title: [Toward a high quality glaucoma care].
abstract: The following studies were performed to solve current problems in glaucoma care and to pursue quality glaucoma care. Using a scanning peripheral anterior chamber depth analyzer that we developed, we: 1) conducted cross-sectional screening for eyes with angle closure; 2) examined longitudinal changes in anterior chamber depth and occurrence rates of primary angle closure in local senior residents; 3) investigated the significance of the anterior chamber and the angle of eyes with open angle glaucoma; and 4) looked into possible applications of anterior chamber depth and the angle in routine examinations. We investigated the effects of retinal glial cells and optic nerve astrocytes on retinal ganglion cell (RGC) survival and neurite growth using a culture system. We also identified candidate genies of retinal glial cells and optic nerve astrocytes affecting RGC survival and neurite growth using microarray and siRNA systems. SRC, a membrane-associated 60-kDa tyrosine kinase, is reported to be involved in neuron death and neurite growth. We developed two types of gene-targeted mice in which we modified the status of SRC phosphorylation. We compared RGC survival and neurite growth by conducting in vivo and in vitro experiments. Adherence is currently a very important issue in the field of glaucoma. We developed a nm thick and composed of 21.5 chitosan-sodium alginate pairs. IOP reduction and its duration, as well as adverse effects, were investigated. In addition, we established and evaluated a support system for glaucoma care in an effort to promote participation of glaucoma patients in glaucoma care using information and communication technology. This system improved the literacy of glaucoma patients as well as glaucoma medical therapy. At the same time, in order to ably provide glaucoma care given the increase in the number of glaucoma patients and the shortage of glaucoma specialists, a tele-medicine system for ophthalmology was developed, in which ophthalmologists are able to operate a slit-lamp system from remote areas. We compared the accuracy of diagnosis of ocular surface diseases using this tele-medicine system with that of a conventional slit-lamp system. We anticipate that the combination of Internet-based glaucoma support system with the tele-medicine system for ophthalmology will form a new framework for glaucoma care for both chronic and acute stage patients.
authors.affiliation: Department of Community and Family Medicine, University of Yamanashi, Chuo-shi, Yamanashi-ken, Japan. kenjik@yamanashi.ac.jp
authors.forename: Kenji
authors.initials: K
authors.lastname: Kashiwagi
mesh_terms: D000818:Animals; D005901:Glaucoma / Q000175:diagnosis / Q000473:pathology / Q000628:therapy*; D005902:Glaucoma, Open-Angle / Q000175:diagnosis / Q000628:therapy; D006801:Humans; D051379:Mice; D036103:Nanotechnology; D009900:Optic Nerve / Q000473:pathology; D010358:Patient Participation; D012160:Retina / Q000473:pathology; D017216:Telemedicine