Jpn. J. Ophthalmol. [JOURNAL]
Sun
200 papers
The intraocular lens position in high myopia eyes.
Wang Z, He S, Ding N … +2 more , Xin C, Dong Z
Jpn J Ophthalmol · 2026 May · PMID 41758441 · Full text
PURPOSE: To explore the positional relationship between intraocular lens (IOL) and crystalline lens (CLL) by anterior segment optical coherence tomography (AS-OCT) in high myopia complicated with cataract eyes. STUDY DES...
PURPOSE: To explore the positional relationship between intraocular lens (IOL) and crystalline lens (CLL) by anterior segment optical coherence tomography (AS-OCT) in high myopia complicated with cataract eyes. STUDY DESIGN: Retrospective and consecutive study. METHODS: Patients who had undergone phacoemulsification with IOL implantation were reviewed. Exclusion criteria were any ocular history that could have affected the zonules, poor pupil dilation and intra- or post- operative complications. The magnitude and direction of tilt and decentration of CLL and IOL, CLL thickness (LT), anterior chamber depth (ACD) and axial length (AL) were measured. RESULTS: Fifty eyes without high myopia (EM group) and 73 high myopia eyes (HM group) were recruited. The magnitude of tilt and decentration of CLL was significantly different between the HM and EM group (p <0.01, p <0.01). In terms of the decentration, the magnitude of IOL was significantly higher than of CLL in both the HM and EM groups (p < 0.01; p =0.043). Multivariate analysis showed that only the alignment of CLL was related with the position of IOL in both group (R =0.237, p < 0.01, R =0.097, p =0.042; R =0.476, p < 0.01, R =0.359, p < 0.01). CONCLUSIONS: Alignment of CLL in high myopia eyes determines the position of the IOL. Moreover, the IOL in high myopia was more decentrated, while this discrepancy did not reach a level that would compromise visual quality, it needs to be taken into consideration.
One-year outcomes of pneumatic displacement for submacular hemorrhage secondary to neovascular age-related macular degeneration.
Itagaki K, Mukai R, Honjo J … +1 more , Sekiryu T
Jpn J Ophthalmol · 2026 Feb · PMID 41746581 · Publisher ↗
PURPOSE: To investigate the one-year outcomes of pneumatic displacement for submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). We compared cases of polypoidal choroidal vasculop...
PURPOSE: To investigate the one-year outcomes of pneumatic displacement for submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). We compared cases of polypoidal choroidal vasculopathy (PCV) and non-PCV. STUDY DESIGN: A retrospective observational study. METHODS: We reviewed the medical records of 76 eyes of 74 patients with SMH secondary to nAMD who underwent pneumatic displacement as initial treatment. The primary outcomes were best-corrected visual acuity (BCVA), complications, and additional treatment. RESULTS: We examined 54 eyes with PCV and 22 eyes with non- PCV. Approximately 0.5 mL of 100% sulfur hexafluoride (SF) gas was injected into the vitreous cavity. After pneumatic displacement, 19 eyes (25%) underwent vitrectomy for complications such as vitreous hemorrhage or retinal detachment. Additionally, 95% of eyes that underwent vitrectomy had hemorrhage extending beyond the arcade vessels at baseline. During the 12 months, the average number of anti-vascular endothelial growth factor (VEGF) injections was 7.0±3.6 in PCV cases and 7.0±3.3 in non-PCV cases (P=0.74). The mean BCVA at 12 months improved from 0.77±0.44 to 0.42±0.45 in PCV cases (P<0.01) and from 1.13±0.51 to 0.88±0.59 in non-PCV cases (P=0.01). The PCV group had better BCVA than the non-PCV group at both time points (P<0.01). In the previously treated group, 100% of non-PCV cases had worsened visual acuity compared to pre-onset SMH, while 62% of PCV cases maintained pre-onset visual acuity (P<0.01). CONCLUSION: Pneumatic displacement resulted in superior visual outcomes in the PCV group compared to the non-PCV group for submacular hemorrhage secondary to nAMD. .
A prospective, randomized study comparing the effects of preservative-free latanoprost and preserved latanoprost eyedrops on MMP-9 expression and ocular surface disease index in glaucoma patients.
Kang E, Park JH, Yoo C … +1 more , Kim YY
Jpn J Ophthalmol · 2026 Feb · PMID 41739410 · Publisher ↗
PURPOSE: To investigate the effect of preservative-containing and preservative-free latanoprost eyedrops on dry eye symptoms and matrix metalloproteinase 9 expression in untreated open-angle glaucoma patients. STUDY DESI...
PURPOSE: To investigate the effect of preservative-containing and preservative-free latanoprost eyedrops on dry eye symptoms and matrix metalloproteinase 9 expression in untreated open-angle glaucoma patients. STUDY DESIGN: Prospective METHODS: Treatment-naïve open-angle glaucoma patients were randomly assigned to either preservative-containing or preservative-free latanoprost groups. The ocular surface disease index score, Schirmer test, tear break up time, corneal staining score, and matrix metalloproteinase 9 expression in tears were prospectively compared before and at 1 and 3 months after drug instillation. RESULTS: Ocular surface disease index score, Schirmer's test, tear break up time, corneal staining score, and matrix metalloproteinase 9 expression levels did not significantly differ between the two groups before drug instillation. After 3 months, the preservative-free latanoprost group exhibited a significantly longer tear break up time and improved corneal staining score. The proportion of patients with positive matrix metalloproteinase 9 in tears was lower in the preservative-free group, although this difference was not statistically significant (75.0% vs. 62.5%, P = 0.118). CONCLUSION: Compared with preservative-containing latanoprost, the preservative-free preparation led to improved tear break up time and a potential reduction in positive matrix metalloproteinase 9 expression after 3 months in untreated open-angle glaucoma patients.
Conjunctival allergic inflammation involving the interleukin-23/T helper type 17 immune axis in an experimental allergic conjunctivitis mouse model.
Adachi R, Shoji J, Inada N … +2 more , Tomioka A, Yamagami S
Jpn J Ophthalmol · 2026 Feb · PMID 41680338 · Publisher ↗
PURPOSE: To investigate the role of the interleukin-23 (IL-23)/T helper type 17 (Th17) immune axis in conjunctival allergic inflammation using a murine model of experimental allergic conjunctivitis (EAC). STUDY DESIGN: E...
PURPOSE: To investigate the role of the interleukin-23 (IL-23)/T helper type 17 (Th17) immune axis in conjunctival allergic inflammation using a murine model of experimental allergic conjunctivitis (EAC). STUDY DESIGN: Experimental study. METHODS: BALB/c mice were assigned to four groups: control (untreated), allergy (EAC), IL-23 (EAC with IL-23 eyelid injection), and non-sensitized IL-23 (non-sensitized with IL-23 eyelid injection). Conjunctival tissue was analyzed histologically to quantify eosinophil and neutrophil infiltration. Gene expression of mRNA in conjunctival tissue was assessed using a PCR array and quantitative RT-PCR. RESULTS: Eosinophilic and neutrophilic infiltration in the subconjunctival tissue was more pronounced in the IL-23 group than in the allergy and control groups. PCR array and quantitative RT-PCR analyses revealed significantly elevated Ccl17/Tarc mRNA expression in the IL-23 group compared to the allergy group. IL-17A mRNA, undetectable in the allergy group, was expressed in the IL-23 group. Additionally, PCR array comparisons between the IL-23 and non-sensitized IL-23 groups showed a significant increase in Rorc and Il1r1 expression in the IL-23 group. At the same time, Mmp3, Ccl7, and Ccr2 were significantly upregulated in the non-sensitized IL-23 group. RT-PCR analysis also demonstrated higher IL-17A mRNA levels in the non-sensitized IL-23 group than in the IL-23 group. CONCLUSION: IL-23 induces mixed eosinophilic-neutrophilic inflammation in conjunctival tissue, characterized by enhanced Th2 and weak Th17 responses in a murine model of EAC. These findings suggest a modulatory role of the IL-23/Th17 axis in influencing the severity and phenotype of allergic conjunctival inflammation.
Clinical efficacy, safety, and success factors of botulinum toxin type A in the treatment of acute acquired comitant esotropia.
Ui M, Goseki T, Watanabe A … +5 more , Fueki K, Komiya Y, Hasunuma R, Tsutsumi N, Yoshida H
Jpn J Ophthalmol · 2026 Feb · PMID 41678132 · Publisher ↗
PURPOSE: Acute acquired comitant esotropia (AACE) is an increasingly reported form of esotropia, possibly linked to the rising use of digital devices. Botulinum toxin type A (BTXA) has emerged as a minimally invasive tre...
PURPOSE: Acute acquired comitant esotropia (AACE) is an increasingly reported form of esotropia, possibly linked to the rising use of digital devices. Botulinum toxin type A (BTXA) has emerged as a minimally invasive treatment alternative to surgery, particularly for patients with diplopia. We aimed to investigate the efficacy and safety of BTXA injections in treating AACE while identifying factors contributing to successful treatment outcomes. STUDY DESIGN: A retrospective, single-center study. METHODS: This study retrospectively evaluated 228 patients with AACE who received BTXA injections at a single center. Treatment outcomes, adverse events, and factors influencing success were analyzed. Successful outcomes were defined as either the absence of diplopia in the primary position or an angle of deviation of ≤10 prism diopters from orthotropia, both evaluated at more than 6 months after the last injection. RESULTS: The average patient age was 30.9 years, and 52% achieved successful outcomes. Transient adverse events, including blepharoptosis (24%) and hypertropia (16%), were observed. The study found that shorter duration from onset to treatment (P = 0.018) and post-treatment overcorrection (P = 0.0073) were associated with higher success rates. Although some patients required additional treatment or surgery due to recurrence, BTXA was an effective intervention for AACE, with a significant improvement in eye alignment and stereopsis. CONCLUSION: Early intervention with BTXA is crucial for successful outcomes and offers a safe, less invasive alternative to traditional strabismus surgery.
α-Crystallins and vascular endothelial growth factor in aqueous humor of patients with neovascular age-related macular degeneration.
Kim JY, Lee J, Oh SB … +2 more , Kim C, Park YH
Jpn J Ophthalmol · 2026 May · PMID 41632222 · Publisher ↗
PURPOSE: This study investigated aqueous humor (AH) levels of α-crystallins and vascular endothelial growth factor (VEGF) in patients with neovascular age-related macular degeneration (nAMD). STUDY DESIGN: Prospective st...
PURPOSE: This study investigated aqueous humor (AH) levels of α-crystallins and vascular endothelial growth factor (VEGF) in patients with neovascular age-related macular degeneration (nAMD). STUDY DESIGN: Prospective study. METHODS: AH samples were collected from treatment-naïve phakic nAMD patients before the first and third anti-VEGF injections and from cataract patients without retinal disease as controls. αB-crystallin, αA-crystallin, and VEGF levels were quantified using enzyme-linked immunosorbent assay. Patients were classified as good responders (achieved remission) or poor responders (persistent intraretinal or subretinal fluid) according to response after three consecutive monthly anti-VEGF injections. RESULTS: A total of 28 eyes from 24 nAMD patients and 27 eyes from 23 controls were analyzed. nAMD showed higher αB-crystallin and VEGF, but similar αA-crystallin levels versus controls (P < 0.001, P = 0.002, and P = 0.721, respectively). In nAMD eyes, after two anti-VEGF injections, αB-crystallin and αA-crystallin remained unchanged, whereas VEGF decreased (P = 0.057, P = 0.182, and P = 0.017, respectively). Among nAMD eyes, 20 eyes from 18 patients were good responders and 8 from 6 were poor responders. Good responders demonstrated reductions in αB-crystallin and VEGF (P = 0.016 and P = 0.002, respectively), whereas poor responders showed no significant changes (P = 0.249 and P = 0.075, respectively). In untreated nAMD eyes, αB-crystallin and VEGF levels showed a positive correlation (P = 0.010). CONCLUSION: In nAMD, AH αB-crystallin levels were elevated compared with controls. Among good responders to anti-VEGF therapy, αB-crystallin levels decreased. Moreover, αB-crystallin levels showed a positive correlation with VEGF.
Real-world six-month outcomes after switching from aflibercept 2 mg to aflibercept 8 mg for neovascular age-related macular degeneration.
Kindo H, Hosokawa MM, Ouchi C … +4 more , Matoba R, Morita T, Hayashi J, Morizane Y
Jpn J Ophthalmol · 2026 May · PMID 41629572 · Full text
PURPOSE: To investigate 6-month outcomes in eyes with neovascular age-related macular degeneration (nAMD) switched from intravitreal aflibercept 2 mg to intravitreal aflibercept 8 mg. STUDY DESIGN: Retrospective observat...
PURPOSE: To investigate 6-month outcomes in eyes with neovascular age-related macular degeneration (nAMD) switched from intravitreal aflibercept 2 mg to intravitreal aflibercept 8 mg. STUDY DESIGN: Retrospective observational study. METHODS: We reviewed records of consecutive nAMD eyes switched from aflibercept 2 mg to 8 mg. In eyes continuing aflibercept 8 mg, best-corrected visual acuity (BCVA), treatment intervals, and anatomical/exudative parameters were evaluated at 6 months. In eyes that could not continue, reasons for discontinuation were examined. RESULTS: Forty-four eyes from 44 patients were included. At 6 months, 35 eyes (79.5%) continued and 9 (20.5%) discontinued aflibercept 8 mg. Discontinuing eyes had significantly shorter pre-switch treatment intervals and more frequent prior therapies than continuing eyes. In the continuation group, BCVA remained stable (median 0.05 to 0.00 logMAR, P = 0.351), while the treatment interval was significantly extended (median 7.0 to 9.0 weeks, P < 0.001). Central retinal thickness and pigment epithelial detachment height decreased significantly (P = 0.035 and P = 0.021, respectively). The proportion of eyes with subretinal fluid significantly decreased from 74.3 to 37.1% (P = 0.003). Of the discontinuations, 4 were due to worsening exudation and 5 to inability to extend to ≥8 weeks as required by labeling. No intraocular inflammation or serious adverse events occurred. CONCLUSIONS: Switching to aflibercept 8 mg achieved anatomical improvements and longer treatment intervals in ~80% of nAMD cases, suggesting it may be a useful alternative to aflibercept 2 mg. However, continuation may be difficult in refractory cases requiring frequent injections before switching.
Advancement of cataract classification with artificial intelligence using anterior segment optical coherence tomography images with self-supervised vision transformer.
Takinami S, Ueno Y, Mori H … +3 more , Morita Y, Seita J, Oshika T
Jpn J Ophthalmol · 2026 May · PMID 41593412 · Publisher ↗
PURPOSE: To evaluate the efficacy of a self-supervised learning Vision Transformer (ViT) for classification of the nucleus, cortex, and posterior capsule cataract severity utilizing anterior segment optical coherence tom...
PURPOSE: To evaluate the efficacy of a self-supervised learning Vision Transformer (ViT) for classification of the nucleus, cortex, and posterior capsule cataract severity utilizing anterior segment optical coherence tomography (AS-OCT) images. STUDY DESIGN: Artificial intelligence (AI) model training. METHODS: Overall, 1,693 eyes were imaged using AS-OCT, with 1,023 classified according to the Lens Opacities Classification System III for supervised training at the Department of Ophthalmology, University of Tsukuba Hospital, Japan. Five AI models were compared: ResNet18, ViT with/without ImageNet pre-training, and Self-Supervised ViT (SS-ViT) constructed using AS-OCT images from 670 eyes. These models were evaluated across five classification tasks: nuclear cataract 2-class (N1 vs. N2≥), 3-class (N1, N2-N3, N4≥), and 6-class classifications; and 2-class classifications for both cortical (C1 vs. C2≥) and posterior subcapsular cataracts (P1 vs. P2≥). Performance was measured using Area Under the Precision-Recall Curve (AUPRC). RESULTS: In the nuclear cataract 2-class classification, ResNet18, ViT, and SS-ViT, which were pre-trained on ImageNet, demonstrated the highest AUPRC of 0.999. For the nuclear cataract 3-class classification, SS-ViT exhibited the highest AUPRC of 0.939. In the 6-class classification of nuclear cataract, SS-ViT attained the highest value with an AUPRC of 0.788. In the 2-class classification of cortical cataract, SS-ViT demonstrated the highest performance with an AUPRC of 0.774, while in the 2-class classification of posterior subcapsular cataract, SS-ViT exhibited the most favorable performance with an AUPRC of 0.506. CONCLUSION: Our findings demonstrate the effectiveness of a self-supervised ViT model for severity classification of nuclear, cortical, and posterior subcapsular cataracts on AS-OCT.
Impact of watercleft localization on higher-order aberrations and visual function.
Mita N, Seki Y, Ukai Y … +7 more , Mito T, Sasaki Y, Sasaki M, Miyashita H, Shibuya E, Kubo E, Sasaki H
Jpn J Ophthalmol · 2026 Mar · PMID 41559484 · Publisher ↗
PURPOSE: This study investigated the relationship between watercleft localization in crystalline lenses and higher-order aberrations. STUDY DESIGN: Single-center, retrospective, observational study METHODS: The study inc...
PURPOSE: This study investigated the relationship between watercleft localization in crystalline lenses and higher-order aberrations. STUDY DESIGN: Single-center, retrospective, observational study METHODS: The study included 131 right eyes from 131 patients. The patients underwent complete ophthalmic examinations, swept-source anterior-segment optical coherence tomography (Tomey Corporation), and wavefront analysis with a wavefront analyzer (Topcon Corporation). Waterclefts were classified according to the Kanazawa Medical University Cataract Classification and Grading System. On the basis of their location, the central and peripheral watercleft types were further categorized as anterior waterclefts (AWC) or posterior cortical waterclefts (PWC). RESULTS: The total cross-sectional areas and volumes of the central waterclefts were 7.722 ± 5.926 mm and 1.413 ± 1.357 mm for the C-AWC and 2.443 ± 2.422 mm and 0.214 ± 0.286 mm for the C-PWC, respectively. The size (area and volume) of the C-AWC was significantly larger than that of the C-PWC. Both eyes exhibited significantly higher levels of higher-order aberrations and lower visual acuity than did the clear eye in both cases (P <.05). CONCLUSION: Central-type waterclefts caused visual deterioration, with a significant correlation between size and visual function. For the same cross-sectional area and volume, the effects on higher-order aberrations and visual acuity were greater with C-PWC than with C-AWC.
Distribution of axial length in Japanese children and adolescents aged 4 to 19 years.
Fujioka S, Takada N, Yoshida S … +13 more , Ishikuro M, Kobayashi M, Shinoda G, Noda A, Orui M, Obara T, Tsuda S, Himori N, Hanyuda A, Kawasaki R, Kuriyama S, Fuse N, Nakazawa T
Jpn J Ophthalmol · 2026 May · PMID 41553439 · Full text
PURPOSE: To investigate the distribution of axial length (AL) and the prevalence of long axial length (LAL) in Japanese children and adolescents. STUDY DESIGN: cross-sectional observational study METHODS: We analyzed AL...
PURPOSE: To investigate the distribution of axial length (AL) and the prevalence of long axial length (LAL) in Japanese children and adolescents. STUDY DESIGN: cross-sectional observational study METHODS: We analyzed AL data from 14,482 participants (7,457 boys and 7,025 girls) aged 4-19 in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study in Japan. AL was measured using a non-contact optical axis measurement device. We evaluated the distribution of AL in the participants with box plots for age. Segmented regression identified age-related trends and breakpoints. We calculated the age-specific proportions of participants with AL ≥ 24.5 mm and those with AL ≥ 26 mm, defined as LAL, which were considered indicative of suspected myopia. RESULTS: Mean AL increased with age, with a break point at 11.73 years. The slope before the break point was β = 0.27, while the slope after the break point decreased to β = 0.12. Boys showed earlier break point (9.87 years) than girls (15.91 years). Proportions with AL ≥ 24.5mm and ≥26mm began to increase approximately at 8 and 10 years of age respectively, with sex differences noted between ages 7 to 10 years and 10 to 11 years. CONCLUSION: This was the first large-scale AL survey in Japan and revealed the age and sex related distribution of AL and the proportion with LAL among Japanese children and adolescents aged 4 to 19 years.
Clinical and genetic characterization of REEP6-associated retinopathy in a Japanese cohort.
Tsuboi T, Mizobuchi K, Yoshitake K … +8 more , Kuniyoshi K, Kominami T, Ueno S, Nishiguchi KM, Kusaka S, Iwata T, Hayashi T, Nakano T
Jpn J Ophthalmol · 2026 May · PMID 41553438 · Publisher ↗
PURPOSE: To characterize the clinical and genetic features of REEP6-associated retinopathy in 8 Japanese patients from 7 families STUDY DESIGN: Retrospective, multicenter cohort study METHODS: Biallelic REEP6 variants we...
PURPOSE: To characterize the clinical and genetic features of REEP6-associated retinopathy in 8 Japanese patients from 7 families STUDY DESIGN: Retrospective, multicenter cohort study METHODS: Biallelic REEP6 variants were identified by use of whole-exome sequencing in patients with inherited retinal dystrophy (IRD). Comprehensive ophthalmic assessments were performed in all the patients. RESULTS: Among a nationwide cohort of 2011 patients with IRD, 8 patients from 7 families were found to carry biallelic REEP6 variants. Four distinct variants were identified: c.223G>A, p.Glu75Lys; c.268G>C, p.Val90Leu; c.280_281del, p.Leu94ValfsTer86 (novel frameshift), and c.598+1G>A. Five families (Families 1-5) carried the compound heterozygous p.Val90Leu and c.598+1G>A variants. The other two had either homozygous c.598+1G>A (Family 6) or compound heterozygous p.Glu75Lys/p.Leu94ValfsTer86 (Family 7). In Families 1-5, the patients exhibited relatively mild phenotypes with limited to peripheral retinal degeneration in the younger patients and gradual posterior pole involvement in the older patients. Optical coherence tomography revealed well-preserved outer retinal layers at the macula, and good visual acuity was maintained even in some of the older patients. In contrast, the 2 patients in Families 6 and 7 exhibited more severe phenotypes, including macular atrophy and visual acuity decline. CONCLUSIONS: The combination of p.Val90Leu and c.598+1G>A variants was associated with a milder phenotype, supporting the hypothesis that p.Val90Leu is a hypomorphic variant. These findings expand the clinical and genetic spectra of REEP6-associated retinopathy, particularly among East Asian populations.
Risk factors for re-detachment after 25-gauge pars plana primary vitrectomy for rhegmatogenous retinal detachment: a retrospective observational single-center study.
Mizuguchi T, Horiguchi M, Ito Y … +3 more , Sakurai R, Yata K, Tanikawa A
Jpn J Ophthalmol · 2026 Mar · PMID 41553437 · Publisher ↗
PURPOSE: Recurrent retinal detachment (re-RD) after rhegmatogenous retinal detachment (RRD) surgery is associated with poor visual outcomes. This retrospective study evaluated the incidence and risk factors for re-RD fol...
PURPOSE: Recurrent retinal detachment (re-RD) after rhegmatogenous retinal detachment (RRD) surgery is associated with poor visual outcomes. This retrospective study evaluated the incidence and risk factors for re-RD following primary 25-gauge pars plana primary vitrectomy (25G-PPV). STUDY DESIGN: Retrospective observational study METHODS: Consecutive patients who underwent initial 25G-PPV at Fujita Health University Hospital between January 2011 and March 2019 were included. After applying exclusion criteria, preoperative and surgical factors were obtained from medical records. Patients were categorized into re-RD and initial reattachment groups. Univariate analysis was used to identify factors associated with re-RD, followed by multivariate analysis of significant variables. RESULTS: Among 1399 eyes, the mean age was 56.5±11.0 years. The re-RD and reattachment groups included 89 and 1310 eyes, respectively. The initial reattachment rate was 93.2%. Significant differences were observed between macular detachment and inferior retinal break (RB). The odds ratios of macular detachment and inferior RB in the re-RD group were 1.70 (95% confidence interval [CI] 1.05-2.79) and 2.26 (1.40-3.61), respectively. CONCLUSION: The initial reattachment rate with 25G-PPV was 93.2%. The re-RD group showed higher rates of macular detachment and a higher proportion of inferior RB, identified as risk factors for re-RD. RD due to inferior RB with macular detachment may require vitrectomy combined with buckling.
Comparison of the effectiveness between propensity score-matched trabecular micro-bypass stent versus ab interno trabeculotomy.
Nakagawa S, Kanda S, Totsuka K … +4 more , Chen YN, Okinaga K, Takamoto M, Ishii K
Jpn J Ophthalmol · 2026 May · PMID 41533258 · Publisher ↗
PURPOSE: To assess the efficacy of trabecular micro-bypass stents (IS) versus ab interno trabeculotomy (LOT) performed alongside cataract surgery; and to ensure patient comparability across both surgical groups concernin...
PURPOSE: To assess the efficacy of trabecular micro-bypass stents (IS) versus ab interno trabeculotomy (LOT) performed alongside cataract surgery; and to ensure patient comparability across both surgical groups concerning age, intraocular pressure (IOP), medication score, and disease type. STUDY DESIGN: Retrospective cohort METHODS: Overall, 194 eyes were assessed from 107 Japanese patients with open-angle glaucoma or exfoliation glaucoma who received IS plus cataract surgery at Saitama Red Cross Hospital between July 2017 and January 2022. Another 88 eyes were assessed from 58 patients who underwent combined LOT and cataract surgery at the same hospital between January 2018 and December 2019. Both cohorts were followed-up for ≥6 months. Propensity scoring facilitated between-group patient background matching. Overall, 62 eyes per group matched for preoperative characteristics were analyzed. RESULTS: Six-month postoperative IOP was 14.50 ± 2.26 and 14.08 ± 2.50 mmHg for IS and LOT, respectively, with medication scores of 1.50 ± 1.17 (IS) and 1.71 ± 1.60 (LOT), indicating no significant differences. The IOP reduction rate was 19.03 ± 13.34% (IS) and 18.94 ± 23.26% (LOT), showing no significant difference. Both groups exhibited similar medication score reductions (-1.11 ± 1.04 [IS], and -0.92 ± 1.47 [LOT]). Preoperative IOP significantly correlated with IOP reduction rate in both procedures. LOT patients experienced more hyphema postoperatively, versus IS patients. CONCLUSION: In eyes with relatively well-controlled preoperative IOP-where either IS or LOT could be reasonably selected-either procedure offers similar surgical outcomes, with comparable postoperative performance and complication rates, except for postoperative hyphema.
Ten-year changes in risk factors for requiring treatment of retinopathy of prematurity in extremely low birth weight infants: a multicenter study in Tokyo.
Tachikawa T, Masunaga K, Kiyota M … +19 more , Kushima R, Nishina S, Isayama T, Noda E, Okazaki K, Funaki T, Nakao A, Matsumoto T, Arai H, Saito Y, Miyazawa T, Negishi T, Shoji H, Toyama T, Nishimura R, Ueno R, Sato F, Morikawa Y, Neonatal Research Network of Japan
Jpn J Ophthalmol · 2026 May · PMID 41533257 · Publisher ↗
PURPOSE: To investigate 10-year changes in risk factors associated with treatment required for retinopathy of prematurity (ROP) in extremely low birth weight infants. STUDY DESIGN: Retrospective cohort study. METHODS: Da...
PURPOSE: To investigate 10-year changes in risk factors associated with treatment required for retinopathy of prematurity (ROP) in extremely low birth weight infants. STUDY DESIGN: Retrospective cohort study. METHODS: Data for extremely low birth weight infants born in 2011 (Group 1) and those born in 2020-2021 (Group 2) were extracted from the Neonatal Research Network of Japan, with a total of 564 cases. The frequency of ROP treatment-related risk factors and results of multivariate analyses were compared between the two groups. Missing data in covariates were handled using multiple imputation. RESULTS: Group 2 had a significantly lower birth weight (p=0.038), gestational age (p=0.037), and Apgar scores (p<0.001), than Group 1. The frequencies of resuscitation with intubation (p=0.030), oxygen therapy beyond 36 weeks' postmenstrual age (p<0.001), chronic lung disease (p=0.012), gastrointestinal perforation (p=0.030), and red blood cell transfusion (p=0.018) were higher in Group 2 than in Group 1. However, the incidence and treatment rate of ROP decreased over time. The multivariate analysis shows that mechanical ventilation for 60 days or more is a strong independent risk factor for ROP treatment in Group 1, but this effect disappeared in Group 2. CONCLUSION: Birth weight and gestational age of extremely low birth weight infants born in Tokyo have decreased significantly compared with 10 years previously, and the severity of ROP has not increased. Advances in respiratory management may have contributed to reducing the risk of developing severe ROP.
Incidence and clinical features of malignant glaucoma after Preserflo MicroShunt implantation.
Koga Y, Mieno H, Mori K … +5 more , Yoshii K, Fukuzawa K, Ikushima T, Ueno M, Sotozono C
Jpn J Ophthalmol · 2026 May · PMID 41533256 · Publisher ↗
PURPOSE: To investigate the incidence and clinical characteristics of malignant glaucoma (MG) following Preserflo MicroShunt (PMS) implantation. STUDY DESIGN: Retrospective multicenter cohort study METHODS: We investigat...
PURPOSE: To investigate the incidence and clinical characteristics of malignant glaucoma (MG) following Preserflo MicroShunt (PMS) implantation. STUDY DESIGN: Retrospective multicenter cohort study METHODS: We investigated 957 consecutive eyes that underwent PMS implantation between August 2022 and May 2025. In all eyes, patient age, sex, glaucoma subtype, preoperative intraocular pressure (IOP), medication score, axial length (AL), and use of intraluminal suture stenting (ISS) were examined. We identified cases in which MG developed postoperatively and compared age, preoperative IOP, medication score, and AL between the MG and non-MG groups. The timing of MG onset and treatment outcomes were also evaluated. After Bonferroni correction, the adjusted significance level was set at P<0.0125 (0.05/4). RESULTS: MG occurred in 4 eyes (0.42%) of 2 men and 2 women, with a median age of 85.5 years (interquartile range [IQR], 84-90 years). All eyes were diagnosed with exfoliation glaucoma (XFG). Patients in whom MG developed were significantly older (P=0.006) and had a significantly higher preoperative IOP (P=0.006) than those without MG. No significant differences in AL or medication score were observed between the groups. MG developed on postoperative days 2, 3, and 4 in 3 eyes without ISS. In 1 case with ISS, MG occurred 3 days after ISS removal, but not during ISS placement. All MG cases were successfully treated with irido-zonulo-hyaloido-vitrectomy, with or without pars plana vitrectomy. CONCLUSIONS: Although rare, MG can occur in the early postoperative period after PMS implantation, particularly in older patients with a high preoperative IOP.
Long-term ocular outcomes and prognostic factors for clinical recovery in carotid cavernous fistulas: a retrospective single-center study of 141 eyes.
Witthayaweerasak J, Mukmonthein S, Aui-Aree N … +2 more , Aryasit O, Aramrat C
Jpn J Ophthalmol · 2026 May · PMID 41505026 · Publisher ↗
PURPOSE: To evaluate carotid cavernous fistula (CCF) ocular manifestations and outcomes and analyze predictors for clinical recovery within a 1-year follow-up period. STUDY DESIGN: Retrospective cohort study. METHODS: Pa...
PURPOSE: To evaluate carotid cavernous fistula (CCF) ocular manifestations and outcomes and analyze predictors for clinical recovery within a 1-year follow-up period. STUDY DESIGN: Retrospective cohort study. METHODS: Patients diagnosed with CCF were included. Clinical characteristics, visual acuity (VA), and intraocular pressure (IOP) were reviewed at baseline and at 1, 3, 6, and 12 months after treatment. RESULTS: Of the 141 eyes with CCF (133 patients), 45 and 96 were direct and indirect CCF, respectively. The most common ocular manifestations for both fistula types were dilated episcleral vessels (90.8%) and proptosis (75.9%). Embolization was performed in 43 (95.6%) and 51 (53.1%) eyes with direct and indirect CCF, respectively. The complete recovery rate from both CCFs at 1-year postembolization was 73.9%, whilst the recovery rate from the indirect type at 1-year postconservation was 21.2%. Factors predicting complete recovery included symptom duration of ≤30 days for direct CCF (adjusted odd ratio [aOR] = 7.77, P = .003) and embolization for indirect CCF (aOR = 3.63, P = .012). Overall, the VA significantly improved at 6 months after sole embolization (P <.05). Final good VA (≥20/40) and IOP (≤21 mm Hg) were attained in 64.0% and 96.9% of the cases, respectively. Initial VA of >20/200 (aOR = 38.78, P <.001) and age (aOR = 0.95, P <.001) were significantly associated with good final visual outcomes in both CCF types. CONCLUSION: Patients with CCF required long-term follow-up of clinical recovery. Visual acuity at initial presentation and age should be considered for visual outcome prediction. Prompt diagnosis of direct fistula within 1 month and early embolization of indirect CCF can prevent residual symptoms following treatment.
Significant correlation between retinal blood flow and visual acuity in recovery after vitrectomy for rhegmatogenous retinal detachment with macular detachment.
Ueno I, Tsuiki E, Suzuma K … +5 more , Nakano Y, Kinoshita H, Matsumoto M, Uematsu M, Kitaoka T
Jpn J Ophthalmol · 2026 May · PMID 41484528 · Publisher ↗
PURPOSE: This study aimed to investigate differences in retinal blood flow leading to visual recovery in cases of macular detachment in rhegmatogenous retinal detachment (RRD). STUDY DESIGN: Observational, retrospective...
PURPOSE: This study aimed to investigate differences in retinal blood flow leading to visual recovery in cases of macular detachment in rhegmatogenous retinal detachment (RRD). STUDY DESIGN: Observational, retrospective case series. METHODS: We studied 64 eyes diagnosed with unilateral RRD with macular detachment that underwent pars plana vitrectomy from May 2010 to July 2015 at the Department of Ophthalmology, Nagasaki University Graduate School of Biomedical Sciences. We retrospectively measured visual acuity, blood pressure, intraocular pressure, and retinal blood flow using laser speckle flowgraphy (LSFG) preoperatively and at 1, 3, 6, and 12 months postoperatively. RESULTS: LogMAR visual acuity significantly improved one month after surgery (p<0.001. Friedman test with post-hoc test Bonferroni correction). The average mean blur rate (MBR) significantly improved three months after surgery compared to before surgery (95.9±26.0%, p<0.001). A significant correlation was observed between logMAR visual acuity and MBR changes at 1 month (r=- 0.42, p=0.007), 3 months (r=- 0.46, p=0.003), 12 months (r=- 0.32, p=0.03). CONCLUSION: When vitrectomy is performed for RRD, the retina is repositioned, resulting in significant improvements in visual acuity and retinal blood flow. TRANSLATIONAL RELEVANCE: Visual acuity recovery is correlated with the recovery of retinal blood flow.
Age-stratified comparison of visual function between eyes with an enhanced monofocal intraocular lens and phakic eyes.
Hayashi K, Yoshida M, Hayashi S … +1 more , Hirata A
Jpn J Ophthalmol · 2026 May · PMID 41484527 · Publisher ↗
PURPOSE: To compare visual function between pseudophakic eyes with enhanced monofocal intraocular lenses (IOLs) and phakic eyes with clear lenses among patients in their 50s, 60s, and 70s. STUDY DESIGN: Prospective compa...
PURPOSE: To compare visual function between pseudophakic eyes with enhanced monofocal intraocular lenses (IOLs) and phakic eyes with clear lenses among patients in their 50s, 60s, and 70s. STUDY DESIGN: Prospective comparative study. METHODS: One hundred thirty-eight eyes with enhanced monofocal IOLs (enhanced monofocal group) and 117 phakic eyes with clear lenses (phakic group) among patients in their 50s-70s were enrolled. Distance-corrected visual acuity (VA) at various distances, and photopic and mesopic contrast VA were evaluated at 2 months postoperatively and compared between groups. RESULTS: In all age categories (50 s, 60 s, and 70 s), mean distance-corrected VA at the distances examined did not differ significantly between the enhanced monofocal and phakic groups. Mean contrast VA tended to be better in the enhanced monofocal group than in the phakic group. The difference was significant for photopic low contrast VA at 5% contrast in participants in their 50s (P = 0.002); mesopic contrast VA (P < 0.001) in participants in their 60s; and for photopic contrast VA at 10% and 5% contrasts and as well as mesopic contrast VA at 25% and 10% contrasts in participants in their 70s (P ≤ 0.003). CONCLUSIONS: Among patients in their 50 s, 60 s, and 70 s, the accommodative range did not differ significantly between eyes with enhanced monofocal IOL and phakic eyes with clear lenses. Contrast sensitivity was generally better in eyes with enhanced monofocal IOLs than in phakic eyes, supporting the replacement of clear lenses with enhanced monofocal IOLs in patients of these ages with certain ocular pathologies.
A deep learning-based pachychoroid index based on choroidal image patterns of central serous chorioretinopathy using enhanced-depth-imaging optical coherence tomography.
Saito M, Mitamura M, Ito Y … +3 more , Endo H, Katsuta S, Ishida S
Jpn J Ophthalmol · 2026 May · PMID 41452567 · Publisher ↗
PURPOSE: The study aimed to develop and evaluate a deep learning-based program called the Hokkaido University pachychoroid index (HUPI) from choroidal imaging patterns of enhanced-depth-imaging optical coherence tomograp...
PURPOSE: The study aimed to develop and evaluate a deep learning-based program called the Hokkaido University pachychoroid index (HUPI) from choroidal imaging patterns of enhanced-depth-imaging optical coherence tomography (EDI-OCT) in central serous chorioretinopathy (CSC), to function as the representative indicator of pachychoroid spectrum diseases. STUDY DESIGN: A single center, retrospective, observational study. METHODS: A modified LeNet was trained and validated using choroidal images (128 x 128 pixels) extracted from EDI-OCT images of representative 37 CSC and 40 normal eyes. The HUPI was then generated from the algorithm, ranging between 0 and 1 (1: the most pachychoroid-like feature). Choroidal images were used to prevent learning of SRF information. To evaluate discriminative ability, the area under the curve (AUC) of HUPI was compared to conventional choroidal indices using 69 acute CSC and 100 normal eyes. The HUPI of 69 acute CSC eyes, 35 convalescent CSC eyes, 86 fellow eyes of 104 patients diagnosed with CSC, and 100 normal eyes were calculated for comparison. RESULTS: HUPI showed a high ability to discriminate between acute CSC and normal eyes (AUC = 0.86), followed by the luminal to total choroidal area ratio (0.77), central choroidal thickness (0.76) and total choroidal area (0.75). The mean values of HUPI for normal, acute CSC, convalescent CSC, and CSC fellow eyes were 0.29±0.32, 0.77±0.28, 0.70±0.28 and 0.61±0.35, respectively. HUPI cut-off threshold was 0.66 with a sensitivity of 0.84 and a specificity of 0.77. CONCLUSIONS: HUPI, a quantitative index of imaging patterns of pachychoroid, demonstrated a high ability to discriminate pachychoroid from normal eyes.
Intravitreal aflibercept 8 mg in patients from Japan with diabetic macular edema: 48-week subgroup analysis of the PHOTON trial.
Suzuma K, Murata T, Shimura M … +16 more , Yoshida S, Kishino G, Berliner AJ, Chu KW, Reed K, Vitti R, Cheng Y, Voronca D, Bhore R, Leal S, Morgan-Warren P, Schulze A, Schmidt-Ott U, Kobayashi M, Sakamoto T, PHOTON Investigators
Jpn J Ophthalmol · 2026 Jan · PMID 41452566 · Full text
PURPOSE: In the pivotal PHOTON trial of patients with diabetic macular edema (DME), aflibercept 8 mg administered every 12 (8q12) and 16 (8q16) weeks demonstrated similar visual and anatomic outcomes with no new safety s...
PURPOSE: In the pivotal PHOTON trial of patients with diabetic macular edema (DME), aflibercept 8 mg administered every 12 (8q12) and 16 (8q16) weeks demonstrated similar visual and anatomic outcomes with no new safety signals to aflibercept 2 mg every 8 weeks (2q8). We conducted a prespecified subgroup analysis to assess the efficacy, durability, and safety of aflibercept 8 mg in the Japanese patients from PHOTON. STUDY DESIGN: Prespecified subgroup analysis of the Phase 3 PHOTON trial (NCT04429503). METHODS: Adult patients with DME were randomized 1:2:1 to receive intravitreal aflibercept 2q8, 8q12, or 8q16 following initial monthly doses. Patients randomized to 8q12 and 8q16 were eligible for dose regimen modification. The primary endpoint was change from baseline in best-corrected visual acuity (BCVA) at Week 48. Prespecified efficacy and safety outcomes at/through Week 48 are reported, segmented by Japan versus the rest of world (non-Japan). RESULTS: In the Japan and non-Japan subgroups, respectively, mean changes in BCVA were +7.0 and +9.0 (8q12), +7.4 and +7.9 (8q16), and +8.0 and +9.4 (2q8) letters at Week 48; differences in least squares means were -0.30 and -0.64 letters between 8q12 and 2q8 and +0.17 and -1.76 letters between 8q16 and 2q8; ocular treatment-emergent adverse events were reported in 32.4% and 31.6% (8q12), 35.3% and 28.8% (8q16), and 30.0% and 27.2% (2q8) of patients. CONCLUSION: Improvements in BCVA at Week 48 were generally similar with aflibercept 8 mg versus 2 mg in this subgroup analysis of Japanese and non-Japanese patients with DME, suggesting that the primary findings from PHOTON may be generalized to the Japanese population.
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