永井 紀博 (ナガイ ノリヒロ)

Nagai, Norihiro

写真a

所属(所属キャンパス)

医学部 眼科学教室 (信濃町)

職名

専任講師

外部リンク

 

研究分野 【 表示 / 非表示

  • 眼科学

研究キーワード 【 表示 / 非表示

  • 加齢黄斑変性

  • 網膜

  • 黄斑色素

研究テーマ 【 表示 / 非表示

  • 黄斑色素と加齢黄斑変性, 

    2014年04月
    -
    継続中

  • 加齢黄斑変性の病態, 

    2006年04月
    -
    継続中

  • レニン・アンジオテンシン系と網膜病態, 

    2005年04月
    -
    継続中

 

論文 【 表示 / 非表示

  • Absolute and estimated values of macular pigment optical density in young and aged Asian participants with or without age-related macular degeneration

    Ozawa Yoko, Shigeno Yuta, Nagai Norihiro, Suzuki Misa, Kurihara Toshihide, Minami Sakiko, Hirano Eri, Shinoda Hajime, Kobayashi Saori, Tsubota Kazuo

    BMC Ophthalmology 17 ( 1 )  2017年08月

    研究論文(学術雑誌), 共著,  ISSN  1471-2415

     概要を見る

    <p>Background: Lutein and zeaxanthin are suggested micronutrient supplements to prevent the progression of age-related macular degeneration (AMD), a leading cause of blindness worldwide. To monitor the levels of lutein/zeaxanthin in the macula, macular pigment optical density (MPOD) is measured. A commercially available device (MPSII®, Elektron Technology, Switzerland), using technology based on heterochromatic flicker photometry, can measure both absolute and estimated values of MPOD. However, whether the estimated value is applicable to Asian individuals and/or AMD patients remains to be determined. Methods: The absolute and estimated values of MPOD were measured using the MPSII® device in 77 participants with a best-corrected visual acuity (BCVA) &gt; 0.099 (logMAR score). Results: The studied eyes included 17 young (20-29 years) healthy, 26 aged (&gt;50 years) healthy, 18 aged and AMD-fellow, and 16 aged AMD eyes. The mean BCVA among the groups were not significantly different. Both absolute and estimated values were measurable in all eyes of young healthy group. However, absolute values were measurable in only 57.7%, 66.7%, and 43.8%, of the aged healthy, AMD-fellow, and AMD groups, respectively, and 56.7% of the eyes included in the 3 aged groups. In contrast, the estimated value was measurable in 84.6%, 88.9% and 93.8% of the groups, respectively, and 88.3% of eyes in the pooled aged group. The estimated value was correlated with absolute value in individuals from all groups by Spearman's correlation coefficient analyses (young healthy: R2 = 0.885, P = 0.0001; aged healthy: R2 = 0.765, P = 0.001; AMD-fellow: R2 = 0.851, P = 0.0001; and AMD: R2 = 0.860, P = 0.013). Using the estimated value, significantly lower MPOD values were found in aged AMD-related eyes, which included both AMD-fellow and AMD eyes, compared with aged healthy eyes by Student's t-test (P = 0.02). Conclusions: Absolute, in contrast to estimated, value was measurable in a limited number of aged participants; however, it was correlated with estimated value both in young and aged Asian populations with or without AMD. These results may inform future clinical studies investigating the measurement of MPOD in understanding the role of macular pigments in the pathogenesis of AMD.</p>

  • Neuroprotective effect of bilberry extract in a murine model of photo-stressed retina

    Osada Hideto, Okamoto Tomohiro, Kawashima Hirohiko, Toda Eriko, Miyake Seiji, Nagai Norihiro, Kobayashi Saori, Tsubota Kazuo, Ozawa Yoko

    PLoS One 12 ( 6 )  2017年06月

    研究論文(学術雑誌), 共著,  ISSN  1932-6203

     概要を見る

    <p>Excessive exposure to light promotes degenerative and blinding retinal diseases such as age-related macular degeneration and retinitis pigmentosa. However, the underlying mechanisms of photo-induced retinal degeneration are not fully understood, and a generalizable preventive intervention has not been proposed. Bilberry extract is an antioxidant-rich supplement that ameliorates ocular symptoms. However, its effects on photo-stressed retinas have not been clarified. In this study, we examined the neuroprotective effects of bilberry extract against photo-stress in murine retinas. Light-induced visual function impairment recorded by scotopic and phototopic electroretinograms showing respective rod and cone photoreceptor function was attenuated by oral administration of bilberry extract through a stomach tube in Balb/c mice (750 mg/kg body weight). Bilberry extract also suppressed photo-induced apoptosis in the photoreceptor cell layer and shortening of the outer segments of rod and cone photoreceptors. Levels of photo-induced reactive oxygen species (ROS), oxidative and endoplasmic reticulum (ER) stress markers, as measured by real-time reverse transcriptase polymerase chain reaction, were reduced by bilberry extract treatment. Reduction of ROS by N-acetyl-L-cysteine, a well-known antioxidant also suppressed ER stress. Immunohistochemical analysis of activating transcription factor 4 expression showed the presence of ER stress in the retina, and at least in part, in Müller glial cells. The photo-induced disruption of tight junctions in the retinal pigment epithelium was also attenuated by bilberry extract, repressing an oxidative stress marker, although ER stress markers were not repressed. Our results suggest that bilberry extract attenuates photo-induced apoptosis and visual dysfunction most likely, and at least in part, through ROS reduction, and subsequent ER stress attenuation in the retina. This study can help understand the mechanisms of photo-stress and contribute to developing a new, potentially useful therapeutic approach using bilberry extract for preventing retinal photo-damage.</p>

  • Sneddon's syndrome with optic disc macroaneurysm and macular edema successfully treated with subtenon steroid injection

    永井 紀博

    ACTA OPHTHALMOLOGICA 94 ( 6 ) E517 - E519 2016年09月

    研究論文(学術雑誌),  ISSN  1755-375X

  • Non-responsiveness to intravitreal aflibercept treatment in neovascular age-related macular degeneration

    Nagai Norihiro, Suzuki Misa, Uchida Atsuro, Kurihara Toshihide, Kamoshita Mamoru, Minami Sakiko, Shinoda Hajime, Tsubota Kazuo, Ozawa Yoko

    Scientific Reports 6 2016年07月

    研究論文(学術雑誌), 共著,  ISSN  2045-2322

     概要を見る

    <p>The prognosis of neovascular age-related macular degeneration (AMD) has been improved by anti-vascular endothelial growth factor treatments, including intravitreal aflibercept (IVA) treatment. However, many patients remain incurable. In this study, we retrospectively evaluated non-responsiveness to IVA monotherapy at 12 months in 133 eyes of 133 AMD patients. Sixty-two patients were initially treatment-naive, and 71 had received other treatments before IVA (the treatment-switched group). Mean best-corrected visual acuity (BCVA) was improved in the treatment-naive group but not in the treatment-switched group, although mean central retinal thickness (CRT) decreased in both groups. The respective percentages of non-responders as determined by worsened BCVA in the treatment-naive and treatment-switched groups were 8.1% and 15.5%, and via fundus findings, they were 12.9% and 8.5%. Multivariate analyses adjusted for age, gender, CRT, and greatest linear dimension showed that serous pigment epithelial detachment (PED) at baseline was associated with non-responsiveness in both groups as determined by BCVA and by fundus findings, and fibrovascular PED measurements indicated no response as determined by fundus findings in the treatment-switched group. The results reported herein may assist the formulation of appropriate treatment protocols for AMD patients.</p>

  • Distinct Responsiveness to Intravitreal Ranibizumab Therapy in Polypoidal Choroidal Vasculopathy with Single or Multiple Polyps

    Suzuki Misa, Nagai Norihiro, Shinoda Hajime, Uchida Atsuro, Kurihara Toshihide, Tomita Yohei, Kamoshita Mamoru, Iyama Chigusa, Tsubota Kazuo, Ozawa Yoko

    American Journal of Ophthalmology 166   52 - 59 2016年06月

    研究論文(学術雑誌), 共著,  ISSN  0002-9394

     概要を見る

    <p>Purpose: To understand the prognosis of polypoidal choroidal vasculopathy (PCV) by evaluating the responsiveness to intravitreal ranibizumab (IVR) monotherapy according to the presence of a single or multiple polyps. Design: Retrospective case series. Methods: We included 48 treatment-naïve eyes of 48 patients who received IVR monotherapy at the Medical Retina Division Clinic, Keio University Hospital between March 2009 and January 2013 and attended the clinic for at least 12 months. All patients received 3 monthly IVR injections followed by pro re nata injections and were divided into single polyp and multiple polyps groups according to indocyanine green angiography and optical coherence tomography (OCT) findings. The outcome measures included changes in best-corrected visual acuity (BCVA) and OCT findings over 2 years after initial IVR. Results: At baseline, the multiple polyps group exhibited a poorer BCVA, larger greatest linear dimension, and higher prevalence of fibrovascular pigment epithelial detachment compared with the single polyp group. Over 2 years, the multiple polyps group showed no improvement in BCVA, although the central retinal thickness (CRT) decreased in both groups. The multiple polyps group exhibited a significantly greater CRT at 1 year and required more injections in the first year compared with the single polyp group; furthermore, it included a higher number of nonresponders judged either by BCVA or fundus findings at 1 year and fundus findings at 2 years. Conclusions: We propose that the stratification of PCV lesions according to the presence of single or multiple polyps may be valuable to understand the prognosis.</p>

全件表示 >>

KOARA(リポジトリ)収録論文等 【 表示 / 非表示

全件表示 >>

総説・解説等 【 表示 / 非表示

  • Maculopapular rash after intravitreal injection of an antivascular endothelial growth factor, aflibercept, for treating age-related macular degeneration A case report

    永井 紀博

    MEDICINE 96 ( 21 ) 2252 - 2259 2017年05月

    総説・解説(商業誌、新聞、ウェブメディア),  ISSN  0025-7974

     概要を見る

    RATIONALE:
    Aflibercept, an anti-vascular endothelial growth factor (VEGF) drug, is used for treatment of colon cancer as well as retinal diseases, including wet age-related macular degeneration (AMD). It is injected into the vitreous cavity of eyes for treatment of AMD. Although vascular suppression-including cardiovascular events-and local infection related to the injection procedure are well-known potential adverse events, pathological immune responses after intravitreal aflibercept (IVA) injection have not been described.

    PATIENT CONCERNS:

    A 60-year-old Japanese man diagnosed with polypoidal choroidal vasculopathy (PCV), a subtype of wet AMD, was treated by anti-VEGF injection. Ten hours after the last IVA injection, he presented with systemic erythema with itching.

    DIAGNOSES:

    On the basis of the palpable erythema and papules observed on the trunk and extremities, along with redness of the pharynx, the patient was diagnosed with maculopapular-type drug eruption. The findings of biopsy of erythematous skin on the back revealed lymphocyte infiltration and telangiectasia in the upper dermis, thus confirming the diagnosis.

    INTERVENTIONS:

    The patient was administered 30 mg prednisolone to resolve the immunoreaction.

    OUTCOMES:

    With this treatment, the eruption turned brown, and the pharyngeal lesion and itching were resolved, and the maculopapular rash after intravitreal IVA was resolved.

  • 【Coming Soon!新規治療】 糖尿病網膜症の抗脂質治療(フィブラート系薬剤)

    永井 紀博

    Retina Medicine 6 ( 1 ) 22 - 26 2017年04月

    総説・解説(商業誌、新聞、ウェブメディア)

     概要を見る

    糖尿病網膜症の加療にはレーザー、硝子体手術、抗VEGF療法などがあるが、糖尿病網膜症の病態形成の基盤となっている血糖や血圧など全身コントロールが重要であることは言うまでもない。脂質異常症の治療薬であるフィブラートによって糖尿病網膜症の進行が抑制されることがFIELD試験、ACCORD Eye試験で報告され、オーストラリアではフェノフィブラートの「糖尿病網膜症の進行抑制」に対する適応承認がなされた。フィブラートは核内受容体であるPPAR-αの活性化を介して高トリグリセライド血症および低HDLコレステロール血症を改善する。これらの脂質異常がある糖尿病網膜症患者にはフィブラートの使用を考慮してよい。

  • 抗VEGF治療セミナー 加齢黄斑変性に対して10年視力維持をめざす抗VEGF療法

    永井 紀博

    あたらしい眼科 34 ( 1 ) 85 - 86 2017年01月

    総説・解説(学術雑誌), 単著

  • 【眼疾患と炎症】 後眼部 糖尿病網膜症と炎症

    永井 紀博

    別冊Bio Clinica: 慢性炎症と疾患 4 ( 3 ) 60 - 64 2015年08月

    総説・解説(商業誌、新聞、ウェブメディア), 単著

     概要を見る

    糖尿病網膜症は、高血糖による代謝異常や炎症機序により網膜血管壁を構成する細胞に変化をきたし、網膜および硝子体に異常を来す網膜血管疾患であり、日本における後天性失明原因の第2位である。その病態形成には血管内皮増殖因子(vascular endothelial growth factor)だけでなく、Interleukin(IL)-6などのサイトカイン、白血球を中心とした炎症細胞などの炎症因子が多重に関与して病態を形成している。網膜組織におけるレニン・アンジオテンシン系は糖尿病網膜症の形成に関与し、大規模臨床試験でも糖尿病網膜症の改善効果が報告された。

  • 【ターゲット別!画像診断お助けガイド-基本画像から最新モダリティまで】 動物モデルを用いた研究と画像 網膜新生血管モデル

    永井 紀博

    臨床眼科 68 ( 11 ) 372 - 374 2014年10月

    総説・解説(商業誌、新聞、ウェブメディア)

全件表示 >>

研究発表 【 表示 / 非表示

  • 高脂肪食による視機能障害とマクロファージ

    永井 紀博

    第39回日本炎症・再生医学会, 2018年07月, ポスター(一般)

  • PCVに対する抗VEGF療法における再発因子ー脈絡膜に着目してー

    永井 紀博

    第5回AMD Expert clinical conference, 2018年06月, 口頭(一般)

  • 抗VEGF療法に反応不良の滲出型加齢黄斑変性に対するアフリベルセプトの作用

    永井 紀博

    第67回日本臨床眼科学会, 2017年11月, ポスター(一般)

  • 健常者の黄斑色素密度とOCT所見の相関

    永井 紀博

    第71回日本臨床眼科学会, 2017年10月, ポスター(一般)

  • 黄斑色素の定量

    永井 紀博

    第71回日本臨床眼科学会, 2017年10月, 口頭(招待・特別)

全件表示 >>

競争的資金等の研究課題 【 表示 / 非表示

  • 食生活リズムによる加齢黄斑変性の制御

    2019年04月
    -
    2022年03月

    文部科学省・日本学術振興会, 科学研究費助成事業, 永井 紀博, 基盤研究(C), 補助金,  代表

  • 高脂肪食による加齢黄斑変性発症のレニン・アンジオテンシン系による制御

    2016年
    -
    2018年

    科学研究費補助金(文部科学省・日本学術振興会), 永井紀博, 補助金,  代表

 

担当授業科目 【 表示 / 非表示

  • 眼科学講義

    2019年度

  • 慢性期病態学各論

    2019年度

担当経験のある授業科目 【 表示 / 非表示

  • 眼科学

    慶應義塾, 2018年度, 通年, 100人

    眼科学各論

  • 眼科学

    慶應義塾, 2018年度, 通年, 専門科目, 講義, 100人

    眼科学総論

  • 眼科学

    慶應義塾, 2018年度, 通年, 専門科目, 実習・実験, 専任, 100人

    細隙灯顕微鏡実習

  • 眼科学

    慶應義塾, 2018年度, 通年, 専門科目, 講義, 専任, 100人

    眼科検査法

  • 眼科学

    慶應義塾, 2017年度, 通年, 専門科目, 実習・実験, 専任, 100人

    細隙灯顕微鏡実習

全件表示 >>

教育活動及び特記事項 【 表示 / 非表示

  • 慶應義塾大学医療系三学部合同教育(後期)ファシリテーター

    2016年04月
    -
    継続中

    , その他特記事項

  • 専修医担当主任

    2013年04月
    -
    2015年03月

    , その他特記事項

  • 卒後教育研修医担当主任

    2013年04月
    -
    2015年03月

    , その他特記事項