Jpn. J. Ophthalmol. [JOURNAL]
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200 papers
Evaluation of factors relating to the development of multiple subepithelial corneal infiltrates of adenoviral keratoconjunctivitis using categorical data analysis program.
Kitaichi N, Dei R, Hinokuma R … +3 more , Yoshikawa I, Hiraoka M, Nakajima K
Jpn J Ophthalmol · 2025 Jul · PMID 40418487 · Publisher ↗
PURPOSE: Adenoviral keratoconjunctivitis is the most common infectious disease in ophthalmology. Its clinical forms include epidemic keratoconjunctivitis (EKC) and pharyngoconjunctival fever (PCF). EKC can be complicated...
PURPOSE: Adenoviral keratoconjunctivitis is the most common infectious disease in ophthalmology. Its clinical forms include epidemic keratoconjunctivitis (EKC) and pharyngoconjunctival fever (PCF). EKC can be complicated by multiple subepithelial infiltrates (MSI) of the cornea, which affect visual outcomes. As at present, artificial intelligence and machine learning are becoming increasingly important not only in the diagnostic imaging field but also in the clinical data science field, we investigated a predictive model for the development of corneal MSI in adenoviral keratoconjunctivitis. STUDY DESIGN: Retrospective cohort study. METHODS: One hundred and forty cases of adenovirus keratoconjunctivitis diagnosed at Hinokuma Eye Clinic were enrolled. The dependent variable was corneal MSI, and the independent variables were adenovirus genotype, bilaterality, subconjunctival hemorrhage, eyelid swelling, conjunctival edema, conjunctival opacity, pseudomembrane, corneal epithelial findings, preauricular lymphadenopathy, eye discharge, lacrimation, eye pain, foreign body sensation, and itchy eye, which were analyzed by a categorical data analysis program (CATDAP). RESULTS: For single independent variables, corneal epithelial findings (Akaike information criterion, AIC=-6.46) and type 54 (AIC=-4.30) showed high predictive performance. In the combination of multiple independent variables, Type 56 or Type 37 with corneal epithelial damage also showed high predictive performance. CONCLUSION: Predicting the occurrence of corneal MSI has until now been considered difficult. When a patient with EKC has marginal corneal epithelial or subepithelial opacities at initial presentation, it is presumed that the patient has a relatively high risk of developing MSI. Knowing the prevalent virus type in advance, would prove helpful in the diagnosis.
Clinical presentation and prognostic factors of eyelid sebaceous carcinoma.
Aihara Y, Ikegami M, Suehara Y … +6 more , Watanabe T, Yoshimoto S, Mori T, Mano H, Kohsaka S, Suzuki S
Jpn J Ophthalmol · 2025 Jul · PMID 40413654 · Full text
PURPOSE: To clarify the demographics, clinical features, outcomes, and prognostic factors of Japanese patients with eyelid sebaceous carcinoma. STUDY DESIGN: Retrospective study. METHODS: Fifty-two patients with eyelid s...
PURPOSE: To clarify the demographics, clinical features, outcomes, and prognostic factors of Japanese patients with eyelid sebaceous carcinoma. STUDY DESIGN: Retrospective study. METHODS: Fifty-two patients with eyelid sebaceous carcinoma diagnosed histopathologically at the National Cancer Center Hospital in Japan between 2013 and 2023 were reviewed and their outcomes were examined. RESULTS: There were 21 men and 31 women. The median age at diagnosis was 73 (range 39-95) years old. The tumor was located in the upper eyelid in 33 patients (63%), in the lower eyelid in 16 patients (31%), and in both eyelids in 3 patients (6%). The initial curative treatment included surgical resection with or without eyelid reconstruction in 41 cases (79%), orbital exenteration in 4 cases (8%), and radiation therapy in 7 cases (13%). Two- and five-year adjusted survival rates were 97.4% and 93.7%, respectively. Local recurrence occurred in 15 cases (29%). Lymph node metastasis was confirmed in 13 cases (27%), distant metastasis in 5 cases (10%), and 3 patients (6%) died of lung metastasis. T2b or more advanced T stage was associated with a risk of shorter overall survival (HR = 5.3, 95% CI = 1.2-23, p = 0.024) compared with T2a or earlier stage, as well as lymph node metastasis (HR = 82, 95% CI = 2.6-2.6e+03, p = 0.013). A positive surgical margin increased the risk of local recurrence (HR = 37, 95% CI = 5.9- 235, p = 0.00012). CONCLUSION: Proper diagnosis and margin-free resection are necessary before eyelid sebaceous carcinoma can further develop.
Therapeutic outcomes of ranibizumab for zone ii stage 2 retinopathy of prematurity with plus disease.
Nakagawa Y, Murayama Y, Suzuki Y … +2 more , Uchiyama A, Suzuki T
Jpn J Ophthalmol · 2025 Jul · PMID 40377801 · Full text
PURPOSE: This study aimed to evaluate the efficacy of intravitreal injections of ranibizumab (IVR) in treating zone II stage 2 retinopathy of prematurity with plus disease (ROP II2+) in preterm infants, focusing on two p...
PURPOSE: This study aimed to evaluate the efficacy of intravitreal injections of ranibizumab (IVR) in treating zone II stage 2 retinopathy of prematurity with plus disease (ROP II2+) in preterm infants, focusing on two primary outcomes: reactivation and persistent avascular retina (PAR). STUDY DESIGN: Retrospective and consecutive case series. METHODS: This retrospective study reviewed the medical records of preterm infants treated with IVR at Tokai University hospital between December 2019 and September 2023. Data on reactivation, PAR, and other clinical outcomes were analyzed using generalized estimating equations to account for correlations between eyes. RESULTS: Thirty eyes from 16 infants received IVR treatment. Following initial IVR all eyes achieved remission for over one year with IVR alone. Forty percent of these eyes required subsequent treatment due to reactivation, with a median reactivation time of 70 days. One year after initial IVR, PAR was observed in 11 out of the 30 eyes. Lower birth weight was associated with a tendency toward reactivation, and it also showed a significant correlation with the development of PAR. CONCLUSIONS: This research supports the effectiveness of IVR for ROP II2+ over a one-year period. The links between lower birth weight and both reactivation and PAR might guide refinements in therapeutic strategies.
Intravenous immunoglobulin for the acute treatment of refractory optic neuritis in Japan.
Takahashi Y, Kezuka T, Shikishima K … +10 more , Yamagami A, Chuman H, Nakamura M, Ueki S, Kimura A, Hashimoto M, Tatsui S, Shoji N, Ishikawa H, Collaborative Research Group: Investigators
Jpn J Ophthalmol · 2025 Sep · PMID 40377800 · Full text
PURPOSE: To investigate the usage status and evaluate the efficacy of intravenous immunoglobulin (IVIG) for the acute treatment of optic neuritis (ON) in Japan. STUDY DESIGN: Multicenter retrospective case series. METHOD...
PURPOSE: To investigate the usage status and evaluate the efficacy of intravenous immunoglobulin (IVIG) for the acute treatment of optic neuritis (ON) in Japan. STUDY DESIGN: Multicenter retrospective case series. METHODS: The study subjects were patients with steroid-resistant acute ON in whom IVIG had been initiated between January 2020 and August 2022 at 30 facilities in Japan. The clinical characteristics, visual acuity, and adverse events following IVIG were compared among anti-aquaporin 4 antibody positive ON (AQP4-ON), anti-myelin oligodendrocyte glycoprotein antibody positive ON (MOG-ON), and idiopathic ON (ION). RESULTS: The study included sixty-five patients (76 eyes); the main clinical department administering IVIG was ophthalmology (50 cases, 77.0 %). 43 cases had their first ON attack and 22 cases had recurrent ON. Plasmapheresis (PP) was combined in 21 cases. The efficacy endpoint, changes in logarithm of the minimum angle of resolution (logMAR) after IVIG compared with preIVIG, showed statistically significant improvement in the AQP4-ON group at one week, 4 weeks, and 12 weeks after IVIG (p=0.015, p<0.001, p<0.001, respectively). In the MOG-ON group, excluding cases with combined PP, logMAR post IVIG did not improve significantly compared with preIVIG. Among the ION group, compared with preIVIG, logMAR at 4weeks and 12 weeks post IVIG were statistically significant improved (p=0.019, p=0.023, respectively). Adverse events occurred in 7 patients with IVIG. 4 of the 7 patients continued the IVIG treatment, and 3 patients discontinued it within 5 days. CONCLUSION: This study demonstrates that IVIG may be an effective new option for acute treatment of steroid-resistant ON as an add-on to conventional therapy.
The relationship between aldosterone-induced retinal ganglion cell loss, blood pressure, and intraocular pressure.
Edo A, Hirooka K, Onoe H … +1 more , Kiuchi Y
Jpn J Ophthalmol · 2025 Jul · PMID 40377799 · Publisher ↗
PURPOSE: To elucidate whether systemic blood pressure affects retinal ganglion cell (RGC) survival in rats administered systemic aldosterone STUDY DESIGN: Experimental study design METHODS: Rats were continuously adminis...
PURPOSE: To elucidate whether systemic blood pressure affects retinal ganglion cell (RGC) survival in rats administered systemic aldosterone STUDY DESIGN: Experimental study design METHODS: Rats were continuously administered aldosterone or vehicle via a subcutaneous osmotic mini-pump. Hypertension was induced by the provision of saline as their drinking water. Systolic and diastolic blood pressures and intraocular pressure (IOP) were measured at the baseline and at 1-6 weeks after administration of aldosterone-water, aldosterone-saline, vehicle-water, or vehicle-saline. The number of retrogradely labelled RGCs in retinal flat mounts were counted after 6 weeks of treatment. Aldosterone-treated rats also received eplerenone (a mineralocorticoid receptor antagonist) or hydralazine (a vasodilator), and changes in systolic and diastolic blood pressures, IOP, and the number of RGCs were examined. RESULTS: The number of RGCs was significantly reduced in rats treated with aldosterone, regardless of whether they drank water or saline (aldosterone/saline group vs vehicle/saline group: 1464.8 ± 29.7 vs 1763.3 ± 106.5, respectively, P = 0.01; aldosterone/water group vs vehicle/water group: 1433.3 ± 30.2 vs 1815.0 ± 193.9, respectively, P <0.01). No change in IOP with aldosterone or saline administration was observed (P >0.05). Although eplerenone or hydralazine treatment in animals receiving aldosterone and saline reduced the systolic and diastolic blood pressures as compared with in the controls, the number of RGCs was only preserved in the eplerenone-treated group (eplerenone group vs control group: 1868.5 ± 177.7 vs 1464.8 ± 29.7, respectively, P <0.01; hydralazine group vs control group 1554.5 ± 34.9 vs 1464.8 ± 29.7, respectively, P = 0.48). No change in IOP after eplerenone or hydralazine treatment was observed (P >0.05). CONCLUSION: Aldosterone-induced RGC loss is not affected by systemic blood pressure or IOP.
Evaluating efficacy of 0.125% atropine using a myopia progression machine learning model.
Han CY, Kim SR, Kim DH
Jpn J Ophthalmol · 2025 Sep · PMID 40372543 · Publisher ↗
PURPOSE: To investigate the usefulness of a machine learning (ML) model that can predict the natural course of childhood myopia in evaluation of the inhibitory effects of 0.125% atropine on the progression of childhood m...
PURPOSE: To investigate the usefulness of a machine learning (ML) model that can predict the natural course of childhood myopia in evaluation of the inhibitory effects of 0.125% atropine on the progression of childhood myopia. STUDY DESIGN: Retrospective, cohort study. METHODS: A retrospective analysis was conducted on children treated daily with 0.125% atropine eye drops. The children were classified into 6-, 12-, 18-, 24-, and 30-month group based on the treatment duration. Spherical equivalents (SE) at the last treatment time point were compared with the pretreatment and ML-predicted SE. The myopia suppression rate due to treatment was calculated based on the first- and ML-predicted SE. RESULTS: A total of 771 eyes (402 boys and 369 girls) from 397 children were included. The participants' mean age was 8.0 ± 1.5 years. The first SE of -2.87 ± 1.67 diopters (D), treatment led to a mean SE of -3.44 ± 1.90 D, showing a significant reduction in myopia progression compared to the ML model's prediction of -4.12 ± 1.75 D. Except for the 6-month group, the last SE was statistically significantly less myopic than the predicted SE, indicating that treatment suppressed progression compared to the natural course. The mean myopia suppression rate was 53.5%, with definite differences between the groups. CONCLUSION: Treatment with 0.125% atropine may suppress myopia progression in children compared with the ML child myopia prediction model. The application of a machine learning model to predict myopia progression may assist in evaluating the efficacy of 0.125% atropine treatment.
Two-year outcomes of treat-and-extend regimen with intravitreal faricimab for treatment-naïve neovascular age-related macular degeneration.
Hoshino J, Matsumoto H, Numaga S … +2 more , Nakamura K, Akiyama H
Jpn J Ophthalmol · 2025 Jul · PMID 40347367 · Publisher ↗
PURPOSE: We previously reported 1-year outcomes of a treat-and-extend (TAE) regimen with intravitreal faricimab (IVF) for treatment-naïve neovascular age-related macular degeneration (nAMD). Herein, we evaluated the seco...
PURPOSE: We previously reported 1-year outcomes of a treat-and-extend (TAE) regimen with intravitreal faricimab (IVF) for treatment-naïve neovascular age-related macular degeneration (nAMD). Herein, we evaluated the second-year results of this TAE regimen with IVF in eyes completing the first-year treatment. STUDY DESIGN: Retrospective, interventional case series. METHODS: We retrospectively studied 30 eyes with treatment-naïve nAMD that had completed the initial year of treatment, assessing best-corrected visual acuity (BCVA), foveal thickness (FT), central choroidal thickness (CCT), total number of injections over 2 years, and intended injection interval at the last visit. RESULTS: Twenty-five eyes completed the 2-year IVF treatment. There was no significant difference between pre-treatment and 2 years post-treatment BCVA. FT and CCT both showed significant reductions, maintained during the 2-year study period. The total number of injections was 10.1 ± 1.2 over the 2 years. The intended injection interval at the last visit was 13.0 ± 3.4 weeks. Of 5 eyes not completing 2 years of IVF treatment, 4 were switched to other anti-vascular endothelial growth factor (VEGF) agents due to persistent fluids despite IVF at 8-week intervals. In the remaining eye, IVF treatment was discontinued due to suspected faricimab-related intraocular inflammation. CONCLUSIONS: The TAE regimen with IVF for treatment-naïve nAMD was effective during a 2-year period for improving exudative changes and maintaining visual acuity. Although IVF was found to be a relatively safe treatment for nAMD, there were cases requiring a switch to other anti-VEGF agents due to inadequate fluid control effect.
Factors predictive of treatment outcomes in submacular hemorrhage secondary to age-related macular degeneration.
Watanabe Y, Koto T, Takahashi A … +9 more , Mizuno M, Ishida T, Nakajima K, Takeuchi J, Yokoi T, Nakayama M, Okada AA, Inoue M, Kataoka K
Jpn J Ophthalmol · 2025 Sep · PMID 40347366 · Publisher ↗
PURPOSE: To identify predictors for visual outcomes of eyes with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). STUDY DESIGN: Retrospective observational study. METHODS: Cli...
PURPOSE: To identify predictors for visual outcomes of eyes with submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). STUDY DESIGN: Retrospective observational study. METHODS: Clinical data from patients diagnosed with SMH secondary to nAMD and treated with pneumatic displacement were collected. SMH thickness was measured by optical coherence tomography (OCT) at baseline and 1 week. Possible factors associated with best-corrected visual acuity (BCVA) gain at 3 months were analyzed. RESULTS: Fifty-six eyes of 56 patients (18 female/38 male; mean age, 77.8 ± 10.1 years) were analyzed; 34 were treatment-naïve and 22 were previously treated with anti-vascular endothelial growth factor agents. Multivariable analysis showed that greater BCVA gain more than 0.3 logMAR at 3 months post-treatment was associated with being treatment-naïve (odds ratio [OR], 34.30; 95% confidence interval [CI], 1.38-851.91; P = 0.031), thinner SMH thickness at 1 week after pneumatic displacement (OR, 0.38 per 50-unit increase; CI, 0.18-0.80; P = 0.011), and worse baseline BCVA (OR, 2.58 per 0.1-unit increase; CI, 1.31-5.07; P = 0.006), but not associated with age (OR, 0.50; 95% CI, 0.24-1.06), the time from onset to pneumatic displacement (OR, 1.04; 95%CI, 0.87-1.23), SMH thickness at baseline (OR, 0.92; 95%CI, 0.63-1.36), and the presence of subfoveal hemorrhagic PED (OR, 0.72; 95%CI, 0.08-6.84). CONCLUSION: This study identifies novel factors predictive of visual outcomes for pneumatic displacement for SMH due to nAMD. The presence of residual SMH at 1 week following unsuccessful pneumatic displacement may warrant further intervention.
Ab interno removal of malpositioned ex-press glaucoma device combined with bleb needling.
Kobayashi D, Akagi T, Togano T … +2 more , Iikawa R, Fukuchi T
Jpn J Ophthalmol · 2025 Jul · PMID 40332644 · Publisher ↗
PURPOSE: We present an ab interno removal technique combined with a needling procedure for a malpositioned Ex-PRESS glaucoma shunt. STUDY DESIGN: Retrospective case series. METHODS: This study examined four cases of malp...
PURPOSE: We present an ab interno removal technique combined with a needling procedure for a malpositioned Ex-PRESS glaucoma shunt. STUDY DESIGN: Retrospective case series. METHODS: This study examined four cases of malpositioned Ex-PRESS shunts. Needle bleb revision was performed to expand the space under the scleral flap and bleb area. Clinical data, including corneal endothelial cell density (ECD), intraocular pressure (IOP), and anterior segment optical coherence tomography images (AS-OCT), were retrieved from clinical records. RESULTS: All four cases underwent ab interno shunt removal combined with needle bleb revision without any serious complications. In three cases of anterior shunt malposition, a reduction in ECD was apparent before surgery but remained relatively stable after surgery. In one patient with posterior shunt malposition, shunt occlusion was suspected before surgery, but bleb formation and IOP improved after surgery. IOP was 8 mmHg to 21 mmHg (median, 10.5 mmHg) before surgery and 5 mmHg to 17 mmHg (median, 10 mmHg) 12 months after surgery. No additional glaucoma surgery was required within the first 12 months; however, after 12 months, two patients required additional glaucoma surgery. CONCLUSION: Ab interno Ex-PRESS device removal combined with bleb needling is an important procedure in patients with malpositioned Ex-PRESS devices.
Evaluation of changes in retinal light sensitivity thresholds in the early postoperative days after trabeculectomy using microperimetry.
Yoshida T, Ogawa S, Miki T … +8 more , Kodera Y, Shimizu G, Yoshimoto S, Sugisawa K, Ohno M, Yasuda S, Shiotani Y, Ohno-Matsui K
Jpn J Ophthalmol · 2025 May · PMID 40332643 · Publisher ↗
PURPOSE: To investigate early postoperative changes in retinal light sensitivity at the foveal and paramacular points in open angle glaucoma patients. STUDY DESIGN: Retrospective cohort study. METHODS: Twenty-four eyes u...
PURPOSE: To investigate early postoperative changes in retinal light sensitivity at the foveal and paramacular points in open angle glaucoma patients. STUDY DESIGN: Retrospective cohort study. METHODS: Twenty-four eyes undergoing trabeculectomy were analyzed. Retinal light sensitivity thresholds were measured using microperimetry both before and 7 days after surgery. Linear regression analysis identified factors affecting postoperative sensitivity changes. We also evaluated the correlation between changes in the threshold of retinal light sensitivity at the foveal and paramacular points. RESULTS: Intraocular pressure significantly decreased postoperatively. The mean threshold values of retinal light sensitivity following surgery showed no statistically significant changes compared with preoperative values across all eyes. Specifically, the mean threshold values increased in 4 eyes, decreased in 2, and remained stable in 18. Upon analyzing each examination point, 71.8% eyes exhibited stability, 12.8% showed a decrease of less than -6 dB, and 15.4% demonstrated an improvement of more than +6 dB in threshold values of retinal light sensitivity post-surgery. Changes in retinal light sensitivity at most paramacular points were found to be independent of those at the fovea. Excessive IOP reduction was identified as a significant risk factor for central visual field impairment. CONCLUSIONS: Localized changes in retinal light sensitivity thresholds can vary in the early postoperative period following trabeculectomy, highlighting the need to monitor localized retinal function to better understand its impact on visual outcomes.
Clinical study of thyroid eye disease combined with myasthenia gravis.
Wu Y, Li Y, He W
Jpn J Ophthalmol · 2025 Sep · PMID 40323520 · Publisher ↗
PURPOSE: To investigate the clinical features and prognostic factors of patients with thyroid eye disease (TED) combined with myasthenia gravis (MG) at a tertiary comprehensive hospital in China during a 10-year period....
PURPOSE: To investigate the clinical features and prognostic factors of patients with thyroid eye disease (TED) combined with myasthenia gravis (MG) at a tertiary comprehensive hospital in China during a 10-year period. STUDY DESIGN: retrospective study. METHODS: A case series of patients diagnosed with TED combined with MG was conducted at a tertiary general hospital over 10 years. Medical records of general conditions, clinical presentation, imaging and laboratory tests, treatment modalities, and prognostic outcomes were reviewed. RESULTS: Twenty-three patients with TED combined with MG were found throughout the study period. The mean age was 42.57 ± 14.89 years with 10 men and 13 women. Ocular motility disorders (82.61%), diplopia (73.91%), and ptosis (73.91%) were the primary clinical manifestations, and ocular motility disorders with limited movement in all directions were common (17 eyes) (50.00%). Active (69.57%) and moderate-to-severe (82.61%) TED was common, and hyperthyroidism was the most common complication of thyroid disease (57.17%). Ocular MG was the predominant subtype of MG (86.96%). Chest CT or pathologic examination identified thymic hyperplasia in 4 patients (17.39%) and thymoma in 1 patient (4.35%). A statistically significant association was observed between smoking and an unfavorable prognosis of TED combined with MG (P<0.05). CONCLUSIONS: MG should be taken into account in patients with TED who exhibit the following: unilateral or bilateral ptosis, ptosis in one eye and upper eyelid retraction in the other, obvious eye movement disorders without or with mild involvement of the extraocular muscles on imaging, and symptoms of morning and evening fluctuations. Ophthalmologists should refer these patients to the Department of Neurology to avoid misdiagnosis or underdiagnosis. The co-occurrence of TED and MG is rare clinically, mostly affecting young and middle-aged women, with ocular MG and hyperthyroidism as the main clinical subtype, and thymic hyperplasia or thymoma in a small percentage. Smoking is an independent risk factor for poor prognosis of TED combined with MG.
Neuro-ophthalmic findings of Visual Snow Syndrome in Korea.
Park HE, Shin HJ, Lee AG
Jpn J Ophthalmol · 2025 Jul · PMID 40323519 · Publisher ↗
PURPOSE: To investigate the neuro-ophthalmologic characteristics, potential triggers, and treatment responses of visual snow syndrome (VSS) in a Korean population. STUDY DESIGN: Retrospective case series. METHODS: We ret...
PURPOSE: To investigate the neuro-ophthalmologic characteristics, potential triggers, and treatment responses of visual snow syndrome (VSS) in a Korean population. STUDY DESIGN: Retrospective case series. METHODS: We retrospectively reviewed the data of patients diagnosed with VSS at a tertiary hospital from March 2021 to February 2024. Data on visual and nonvisual symptoms, self-reported events that caused VSS, and medical and psychiatric comorbidities were chart-reviewed. Neuroimaging findings from MRI and F-FDG PET were evaluated, along with treatment responses to pharmacological interventions and filter glasses. RESULTS: The sample comprised 27 men and 36 women, with a mean age of 27±11 years (mean±SD) and onset age of 22.4±11 years. Common symptoms included floaters, palinopsia, anxiety, and depression. Fourteen participants attributed VSS onset to specific ophthalmic events (e.g. refractive surgery or ophthalmic examinations with bright-light). F-FDG PET scans showed hypermetabolism in the visual cortices (81.8%), with no significant MRI abnormalities. Lamotrigine (18.9%), alprazolam (20%), and filter glasses (32.1%) showed modest efficacy in reducing the intensity of VSS. CONCLUSION: Korean patients with VSS exhibited clinical features, neuroimaging findings, and treatment responses similar to those reported in Western populations. Ophthalmic procedures, such as refractive surgery and bright-light examinations, may act as potential triggers in susceptible individuals. Although functional imaging, including F-FDG PET, may be useful for evaluating VSS, further studies with healthy controls and quantitative analyses are needed to validate its diagnostic value. Given the modest treatment efficacy, a multidisciplinary approach combining pharmacological intervention, filter glasses, and psychological support is essential to optimize outcomes.
Effectiveness and safety of biosimilar infliximab CT-P13 in the treatment of refractory uveitis associated with Behçet's disease.
Lee C, Takeuchi M, Kawagoe T … +11 more , Nakamura J, Shibuya E, Ishihara M, Yamada N, Mizuki Y, Meguro A, Kirino Y, Soejima Y, Hirahara L, Iizuka Y, Mizuki N
Jpn J Ophthalmol · 2025 Sep · PMID 40304888 · Publisher ↗
PURPOSE: This study evaluated the effectiveness and safety of the biosimilar infliximab CT-P13 in treating refractory uveitis associated with Behçet's disease. STUDY DESIGN: Retrospective study. METHODS: A retrospective...
PURPOSE: This study evaluated the effectiveness and safety of the biosimilar infliximab CT-P13 in treating refractory uveitis associated with Behçet's disease. STUDY DESIGN: Retrospective study. METHODS: A retrospective analysis of medical records from seven patients was conducted, categorizing them into two groups: those initially treated with CT-P13 (Group 1) and those switched from other tumor necrosis factor inhibitors (Group 2). Data on demographics, treatment duration, ocular inflammatory attacks, visual acuity changes, relapse rates, and adverse events were collected. RESULTS: Seven patients (mean age: 32.0 ± 17.7 years) with refractory uveitis associated with Behçet's disease were included. Four patients in Group 1 received CT-P13 as their first-line biologic therapy, of whom two (50%) achieved remission. All patients exhibited a significant reduction in relapses in the 6 months before and after CT-P13 treatment (Wilcoxon test, p = 0.031). Three patients in Group 2, switched from original infliximab, maintained remission for an average of 11.0 ± 2.0 months. Overall, 71.4% of patients achieved remission. No significant changes in visual acuity were observed in either group. One adverse event occurred, but no adverse drug reactions were reported. CONCLUSION: The biosimilar infliximab CT-P13 appears to be an effective and cost-efficient option for managing refractory uveitis in Behçet's disease. This finding highlights its potential in managing this challenging condition and warrants further investigation in larger patient cohorts.
Association between the retinal age gap and systemic diseases in the Japanese population: the Nagahama study.
Kamei T, Miyake M, Sado K … +6 more , Morino K, Mori Y, Tabara Y, Matsuda F, Tamura H, Tsujikawa A
Jpn J Ophthalmol · 2025 Jul · PMID 40304887 · Full text
PURPOSE: To investigate the retinal age gap, defined as the difference between deep learning-predicted retinal age and chronological age, as a potential biomarker of systemic health in the Japanese population. STUDY DESI...
PURPOSE: To investigate the retinal age gap, defined as the difference between deep learning-predicted retinal age and chronological age, as a potential biomarker of systemic health in the Japanese population. STUDY DESIGN: Prospective cohort study. METHODS: Data from the Nagahama Study, a large-scale Japanese cohort study, were used. Participants were divided into fine-tuning (n=2,261) and analysis (n=6,070) cohorts based on their visit status across the two periods. The fine-tuning cohort only included individuals without a history of systemic or cardiovascular diseases. A deep learning model, originally released in the Japan Ocular Imaging Registry, was fine-tuned using a fine-tuning cohort to predict retinal age from images. This refined model was then applied to the analysis cohort to calculate retinal age gaps. We conducted cross-sectional and longitudinal analyses to examine the association of these gaps with systemic and cardiovascular diseases. RESULTS: The retinal age-prediction model achieved a mean absolute error of 3.00-3.42 years. Cross-sectional analysis revealed significant associations between the retinal age gap and a history of diabetes (β = 1.08, p < 0.001) and hyperlipidemia (β = -0.67, p < 0.001). Longitudinal analysis showed no significant association between the baseline retinal age gap and disease onset. However, onset of hypertension (β = 0.35, p = 0.049) and hyperlipidemia (β = 0.34, p = 0.035) showed marginal associations with an increase in retinal age gap over time. CONCLUSION: The retinal age gap is a promising biomarker for systemic health, particularly in relation to diabetes, hypertension, and hyperlipidemia.
Binocular visual function in middle-aged patients with unilateral cataract: multifocal versus enhanced monofocal intraocular lens.
Hayashi K, Yoshida M, Manabe SI … +1 more , Yoshimura K
Jpn J Ophthalmol · 2025 Jul · PMID 40304886 · Publisher ↗
PURPOSE: To compare binocular visual function of middle-aged patients in the process of presbyopia progression with unilateral cataract who received a trifocal intraocular lens (IOL; Alcon PanOptix) with those who receiv...
PURPOSE: To compare binocular visual function of middle-aged patients in the process of presbyopia progression with unilateral cataract who received a trifocal intraocular lens (IOL; Alcon PanOptix) with those who received an enhanced monofocal (EM) IOL (Johnson & Johnson Eyehance). STUDY DESIGN: Nonrandomized comparative study. METHODS: This study enrolled patients in their 40s and 50s with unilateral cataract whose fellow eyes were myopic and the operated eyes were implanted with either a trifocal IOL (n=28, targeting emmetropia) or an EM IOL (n=28, targeting myopia), and patients whose fellow eyes were emmetropic and the operated eyes were implanted with a trifocal IOL (n=25, targeting emmetropia) or an EM IOL (n=23; targeting emmetropia). At 3 months postoperatively, binocular uncorrected and corrected all-distance VA and contrast VA were compared between patients receiving the trifocal and EM IOLs. RESULTS: In the myopia category, mean binocular uncorrected VA from ∞ to 1.0 m was significantly better (P<0.001) and at near distance was significantly worse (P<0.001) in the trifocal group than in the EM group. In the emmetropia category, binocular uncorrected VA from ∞ to 2.0 m and binocular contrast VA at most contrasts were significantly better in the EM group than in the trifocal group (P≤0.043). CONCLUSION: Trifocal IOLs provide significantly better binocular uncorrected far to intermediate VAs and worse near VA than EM IOLs in patients whose fellow eye is myopic, while EM IOLs provide significantly better far VA and contrast sensitivity in patients whose fellow eye is emmetropic.
Association of postoperative delirium with visual acuity after ophthalmic surgeries under local anesthesia.
Koga Y, Kitazawa K, Shinozaki G … +7 more , Yoshii K, Hughes JB, Yamashita Y, Kojima K, Ueno M, Kinoshita S, Sotozono C
Jpn J Ophthalmol · 2025 Jul · PMID 40304885 · Publisher ↗
PURPOSE: To investigate the incidence rate and risk factors for postoperative delirium (POD) following ophthalmic surgery under local anesthesia. STUDY DESIGN: A retrospective study METHODS: We retrospectively investigat...
PURPOSE: To investigate the incidence rate and risk factors for postoperative delirium (POD) following ophthalmic surgery under local anesthesia. STUDY DESIGN: A retrospective study METHODS: We retrospectively investigated the incidence rate of POD in 4658 patients who underwent vitrectomy or glaucoma surgery between January 2009 to March 2023 and analyzed the risk factors with multivariate logistic regression compared to non-delirium patients. Risk indices included age, sex, operation time, preoperative best-corrected visual acuity (pre-BCVA), comorbidity of dementia, and the use of sedative or hypnotic drugs. RESULTS: POD developed in 19 out of 4658 patients (0.41%). POD was more prevalent in older patients and those with dementia (P < 0.001 and P < 0.001, respectively). However, sex, longer operation time, the use of sedative or hypnotic drugs were not associated with POD. The low pre-BCVA in either operated eye or fellow eye was more likely observed in patients with POD (P = 0.003 and P = 0.001, respectively). The multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.00-1.12; P = 0.04), dementia (OR, 34.95; 95% CI, 12.32-99.15; P < 0.001), pre-BCVA in the operated eye (OR, 2.00; 95% CI, 1.13-3.53; P = 0.02) and pre-BCVA in the fellow eye (OR, 1.83; 95% CI, 1.16-2.89; P = 0.01) were significantly associated with developing POD. CONCLUSIONS: POD developed following ophthalmic surgery under local anesthesia. Identified risk factors included older age, comorbid dementia and low pre-BCVA.
Clarity of surgical field displayed on 3D monitor with local dimming technology during heads-up surgery.
Nakajima K, Takeuchi J, Yokoi T … +5 more , Mizuno M, Koto T, Ishida T, Ozawa H, Inoue M
Jpn J Ophthalmol · 2025 Jul · PMID 40299255 · Publisher ↗
PURPOSE: To compare the clarity of images displayed on a 3D local dimming technology (LDT) monitor (LMD-XH550MT) to that on a conventional 3D monitor (LMD-X550MT) integrated into the Artevo 800 system. STUDY DESIGN: Labo...
PURPOSE: To compare the clarity of images displayed on a 3D local dimming technology (LDT) monitor (LMD-XH550MT) to that on a conventional 3D monitor (LMD-X550MT) integrated into the Artevo 800 system. STUDY DESIGN: Laboratory investigation METHODS: Six vitreoretinal surgeons evaluated the clarity of the surgical field on photographs displayed simultaneously on 2 monitors during cataract and vitreous surgery by the Artevo 800 system. The visibility scores were made on a 5-point scale for images recorded during anterior capsulotomy, phacoemulsification, cortex aspiration, core vitrectomy, and peeling an epiretinal membrane or an internal limiting membrane (ILM). The skewness and kurtosis of the images during anterior and posterior segment surgery were evaluated. RESULTS: The mean visibility scores were significantly higher with the LDT monitor at 4.7±0.1 than with the conventional monitor at 2.9±0.1 (P<0.001). The visibility scores for anterior capsulotomy (P=0.034), phacoemulsification (P=0.036), cortex aspiration (P=0.036), core vitrectomy (P=0.035), peeling of epiretinal membrane (P=0.036), and ILM (P=0.036) were significantly higher with the LDT monitor than with the conventional monitor. The absolute value of skewness during anterior segment surgery was significantly lower with the LDT monitor (0.20±0.05) than with the conventional monitor (-0.44±0.06, P=0.03). CONCLUSION: Higher contrast with the LDT monitor was attained by adjusting the backlight brightness according to the brightness of the images, which provided better image clarity for 3D heads-up cataract and vitreous surgery.
Comparison of Heidelberg Multi-Color Anomaloskop with NEITZ anomaloscope OT-II to diagnose color-vision deficiency.
Mokuno K, Kaneko H, Ito H … +2 more , Takahashi H, Yasuma T
Jpn J Ophthalmol · 2025 Jul · PMID 40299254 · Full text
PURPOSE: To determine the degree of agreement between the results of the Heidelberg Multi-Color Anomaloskop (HMC) and NEITZ anomaloscope OT-II (OT-II). STUDY DESIGN: Retrospective. METHODS: The study included 53 patients...
PURPOSE: To determine the degree of agreement between the results of the Heidelberg Multi-Color Anomaloskop (HMC) and NEITZ anomaloscope OT-II (OT-II). STUDY DESIGN: Retrospective. METHODS: The study included 53 patients who underwent color-vision testing at Kariya Toyota General Hospital between March 2019 and April 2022. The participants included 2 patients with normal color vision, 10 with protanopia, 3 with protanomaly, 22 with deuteranopia, and 16 with deuteranomaly. Color-vision testing was performed using the Ishihara Test for Colour Deficiency, Standard Pseudoisochromatic Plates Part 1, Farnsworth Dichotomous Test for Color Blindness Panel-15, HMC, and OT-II. An agreement was determined using intraclass correlation coefficients (ICC) and Bland-Altman analysis. The minimum, median, and maximum red-green mixture and yellow monochromatic values of the equal values obtained from HMC and OT-II were examined. RESULTS: The ICCs between the results of HMC and OT-II were 0.979, 0.979, and 0.985, for the minimum, median, and maximum red-green mixture and 0.943, 0.755, and 0.919 for the yellow monochromatic values, respectively (p < 0.0001 in all). In the Bland-Altman analysis, the differences were mostly within the limits of agreement. Fixed errors were observed for the maximum red-green mixture and minimum yellow monochromatic values. Proportional errors were observed for the maximum red-green mixture and yellow monochromatic values. CONCLUSIONS: HMC and OT-II showed high agreement for all values in the ICC and Bland-Altman analyses. In the Bland-Altman analysis, systemic errors were observed in the maximum red-green mixture value and the minimum and maximum yellow monochromatic values.
Bacteriologic profile and antimicrobial resistance in infants aged 1 year or younger with congenital nasolacrimal duct obstruction.
Sultanbayeva Z, Issergepova B, Kapanova A … +1 more , Ruslanuly K
Jpn J Ophthalmol · 2025 May · PMID 40285801 · Full text
PURPOSE: The aim of the study was to evaluate conjunctival flora and antibiotic susceptibility in infants aged 1 year or younger with congenital nasolacrimal duct obstruction (CNLDO), creating an overall profile of antim...
PURPOSE: The aim of the study was to evaluate conjunctival flora and antibiotic susceptibility in infants aged 1 year or younger with congenital nasolacrimal duct obstruction (CNLDO), creating an overall profile of antimicrobial susceptibility. STUDY DESIGN: Retrospective. METHODS: The analysis was conducted at the Kazakh Eye Research Institute over a period of 6 years, from January 2017 to December 2022. Cultures were grown on various agars for bacterial and fungal analyses, with sensitivity testing via Vitek 2 Compact. RESULTS: We examined 1210 conjunctival cultures from infants with CNLDO, yielding 1212 isolates. Most were gram-positive bacteria (77.15%), with fewer gram-negative bacteria (22.28%) and fungi (0.57%). Among the gram-positive bacteria, Staphylococcus species (61.06%) were predominant, including S epidermidis (17.49%), S aureus (10.73%), and S saprophyticus (9.32%). Enterococcus species (6.52%) and Streptococcus species (6.02%) followed. Among the gram-negative bacteria, Escherichia coli (5.78%) was most prevalent, followed by Pseudomonas species. (4.54%), Enterobacter cloacae (3.71%), and Klebsiella species (3.63%). The majority of the fungi were Candida albicans, accounting for 4 isolates (0.33%). Most of the bacteria showed high sensitivity to moxifloxacin (92.52%), levofloxacin (88.99%), gentamicin (86.74%), vancomycin (86.52%), cefotaxime (85.27%), and ofloxacin (85.62%). High resistance was noted for erythromycin (32.84%), clindamycin (28.13%), and tetracycline (21.65%). CONCLUSION: In this study, we identified Staphylococcus, Enterococcus, and Streptococcus species and E coli as key CNLDO bacteria and highly responsive to antibiotics like levofloxacin and moxifloxacin. These findings guide effective antibiotic choices for CNLDO treatment, aiding in the prevention of antibiotic resistance.
Efficacy of the double-dose medial rectus muscle recession technique for sagging eye syndrome with esotropia of 10-prism diopters or less at distance.
Iida K, Goseki T, Fukaya K … +5 more , Aoki T, Kuga S, Ariga C, Onouchi H, Nakano T
Jpn J Ophthalmol · 2025 May · PMID 40278975 · Publisher ↗
PURPOSE: To evaluate the surgical outcomes for small-angle sagging eye syndrome (SES) with a distance horizontal deviation of 10 Δ or less. STUDY DESIGN: Retrospective observational case series METHODS: Six SES patients...
PURPOSE: To evaluate the surgical outcomes for small-angle sagging eye syndrome (SES) with a distance horizontal deviation of 10 Δ or less. STUDY DESIGN: Retrospective observational case series METHODS: Six SES patients (mean age 77.2 ± 5.4 years, 4 men and 2 women) with distance esotropia of 10 Δ or less who underwent medial rectus recession at a single center in Shizuoka, Japan, from January 2020 to December 2023 were studied. Patients with high myopia (axial length ≥ 27 mm, refraction ≤-6 D) were excluded. Preoperative and postoperative alternate prism cover tests, Stereo Fly test (SFT) results, and presence of diplopia were assessed. RESULTS: The patients underwent unilateral (n = 5) and bilateral (n = 1) medial rectus recession (6.4 ± 0.65 mm and 4.5 mm respectively), with 1 patient undergoing vertical muscle surgery. Preoperative/postoperative deviations (Δ) were distance horizontal +7.3 ± 2.4/-1.5 ± 2.5 (P = 0.035), distance vertical 2.2 ± 2.0/1.0 ± 1.3 (P = 0.42), near horizontal - 0.3 ± 3.2/-8.3 ± 6.4 (P = 0.058), and near vertical 2.0 ± 1.7/1.3 ± 1.8 (P = 0.59). The SFT (log) value was 1.99 ± 0.31/1.73 ± 0.21 (P = 0.056). Three patients experienced transient postoperative diplopia, which resolved over time. The diplopia improved in patients with concurrent vertical muscle surgery or a preoperative vertical deviation of 2 Δ or less (4 patients, 66.7%). However, those with a preoperative vertical deviation of 3 Δ or more (2 patients, 33.3%) required postoperative prism glasses. CONCLUSION: Medial rectus recession in small-angle SES with a distance horizontal deviation of 10 Δ or less significantly improved distance horizontal deviation without inducing exotropia at near, with a trend towards improved stereopsis. Patients with a preoperative vertical deviation of 3 Δ or more had persistent postoperative vertical diplopia.
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