Development of new glaucoma drugs wing experimental glaucoma models and clinical study on pertinence of modem glaucoma management

基础研究1.结论：1.一种新型的钙蛋白酶抑制剂对NMDA诱导的视网膜神经节细胞损伤具有神经保护作用。几种市售抗青光眼药物对培养的人结膜细胞具有抗增殖作用。洛美利嗪是一种钙通道阻滞剂。对小鼠视网膜神经节细胞损伤有神经保护作用。金属硫蛋白对NMDA诱导的小鼠视网膜神经节细胞损伤也有神经保护作用。钴可诱导小鼠光感受器细胞选择性丧失。研究组织型纤溶酶原激活物在视网膜和视神经细胞凋亡中的作用。分析原发性闭角型青光眼/原发性闭角型青光眼的预后。结果：1.PAS程度和Gon的存在与预后不良密切相关。建立了一种利用新型立体眼底相机分析青光眼视神经病理的新方法。多焦ERG测量的鼻区和颞区第二核反应的不对称性被发现与正常眼压性青光眼的视野恶化程度有关。充分的眼压降低显著减少了原发性开角型青光眼和正常眼压性青光眼患者视盘出血的发生。我们建立了正常眼压性青光眼24小时眼压变化的基础数据。一项以人群为基础的研究发现，在40岁或以上的日本人中，青光眼的总患病率为5.0%，PACG的患病率为0.6%。在日本建立了海德堡视网膜断层扫描仪测量的视盘地形图的基础数据。对眼压降低和房水流出的分析并未揭示拉坦前列素降低眼压与治疗前C值之间的明确关系。

Basic research1. A new calpain inhibitor was Lund to have neuroprotective effect against NMDA-induced retinal ganglion cell damage.2. Several commercial anti-glaucoma drugs have anti-proliferative effect on cultured human conjunctival cells.3. Lomerizine, a calcium-channel blocker, was found. To have neuroprotective effect against retinal ganglion cell damage in a mouse model.4. Metallothionein also has neuroprotective effect against NMDA-induced retinal ganglion cell damage in a mouse model.5. Cobalt may induce selective loss of photoreceptor cells in mice.6. The role of tissue type plasminogen activator was investigated in relation with apoptosis of retina and optic nerve.Clinical research1. Prognosis of primary angle-closure/primary angle-closure glaucoma was analyzed. It was found that PAS extent and presence of GON were closely correlated with the poor prognosis.2. Anew method to analyze glaucomatous optic nerve pathology was established using a new stereo-fundus camera.3. Asymmetry of the second kernel response measured by multifocal ERG between nasal and temporal regions was found to be related with the degree of visual field deterioration in normal-tension glaucoma.4. It was Lund that sufficient IOP reduction significantly reduced the development of optic disc hemorrhages in both primary open-angle glaucoma and normal-tension glaucoma.5. We established basic data of 24-hr variation of IOP in normal-tension glaucoma.6. A population-based study found that the prevalence of total glaucoma was 5.0% and that of PACG to be 0.6% in Japanese aged 40 or older.7. Basic data on optic disc topography measured by Heidelberg Retina Tomograph were established in Japanese.8. An analysis on IOP reduction and aqueous outflow did not reveal definite relationship between IOP reduction by latanoprost and pretreatment tonographic C-value.