Establishment of therapeutic strategy for glaucomatous optic neuropathy

临床研究：青光眼滤过性手术与抗丝裂霉素C进行了严格的评价。手术在保留视野的情况下具有良好的眼球扩张效果。然而，它在相当数量的病例中导致视力下降，主要是白内障的发展。多变量分析显示，血管损害，如存在椎间盘出血是一个显着的负性正常眼压性青光眼的预后因素。治疗与钙阻滞剂以及二氧化碳吸入改善眼眶血流动力学。丝裂霉素C的新的交付系统：一个新的交付系统丝裂霉素C作为一种辅助青光眼手术进行了调查。溶解在热固性凝胶中的丝裂霉素C明显提高了兔的手术成功率，并显著降低了药剂的总剂量。一个非穿透性青光眼手术的援助下的准分子激光进行了调查，发现容易和quantitatives.Neuroprotective治疗：我们建立了两种新的大鼠模型的神经保护研究。利用该模型，发现一些药物如NMDA受体拮抗剂、他克莫司、倍他洛尔等对青光眼性视神经病变引起的视网膜神经节细胞死亡具有神经保护作用。

Clinical investigation : Glaucoma filtering surgery with adjunctive mitomycin C was critically evaluated. The surgery was found to have excellent ocular hypotensive effect with preserving the visual field. It, however, caused visual acuity deterioration in a substantial number of cases, mainly by cataract development. A multivariate analysis revealed that vascular compromise such as the presence of disc hemorrhage is a significantly negative prognostic factor for normal-tension glaucoma. Treatment with calcium-blockers as well as carbon dioxide inhalation improved orbital hemodynamics.New delivery system for mitomycin C : A new delivery system for mitomycin C as an adjunct to glaucoma surgery was investigated. Mitomycin C dissolved in a thermosetting gel clearly improved the surgical success in the rabbit with significant decrease in the total dose of the agent. A nonpenetrating glaucoma surgery with an aid of an excimer laser was investigated and found to be performed easily and quantitatively.Neuroprotective treatment : We established two new types of rat models for neuroprotective study. Using the models, some drugs such as NMDA receptor antagonists, tacrolimus, betaxolol and so on, were found to have neuroprotective effect against retinal ganglion cell death caused by glaucomatous optic neuropathy.