視網膜專題演講會 Retina Symposium
14 Dec 2025
10:50
12:01
701B
Taiji SakamotoJapan
Moderator
My journey of retinal detachmentIn the 1990s, I began studying retinal detachment (RD) as a model for neuronal degeneration, particularly apoptosis. I discovered that necrotic retinal cells release highly toxic substances, but the vitreous body neutralizes them. Taking advantage of this, we developed a vitreous surgery method using hyaluronic acid.
Subsequently, I worked as a surgeon to treat RD. At that time, vitreous surgery was extremely challenging because we could not visualize the retina or vitreous during surgery. Observing success in simplifying ILM peeling with ICG staining, I developed a method to visualize the vitreous using triamcinolone. Lacking knowledge about patents (At that time, we were already using this method), I initially let another doctor publish the first report, but later we conducted a prospective comparative study demonstrating that triamcinolone-assisted vitrectomy made the surgery safer. Our group then developed a safer vital dye called brilliant blue, which is now used worldwide.
While surgical techniques improved, the subjective nature of surgery made objective assessment difficult. To address this issue, I believed a national retinal RD was necessary and established the Japan RD Registry to collect data. Our findings revealed the reality of RD treatment in Japan, including a significant result that in more conservative regions, women were less likely to undergo surgery. This highlighted the need for societal intervention to ensure all patients receive care. Despite my efforts to avoid social activities by focusing on basic medicine and RD treatment, I concluded that improving society was essential to effectively treat RD.
許淑娟 Shwu-Jiuan SheuTaiwan
Moderator
Risk factors associated with sight threatening diabetic retinopathy (STDR) severity and progression in diabetes mellitus (DM) patientsPurpose: This study aims to examine factors associated with sight threatening diabetic retinopathy (STDR) severity and progression in diabetes mellitus (DM) patients. Specifically, we focus on the initial HbA1C at diagnosis, its change at ophthalmologic visit and medication adherence (MR).
Research Design and Methods: A prospective study involving 300 type II DM patients (≥20 years) was conducted from July 2022 to January 2024. MR was assessed using the Taiwanese version of the Morisky Medication Adherence Scale-8 (MMAS-8). DR progression was evaluated through a defined clinical scoring system. Statistical analyses included chi-square tests and logistic regression to examine the factors associated with STDR severity and progression.
Results: After excluding 122 patients for missing data, 178 participants were analyzed. Changes in HbA1c were strongly associated with STDR. Both improvements and deteriorations or sustained high in HbA1c levels were linked to an increased likelihood of advanced DR scores compared to sustained low group. Those with sustained high HbA1c had the most impact. High initial HbA1c had a greater impact on females, age <65, patients lacking exercise or diet control. Patients with low or moderate MR showed significantly higher HbA1c level at ophthalmologic visit, and increased risk developing STDR. Age ≥65 years was a protective factor against higher DR scores.
Conclusions: This study highlights the relationship between initial blood glucose levels at diabetes diagnosis, and subsequent HbA1c change during ophthalmology visits concerning DR severity and progression. High initial HbA1c might indicate the need for frequent ophthalmic visit.