目でわかる眼疾患の見分け方 ぶどう膜疾患、網膜・硝子体疾患
    (担当:範囲:眼内悪性リンパ腫、地図状脈絡膜炎)メジカルビュー社 2016年04月

MISC

  • 接触式広角眼底カメラRetCam 3とPanoCam Soloの比較
    中嶌 彩夏; 日下 俊次; 國吉 一樹; 岩橋 千春; 眞野 福太郎; 大賀 智行 眼科臨床紀要 16 (6) 456 -456 2023年06月
  • Stage 4A未熟児網膜症に対する水晶体温存硝子体手術後の長期視力予後
    岩橋 千春; 立花 都子; 栗原 智樹; 國吉 一樹; 日下 俊次 日本眼科学会雑誌 127 (臨増) 232 -232 2023年03月
  • 【眼科外来診療クオリティアップ】ぶどう膜 ぶどう膜炎患者のロービジョンケア
    岩橋 千春 あたらしい眼科 39 (臨増) 241 -245 2022年11月
  • 岩橋 千春 臨床眼科 76 (12) 1534 -1538 2022年11月
  • 【眼科外来診療クオリティアップ】ぶどう膜 ぶどう膜炎患者のロービジョンケア
    岩橋 千春 あたらしい眼科 39 (臨増) 241 -245 2022年11月
  • 【未熟児網膜症アップデート】わかりやすい臨床講座 ROPの治療 硝子体手術・晩期合併症
    岩橋 千春; 日下 俊次 日本の眼科 93 (10) 1410 -1415 2022年10月
  • ステロイド内服中に発症したStevens-Johnson症候群の一例
    川口 奈都美; 岩橋 千春; 堀田 芙美香; 日下 俊次 眼科臨床紀要 15 (7) 495 -495 2022年07月
  • 祖父江 茜; 岩橋 千春; 大黒 伸行 眼科臨床紀要 15 (6) 384 -388 2022年06月
  • 未熟児網膜症研究の進歩 未熟児網膜症に対する抗VEGF療法の効果および治療後の再燃
    岩橋 千春 眼科臨床紀要 15 (6) 415 -415 2022年06月
  • 未熟児網膜症に対するranibizumab単独投与治療後の経過
    歌村 翔子; 國吉 一樹; 岩橋 千春; 七部 史; 坂本 万寿夫; 和田 紀久; 日下 俊次 眼科臨床紀要 15 (6) 418 -419 2022年06月
  • 先天網膜分離症に対する硝子体手術の治療成績
    岩橋 千春; 松下 五佳; 近藤 寛之; 國吉 一樹; 日下 俊次 眼科臨床紀要 15 (6) 420 -420 2022年06月
  • 【白内障 ベーシック&アドバンスト 検査・手術・ケアのキーワード・最新のスタンダードがわかる!】(5章)手術準備
    岩橋 千春 眼科ケア (2022春季増刊) 82 -92 2022年04月
  • 先天網膜分離症の光干渉断層計検査所見
    中嶌 彩夏; 國吉 一樹; 岩橋 千春; 眞野 福太郎; 日下 俊次 眼科臨床紀要 15 (2) 158 -158 2022年02月
  • ベーチェット病に中心性漿液性脈絡網膜症を合併した2例
    岩橋 千春; 眞下 永; 大黒 伸行; 五味 文 眼科臨床紀要 14 (11) 759 -760 2021年11月
  • Stage 4A未熟児網膜症術後の長期視力経過
    立花 都子; 岩橋 千春; 國吉 一樹; 阿部 考助; 日下 俊次 眼科臨床紀要 14 (6) 383 -384 2021年06月
  • Stage 4A未熟児網膜症術後の長期視力経過
    立花 都子; 岩橋 千春; 國吉 一樹; 阿部 考助; 日下 俊次 眼科臨床紀要 14 (6) 383 -384 2021年06月
  • 急性網膜壊死
    岩橋 千春 日本眼科学会雑誌 125 (臨増) 94 -94 2021年03月
  • まだまだ広がるぶどう膜炎の分子標的治療
    岩橋 千春 日本眼科学会雑誌 125 (臨増) 147 -147 2021年03月
  • 未熟児網膜症に対する抗VEGF治療後に硝子体手術を要した症例の臨床的特徴
    近藤 千桜里; 岩橋 千春; 國吉 一樹; 日下 俊次 日本眼科学会雑誌 125 (臨増) 206 -206 2021年03月
  • PICに対する低用量ステロイド治療の有用性の検討
    祖父江 茜; 岩橋 千春; 濱野 結貴; 梅村 享平; 春田 真美; 南 高正; 眞下 永; 大黒 伸行 日本眼科学会雑誌 125 (臨増) 213 -213 2021年03月
  • 急性網膜壊死
    岩橋 千春 日本眼科学会雑誌 125 (臨増) 94 -94 2021年03月
  • まだまだ広がるぶどう膜炎の分子標的治療
    岩橋 千春 日本眼科学会雑誌 125 (臨増) 147 -147 2021年03月
  • 未熟児網膜症に対する抗VEGF治療後に硝子体手術を要した症例の臨床的特徴
    近藤 千桜里; 岩橋 千春; 國吉 一樹; 日下 俊次 日本眼科学会雑誌 125 (臨増) 206 -206 2021年03月
  • PICに対する低用量ステロイド治療の有用性の検討
    祖父江 茜; 岩橋 千春; 濱野 結貴; 梅村 享平; 春田 真美; 南 高正; 眞下 永; 大黒 伸行 日本眼科学会雑誌 125 (臨増) 213 -213 2021年03月
  • 脈絡膜皺襞を呈したANCA関連血管炎の1例
    岩橋 千春; 杉野 日彦; 上野 覚; 山雄 さやか; 坂本 万寿夫; 日下 俊次 眼科臨床紀要 13 (11) 741 -741 2020年11月
  • 脈絡膜皺襞を呈したANCA関連血管炎の1例
    岩橋 千春; 杉野 日彦; 上野 覚; 山雄 さやか; 坂本 万寿夫; 日下 俊次 眼科臨床紀要 13 (11) 741 -741 2020年11月
  • 吉岡 茉依子; 岩橋 千春; 大黒 伸行 小児科 61 (6) 841 -846 2020年05月
  • 小児汎ぶどう膜炎の臨床的特徴
    岩橋 千春; 河 共美; 春田 真実; 南 高正; 眞下 永; 大黒 伸行 日本眼科学会雑誌 124 (臨増) 243 -243 2020年03月
  • 【令和新時代の医療トピックス】非感染性ぶどう膜炎の治療戦略
    岩橋 千春; 大黒 伸行 クリニシアン 67 (1) 52 -56 2020年01月
  • 【中途失明の可能性のある疾患Q&A】中途失明の可能性のある疾患とその検査/治療 ぶどう膜炎 サルコイドーシスによる眼症状と治療法を教えてください
    岩橋 千春; 大黒 伸行 あたらしい眼科 36 (臨増) 84 -86 2019年11月
  • 【ぶどう膜炎における診断・治療の最前線】わがりやすい臨床講座 ぶどう膜炎における外科的手技
    岩橋 千春; 大黒 伸行 日本の眼科 90 (6) 704 -709 2019年06月
  • 眼原発悪性リンパ腫の眼所見と中枢神経浸潤についての検討
    岩橋 千春; 紀田 侑子; 氏家 秀敏; 菅原 浩之; 大黒 伸行 日本眼科学会雑誌 123 (臨増) 223 -223 2019年03月
  • 岩橋 千春; 大黒 伸行 臨床眼科 73 (3) 262 -265 2019年03月
  • 岩橋 千春; 大黒 伸行 あたらしい眼科 35 (12) 1625 -1630 2018年12月
  • 吉岡 茉依子; 小野 ひかり; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 岩橋 千春; 大黒 伸行 臨床眼科 72 (8) 1111 -1117 2018年08月
  • 眼底異常を機に肺癌が発見された2症例
    岩橋 千春; 池田 勝浩; 小椋 有貴; 矢野 晋策; 御手洗 慶一 住友病院医学雑誌 (45) 40 -40 2018年07月
  • 抗TNF-α抗体製剤投与後に内眼炎を発症した4症例
    岩橋 千春; 吉岡 茉依子; 小野 ひかり; 春田 真実; 南 高正; 眞下 永; 下條 裕史; 大黒 伸行 日本眼科学会雑誌 122 (臨増) 193 -193 2018年03月
  • 中心性漿液性脈絡網膜症へのステロイドの関与 多施設後向き調査結果
    荒木 敬士; 石川 裕人; 岩橋 千春; 小椋 有貴; 仁木 昌徳; 杉本 昌彦; 西 智; 加藤 亜紀; 長谷川 綾華; 高村 佳宏; 五味 文; 臨床網膜研究会 日本眼科学会雑誌 122 (臨増) 295 -295 2018年03月
  • 【眼科救急Q&A】救急疾患ごとの基本的な対処法 ぶどう膜炎 Behcet病の発作時の所見と治療法について教えてください
    岩橋 千春; 大黒 伸行 あたらしい眼科 34 (臨増) 194 -196 2017年11月
  • 岩橋 千春; 大黒 信行 OCULISTA (48) 85 -90 2017年03月
  • 網膜静脈閉塞症に対するトリアムシノロンとラニビズマブの同時投与の短期治療成績
    岩橋 千春; 小椋 有貴; 矢野 晋策; 田中 知香; 中川 智哉; 五味 文 眼科臨床紀要 9 (11) 921 -921 2016年11月
  • Chiharu Iwahashi; Minoru Fujimoto; Tomoharu Ohkawara; Hayato Urushima; Satoshi Serada; Tetsuji Naka ARTHRITIS & RHEUMATOLOGY 68 2016年10月
  • 【眼感染症の傾向と対策-完全マニュアル】疾患別 診断・治療の進め方と処方例 ぶどう膜・網脈絡膜疾患 急性網膜壊死
    岩橋 千春; 大黒 伸行 臨床眼科 70 (11) 238 -243 2016年10月
  • 高齢者における中心性漿液性脈絡網膜症の特徴
    田中 知香; 小椋 有貴; 矢野 晋策; 岩橋 千春; 中川 智哉; 五味 文 眼科臨床紀要 9 (10) 843 -844 2016年10月
  • 未熟児網膜症に対する水晶体温存硝子体術後の水晶体透明性
    立花 都子; 日下 俊次; 阿部 考助; 森本 壮; 國吉 一樹; 杉岡 孝二; 岩橋 千春; 不二門 尚; 下村 嘉一 眼科臨床紀要 9 (9) 773 -773 2016年09月
  • 岩橋 千春; 大黒 伸行 あたらしい眼科 33 (7) 953 -956 2016年07月
  • 未熟児網膜症に対する水晶体温存硝子体術後の水晶体透明性
    立花 都子; 日下 俊次; 阿部 考助; 森本 壮; 國吉 一樹; 杉岡 孝二; 岩橋 千春; 不二門 尚; 下村 嘉一 日本眼科学会雑誌 120 (臨増) 192 -192 2016年03月
  • 白内障手術の加齢黄斑変性にもたらす影響
    小椋 有貴; 矢野 晋策; 田中 知香; 岩橋 千春; 中川 智哉; 五味 文 日本眼科学会雑誌 120 (臨増) 311 -311 2016年03月
  • 眼底異常を機に肺癌が発見された2症例
    岩橋 千春; 小椋 有貴; 矢野 晋策; 田中 知香; 中川 智哉; 五味 文 眼科臨床紀要 9 (2) 185 -185 2016年02月
  • Hayato Urushima; Minoru Fujimoto; Chiharu Iwahashi; Tomoharu Ohkawara; Hiromi Honda; Satoshi Serada; Tetsuji Naka ARTHRITIS & RHEUMATOLOGY 67 2015年10月
  • 急性網膜壊死に対する硝子体手術の功罪
    岩橋 千春 眼科手術 28 (4) 559 -561 2015年10月
  • 岩橋千春; 岩橋千春; 藤本穣; 野村慎太郎; 三嶋隆; 世良田聡; 仲哲治 日本眼感染症学会・日本眼炎症学会・日本コンタクトレンズ学会総会・日本涙道・涙液学会プログラム・講演抄録集 52nd-49th-58th-4th 85 2015年
  • 岩橋 千春; 大黒 伸行 眼科 57 (1) 45 -49 2015年01月
  • 宇留島 隼人; 藤本 穣; 岩橋 千春; 大河原 知治; 本田 宏美; 世良田 聡; 仲 哲治 日本臨床免疫学会会誌 38 (4) 335a -335a 2015年
  • 本田 宏美; 藤本 穣; 大河原 知治; 宇留島 隼人; 岩橋 千春; 世良田 聡; 仲 哲治 日本臨床免疫学会会誌 38 (4) 315b -315b 2015年
  • 岩橋 千春; 大黒 伸行 臨床眼科 69 (1) 28 -32 2015年01月
  • 岩橋 千春; 大黒 伸行 眼科 57 (1) 45 -49 2015年01月
  • 結核性ぶどう膜炎の臨床像および治療予後の検討
    多田 明日美; 岩橋 千春; 中井 慶; 南場 研一; 田岡 アナベルあやめ; 高瀬 博; 後藤 浩; 蕪城 俊克; 水木 信久; 安積 淳; 園田 康平; 武田 篤信; 大黒 伸行 日本眼科学会雑誌 118 (10) 857 -857 2014年10月
  • 未熟児網膜症に対する硝子体手術後の高眼圧症例の検討
    岩橋 千春 眼科臨床紀要 7 (5) 376 -376 2014年05月
  • 岩橋千春; 藤本穣; 野村慎太郎; 中井慶; 大黒伸行; 西田幸二; 仲哲治 日本眼感染症学会・日本眼炎症学会・日本コンタクトレンズ学会総会・日本涙道・涙液学会プログラム・講演抄録集 51st-48th-57th-3rd 88 2014年
  • 【眼科診療指針のパラダイムシフト 網膜硝子体/ぶどう膜/神経眼科/眼腫瘍・眼窩・ロービジョン【編】】ぶどう膜 桐沢型ぶどう膜炎の治療
    岩橋 千春; 大黒 伸行 眼科 56 (2) 236 -240 2014年01月
  • 【ぶどう膜炎 外来診療】ぶどう膜炎の治療
    岩橋 千春; 大黒 伸行 OCULISTA (5) 25 -30 2013年08月
  • 岩橋 千春; 大黒 伸行 あたらしい眼科 = Journal of the eye 30 (3) 337 -341 2013年03月
  • 【眼科薬物療法】ぶどう膜 急性網膜壊死
    岩橋 千春 眼科 54 (10) 1362 -1364 2012年09月
  • 中島 浩士; 恵美 和幸; 佐藤 達彦; 岩橋 千春; 坂東 肇; 池田 俊英 日本眼科学会雑誌 116 (6) 560 -567 2012年06月
  • Stage 3未熟児網膜症に対するbevacizumab硝子体内投与の短期成績
    日下 俊次; 荒堀 仁美; 和田 和子; 岩橋 千春; 佐藤 達彦 眼科臨床紀要 4 (10) 993 -993 2011年10月
  • 増殖硝子体網膜症に対する25ゲージ硝子体手術成績
    岩橋 千春; 佐藤 達彦; 坂東 肇; 池田 俊英; 恵美 和幸 日本職業・災害医学会会誌 59 (臨増) 別158 -別158 2011年10月
  • 井石 涼; 鈴木 三保子; 岩橋 千春 臨床眼科 65 (6) 803 -807 2011年06月
  • 岩橋 千春; 大黒 伸行 あたらしい眼科 = Journal of the eye 28 (4) 463 -467 2011年04月
  • 未熟児網膜症に対する硝子体手術後の続発緑内障
    島 千春; 日下 俊次; 大鳥 安正; 三木 篤也; 松下 賢治; 木内 良明; 不二門 尚 眼科臨床紀要 3 (4) 405 -405 2010年04月
  • 未熟児網膜症に対する硝子体手術後の続発緑内障
    島 千春; 日下 俊次; 大鳥 安正; 張野 正誉; 三木 篤也; 松下 賢治; 木内 良明; 岡田 守生; 不二門 尚 日本眼科学会雑誌 113 (10) 992 -993 2009年10月
  • 島 千春; 山田 晃; 壺阪 真子; 櫻井 元子; 中谷 幸次; 木下 和郎; 岸田 修; 藤本 敬; 南 雄三 肝臓 49 (10) 470 -475 2008年10月
  • 原 吉幸; 島 千春; 田上 美和 臨床眼科 62 (7) 1131 -1133 2008年07月
  • 島 千春; 春田 亘史; 西信 良嗣; 大黒 伸行; 田野 保雄 あたらしい眼科 = Journal of the eye 25 (6) 851 -854 2008年06月
  • 島 千春; 井上 智之; 大島 佑介 IOL & RS : Japanese journal of cataract and refractive surgery : 日本眼内レンズ屈折手術学会誌 22 (2) 229 -233 2008年06月
  • 島 千春; 大島 佑介; 前田 直之 眼科手術 = Journal of ophthalmic surgery 21 (1) 45 -48 2008年01月
  • 島 千春; 大島 佑介; 近藤 峰夫 あたらしい眼科 = Journal of the eye 24 (11) 1509 -1511 2007年11月
  • 島 千春; 近藤 真也; 中谷 幸次 綜合臨床 55 (3) 583 -585 2006年03月

受賞

  • 2017年07月 日本眼炎症学会 日本眼炎症学会学術奨励賞
     CTLA4-Igによるぶどう膜炎の抑制機序
  • 2013年07月 日本小児眼科学会 第9回日本小児眼科学会賞
     未熟児網膜症に対する硝子体手術後の高眼圧症例の検討

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