Jpn. J. Ophthalmol. [JOURNAL]
Sun
200 papers
Correction: Clinical practice guideline for anterior segment dysgenesis.
Research on rare and intractable diseases, Health, Labour and Welfare Sciences Research Grants Clinical Practice Guideline Development Committee for Anterior segment dysgenesis of the “Research group on establishing standardized diagnosis and treatment of Intractable corneal diseases”
Jpn J Ophthalmol · 2026 Jul · PMID 42397668 · Publisher ↗
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Association between subjective symptoms and severity in patients with Fuchs endothelial corneal dystrophy.
Koizumi Y, Oie Y, Maeno S … +19 more , Nishida N, Kai C, Kamuro R, Miyata K, Yokogawa H, Mori N, Kobayashi A, Fukuoka H, Sotozono C, Yamada M, Hayashi T, Yamaguchi T, Shiraishi A, Nakatani S, Yamaguchi M, Usui T, Hirayama M, Kawasaki R, Nishida K
Jpn J Ophthalmol · 2026 Jul · PMID 42397667 · Publisher ↗
PURPOSE: To investigate the association between subjective symptoms and severity in patients with Fuchs endothelial corneal dystrophy (FECD). STUDY DESIGN: Observational case series. METHODS: This study included patients...
PURPOSE: To investigate the association between subjective symptoms and severity in patients with Fuchs endothelial corneal dystrophy (FECD). STUDY DESIGN: Observational case series. METHODS: This study included patients with FECD registered in the Japanese National FECD registry with recorded subjective symptoms, including morning blur, ocular pain, visual disturbance, and glare. Severity assessments included central corneal thickness (CCT) and modified Krachmer grading using the more severely affected eye with greater CCT for each patient. The area under the curve (AUC) was used to evaluate the predictive ability of subjective symptoms based on disease severity. RESULTS: This study included 137 cases (mean age: 69±11 years; men, n=32) with subjective symptom records. The threshold values of CCT for predicting subjective symptoms based on the Youden index were 623 µm for morning blur compared to that at night (AUC, 0.76), 653 µm for ocular pain (AUC, 0.79), 623 µm for visual disturbance (AUC, 0.69), and 581 µm for glare (AUC, 0.60). The threshold values of the modified Krachmer grading for predicting subjective symptoms were grade 5 for morning blur compared to that at night (AUC, 0.85), and grade 6 for ocular pain (AUC, 0.79), grade 5 for visual disturbance (AUC, 0.72), and grade 4 for glare (AUC, 0.70). CONCLUSION: The predictive ability of subjective symptoms based on disease severity in patients with FECD was relatively high using the modified Krachmer grading. The severity threshold for each subjective symptom was considered helpful in deciding on interventional treatment.
Prevalence and clinical characteristics of Terson syndrome among survivors of aneurysmal subarachnoid hemorrhage: a nationwide study in Japan.
Tanaka T, Miyamoto Y, Aso S … +3 more , Matsuo Y, Fushimi K, Yasunaga H
Jpn J Ophthalmol · 2026 Jul · PMID 42397666 · Publisher ↗
PURPOSE: To investigate the characteristics of Terson syndrome (TS) among survivors of aneurysmal subarachnoid hemorrhage (aSAH). STUDY DESIGN: Retrospective study METHODS: Using the Japanese Diagnosis Procedure Combinat...
PURPOSE: To investigate the characteristics of Terson syndrome (TS) among survivors of aneurysmal subarachnoid hemorrhage (aSAH). STUDY DESIGN: Retrospective study METHODS: Using the Japanese Diagnosis Procedure Combination database, we identified patients diagnosed with aSAH at admission between July 1, 2010 and March 31, 2023 in Japan. The prevalence of TS in aSAH survivors was examined, along with comparisons of patient backgrounds between survivors with TS and those without TS. We compared the characteristics and outcomes in patients with TS who underwent vitrectomy with those in patients who did not, and analyzed the laterality of the surgery. RESULTS: Among 143,058 patients with aSAH, 104,576 (73.1%) survived. TS was diagnosed in 860 (0.8%) survivors. The patients with TS were younger (mean [standard deviation, SD] age: 53.3 [11.4] vs 64.0 [14.6] years) than those without TS. Among the patients with TS, 243 (28.3%) patients underwent vitrectomy during hospitalization, with a median interval of 38 days from admission to surgery. Of the patients with TS who underwent vitrectomy, 160 (66.4%) and 81 (33.6%) patients underwent unilateral and bilateral vitrectomy, respectively. CONCLUSION: In this retrospective study, the prevalence of TS among aSAH survivors was less than 1%. Vitrectomy was performed in approximately one-third of the patients with TS, with one-third of these patients undergoing bilateral surgery during hospitalization.
Epidemiology and treatment trends of retinopathy of prematurity: a multi-center study involving four Asian centers and one European center (2016-2023).
Tseng YH, Padhi TR, Bhunia S … +16 more , Seshasai S, Tsai AS, Tan GS, Visruthan NK, Lai CHY, Hui TYG, Yiu RS, Teixeira SMP, da Costa TR, Wu PL, Kang EY, Chen KJ, Wang NK, Hwang YS, Lai CC, Wu WC
Jpn J Ophthalmol · 2026 Jul · PMID 42397665 · Publisher ↗
PURPOSE: To investigate regional differences in the epidemiology and treatment of retinopathy of prematurity (ROP) from 2016 to 2023. STUDY DESIGN: Retrospective multicenter cohort study METHODS: Premature infants screen...
PURPOSE: To investigate regional differences in the epidemiology and treatment of retinopathy of prematurity (ROP) from 2016 to 2023. STUDY DESIGN: Retrospective multicenter cohort study METHODS: Premature infants screened for ROP at a single tertiary referral center in each of five countries/regions (Taiwan, Hong Kong, Singapore, India, and Portugal) during the study period. Demographic characteristics, incidences of ROP and type 1 ROP, and treatment modalities were analyzed. Screening criteria followed local protocols. Logistic regression was used to assess trends, and intergroup comparisons were performed using Kruskal-Wallis and chi-square tests. RESULTS: A total of 15,031 premature infants were enrolled. Demographics varied significantly (p <0.001); India had the highest gestational age and birth weight, and the lowest proportion of very low birth weight and extremely low birth weight infants with type 1 ROP (p <0.001). Hong Kong had the lowest ROP incidence, while Singapore showed a significant increase over time (p = 0.003). Type 1 ROP rates were higher in Taiwan and India than in Hong Kong and Singapore, with a significant decline observed only in Taiwan (p = 0.005). Anti-Vascular Endothelial Growth Factor (Anti-VEGF) injections were increasingly preferred as initial treatment, with bevacizumab being the most frequently used (87.3%). CONCLUSION: From 2016 to 2023, ROP incidence and treatment showed significant regional differences. ROP increased in Singapore, while type 1 ROP decreased significantly in Taiwan. Although anti-VEGF therapy has become more common, laser treatment remains dominant in Hong Kong.
Clinical characteristics of angioid streaks in Japanese patients.
Maruko R, Maruko I, Hashiya N … +1 more , Hasegawa T
Jpn J Ophthalmol · 2026 Jul · PMID 42397664 · Publisher ↗
PURPOSE: To characterize fundus findings and the presence of pseudoxanthoma elasticum (PXE) in Japanese patients with angioid streaks (AS). STUDY DESIGN: Retrospective, single-center observational study. METHODS: This re...
PURPOSE: To characterize fundus findings and the presence of pseudoxanthoma elasticum (PXE) in Japanese patients with angioid streaks (AS). STUDY DESIGN: Retrospective, single-center observational study. METHODS: This retrospective study included 33 patients (66 eyes) diagnosed with AS who underwent color fundus photography, optical coherence tomography, and fundus autofluorescence. The presence of PXE, peau d'orange, choroidal neovascularization (CNV), macular atrophy, comet tail lesions, pattern dystrophy-like changes, subretinal drusenoid deposits (SDD), outer retinal tubulation (ORT), and optic nerve head drusen were evaluated. RESULTS: PXE was diagnosed in 15 of 33 patients (45.5%), whereas peau d'orange was observed in 36 eyes (54.5%). There were no significant differences in the prevalence of peau d'orange (P=1.00) or comet tail lesions (P=0.70) between patients with and without clinical PXE diagnosis. CNV and macular atrophy were each present in 31 eyes (47.0%). Comet tail lesions, pattern dystrophy-like changes, SDD, and ORT were found in 17 (25.8%), 21 (31.8%), 6 (9.1%), and 13 (19.7%) eyes, respectively; optic nerve head drusen were not detected. Most pattern dystrophy-like changes (81.0%), SDD (83.3%), and ORT (92.3%) were associated with CNV. CONCLUSION: Japanese patients with AS showed a high frequency of CNV, which is often accompanied by macular atrophy and photoreceptor-related structural changes. Furthermore, the prevalence of peau d'orange was higher than of clinically diagnosed PXE, suggesting possible underdiagnosis of PXE in this cohort.
Preoperative risk factors for uncontrolled intraocular pressure after vitrectomy combined with intrascleral fixation of the intraocular lens.
Suzue M, Sakimoto S, Kanai M … +9 more , Shiraki A, Shiraki N, Goto S, Maruyama K, Usui S, Sakaguchi H, Matsushita K, Maeno T, Nishida K
Jpn J Ophthalmol · 2026 Jul · PMID 42397663 · Publisher ↗
PURPOSE: To evaluate the factors affecting uncontrolled intraocular pressure (IOP) in eyes with crystalline lens, intraocular lens (IOL) dislocation, or aphakia after pars plana vitrectomy (PPV) combined with the flanged...
PURPOSE: To evaluate the factors affecting uncontrolled intraocular pressure (IOP) in eyes with crystalline lens, intraocular lens (IOL) dislocation, or aphakia after pars plana vitrectomy (PPV) combined with the flanged intrascleral IOL fixation technique (ISF) (PPV-ISF), and to examine the risk of high IOP or glaucoma surgery after PPV-ISF. STUDY DESIGN: Retrospective observational cohort study METHODS: This study investigated 100 eyes (97 patients) who underwent PPV-ISF at Osaka University Graduate School of Medicine between July 2020 and June 2022. We evaluated the association of the outcomes of postoperative IOP control with preoperative and postoperative factors. Uncontrolled IOP was defined as an increase in glaucoma eye-drop use or necessity of glaucoma surgery. RESULTS: The mean patient age was 67.9 ± 16.1 years. Among 100 eyes, 13 (13%) were diagnosed with exfoliation syndrome (XFS). Age and XFS were associated with preoperative ocular hypertension (P = .03, P = .005). After PPV-ISF, the use of eye drops was increased in 25 patients, and 10 eyes (10%) underwent glaucoma surgery. In the multiple logistic regression analysis, the odds ratios for uncontrolled IOP in XFS, previous glaucoma surgery, and previous vitrectomy surgery were 5.67 (P = .001), 8.98 (P = .004), and 1.43 (P = .508), respectively. CONCLUSION: XFS and history of glaucoma surgery are associated with poor IOP control after PPV-ISF surgery.
Utility of liquid-based cytology and cell block obtained by vitrectomy under infusion to diagnose vitreoretinal lymphoma.
Ohe R, Oyanagi S, Inamura E … +8 more , Kitaoka T, Kabasawa T, Suzuki K, Uchiyama N, Shida A, Suzuki T, Togashi K, Kaneko Y
Jpn J Ophthalmol · 2026 Jun · PMID 42377388 · Publisher ↗
PURPOSE: To confirm the definitive diagnostic method of vitreoretinal lymphoma by vitrectomy under infusion. STUDY DESIGN: Retrospective, pathological analysis METHODS: Twenty-two patients participated in this study; 29...
PURPOSE: To confirm the definitive diagnostic method of vitreoretinal lymphoma by vitrectomy under infusion. STUDY DESIGN: Retrospective, pathological analysis METHODS: Twenty-two patients participated in this study; 29 vitreous samples were obtained under infusion. Liquid-based cytology (LBC) was performed by targeting areas with a high cell concentration while observing the surgical field under infusion. Cell block analysis was performed by the vitreous cell components in the intraocular irrigating fluid. RESULTS: Our vitreous sample collection did not result in adverse events. In LBC samples, atypical large lymphoid cells were identified in 89.7%. These samples contained between 30 and over 10,000 atypical large lymphoid cells. Necrosis was observed in 76.9% in the background of LBC samples. In cell block samples, atypical large lymphoid cells were identified in 87.0%. Immunohistochemical staining revealed the following immunophenotypes for the lymphoid cells: CD20 (100%), CD79a (100%), CD10 (0%), BCL6 (57.1%), MUM1 (85.7%), and Ki-67 LI 66.3±12.7%. CONCLUSION: This method ensures safety and high diagnostic accuracy, thereby contributing to the definitive diagnosis of vitreoretinal lymphoma.
Geographic atrophy progression and subretinal drusenoid deposits in a real-world Japanese cohort.
Takayama T, Takahashi H, Tsuge T … +9 more , Chiba M, Esmaeelpour M, Inoda S, Tampo H, Hashimoto Y, Kimura K, Fukuju Y, Kaburaki T, Yanagi Y
Jpn J Ophthalmol · 2026 Jun · PMID 42371273 · Publisher ↗
PURPOSE: To investigate the natural course of geographic atrophy (GA) in Japanese patients, with a focus on factors associated with the change of GA size over time and visual acuity decline. STUDY DESIGN: Retrospective,...
PURPOSE: To investigate the natural course of geographic atrophy (GA) in Japanese patients, with a focus on factors associated with the change of GA size over time and visual acuity decline. STUDY DESIGN: Retrospective, single-center observational study. METHODS: We reviewed 40 eyes of 40 patients with GA and longitudinal fundus autofluorescence (FAF) imaging. Annual progression rates were calculated as square root-transformed (mm/year). Assessed factors included age, sex, smoking history, diabetes, hypertension, baseline best-corrected visual acuity (BCVA), baseline lesion size, foveal center involvement, choroidal thickness, FAF subtypes, and presence of subretinal drusenoid deposits (SDD). Visual outcomes were assessed as change in BCVA (ΔBCVA, logarithm of the minimum angle of resolution (logMAR)). RESULTS: Median age was 75.5 years; 50% of eyes had SDD. The median annual GA progression rate was 0.16 mm/year in square root units. Baseline GA area and the presence of SDD were independent predictors of GA progression (β = -0.0837, p = 0.015; β = +0.3064, p = 0.009, respectively). In multivariable analysis, baseline GA area also remained a significant predictor of visual deterioration (β = +0.1369, p = 0.002). When stratified by FAF patterns, there was significant worsening of BCVA in the Diffuse (p = 0.0027) and Banded (p = 0.0117) subtypes, whereas the None and Other subtypes did not show significant changes in BCVA over one year. CONCLUSIONS: SDD was identified as a significant risk factor for GA progression in Japanese patients. These findings improve understanding of natural history of GA in Japanese population and may inform risk stratification.
Axial length correction in retinal thickness measurements in diabetic retinopathy.
Mukawa S, Hirano T, Chiku Y … +8 more , Kajiwara S, Sekiya E, Fujihara H, Tomihara R, Ito S, Hoshiyama K, Kakihara S, Murata T
Jpn J Ophthalmol · 2026 Jun · PMID 42371272 · Publisher ↗
PURPOSE: To use the RS-1 Glauvas (NIDEK) system to evaluate the effect of axial length (AL) correction on retinal thickness (RT) with optical coherence tomography (OCT). STUDY DESIGN: Observational, cross-sectional study...
PURPOSE: To use the RS-1 Glauvas (NIDEK) system to evaluate the effect of axial length (AL) correction on retinal thickness (RT) with optical coherence tomography (OCT). STUDY DESIGN: Observational, cross-sectional study. METHODS: Between November 2023 and April 2024, 165 eyes from patients with diabetes underwent OCT imaging. RT was measured with and without AL-based magnification correction with the Early Treatment Diabetic Retinopathy Study (ETDRS) grid, which comprises three concentric circles (diameters; 1, 3, and 6 mm), with the inner and outer rings divided into superior, temporal, nasal, and inferior sectors. Measurements were calculated using two settings: a fixed AL of 24 mm (uncorrected) and the individually measured AL for each eye (corrected). The difference between uncorrected and corrected RT measurements was analyzed using Bland-Altman analysis. Linear regression analysis was performed to assess the association between AL and the measurement difference. RESULTS: The mean AL was 23.9 ± 1.2 mm. Bland-Altman analysis for central subfield thickness (CST) showed a small mean difference between corrected and uncorrected measurements (bias -0.34 µm; 95% limits of agreement -6.32 to 5.63 µm). Linear regression demonstrated a significant positive association between AL and the difference in CST measurements (R = 0.70, p < 0.0001), indicating that uncorrected measurements tended to underestimate and overestimate RT in eyes with shorter and longer AL, respectively. CONCLUSION: AL differences affect the effective OCT scan area and may influence RT measurements. Applying AL correction minimizes measurement bias caused by transverse magnification and improves the accuracy of RT assessment.
Association between the anatomical location of conjunctivochalasis and subjective symptoms: a multicenter retrospective study.
Den S, Toda I, Nakano T
Jpn J Ophthalmol · 2026 Jun · PMID 42371271 · Publisher ↗
PURPOSE: To investigate the association between the anatomical location of conjunctivochalasis (CCh) and subjective chief complaints in patients who underwent surgical treatment. STUDY DESIGN: Retrospective multicenter s...
PURPOSE: To investigate the association between the anatomical location of conjunctivochalasis (CCh) and subjective chief complaints in patients who underwent surgical treatment. STUDY DESIGN: Retrospective multicenter study METHODS: This study included 39 eyes of 27 patients undergoing surgery for symptomatic CCh. CCh location was classified as total, nasal, nasal-plus-temporal, or temporal; chief complaints were registered as discomfort/foreign body sensation (FBS), epiphora, or cosmetic complaint. Associations were evaluated by Chi-square test (Cramér's V) and pairwise Fisher's exact tests; age differences by Kruskal-Wallis test. RESULTS: A significant association was found between CCh location and chief complaint (χ = 35.48, P = 0.000003; Cramér's V = 0.674). Total CCh was predominantly associated with discomfort/FBS (P = 0.0038). Nasal CCh showed a predominant pattern of epiphora. Nasal-plus-temporal CCh showed a mixed pattern, epiphora and discomfort/FBS. Temporal CCh was observed predominantly with cosmetic complaints (P < 0.001). Patients with cosmetic complaints were significantly younger than those in other symptom groups (P = 0.0003). CONCLUSION: In this surgically selected cohort, subjective symptoms were significantly associated with CCh location. Total CCh was associated with discomfort/FBS, nasal CCh with epiphora, and temporal CCh with cosmetic complaints. The combination of CCh location and patient age may further clarify the clinical presentation: older patients with total CCh sought surgery for mechanical irritation, while younger patients with temporal CCh sought surgery for cosmetic reasons. Recognizing this location- and age-based pattern may help clinicians anticipate the chief complaint and support individualized surgical decision-making.
Efficacy and safety of sepetaprost in patients with primary open-angle glaucoma or ocular hypertension: results from the randomised, phase 3 ANGEL-J1 study.
Inatani M, Kanamori A, Inai M … +2 more , Ikeda T, Angeles R
Jpn J Ophthalmol · 2026 Jun · PMID 42298273 · Publisher ↗
PURPOSE: To evaluate the efficacy and safety of sepetaprost, a novel dual FP/EP3 receptor agonist, in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT). STUDY DESIGN: ANGEL-J1 (NCT05495061) wa...
PURPOSE: To evaluate the efficacy and safety of sepetaprost, a novel dual FP/EP3 receptor agonist, in patients with primary open-angle glaucoma (POAG) or ocular hypertension (OHT). STUDY DESIGN: ANGEL-J1 (NCT05495061) was a phase 3, randomised, investigator-masked, active-controlled, parallel-group, non-inferiority study across 49 sites in Japan. METHODS: Adults with POAG or OHT were randomised 1:1 to topical sepetaprost 0.002% or latanoprost 0.005%, once daily for 3 months. The primary endpoint was change in mean diurnal intraocular pressure (IOP) from baseline at week 4 (non-inferiority margin, 1.5 mmHg); a key secondary endpoint was mean change in IOP from baseline over 3 months. Safety outcomes included the incidence of adverse drug reactions (ADRs). RESULTS: In total, 325 patients were randomised to sepetaprost (n=162) or latanoprost (n=163). In mixed model for repeated measures analyses, ANGEL-J1 met its primary endpoint; the least-squares mean (± standard error) change in mean diurnal IOP from baseline at week 4 was -5.77±0.16 mmHg in the sepetaprost group, which was non-inferior to -6.10±0.16 mmHg in the latanoprost group (least-squares mean difference, 0.32 mmHg [95% confidence interval, -0.12, 0.77]). Non-inferiority for the key secondary endpoint was also established, with comparable mean reductions in IOP between groups maintained over 3 months. ADRs occurred in 59 patients (36.4%) receiving sepetaprost and 33 (20.2%) receiving latanoprost; the most common ADR was conjunctival hyperaemia (29.6% and 8.6%, respectively; mostly mild in severity). CONCLUSION: In patients with POAG or OHT, sepetaprost demonstrated IOP-lowering efficacy that was non-inferior to latanoprost, and an acceptable safety profile.
Long-term safety and efficacy of sepetaprost, with or without timolol, in patients with open-angle glaucoma or ocular hypertension: results from the randomised, phase 3 ANGEL-J2 study.
Inatani M, Tone Y, Ikeda T … +1 more , Angeles R
Jpn J Ophthalmol · 2026 Jun · PMID 42298272 · Publisher ↗
PURPOSE: To evaluate the long-term safety and intraocular pressure (IOP)-lowering efficacy of sepetaprost, a novel dual FP/EP3 receptor agonist, in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). ST...
PURPOSE: To evaluate the long-term safety and intraocular pressure (IOP)-lowering efficacy of sepetaprost, a novel dual FP/EP3 receptor agonist, in patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). STUDY DESIGN: ANGEL-J2 (NCT05503901) was a phase 3, randomised, parallel-group, open-label study across 20 sites in Japan. METHODS: Adult patients with IOP ≥16 and <22 mmHg were assigned to once-daily sepetaprost 0.002% (Group 1), whereas patients with IOP ≥22 and ≤34 mmHg were randomised 1:1 to once-daily sepetaprost 0.002% alone (Group 2) and with twice-daily timolol 0.5% (Group 3). Over 52 weeks of treatment, efficacy was assessed as the change in mean diurnal IOP from baseline; safety outcomes included the incidence of adverse drug reactions (ADRs). RESULTS: In total, 131 patients were assigned to Group 1 (n=49), Group 2 (n=42), or Group 3 (n=40). In each group, treatment was associated with rapid and sustained reductions in IOP versus baseline (p<0.0001 at all time-points). Mean (± standard error) change in diurnal IOP from baseline at week 52 was -4.40±0.24, -6.38±0.32, and -7.51±0.29 mmHg in Groups 1, 2, and 3, respectively; similarly, mixed model for repeated measures analyses found that reductions in mean diurnal IOP over 52 weeks were greater in Group 3 versus Group 2. ADRs were reported in 80 patients overall (59.2-65.0% across groups), most commonly mild eyelash growth (22.4-42.5%) and mild conjunctival hyperaemia (28.6-30.6%). CONCLUSION: Sepetaprost, with or without timolol, demonstrated good tolerability and may represent an efficacious long-term treatment option for OAG or OHT.
Evaluation of anterior scleral thickness in pachychoroid pigment epitheliopathy, central serous chorioretinopathy and pachychoroid neovasculopathy.
Şahin Şekerci AN, Atalay AŞ, Cankı EK … +1 more , Koca S
Jpn J Ophthalmol · 2026 Jun · PMID 42287503 · Publisher ↗
PURPOSE: To compare anterior scleral thickness (AST) among pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV) and healthy controls. STUDY DESIGN: Retrosp...
PURPOSE: To compare anterior scleral thickness (AST) among pachychoroid pigment epitheliopathy (PPE), central serous chorioretinopathy (CSC), pachychoroid neovasculopathy (PNV) and healthy controls. STUDY DESIGN: Retrospective cross-sectional study. METHODS: This single-center, retrospective cross-sectional study included 73 eyes of 72 patients with pachychoroid spectrum disease (PPE (n = 35), CSC (n = 25), PNV (n = 12)) and 29 control eyes. All participants underwent comprehensive ophthalmic examination and swept-source optic coherence tomography (OCT) (Topcon DRI-OCT Triton). Choroidal thickness (CT) was measured subfoveally, at 500 and 1000 μm nasal/temporal to the fovea, and sublesionally. AST was measured with the anterior segment mode 6 mm posterior to the scleral spur in four quadrants. RESULTS: CT was significantly greater in CSC than in PPE, PNV, and controls at all macular locations (all p < 0.001). Sublesional CT differed among pachychoroid groups (p = 0.005), with CSC thicker than PPE (p = 0.002) and PNV (p = 0.011); PPE and PNV did not differ (p = 1.000). Anterior scleral thickness was significantly greater in all quadrants in the pachychoroid groups compared with controls (p < 0.001). Superior AST was greater in PPE than PNV (p = 0.044); other inter-pachychoroid comparisons were not significant (p > 0.05). In multivariate linear regression model, the presence of pachychoroid spectrum disease was independently associated with thicker AST after adjustment for age, sex, AXL, and SE (p< 0.001 for all quadrants). CONCLUSION: Eyes with pachychoroid spectrum disease exhibit increased AST relative to controls, while diffuse CT thickening is most pronounced in CSC. These findings support a pathophysiologic association between scleral structure and choroidal venous overload in pachychoroid disorders and highlight AST as a potential structural biomarker.
Temporal versus superior clear corneal incision for eyes with oblique astigmatism: a randomized comparative study.
Hayashi K, Uno K, Hayashi S … +1 more , Hirata A
Jpn J Ophthalmol · 2026 Jun · PMID 42287502 · Publisher ↗
PURPOSE: To compare the amount of total cornea astigmatism and corneal astigmatic change between eyes with near against-the-rule (ATR) and near with-the-rule (WTR) oblique astigmatism that underwent a temporal (TCI) or s...
PURPOSE: To compare the amount of total cornea astigmatism and corneal astigmatic change between eyes with near against-the-rule (ATR) and near with-the-rule (WTR) oblique astigmatism that underwent a temporal (TCI) or superior clear corneal incisions (SCI). STUDY DESIGN: Randomized comparative study. METHODS: Two-hundred forty eyes with near ATR (46°-59° and 121°-135°; n=120) or near WTR (31°-45° and 136°-149°; n=120) oblique corneal astigmatism of ≥ 0.5 diopters were randomly assigned to undergo a 2.4-mm TCI or SCI. The vertical/horizontal (Rx) and oblique astigmatism components (Ry) were evaluated preoperatively and at 2 months postoperatively. Bivariate analysis was performed to compare between the two time points and the TCI and SCI groups. RESULTS: All 240 eyes were included in the analysis. In eyes with near ATR or near WTR oblique astigmatism, the mean Rx and Ry did not change significantly in the TCI group but were significantly increased from preoperatively to 2 months postoperatively in the SCI group (P≤0.002). The mean Rx and Ry did not differ significantly between the TCI and SCI groups preoperatively, but these values were significantly lower in the TCI group than in the SCI group at 2 months postoperatively (P<0.001). CONCLUSIONS: TCI did not significantly change the corneal astigmatism, while SCI increased the astigmatism from preoperatively to 2 months postoperatively in eyes with near ATR or WTR oblique astigmatism. Residual corneal astigmatism at 2 months postoperatively was significantly lower after TCI than after SCI, suggesting that TCI is a more favorable surgical approach for eyes with oblique astigmatism.
2024 survey of the frequency of fixed-combination eye drop use by patients with glaucoma at multiple private practices in Japan.
Inoue K, Shiokawa M, Kunimatsu-Sanuki S … +2 more , Tomita G, Ishida K
Jpn J Ophthalmol · 2026 Jun · PMID 42274971 · Publisher ↗
PURPOSE: To investigate the current (2024) use of fixed-combination eye drops in Japanese patients with glaucoma. STUDY DESIGN: Cross-sectional survey. METHODS: The survey included 6323 outpatients (6323 eyes) with glauc...
PURPOSE: To investigate the current (2024) use of fixed-combination eye drops in Japanese patients with glaucoma. STUDY DESIGN: Cross-sectional survey. METHODS: The survey included 6323 outpatients (6323 eyes) with glaucoma or ocular hypertension at 82 private practices from March 10 to 16, 2024. The use of fixed-combination eye drops, including prostaglandin F (FP) receptor agonist/β-blocker (FP/β), carbonic anhydrase inhibitor/β-blocker (CAI/β), α2-adrenergic agonist/β-blocker (α2/β), α2-adrenergic agonist/carbonic anhydrase inhibitor (α2/CAI), and α2-adrenergic agonist/Rho-associated protein kinase (α2/ROCK), was analyzed, stratified by the number of medications used. The results were compared with those of a 2020 survey via χ tests. RESULTS: FP/β, CAI/β, α2/β, α2/CAI, and α2/ROCK were used by respectively 56.4%, 8.0%, 2.2%, 2.9%, and 0.6% of 2-medication users; 42.5%, 30.2%, 3.2%, 11.2%, and 4.1% of 3-medication users; and 56.6%, 32.1%, 1.7%, 45.5%, and 14.4% of ≥4-medication users. FP/β were the most commonly used in all groups. Compared with the previous survey, the use of FP/β increased significantly in all groups, while that of CAI/β decreased significantly. Among four-medication users, 228 patients (44.4%) used two types of fixed-combination eye drops. In this group, FP/β + α2/CAI (186 cases) was the most common. Among five-medication users, 186 patients (69.9%) used two types of fixed-combination eye drops. In this group, FP/β + α2/CAI + one additional drug (131 cases) was the most common. CONCLUSION: Fixed-combination eye drops were used in >70% of patients using 2 medications and >90% of patients using ≥3 medications. Over time, the use of FP/β increased, while the use of CAI/β decreased.
Surgical procedures and outcomes in patients with tear drainage system disorders associated with the anticancer agent S-1.
Sasaki T, Sounou T, Higashide T
Jpn J Ophthalmol · 2026 Jun · PMID 42274970 · Publisher ↗
PURPOSE: S-1 is a first-line oral anti-cancer drug widely used in Japan. This study evaluated surgical outcomes for S-1-associated tear drainage system disorders (S-1/TDSD) and explored strategies to improve outcomes. ST...
PURPOSE: S-1 is a first-line oral anti-cancer drug widely used in Japan. This study evaluated surgical outcomes for S-1-associated tear drainage system disorders (S-1/TDSD) and explored strategies to improve outcomes. STUDY DESIGN: Multicenter, retrospective observational study. METHODS: Fifty-one patients (89 sides; 31 men and 20 women; mean age ± SD, 68.7 ± 10.7 years; range 49─85 years) with S-1/TDSD were included. Surgical procedures performed were: three-snip procedure; exploratory horizontal part canaliculotomy; probing with tube placement; and conjunctivodacryocystorhinostomy with Jones tube insertion. RESULTS: The cases were classified as: punctal occlusion (Group a, 34 sides), both stenosed canaliculi (Group b, 2 sides), patent canaliculus and mono-canalicular obstruction (CO) (Group c, 9 sides), one soft or tightCO and contralateral softCO (Group d, 13 sides), tightCOs in both canaliculi (Group e, 27 sides), and common CO (Group f, 4 sides). The three-snip procedure for Group a was successful in 32 of 34 sides (94.1%). Probing with intubation for Group b was successful in all cases (2/2). Conjunctivodacryocystorhinostomy for Group e was successful in 15 of 20 sides (75.0%) and dacryoendoscopic canaliculo-incision for Group e was successful in 4 of 4 sides (100%). However, exploratory horizontal part canaliculotomy and probing for Groups c and d were successful in 14%─42% of cases. CONCLUSION: The three-snip procedure for punctal occlusions showed favorable outcomes but procedures preserving the canaliculus, especially in patients with horizontal CO, did not yield good results, even for an affected single canaliculus.
Risk factors for postoperative endothelial keratoplasty after cataract surgery in patients with Fuchs endothelial corneal dystrophy using anterior segment optical coherence tomography.
Ueda M, Oie Y, Maeno S … +11 more , Kai C, Kamuro R, Soma T, Shimizu T, Igarashi A, Yukari Y, Hayashi T, Yagi-Yaguchi Y, Yamaguchi T, Kawasaki R, Nishida K
Jpn J Ophthalmol · 2026 Jun · PMID 42274969 · Publisher ↗
PURPOSE: To analyze anterior segment optical coherence tomography (AS-OCT)-derived risk factors for endothelial keratoplasty (EK) after cataract surgery in patients with Fuchs endothelial corneal dystrophy (FECD). STUDY...
PURPOSE: To analyze anterior segment optical coherence tomography (AS-OCT)-derived risk factors for endothelial keratoplasty (EK) after cataract surgery in patients with Fuchs endothelial corneal dystrophy (FECD). STUDY DESIGN: Retrospective observational study. METHODS: We included 73 eyes from 55 consecutive patients with FECD who underwent cataract surgery at three tertiary care institutions between March 2017 and July 2023. We explored the association between preoperative factors (age, sex, incision site, central corneal thickness, anterior chamber depth, components for the anterior and posterior corneal surfaces by Fourier analysis, and signal intensity by AS-OCT) and the requirement for EK within 12 months after cataract surgery. We performed univariate and multivariate regression analyses to calculate the area under the receiver operating characteristic curve (AUC). RESULTS: Of the 73 eyes, 27 (37.0%) required EK. In the univariate analysis, the higher order irregularity component of the 6 mm posterior corneal surface by Fourier analysis yielded the highest AUC of 0.86 (sensitivity: 0.85; specificity: 0.74). In the multivariate analysis, the asymmetry component of the 3 mm anterior corneal surface by Fourier analysis yielded the highest AUC of 0.94, in addition to age, sex, incision site, and anterior chamber depth (sensitivity: 0.93; specificity: 0.85). Thus, we developed a novel logistic regression model incorporating fully quantitative imaging biomarkers from AS-OCT to estimate the probability of requiring EK. CONCLUSION: The multiple regression model might provide a practical framework for optimizing surgical planning in patients with FECD undergoing cataract surgery, including deciding for either cataract surgery alone or combined EK.
Trends in childhood myopia over a 5-year interval: Korea national health and nutrition examination survey 2016 and 2021.
Na DG, Kim DH
Jpn J Ophthalmol · 2026 Jun · PMID 42274968 · Publisher ↗
PURPOSE: To investigate changes in myopia over a 5-year interval during childhood using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2021. STUDY DESIGN: Cross-sectional analysis...
PURPOSE: To investigate changes in myopia over a 5-year interval during childhood using data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 and 2021. STUDY DESIGN: Cross-sectional analysis based on nationally representative KNHANES data. METHODS: Participants aged 5-15 years from the 2016 KNHANES and 10-20 years from the 2021 KNHANES were included. Refractive errors were converted to spherical equivalents (SE) for comparison, and the more myopic eye was analyzed. SE percentiles were calculated across the entire refractive spectrum, ranging from hyperopia to myopia. SE differences were assessed by comparing the 2016 data with the corresponding 2021 data for participants who were 5 years older. Those with previous ocular surgery were excluded. RESULTS: A total of 1005 participants from 2016 and 576 from 2021 were analyzed. Mean SE was -1.62 ± 2.05 D in 2016 and -2.96 ± 2.73 D in 2021 (p < 0.001). Among participants aged 5-10 and 12-13 years in 2016, SE values differed significantly from age-matched participants in 2021 (p < 0.05 for each group). Participants aged 5-10 years in 2016 within the 50th-90th percentile range showed SE changes exceeding -1.0 D compared with their 2021 counterparts. Greater myopic changes were observed in younger participants and in those with higher baseline myopia percentiles. CONCLUSION: This cross-sectional comparison indicates that children with a younger baseline age and higher baseline myopia percentiles experience greater myopic changes over a 5-year interval, emphasizing the need for early myopia control.
Pattern of uveitis in first-time patients at a tertiary referral center in Saitama, Japan.
Taguchi R, Yano M, Nishimura K … +8 more , Hiranuma Y, Saima Y, Mito S, Tanaka Y, Shimmura M, Takano H, Kakehashi A, Kaburaki T
Jpn J Ophthalmol · 2026 Jun · PMID 42274967 · Publisher ↗
PURPOSE: The distribution of uveitis varies worldwide and changes over time. Although nationwide surveys in Japan report shifts in disease patterns, updated epidemiological data after 2020 remain limited. In this study,...
PURPOSE: The distribution of uveitis varies worldwide and changes over time. Although nationwide surveys in Japan report shifts in disease patterns, updated epidemiological data after 2020 remain limited. In this study, we investigated the current pattern of uveitis among first-time patients at a regional university hospital in Japan and compared the findings with previous nationwide surveys. STUDY DESIGN: Retrospective observational study. METHODS: We retrospectively reviewed the medical records of patients with uveitis who first visited Saitama Medical Center, Jichi Medical University, between January 1, 2020, and December 31, 2023. Collected data included age, sex, diagnosis, and anatomical classification of uveitis. RESULTS: A total of 671 patients were included, with a mean age of 57.8 ± 21.1 years. Panuveitis was the most common anatomical subtype (55.0%), followed by anterior (34.9%), posterior (9.4%), and intermediate uveitis (0.7%). Definitive diagnoses were established in 62.7% of patients. The most frequent etiologies were sarcoidosis (9.7%), Vogt-Koyanagi-Harada disease (8.2%), herpetic iritis (6.3%), intraocular lymphoma (4.5%), and Behçet's disease (3.7%). Compared with previous nationwide surveys, higher proportions of cytomegalovirus retinitis (CMVR) and intraocular lymphoma were found. CONCLUSION: The findings in this study provide updated epidemiological data on uveitis in Japan, revealing higher proportions of CMVR and intraocular lymphoma among first-time patients at a regional university hospital. These trends might reflect population aging and an increasing number of immunocompromised patients, including those receiving immunosuppressive therapy or having hematologic malignancies.
Development of a machine learning model using systemic and ophthalmic parameters to detect sleep-disordered breathing in glaucoma patients.
Kiyota N, Yamazaki M, Himori N … +8 more , Ninomiya T, Osada K, Yabana T, Maekawa S, Tsuda S, Omodaka K, Yokoyama Y, Nakazawa T
Jpn J Ophthalmol · 2026 Jun · PMID 42257836 · Publisher ↗
PURPOSE: To develop and validate a machine-learning model using systemic and ophthalmic parameters that predicts sleep-disordered breathing (SDB) in patients with open-angle glaucoma (OAG). STUDY DESIGN: Retrospective cr...
PURPOSE: To develop and validate a machine-learning model using systemic and ophthalmic parameters that predicts sleep-disordered breathing (SDB) in patients with open-angle glaucoma (OAG). STUDY DESIGN: Retrospective cross-sectional study METHODS: We analyzed 513 patients with OAG (955 eyes) treated at Seiryo Eye Clinic. All the participants underwent comprehensive ophthalmic examinations, including Humphrey visual field (HVF) testing, and home sleep apnea testing (HSAT) to obtain the 4% oxygen desaturation index (ODI). SDB was operationally defined as ODI-SAS, ie, sleep apnea syndrome (SAS) defined by HSAT-derived 4% ODI ≥15 events per hour. Sixteen algorithms were trained to predict ODI-SAS; model performance was assessed by the area under the receiver operating characteristic curve (ROC-AUC), precision, recall, the F1 score, and the Matthews correlation coefficient (MCC). RESULTS: One hundred fifty-eight patients (30.80%) met the ODI-SAS criterion. ODI-SAS status was associated with a history of hypertension, higher body mass index, family-reported apnea, shorter axial length, fewer antiglaucoma medications, and worse inferocentral total deviation on HVF (all P < 0.05), but not with self-awareness of snoring or previous SAS diagnosis. A gradient-boosted decision-tree model (CatBoost) achieved the best performance (ROC-AUC 0.86), with precision 0.692, recall 0.711, F1 score 0.701, and MCC 0.543. CONCLUSION: Machine-learning models can predict ODI-SAS in glaucoma using systemic risk factors together with ophthalmic features, including inferocentral visual-field defects. Such models may help identify OAG patients who warrant formal sleep evaluation.
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