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Show NEURO- OPHTHALMOLOGY AT LARGE The 43rd Annual Meeting of the Japanese Neuro- Ophthalmology Society Beppu, Japan November 11- 13, 2005 The 43rd Annual Meeting of the Japanese Neuro-ophthalmology Society was held in Beppu, Japan on November 11- 13, 2005. The meeting was expertly hosted and organized by Professor Kazuo Nakatsuka, MD, chair of the Department of Ophthalmology, Oita Medical University, Oita, Japan. The meeting secretary was Professor Masamoto Imaizumi, MD, also of Oita University. The meeting was attended by 372 neurologists and ophthalmologists and included 58 platform presentations, 52 posters, and several invited lectures. The meeting was conducted in Japanese at the B Con Plaza, a modern multi- purpose conference facility with an outstanding lecture hall. Beppu, the host city, is located in the southern part of Japan, an area famous for its " onsen," or hot spring baths. Audience participation was moderated with insightful discussion of presented papers which promoted lively interaction between audience and speakers. The posters were of high quality. A banquet reception highlighted the collegial nature of the meeting and featured the finest Japanese food. In his special lecture presentation, Professor Yoshikazu Shinoda, Department of System Neurophysiology, Tokyo Medical and Dental University, discussed the regulation of saccadic eye movements. Visiting from the Scheie Eye Institute, University of Pennsylvania, Nicholas J. Volpe, MD, ( Philadelphia, PA) delivered a lecture entitled " Optic Neuropathy Update." In his lecture entitled " Neural Mechanisms of Generation and Suppression of Saccadic Eye Movements," Professor Yoshikazu Shinoda and his colleagues reported on the effects of electrical stimulation of the frontal eye fields ( FEF) in monkeys. The FEF are believed to be involved in the generation of saccades, but several recent lines of evidence show that the FEF is also involved in the suppression of saccades. By electrical stimulation of the FEF, Professor Shinoda and colleagues found suppression of ipsilateral and bilateral visually- guided and memory-guided saccades. Suppression of ipsilateral saccades occurred at stimulus intensities lower than those needed to elicit saccades, whereas suppression of bilateral saccades required stimulation of a localized area of the FEF. Saccadic suppression of this nature may play a role in maintaining visual fixation. Dr. Volpe's " Optic Neuropathy Update" lecture highlighted the current thinking concerning the pathogenesis of anterior ischemic optic neuropathy ( AION) and idiopathic intracranial hypertension and emphasized the important differences in clinical profiles and treatment trial results involving patients with " western" optic neuritis/ multiple sclerosis as compared to those involving patients with the " opticospinal" form of multiple sclerosis encountered more commonly in Japan. Several authors reported their findings using optic nerve imaging modalities and multifocal visual evoked potentials. A group at Kobe City General Hospital studying optic disc edema in various optic neuropathies using scanning laser polarimetry with variable corneal compensation ( Gdx VCC) found that this technique did not always disclose findings equivalent to those found on ophthalmoscopy. A group at Kyoto University found that Gdx VCC and optical coherence tomography ( OCT) showed inconsistent measurements of retinal nerve fiber layer ( RNFL) thickness in patients with AION and papilledema. They concluded that these techniques may not accurately measure RNFL thickness. A group at Kobe University analyzed optic nerve heads in patients with compressive optic neuropathy and " band atrophy" using Heidelberg retinal tomography ( HRT) and OCT. While the HRT analysis did not show a significant difference in disc cupping as compared with normal controls, OCT did show enlargement of the optic cup. The authors attributed the difference in results between the two modalities to an underestimation of optic disc size by HRT. Professor Atsushi Mizota and his associates at Juntendo University in Chiba applied simultaneous OCT and scanning laser ophthalmoscopy ( SLO) to patients with AION and optic neuritis. There was a good correlation between ophthalmoscopic findings and SLO- OCT They concluded that SLO- OCT could be helpful in the study of optic neuropathies. Using OCT 3, a group at Nagoya University 78 J Neuro- Ophthalmol, Vol. 26, No. 1, 2006 Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. Neuro- Ophthalmology at Large J Neuro- Ophthalmol, Vol. 26, No. 1, 2006 Invited speaker Nicholas J. Volpe, MD, ( Philadelphia, PA) and meeting president Professor Kazuo Nakatsuka, MD, ( Oita, Japan) stand beside a poster announcing the 43rd Annual Meeting of the Japanese Neuro- Ophthalmology Society. The scientific session in progress at the lecture hall facility at B Con Plaza, Beppu, Japan. compared optic nerve heads of dominant optic atrophy with those of normal tension glaucoma. The optic disc cupping was shallower in dominant optic atrophy. Based on these reports, these techniques appear promising but unready for routine clinical use. Other presentations reported point mutations ( LYS 198 polymorphism) in patients with AION and one presentation found that four out of 410 patients taking ethambutol hydrochloride developed optic neuropathy. All four of the patients developing optic neuropathy used ethambutol at a dose ranging from 16- 29 mg/ kg/ day Transcorneal electric stimulation, which has been found to rescue axotomized retinal ganglion cells in rats, Attendees at the meeting review and discuss the scientific posters. 79 Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. J Neuro- Ophthalmol, Vol. 26, No. 1, 2006 Miki and Volpe was used in five patients with traumatic optic neuropathy by a research group at Osaka University ( Osaka, Japan). The patients had reduced visual acuity ranging from hand movements to 20/ 100. All patients had improvement in visual acuity after six months. Professor Taiji Takanashi ( Department of Ophthalmology, Shimane University, Izumo, Japan) reported a rare case of akinetopsia caused by sinus thrombosis. Brain single photon emission computed tomography revealed bilateral V5 lesions. This case highlights the importance of careful history taking; otherwise one would tend to dismiss as psychogenic an odd symptom such as the inability to stop pouring water in a glass before it gets full. A group at Inouye Eye Hospital reported two patients with hemifacial spasm who were found to have an aneurysm and a meningioma compressing the seventh nerve at its exit from the brainstem. Among 400 cases in which these authors performed MRI, only these four demonstrated brain lesions. The authors concluded that neuroimaging should be done to rule out intracranial lesions in hemifacial spasm. The meeting included an introductory presentation concerning the upcoming meeting of the 16th International Neuro- Ophthalmology Society, to be held at Zojoji Temple in Tokyo, Japan from November 29, 2006 to December 2, 2006. The meeting will be hosted by the Inouye Eye Hospital and Professor Masato Wakakura ( Tokyo, Japan). Professor Nakatsuka, his colleagues and residents at Oita University, and the Japanese neuro- ophthalmic community are to be commended for the organization and hosting of an outstanding congress. Atsushi Miki, MD, PhD Division of Ophthalmology and Vision Science School of Medicine and Dental Science Niigata University Niigata City, Japan Nicholas J. Volpe, MD Scheie Eye Institute University of Pennsylvania School of Medicine Philadelphia, Pennsylvania 80 © 2006 Lippincott Williams & Wilkins Copyright © Lippincott Williams & Wilkins. Unauthorized reproduction of this article is prohibited. |