PURPOSE: To evaluate the outcomes of micropulse transscleral cyclophotocoagulation (MP-CPC) for refractory glaucoma in children. STUDY DESIGN: Retrospective study. METHODS: We evaluated the data from children with refrac...PURPOSE: To evaluate the outcomes of micropulse transscleral cyclophotocoagulation (MP-CPC) for refractory glaucoma in children. STUDY DESIGN: Retrospective study. METHODS: We evaluated the data from children with refractory glaucoma who underwent MP-CPC from July 2022 to December 2024 at the National Center for Child Health and Development and who were followed up for at least 3 months. The retrospective analysis included age; glaucoma type; history of glaucoma surgery; intraocular pressure (IOP) at baseline and at 1, 3, and 6 months postoperatively; medication score administered before and after surgery; visual acuity; and complications. RESULTS: Twenty-nine eyes of 24 patients (average age, 101.3 ± 68.1 months) were included in this study. The most common types of glaucoma were glaucoma associated with nonacquired ocular anomalies and glaucoma after cataract surgery, accounting for 11 eyes (37.9%). The average number of glaucoma surgeries performed before treatment was 1.9 ± 1.6. The average follow-up period was 16.1 ± 7.9 months. Using a mixed-effects model, the mean IOP decreased by -9.8 mm Hg at 1 month (P <.01), -7.5 mm Hg at 3 months (P <.01), and -7.4 mm Hg at 6 months (P <.01). The median medication score (interquartile range) decreased from 5 (4-6) preoperatively to 4 (3-5) at 1, 3, and 6 months postoperatively. After undergoing the first MP-CPC, 19 eyes (65.5%) required reoperation for glaucoma. Eleven eyes (37.9%) required reoperation within 6 months postoperatively, and 17 eyes (58.6%) required reoperation within 1 year. CONCLUSION: MP-CPC effectively reduces IOP in children with refractory glaucoma without causing visual impairment or serious complications.
PURPOSE: We measured objective cyclodeviation in patients aged 10-90 years and evaluated differences between age groups, sexes, and eye sides using the disc-fovea angle (DFA). STUDY DESIGN: Retrospective observational st...PURPOSE: We measured objective cyclodeviation in patients aged 10-90 years and evaluated differences between age groups, sexes, and eye sides using the disc-fovea angle (DFA). STUDY DESIGN: Retrospective observational study METHODS: Patients who underwent fundus photography at Kozawa Eye Hospital and Diabetes Center between January 2016 and August 2021 were included. The participants aged 10-90 years were allocated into 10-year age groups. Each age group comprised 400 eyes from 200 participants (100 male and 100 female participants), resulting in a total of 3,600 eyes from 1,800 participants. DFA, defined as the angle between a horizontal line passing through the macula and the line joining the central fossa and papillary center, was analyzed using the Angle Tool in ImageJ software. When the horizontal line passing through the macula was higher than the line joining the central fossa and papillary center, the eye was classified as having excyclotorsion, indicated by a positive sign. RESULTS: DFA increased with age, from 6.37 ± 3.56° in participants in their 10s to 8.46 ± 3.96° in those in their 90s (p < 0.0001). DFA was significantly different between sexes (male vs. female: 7.25 ± 3.60° vs. 7.65 ± 3.71°; p < 0.0001). Additionally, a significant difference was observed between eye sides (right vs. left eye: 7.13 ± 3.69° vs. 7.77 ± 3.60°; p < 0.0001). CONCLUSION: DFA increases with age, exhibits higher values in female individuals, and shows greater measurements in the left eye.
PURPOSE: To evaluate long-term outcomes of photocoagulation (PC) and intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP). STUDY DESIGN: Retrospective paired-eye comparison. METHODS: Twenty-one patients (4...PURPOSE: To evaluate long-term outcomes of photocoagulation (PC) and intravitreal bevacizumab (IVB) for retinopathy of prematurity (ROP). STUDY DESIGN: Retrospective paired-eye comparison. METHODS: Twenty-one patients (42 eyes) treated for ROP between 2009-2010 were included. In each subject, one eye received PC and the fellow IVB. Visual acuity (VA), refraction (spherical equivalent [SE], cylinder power [CP], corneal astigmatism [CA]), and ocular biometry (corneal curvature radius, anterior chamber depth [ACD], lens thickness [LT], and axial length [AL]) were assessed at corrected ages of 1, 5, and 9 years. Cross-sectional differences were analyzed using the Wilcoxon signed-rank test, with Bonferroni correction applied at 9 years. Annual rates of change were evaluated using a linear mixed-effects model (LMM). Inter-treatment differences were assessed using Spearman correlation analysis. RESULTS: At 9 years, PC-treated eyes showed significantly worse VA, greater myopia, and shorter AL (all p < 0.05). ACD was deeper in IVB-treated eyes, while CP and CA were greater in PC-treated eyes. LMM revealed a significantly faster progression of myopia and CP in PC-treated eyes. Conversely, the annual rates of ACD deepening and LT thinning were significantly faster in IVB-treated eyes, whereas no significant differences were observed for VA or AL. Inter-treatment differences in SE were significantly correlated with AL differences, whereas VA differences were correlated with ACD. CONCLUSION: IVB-treated eyes showed better VA, less myopia, and more favorable refractive and biometric parameters. SE differences were associated with AL, whereas VA differences were associated with ACD, indicating distinct structural mechanisms.
PURPOSE: To assess the 6-month efficacy and safety of oxymetazoline hydrochloride ophthalmic solution 0.1% (OMZ 0.1%) versus placebo for acquired blepharoptosis. STUDY DESIGN: A phase 3, randomized, double-masked, parall...PURPOSE: To assess the 6-month efficacy and safety of oxymetazoline hydrochloride ophthalmic solution 0.1% (OMZ 0.1%) versus placebo for acquired blepharoptosis. STUDY DESIGN: A phase 3, randomized, double-masked, parallel-group, multicenter study conducted in Japan. METHODS: Patients were randomized 1:1:1 to OMZ 0.1%, once daily (QD) or twice daily (BID), or placebo. Patients received OMZ 0.1% for 6 months. Patients in the placebo group were randomized after 3 months (Treatment Period 1) to OMZ 0.1%, either QD or BID, for the remaining 3 months (Treatment Period 2). The primary efficacy endpoint was the marginal reflex distance-1 (MRD-1) change from baseline to Day 14 (2 hours after the morning drop) with OMZ 0.1% QD or BID versus placebo. Adverse events and adverse drug reactions (ADRs) were recorded. RESULTS: Overall, baseline MRD-1 (standard deviation) of 336 patients analyzed (n=112 per group) was 1.31 (0.83) mm (Day 0). MRD-1 change from baseline to Day 14 (2 hours after the morning drop) was 1.09 (0.07), 0.93 (0.07), and 0.50 (0.07) mm, with OMZ 0.1% QD, BID, and placebo, respectively. There was a statistically significant difference in the least squares mean (standard error) MRD-1 change versus placebo with OMZ 0.1% QD (0.59 [0.10] mm; 95% CI 0.38, 0.79) and OMZ 0.1% BID (0.43 [0.10] mm; 95% CI 0.23, 0.64) (both p<0.05). All ADRs related to the study drug were mild. CONCLUSION: Fourteen days of OMZ 0.1% treatment significantly increased MRD-1 versus placebo. There was no loss of effect after 6 months of treatment and no significant safety concerns.
Research on rare and intractable diseases, Health, Labour and Welfare Sciences Research Grants Clinical Practice Guideline Development Committee for Aniridia of the “Research group on establishing standardized diagnosis and treatment of Intractable corneal diseases”
Jpn J Ophthalmol
· 2026 Mar · PMID 41954827
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PURPOSE: We compared the magnitude of surgically induced astigmatism (SIA) following PreserFlo MicroShunt (PMS) implantation versus conventional trabeculectomy (Trab), with both procedures being performed with mitomycin...PURPOSE: We compared the magnitude of surgically induced astigmatism (SIA) following PreserFlo MicroShunt (PMS) implantation versus conventional trabeculectomy (Trab), with both procedures being performed with mitomycin C (MMC). STUDY DESIGN: Retrospective cohort study METHODS: We included 113 eyes of 113 patients who underwent standalone PMS surgery and 78 eyes of 78 patients who underwent standalone Trab, all with no previous history of glaucoma surgery. Corneal astigmatism was measured preoperatively and at 3 months postoperatively by use of an automated keratometer. The mean SIA (M-SIA) and centroid SIA (C-SIA) were calculated by use of a dedicated vector analysis tool. Preoperative and postoperative intraocular pressure (IOP) and visual acuity (VA) were compared by use of paired t tests. The Mann-Whitney U test was used to compare the M-SIA between the groups. RESULTS: Postoperatively, the IOP decreased from 20.9 to 11.5 mm Hg in the PMS group and from 20.6 to 9.3 mm Hg in the Trab group (P <0.001 for both). The C-SIA demonstrated an astigmatic shift toward the site of tube insertion in the PMS group and toward the scleral flap location in the Trab group. The M-SIA was significantly lower in the eyes treated with PMS than in those treated with Trab in the superonasal quadrant, but not in the superotemporal site. The VA remained stable in the PMS group, whereas a significant decline was observed in the Trab group. CONCLUSIONS: The PMS is an effective surgical option for reducing IOP while minimizing SIA at 3 months postoperatively. By better preserving visual function, the PMS may contribute to improved vision and overall patient satisfaction with the surgical outcomes.
PURPOSE: To evaluate the clinical performance of "Direct Strip PCR," a multiplex solid-phase real-time polymerase chain reaction (PCR) kit, for diagnosing infectious uveitis. STUDY DESIGN: Multicenter, prospective, diagn...PURPOSE: To evaluate the clinical performance of "Direct Strip PCR," a multiplex solid-phase real-time polymerase chain reaction (PCR) kit, for diagnosing infectious uveitis. STUDY DESIGN: Multicenter, prospective, diagnostic accuracy study METHODS: We analyzed 475 ocular-fluid samples (336 aqueous humor and 139 vitreous fluid) from 29 sites in Japan. Direct Strip PCR, an IVD-grade multiplex real-time PCR kit targeting HSV-1, HSV-2, VZV, EBV, CMV, HHV-6, HTLV-1, Toxoplasma gondii, and Treponema pallidum requiring no DNA extraction and incorporating internal controls, was compared with quantitative PCR (qPCR) for concordance and DNA copy-number correlation. RESULTS: All 9 of the target pathogens were detected. Direct Strip PCR showed excellent agreement with qPCR, with percent positive agreement (PPA), percent negative agreement (PNA), and percent overall agreement (POA) in aqueous humor of 98.0%, 99.2%, and 98.5%, respectively, and in vitreous fluid of 95.7%, 97.1%, and 96.4%, respectively, indicating high concordance for positive and negative results. All the values exceeded predefined 90% thresholds agreed upon with the Pharmaceuticals and Medical Devices Agency, meeting the required performance criteria. Discordant results were infrequent (10/4275 targets) and involved low-copy samples near the detection limit. The DNA copy numbers correlated strongly between the methods (r = 0.948-0.996). No adverse events were reported. CONCLUSION: Direct Strip PCR demonstrated high concordance with qPCR, reliably detected major pathogens of infectious uveitis, and yielded quantitative results that correlated with the qPCR results, supporting disease monitoring. Its solid-phase, extraction-free, and per-run calibration-free format provides a practical basis for regulatory submissions and global dissemination of multiplex PCR.
PURPOSE: To investigate long-term changes in peripapillary retinal nerve fiber layer thickness (RNFLT) after surgery for vitreomacular traction syndrome (VMTS), and to identify prognostic factors for surgical outcomes. S...PURPOSE: To investigate long-term changes in peripapillary retinal nerve fiber layer thickness (RNFLT) after surgery for vitreomacular traction syndrome (VMTS), and to identify prognostic factors for surgical outcomes. STUDY DESIGN: Retrospective chart review. METHODS: This retrospective study included 34 eyes from 34 patients with unilateral VMTS who underwent pars plana vitrectomy (PPV) with internal limiting membrane (ILM) peeling and completed a 12-month follow-up. Best-corrected visual acuity (BCVA), central macular thickness (CMT), and peripapillary RNFLT were measured at baseline and at 1, 3, 6, and 12 months postoperatively using swept-source optical coherence tomography (OCT). Longitudinal changes and baseline predictors of visual outcomes were analyzed. RESULTS: BCVA improved significantly from 3 months postoperatively (P < 0.001), while CMT reduction was evident from 1 month (P < 0.001). RNFLT progressively decreased across all quadrants, with early thinning in the inferior sector (P = 0.014). Compared with fellow eyes, operated eyes showed greater temporal RNFLT preoperatively but thinner global and inferior RNFLT at 12 months. Better postoperative BCVA correlated with better baseline BCVA, thinner preoperative CMT, and thicker preoperative inferior RNFLT, although baseline BCVA was the strongest independent predictor. CONCLUSIONS: VMTS eyes demonstrated progressive RNFLT thinning after surgery, reflecting both resolution of vitreous traction and underlying neuronal vulnerability. Baseline BCVA was the most reliable prognostic factor, while CMT and inferior RNFLT may provide additional insights into surgical outcomes.
PURPOSE: To establish normative apparent diffusion coefficient (ADC) values of the lacrimal gland in a large cohort of healthy subjects and to compare the results with previously reported data. STUDY DESIGN: Retrospectiv...PURPOSE: To establish normative apparent diffusion coefficient (ADC) values of the lacrimal gland in a large cohort of healthy subjects and to compare the results with previously reported data. STUDY DESIGN: Retrospective cohort study. METHODS: Brain magnetic resonance (MR) images of 260 healthy individuals were retrospectively analyzed. ADC measurements were performed bilaterally using a standardized region of interest (ROI) technique. The values were compared according to age and sex. To ensure normalization and standardization, vitreous ADC measurements were performed using the same ROI used for lacrimal gland measurements. Lacrimal gland ADC values were divided by vitreous ADC values. RESULTS: The lacrimal gland ADCmean value was 1.29 ± 0.14 ×10⁻ mm/s. No significant difference was observed in terms of ADC measurements between the right and left glands (p > 0.05). Sex had no statistically significant effect on ADC values (p > 0.05). The mean vitreous ADC value was 3.08 ± 0.20 ×10⁻ mm/s. The lacrimal gland/vitreous ADCmean ratio was 0.42 ± 0.05. Correlation analysis revealed weak positive correlations between age and lacrimal gland ADCmean (r = 0.185, p = 0.003) and ADCmax (r = 0.260, p < 0.001). CONCLUSION: This study presents a large series on normative ADC values of the lacrimal gland in healthy individuals. The results provide reliable reference data that may assist in the differential diagnosis of inflammatory and neoplastic pathologies.
Research on rare and intractable diseases, Health, Labour and Welfare Sciences Research Grants Clinical Practice Guideline Development Committee for Aniridia of the “Research group on establishing standardized diagnosis and treatment of Intractable corneal diseases”
Jpn J Ophthalmol
· 2026 Mar · PMID 41903000
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PURPOSE: To investigate the long-term longitudinal changes of the retinal morphology and visual function in patients with fundus albipunctatus (FA). STUDY DESIGN: Retrospective observational study. METHODS: Seventeen Jap...PURPOSE: To investigate the long-term longitudinal changes of the retinal morphology and visual function in patients with fundus albipunctatus (FA). STUDY DESIGN: Retrospective observational study. METHODS: Seventeen Japanese patients with FA who had pathogenic variants of the RDH5 gene were studied in a multicenter retrospective study. RESULTS: The baseline ages ranged from 3 to 61 years, and the patients were followed longitudinally for 3 to 21 years. The relative size of the flecks/dots decreased throughout the course of the disease; rapidly in the first and second decades of life and slowly thereafter. The flecks/dots in the OCT images were seen as hyperreflective flat deposits on the retinal pigment epithelium in the first decade of life, and as hyperreflective pile-like formations that extended to the ellipsoid zone (EZ) of the photoreceptors after the second decade of life. At later ages, the EZ in the mid-peripheral retina was not present due to photoreceptor atrophy. The Goldmann visual fields had a peripheral constriction in 7 of 11 cases that developed during the course of the disease process. CONCLUSION: The long-term longitudinal observations of the morphological changes of the retina and visual fields revealed that FA is a slowly progressive retinal dystrophy with atrophy of the peripheral photoreceptors in older patients. These findings will be very important information for the patients when providing genetic counseling.
Kamikawa A, Kiyohara K, Shirane M
… +13 more, Shimokawa S, Hisai T, Kobayashi Y, Yamaguchi M, Notomi S, Ishikawa K, Kiyohara T, Wakisaka Y, Ago T, Kitazono T, Sonoda KH, Nakamura K, Murakami Y
PURPOSE: Retinal artery occlusion (RAO) is frequently associated with cerebrovascular and cardiovascular events, and guidelines highlight the need for secondary prevention. Since 2019, our hospital has implemented collab...PURPOSE: Retinal artery occlusion (RAO) is frequently associated with cerebrovascular and cardiovascular events, and guidelines highlight the need for secondary prevention. Since 2019, our hospital has implemented collaborative care between ophthalmologists and vascular neurologists for acute RAO, and here, we report the clinical outcomes before and after this approach. STUDY DESIGN: Retrospective observational study. METHODS: Eighty-seven patients (mean age: 72.2 ± 13.4 years; 40 male) diagnosed with central retinal artery occlusion (CRAO), branch retinal artery occlusion (BRAO), or cilioretinal artery occlusion (CLRAO) at Kyushu University Hospital between March 2013 and May 2024 were retrospectively analyzed, and information on patient backgrounds, ocular and systemic examinations, and treatments was obtained. RESULTS: The disease types were CRAO in 58, BRAO in 24, and CLRAO in 5 patients. Systemic complications before and after collaborative care included hypertension (67% before vs 79% after), diabetes (28% vs 17%), dyslipidemia (41% vs 44%), cerebrovascular diseases (21% vs 10%), carotid artery diseases (18% vs 40%, P = 0.03), and cardiac diseases (3% vs 27%, P = 0.002). After initiation of collaborative care, the causes of RAO were identified as large-artery atherosclerosis (LAA) in 29%, cardioembolism (CE) in 23%, undetermined in 38%, other determined in 8%, and insufficient evaluation in 2% of the patients. Anticoagulants were commonly prescribed for patients with CE, whilst antiplatelet agents were prescribed for those with LAA or embolic stroke of undetermined source (ESUS). CONCLUSION: Integrated collaborative care facilitates prompt detection of systemic vascular complications and initiation of secondary preventive treatments in patients with RAO.
PURPOSE: To compare choriocapillaris flow voids in pachychoroid spectrum disorders with an optical coherence tomography angiography (OCTA) image processing strategy excluding artifacts. STUDY DESIGN: Retrospective case-c...PURPOSE: To compare choriocapillaris flow voids in pachychoroid spectrum disorders with an optical coherence tomography angiography (OCTA) image processing strategy excluding artifacts. STUDY DESIGN: Retrospective case-control study. METHODS: This study included 22 eyes with pachychoroid pigment epitheliopathy (PPE), 25 with spontaneously resolved central serous chorioretinopathy (CSC), 20 with photodynamic therapy (PDT)-treated CSC, 21 with active CSC, 19 with pachychoroid neovasculopathy (PNV) and 24 healthy eyes. The number, average area, and maximum area of flow voids and the percentage of nonperfused choriocapillaris area (PNPCA) were evaluated on artifact-removed binarized OCTA images using a custom MATLAB-powered algorithm. RESULTS: The PNV group had the largest flow void maximum area, flow void average area, and PNPCA. After adjusting for covariates, PPE, active-CSC, and PNV were associated with increased PNPCA and with increases across all choriocapillaris flow-void parameters, whereas PDT-CSC was associated only with a larger maximum flow-void area. In pairwise comparisons, PNV showed a greater maximum flow-void area than other groups, and PNV had a higher average flow-void area than controls and spontaneously resolved CSC (p < 0.05). Pairwise comparisons showed no significant differences in the number of flow voids among the groups. The location of the maximum flow-void area was consistent with the location of pachyvessels (80%) and choroidal neovascularization (84.2%). CONCLUSIONS: Flow void parameters have higher values in pachychoroid eyes than in healthy controls. These parameters are worst in eyes with PNV. The maximum area of the choriocapillaris flow void, especially, may be a marker of focal ischemia and the tendency to development of PNV.
PURPOSE: To characterize choroidal circulation in the vortex veins in central serous chorioretinopathy. STUDY DESIGN: Single-center retrospective study. METHODS: The study included 22 eyes with central serous chorioretin...PURPOSE: To characterize choroidal circulation in the vortex veins in central serous chorioretinopathy. STUDY DESIGN: Single-center retrospective study. METHODS: The study included 22 eyes with central serous chorioretinopathy from 22 patients with serous retinal detachment at the macula (18 men and four women, mean age 47.3 years). Ultra-widefield indocyanine green angiography was performed using OptosCalifornia, and images were taken intermittently from the early to the late phase (> 20 min of contrast) to examine late images of the vortex veins. Findings in the affected and contralateral eyes were also compared. RESULTS: In 13 of the 22 eyes, the vortex veins were hypofluorescent in all quadrants and continuous with the vortex ampullae. In five eyes, only the asymmetric dilated vortex vein was hypofluorescent, and in four eyes, the vortex veins were not hypofluorescent. Of the 22 contralateral eyes examined, 20 eyes exhibited identical findings in the vortex veins to those observed in the affected eye. Of the four eyes that did not exhibit hypofluorescence of the vortex veins in the affected eye, two eyes had partial hypofluorescence of some vortex veins in the contralateral eye, showing different findings. CONCLUSIONS: In the late phase, some eyes showed hypofluorescence due to the washout of indocyanine green dye in the vortex veins and others did not, suggesting that obstruction of the scleral passage in the choroidal venous outflow is not the main cause of the syndrome.
Although Japan has an established welfare system for individuals with visual impairments, medical-welfare coordination remains limited. To address this gap, the Low Vision Care Hub (LVCH) was established within a univers...Although Japan has an established welfare system for individuals with visual impairments, medical-welfare coordination remains limited. To address this gap, the Low Vision Care Hub (LVCH) was established within a university hospital. We evaluated the impact of LVCH on visitor satisfaction before and after consultation STUDY DESIGN: A single-center, one-group pre-post study METHODS: Individuals with self-reported functional vision difficulties who visited LVCH between July 1 and December 20, 2024 were included. Consultation was provided based on seven domains of low vision care outlined by the Japan Society for Low-Vision Research and Rehabilitation. Satisfaction was measured on a custom 6-point ordinal scale (0-5) pre/post consultation. Changes in satisfaction scores were analyzed using the Wilcoxon signed-rank test. Multivariable logistic regression adjusted for potential confounders RESULTS: Ninety-three participants were included. Satisfaction scores significantly increased after consultation (p < .001) and improvements were consistent across sex, age groups, and visual impairment classification using the International Council of Ophthalmology (ICO) criteria (all p < .001). Notably, participants not meeting the ICO-defined low vision criteria also improved (p < .001). On multivariable logistic regression, only older age (≥ 60 years) remained significantly associated with a markedly improved satisfaction score (OR = 2.98, 95% CI 1.10-8.05, p = .03) CONCLUSION: Consultations provided at LVCH significantly improved visitor satisfaction, including those who did not meet the ICO low vision criteria. Consultation may be particularly effective in individuals aged over 60 years. Overall, early-stage intervention through structured consultation may benefit individuals with functional vision difficulties.
PURPOSE: To identify predictors of ocular complications and to investigate treatment approaches in patients with facial paralysis (FP) in Taiwan. STUDY DESIGN: Retrospective database study. METHODS: Patients with FP in t...PURPOSE: To identify predictors of ocular complications and to investigate treatment approaches in patients with facial paralysis (FP) in Taiwan. STUDY DESIGN: Retrospective database study. METHODS: Patients with FP in the Chang Gung Research Database (2001-2022) were enrolled. Primary outcomes were ocular complications, including eyelid malposition (eg, lagophthalmos, ectropion) and ocular surface diseases (eg, recurrent corneal erosion, corneal ulcer). Predictors (demographics, comorbidities, and causes of FP) were assessed by use of the Cox proportional hazards model. A hazard ratio (HR) ≥1.50 or ≤0.67 was predefined as clinically significant. Secondary outcomes included treatment approaches. RESULTS: Among 36,382 patients with FP, 55.38% were diagnosed with Bell palsy; 4.95%, with new stroke; and 4.55%, with head and neck injury. Ocular complications developed in 9.22% of the patients. Factors associated with increased hazard included underlying chronic obstructive pulmonary disease (HR: 1.64; 95% CI: 1.46-1.85) and causes of FP due to head and neck injury (HR: 2.47; 95% CI: 2.19-2.79), brain tumors (HR: 2.26; 95% CI: 1.93-2.66), birth trauma (HR: 1.70; 95% CI: 1.42-2.04), surgery for brain tumors (HR: 1.59; 95% CI: 1.11-2.28), and head and neck tumors (HR: 1.56; 95% CI: 1.29-1.89). Among all the causes of FP, Bell palsy was associated with the lowest hazard of ocular complications (HR: 0.81; 95% CI: 0.75-0.88). Surgeries were required in 10.35% of patients, including 1.34% for dynamic reconstruction (muscle transfer and/or neurotization), 0.98% for static eyelid surgeries (eg, eyelid malposition correction, temporary tarsorrhaphy), and 0.05% for corneal transplant. CONCLUSION: Bell palsy, the predominant cause of FP, showed the lowest hazard of ocular complications, whilst head and neck injuries showed the highest hazard.
PURPOSE: Visual acuity (VA) assessment is crucial for evaluating visual function, but inter-clinic VA measurement variations were observed in patients with epiretinal membrane (ERM). Inter-clinic variations in acuity cha...PURPOSE: Visual acuity (VA) assessment is crucial for evaluating visual function, but inter-clinic VA measurement variations were observed in patients with epiretinal membrane (ERM). Inter-clinic variations in acuity chart luminance exist because the International Organization for Standardization (ISO) recommends a range of 80-320 cd/m for VA charts. We investigated the effects of luminance within this ISO range on the VA in patients with ERM. STUDY DESIGN: Prospective observational study. METHODS: We analyzed data from 187 patients with ERM and a normal fellow eye with a decimal VA of ≥1.0 at 320 cd/m OU. Baseline VA was measured at 320 cd/m, then reduced in 0.1-log unit steps using neutral density filters. Metamorphopsia was evaluated with the Amsler Grid Test. The luminance causing a two-line VA reduction from 320 cd/m was measured before and after ERM removal. RESULTS: In normal fellow eyes, a two-line VA reduction occurred at approximately 40 cd/m, indicating stable VA within the normal ISO range, while in affected eyes, it happened at around 150 cd/m. The luminance difference causing a two-line VA reduction between eyes with and without metamorphopsia was not significant. For surgical patients, the luminance causing a two-line VA reduction decreased over time: from 153 cd/m preoperatively to 36 cd/m at 6 months postoperatively. CONCLUSIONS: Considering the luminance is critical when measuring VA in patients with ERM.
PURPOSE: To evaluate the biomechanical and tomographic characteristics of keratoconic corneas undergoing accelerated cross-linking (CXL) for over one year and to assess the impact of cone localization on postoperative bi...PURPOSE: To evaluate the biomechanical and tomographic characteristics of keratoconic corneas undergoing accelerated cross-linking (CXL) for over one year and to assess the impact of cone localization on postoperative biomechanical behavior. STUDY DESIGN: Prospective-comparative. METHODS: This study included 68 eyes of 68 patients with progressive keratoconus. Based on cone location, the patients were divided into two groups: group 1 (central cone; 34 eyes) and group 2 (paracentral cone; 34 eyes). Scheimpflug imaging was used to assess the corneal thickness, anterior and posterior Kmean, Kmax, and astigmatism. The Ocular Response Analyzer (ORA) measures corneal compensated intraocular pressure (IOPcc), Goldmann-correlated pressure (IOPg), corneal hysteresis (CH), and corneal resistance factor (CRF). All the baseline measurements were repeated at 1, 6, and 12 months. Demarcation line (DL) depth was assessed at 1 month using anterior segment optical coherence tomography. Best corrected visual acuity was recorded at each visit. RESULTS: At 1year, anterior Kmean, posterior Kmean and Kmax showed significant reductions (p < 0.01). No significant differences in CH or CRF changes were found between the central and peripheral cones (p = 0.22, p = 0.33). Visual improvement and reduction in spherical equivalent were greater in the central cone group (p = 0.03, p = 0.03). DL depth correlated positively with CH and CRF at 1 month (p = 0.02, p = 0.008), but not at 1 year. CONCLUSION: Accelerated CXL improves corneal shape, but may not produce detectable changes in ORA-derived biomechanics. Regional stiffening may not be captured by global indices, and the cone location appears to be more influential on visual recovery than biomechanical parameters.
PURPOSE: To compare the monocular uncorrected visual acuity (UCVA) and contrast sensitivity (CS) of three enhanced monofocal intraocular lenses (IOLs) under emmetropic and mild myopic refractive targets. STUDY DESIGN: Si...PURPOSE: To compare the monocular uncorrected visual acuity (UCVA) and contrast sensitivity (CS) of three enhanced monofocal intraocular lenses (IOLs) under emmetropic and mild myopic refractive targets. STUDY DESIGN: Single-center retrospective observational study. METHODS: Among 198 patients (244 eyes) who underwent uneventful cataract surgery with enhanced monofocal IOL implantation (Tecnis Eyhance [DIB00V, E group], Vivinex Impress [XY1-EM, I group], NIDEK NSP-3 [N group]) with emmetropia or mild myopia (-1.00D), refractive targets, monocular UCVA at six different distances (5, 1, 70, 50, 40, and 30 cm) and CS with and without glare were assessed 1 month postoperatively and compared using the Kruskal-Wallis test followed by the Steel-Dwass post-hoc test. RESULTS: In the emmetropic group, UCVA for all IOLs achieved ≤ 0.2 logMAR from 5 m to 50 cm, with significantly better UCVA at 5 m in the E than I group (p = 0.0300) and at 50 cm in the I than N group (p = 0.0242). For mild myopia, the N group achieved better UCVA at 5 m (p = 0.0066), the I group showed superior near-visual acuity at 30 cm than the E group (p = 0.0457), and UCVA for all IOLs achieved ≤ 0.2 logMAR from 1 m to 40 cm, with the highest CS at 6, 12, and 18 cycles per degree, with and without glare, in the E group. These findings suggest that combining enhanced monofocal IOLs with mild myopic targeting (-1.0 D) may optimize functional vision for everyday activities, particularly in older adults who rely on safe intermediate and near vision in daily life. CONCLUSIONS: All IOLs showed good UCVA. The E, I, and N groups demonstrated balanced visual performance, with superior contrast sensitivity, superior near-to-intermediate vision, and superior distance vision, respectively.
Fundus parameters can be used to quantify masculinity or femininity as a fundus sex index (FSI) ranging from 0 to 1. The purpose of this study was to investigate the association between smoking, hypertension, diabetes, a...Fundus parameters can be used to quantify masculinity or femininity as a fundus sex index (FSI) ranging from 0 to 1. The purpose of this study was to investigate the association between smoking, hypertension, diabetes, and FSI in the Kumejima population study STUDY DESIGN: Prospective cross-sectional observational population study METHODS: Using color fundus photographs obtained from the Kumejima population study, 1653 healthy right eyes with reliable fundus parameter measurements were included. The tessellation fundus index R/(R + G + B), red-green-blue intensity in eight locations around the optic disc and foveal region, optic disc ovality ratio, papillomacular angle, and retinal vessel angles were quantified using ImageJ. The FSI was calculated using machine learning from the 42 fundus parameters, and the Mann-Whitney U-test was used to assess whether there were differences in the FSI depending on the presence or absence of smoking, hypertension, and diabetes RESULTS: The mean age of the 838 men and 815 women included in this study was 52.8 and 54.0 years, respectively. The FSI of the smoking group was lower than of the non-smoking group overall (P < 0.001). The FSI of the hypertension and diabetes groups was significantly higher than of the non-hypertension (P = 0.005) and non-diabetes (P = 0.017) groups only in women CONCLUSION: In the Kumejima population study of healthy eyes in individuals aged 40 years or older, the fundus tended to be more feminine in women with hypertension or diabetes than in those without these conditions.