Jpn. J. Ophthalmol. [JOURNAL]
Sun
200 papers
Tomographic and biomechanical refractive findings in ocular pediatric allergy.
Tangpagasit W, Thitiwichienlert S, Hongsuraphan D
Jpn J Ophthalmol · 2026 Jan · PMID 40711502 · Full text
PURPOSE: To investigate corneal tomographic and biomechanical refractive findings in ocular pediatric allergy to identify high-risk eyes for ectasia. STUDY DESIGN: A cross-sectional study METHODS: Fifty-seven patients (5...
PURPOSE: To investigate corneal tomographic and biomechanical refractive findings in ocular pediatric allergy to identify high-risk eyes for ectasia. STUDY DESIGN: A cross-sectional study METHODS: Fifty-seven patients (5-18 years), diagnosed with allergic conjunctival disease (ACD) between July 2022 and September 2023, underwent comprehensive ocular examinations and clinical assessments. The Ocular Allergy Severity Score (OCAS Score) was calculated to assess the severity of signs and symptoms. Tomographic-based and biomechanical parameters, including Corvis Biomechanical Index (CBI), Tomographic and Biomechanical Index (TBI), Belin/Ambrósio Deviation (BAD-D), and KISA% index, with a cut-off value of 0.5, 0.79, 2.6 and 100, respectively, were employed to identify corneal ectasia. RESULTS: Among 57 patients, 54.4% were diagnosed with vernal keratoconjunctivitis, 26.3% with seasonal allergic conjunctivitis, and 19.3% with atopic keratoconjunctivitis. The itching was the most common initial ocular symptom, followed by irritation and redness. The high-risk eyes for ectasia (based on CBI, TBI, BAD-D, and KISA%) were identified in 23.7%, 19.3%, 13.2%, and 7.9%, respectively. The ectatic group (determined by TBI) exhibited significantly higher mean curvature power (Km) (46.48±3.64 vs 43.10±1.31, p<0.001) and lower central corneal thickness (525.09±42.21 vs 561.20±30.91, p<0.001). However, there was no significant difference in the severity score of signs and symptoms between ectatic and non-ectatic groups. Isoametropic amblyopia was identified in 8.8% of patients, and anisometropic amblyopia was present in 1.8%. CONCLUSION: In ocular pediatric allergy, the risk of developing corneal ectasia is unrelated to the severity of signs and symptoms. Therefore, routine tomographic and biomechanical evaluations are recommended.
Implementation of pneumatic retinopexy in the Japanese population.
Akiyama K, Matsuki T, Watanabe K … +3 more , Pecaku A, Naidu S, Muni RH
Jpn J Ophthalmol · 2026 Jan · PMID 40711501 · Full text
PURPOSE: To propose an implementation model for pneumatic retinopexy (PnR) in a region where PnR is performed infrequently, and to assess its impact on treatment of rhegmatogenous retinal detachment (RRD). STUDY DESIGN:...
PURPOSE: To propose an implementation model for pneumatic retinopexy (PnR) in a region where PnR is performed infrequently, and to assess its impact on treatment of rhegmatogenous retinal detachment (RRD). STUDY DESIGN: Retrospective case series. METHODS: We reviewed 222 consecutive eyes with primary RRD treated from July 2017 to September 2023 at a tertiary care center in Japan. The treatment methods utilized included pars plana vitrectomy (PPV), scleral buckling (SB) and PnR. The surgeon learned PnR through social media. Primary anatomic reattachment rate (PARR) and visual acuity outcomes were compared between the pre-PnR (prior to the implementation; 110 eyes) and post-PnR (after the implementation; 112 eyes) periods, as well as between PnR and PPV in the post-PnR period. PARR for PnR was also evaluated based on RRD characteristics and gas injection frequency. RESULTS: In the post-PnR period PnR was performed in 53.6% (60/112)of cases. The PARR was similar in the pre-PnR (97.3%) and post-PnR (93.8%) periods (P=.33). Visual outcomes were similar both across periods and between PnR and PPV at 3, 6 and 12 month post-operatively. The PARR for PnR was 88.3% overall, 90.5% in eyes meeting the Primary Rhegmatogenous Retinal Detachment Outcomes Randomized Trial (PIVOT) criteria, 93.3% in eyes with a single break and 100% in eyes with a single break meeting PIVOT criteria. Eyes with a single gas injection had higher PARR than eyes requiring an additional gas injection (93.5% vs. 71.4%). CONCLUSION: Remote-learning utilizing social media effectively enabled PnR implementation with favorable anatomic and functional outcomes in a real-world setting in Japan.
Six-month comparative outcomes of aflibercept and faricimab in treatment-naïve macular edema secondary to branch retinal vein occlusion.
Hikichi T, Kurabe H, Notoya A … +3 more , Oguro Y, Hirano M, Doi Y
Jpn J Ophthalmol · 2026 Jan · PMID 40694284 · Publisher ↗
PURPOSE: To compare the 6-month outcomes of aflibercept and faricimab in treatment-naïve macular edema secondary to branch retinal vein occlusion (BRVOME). STUDY DESIGN: Retrospective observational study. METHODS: The ch...
PURPOSE: To compare the 6-month outcomes of aflibercept and faricimab in treatment-naïve macular edema secondary to branch retinal vein occlusion (BRVOME). STUDY DESIGN: Retrospective observational study. METHODS: The charts of consecutive treatment-naïve eyes with BRVOME treated with intravitreal injection therapy between December 2023 and August 2024 at Hikichi Eye Clinic (Sapporo, Japan) were reviewed; all eyes treated between December 2023 and April 2024 were administrated with aflibercept and all eyes treated between May 2024 and August 2024 were administrated with faricimab. Best-corrected visual acuity (BCVA) and central foveal thickness (CFT) were assessed at baseline, 1, 3, and 6 months. Injection frequency and safety were also evaluated. RESULTS: Fifty-four eyes (29 aflibercept, 25 faricimab) were included. Both groups showed significant improvement in BCVA (from 0.39 ± 0.29 to 0.09 ± 0.23) and CFT (from 617 ± 132 to 201 ± 68 µm) over 6 months (p < 0.001). The mean number of injections was significantly lower in the faricimab group (1.96 ± 0.68) than the aflibercept group (2.45 ± 0.87; p = 0.024). No serious adverse events were reported. CONCLUSION: Faricimab achieved similar visual and anatomical outcomes to aflibercept while requiring fewer injections, suggesting a potential advantage in reducing treatment burden.
Corneal irregularity of the anterior and posterior surface in patients with limbal stem cell deficiency evaluated with anterior-segment optical coherence tomography.
Goto H, Ono T, Taketani Y … +5 more , Abe Y, Kimakura M, Toyono T, Aihara M, Miyai T
Jpn J Ophthalmol · 2025 Sep · PMID 40690095 · Full text
PURPOSE: To evaluate corneal anterior and posterior irregularities due to limbal stem cell deficiency (LSCD) based on staging using Fourier harmonic analysis with anterior segment optical coherence tomography (AS-OCT). S...
PURPOSE: To evaluate corneal anterior and posterior irregularities due to limbal stem cell deficiency (LSCD) based on staging using Fourier harmonic analysis with anterior segment optical coherence tomography (AS-OCT). STUDY DESIGN: Retrospective observational study. METHODS: Patients with LSCD and those without anterior segment disease (controls), examined using AS-OCT, were retrospectively included. Based on Fourier harmonic analysis of the central 3 mm, spherical components, regular astigmatism, asymmetry components, and higher-order irregularities of the anterior, posterior, and total corneas were compared between the groups. RESULTS: We analyzed 72 eyes of 72 patients-25 eyes of 25 patients (63.0 ± 15.8 years) with LSCD and 47 eyes of 47 patients (66.8 ± 9.5 years) in the control group. Regular astigmatism, asymmetry components, and higher-order irregularities of the anterior, posterior, and total corneas were higher in LSCD than in the control group (all P < 0.001). Based on LSCD staging, asymmetry components of the total cornea were higher in LSCD stages I, II, and III than in the controls (P = 0.034, P < 0.001, and P < 0.001, respectively). Additionally, higher-order irregularity was larger in stages II and III of LSCD than in the controls (all P < 0.001). The higher-order irregularity in LSCD significantly correlated with best-corrected visual acuity (P = 0.034). CONCLUSION: Corneal irregularities in the anterior and posterior corneas increased in patients with LSCD and contributed to best-corrected visual acuity. Even in patients at stage I, where the lesion spared the central 5 mm, an increase in asymmetric astigmatism within the central 3 mm was observed.
Minimally invasive strabismus surgery versus conventional surgical technique for inferior oblique recessions.
Dhar T, Dadeya S, Tomar V … +2 more , Sharda S, Kumari S
Jpn J Ophthalmol · 2026 Jan · PMID 40663230 · Publisher ↗
PURPOSE: Minimally invasive strabismus surgery (MISS) employs keyhole incisions to expose muscles and perform surgery. MISS has been found to yield better cosmetic outcomes after surgery involving horizontal recti. To fu...
PURPOSE: Minimally invasive strabismus surgery (MISS) employs keyhole incisions to expose muscles and perform surgery. MISS has been found to yield better cosmetic outcomes after surgery involving horizontal recti. To further these findings, our study compared MISS for inferior oblique (IO) recession with conventional approach, in terms of complications and functional outcomes. STUDY DESIGN: Prospective Interventional study METHODS: Forty adult patients with inferior oblique overaction (IOOA) were randomly divided into two groups-those undergoing recession by MISS and those by conventional technique. MISS involved making a small radial cut over IO insertion, while in the conventional group recession was done via larger conjunctival incision. Main Outcome Measures included conjunctival injection, chemosis, periorbital edema and residual IOOA recorded during the first six postoperative weeks. Patients were followed up at postoperative day 1, day 7 and 6 weeks. RESULTS: The mean age of patients was 21.17±3.43 years. The average recession performed was 9.5±0.98 mm (conventional: 9.4±1.14 mm; MISS: 9.6±0.82 mm; p>0.05). Conjunctival congestion (p<0.05) and periorbital edema (p<0.01) were significantly less in MISS than in the conventional group. There was also a significant difference in chemosis on postoperative days one and seven (p=0.00015 & 0.035 respectively). However, both groups had similar appearance at week six. No significant difference was found for final alignment and residual IOOA. CONCLUSION: This study shows that the MISS technique is feasible for inferior oblique recessions. It seems to be particularly superior in the immediate postoperative period, due to fewer conjunctival and periorbital swelling complications. Long-term results did not differ between the two groups.
Japanese clinical guidelines for neovascular age-related macular degeneration.
Iida T, Gomi F, Yasukawa T … +5 more , Yamashiro K, Honda S, Maruko I, Kataoka K, Japanese Retina and Vitreous Society Guidelines Committee for Neovascular Age-Related Macular Degeneration
Jpn J Ophthalmol · 2025 Jul · PMID 40658332 · Full text
Recent advances in imaging technology and increased options of pharmaceutical therapy require that guidelines on the diagnostic criteria and treatment of neovascular age-related macular degeneration (AMD) be updated at r...
Recent advances in imaging technology and increased options of pharmaceutical therapy require that guidelines on the diagnostic criteria and treatment of neovascular age-related macular degeneration (AMD) be updated at regular intervals. These guidelines aim to standardize the management of neovascular AMD based on the latest understanding of its pathophysiology, advancements in diagnostic imaging modalities, and treatment options. The key updates include: (1) a revision of terminology and stage classification, adopting the AMD classifications of atrophic and neovascular, and adding end-stage AMD to the existing early, intermediate, and late stages; (2) the inclusion of pachychoroid in addition to drusen in the initial pathophysiology and pathogenic background; (3) diagnostic criteria defined by the presence of macular neovascularization based on multimodal imaging, including optical coherence tomography (OCT) and OCT angiography; (4) assessment of disease activity based on OCT; and (5) treatment guidance, including prophylaxis and low vision care as well as loading and maintenance phases by use of anti-vascular endothelial growth factor therapy and adjunctive therapies. We hope that these guidelines will be useful for those working in clinical practice in Japan, in other Asian countries, and in countries outside Asia.
Reduced plasma oxytocin levels in patients with open-angle glaucoma.
Yamada Y, Sato K, Tsuda S … +8 more , Yokoyama Y, Himori N, Kiyota N, Takahashi N, Takeda Y, Yamaguchi C, Omodaka K, Nakazawa T
Jpn J Ophthalmol · 2026 Jan · PMID 40658331 · Full text
PURPOSE: We explored the role of oxytocin in glaucoma by measuring the blood levels of oxytocin in glaucoma patients, comparing them to normal control subjects, and examining its association with clinical parameters. STU...
PURPOSE: We explored the role of oxytocin in glaucoma by measuring the blood levels of oxytocin in glaucoma patients, comparing them to normal control subjects, and examining its association with clinical parameters. STUDY DESIGN: Retrospective cross-sectional study. MATERIAL AND METHODS: After obtaining informed consent from 181 glaucoma patients and 44 age-matched control participants, we collected blood samples in ethylenediaminetetraacetic acid (EDTA) tubes and centrifuged them at 2000 g for 25 minutes at 4 °C. The resulting plasma was assayed for oxytocin concentration with an Enzyme Linked Immunosorbent Assay (ELISA) kit. We compared oxytocin concentrations in the control and glaucoma groups, and within the glaucoma group, we determined whether the oxytocin levels were correlated with mean deviation (MD) and sectoral total deviation (TD). Furthermore, in 33 patients who underwent at least five visual field tests over a two-year period following oxytocin measurements and received no surgical interventions during that time, we determined whether the oxytocin levels were correlated with MD slope and sectoral TD slopes. RESULTS: Oxytocin levels in glaucoma patients were significantly lower than in age- and sex-matched normal controls (723.34 ± 303.44 vs. 557.59 ± 296.04 pg/ml, p=0.002). In glaucoma patients, oxytocin levels were significantly correlated with MD and inferior TD after adjustment for age and sex (β=0.149, p=0.041; β=0.156, p=0.034, respectively). There was a weak negative correlation between oxytocin concentration and MD slope (β=-0.334, p=0.084) and a weak negative correlation with central TD slope (β=-0.405, p=0.039), adjusted for age, sex, and history of additional eye drops. CONCLUSION: Oxytocin concentrations in glaucoma patients were significantly lower than in normal subjects and associated with the severity and progression of visual field defects. Given the wide variety of the pharmacological actions of oxytocin, it may be involved in the pathogenesis of glaucoma. Our results suggest that plasma oxytocin measurements may open a new avenue for glaucoma care.
Correction to: Retinal displacement using optical coherence tomography angiography and metamorphopsia in eyes undergoing macular hole surgery.
Tsukahara S, Takeyama A, Ishida M
Jpn J Ophthalmol · 2025 Sep · PMID 40637953 · Full text
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Loading phase outcomes of intravitreal aflibercept 8 mg for treatment-naïve neovascular age-related macular degeneration.
Matsumoto H, Hoshino J, Numaga S … +2 more , Asatori Y, Akiyama H
Jpn J Ophthalmol · 2025 Nov · PMID 40637952 · Publisher ↗
PURPOSE: To investigate the efficacy and safety of loading phase treatment with 3 monthly intravitreal injections of aflibercept 8 mg for neovascular age-related macular degeneration (nAMD). STUDY DESIGN: Retrospective,...
PURPOSE: To investigate the efficacy and safety of loading phase treatment with 3 monthly intravitreal injections of aflibercept 8 mg for neovascular age-related macular degeneration (nAMD). STUDY DESIGN: Retrospective, interventional case series. METHODS: We retrospectively analyzed 83 consecutive eyes of 80 patients with treatment-naïve nAMD who received 3 monthly injections of aflibercept 8 mg as a loading phase treatment. Best-corrected visual acuity (BCVA), foveal thickness, central choroidal thickness (CCT), and dry macula achievement were all assessed every 4 weeks. Moreover, polypoidal lesion regression was evaluated after the loading phase. RESULTS: Seventy eyes (84.3%) of 67 patients completed the 3 monthly injections of aflibercept 8 mg. In these cases, BCVA was 0.33±0.45 at baseline and showed significant improvement to 0.22±0.38 at week 12 (P<0.01). Foveal thickness was 313±135µm at baseline, decreasing significantly to 171±76µm at week 12 (P<0.01). CCT was 193±98µm at baseline, decreasing significantly to 160±85µm at week 12 (P<0.01). Dry macula had been achieved in 58 (82.9%) of 70 eyes at week 12. Indocyanine green angiography after the loading phase revealed complete polypoidal lesion regression in 16 of 22 eyes (72.7%) with polypoidal lesions. Among the 13 eyes (15.7%) not completing the loading phase treatment, 9 (10.8%) developed non-infectious intraocular inflammation (IOI) associated with retinal vasculitis and aflibercept 8 mg administration was thus discontinued. CONCLUSIONS: Loading phase treatment with intravitreal aflibercept 8 mg appears to be effective for improving visual acuity and ameliorating exudative changes in eyes with nAMD. However, careful monitoring is required due to the potential development of IOI associated with retinal vasculitis.
Age-related difference in the presbyopia-correcting effect of trifocal and enhanced monofocal intraocular lenses.
Hayashi K, Uno K, Hayashi S … +1 more , Yoshida M
Jpn J Ophthalmol · 2026 Jan · PMID 40632441 · Publisher ↗
PURPOSE: To compare visual outcomes among three age groups in eyes with a trifocal (Alcon PanOptix) or enhanced monofocal intraocular lens (IOLs; Johnson & Johnson Eyhance). STUDY DESIGN: Nonrandomized comparative study....
PURPOSE: To compare visual outcomes among three age groups in eyes with a trifocal (Alcon PanOptix) or enhanced monofocal intraocular lens (IOLs; Johnson & Johnson Eyhance). STUDY DESIGN: Nonrandomized comparative study. METHODS: Seventy-eight eyes of 78 patients who received a trifocal IOL (trifocal category) and 78 eyes of 78 patients who received an enhanced monofocal IOL (enhanced monofocal category) were enrolled. Patients were stratified by age decade (n=26/group): 40-59 years of age (40s & 50s), 60-69 years of age (60s), and 70-79 years of age (70s). Uncorrected and distance-corrected visual acuity (VA) at various distances and photopic and mesopic contrast VA were examined at 3 months postoperatively and compared among age groups. RESULTS: No significant differences in the mean uncorrected and distance-corrected VAs were detected at nearly all distances among the three age groups for either the trifocal or enhanced monofocal category. Mean photopic contrast VA was significantly different among the three age groups at 100% contrast for the trifocal category (P=0.018) and at 25%, 10%, 5%, and 2.5% contrasts in the enhanced monofocal category (P≤0.005); it was significantly better in the 40s & 50s age group than in the 60s or 70s age group (P≤0.002). CONCLUSION: All-distance VA in eyes with a trifocal IOL and an enhanced monofocal IOL was essentially comparable among patients 40-79 years of age although contrast sensitivity was significantly worse in older patients, suggesting that these IOLs can be implanted irrespective of patient age with careful consideration of the age-dependent decline in contrast sensitivity.
In vivo characterization of morphologic changes in the lens during accommodation as a function of age by use of OCT with swept-source technology.
Cantó-Cerdán M, Siverio-Colomina A, Yébana-Rubio P … +3 more , García-Corral MJ, Cervera-Sánchez Z, Martínez-Abad A
Jpn J Ophthalmol · 2025 Nov · PMID 40622459 · Publisher ↗
PURPOSE: To characterize the in vivo morphologic and biometric changes in the lens during accommodation as a function of age by use of swept-source OCT technology STUDY DESIGN: Observational, prospective study METHODS: C...
PURPOSE: To characterize the in vivo morphologic and biometric changes in the lens during accommodation as a function of age by use of swept-source OCT technology STUDY DESIGN: Observational, prospective study METHODS: Complete optometric and ophthalmologic examinations were performed on all the patients to determine their eligibility for inclusion in the study. The examinations included anterior segment measurements obtained using swept-source OCT. Morphologic parameters of the lens were analysed under accommodative stimuli of 0, -1, -2, -3, and -6 D. A second measurement was taken 10 minutes after the first. RESULTS: Three hundred eyes of 300 patients were enrolled in the study. Structural changes in the lens were observed, specifically in the anterior and posterior radii, which decreased with accommodation, and the total thickness of the lens, which increased. In patients aged younger than 40 years, significant changes were found in the curvature radius and lens thickness during accommodation. In patients aged older than 40 years, these changes began to diminish. Significant differences between stimuli (P <.05) were observed in all the groups, demonstrating lens variation during accommodation and its dependence on age. Repeatability analysis showed an intraclass correlation coefficient of >0.700 for all the parameters. CONCLUSIONS: During accommodation, the anterior and posterior curvatures of the lens decrease, while its thickness increases. Age-related differences remained significant, indicating persistent changes over time. Swept-source OCT demonstrated high repeatability, particularly for anterior curvature, thickness, and tilt, even under accommodation.
Accuracy of no-history formulae for intraocular lens power calculation in post-myopic laser vision correction eyes: a multicenter study in Japan.
Goto S, Mori Y, Torii H … +5 more , Hasegawa Y, Kojima T, Kamiya K, Shiba T, Miyata K
Jpn J Ophthalmol · 2025 Sep · PMID 40622458 · Publisher ↗
PURPOSE: To compare the refractive prediction accuracy of seven no-history intraocular lens (IOL) power calculation formulas in post-myopic laser vision correction (M-LVC) eyes in Japanese patients. STUDY DESIGN: Multice...
PURPOSE: To compare the refractive prediction accuracy of seven no-history intraocular lens (IOL) power calculation formulas in post-myopic laser vision correction (M-LVC) eyes in Japanese patients. STUDY DESIGN: Multicenter retrospective case series. METHODS: This study included patients with previous M-LVC who underwent cataract surgery between 2016 and 2023. IOL power calculation formulas were assessed using measurements from a swept-source optical coherence biometer. Refractive prediction errors were calculated for the Emmetropia Verifying Optical 2.0 (EVO 2.0), Post Myopic LASIK/PRK Hoffer QST (Hoffer QST), and Post-M-LVC PEARL-DGS (PEARL-DGS) formulas. These results were compared with those obtained from the Barrett True-K No History (BTKNH), Haigis-L, Shammas, and ASCRS average formulas. Heteroscedastic testing for root mean square absolute error (RMSAE) was used to evaluate formula performance. RESULTS: The study comprised 125 post-LASIK eyes from 89 patients. Only the BTKNH had mean numerical errors not significantly different from zero. The formulas were ranked by absolute prediction error (MAE): ASCRS average (0.42 D), BTKNH (0.43 D), Hoffer QST (0.46 D), Pearl-DGS and Shammas (0.46 D), EVO 2.0 (0.48 D), and Haigis-L (0.51 D). The BTKNH and ASCRS average demonstrated smaller RMSAE compared to Shammas (P < .0001). The Hoffer QST had a smaller RMSAE than Pearl-DGS (P = 0.02). CONCLUSION: The BTKNH, ASCRS average, and Hoffer QST formulas are precise and reliable for improving postoperative refractive outcomes in Japanese patients with a history of M-LVC.
Optic nerve MRI findings in Leber's hereditary optic neuropathy.
Takai Y, Yamagami A, Iwasa M … +4 more , Inoue K, Yasumoto R, Ishikawa H, Wakakura M
Jpn J Ophthalmol · 2026 Jan · PMID 40601176 · Publisher ↗
PURPOSE: This study aimed to investigate the characteristics of magnetic resonance imaging (MRI) of lesions in Lebers hereditary optic neuropathy (LHON). STUDY DESIGN: Retrospective study. METHODS: We examined the clinic...
PURPOSE: This study aimed to investigate the characteristics of magnetic resonance imaging (MRI) of lesions in Lebers hereditary optic neuropathy (LHON). STUDY DESIGN: Retrospective study. METHODS: We examined the clinical characteristics and MRI scans of lesion locations in 34 LHON cases (68 eyes) with m.11778G>A mutation, examined within six months of onset who had detailed MRI imaging records available. RESULTS: The median age was 36.5 (range: 10-75) years, with 26 male cases. MRI lesions were observed in 15 cases, with the following distribution: isolated intraorbital lesions in 7 cases, intraorbital + optic canal lesions in 1 case, intraorbital + optic canal + intracranial lesions in 1 case, optic canal + intracranial lesions in 1 case, optic canal + intracranial + chiasmal lesions in 1 case, intracranial + chiasmal lesions in 3 cases, and chiasmal + optic tract lesions in 1 case. There were no significant differences in clinical characteristics between patients with and without MRI lesions. Cases with chiasmal lesions tended to be younger (chiasmal lesion group [n=5] vs. non-chiasmal lesion group [n=29]: median age 25 [range: 11-30] years vs. 44 [range: 10-75] years, p=0.02, Mann-Whitney U test), although there were no significant differences in sex or time to MRI imaging. CONCLUSION: MRI lesions can extend from the intraorbital optic nerve to the chiasm and tract. Consistent with previous reports, chiasmal involvement was frequently observed and was more prevalent in younger patients. Recognition of these characteristic MRI and clinical findings is crucial in the differential diagnosis of subacute progressive optic neuropathy.
Neuroprotective effect of ripasudil on retinal ganglion cells via an antioxidative mechanism.
Yamagishi-Kimura R, Honjo M, Aihara M
Jpn J Ophthalmol · 2025 Sep · PMID 40601175 · Full text
PURPOSE: To evaluate the neuroprotective effect of ripasudil, a rho-kinase inhibitor that is a commercially available glaucoma medication that lowers intraocular pressure. We explored the effects of ripasudil on retinal...
PURPOSE: To evaluate the neuroprotective effect of ripasudil, a rho-kinase inhibitor that is a commercially available glaucoma medication that lowers intraocular pressure. We explored the effects of ripasudil on retinal damage via oxidative stress (OS) in primary rat retinal ganglion cell (RGC) cultures and NMDA-induced retinal damage in mice. STUDY DESIGN: Experimental investigation METHODS: Primary rat RGCs were isolated via a 2-step immunopanning method and cultured under normal cultivation conditions for 72 h and for a further 24 h in antioxidant-free medium for OS. We measured the number of living RGCs by use of calcein-AM and calpain activity via calpain immunoreactivity assays. Furthermore, we evaluated the effects of ripasudil via RGC counting in retinal flat-mounts from Thy1-CFP mice, retinal thickness via optical coherence tomography, and reduced glutathione levels via GSSG/GSH assays in NMDA-induced retinal damage. RESULTS: The living RGC counts of normal, OS, 0.1, 1, 10, and 100 uM ripasudil under OS were 236.0 ± 21.6, 155.0 ± 13.2, 155.9 ± 17.1, 158.9 ± 12.0, 184.8 ± 26.9, and 201.1 ± 24.8 cells, respectively. 10 or 100 uM ripasudil significantly inhibited the OS-induced RGC reduction (P < 0.05 or 0.01). Furthermore, the enhanced calpain activity induced by OS was suppressed by 100 uM ripasudil (P < 0.05). In an in vivo study, the RGC counts in the NMDA-treated group were lower than those of the non-NMDA-treated group. NMDA-induced RGC loss was significantly suppressed by ripasudil (P < 0.01). Retinal thinning after 3 weeks of NMDA injection was also inhibited by ripasudil (P < 0.01 or 0.05). Furthermore, NMDA increased the glutathione level, whereas ripasudil suppressed it (P < 0.05). CONCLUSIONS: Ripasudil may have neuroprotective effects via an antioxidative mechanism, which could be useful as an intraocular pressure-independent additive.
The role of SIX6 gene in juvenile open-angle glaucoma: a subtle contributor to the mutational landscape.
Yadav M, Sachdeva S, Yadav A … +8 more , Bhardwaj A, Panghal V, Kumari A, Yadav R, Kumar R, Singh M, Sharma S, Tanwar M
Jpn J Ophthalmol · 2025 Nov · PMID 40576883 · Publisher ↗
PURPOSE: Juvenile onset open-angle glaucoma (JOAG) typically affects individuals under 40 years of age, causing a rise in intraocular pressure that results in considerable damage to the optic nerve. To expand the spectru...
PURPOSE: Juvenile onset open-angle glaucoma (JOAG) typically affects individuals under 40 years of age, causing a rise in intraocular pressure that results in considerable damage to the optic nerve. To expand the spectrum of mutations linked to JOAG and explore their structural consequences, we examined the genetic alterations within the SIX6 gene. STUDY DESIGN: We focused on assessing the whole coding region of the SIX6 gene and the clinical significance of the common SIX6 gene single nucleotide polymorphisms (SNP) rs10483727 and rs33912345, specifically analyzing its association with key clinical factors, including intraocular pressure (IOP), visual acuity, and the vertical cup-to-disc ratio (VCDR). METHOD: The study included 111 unrelated patients with confirmed JOAG and 100 healthy adult controls without any ocular or systemic conditions. The patients initially underwent genetic screening for pathogenic variants in the CYP1B1, MYOC, and OPTN genes. Individuals who tested negative for pathogenic variants in these three genes (n=81) were subsequently screened for variants in the SIX6 gene while all 111 patients and 100 control samples were screened for SNPs to strengthen the statistical correlation. Identified sequence variations were searched in the ClinVar databases, HGMD, and dbSNP. Six different online available algorithms including REVEL, SIFT, CADD, Mutation Taster, IMutant2.0, and MetaLR were used for the pathogenicity prediction of missense variations. The Structural consequences of detected possible pathogenic variations were predicted by using PyMol, Chimera and molecular dynamics (MD) simulation of these changes. Statistical analyses assessed the association of rs33912345 with disease phenotypes. RESULTS: Sanger sequencing identified seven nucleotide variants in the SIX6 gene, including five missense and two synonymous variants. Two missense variants, p.(A99G) and p.(S156R), were predicted to be pathogenic. The novel variant p.(A99G) was absent in controls and demonstrated significant structural disruption, with altered intramolecular interactions and steric clashes. Homology analysis revealed high evolutionary conservation at the mutated positions, highlighting their functional significance. MD simulations confirmed altered stability in the mutant proteins. Logistic regression linked rs33912345 to JOAG, with significant associations observed for IOP (p = 0.01538), and VCDR (p = 0.019). CONCLUSION: This study identified novel and known pathogenic variants in the SIX6 gene that may contribute to JOAG pathogenesis. Structural and functional analyses suggest that these mutations disrupt protein function. The findings enhance our understanding of JOAG genetics and may aid in early diagnosis and therapeutic targeting.
Short‑term outcomes of switching to faricimab for macular edema secondary to retinal vein occlusion.
Hikichi T, Kurabe H, Notoya A … +3 more , Oguro Y, Hirano M, Doi Y
Jpn J Ophthalmol · 2025 Nov · PMID 40576882 · Publisher ↗
PURPOSE: This study evaluated the anatomical and functional outcomes in patients with macular edema (ME) secondary to retinal vein occlusion (RVO) who were switched from conventional anti-vascular endothelial growth fact...
PURPOSE: This study evaluated the anatomical and functional outcomes in patients with macular edema (ME) secondary to retinal vein occlusion (RVO) who were switched from conventional anti-vascular endothelial growth factor (VEGF) agents to faricimab. STUDY DESIGN: Retrospective observational study. METHODS: This study included 42 eyes from 42 patients treated at Hikichi Eye Clinic between April and August 2024. All patients had relapsed ME despite prior treatment with aflibercept and were switched to intravitreal faricimab (6.0 mg). The primary endpoints included best-corrected visual acuity (BCVA), central foveal thickness (CFT), and intravitreal injection intervals over six months. RESULTS: The mean (± standard error) CFT significantly decreased from 356 ± 23 μm to 214 ± 3 μm at one month (p < 0.01) and remained stable at the final visit (205 ± 4 μm). Logarithm of the minimum angle of resolution (logMAR) BCVA improved from 0.16 ± 0.03 to 0.04 ± 0.03 at one month (p < 0.01) and remained at 0.02 ± 0.02 at the final visit. The mean injection interval was significantly extended from 12.3 ± 0.4 weeks to 16.2 ± 0.5 weeks (p < 0.01). CONCLUSION: Faricimab improved anatomical and functional outcomes while extending treatment intervals in ME secondary to RVO. Further large-scale, prospective, and long-term follow-up studies are needed to confirm these findings.
Comparison of intraocular pressure elevation following intravitreal injection of 70 µl aflibercept 8 mg.
Lu X, Kataoka K, Kumagai M … +4 more , Nochi Y, Yamamoto A, Ko R, Okada AA
Jpn J Ophthalmol · 2025 Nov · PMID 40569499 · Publisher ↗
PURPOSE: To assess the effect of increased injection volume on intraocular pressure (IOP) following intravitreal injections of aflibercept 8 mg (70 µl) compared to conventional anti-vascular endothelial growth factor dru...
PURPOSE: To assess the effect of increased injection volume on intraocular pressure (IOP) following intravitreal injections of aflibercept 8 mg (70 µl) compared to conventional anti-vascular endothelial growth factor drugs. STUDY DESIGN: Retrospective observational study METHODS: This retrospective observational study included eyes treated with 50 µl of either aflibercept 2 mg or faricimab 6 mg, followed by a switch to 70 µl of aflibercept 8 mg. IOP was measured before and 30 minutes after intravitreal injections. IOP changes in treated and fellow eyes were analyzed, with potential associations examined between IOP changes and clinical parameters. RESULTS: A total of 88 eyes from 85 patients were switched to aflibercept 8 mg during the study period. Due to incomplete data, 17 eyes from 15 patients were excluded, leaving 71 eyes from 70 patients for the analysis. IOP significantly increased from 13.2 ± 2.9 mmHg to 19.1± 5.4 mmHg (P< 0.001) with 50 µl injections and from 13.3 ± 2.9 mmHg to 19.8 ± 4.8 mmHg (P<0.001) with 70 µl injections. The IOP increases were 6.0 ± 5.0 mmHg with 50 µl injections and 6.5 ± 4.3 mmHg with 70 µl injections, with no statistically significant difference (P = 0.20). An IOP exceeding 26 mmHg was observed in 6 eyes treated with 50 µl injections and 10 eyes with 70 µl injections, with no significant difference in IOP distribution between the volumes (P = 0.20). CONCLUSION: There was no additional increase in IOP 30 minutes after intravitreal injections when switching from 50 µl to 70 µl volumes.
Outcomes of a randomised trial comparing 360° and 180° schlemm's canal incisions in suture trabeculotomy ab interno for primary open-angle glaucoma and exfoliation glaucoma: a 5-year analysis.
Sato T, Kawaji T
Jpn J Ophthalmol · 2025 Nov · PMID 40553388 · Publisher ↗
PURPOSE: We aimed to report the 5-year efficacy and safety data of suture trabeculotomy ab interno (SLOT ab interno) in patients with primary open-angle glaucoma and exfoliation glaucoma. STUDY DESIGN: Single-centre, thr...
PURPOSE: We aimed to report the 5-year efficacy and safety data of suture trabeculotomy ab interno (SLOT ab interno) in patients with primary open-angle glaucoma and exfoliation glaucoma. STUDY DESIGN: Single-centre, three-arm randomised trial. METHODS: Ninety-nine eyes of 99 patients were randomly assigned to one of three groups: the 360° (n = 34), upper-180° (n = 34), and lower-180° (n = 31) groups. We evaluated intraocular pressure (IOP), medication use, and visual field progression. Surgical success (with or without medication) was defined as IOP ≤21 mmHg with a ≥20% reduction (criterion A) or IOP ≤15 mmHg with a ≥ 20% reduction (criterion B). Visual field progression was assessed by MD values at fixed postoperative time points and by the MD slope (dB/year). RESULTS: Fifty-six of 99 eyes (56.5%) completed 5 years of follow-up. At 5 years, the mean IOP decreased from 18.8 ± 5.7 to 13.5 ± 3.1 mmHg (28% reduction, p<0.001), with medication use decreasing from 3.3 ± 1.1 to 2.0 ± 1.7 (p=0.005) and a mean MD slope of -0.2 dB/year. No significant differences in surgical success rates (criteria A and B), MD values, or MD slopes were observed among the groups. CONCLUSION: The extent of Schlemm's canal incisions (360°, upper-180°, or lower-180°) during SLOT ab interno has no significant effect on IOP reduction or medication use over 5 years.
A single center experience of intraocular pressure control with glaucoma drainage device use in pediatric and adult patients.
Garmany A, Jamali Dogahe S, Knier K … +4 more , Kung F, Sargent J, Hodge D, Khanna C
Jpn J Ophthalmol · 2025 Jul · PMID 40542982 · Full text
PURPOSE: This retrospective cohort compared the cumulative probability of success for glaucoma drainage device (GDD) implantation in pediatric and adult patients. STUDY DESIGN: This retrospective study enrolled adult and...
PURPOSE: This retrospective cohort compared the cumulative probability of success for glaucoma drainage device (GDD) implantation in pediatric and adult patients. STUDY DESIGN: This retrospective study enrolled adult and pediatric patients who had received a GDD between January 1, 1985 and December 31, 2017. METHODS: Kaplan-Meier method was used to estimate the cumulative probability of success in the pediatric and adult patients. Successful intraocular pressure (IOP) control was defined as (i) a 20% reduction from baseline and (ii) IOP>6 and <18. Inadequate IOP control and failure were defined as a violation of these two criteria over two consecutive visits. Cox proportional hazards models enabled assessing the influence of sex, GDD location, and GDD type on IOP control. RESULTS: A total of 425 adult eyes from 372 individuals and 41 pediatric eyes from 28 individuals were included. The median follow-up time was 55 months for adults and 87 months for children. Superior temporal GDD placement was most employed for both (p=0.16). Adults were more likely to receive a Baerveldt 350 (p=0.04) and children were more likely to receive an Ahmed S2 (p<0.001). Adults and children had a median survival time of 2.99 and 0.82, respectively, and did not have a statistically significant difference in GDD failure rate (p=0.18). Additionally, sex, GDD location, and GDD type did not affect the success rate. CONCLUSIONS: Children and adults had a similar cumulative probability of success following GDD implantation. This study found that GDD type, GDD location, and glaucoma type did not influence the probability of successful IOP control.
Development of a reliability criterion for the binocular Esterman visual field test.
Hirasawa K, Nagayama-Ito A, Maruta-Akaishizawa C … +1 more , Shoji N
Jpn J Ophthalmol · 2025 Nov · PMID 40542981 · Publisher ↗
PURPOSE: To evaluate the repeatability of the binocular Esterman visual field (bEVF) test and develop a corresponding reliability criterion based on repeatability-associated factors. STUDY DESIGN: Prospective cross-secti...
PURPOSE: To evaluate the repeatability of the binocular Esterman visual field (bEVF) test and develop a corresponding reliability criterion based on repeatability-associated factors. STUDY DESIGN: Prospective cross-sectional study. METHODS: Ninety-five glaucoma patients underwent two bEVF tests on the same day using a Humphrey field analyzer. The repeatability of the bEVF was assessed by the agreement rate for seen and unseen points over all test points between the first and second tests. Factors associated with the repeatability were analyzed with multivariate linear regression analysis. Receiver operating characteristic (ROC) curve analysis was performed for those associated factors to identify the reliability criterion. RESULTS: The mean agreement rate was 88.9% (95% confidence interval [CI]: 73.9%, 99.2%). A total of 44 patients (46.3%), 75 patients (78.9%), and 88 patients (92.6%) had agreement rates of more than 90%, 85%, and 80%, respectively. The false positive (FP) response rate of the bEVF test was negatively associated with the agreement rate (p<0.01). The best cutoff value according to the maximum Youden index for the FP response rate of the bEVF test was >7.1% (sensitivity = 71.0% and specificity = 88.0%), while the cutoff value based on a fixed 95% specificity was >12.1% (sensitivity = 28.6%). CONCLUSION: An approximately 90% agreement rate existed for the bEVF test when applied to glaucoma patients. The FP response rate was associated with the repeatability of the bEVF test, and 8% or at least 13% may serve as a useful reference to ensure an agreement rate of 80% or higher.
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