Language：English   Publishing type：Research paper (scientific journal)  

Visual functions that affect vision-related quality of life (VR-QoL) before and after intravitreal injection of ranibizumab in patients with cystoid macular edema secondary to central retinal vein occlusion (CRVO-CME) are poorly understood. This multicenter, open-label, single-arm prospective study included 23 treatment-naïve patients with CRVO-CME. The best-corrected visual acuity (BCVA), letter contrast sensitivity (LCS), severity of metamorphopsia (M-CHARTS), amount of aniseikonia (New Aniseikonia Test), and stereopsis (Titmus Stereo Test and TNO stereotest) were examined every month from before treatment to 12 months after treatment. For VR-QoL assessment, the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was provided to the patients before treatment and at 3, 6, and 12 months after treatment. Stepwise multiple regression analysis revealed that the BCVA of the fellow eye was related to the VFQ-25 composite score before treatment, and that the BCVA of the fellow eye and TNO values were related to the VFQ-25 composite score 12 months after treatment. Changes in LCS were significantly correlated with changes in the VFQ-25 composite score. In patients with CRVO-CME, visual acuity of the fellow eye had the strongest impact on VR-QoL. The contrast sensitivity of the affected eye and stereopsis were also associated with VR-QoL.

DOI： 10.3390/jcm11144139

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

Multiple intravitreal injections, which are painful and costly, are often required in the treatment of retinal disorders. Therefore, a novel drug delivery system using hydrogels is currently being evaluated as an alternative. This study aimed to evaluate the ability of tetra-armed polyethylene glycol (tetra-PEG) gel for sustained release in vitro. Bevacizumab-loaded tetra-PEG gel and 5-Carboxyfluorescein N-succinimidyl ester (FAM-NHS)-labeled IgG-loaded tetra-PEG gel were prepared by mixing tetra-PEG with thiol termini (tetra-PEG-SH) solution, maleimide termini (tetra-PEG-MA) solution, and bevacizumab or FAM-NHS labeled IgG. The gels were prepared with three different polymer concentrations of 1.5%, 5%, and 10%, then an in vitro release study performed to assess the sustained release ability of the drug-loaded tetra-PEG gels. High performance liquid chromatography (HPLC) was used to test the structural stability of the bevacizumab released from the tetra-PEG gel. The binding of bevacizumab to tetra-PEG-SH or MA was assessed using SDS-polyacrylamide gel electrophoresis (PAGE). The bioactivity of released bevacizumab was tested using KDR/NFAT-RE HEK293 cells. In addition, in vitro degradation and swelling studies were also performed. The in vitro release analysis showed that the release of bevacizumab was slower in the 5% and 10% tetra-PEG gels than that of 1.5% tetra-PEG gels. Similarly, the release of FAM-NHS-labeled IgG was slowest in the 1.5%, 5%, and 10% tetra-PEG gels, in that order. The 5% and 10% tetra-PEG gels released bevacizumab and FAM-NHS-labeled IgG over a period of 1-2 weeks. Both bevacizumab and FAM-NHS-labeled IgG were not fully released in 2 weeks. HPLC analysis showed that the retention time of the samples released from the bevacizumab-loaded tetra-PEG gel was similar to that of the bevacizumab standard. The SDS-PAGE analysis showed that bevacizumab binds to tetra-PEG-MA. The bioactivity assay test revealed no decrease in the bioactivity of the released bevacizumab. In vitro degradation and swelling studies revealed that 1.5%, 5%, and 10% tetra-PEG gels expanded by approximately 1.4-, 2-, and 3-fold, respectively. Based on the results of the release and swelling tests, 5% tetra-PEG gels are considered good candidates for controlled release systems for therapeutic antibodies such as bevacizumab. The binding of PEG to the therapeutic antibodies may reduce the availability of therapeutic antibodies that can be released.

DOI： 10.1016/j.exer.2022.109206

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ PUBLISHING GROUP  

[Background] To investigate the relationship between stereopsis and vision-related quality of life (VR-QOL) in patients with branch retinal vein occlusion (BRVO) before and after treatment with intravitreal ranibizumab (IVR).
[Methods] This prospective multicentred observational study included 37 patients undergoing IVR treatment for unilateral BRVO and 24 age-matched healthy controls.Stereopsis was evaluated using the TNO stereo test (TNO) and Titmus stereo test (TST) every month, and the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was administered at baseline, then at 3, 6 and 12 months after treatment.
[Results] Time course of the changes in stereopsis and VR-QOL. IVR treatment significantly reduced central fovea thickness and improved both the TNO and the TST from 2 to 12 months (both p<0.05). Stereopsis before and after IVR injection in the eyes with BRVO were significantly worse than those in control subjects (TNO, p<0.001; TST, p<0.001). The VFQ-25 composite score significantly improved from 3 to 12 months after IVR treatment (p<0.05). Univariate analysis showed that the TNO score at baseline was significantly correlated with the VFQ-25 composite score at baseline and after treatment (p<0.05, p<0.05, respectively). TST score was not associated with the VFQ-25 composite score at baseline or after treatment.
[Conclusions] Treatment with IVR for BRVO improved cystoid macular oedema, which was correlated to improved stereopsis, although not to the control level. The TNO score at baseline was associated with VR-QOL in patients with BRVO.

DOI： 10.1136/bmjophth-2021-000925

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Language：English   Publishing type：Research paper (scientific journal)  

PURPOSE: To investigate the clinical features, treatment options, and visual outcomes of submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD). DESIGN: A retrospective, observational case series. METHODS: Setting: Multicenter institutional setting. Patient Population: A total of 127 patients (127 eyes; 88 men, 39 women; (mean age, 74.2 years)) diagnosed with AMD-associated SMHs exceeding 2 disc diameters involving the fovea. Observation: The AMD types, previous treatments, treatment options, anatomic findings, and best-corrected visual acuity (BCVA) were assessed. Main Outcome Measures: Clinical features, treatment options, and visual outcomes of SMHs secondary to nAMD. RESULTS: Thirty-two eyes had typical AMD, 94 eyes polypoidal choroidal vasculopathy (PCV), and one eye retinal angiomatous proliferation. Eighty-five eyes were treatment-naïve; 42 eyes were treated previously: anti-vascular endothelial growth factor (VEGF) therapy (n = 26), photodynamic therapy (n = 3), and combined therapy (n = 13). Treatment of SMHs included vitrectomy (36 eyes), pneumatic displacement (49 eyes), and anti-VEGF monotherapy (42 eyes). The final BCVA improved significantly in treatment-naïve cases from 0.86 to 0.62 logarithm of the minimal angle of resolution (logMAR) unit (Snellen equivalent from 20/145 to 20/83) and from 0.80 to 0.56 (Snellen equivalent from 20/126 to 20/73) in PCV cases. Meanwhile, the BCVA logMAR values improved from 1.15 to 0.75 (Snellen equivalent from 20/283 to 20/112) and from 0.87 to 0.63 (Snellen equivalent from 20/148 to 20/85) in eyes that underwent vitrectomy or pneumatic displacement, respectively. In eyes with BCVAs between 20/133 to 20/40 at SMH onset, the final VA in the pneumatic displacement group was better than in the anti-VEGF monotherapy group. One eye had a retinal detachment and 1 eye had a macular hole in the vitrectomy group, and 5 eyes had a vitreous hemorrhage in the pneumatic displacement group. CONCLUSIONS: The recommended treatment for SMHs secondary to nAMD exceeding 2 disc area and with BCVA below 20/40 is vitrectomy or pneumatic displacement for visual improvement.

DOI： 10.1371/journal.pone.0271447

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PORTFOLIO  

The study aimed to evaluate changes in stereopsis and vision-related quality of life (VR-QOL) in patients with central retinal vein occlusion (CRVO) following intravitreal ranibizumab injection (IVR) and investigate the relationship between stereopsis and VR-QOL. This study included 23 treatment-naive patients with non-ischemic CRVO and 13 age-matched normal controls. Stereopsis, best-corrected visual acuity (BCVA), VR-QOL, and retinal microstructures were examined pre-treatment and 12 months post-treatment. The Titmus Stereo Test (TST) and TNO stereotest (TNO) were used to evaluate stereopsis. VR-QOL was evaluated using the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25). IVR immediately and significantly improved the TST values, TNO values, composite VFQ-25 score, BCVA, and central foveal thickness in patients with CRVO. The 12-month post-treatment TST and TNO values were significantly worse in the CRVO group compared to those in the normal group. At the baseline, the composite VFQ-25 score significantly correlated only with the TST value. Multivariate analysis revealed significant associations between the 12-month post-treatment composite VFQ-25 score and the baseline and 12-month post-treatment TNO values. In conclusion, IVR immediately improved stereopsis in CRVO, albeit below normal levels. Stereopsis (not visual acuity) was associated with pre- and post-treatment VR-QOL in patients with CRVO.

DOI： 10.1038/s41598-021-00094-z

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

Purpose To quantify aniseikonia following intravitreal ranibizumab (IVR) in patients with branch retinal vein occlusion (BRVO) and assess the relationship between aniseikonia and retinal microstructure. Study design Prospective observational study. Methods This study included 50 patients undergoing IVR treatment for unilateral BRVO. The degree of aniseikonia and best-corrected visual acuity (BCVA) was examined, and retinal microstructure was assessed with optical coherence tomography (OCT) before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on OCT images, we assessed central retinal thickness (CRT), presence of the epiretinal membrane, and serous retinal detachment (SRD), as well as status of the external limiting membrane and ellipsoid zone. Results At baseline, mean aniseikonia was - 1.0 +/- 2.5%, ranging from - 11.0 to + 6.0%. Nine out of 50 patients had micropsia (18%), one had macropsia (2%), and 40 had no aniseikonia (80%). After 6 months of treatment, mean aniseikonia was - 0.7 +/- 1.5%, ranging from - 4.5 to + 3.5%. BCVA significantly improved after treatment (P < 0.001), but aniseikonia did not change (P = 0.73). In patients with BRVO who had micropsia (<= - 2.0%) at baseline, mean aniseikonia significantly improved from - 4.8 +/- 3.3% to - 0.9 +/- 1.4% (P < 0.05). Aniseikonia after treatment significantly correlated with BCVA (P < 0.05) and the presence of SRD at baseline (P < 0.05). Conclusion Majority of eyes with aniseikonia in BRVO had micropsia. The BCVA as well as the micropsia improved following treatment with IVR for BRVO. BCVA and the presence of SRD were predictors of post-treatment aniseikonia.

DOI： 10.1007/s10384-021-00852-6

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ PUBLISHING GROUP  

Synopsis/precis We investigated the relationship between contrast sensitivity (CS) and vision-related quality of life (VR-QOL) in patients with central retinal vein occlusion following ranibizumab intravitreal injection; CS showed a stronger association with VR-QOL than visual acuity. Background/aims To investigate the relationship between CS, VR-QOL and optical coherence tomography (OCT) findings in patients with cystoid macular oedema secondary to central retinal vein occlusion (CRVO-CMO) following intravitreal injection of ranibizumab. Methods This was a multicentre, open-label, single-arm, prospective study. The study included 23 patients with CRVO-CMO who were followed up for 12 months after treatment. The best-corrected visual acuity (BCVA), letter contrast sensitivity (LCS) and OCT images were obtained every month. For VR-QOL assessment, the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was administered to the patients before treatment and at 3, 6 and 12 months following treatment. Results The LCS and VFQ-25 composite score improved significantly from baseline to 12 months following treatment. The multiple regression analysis revealed that the LCS of the affected eye and BCVA of the fellow eye were related to the VFQ-25 composite score following treatment. The LCS improvement showed a significant correlation with the improvement in the VFQ-25 composite score, whereas the BCVA improvement was not correlated with the improvement in the VFQ-25 composite score. Stepwise multiple regression analyses revealed that, at the time of macular oedema resolution, the distance between the external limiting membrane and retinal pigment epithelium (ELM-RPE) and average ganglion cell-inner plexiform layer (GCIPL) thickness were associated with LCS. Conclusion CS had a stronger association with VR-QOL than with BCVA in patients with CRVO-CMO. With the resolution of macular oedema, CS was associated with ELM-RPE thickness and average GCIPL thickness.

DOI： 10.1136/bjophthalmol-2021-319863

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

The current method of controlling the focus of an accommodating intraocular lens is based on ciliary muscle contraction and cannot be used in older patients with presbyopia. We aimed to develop a dynamically accommodating intraocular lens powered by a membrane-shaped ion polymer metal composite actuator that is thin enough to be inserted in the eye. This study addresses two key problems identified in our previous accommodating intraocular lens prototype: the lack of repeatability due to the use of swine lenses instead of artificial lenses and the occurrence of a sixth order aberration. Thus, we present a new accommodating intraocular lens design and a method to transfer energy to actuators. To accommodate lens deformation and depth of focus, we used a membrane-shaped ion polymer metal composite actuator, thin enough to be inserted in the eye, and used an artificial silicone lens. To prevent the sixth order aberration, we included a ring between the ion polymer metal composite actuator and the lens. Different voltage patterns were applied to the IPMC actuator and changes in focus were observed. We were able to obtain repeatability and prevent the sixth order aberration. The dioptric power changed to ±0.23 D when ±1.5 V was used; however, at >1.5 V, a large accommodating range occurred, in addition to astigmatic vision. Thus, we have developed a novel prototype that is completely artificial, allowing reproducible and repeatable results. Visual accommodative demands were successfully met; however, although astigmatic vision was lessened, it was not completely eradicated.

DOI： 10.1371/journal.pone.0252986

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER INC  

This is the first report to mention the association between visual outcome and mechanism of injury in patients with an OGI with NLP at first examination.

DOI： 10.1016/j.oret.2020.10.009

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MDPI  

Bacterial endophthalmitis is an intraocular infection that causes rapid vison loss. Pathogens can infect the intraocular space directly (exogenous endophthalmitis (ExE)) or indirectly (endogenous endophthalmitis (EnE)). To identify predictive factors for the visual prognosis of Japanese patients with bacterial endophthalmitis, we retrospectively examined the bacterial endophthalmitis characteristics of 314 Japanese patients and performed statistics using these clinical data. Older patients, with significantly more severe clinical symptoms, were prevalent in the ExE group compared with the EnE group. However, the final best-corrected visual acuity (BCVA) was not significantly different between the ExE and EnE groups. Bacteria isolated from patients were not associated with age, sex, or presence of eye symptoms. Genus Streptococcus, Streptococcus pneumoniae, and Enterococcus were more prevalent in ExE patients than EnE patients and contributed to poor final BCVA. The presence of eye pain, bacterial identification, and poor BCVA at baseline were risk factors for final visual impairment.

DOI： 10.3390/pathogens10040390

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

[PURPOSE] To compare laser photocoagulation and intravitreal injection of bevacizumab (IVB) treatment for retinopathy of prematurity (ROP).
[METHODS] The study included 52 eyes of 26 patients after ROP treatment who were observed up to 5 years of age. Twenty-eight eyes received laser photocoagulation as the initial treatment (laser group), and twenty-four eyes underwent IVB (IVB group). We collected data on gestational age, birth weight, 1- and 5-min Apgar scores, zone and stage at the time of treatment, recurrence of ROP and best-corrected visual acuity (BCVA) (logMAR), equivalent spherical value (SE), ocular complications, and developmental delay at the age of 5.
[RESULTS] More zone I low-stage eyes were treated with IVB than laser. There was no difference in BCVA (p = 0.836). Although the mean SE was not different between the groups (p = 0.280), the prevalence of myopia was significantly higher in the laser group (p = 0.020). Developmental delay was observed in 3 of 14 and 3 of 12 cases in the laser and IVB groups, respectively (p = 0.596). Retinal holes were observed in 2 eyes in the IVB group, with 1 developing localized retinal detachment. There were no significant difference

DOI： 10.1007/s00417-021-05137-9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGERNATURE  

[PURPOSE] To quantify stereopsis and other visual functions in patients with unilateral branch retinal vein occlusion (BRVO) and to investigate vision-related parameters that affect stereopsis.
[DESIGN] Prospective observational study.
[SUBJECTS] Forty-five patients undergoing intravitreal ranibizumab (IVR) treatment for unilateral BRVO.
[METHODS] We examined stereopsis using the Titmus stereo test (TST) and TNO stereotest (TNO), best corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia and degree of aniseikonia before and 6 months after IVR.
[MAIN OUTCOME MEASURES] Visual functions that affect stereopsis.
[RESULTS] Baseline stereopsis in patients with BRVO was 2.7 ± 0.6 (range, 1.6-3.5) in the TST and 2.8 ± 0.5 (range, 1.8-3.3) in TNO. TST and TNO scores were significantly correlated with BCVA and letter contrast sensitivity at baseline (P < 0.001) but not with other visual functions. IVR treatment significantly improved stereopsis, BCVA, and letter contrast sensitivity. After treatment, TST scores were significantly correlated with BCVA (P < 0.001), letter contrast sensitivity (P < 0.001), and aniseikonia (P < 0.01). TNO scores were significantly correlated with BCVA (P < 0.01) and letter contrast sensitivity (P < 0.01). TST and TNO scores after treatment were significantly correlated with BCVA at baseline (P < 0.01 for both).
[CONCLUSIONS] Deterioration of stereopsis in patients with BRVO was associated with changes in visual acuity and contrast sensitivity after treatment. Initial visual acuity is a prognostic factor for posttreatment stereopsis.

DOI： 10.1038/s41433-021-01452-x

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE RESEARCH  

To evaluate the effects of intravitreal ranibizumab injection (IVR) on metamorphopsia in patients with branch retinal vein occlusion (BRVO), and to assess the relationship between metamorphopsia and inner retinal microstructure and other factors. Thirty-three treatment-naïve eyes of 33 patients with macular edema caused by BRVO with at least 12 months of follow-up were included. The degree of metamorphopsia was quantified using the M-CHARTS. Retinal microstructure was assessed with spectral-domain optical coherence tomography. Disorganization of the retinal inner layers (DRIL) at the first month after resolution of the macular edema (early DRIL) and at 12 months after treatment (after DRIL) was studied. Central retinal thickness (CRT), and status of the external limiting membrane as well as ellipsoid zone were also evaluated. IVR treatment significantly improved best-corrected visual acuity (BCVA) and CRT, but the mean metamorphopsia score did not improve even after 12 months. Post-treatment metamorphopsia scores showed a significant correlation with pre-treatment metamorphopsia scores (P < 0.005), the extent of early DRIL (P < 0.05) and after DRIL (P < 0.05), and the number of injections (P < 0.05). Multivariate analysis revealed that the post-treatment mean metamorphopsia score was significantly correlated with the pre-treatment mean metamorphopsia score (P < 0.05). IVR treatment significantly improved BCVA and CRT, but not metamorphopsia. Post-treatment metamorphopsia scores were significantly associated with pre-treatment metamorphopsia scores, the extent of DRIL, and the number of injections. Prognostic factor of metamorphopsia was the degree of pre-treatment metamorphopsia.

DOI： 10.1038/s41598-021-84038-7

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE RESEARCH  

This prospective, open-label, single-arm, non-randomized clinical trial, assessed the efficacy of a 2-year treat-and-extend (T&E) regimen involving intravitreal aflibercept injection (IAI), with the longest treatment interval set to 16 weeks, and adjunct focal/grid laser in diabetic macula edema (DME) patients. We examined 40 eyes (40 adults) with fovea-involving DME from 8 Japanese centers between April 2015 and February 2017. Participants received IAI with an induction period featuring monthly injections and a subsequent T&E period featuring 8-16-week injection interval, adjusted based on optical coherence tomography findings. The primary endpoints were mean changes in the best-corrected visual acuity (BCVA) and central subfield macular thickness (CST) from baseline. Thirty patients (75%) completed the 2-year follow-up. The mean BCVA and CST changed from 60.5 ± 15.6 letters and 499.2 ± 105.6 µm at baseline to 66.6 ± 17.1 letters (P = 0.217) and 315.2 ± 79.0 µm (P < 0.001), respectively, after 2 years. The treatment interval was extended to 12 and 16 weeks in 6.7% and 66.7% of patients, respectively, at the end of 2 years. The T&E aflibercept re

DOI： 10.1038/s41598-021-83811-y

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

PURPOSE: To investigate the efficacy and safety of a treat-and-extend (T&E) regimen using aflibercept (Eylea) for diabetic macular edema (DME). STUDY DESIGN: Prospective, open-label, multicenter, single-arm, nonblinded clinical study. METHODS: Forty eyes of 40 patients with DME received a T&E regimen of intravitreal aflibercept injection (IAI) with the longest treatment interval set to 16 weeks and adjunct focal/grid laser for 1 year. An intent-to-treat analysis was performed using the same last-observation-carried-forward method. A per-protocol analysis was also performed for patients who completed a 1-year T&E regimen. The primary endpoints were mean changes in best-corrected visual acuity (BCVA) and central subfield macular thickness (CST) from baseline. Secondary endpoints included IAI-interval extension and resultant IAI numbers and the association between an early response to IAI and final BCVA gain at 1 year. RESULTS: Thirty-one patients (77.5%) completed the 1-year aflibercept T&E regimen. In these per-protocol participants, the mean CST improvement/reduction was 187.3 ± 145.0 µm (P < .001), but the mean BCVA gain was limited to 4.3 ± 12.2 letters (P = .782). Subanalysis revealed that eyes that gained ≥ 4 letters (median at week 12) after the initial 3 consecutive IAIs (induction phase) achieved greater vision improvement (13.8 ± 9.5 letters) than did the residual eyes (- 4.3 ± 9.2 letters) at 1 year (P < .001). Treatment intervals were extended to 12 and 16 weeks in 16.1% (5/31) and 45.2% (14/31) of the patients, respectively. The mean IAI number was 7.0 ± 1.1. CONCLUSIONS: The results of this study suggest that although the BCVA improvement might be somewhat less than that of frequent treatment, a T&E aflibercept regimen with the longest treatment interval set to 16 weeks is a realizable rational strategy for DME treatment over 1 year.

DOI： 10.1007/s10384-021-00820-0

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：眼科臨床紀要会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

[PURPOSE] To investigate the clinical characteristics and visual outcomes of patients with work-related open globe injuries (OGIs) and compare them with patients with non-work-related OGIs.
[DESIGN] Retrospective, observational, multicentre, case-control study.
[METHODS] A total of 374 patients with work-related OGIs and 170 patients with non-work-related OGIs who presented to hospitals that belong to the Japan-Clinical Research of Study group from 2005 to 2015 were included in this study. Clinical data including age, sex, initial and final visual acuity, type of open globe injury, lens status, zone of injury, wound length, and presence of proliferative vitreoretinopathy, retinal detachment, expulsive haemorrhage, and endophthalmitis were recorded.
[MAIN OUTCOME MEASURES] Visual acuity. Results Work-related OGIs were associated with younger age, male sex, better initial and final visual acuity, more laceration, smaller wounds, presence of retinal detachment, and expulsive haemorrhage, compared with non-work-related OGIs. Multiple regression analysis revealed that final visual acuity is significantly associated with initial visual acuity, wound length, and the presence of proliferat

DOI： 10.1038/s41598-020-57568-9

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Other Link： http://www.nature.com/articles/s41598-020-57568-9

Language：Japanese   Publisher：(公社)日本小児科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE RESEARCH  

The aim of this prospective study was to evaluate the changes in stereopsis in patients who underwent vitrectomy for macular hole (MH) and assess the relationship between stereopsis and retinal microstructures. Fifty-two patients who underwent successful vitrectomy for unilateral MH and 20 control participants were recruited. We examined stereopsis using the Titmus Stereo Test (TST) and TNO stereotest (TNO), optical coherence tomography, and best-corrected visual acuity measurements, preoperatively, and at 3, 6, and 12 months postoperatively. As a result, preoperative and postoperative 3, 6, and 12-month values of stereopsis assessed by TST (log) were 2.7, 2.2, 2.2, and 2.2, respectively. TNO (log) were 2.8, 2.5, 2.4, and 2.4, respectively. Stereopsis in MH after surgery was significantly worse than that in normal participants (p < 0.001). Preoperative TST significantly correlated with MH size and defect length of external limiting membrane (ELM). Postoperative TST demonstrated significant correlation with the preoperative ELM defect length, and postoperative TNO was associated with the preoperative interdigitation zone defect length. Vitrectomy for MH significantly improved stereopsis, although not to normal levels. The ELM defect lengths, which approximately correspond to TST circles, are prognostic factors for postoperative stereopsis by TST. The interdigitation zone defect length, similar in size to the TNO index, is a prognostic factor for postoperative stereopsis by TNO.

DOI： 10.1038/s41598-020-76648-4

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

Purpose To evaluate contrast sensitivity (CS) in patients with branch retinal vein occlusion (BRVO) following intravitreal ranibizumab injection (IVR), and to investigate the relationship between CS and retinal microstructure. Design A retrospective, observational case series. Methods We included 23 eyes with treatment naive BRVO followed up for 6 months after treatment. Best-corrected visual acuity (BCVA), letter contrast sensitivity (LC), and 10% low contrast visual acuity (LCVA) were measured. All tests were performed before and 1, 2, 3, 4, 5, and 6 months after treatment. Based on optical coherence tomography (OCT) images, we assessed central retinal thickness (CRT), presence of serous retinal detachment (SRD), and status of the external limiting membrane (ELM) and ellipsoid zone (EZ). Results IVR treatment significantly improved CS (LC:P < 0.0001, LCVA:P = 0.004) as well as BCVA (P = 0.015) and CRT (P < 0.0001). LC and LCVA at 6 months after treatment were significantly correlated with presence of SRD before treatment. At 6 months after treatment, LCVA was significantly correlated with pre-treatment CRT (P = 0.042). In patients with good baseline BCVA, LCVA showed significant improvements (P = 0.022) although their BCVA did not change. In patients with poor improvement in BCVA, LC and LCVA also showed significant improvements (P = 0.008,P = 0.005). Conclusion IVR treatment for BRVO improves both BCVA and CS. Even in patients without any improvement in visual acuity, CS does improve.

DOI： 10.1007/s10384-020-00758-9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BMJ PUBLISHING GROUP  

[BACKGROUND/AIMS] To investigate the yearly change of real-world outcomes for best corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve diabetic macular oedema (DMO).
[METHODS] Retrospective analysis of aggregated, longitudinal medical records obtained from 27 retina specialised institutions in Japan from Survey of Treatment for DMO database. A total of 2049 treatment-naïve centre involving DMO eyes of which the initial intervention started between 2010 and 2015, and had been followed for 2 years, were eligible. As interventions, antivascular endothelial growth factor (VEGF) agents, local corticosteroids, macular photocoagulation and vitrectomy were defined. In each eye, baseline and final BCVA, the number of each intervention for 2 years was extracted. Each eye was classified by starting year of interventional treatment.
[RESULTS] Although baseline BCVA did not change by year, 2-year improvement of BCVA had been increased, and reached to +6.5 letters in the latest term. There is little difference among starting year about proportions of eyes which BCVA gained >15 letters, in contrast to those which lost >15 letters were decreased by year. The pro

DOI： 10.1136/bjophthalmol-2019-315726

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

This study evaluated stereopsis and other visual functions in patients with idiopathic macular hole (MH), and sought to identify vision-related parameters that affect stereopsis. In this prospective, consecutive, comparative study, 39 eyes of 39 patients with unilateral idiopathic MH were included. At baseline and at 6 months after MH surgery, we evaluated stereopsis, with the Titmus stereo test (TST) and TNO stereotest (TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, as assessed using M-CHARTS, and extent of aniseikonia, by the new aniseikonia test. Preoperative stereopsis (log) in patients with MH were 2.72 ± 0.53 (range 1.9-4.1) in the TST and 2.82 ± 0.65 (range 1.8-3.9) in the TNO. Preoperative TST was significantly correlated with letter contrast sensitivity (p < 0.05), but not with the other visual functions. TNO showed significant correlation with letter contrast sensitivity (p < 0.05) and aniseikonia (p < 0.005). Preoperative TNO was associated with aniseikonia by multivariate analysis (p < 0.005). MH surgery significantly improved stereopsis, BCVA, letter contrast sensitivity, metamorphopsia, and aniseikonia. Postoperative TST and TNO was significantly associated with BCVA by multivariate analysis. Deterioration of stereopsis in MH patients is associated with contrast sensitivity and the degree of aniseikonia.

DOI： 10.1038/s41598-020-59844-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

This study evaluated stereopsis and other visual functions in patients with idiopathic macular hole (MH), and sought to identify vision-related parameters that affect stereopsis. In this prospective, consecutive, comparative study, 39 eyes of 39 patients with unilateral idiopathic MH were included. At baseline and at 6 months after MH surgery, we evaluated stereopsis, with the Titmus stereo test (TST) and TNO stereotest (TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, as assessed using M-CHARTS, and extent of aniseikonia, by the new aniseikonia test. Preoperative stereopsis (log) in patients with MH were 2.72 ± 0.53 (range 1.9-4.1) in the TST and 2.82 ± 0.65 (range 1.8-3.9) in the TNO. Preoperative TST was significantly correlated with letter contrast sensitivity (p < 0.05), but not with the other visual functions. TNO showed significant correlation with letter contrast sensitivity (p < 0.05) and aniseikonia (p < 0.005). Preoperative TNO was associated with aniseikonia by multivariate analysis (p < 0.005). MH surgery significantly improved stereopsis, BCVA, letter contrast sensitivity, metamorphopsia, and

DOI： 10.1038/s41598-020-59844-0

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

PURPOSE: To investigate stereopsis and other visual functions in patients with unilateral epiretinal membrane (ERM) and to identify vision-related parameters affecting stereopsis. METHODS: This prospective study included 63 consecutive patients who were scheduled to undergo vitrectomy for unilateral idiopathic ERM. We examined stereopsis (Titmus Stereo Test, TST; TNO stereotest, TNO), best-corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia, and degree of aniseikonia preoperatively and 6 months postoperatively. RESULTS: Preoperatively, we observed significant correlation between TST scores and other vision-related parameters except severity of metamorphopsia and between TNO score and all the vision-related parameters. Multiple regression analysis showed that preoperative TST and TNO scores were significantly associated with the degree of aniseikonia (both P < 0.01). ERM surgery significantly improved stereopsis, BCVA, contrast sensitivity, and metamorphopsia, but not aniseikonia. Postoperatively, TST was significantly associated with BCVA, and TNO showed association with BCVA and aniseikonia. Postoperative TST and TNO scores showed significant correlation with preoperative aniseikonia (P < 0.005 and P < 0.001, respectively). CONCLUSIONS: Impairment of stereopsis in patients with unilateral ERM was considered to be due to retinally induced aniseikonia. Aniseikonia did not improve by surgery, and preoperative aniseikonia can be a prognostic factor for postoperative stereopsis.

DOI： 10.1007/s00417-020-04625-8

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

Purpose: Postoperative vitreous hemorrhage is a vision-impacting complication of vitrectomy. This preclinical in vitro study assessed the potential ability of a nonswelling polyethylene glycol-based artificial vitreous hydrogel to maintain transparency in the vitreous cavity in the presence of vitreous hemorrhage. Methods: Samples (1 mL) of diluted blood at concentrations of 0.1%, 0.25%, 0.5%, and 1.25% were added to 1 mL samples of polymerized hydrogel in cuvettes (gel + blood group); 2 mL samples of diluted blood at the same concentrations were prepared as controls (blood only group). Spectral transmission curves for the hydrogel (gel + blood group) and diluted blood (blood only group) were obtained before and on days 1, 2, 5, 7, 14, and 28 of the experiment. Between-group comparisons were made using the Student's t-test. The percentage of transmittance in the visible light spectrum (400-700 nm) was measured at each time point. Results: Mean light transmittance was maintained at >90% until day 7 in the gel + blood group and was significantly greater in the gel + blood than in the blood only groups in samples containing blood diluted to 0.25%, 0.5%, and 1.25% during the 28-day study period (P < 0.05). Conclusions: A nonswelling polyethylene glycol-based artificial vitreous hydrogel maintained high optical transparency in the presence of blood through the study period. Injection of this hydrogel into the vitreous cavity at the end of surgery might help to prevent or mitigate vitreous hemorrhage-associated postoperative visual loss.

DOI： 10.1167/tvst.8.6.33

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Language：English   Publishing type：Research paper (scientific journal)  

BACKGROUND/AIMS: To investigate real-world outcomes for best-corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve, centr-involving diabetic macular oedema (DME). METHODS: Retrospective analysis of longitudinal medical records obtained from 27 institutions specialising in retinal diseases in Japan. A total of 2049 eyes with treatment-naïve DME commencing intervention between 2010 and 2015 who were followed for 2 years were eligible. Interventions for DME included anti-vascular endothelial growth factor (VEGF) therapy, local corticosteroid therapy, macular photocoagulation and vitrectomy. Baseline and final BCVA (logMAR) were assessed. Eyes were classified by the treatment pattern, depending on whether anti-VEGF therapy was used, into an anti-VEGF monotherapy group (group A), a combination therapy group (group B) and a group without anti-VEGF therapy (group C). RESULTS: The mean 2-year improvement of BCVA was -0.04±0.40 and final BCVA of >20/40 was obtained in 46.3% of eyes. Based on the treatment pattern, there were 427 eyes (20.9%) in group A, 807 eyes (39.4%) in group B and 815 eyes (39.8%) in group C. Mean improvement of BCVA was -0.09±0.39, -0.02±0.40 and -0.05±0.39, and the percentage of eyes with final BCVA of >20/40 was 49.4%, 38.9%, and 52.0%, respectively. CONCLUSION: Following 2-year real-world management of treatment-naïve DME in Japan, BCVA improved by 2 letters. Eyes treated by anti-VEGF monotherapy showed a better visual prognosis than eyes receiving combination therapy. Despite treatment for DME being selected by specialists in consideration of medical and social factors, a satisfactory visual prognosis was not obtained, but final BCVA remained >20/40 in half of all eyes.

DOI： 10.1136/bjophthalmol-2019-315199

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To assess the efficacy and safety of a new technique, back-flow hydrodissection. SETTING: Hirota Eye Clinic, Yamaguchi, and Department of Ophthalmology, University of Tsukuba, Ibaraki, Japan. DESIGN: Prospective case series and experimental study. METHODS: For back-flow hydrodissection, the irrigation line was connected to the aspiration port of an irrigation/aspiration handpiece using a female-female connector with the irrigation port open. The balanced salt solution was irrigated from the aspiration tip opening with constant pressure, hydrodissection was performed, and the excess fluid was evacuated via the sleeve lumen. In a clinical study, 200 eyes were randomly assigned to conventional hydrodissection with an irrigation cannula or back-flow hydrodissection. In experimental studies, intraocular pressure (IOP) fluctuation and fluid dynamics in the anterior and posterior chamber were evaluated in porcine eyes. RESULTS: The lens became freely mobile in the capsular bag in 99 (99%) of 100 eyes and in 96 (96%) of 100 eyes in the back-flow hydrodissection group and conventional hydrodissection group, respectively (P = .369). There were no between-group differences in any other surgery-related parameters, including surgical time and the complication rate. In porcine eyes, conventional hydrodissection induced a significantly larger increase in IOP than back-flow hydrodissection (P < .0001). Conventional hydrodissection immediately washed out fluorescein-stained ophthalmic viscosurgical device (OVD) from the anterior chamber, while there was little leakage of OVD from the eye with back-flow hydrodissection. The endoscopic view showed that conventional hydrodissection induced rapid and severe bulging of the posterior capsule; however, bulging was gentle and mild with back-flow hydrodissection. CONCLUSION: Back-flow hydrodissection was safe and effective in disengaging the lens from the capsule, ensuring a freely mobile lens.

DOI： 10.1016/j.jcrs.2019.05.016

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

This study investigated the changes in the severity of aniseikonia after surgery for macula-off retinal detachment (RD), and the relationship between aniseikonia and retinal microstructures. The study included 26 eyes of 26 patients undergoing RD surgery. Visual acuity was measured preoperatively, and at 3, 6, and 12 months postoperatively. Degree of aniseikonia and OCT images were obtained at 3, 6, and 12 months postoperatively. The aniseikonia values (mean ± standard deviation) at 3, 6, and 12 months postoperatively were -5.3 ± 4.2%, -4.4 ± 4.4%, and -3.1 ± 3.2%, respectively. Significant improvement was observed from 3 to 12 months postoperatively (P = 0.001). Twelve months postoperatively, 14 eyes had micropsia, 1 eye had macropsia, and 11 eyes were free of aniseikonia. Stepwise multiple regression analyses revealed that the severity of aniseikonia at 12 months postoperatively was significantly associated with postoperative development of cystoid macular edema (CME) and epiretinal membrane (ERM), as well as area of preoperative RD. In conclusion, although aniseikonia was gradually relieved after RD surgery during a 1-year follow-up period, approximately half of patients had aniseikonia and almost all of them had micropsia. Aniseikonia was associated with presence of postoperative CME, ERM, and area of preoperative RD.

DOI： 10.1038/s41598-019-48112-5

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)  

[PURPOSE] To evaluate stereopsis before and after intravitreal ranibizumab (IVR) injections in patients with branch retinal vein occlusion (BRVO) and investigate the relationship between stereopsis and retinal microstructure.
[DESIGN] Prospective, observational, controlled study.
[PARTICIPANTS] Thirty-two eyes of 32 patients undergoing IVR treatment for BRVO and 28 eyes of age-matched healthy control participants.
[METHODS] Stereopsis was measured using the Titmus stereo test (TST) and TNO stereo test before and 1, 2, 3, 4, 5, and 6 months after treatment.
[MAIN OUTCOME MEASURES] Stereopsis, best-corrected visual acuity (BCVA), duration of disease, central retinal thickness, status of the external limiting membrane, ellipsoid zone, and external limiting membrane, and serous retinal detachment (SRD) after treatment.
[RESULTS] Treatment with IVR significantly improved the TST (P < 0.001) and TNO stereo test (P < 0.05) scores as well as BCVA (P < 0.001) and central retinal thickness (P < 0.005). Stereopsis after IVR injection in eyes with BRVO was significantly worse than that in healthy control participants (TST, P < 0.001; TNO stereo test, P < 0.001). The TST and TNO stereo test scores were correlated significantly with BCVA and the presence of SRD at baseline. After 6 months of treatment, an association of TST and TNO stereo test scores with BCVA and status of the external limiting membrane and ellipsoid zone was observed. Stereopsis after treatment showed a significant relationship with BCVA and presence of SRD at baseline.
[CONCLUSIONS] Administration of IVR for BRVO improved early stereopsis, albeit not to a normal level. Presence of SRD and visual acuity were predictors of stereopsis after treatment in patients with BRVO.

DOI： 10.1016/j.oret.2019.04.003

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：Ovid Technologies (Wolters Kluwer Health)  

Purpose: To evaluate the clinical characteristics and visual outcomes of patients with traffic accident-related open globe injuries, and to examine preoperative factors influencing the visual prognosis after pars plana vitrectomy, as compared with common open globe injuries. Methods: Patients with open globe injuries, who underwent pars plana vitrectomy, were identified. Patients' demographic and clinical data were entered into a computerized database for review and analysis; data included age, sex, initial visual acuity, duration between onset of injury and surgery, information about the type and cause of injury, wound location and length, presence of ocular complications, and final visual acuity. Results: Of the 355 open globe injuries, 14 were sustained during a traffic-related accident; the average age was 50.4 years (range: 20-85) and most (78.6%) were men. Of these 14 patients, 9 (64.3%) presented with rupture and 5 (35.7%) with laceration. Injuries were caused while driving (6 eyes; 42.9%), riding a bicycle (5 eyes; 35.7%), involved in car accident while walking (2 eyes; 14.3%), and riding a motorbike (1 eye; 7.1%). Initial visual acuity was significantly related to final vi

DOI： 10.1097/iae.0000000000002012

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

[PURPOSE] To evaluate the short-term changes in intraocular pressure (IOP) after intravitreal injection of bevacizumab (IVB) in premature infants with retinopathy of prematurity (ROP).
[STUDY DESIGN] Prospective cohort study.
[METHODS] Twenty-two eyes of 11 premature infants with ROP were evaluated. The control eyes were from adults who received an intravitreal injection of antivascular endothelial growth factor agent. The patients received a 0.025 mL (0.625 mg) IVB for the ROP. The IOP was measured with a rebound tonometer at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection. The clinical data were collected. The main outcome measures were the IOP values at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection.
[RESULTS] The mean IOP values at baseline, immediately after the injection, and at 5, 10, 15, 20, and 30 minutes after the injection were 12.3 ± 3.0, 40.1 ± 10.7, 20.8 ± 5.1, 15.1 ± 4.8, 11.9 ± 3.2, 9.9 ± 2.6, and 8.8 ± 2.1 mmHg, respectively. The IOP was significantly higher at 5 minutes after the injection (P < .01); however, the pressure in all the eyes normalized (< 21 mmHg) within 15 minutes. None of the clinical parameters, including axial length, was correlated with a high IOP after IVB.
[CONCLUSION] In premature infants with ROP, IVB is tolerable in terms of the short-term elevation in IOP, which returned to a safe range (< 21 mmHg) within 15 minutes of the injection in all the patients. Consecutive IOP measurement might not be necessary after IVB in premature infants with ROP.

DOI： 10.1007/s10384-019-00661-y

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

[PURPOSE] To evaluate real-world evidence for young Japanese patients with rhegmatogenous retinal detachment (RRD) by retrospectively examining surgical procedures and clinical outcomes in the Japan Clinical Retina Study group.
[METHODS] This was a multicentre retrospective study of the medical records of 562 young patients (384 males and 178 females; mean age: 33.0 ± 11.8 years) who had been diagnosed with RRD and who underwent surgical procedures in participating centres during the period between April 2013 and August 2016.
[RESULTS] The selected surgeries were scleral buckling (SB) for 295 eyes (49.7%) and pars plana vitrectomy (PPV) for 262 eyes (44.1%). Between the two surgical procedures, there was no significant difference in the primary anatomical reattachment rate (PARR, SB = 92.2%, PPV = 93.9%); improvements in vision were noted in both groups. The incidences of proliferative vitreoretinopathy and cataract formation within 1 year of PPV were 2.3% (p = 0.0047) and 6.5% (p = 0.0005), whereas they were 0% and 1.0% in the SB group, respectively.
[CONCLUSION] Scleral buckling (SB) and PPV were chosen with almost equal frequency for young patients with RRD. Clinica

DOI： 10.1111/aos.14050

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Publishing type：Research paper (scientific journal)   Publisher：Springer Science and Business Media LLC  

DOI： 10.1007/s10384-018-0638-x

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Other Link： http://link.springer.com/content/pdf/10.1007/s10384-018-0638-x.pdf

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ACADEMIC PRESS LTD- ELSEVIER SCIENCE LTD  

The purpose of this study was to evaluate absorbable polyethylene glycol (PEG)-based synthetic hydrogel as a sealant for retinal breaks in rhegmatogenous retinal detachment (RD). A three-port, 25-gauge vitrectomy was performed on nine Dutch pigmented rabbit eyes. Subsequently, RD was induced by creating a retinal break. The retina was then reattached by fluid-air exchange. In six of nine eyes (RD-PEG group), PEG sealant was applied to completely cover the retinal breaks, and then photopolymerized with light; thereafter, intravitreous air was replaced with balanced salt solution (BSS). In the remaining three eyes (RD group), PEG sealant was not applied, but the intravitreous air was replaced with BSS. Ophthalmological examinations and intraocular pressure measurements were conducted preoperatively, and at 1 and 7 days, and 1, 3, and 6 months postoperatively. Histological examinations of the eyes were performed after 6 postoperative months. At surgery, retinal reattachment with PEG sealant was achieved in all eyes in the RD-PEG group. Fundoscopic and optical coherence tomographic examinations revealed that the retina remained attached in all the eyes of the RD-PEG group throughout th

DOI： 10.1016/j.exer.2018.08.004

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier BV  

[PURPOSE] To evaluate the relationship between retinal microstructure and central visual field sensitivity (CVFS) after vitrectomy with internal limiting membrane (ILM) peeling for epiretinal membrane (ERM) using swept-source (SS) OCT and Humphrey Field Analyzer (HFA) (Zeiss, Dublin, CA) 10-2 program.
[DESIGN] Retrospective, interventional case series.
[PARTICIPANTS] Forty-five eyes in 45 patients with unilateral ERM who were treated with vitrectomy with ILM peeling using indocyanine green (ICG) or triamcinolone acetonide (TA) staining.
[METHODS] We evaluated retinal microstructure (full thickness of the retina, thickness of the retinal ganglion cell complex [GCC], and thickness of the outer retinal layer) with SS-OCT and CVFS using HFA 10-2 before and 3 and 12 months after vitrectomy with ILM peeling. Data were analyzed using a standard Early Treatment of Diabetic Retinopathy Study (ETDRS) grid, with thresholds measured at 68 points corresponding to ETDRS grid locations using HFA 10-2. Retinal microstructure and CVFS in normal contralateral eyes were also measured and used as controls. We also compared the ICG-stained group (27 eyes), TA-stained group (18 eyes), and control group

DOI： 10.1016/j.oret.2018.04.020

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

[PURPOSE] To describe the epidemiology and clinical outcomes of open globe injuries (OGIs) in Japan over 10 years, and examine preoperative factors influencing the visual prognosis after surgery.
[STUDY DESIGN] Retrospective, observational, multicenter case-series study.
[METHODS] Patients' data were entered into a computerized database for review and statistical analyses. The following parameters were assessed; age, gender, initial and final visual acuity, duration between onset and surgery, presence of lens in the eye, characteristics of injury, presence of ocular complications, and number of surgeries.
[RESULTS] The records of 374 eyes with OGI were enrolled. The average age of the patients was 56.8 ± 22.1 years, and the majority of patients were men (73.5%). Compared to the overall cohort, work-related OGI was the most common, associated with significantly better final visual acuity, whereas patients with fall-down OGI showed significantly worse final visual acuity (P < 0.05). Among the types of injury, both the initial and final visual acuity were significantly worse in the rupture group than in the laceration group. Multiple liner regression analyses revealed that the final visual acuity was significantly associated with initial visual acuity, type of injury (rupture), retinal detachment, and proliferative vitreoretinopathy.
[CONCLUSION] To predict the visual outcome in patients with OGI, ophthalmologists need to pay attention not only to the initial visual acuity but also to initial ocular conditions, such as the presence of ocular complications.

DOI： 10.1007/s10384-018-0638-x

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

[OBJECTIVE] To determine the current clinical preferences of anti-vascular endothelial growth factor (VEGF) treatment protocols for diabetic macular edema (DME) in Japan.
[RESEARCH DESIGN AND METHODS] This was a descriptive cross-sectional study. Answers to a questionnaire consisting of 16 questions were obtained from 176 of 278 (63.3%) surveyed ophthalmologists.
[RESULTS] The results showed that 81.2% preferred intravitreal injections of anti-VEGF antibodies as the first line therapy. The most important indicators for beginning anti-VEGF therapy were: the best-corrected visual acuity (BCVA) in 44.3% and the retinal thickness in 30.7%. In the loading phase, 53.4% preferred a single injection, and in the maintenance phase, 75.0% preferred the pro re nata (PRN) regimen. Financial limitation (85.8%) was reported as the most important difficulty in the treatment. For combination therapy with anti-VEGF treatment, panretinal photocoagulation, focal-PC, and a sub-Tenon's steroid injection were preferred. The contraindications for anti-VEGF therapy were: prior cerebral infarction (72.7%). For use of both approved anti-VEGF agents in Japan, ranibizumab and aflibercept, 39.8% doctors used th

DOI： 10.1111/jdi.12929

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

[PURPOSE] A surgical technique is described that facilitates membrane peeling in patients with macular diseases by using small amounts of perfluorocarbon liquid (PFCL) and brilliant blue G (BBG) dye.
[STUDY DESIGN] Retrospective cohort study.
[METHODS] After placing about 1.0-1.5 cc PFCL on the macular area, BBG was applied with a 27-gauge blunt needle at the interface of PFCL and retina. The membrane peeling was performed under PFCL.
[RESULTS] The amount of BBG dye with PFCL-assisted staining technique has the potential to be smaller than in conventional staining method. Since the displacement angle of the membrane during peeling procedures is considerably increased by PFCL, combined with its high specific gravity and interfacial tension, the risk of tearing the membrane during manipulation is reduced to a great extent. The postoperative visual function in patients with PFCL-assisted peeling was comparable to that of patients without PFCL-assisted peeling.
[CONCLUSION] The PFCL-assisted technique enables sufficient membrane staining with minimal amounts of BBG dye, with tearing of the epiretinal membrane or internal limiting membrane being less likely than with the conventional method.

DOI： 10.1007/s10384-018-0613-6

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Blackwell Publishing Ltd  

Purpose: To compare rates of myopia progression and adverse events between orthokeratology (OK) and soft contact lens (SCL) wearers over a 10-year period in schoolchildren. Methods: Medical records of consecutive patients (≤16 years of age at baseline) who started OK for myopia correction and continued the treatment for 10 years were retrospectively reviewed. For the control group, patients who started using soft contact lenses (SCLs) for myopia correction and continued to use them for 10 years were also reviewed. Clinical data, including sex, age, manifest refraction, visual acuity, prescription lens power, and adverse events during the 10-year period, were recorded. Estimated myopia progression was calculated as the sum of ‘changes in prescription lens power during 10 years’ and ‘residual refractive errors at the 10-year visit,’ and was compared between groups. We also compared the incidence of adverse events between groups over the 10-year study period. Results: A total of 104 eyes of 53 patients who underwent OK treatment and 78 eyes of 39 patients who wore SCLs fulfilled the criteria. The estimated myopia progression over the 10-year period found in the OK and SCL groups were −1.26 ± 0.98 and −1.79 ± 1.24 days, respectively
this difference was statistically significant (p = 0.001). Additionally, lower myopia progression was found in the OK in comparison to the SCL group at all baseline ages (p = 0.003 to p = 0.049) except at 16 years old (p = 0.41). No significant difference was found in the number of adverse events found between the OK (119) and SCL (103) groups (p = 0.72). Conclusions: The results of this study supports the long-term efficacy and safety of OK lens wear in reducing myopia progression in schoolchildren.

DOI： 10.1111/opo.12460

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：医学書院  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY  

The purpose of this study was to compare the surgical outcomes of vitrectomy with conventional internal limiting membrane (C-ILM) peeling to that with the inverted ILM (I-ILM) flap technique for large macular holes (MHs). This was a retrospective chart review of consecutive cases with a large MH at nine hospitals in Japan. Among the 1342 eyes, 165 eyes of 165 cases met the inclusion criteria. The results for medium-large MHs with a diameter 400-550 μm were compared to that of eyes with an extra-large MH with a diameter >550 μm. In addition, the results of C-ILM peeling were compared to that of the I-ILM technique. In medium-large MHs, the closure rate was 95.2% (59/62) by C-ILM peeling and 100% (19/19) by the I-ILM technique. In extra-large MHs, the closure rate was 88.4% (38/43) by C-ILM peeling and 100% (41/41) by I-ILM. Although the difference between the two methods was not significant, the I-ILM technique was successful in 100% of the cases. Multiple logistic regression analysis showed the best-corrected visual acuity (BCVA) at 6 months was significantly associated with the preoperative BCVA, MH size, age and sex of the patient. Analyses of the eyes with extra-large MHs s

DOI： 10.1111/aos.13795

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

[PURPOSE] To determine the effects of astigmatism on contrast sensitivity (CS).
[METHODS] Eighteen normal volunteers (30.5 ± 6.0 [mean ± SD] years) were recruited. After correcting each refractive error by spectacles, against-the-rule (ATR) or with-the-rule (WTR) astigmatism of +1.00, +2.00 and +3.00 D was intentionally produced in both eyes, and then binocular CS was measured. The cylindrical addition of different powers (+1.00-+3.00 D) was compensated with spherical lenses so that the spherical equivalent refraction became zero in each eye. Subsequently, the above cylindrical addition was monocularly induced, and binocular CS was measured again. The relation between CS and astigmatic power, axis, and monocular or binocular astigmatism was investigated.
[RESULTS] With binocular ATR and WTR astigmatism, increases in astigmatic power significantly correlated with decreases in the area under the log contrast sensitivity function (AULCSF). With monocular astigmatic defocus, astigmatic power addition did not affect AULCSF. With binocular astigmatic defocus of high-power (+2.00 and +3.00 D), ATR astigmatism deteriorated AULCSF more than WTR astigmatism. In a comparison between binocular and monocular astigmatic defocus, CS was significantly worse with binocular astigmatic defocus than with monocular astigmatic defocus at higher spatial frequencies regardless of astigmatic power.
[CONCLUSIONS] Binocular astigmatic defocus deteriorates CS depending on the amount of astigmatic power. ATR astigmatism reduces CS more than WTR astigmatism dose. In addition, binocular astigmatic defocus affects CS more severely than monocular astigmatic defocus especially at high spatial frequencies.

DOI： 10.1371/journal.pone.0202340

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

[PURPOSE] To determine the efficacy of the combination therapy of intravitreal ranibizumab (IVR) and 577-nm yellow laser subthreshold micropulse laser photocoagulation (SMLP) for macular edema secondary to branch retinal vein occlusion cystoid macular edema.
[METHODS] Retrospective, consecutive, case-control study. Forty-six eyes of 46 patients with treatment-naive branch retinal vein occlusion cystoid macular edema were enrolled. The IVR + SMLP group consisted of 22 patients who had undergone both SMLP and IVR. Intravitreal ranibizumab group consisted of 24 patients who had undergone IVR monotherapy. Intravitreal ranibizumab therapy was one initial injection and on a pro re nata in both groups, and SMLP was performed at 1 month after IVR in the IVR + SMLP group. Preoperatively and monthly, best-corrected visual acuity and central retinal thickness were evaluated using swept source optical coherence tomography.
[RESULTS] Best-corrected visual acuity and central retinal thickness significantly improved at 6 months in IVR + SMLP and IVR groups. Best-corrected visual acuity and central retinal thickness were not significantly different between the two groups at any time points. The nu

DOI： 10.1097/IAE.0000000000002165

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：眼科臨床紀要会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Verlag  

Purpose: To quantitatively assess the biometry of the ciliary body in normal human eyes using ultrasound biomicroscopy. Methods: We evaluated 85 eyes of 85 normal subjects (35 men and 50 women), whose age ranged from 11 to 86 years (mean ± SD, 56.8 ± 20.4 years). The eyes were assessed along the 3-, 6-, 9-, and 12-o’clock meridians relative to the center of the cornea. Clinical data were collected, including age, axial length, ciliary body length (CBL), ciliary body thickness (CBT), anterior chamber depth, iris root thickness, trabecular–iris angle, and scleral-ciliary process angle. Axial length was measured using A-scan ultrasonography. Results: CBL and CBT tended to be larger in the superior than in the inferior quadrant, but the differences among the four quadrants were not statistically significant. The average CBL showed a significant positive correlation with the average CBT (r = 0.40, P &lt
 0.001). Average CBL and CBT were significantly correlated with axial length (r = 0.33, P = 0.031
r = 0.46, P &lt
 0.01 respectively). In addition, the average CBL was significantly correlated with anterior chamber depth (r = 0.23, P &lt
 0.05), trabecular-iris angle (r = 0.29, P = 0.01), and scleral-ciliary process angle (r = 0.40, P &lt
 0.001). Conclusions: Ultrasound biomicroscopic imaging demonstrated that the ciliary body is similar in size in all circumferences, and eyes with longer axial length have an elongated and thicker ciliary body. The values obtained in the present study may serve as standard clinical references.

DOI： 10.1007/s00417-017-3809-4

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To quantitatively assess the biometry of the ciliary body in normal human eyes using ultrasound biomicroscopy.
We evaluated 85 eyes of 85 normal subjects (35 men and 50 women), whose age ranged from 11 to 86 years (mean +/- SD, 56.8 +/- 20.4 years). The eyes were assessed along the 3-, 6-, 9-, and 12-o'clock meridians relative to the center of the cornea. Clinical data were collected, including age, axial length, ciliary body length (CBL), ciliary body thickness (CBT), anterior chamber depth, iris root thickness, trabecular-iris angle, and scleral-ciliary process angle. Axial length was measured using A-scan ultrasonography.
CBL and CBT tended to be larger in the superior than in the inferior quadrant, but the differences among the four quadrants were not statistically significant. The average CBL showed a significant positive correlation with the average CBT (r = 0.40, P &lt; 0.001). Average CBL and CBT were significantly correlated with axial length (r = 0.33, P = 0.031; r = 0.46, P &lt; 0.01 respectively). In addition, the average CBL was significantly correlated with anterior chamber depth (r = 0.23, P &lt; 0.05), trabecular-iris angle (r = 0.29, P = 0.01), and scleral-ciliary process angle (r = 0.40, P &lt; 0.001).
Ultrasound biomicroscopic imaging demonstrated that the ciliary body is similar in size in all circumferences, and eyes with longer axial length have an elongated and thicker ciliary body. The values obtained in the present study may serve as standard clinical references.

DOI： 10.1007/s00417-017-3809-4

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Language：Japanese   Publisher：眼科臨床紀要会  

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Our purpose was to determine the effect of fluid-air exchange on the amount of silicone oil (SO) droplets remaining in the vitreous cavity after removal of the main body of the SO.
This was a retrospective comparative study of 56 eyes of 56 patients that had undergone vitrectomy with SO tamponade. Fluid-air exchange was performed during surgery in 30 eyes [Air Ex(+) group] and was not done in 26 eyes [Air Ex(-) group]. All of the eyes were examined by ultrasonography, and the images were converted to binarized image. The amount of residual SO droplets/vitreal area in the images was expressed as the, "silicone oil index (SOI)". The correlations between SOI and clinical findings were determined.
The SOI was significantly correlated with the axial length (AL, R = 0.444, P = 0.023). The SOI in the Air Ex(+) group was significantly higher (7.4 +/- 2.6%) than in the Air Ex(-) group (4.9 +/- 3.4%; P = 0.004). Multiple linear regression analyses showed that the SOI was independently and significantly correlated with the AL and the Air Ex(+) group (P = 0.003, P = 0.006, respectively).
Fluid-air exchange during vitrectomy to remove residual SO is not effective. Our findings indicate that it may increase the amount of residual SO droplets.

DOI： 10.1007/s00417-017-3701-2

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Verlag  

Purpose: The purpose was to quantify and compare the severity of aniseikonia in patients undergoing vitrectomy for various retinal disorders. Methods: We studied 357 patients with retinal disorders including epiretinal membrane (ERM), macular hole (MH), cystoid macular edema with branch / central retinal vein occlusion (BRVO-CME / CRVO-CME), diabetic macular edema (DME), macula-off rhegmatogenous retinal detachment (M-off RD), and macula-on RD (M-on RD) as well as 31 normal controls. The amount of aniseikonia was measured using the New Aniseikonia Test preoperatively and at 6 months postoperatively. Results: Of all patients, 59% presented aniseikonia. Preoperative and postoperative mean aniseikonia were 4.0 ± 4.1% and 3.0 ± 3.6%, respectively. In particular, 68% of patients with ERM had macropsia, and approximately half of MH, RVO-CME, DME, and M-off RD patients had micropsia. Preoperative aniseikonia was significantly severe in ERM than in other disorders. Vitrectomy improved aniseikonia only in MH, while visual acuity was improved in all disorders except CRVO-CME. Conclusion: More than half of the patients showed aniseikonia preoperatively. A majority of ERM patients exhibited macropsia, whereas MH, RVO-CME, DME, and macula-off RD patients presented micropsia. The aniseikonia score was greatest in ERM patients. In most retinal disorders, surgery significantly improved visual acuity, but not aniseikonia.

DOI： 10.1007/s00417-017-3597-x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Degradation-induced swelling in implanted hydrogels can cause severe adverse reactions in surrounding tissues. Here, we report a new class of hydrogel with extremely low swelling pressure, and demonstrate its use as an artificial vitreous body. The hydrogel has ultralow polymer content (4.0 g l(-1)), low cytotoxicity, and forms in situ in 10 minutes via the crosslinking of clusters of highly branched polymers of tetra-armed poly(ethylene glycol) prepolymers. After injection and gelation in the eyes of rabbits, the hydrogel functioned as an artificial vitreous body for over a year without adverse effects, and proved effective for the treatment of retinal detachment. The properties of the hydrogel make it a promising candidate as an infill biomaterial for a range of biomedical applications.

DOI： 10.1038/s41551-017-0044

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：Japanese   Publisher：(一社)茨城県医師会  

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

[PURPOSE] The purpose was to quantify and compare the severity of aniseikonia in patients undergoing vitrectomy for various retinal disorders.
[METHODS] We studied 357 patients with retinal disorders including epiretinal membrane (ERM), macular hole (MH), cystoid macular edema with branch / central retinal vein occlusion (BRVO-CME / CRVO-CME), diabetic macular edema (DME), macula-off rhegmatogenous retinal detachment (M-off RD), and macula-on RD (M-on RD) as well as 31 normal controls. The amount of aniseikonia was measured using the New Aniseikonia Test preoperatively and at 6 months postoperatively.
[RESULTS] Of all patients, 59% presented aniseikonia. Preoperative and postoperative mean aniseikonia were 4.0 ± 4.1% and 3.0 ± 3.6%, respectively. In particular, 68% of patients with ERM had macropsia, and approximately half of MH, RVO-CME, DME, and M-off RD patients had micropsia. Preoperative aniseikonia was significantly severe in ERM than in other disorders. Vitrectomy improved aniseikonia only in MH, while visual acuity was improved in all disorders except CRVO-CME.
[CONCLUSION] More than half of the patients showed aniseikonia preoperatively. A majority of ERM patients exhibited macropsia, whereas MH, RVO-CME, DME, and macula-off RD patients presented micropsia. The aniseikonia score was greatest in ERM patients. In most retinal disorders, surgery significantly improved visual acuity, but not aniseikonia.

DOI： 10.1007/s00417-017-3597-x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: To quantify metamorphopsia in patients undergoing vitrectomy for idiopathic macular hole (MH) and to investigate the relationship between metamorphopsia and foveal microstructure.
Methods: This is prospective, consecutive, interventional study. Fifty-one eyes of MH were included. Severity of metamorphopsia was quantified using the M-CHARTS and foveal microstructure was assessed with optical coherence tomography preoperatively and at 3 months, 6 months postoperatively. Based on the optical coherence tomography images, the authors quantified minimum and base diameters of MH, macular thickness, defect lengths of external limiting membrane, ellipsoid zone and interdigitation zone, and the area of intraretinal cysts within the fluid cuff.
Results: Mean metamorphopsia score was significantly improved from 0.82 to 0.44. Postoperative mean and horizontal metamorphopsia scores were correlated with pre-operative base diameters of MH, defect lengths of external limiting membrane, and the area of cysts in fluid cuff. Multiple regression analysis revealed that postoperative mean and horizontal metamorphopsia scores were significantly positively relevant to the area of intraretinal cysts within the fluid cuff. Postoperative vertical metamorphopsia score was also correlated with the area of intraretinal cysts within the fluid cuff.
Conclusion: Vitrectomy for MH improved metamorphopsia. Postoperative metamorphopsia was associated with the preoperative area of intraretinal cysts within the fluid cuff.

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We aimed to investigate the relationship between the severity of metamorphopsia and the foveal microstructure measured with spectral-domain optical coherence tomography (SD-OCT) in patients with cystoid macular edema caused by branch retinal vein occlusion (BRVO-CME).
The study included 30 eyes of 30 patients with BRVO-CME. We examined visual acuity and the severity of metamorphopsia using M-CHARTS. Central foveal thickness, central retinal thickness at the fovea (CRT-1 mm), and macular volume were measured with SD-OCT software. The status of ellipsoid zone (EZ), external limiting membrane (ELM), outer retinal cyst, and inner retinal cyst was also evaluated.
The mean metamorphopsia score was 0.77 +/- 0.50, with 28 of 30 patients (93 %) having metamorphopsia (metamorphopsia score aeyen 0.2). The vertical metamorphopsia score (0.89 +/- 0.54) was significantly higher than the horizontal metamorphopsia score (0.64 +/- 0.53) (p &lt; 0.005). The status of EZ and ELM was significantly associated with visual acuity, but not with the mean metamorphopsia score. The mean metamorphopsia score was significantly related to CRT-1 mm (p &lt; 0.05) and the presence of inner retinal cyst (p &lt; 0.05).
The severity of metamorphopsia was significantly associated with central retinal thickness and the presence of inner retinal cyst.

DOI： 10.1007/s00417-016-3382-2

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Other Link： http://search.jamas.or.jp/link/ui/2017043840

Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To assess 1-year clinical results of toric intraocular lenses (IOLs) in eyes having with the-rule (WTR), against-the-rule (ATR), or oblique corneal astigmatism.
SETTING: Four ophthalmic surgical sites, Japan.
DESIGN: Prospective case series.
METHODS: One of 3 toric IOLs or 1 nontoric IOL was implanted in eyes having phacoemulsification and IOL implantation.
RESULTS: The study comprised 218 eyes (155 patients). Based on the suggestion of an online toric calculator with anterior corneal curvature data, 63 eyes received the SN6AT3 IOL with a cylinder power of 1.50 diopters [D] at IOL plane (1.50 D cylinder IOL) 55 eyes the SN6AT4 IOL with a cylinder power of 2.25 D at IOL plane (2.25 D cylinder 10L), and 58 eyes the SN6AT5 IOL with a cylinder power of 3.00 D at IOL plane (3.00 D cylinder 10L) (all Acrysof IQ toric), and 42 eyes received the SN6OWF IOL (nontoric 10L). One hundred ninety-four eyes (89.0%) completed 1-year of follow-up. The centroid error in predicted residual astigmatism calculated using vector analysis was close to the origin in eyes with WTR astigmatism (0.17 diopter [D] @ 174.9 +/- 0.54 D), while those with ATR and oblique astigmatism were significantly shifted toward the ATR direction (P &lt; .001). The distance from the origin was significantly smaller in the WTR group than in ATR and oblique groups (P &lt; .05). The centroid errors were shifted toward ATR in all toric IOL groups (P &lt; .001); however, the distance from the origin was not different between groups (P = .52). Postoperatively, the mean absolute misalignment of the IOLs was 5.92 degrees +/- 5.59 (SD) at 1 day and 6.24 +/- 5.87 degrees at 1 year. The results of other clinical parameters were excellent, with no significant differences between astigmatism categories or IOL models.
CONCLUSION: Based on anterior corneal curvature alone, toric IOLs undercorrected ATR and obastigmatism; however, 1-year clinical results of toric IOLs were highly stable and satisfactory. (C) 2016 ASCRS and ESCRS

DOI： 10.1016/j.jcrs.2016.07.034

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PURPOSE: To quantify the severity of aniseikonia in patients undergoing vitrectomy for idiopathic macular hole (MH) and to examine any relationship between aniseikonia and the foveal microstructure. DESIGN: Prospective, consecutive, interventional case series. PARTICIPANTS: We included 56 eyes of 56 patients who underwent vitrectomy to treat idiopathic MH. METHODS: We examined visual acuity, aniseikonia using the New Aniseikonia Test, and foveal structure using optical coherence tomography (OCT) before and 3, 6, and 12 months after surgery. Based on OCT images, minimum and base diameters of MH, height of MH, and defect lengths of the external limiting membrane (ELM), ellipsoid zone, and interdigitation zone were assessed. MAIN OUTCOME MEASURES: Degree of aniseikonia before and after surgery. RESULTS: The mean aniseikonia was -3.2±4.6%, ranging from -15.5% to +5.0%. Of the patients, 55% had micropsia, 7% had macropsia, and 38% had no aniseikonia. The mean absolute value of aniseikonia improved significantly from 3.8±4.1% before surgery to 1.0±1.5% at 12 months after surgery (P < 0.0001). The preoperative mean absolute value of aniseikonia showed a significant correlation with minimum diameters of MH (P < 0.01), base diameters of MH (P < 0.01), and the defect length of ELM (P < 0.05). In multivariate analysis, preoperative aniseikonia showed a significant correlation with the defect length of ELM (P < 0.05). In contrast, postoperative aniseikonia was not associated with any of the parameters. CONCLUSIONS: Approximately half of MH patients had micropsia. Vitrectomy for MH improved aniseikonia. Preoperative aniseikonia was associated with MH size and the defect length of ELM.

DOI： 10.1016/j.ophtha.2016.05.051

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

Purpose: We conducted an in vivo study using Dutch pigmented rabbit eyes to test the usefulness of polyethylene glycol (PEG) sealant for the closure of sutureless sclerotomies in microincisional vitrectomy surgery (MIVS).
Methods: Three-port, 23-gauge vitrectomy was performed on rabbit eyes. After air leakage was confirmed by the application of 0.625% povidone-iodine at the sclerotomy site, PEG sealant was subconjunctivally injected using a 27-gauge needle through conjunctival incisions to cover the sclerotomy wounds, following which it was polymerized by the application of xenon light for 60 seconds. Ophthalmological examinations and intraocular pressure measurements were conducted the day before and 1, 3, 5, and 7 days after surgery. The eyes were enucleated for histological evaluation 7 days after surgery.
Results: PEG sealant was rapidly polymerized by the application of xenon light after subconjunctival injection, and it firmly sealed the sclerotomies without air leakage, as confirmed by povidone-iodine dropping, in all cases. Conjunctival and scleral wounds closed with PEG sealant were successfully attached and remained intact till the end of the follow-up period. There was no sign of postoperative hypotony or infection in any eye, and no adverse effects of PEG sealant were found. In histological examination, linear scar formation and eosinophilic staining of collagen fibers were observed at the sclerotomy sites, while the sclerotomy tunnels appeared tightly closed.
Conclusions: PEG sealant can be useful for the closure of sutureless 23-gauge vitrectomy incisions in rabbits.

DOI： 10.1167/tvst.5.3.7

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Other Link： http://search.jamas.or.jp/link/ui/2017043840

Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose:To evaluate prognostic factors for metamorphopsia in patients undergoing vitrectomy for epiretinal membrane using spectral domain optical coherence tomography.Methods:This study included 53 eyes of 53 patients undergoing vitrectomy for idiopathic epiretinal membrane. The authors examined visual acuity, severity of metamorphopsia with M-CHARTS, and retinal microstructures with spectral domain optical coherence tomography before surgery and 3 months and 6 months after surgery. Central foveal thickness, parafoveal retinal thickness, macular volume, thickness of the ganglion cell layer, inner nuclear layer, and outer retinal layer (ONL + OPL: outer nuclear layer and outer plexiform layer) were analyzed using an image processing program. The status of the outer retinal lines was also evaluated.Results:Preoperative metamorphopsia score (M-score) significantly correlated with central foveal thickness, inner nuclear layer thickness, and ONL + OPL thickness. Postoperative M-score significantly correlated with postoperative central foveal thickness and inner nuclear layer thickness. Inner nuclear layer thickness had significant correlation with M-score at each time point by multiple regression analysis, whereas other parameters were not relevant. Multiple regression analysis showed that preoperative inner nuclear layer thickness yielded the highest regression coefficient with postoperative M-score.Conclusion:Inner nuclear layer thickness was found to be a good indicator of metamorphopsia both before and after surgery and a predictor of postoperative metamorphopsia in patients with epiretinal membrane.

DOI： 10.1097/IAE.0000000000000602

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

To evaluate mesopic functional visual acuity (FVA) with a newly developed system in normal subjects and to compare the results with photopic FVA, sixty-eight healthy volunteers (24.03 +/- 4.42 [mean +/- standard deviation] years) were enrolled in this study. A commercially available FVA measurement system (AS-28; Kowa, Aichi, Japan) was modified to measure FVA under mesopic conditions as well as photopic conditions. Measurements were performed monocularly in photopic conditions during 60 seconds. After dark adaptation for 15 minutes, the same measurements were repeated in mesopic conditions. Outcomes included starting visual acuity (VA), FVA (the average of VAs), visual maintenance ratio (VMR), maximum VA, minimum VA, and numbers of blinks during the 60-second measurement session, and were compared between mesopic and photopic conditions. Starting VA was -0.11 +/- 0.08 and 0.39 +/- 0.12 logarithm of the minimum angle of resolution (logMAR) in photopic and mesopic conditions, respectively. FVA was -0.06 +/- 0.09 and 0.52 +/- 0.14 logMAR, VMR was 0.98 +/- 0.02 and 0.94 +/- 0.04, maximum VA was -0.15 +/- 0.06 and 0.33 +/- 0.12 logMAR, the minimum VA was 0.05 +/- 0.12 and 0.78 +/- 0.20 logMAR, and the number of blinks was 8.23 +/- 7.54 and 7.23 +/- 6.20, respectively. All these parameters except the number of blinks were significantly different between the two conditions (P &lt; 0.001). Besides, the difference between maximum and minimum VAs and standard deviation of VA were significantly larger in mesopic than in photopic conditions (P &lt; 0.001). This study revealed that not only overall visual function decline but also instability of vision under mesopic conditions even in healthy subjects.

DOI： 10.1371/journal.pone.0134505

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：PUBLIC LIBRARY SCIENCE  

To evaluate mesopic functional visual acuity (FVA) with a newly developed system in normal subjects and to compare the results with photopic FVA, sixty-eight healthy volunteers (24.03 +/- 4.42 [mean +/- standard deviation] years) were enrolled in this study. A commercially available FVA measurement system (AS-28; Kowa, Aichi, Japan) was modified to measure FVA under mesopic conditions as well as photopic conditions. Measurements were performed monocularly in photopic conditions during 60 seconds. After dark adaptation for 15 minutes, the same measurements were repeated in mesopic conditions. Outcomes included starting visual acuity (VA), FVA (the average of VAs), visual maintenance ratio (VMR), maximum VA, minimum VA, and numbers of blinks during the 60-second measurement session, and were compared between mesopic and photopic conditions. Starting VA was -0.11 +/- 0.08 and 0.39 +/- 0.12 logarithm of the minimum angle of resolution (logMAR) in photopic and mesopic conditions, respectively. FVA was -0.06 +/- 0.09 and 0.52 +/- 0.14 logMAR, VMR was 0.98 +/- 0.02 and 0.94 +/- 0.04, maximum VA was -0.15 +/- 0.06 and 0.33 +/- 0.12 logMAR, the minimum VA was 0.05 +/- 0.12 and 0.78 +/- 0.20 logMAR, and the number of blinks was 8.23 +/- 7.54 and 7.23 +/- 6.20, respectively. All these parameters except the number of blinks were significantly different between the two conditions (P &lt; 0.001). Besides, the difference between maximum and minimum VAs and standard deviation of VA were significantly larger in mesopic than in photopic conditions (P &lt; 0.001). This study revealed that not only overall visual function decline but also instability of vision under mesopic conditions even in healthy subjects.

DOI： 10.1371/journal.pone.0134505

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Purpose:To evaluate stereopsis in patients undergoing vitrectomy for epiretinal membrane and to investigate the relationship between stereopsis and foveal microstructures.Methods:This study included 55 eyes of 55 patients who underwent vitrectomy for unilateral epiretinal membrane and 27 age-matched normal subjects. We examined stereopsis using the Titmus Stereo Test, TNO stereotest, and, optical coherence tomography before surgery and 6 months after surgery. Central foveal thickness, central retinal thickness at the parafovea (CRT-3 mm), macular volume, and retinal layer thickness were measured with the optical coherence tomography software and an image-processing program.Results:Epiretinal membrane surgery significantly improved stereopsis in Titmus Stereo Test and in TNO. Stereopsis after surgery was significantly worse than in normal subjects. In stepwise multiple regression analysis, preoperative stereopsis showed a significant association with preoperative CRT-3 mm. Postoperative stereopsis was significantly correlated with postoperative inner nuclear layer thickness. Postoperative Titmus Stereo Test and TNO were significantly related to preoperative CRT-3 mm and preoperative macular volume and inner nuclear layer thickness, respectively.Conclusion:Vitrectomy for epiretinal membrane improved stereopsis, albeit not to a normal level. Titmus Stereo Test, a stereotest with a smaller index, was related to CRT-3 mm, whereas TNO with a larger index was correlated with retinal volume of the entire posterior pole and mean inner nuclear layer thickness.

DOI： 10.1097/IAE.0000000000000470

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. Absorbable polyethylene glycol-based synthetic sealant (PEG sealant) polymerizes under xenon illumination and forms a clear, flexible, and firmly adherent hydrogel. The intraocular biocompatibility of PEG sealant and efficacy for closing retinal breaks were evaluated.
METHODS. In an in vitro study, retinal detachment with a tear was created in porcine eyecups after vitreous gel removal. Polyethylene glycol-based synthetic sealant was applied to cover the tear and polymerized with a 40-second application of xenon light. Retinal adhesion strength was tested by forcefully squirting balanced salt solution (BSS) onto the retinal tear. Polyethylene glycol-based synthetic sealant was soaked in the BSS, incubated at 37 degrees C, and the pH measured periodically over 72 hours. In an in vivo study, PEG sealant was injected into the vitreous cavity of the left eyes of rabbits. Ophthalmologic examinations were performed and bilateral ERGs were recorded simultaneously before and 28 days after injection. The eyes were enucleated for histological evaluation.
RESULTS. Adhesion of PEG sealant to the retina was good in BSS. A forceful squirt of BSS onto the retinal tear covered with PEG sealant did not detach the retina; the retinal tear without PEG sealant detached immediately. The pH of the BSS containing PEG sealant was between 7.2 and 8.2. No inflammatory reaction was observed in the eyes throughout 28 days of follow-up. The ERGs recorded before and after injection showed typical patterns. Histological examinations did not reveal any abnormality or inflammation.
CONCLUSIONS. Polyethylene glycol-based synthetic sealant appeared to effectively seal retinal breaks and was not toxic to the eye.

DOI： 10.1167/iovs.14-15349

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Other Link： http://search.jamas.or.jp/link/ui/2015131223

Language：Japanese   Publisher：(公財)日本眼科学会  

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Purpose: To determine ocular optical parameters that affect axial length elongation in myopic children undergoing overnight orthokeratology.
Design: Prospective, noncomparative study.
Participants: Fifty-nine subjects who met the inclusion criteria were enrolled in this study.
Methods: Axial length and ocular wavefront aberration were assessed before and 1 year after the start of orthokeratology. Corneal topography was performed, and then corneal multifocality was calculated for a 4-mm pupil. After evaluating simple correlations between axial elongation and optical parameters, multiple linear regression analysis was performed to identify explanatory variables with a statistically significant contribution to axial elongation.
Main Outcome Measures: Axial length and ocular wavefront aberration before and 1 year after the start of orthokeratology.
Results: Fifty-five subjects completed the 1-year follow-up examinations. At baseline, their age ranged from 7.2 to 12.0 years. The manifest spherical equivalent refractive error ranged from -3.50 to -0.75 diopters. The mean axial length significantly increased from 24.20 mm at baseline to 24.43 mm 1 year after treatment. The axial elongation showed significant simple correlations with the change in C-2(0), change in second-order aberration, change in coma-like aberration, change in spherical-like aberration, change in total higher-order aberrations, change in corneal multifocality, baseline age, and baseline spherical equivalent refractive error, but not C-4(0). Multiple linear regression analysis showed that the change in coma-like aberration was the most relevant variable.
Conclusions: Asymmetric corneal shapes, rather than concentric and radially symmetric shapes, have a considerable effect on retardation of axial elongation, suggesting that the inhibitory effect of orthokeratology on myopia progression is caused by mechanisms other than the reduction in peripheral hyperopic defocus. (C) 2015 by the American Academy of Ophthalmology.

DOI： 10.1016/j.ophtha.2014.07.042

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To evaluate contrast sensitivity (CS) in patients with epiretinal membrane (ERM) following vitrectomy and to investigate the relationship between CS and foveal microstructures with spectral-domain optical coherence tomography (SD-OCT).
METHODS. Thirty-one eyes of 31 patients with ERM were included. We examined CS with a CSV-1000E chart, a logMAR best-corrected visual acuity (BCVA), and foveal microstructure by using SD-OCT before and at 6 months after surgery. From the CS data, the area under the log contrast sensitivity function (AULCSF) was calculated. Based on the OCT images, we quantified the mean thickness of the ganglion cell layer (GCL), the inner nuclear layer (INL), and the outer retinal layer (outer nuclear layer and outer plexiform layer [ONL+OPL]). The status of the photoreceptor inner and outer segment junction (IS/OS) and external limiting membrane (ELM) was also evaluated.
RESULTS. Vitrectomy significantly improved logMAR BCVA and AULCSF. Even in patients with poor improvement of visual acuity (changes in logMAR BCVA by surgery was &lt;= 0.2), postoperative AULCSF significantly increased by treatment (P &lt; 0.05). Postoperative AULCSF showed a significant correlation with preoperative (P &lt; 0.05) and postoperative (P &lt; 0.05) ONL+OPL thickness, whereas other parameters were not relevant. Postoperative logMAR BCVA significantly correlated with postoperative status of IS/OS (P &lt; 0.05) and preoperative ONL+OPL thickness (P &lt; 0.05).
CONCLUSIONS. In patients with ERM, CS improved even though their visual acuity did not recover significantly by vitrectomy. CS was associated with the thickness of outer retinal layer.

DOI： 10.1167/iovs.14-14035

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Purpose: To quantify aniseikonia in patients undergoing vitrectomy for epiretinal membrane (ERM) and to investigate the relationship between the aniseikonia and the foveal microstructure by spectral-domain (SD) optical coherence tomography (OCT).
Design: Prospective, consecutive, interventional case series.
Subjects: This study included 44 eyes of 44 patients undergoing vitrectomy for idiopathic ERM.
Methods: We examined visual acuity and aniseikonia using the New Aniseikonia Test and SD-OCT before and 3 and 6 months after surgery. On the basis of the obtained OCT image, we divided the 1.0 x 1.0-mm area centered on the fovea into 9 sections at 0.25-mm intervals and quantified the following parameters using an image-processing program: central foveal thickness and mean thickness of the ganglion cell layer, inner nuclear layer (INL), and outer retinal layer (outer nuclear layer + outer plexiform layer). The status of the photoreceptor inner segment/outer segment junction, external limiting membrane, and cone outer segment tips also was evaluated.
Main Outcome Measures: Amount of aniseikonia 6 months after surgery.
Results: Of 44 patients, 39 (89%) had macropsia, 1 (2%) had micropsia, and 4 (9%) had no aniseikonia preoperatively. Mean preoperative aniseikonia was 6.2%+/- 4.5%. Vitrectomy significantly improved visual acuity in patients with ERM but did not change the amount of aniseikonia. Multiple regression analysis revealed that preoperative aniseikonia at 6 months was significantly related to preoperative INL thickness, whereas postoperative aniseikonia at 6 months was associated with postoperative INL thickness at 6 months. Preoperative INL thickness was found to be of significant prognostic value for postoperative aniseikonia at 6 months.
Conclusions: Most of the patients with ERM had macropsia. Aniseikonia was not reduced after surgery. The amount of aniseikonia was associated with INL thickness. (C) 2014 by the American Academy of Ophthalmology.

DOI： 10.1016/j.ophtha.2014.05.016

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To evaluate refractive changes after lens-sparing vitrectomy for rhegmatogenous retinal detachment (RD).
DESIGN: Retrospective case series.
METHODS: A retrospective chart review was conducted in 66 eyes of 66 patients (50.0 +/- 9.9 years old) who had undergone lens-sparing vitrectomy for rhegmatogenous RD. Spherical equivalent refractive power was evaluated before and 1, 2, 3, 6, 9, 12, and 15 months after vitrectomy. The relation between refractive changes and several parameters was investigated, such as axial length, presence of preoperative hemorrhage, preoperative spherical equivalent, retinal tear size, logMAR best-corrected visual acuity, number of laser photocoagulations, occurrence of postoperative vitreous hemorrhage, and degree of postoperative inflammatory reaction. Surgical parameters examined included operative time, wide-angle viewing system use, intraoperative adjuvant and gas tamponade use, vitrectomy system gauge, and surgeon.
RESULTS: Significant and continuous myopic shift was observed after vitrectomy throughout the study period. Spherical equivalent was not significantly different between the operated eyes and the fellow control eyes until 3 months after vitrectomy, but the operated eyes were significantly more myopic at 3 months and later postoperatively (P &lt; .05). Of the 58 eyes finally included (8 patients lost to follow-up), 27 (47%) underwent cataract surgery after vitrectomy. Patients who underwent cataract surgery were significantly older than those who did not (P &lt; .05); no other examined parameter was significantly different between groups.
CONCLUSIONS: A significant myopic progression occurred in eyes after lens-sparing vitrectomy for rhegmatogenous RD. A considerable amount of anisometropia occurred, even in the early postoperative period. Patient age was the only risk factor with the potential to advance the nuclear sclerotic cataract progression after vitrectomy. (C) 2014 by Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ajo.2014.05.018

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To quantify aniseikonia after successful surgical repair of rhegmatogenous retinal detachment (RD), and to investigate the relationship between the severity of postoperative aniseikonia and retinal microstructures as well as clinical parameters.
METHODS. The study included 106 eyes of 106 patients, without any history of ocular disease/surgery and with less than 2 diopters of anisometropia, who had undergone successful retinal reattachment surgery. Aniseikonia was measured with the New Aniseikonia Test, and foveal microstructure was assessed with spectral-domain optical coherence tomography (OCT) at 6 months postoperatively.
RESULTS. Twenty-eight of 106 patients (26%) had micropsia; 17 patients (16%) had macropsia; and 61 patients (58%) had no aniseikonia. The mean absolute value of aniseikonia was 2.3 +/- 6 2.9% (range, -12.5% to -12.0%). Of 57 eyes with macula-on RD, 3 had micropsia and 12 had macropsia. Of 49 eyes with macula-off RD, 25 had micropsia and 5 had macropsia. Eyes with micropsia mostly exhibited persistent or transient cystoid macular edema, subretinal fluid, hyperreflective or disruption of IS/OS line, while most of the eyes with macropsia presented epiretinal membrane. Stepwise multiple regression analysis revealed that postoperative best-corrected visual acuity and the area of RD were significantly relevant to the mean absolute value of aniseikonia.
CONCLUSIONS. These results suggested that approximately half of patients with successful repair of RD had aniseikonia. Eyes with macula-off RD tended to show micropsia, while those with macula-on RD mostly presented macropsia. Micropsia and macropsia were primarily caused by respective specific abnormal structures at the foveal region.

DOI： 10.1167/iovs.14-14618

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To evaluate stereopsis after successful surgery for unilateral rhegmatogenous retinal detachment (RD), and to investigate the relationship between stereopsis and clinical factors.
In 75 patients after RD surgery and 28 age-matched normal subjects, stereopsis was measured using the Titmus Stereo Test (TST) and TNO stereotest. Clinical data were collected, including age, gender, circumferential dimension of retinal tears, area and duration of RD, macular status, surgical procedures, postoperative spherical equivalent, and logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA), low-contrast visual acuity, postoperative lens status (phakia/pseudophakia), and presence of postoperative epiretinal membrane (ERM), to determine the factors related to stereopsis.
Stereopsis in patients after surgery was significantly worse than normal subjects (p &lt; 0.0001). Stereopsis in TST was significantly correlated with the area of RD (p &lt; 0.005), difference of postoperative spherical equivalent between two eyes (p &lt; 0.05), postoperative logMAR BCVA (p &lt; 0.005), difference of postoperative logMAR BCVA between two eyes (p &lt; 0.01), and low-contrast visual acuity (p &lt; 0.05). Stereopsis in TNO stereotest showed significant association with postoperative logMAR BCVA (p &lt; 0.05). Stereopsis in both stereotests were significantly worse in patients with macula-off RD than macula-on RD (p &lt; 0.005, p &lt; 0.01 respectively). No significant relationship was found between stereopsis and other factors. Multiple regression analysis revealed that macular status (on/off) had a significant correlation with both stereopsis in TST and TNO stereotest (p = 0.028, p = 0.019 respectively), whereas other clinical parameters were not relevant.
Stereopsis is significantly deteriorated in patients after RD surgery than in normal subjects. Stereopsis was associated with the difference in refraction between two eyes, postoperative visual acuity and contrast sensitivity, and preoperative macular status.

DOI： 10.1007/s00417-014-2566-x

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER JAPAN KK  

Purpose To investigate the vision-related quality of life (VR-QOL) and visual function in patients undergoing intravitreal injection of bevacizumab (IVB) for persistent diabetic macular edema (DME) after vitrectomy.
Methods This institutional study enrolled 20 consecutive patients (20 eyes) who had received 1.25 mg IVB for persistent macular edema after vitrectomy for DME at least 3 months previously. Visual function and VR-QOL were measured before, and 1 and 3 months after IVB. Measurements included the logarithm of the minimum angle of resolution (logMAR), best corrected visual acuity (BCVA), letter contrast sensitivity, severity of metamorphopsia using M-CHARTS, central retinal thickness using optical coherence tomography, and VR-QOL with the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25).
Results One month after IVB, statistically significant improvements were observed in central retinal thickness, letter contrast sensitivity, and the VFQ-25 "mental health'' subscale score (P&lt;0.05, Dunnett test). LogMAR BCVA, metamorphopsia, and the VFQ-25 composite score did not improve significantly. Three months after IVB, there were no significant improvements in any parameters examined.
Conclusions Intravitreal bevacizumab injection for persistent DME after vitrectomy temporarily improved central retinal thickness, contrast sensitivity, and the psychometric aspect of the VR-QOL, but these effects did not last for over 3 months.

DOI： 10.1007/s10384-014-0323-7

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WICHTIG EDITORE  

Purpose: To determine the incidence of and risk factors for intraocular pressure (IOP) elevation in the immediate postoperative period after vitrectomy for various vitreoretinal disorders.
Methods: A prospective study was performed in 228 consecutive patients with various vitreoretinal disorders. The IOP was measured before surgery, at the end of surgery, and at 5 hours and 1 day after surgery using Tono-Pen XL (R). The IOP at the end of surgery was adjusted to 15.0 +/- 2.0 mm Hg.
Results: Intraocular pressure elevation (&gt;25 mm Hg) was found in 55 (24.1%) and 52 (22.8%) patients at 5 hours and 1 day postoperatively, respectively. The IOP at 5 hours was significantly lower in patients with macular hole (MH) than in those with diabetic macular edema, proliferative diabetic retinopathy (PDR), proliferative vitreoretinopathy, or rhegmatogenous retinal detachment (RD). The IOP at 1 day was significantly higher in patients with PDR and RD than in those with MH and epiretinal membrane. Multiple regression analysis revealed that IOP at 5 hours postoperatively had a significant correlation with the number of laser photocoagulation, preoperative IOP, combined cataract surgery, and 20-gauge vitrectomy. The IOP at 1 day postoperatively was significantly associated with these 4 parameters as well as the severity of postoperative vitreous hemorrhage and use of expanding gas tamponade.
Conclusions: Intraocular pressure elevation was found in approximately one-quarter of cases within 1 day following vitrectomy. The risk factors for IOP elevation included number of laser photocoagulation, combined cataract surgery, severity of postoperative vitreous hemorrhage, and use of expanding gas tamponade.

DOI： 10.5301/ejo.5000350

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To investigate the relationship between metamorphopsia and macular morphologic changes after successful repair of rhegmatogenous retinal detachment (RD).
DESIGN: Prospective, interventional, consecutive study.
METHODS: The study included 129 eyes of 129 patients who had undergone successful retinal reattachment surgery. The severity of metamorphopsia was recorded using M-CHARTS and foveal microstructure was assessed with spectral-domain optical coherence tomography (OCT) at 6-12 months postoperatively.
RESULTS: The mean metamorphopsia score was 0.30 +/- 0.46, and 50 of 129 patients (39%) had metamorphopsia. Metamorphopsia was more severe in eyes with macula-off rhegmatogenous RD than those with macula-on (P &lt; .001). Eighteen of 50 eyes with metamorphopsia exhibited abnormal structures in the macular region (epiretinal membrane, disruption of the photoreceptor inner and outer segment junction, cystoid macular edema, macular hole, or subretinal fluid), whereas the other 32 eyes showed no morphologic changes with OCT. In these 32 eyes, the horizontal metamorphopsia score (0.86 +/- 0.50) was significantly higher than the vertical metamorphopsia score (0.62 +/- 0.39, P &lt; .05). Nine of 69 eyes with preoperative macula-on rhegmatogenous RD developed postoperative metamorphopsia. Of the 9 eyes, 6 showed abnormal macular structures and the other 3 had normal-appearing OCT. The macula briefly detached during vitrectomy in these 3 cases.
CONCLUSIONS: In eyes that remained macula-on throughout surgery and had normal-appearing OCT, metamorphopsia did not develop. In some cases, the reason for metamorphopsia was anatomically obvious. In other cases that were preoperative and intraoperative macula-off, postoperative retinal vertical displacement could cause predominantly horizontal metamorphopsia. ((C) 2014 by Elsevier Inc. All rights reserved.)

DOI： 10.1016/j.ajo.2013.08.007

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To compare the Acrysof IQ toric intraocular lens (IOL) and the Acrysof IQ aspheric nontoric IOL and evaluate the effect of preoperative corneal astigmatism orientation on results.
SETTING: Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Ibaraki, Japan.
DESIGN: Comparative case series.
METHODS: This retrospective chart review comprised patients with cataract and preoperative corneal astigmatism between 1.0 diopter (D) and 2.5 D having toric IOL (toric group) or aspheric nontoric IOL (nontoric group) implantation. Eyes were grouped depending on the preoperative axis of corneal astigmatism; that is, with the rule (WTR), against the rule (ATR), and oblique. Preoperative and postoperative analyses included uncorrected (UDVA) and corrected (CDVA) distance visual acuities and cylindrical power preoperatively and 3 months postoperatively.
RESULTS: The postoperative CDVA was not significantly different between the 2 IOLs; however, the postoperative UDVA was significantly better in the toric group than in the nontoric group (P&lt;.0001). The postoperative residual cylindrical power was significantly smaller in the toric group (P&lt;.0001). In eyes with ATR and oblique astigmatism, the mean postoperative UDVA was significantly better in the toric group, whereas there were no differences between the 2 groups in patients with WTR astigmatism.
CONCLUSIONS: There was significant improvement in postoperative cylinder and UDVA with toric IOLs compared with nontoric IOLs. With a superior corneal incision, the benefits of astigmatism correction with the toric IOL were more significant in patients with ATR and oblique astigmatism than in those with WTR astigmatism. (C) 2013 ASCRS and ESCRS

DOI： 10.1016/j.jcrs.2013.06.019

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To investigate intraocular pressure (IOP) fluctuation during various vitrectomy maneuvers using the vitrectomy system (Alcon Constellation Vision System).
DESIGN: An experimental study as laboratory investigation.
METHODS: In porcine eyes, 23- and 25-gauge vitrectomy was performed, and IOP fluctuations were evaluated in vitreous cutting mode, in aspiration mode, and during scleral compression. The measurements were performed with the IOP control setting turned on or off.
RESULTS: Using the 23-gauge system with the IOP control setting turned on, IOP decreased from 30 to 23.7 mm Hg after starting vitreous cutting, and then returned to 30 mm Hg in 2.6 seconds. When the IOP control setting was turned off, IOP decreased to 19.1 mm Hg in 0.9 seconds, and remained at that pressure. Under aspiration at 650 mm Hg without cutting, IOP showed a sharp depression from 30 to 12.2 mm Hg, and then returned to 30.6 mm Hg in 2.6 seconds with the IOP control setting turned on. When the IOP control setting was turned off, IOP decreased to 2.2 mm Hg in 9.7 seconds, and did not recover. When the sclera was compressed without aspiration, IOP rapidly increased to 70-100 mm Hg, and then slowly decreased to 30 mm Hg in 3.5-4.0 seconds, with or without the IOP control system. Similar data were obtained with 25-gauge vitrectomy.
CONCLUSIONS: The IOP control system can attenuate IOP fluctuations during vitrectomy maneuvers. There was no significant difference in IOP fluctuations between 23- and 25-gauge systems. (C) 2013 by Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ajo.2013.06.016

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BIOMED CENTRAL LTD  

Background: To the best of our knowledge, only 14 cases of orbital or periorbital compressed air injuries from air guns or hoses have been reported in the literature.
Case presentation: A 30-year-old man was accidentally injured when a compressed air hose nozzle hit his right eye. The right half of his face was markedly swollen and a skin laceration near the right medial canthus was identified. A computed tomography scan showed subcutaneous and intraorbital emphysema around the right eye as well as cervical and mediastinal emphysema. He was prophylactically treated with systemic and topical antibiotics to prevent infection. All emphysemas had completely resolved 2 weeks after the injury.
Conclusions: A review of all 15 cases (including ours) showed that all patients were male and that 6 of the 15 (40.0%) cases were related to industrial accidents. Although emphysema was restricted to the subconjunctival space in 2 (13.3%) cases, it spread to the orbit in the remaining 13 (86.7%) cases. Cervical and mediastinal emphysemas were found in 3 (20.0%) cases, and intracranial emphysema was confirmed in 6 (40.0%) cases. Prophylactic antibiotics were used in most cases and the prognosis was generally good in all but one patient, who developed optic atrophy and blindness.

DOI： 10.1186/1471-2415-13-68

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To evaluate changes in contrast sensitivity after surgery for macula-on rhegmatogenous retinal detachment (RRD).
DESIGN: Prospective, interventional, consecutive, case-control study.
METHODS: This study included 84 eyes of 84 patients with unilateral macula-on RRD undergoing primary scleral buckling or vitrectomy without postoperative macular complication. We examined the logarithm of the minimal angle of resolution best-corrected visual acuity (logMAR BCVA) and contrast sensitivity at 4 spatial frequencies (3, 6, 12, and 18 cycles/degree) using the CSV-1000E (Vector Vision) before and after surgery. From the data obtained with the CSV-1000E, the area under the log contrast sensitivity function was calculated. The logMAR BCVA and contrast sensitivity in the contralateral normal eyes also were measured and were used as normal controls. Clinical data were collected, including age, gender, surgical procedures, the number of retinal tears, circumferential dimension of retinal tears, and area of retinal detachment, to determine the clinical factors related to visual function.
RESULTS: Preoperative contrast sensitivity was significantly worse in eyes with RRD than in normal controls, but the preoperative logMAR BCVA was not different from that of normal controls. Contrast sensitivity decreased significantly after surgery, but logMAR BCVA did not change by surgery. Multiple regression analysis revealed that postoperative contrast sensitivity had a significant correlation with the circumferential dimension of retinal tears, whereas no clinical parameters were associated significantly with postoperative BCVA.
CONCLUSIONS: Surgery for macula-on RRD did not change visual acuity, whereas contrast sensitivity was affected significantly in association with the extent of retinal tears. ((C) 2013 by Elsevier Inc. All rights reserved.)

DOI： 10.1016/j.ajo.2013.05.017

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MARY ANN LIEBERT, INC  

Purpose: To investigate the influence of an eye ointment on functional visual acuity (FVA) and ocular wavefront aberration. Methods: In 11 healthy volunteers (6 men and 5 women), visual function parameters, such as FVA, visual maintenance ratios (VMR), and minimal visual acuity (minVA), were assessed by the FVA measurement system before and 2, 5, 10, 20, 30, 40, 50, 60, 90, 120, 180, and 240min after administration of ofloxacin eye ointment. Ocular aberration was also measured, and the root mean square (RMS) of second-, third-, fourth-, and total higher-order aberrations was determined. The time course of changes in each parameter was statistically analyzed by using repeated-measures analysis of variance and the Dunnett post hoc test, and relationships between visual function and ocular aberration parameters were also analyzed by the Pearson correlation test. Results: FVA, VMR, and minVA showed significant deteriorations at 2-, 5-, 10-, and 20min after administration of eye ointment compared with the baseline values (P&lt;0.05). All components of ocular wavefront aberration such as second-, third-, fourth-, and total higher-order RMS significantly increased at 2- and 5min after the administration of eye ointment compared with the baseline values (P&lt;0.05). In addition, deteriorations of these visual function parameters were significantly correlated with reduced blink numbers (Pearson's correlation coefficient; r=-0.76, P=0.017 for FVA, r=0.79, P=0.013 for VMR, and r=-0.62, P=0.040 for minVA), and VMR was significantly related with changes in second-order RMS (r=-0.60, P=0.049). Conclusions: Eye ointment significantly reduced visual function for at least 20min. Especially, minVA was worse than 0.155 logMAR, which is legally required for driving, for 3h after the administration. In addition, increases in lower-order aberration and low blink rates were associated with the degradation of visual function.

DOI： 10.1089/jop.2013.0024

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: To investigate the time course of changes in aqueous flare intensity after vitrectomy for rhegmatogenous retinal detachment (RD) and to determine the clinical factors related to an increase in aqueous flare.
Methods: The present study included 22 unilateral patients with RD undergoing primary 20-gauge vitrectomy. Aqueous flare intensity was measured preoperatively and at 1 week, 2 weeks, 1 month, and 3, 6, and 12 months postoperatively using the laser flare meter.
Results: Before vitrectomy, aqueous flare intensity was significantly higher in eyes with RD than in contralateral normal eyes. Vitrectomy increased aqueous flare intensity, and the peak was observed at the first postoperative week. Aqueous flare intensity decreased to a stable level at 3 months postoperatively but remained significantly higher than that of contralateral and preoperative eyes throughout the observation period. Clinical factors that were found to be significantly correlated with an increase in aqueous flare intensity included 1) before the surgical procedure: extent of RD and intraocular pressure, and 2) 3 months postoperatively: size of retinal breaks, number of laser photocoagulation spots, operation time, and performance of combined cataract surgery. Multiple regression analysis revealed that aqueous flare intensity at 3 months postoperatively had significant correlation with the size of retinal breaks (P &lt; 0.005) and the number of laser photocoagulation spots (P &lt; 0.05).
Conclusion: Aqueous flare intensity after vitrectomy for RD decreased to a stable level at 3 months postoperatively but remained significantly higher than the normal level. The size of retinal breaks and the degree of surgical invasion were associated with the increase in aqueous flare. RETINA 32:1862-1867, 2012

DOI： 10.1097/IAE.0b013e3182456f38

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To investigate the relationship between the severity of metamorphopsia and the foveal microstructure measured with spectral-domain optical coherence tomography (SD-OCT) in patients with epiretinal membrane (ERM).
METHODS. This study included 48 eyes of 48 patients with idiopathic ERM and 18 age-matched normal controls. We examined the logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA) and the severity of metamorphopsia using M-CHARTS. Central foveal thickness (CFT), central retinal thickness at the fovea (CRT-1mm) and parafovea (CRT-3mm), and macular volume (MV) were measured with SD-OCT software. Based on the obtained OCT image, we divided the 1.031.0-mm area centered on the fovea into nine sections and quantified the following parameters using an image-processing program: mean thickness of the ganglion cell layer (GCL), inner nuclear layer (INL), and outer retinal layer (ONL+OPL: outer nuclear layer and outer plexiform layer), the degree of the photoreceptor inner and outer segment junction (IS/OS), and external limiting membrane (ELM) disruption.
RESULTS. CFT, CRT-1mm, CRT-3mm, MV, mean GCL, INL, and ONL+OPL thickness were significantly larger in patients with ERM than in normal controls. Multiple regression analysis revealed that the severity of metamorphopsia was significantly related to the mean INL thickness (P &lt; 0.0001). LogMAR BCVA had a significant correlation with the degree of IS/OS disruption (P &lt; 0.05), whereas other parameters were not relevant.
CONCLUSIONS. In patients with idiopathic ERM, the degree of metamorphopsia is associated with INL thickness, and IS/OS status influences visual acuity. (Invest Ophthalmol Vis Sci. 2012; 53: 6770-6775) DOI:10.1167/iovs.12-9683

DOI： 10.1167/iovs.12-9683

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

DOI： 10.1097/IAE.0b013e318263d168

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. Our prospective study was conducted to compare axial length elongation in myopic children receiving long-term overnight orthokeratology (OK) treatment to those wearing spectacles as controls.
METHODS. There were 59 subjects enrolled in this study. The OK group comprised 29 subjects who matched the inclusion criteria for OK. The control group comprised 30 subjects who also matched the inclusion criteria for OK, but preferred spectacles for myopia correction. Axial length was measured periodically for 5 years using an IOLMaster device, and the time course of changes was evaluated and compared between the groups.
RESULTS. A total of 43 subjects (22 and 21 in the OK and control groups, respectively) completed the 5-year follow-up examinations. At baseline, the mean age +/- SD was 10.04 +/- 1.43 and 9.95 +/- 1.59 years, the spherical equivalent refractive error was -1.89 +/- 0.82 and -1.83 +/- 1.06 diopters (D), and the axial length was 24.09 +/- 0.77 and 24.22 +/- 0.71 mm in the OK and control groups, respectively, with no significant differences between the groups. The increase in axial length during the 5-year study period was 0.99 +/- 0.47 and 1.41 +/- 0.68 mm for the OK and control groups, respectively, and the difference was statistically significant (P = 0.0236, unpaired t-test). The annual increases in axial length were significantly different between the groups for the first (P = 0.0002), second (P = 0.0476), and third years (P = 0.0385), but not for the fourth (P = 0.0938) and fifth (P = 0.8633) years. There were no severe complications throughout the study period.
CONCLUSIONS. The current 5-year follow-up study indicated that OK can suppress axial length elongation in childhood myopia. (Invest Ophthalmol Vis Sci. 2012;53:3913-3919) DOI:10.1167/iovs.11-8453

DOI： 10.1167/iovs.11-8453

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Language：Japanese   Publisher：(一社)茨城県医師会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER TOKYO  

The purpose of this study was to determine the incidence of and risk factors for intraocular pressure (IOP) elevation within 24 h following vitrectomy for rhegmatogenous retinal detachment (RD).
We assessed 34 eyes of 34 consecutive patients with RD undergoing vitrectomy and 12 eyes of 12 patients with macular hole as controls. IOP was measured using Tonopen XL before surgery, at the end of surgery, and at 5 h and 1 day postoperatively. IOP at the end of surgery was adjusted to 15.0 +/- A 2.0 mmHg.
IOP elevation was found in five RD eyes at 5 h and in 13 1 day postoperatively. IOP in patients with RD at both 5 h and 1 day postoperatively was significantly higher than that of controls. Circumferential dimension of retinal tears and disease duration were significantly associated with IOP elevation at both 5 h and 1 day postoperatively.
IOP elevation in the early postoperative period following vitrectomy for RD is common. The risk factors for IOP elevation include the extent of retinal tears and duration of detachment. Prophylactic treatment may be useful in eyes with higher risks of IOP elevation.

DOI： 10.1007/s10384-011-0094-3

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Language：Japanese   Publishing type：Research paper (scientific journal)  

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Language：Japanese   Publishing type：Research paper (scientific journal)  

Purpose: To report the vision-related quality of life (QOL) in patients with ocular tumor. Cases and Method: This study was made on 66 patients with ocular tumor, comprising 35 males and 31 females. The age ranged from 20 to 89 years, average 58 years. Malignant tumor was present in 26 cases including lymphoma 16 cases, sebaceous gland carcinoma 5 cases and basal cell carcinoma 3 cases. Benign tumor was present in 40 cases including nevus 8 cases, cyst 8 cases and papilloma 6 cases. QOL was evaluated by VFQ-25. Another group of 91 healthy persons served as control. Results: Vision-related QOL was lower in cases with malignant tumor than in control, with differences in composite score and subscales including dependency and mental health (p&lt
0.05). Cases with orbital tumor showed decrease in near activities and mental health (p&lt
0.05). The tumor size was negatively correlated with QOL (p&lt
0.05). Conclusion: Vision-related QOL is low in cases with malignant tumor. It is lower in patients with orbital tumor than in those with conjunctival or palpebral tumor. Tumor size is negatively correlated with QOL.

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Language：Japanese   Publisher：眼科臨床紀要会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To measure ophthalmodynamometric pressure (ODP) during vitrectomy in patients with proliferative diabetic retinopathy (PDR).
DESIGN: Prospective, interventional, consecutive case series.
METHODS: This study included 75 eyes of 75 patients undergoing vitrectomy for PDR. After core vitrectomy, the intraocular pressure was gradually raised using a vented-gas forced-infusion system (VGFI), and the optic nerve head was continuously monitored through a plano-convex contact lens. When the central retinal artery or its branches on the optic nerve head showed pulsations, the pressure was recorded as ODP. Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured at the time of ODP measurement. Multiple regression analysis was performed to investigate the relationship between ODP and various explanatory variables: DBP, SBP, age, gender, body mass index, presence of hypertension, serum hemoglobin A 1 c, serum total cholesterol, fasting plasma glucose, presence of rubeosis iridis, and severity of PDR.
RESULTS: ODP was 63.6 +/- 11.5 mm Hg (range 15.5-84.4 mm Hg). The ODP significantly correlated with DBP (r = 0.570, P &lt; .0001) and the mean arterial blood pressure (r = 0.522, P &lt; .0001), but not with SBP (r = 0.121, P = .303). Multiple regression analysis revealed that ODP had a significant correlation with DBP (P &lt; .0001), presence of rubeosis iridis (P &lt; .0001), and severity of PDR (P = .046).
CONCLUSIONS: We measured ODP using VGFI during vitrectomy in patients with PDR. The ODP was significantly associated with DBP. The ODP was lower in patients with rubeosis iridis and severe PDR. (Am J Ophthalmol 2011;151:624-629. (C) 2011 by Elsevier Inc. All rights reserved.)

DOI： 10.1016/j.ajo.2010.09.025

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MARY ANN LIEBERT INC  

Purpose: To investigate the influence of 2% carteolol long-acting solution (long-acting carteolol) and 0.5% timolol gel-forming solution (timolol gel) on ocular wavefront aberrations.
Methods: Ocular aberrations were assessed in the right eye of 24 healthy volunteers at baseline and at 2, 5, 10, and 15 min after instillation of long-acting carteolol, timolol gel or physiological saline using the Hartmann-Shack aberrometer. Ten serial measurements were taken over 10 s at each time point, and the root mean square (RMS) of second-, third-, fourth-, and total higher-order aberrations were calculated. The stability index and fluctuation index were also determined.
Results: Second-order aberrations did not change significantly after instillation of study eye-drops. Higher-order aberrations increased significantly after instillation of long-acting carteolol and timolol gel. Timolol gel induced significantly larger changes than long-acting carteolol in third-order RMS at 2 min (P=0.001), fourth-order RMS at 2 (P &lt; 0.001) and 5 (P=0.013) min, and total higher-order RMS at 2 (P &lt; 0.001) and 5 (P=0.016) min after instillation, but not at 10 and 15 min after administration. Fluctuation index increased significantly after instillation of each eye-drop (P &lt; 0.001), with significantly larger increases after timolol gel than long-acting carteolol at 2 min (P=0.005) and 5 min (P=0.011). No significant changes were observed in stability index.
Conclusions: Both topical beta blockers with a once-daily dosing regimen temporarily deteriorate optical quality of the eye by increasing higher-order aberrations, and the increases are much larger after instillation of timolol gel than long-acting carteolol.

DOI： 10.1089/jop.2010.0149

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Purpose: To investigate the influence of timolol maleate 0.5% gel-forming solution and brinzolamide 1% ophthalmic suspension on contrast sensitivity, ocular higher-order aberration (HOA), and corneal surface light scattering.
Design: Prospective, comparative study.
Participants: Forty normal volunteers were enrolled in this study.
Methods: We evaluated contrast sensitivity, ocular HOA, and corneal light scattering before and 2, 5, 10, and 15 minutes after instillation of antiglaucoma eyedrops. Contrast sensitivity function was assessed with the CSV-1000RN chart (Vector Vision Co., Greenville, OH). Higher-order aberration was measured for a 4-mm pupil using the Hartmann-Shack aberrometer (KR-9000PW; Topcon, Tokyo, Japan). Corneal surface light scattering was quantitatively evaluated by using the Scheimpflug camera (EAS-1000, Nidek, Aichi, Japan).
Main Outcome Measures: Time course of changes in contrast sensitivity, ocular HOAs, and corneal light scattering.
Results: Both timolol gel-forming solution and brinzolamide significantly decreased contrast sensitivity for at least 5 minutes after instillation (P &lt; 0.01). There were no significant differences in contrast sensitivity between the drugs at any time points. Higher-order aberration, such as third-and fourth-order aberrations and total HOAs, significantly increased after instillation of each drug (P &lt; 0.001). Timolol gel-forming solution significantly increased HOA up to 5 minutes after instillation (P &lt; 0.05), whereas brinzolamide significantly increased HOA for at least 2 minutes after instillation (P &lt; 0.001). Corneal surface scattering significantly increased for 5 minutes after instillation of brinzolamide (P &lt; 0.01), but not after instillation of timolol gel-forming solution.
Conclusions: Both drugs temporarily deteriorate contrast sensitivity function and optical quality of the eye. However, the mechanism underlying contrast sensitivity reduction seems to be different between the drugs. The reduction may be mainly attributed to increased HOA after instillation of timolol gel and increased light scattering after instillation of brinzolamide.
Financial Disclosure(s): The authors have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2010; 117: 2080-2087 (C) 2010 by the American Academy of Ophthalmology.

DOI： 10.1016/j.ophtha.2010.03.028

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To measure ophthalmodynamometric pressure (ODP) with the vented-gas forced-infusion (VGFI) system during vitrectomy in patients with various vitreoretinal disorders and to investigate factors related to ODP.
METHODS. This study included 169 eyes of 169 patients undergoing pars plana vitrectomy. After core vitrectomy, the intraocular pressure was gradually raised by using the VGFI system. When the central retinal artery or its branches on the optic nerve head showed pulsations, the pressure was recorded as ODP. Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured simultaneously with ODP. Multiple regression analysis was performed to investigate the relationship between ODP and various explanatory variables: DBP, SBP, age, presence of diabetic mellitus (DM) and hypertension (HT), body mass index, and serum total cholesterol.
RESULTS. ODP was 66.9 +/- 12.5 mm Hg (range, 15.5-103.7), and it correlated significantly with DBP (r = 0.60, P &lt; 0.0001) but not with SBP (r = 0.12, P = 0.12). ODP in DM patients who had proliferative diabetic retinopathy and diabetic macular edema was lower than that in non-DM patients, whereas DBP was not significantly different between the two groups. Similar results were obtained in HT patients. Multiple regression analysis revealed that ODP had a significant correlation with DBP (P &lt; 0.0001), presence of DM (P = 0.02), and presence of HT (P = 0.03).
CONCLUSIONS. VGFI is a new method of determining ODP. ODP was significantly associated with DBP and was lower in patients with DM and HT. (Invest Ophthalmol Vis Sci. 2010; 51: 4195-4199) DOI:10.1167/iovs.10-5165

DOI： 10.1167/iovs.10-5165

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To use the 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) to evaluate vision-related quality of life (VR-QOL) in patients with pituitary adenoma who undergo transsphenoidal surgery.
METHODS. The VFQ-25 was self-administered by 74 patients with pituitary adenoma before and 3 months after surgery. Pre- and postoperative clinical data were collected, including age, sex, tumor type and size, logarithm of minimum angle of resolution best corrected visual acuity (logMAR BCVA), critical flicker fusion frequency, static perimetry scores (mean deviation [MD] and corrected pattern SD [CPSD]), duration of ocular symptoms, and number of systemic comorbidities.
RESULTS. Seventy-four patients with a mean age of 48.2 years were studied. Transsphenoidal surgery for pituitary adenoma significantly improved logMAR BCVA and critical fusion flicker frequency in the worse-seeing eye and MD and CPSD scores in both the better-and worse-seeing eyes (P &lt; 0.001). The VFQ-25 composite score and all subscale scores, except those for the general health and color vision subscales, improved significantly (P &lt; 0.05). A multivariate regression analysis revealed that the preoperative VFQ-25 composite score and the preoperative MD and CPSD scores in the better-seeing eye were related to the postoperative VFQ-25 composite score (P &lt; 0.05).
CONCLUSIONS. This study quantitatively demonstrated that transsphenoidal surgery can dramatically improve VR-QOL in pituitary adenoma and that the preoperative VFQ-25 composite score and visual field disturbance in the better-seeing eye are particularly important predictors associated with the postoperative VR-QOL. The use of VFQ-25 provides a more comprehensive overview of the effectiveness of transsphenoidal surgery. (Invest Ophthalmol Vis Sci. 2010; 51:3405-3410) DOI:10.1167/iovs.09-3763

DOI： 10.1167/iovs.09-3763

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：B M J PUBLISHING GROUP  

Aims To investigate the influence of 0.5% timolol gel-forming solution on ocular wavefront aberrations.
Methods In 17 normal volunteers, ocular aberration was assessed before and 5 min, 30 min, 1 h, 2 h, 3 h, 6 h and 12 h after instillation of timolol gel-forming solution. Ocular aberration was sequentially measured over a period of 10 s, and the root-mean-square (RMS) of the second-, third-, fourth- and total higher-order aberrations (HOAs) were determined. From the time course of changes in total HOAs in 10 s, the stability index (SI) and fluctuation index (FI) were calculated. The authors also investigated sequential changes in specific Zernike components such as vertical coma, horizontal coma and spherical aberration.
Results No significant changes in second- order RMS were observed (p=0.452, repeated-measures ANOVA). Topical instillation significantly increased HOAs such as third-, fourth- and total higher-order RMS (p=0.023, p=0.007 and p=0.003, respectively). Multiple comparison analysis revealed significant increases in HOAs 5 min after instillation (p=0.005 for third-, p=0.001 for fourth- and p&lt;0.001 for total higher-order RMS, Dunnett post hoc test). FI increased significantly 5 min after instillation (p=0.013), but SI did not change significantly. With respect to sequential changes in specific components, significant changes were observed in vertical coma (p=0.004, repeated-measures ANOVA) and horizontal coma (p=0.005), but not in spherical aberration.
Conclusion Instillation of timolol gel-forming solution significantly degrades optical quality of the eye for approximately 5 min by increasing HOAs, which may cause blurred vision.

DOI： 10.1136/bjo.2009.164061

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Language：Japanese   Publisher：(公財)日本眼科学会  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Slack, Inc.  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To investigate vision-related quality of life (VR-QOL) in patients undergoing vitrectomy for various vitreoretinal disorders and to evaluate the relationship between VR-QOL and visual function.
METHODS. The study included 100 normal control subjects and 299 patients with various vitreoretinal disorders including proliferative diabetic retinopathy (PDR), diabetic macular edema (DME), branch retinal vein occlusion (BRVO), central retinal vein occlusion (CRVO), macular hole (MH), epiretinal membrane (ERM), and rhegmatogenous retinal detachment (RD). The 25-item National Eye Institute Visual Function Questionnaire (VFQ-25) was answered by the patients with vitreoretinal disorders before and 3 months after pars plana vitrectomy, as well as by the normal control subjects. Clinical data were collected, including visual acuity, contrast sensitivity, and severity of metamorphopsia.
RESULTS. Vitrectomy significantly improved the VFQ-25 composite score in all vitreoretinal disorders. Preoperative VFQ-25 composite scores in MH and ERM were significantly higher than those in PDR, DME, and BRVO. Postoperative VFQ-25 composite scores were significantly higher in MH, ERM, and RD than in PDR, DME, BRVO, and CRVO. A greater improvement in the VFQ-25 composite score was observed in ERM than in DME. Multiple regression analysis revealed that changes in contrast sensitivity had a significant correlation with changes in the VFQ-25 composite score in PDR and DME. Changes in metamorphopsia were significantly associated with changes in the VFQ-25 composite score in MH and ERM.
CONCLUSIONS. Vitrectomy significantly improved VR-QOL in various vitreoretinal disorders. The largest improvement in VR-OL was observed in ERM and smallest improvement in DME. The visual function parameters associated with VR-QOL are different depending on vitreoretinal disorders. (Invest Ophthalmol Vis Sci. 2010; 51: 744-751) DOI: 10.1167/iovs.09-3992

DOI： 10.1167/iovs.09-3992

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本眼科学会  

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2010067496

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：メディカル葵出版  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To quantitatively evaluate the effect of overnight orthokeratology lenses intentionally left decentered after 3 months of wear and assess the influence on clinical outcomes such as ocular higher-order wavefront aberrations and contrast sensitivity function.
SETTING: Department of Ophthalmology, Tsukuba University Hospital, Ibaraki, Japan.
METHODS: This prospective study assessed refraction, visual acuity, corneal topography, wavefront aberration, and contrast sensitivity function before and 3 months after overnight orthokeratology treatment. Decentration of the treatment zone from the center of the entrance pupil was determined using computerized videokeratography (TMS-4) and data-analysis software (MatLab). The relationship between decentration and the clinical parameters was analyzed.
RESULTS: The mean age of the 23 patients (46 eyes) was 24.2 years +/- 3.3 (SD) and the mean spherical equivalent refraction before treatment, -2.38 +/- 0.98 diopters. The mean magnitude of decentration (0.85 +/- 0.51 mm) was statistically significantly correlated with the amount of myopic correction (P&lt;.05), increases in coma-like aberration (P&lt;.01), increases in spherical-like aberration (P&lt;.01), and reductions in contrast sensitivity function (P&lt;.0001). Changes in contrast sensitivity function were also statistically significantly correlated with the amount of myopic correction (P&lt;.05), changes in coma-like aberration (P&lt;.01), and changes in spherical-like aberration (P&lt;.01). Stepwise multiple regression analysis showed that the magnitude of decentration was the only explanatory variable related to contrast sensitivity function (P&lt;.0001).
CONCLUSION: Decentered treatment of orthokeratology resulted in decreased contrast sensitivity after treatment, showing that centration of the procedure is crucial to good outcomes. J Cataract Refract Surg 2009; 35:1918-1926 (C) 2009 ASCRS and ESCRS

DOI： 10.1016/j.jcrs.2009.06.018

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: The purpose of this study was to investigate the influence of overnight orthokeratology on corneal sensation.
Methods: A prospective study was conducted in 34 eyes of 17 patients undergoing overnight orthokeratology. Their ages ranged from 21 to 33 years (23.5 +/- 3.2 years, mean standard deviation). The logarithm of minimum angle of resolution of uncorrected visual acuity at baseline ranged from 0.22 to 1.52 (0.71 +/- 0.32), and myopic refractive error ranged from -1.00 to -4.00 D (-2.15 +/- 0.90 D). Corneal sensation was measured using the Cochet-Bonnet esthesiometer before and 3 months after the start of treatment, and each eye was tested at 5 different corneal locations: one central point and 4 peripheral points at the superior, inferior, temporal, and nasal positions 2 turn away from the limbus.
Results: Overnight orthokeratology significantly reduced corneal sensation from 58.24 +/- 6.14 mm at baseline to 49.12 +/- 13.90 mm at 3 months after the start of treatment at the central point (P = 0.0003, Wilcoxon signed-rank test), from 58.24 +/- 6.14 to 47.65 +/- 14.37 mm at the superior point (P = 0.0002), from 57.50 +/- 6.43 to 48.09 +/- 14.82 mm at the inferior point (P = 0.0004), from 58.24 +/- 6.14 to 50.44 +/- 13.73 mm at the temporal point (P = 0.0009), and from 57.65 +/- 6.54 to 48.68 +/- 14.84 mm at the nasal point (P = 0.0022). There were no significant differences in corneal sensation among these 5 points 3 months after the treatment (P = 0.9549, Kruskal-Wallis test). The induced change in corneal sensation at the central cornea was further analyzed in relation to the amount of myopic correction. There was no significant correlation between the loss of corneal sensation and the amount of myopic correction (r = -0.211, P = 0.2245, Spearman rank correlation).
Conclusions: Overnight orthokeratology significantly reduced corneal sensation at both central and peripheral locations, and the reduction was not correlated with the amount of myopic correction. At present, the clinical significance of this sensory loss is not clear, but practitioners should take this effect into account in the practice of orthokeratology.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To investigate relationship between mesopic contrast sensitivity (CS) function and ocular higher-order aberrations in eyes implanted with conventional spherical intraocular lenses (IOL).
DESIGN: Prospective, nonrandomized case series.
METHODS: Sixty-eight eyes of 48 patients who attained best spectacle-corrected visual acuity (BSCVA) of 20/20 or better after phacoemulsification and spherical IOL implantation were included in the study. At 2 months postoperatively, mesopic CS was measured with the Mesotest II (Oculus; Wetsler, Germany), and ocular higher-order aberrations for a 4-mm pupil were measured with the Hartmann-Shack aberrometer. CS and letter CS under photopic conditions were recorded with the CSV-1000 charts (Vector Vision Co, Greenville, Ohio, USA).
RESULTS: There was significant correlation between mesopic CS and ocular fourth-order root mean square (RMS) of wavefront aberration (Spearman r(s) = -0.293; P =.017), but no correlation was found between mesopic CS and ocular third,order RMS (r(s) = 0.196; P =.189). Ocular third, and fourth-order RMS did not correlate with other parameters, including BSCVA, and CS and letter CS under photopic conditions.
CONCLUSIONS: Mesopic CS is significantly associated with ocular fourth-order RMS of wavefront aberrations in eyes implanted with conventional spherical IOLs. (Am J Ophthalmol 2009;148:298-302. (C) 2009 by Elsevier Inc. All rights reserved.)

DOI： 10.1016/j.ajo.2009.03.022

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-V C H VERLAG GMBH  

A single case of multifocal choroiditis with panuveitis (MFCPU) was investigated by a three-dimensional (3D) high-penetration optical coherence tomography, The HP-OCT is based on a swept-source OCT technology, uses a probe beam with a center wavelength of 1060 nm, and possesses a depth resolution of 10.4 mu min tissue. Two eyes of an MFCPU patient were involved in this study. The eyes were also examined by color fundus photograph, fluorescein angiography (FA), and indocyanine green angiography (ICGA). Findings in these four modalities are comparatively discussed. The OCT scans revealed the following characteristic properties of the lesion sites. Thinning of the retina, destructuring of the retinal layers, and disappearance of the junction of the inner and outer segments of the photoreceptor (IS/OS). Due to the high penetration of this OCT system, the following characteristic properties of the lesions were also observed: localized thinning of the choroid, occlusion of the choroidal vessels, and localized hyper-reflectivity that may represent hyper-pigmentation of the choroid.
[GRAPHICS]
En face high-penetration optical coherence tomography of choroidal inflammation. (C) 2009 by WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim

DOI： 10.1002/jbio.200910017

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose. To assess patient satisfaction following overnight orthokeratology using a visual analogue scale and to find clinical factors that influence patient satisfaction.
Methods. In this prospective study, subjective patient satisfaction with visual outcomes was measured using a visual analogue scale, ranging from 0 (very dissatisfied) to 10 (very satisfied) in 17 patients who completed 1-year follow-up examinations after commencement of orthokeratology. Spherical equivalent refraction at baseline was 2.17 +/- 0.84 diopter (mean +/- SD). Various clinical parameters including refraction, visual acuity, ocular higher-order aberrations, and photopic and mesopic contrast sensitivity function were examined before and after the procedure. The influence of these parameters on patient satisfaction was evaluated using Spearman rank correlation test.
Results. The overall satisfaction with visual outcomes was scored 7.8 +/- 1.8 (range, 3.5 to 10). The level of satisfaction showed significant correlation (Spearman rank correlation coefficient; r = -0.599, p = 0.017) with posttreatment uncorrected visual acuity and pretreatment myopic error (r = 0.500, p = 0.045).
Conclusions. This Study demonstrated a relatively high level of patient satisfaction following overnight orthokeratology. Posttreatment uncorrected visual acuity is associated with patient satisfaction, and patients with higher myopia are predisposed to lower levels of subjective satisfaction. (Optom Vis Sci 2009;86:875-882)

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：B M J PUBLISHING GROUP  

Background: D-beta-Aspartic acid residues, which are biologically uncommon, have been reported to accumulate in various proteins of the living body with age. In the present study, D-beta-aspartic acid-containing proteins were found to be localised in pingueculae, which represent one of the most prominent age-related ocular changes.
Methods: Surgical specimens of conjunctivae with or without pingueculae were obtained from eight patients. Immunohistochemical localisation of D-beta-aspartic acid-containing proteins was performed using a polyclonal antibody against D-beta-aspartic acid-containing peptides.
Results: Strong immunoreactivity to D-beta-aspartic acid-containing peptides was detected in the subepithelial amorphous materials of all surgical specimens with pingueculae. In contrast, no immunoreactivity to D-beta-aspartic acid- containing peptides was detected in the specimens without pingueculae.
Conclusions: Pingueculae are thought to be aggregates of proteins that contain D-beta-aspartic acid residues. It is known that the conversion of L- to D-aspartyl residues is accelerated by ultraviolet irradiation. In addition, D-beta-aspartic acid- containing proteins, in general, tend to aggregate with each other and accumulate in the tissues. These facts indicate that ultraviolet irradiation- induced racemisation of aspartic acid is closely related to the development of pingueculae.

DOI： 10.1136/bjo.2007.135889

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To evaluate the vision-related quality of life (VR-QOL) in patients undergoing vitrectomy for epiretinal membrane (ERM) removal and to investigate the relationship between VR-QOL and the severity of pre/postoperative metamorphopsia.
DESIGN: Prospective, interventional, consecutive, Comparative case series.
METHODS: The 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) was self-administered by 28 patients (age, 66.7 +/- 8.5 years, mean +/- standard deviation) with ERM before and 3 months after vitrectomy. Preoperative and postoperative clinical data were collected, including logarithm of the minimal angle of resolution (logMAR) best-corrected visual acuity (BCVA), letter contrast sensitivity, central macular thickness, and severity of metamorphopsia. The NEI VFQ-25 was also measured in 26 age-matched normal controls.
RESULTS: The preoperative NEI VFQ-25 composite score was significantly lower in ERM patients than in normal controls (P &lt; .0001). Vitrectomy significantly improved NEI VFQ-25 composite score as well as scores of 10 out of 12 subscales (P &lt; .0001), except for general health and peripheral vision. The postoperative NEI VFQ-25 composite score in ERM patients, however, remained significantly lower than that in normal controls (P &lt; .0001). The preoperative NEI VFQ-25 composite score significantly correlated with the severity of preoperative metamorphopsia (P &lt; .05) but not with preoperative logMAR BCVA, letter contrast sensitivity, and central macular thickness. The postoperative NEI VFQ-25 composite score significantly correlated with the degree of postoperative metamorphopsia and logMAR BCVA (P &lt; .05). The changes in NEI VFQ-25 composite score significantly correlated with changes in the severity of metamorphopsia (P &lt; .05), but not with other parameters.
CONCLUSIONS: VR-QOL is significantly impaired in patients with ERM, which is remarkably improved by vitrectomy. The severity of metamorphopsia strongly influences VR-QOL in patients with ERM. (Am J Ophthalmol 2009;147:869-874. (c) 2009 by Elsevier Inc. All rights reserved.)

DOI： 10.1016/j.ajo.2008.11.018

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：JAPAN ATHEROSCLEROSIS SOC  

Aim: Neovascularization is an important event in proliferative diabetic retinopathy (PDR), where various secretory proteins including multiple growth factors are considered to be involved in this process. We searched for secretory proteins expressed in a surgical specimen obtained from the eyes of patients with PDR.
Methods: We developed the oligo-cap signal sequence trap (SST) strategy which enables us to screen for secretory or membrane proteins from a minimal starting material. Using this method, we were able to screen a cDNA library constructed from a surgical specimen obtained from the eyes of the patients with PDR.
Results: Majority of the cloned cDNAs turned out to encode secreted protein acidic and rich in cystein (SPARC), strongly suggesting that SPARC is highly expressed in PDR. Analysis of vitreous fluid from various patients has shown that the concentration of SPARC protein is increased in patients with PDR. Furthermore, subretinal injection of recombinant SPARC adenovirus induced PDR-like changes in the rat eye.
Conclusions: Our results strongly suggested that SPARC is involved in the development of diabetic retinopathy (DR).

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WICHTIG EDITORE  

PURPOSE. To report a rare case of orbital subperiosteal abscess with central retinal artery occlusion that resulted in blindness.
METHODS. A 60-year-old previously healthy woman was referred to the hospital with 4-day history of orbital cellulitis, progressive left eye pain, eyelid swelling, and 1-day history of visual impairment. The patient was diagnosed with subperiosteal abscess of the orbit on diagnostic imaging.
RESULTS. An emergent surgical intervention was performed due to prominent visual impairment. One day after surgery, ophthalmoscopic examination revealed cherry-red spot of the left fundus and central retinal artery occlusion. The final vision of the left eye was no light perception.
CONCLUSIONS. Central retinal artery occlusion, which is a therapeutic emergency, can be associated with acute progression of space-occupying lesion in the orbit such as subperiosteal abscess. (Eur J Ophthalmol 2009; 19: 288-91)

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：日本眼科学会  

Long-term duration of lifestyle-related diseases including diabetes induces various ocular diseases. For this reason, the development of lifestyle-related ocular diseases is closely related to the aging process. In the present study, we tried to reveal the molecular mechanism of lifestyle-related ocular diseases, especially diabetic complications of the eyes, in relation to aging. To unify the molecular mechanisms of diabetic complications and aging changes of the eyes, we focused on two kinds of nonenzymatic post-translational modification products: advanced glycation end products (AGEs) and D-amino acids. We found that the accumulation of proteins rich in AGEs and D-amino acids plays a central role in the development of both diabetic complications and such changes of the eyes as diabetic retinopathy, diabetic keratopathy, pinguecula, spheroidal degeneration of the cornea, and drusen. In addition, decreased function in AGE-modified and D-amino acid-containing proteins is a factor in the development of diabetic complications and aging changes in eyes. In this way, posttranslational changes in molecules and amino acids are important contributing factors in the development of diabeti

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

To investigate the influence of cosmetically tinted soft contact lenses on ocular higher-order aberrations and visual performance, and to analyze the relationship between these parameters after the lens wear.
In 44 eyes of 22 subjects, visual acuity, contrast sensitivity under photopic and mesopic conditions, and ocular higher-order aberrations were evaluated before and after wearing the tinted soft contact lenses (1-day AcuvueA (R) Colours (TM); Vistakon, Jacksonville, FL). Contrast sensitivity under a photopic condition was determined at 3, 6, 12, and 18 cycles per degree, and the area under the log contrast sensitivity function (AULCSF) was calculated. Mesopic contrast sensitivity with and without glare was assessed. Ocular higher-order aberrations for a 4-mm pupil were measured, and coma-like, spherical-like, and total higher-order aberrations were determined.
The tinted contact lens wearing resulted in significant decreases in log contrast sensitivity at all spatial frequencies (P &lt; 0.05) and AULCSF (P &lt; 0.0001), although 100% contrast visual acuity did not change. Log mesopic contrast sensitivity with and without glare was also reduced significantly by the lens wear (P &lt; 0.0001). The contact lens wear significantly increased coma-like, spherical-like, and total higher-order aberrations (P &lt; 0.0001). The induced changes in higher-order aberrations were analyzed in relation to the changes in contrast sensitivity function. Although the changes in coma-like and spherical-like aberrations did not correlate significantly with those in AULCSF (P &gt; 0.05), the changes in total higher-order aberrations showed a significant correlation with those in AULCSF (P &lt; 0.05). On the other hand, there was no significant relationship between the changes in higher-order aberrations and the changes in log mesopic contrast sensitivity with and without glare (P &gt; 0.05).
Cosmetically tinted contact lenses increase ocular higher-order aberrations and worsen contrast sensitivity under both photopic and mesopic conditions. Increases in higher-order aberrations are responsible for decreased contrast sensitivity under the photopic condition. Tinted contact lens wearers should be sufficiently informed about the possible reduction in optical quality of the eye and quality of vision.

DOI： 10.1007/s00417-008-0973-6

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：B M J PUBLISHING GROUP  

Aims: To examine prospectively the recovery of various parameters after discontinuation of overnight orthokeratology.
Methods: Seventeen subjects undergoing orthokeratology for 12 months were examined. Refraction, corneal topography, wavefront aberrometry, a visual acuity test and a contrast sensitivity test were performed at baseline, 12 months after commencement of the procedure, and 1 week and 1 month after discontinuation of the treatment. Asymmetry and higher-order irregularity components were calculated using a Fourier analysis of the corneal topography data. Contrast sensitivity was assessed at four spatial frequencies, and the area under the log contrast sensitivity function (AULCSF) was calculated.
Results: Orthokeratology significantly reduced manifest refraction (p&lt;0.0001) Dunnett test) and significantly improved uncorrected visual acuity (UCVA) at 12 months after commencement of the procedure (p&lt;0.0001). Asymmetry and higher-order irregularity components increased significantly (p&lt;0.0001) p=0.0032, respectively), and third- and fourth-order aberrations also increased significantly (p&lt;0.0001). The treatment resulted in significant decreases in AULCSF (p=0.0004). After discontinuing lens wear, all parameters, such as refraction, UCVA, asymmetry, higher-order irregularity, third- order aberration, fourth-order aberration and AULCSF, returned to the baseline level at 1 week.
Conclusion: This study confirmed that the effect of orthokeratology is completely reversible in light of optical quality of the eye and quality of vision as well as refraction and visual acuity.

DOI： 10.1136/bjo.2007.136655

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To evaluate the clinical significance of the newly developed long-wavelength probe optical coherence tomography (LP-OCT) for the diagnosis of exudative macular diseases.
METHODS. Fourteen eyes of 13 participants were prospectively enrolled in the study. There were seven type I and five type II choroidal neovascularization (CNV) cases associated with age-related macular degeneration and idiopathic neovascularization and one case of polypoidal choroidal vasculopathy (PCV). A custom-built LP-OCT based on swept-source OCT (SS-OCT) technology was used. This new OCT uses a probe beam with a wavelength of 1060 nm that provides deeper penetration into the choroid and higher image contrast to the structures beneath the retinal pigment epithelium (RPE) and pathologic tissues than does conventional OCT. The depth resolution is 10.4 mu m tissue and the measurement speed is 28,000 depth scans/s. All the eyes were also examined by standard short wavelength probe OCT (SP-OCT). The image contrasts of the LP- and SP-OCT were qualitatively evaluated and analyzed by Wilcoxon's paired signed rank test and Spearman's rank correlation test.
RESULTS. In 10 of 14 eyes, high-contrast visualization of the diseases beneath the RPE, CNV, or fibrin was attained. These diseases were almost invisible in the SP-OCT images. The LP- OCT of the remaining eyes also revealed significant improvement in the image contrasts beneath the RPE and CNV. Qualitative evaluation of the image contrasts and subsequent statistical test indicated statistically significant improvement in the image penetration to the choroid of LP- OCT to that of SP-OCT.
CONCLUSIONS. LP-OCT provided significant improvement in the image contrast of exudative macular diseases. (Invest Ophthalmol Vis Sci. 2009; 50: 405-413) DOI:10.1167/iovs.08-2272

DOI： 10.1167/iovs.08-2272

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：NATURE PUBLISHING GROUP  

Aims To evaluate the relation between higher-order aberration of the eye and sensitivity function in eyes with
Methods In 22 eyes of 14 patients with keratoconus (age 30.5 +/- 78.4 years, means +/- SD) and 26 eyes of 13 normal controls (age 29.2 +/- 76.7 years), ocular higher-order aberration for a 6-mm pupil was measured with the Hartmann-Schack aberrometer (KR-9000 PW, Topcon). The root mean (RMS) of third- and fourth-order Zernike coefficients was used to represent higher-order aberrations. The letter-contrast sensitivity examined using the CSV-1000LV contrast (Vector Vision).
Results In the keratoconus group, the letter-contrast sensitivity showed significant correlation with third- order (Spearman&apos;s correlation coefficient r= -0.736, P&lt;0.001) and fourth-order aberrations (r= -0.464, P&lt;0.05). There was borderline correlation between log MAR BSCVA and third- order (r = 0.413, P = 0.070) and fourth-order aberrations (r = 0.394, P = 0.086). In the normal group, the letter-contrast sensitivity had no significant correlation with third- order (r= -0.170, P = 0.411) and fourth-order aberrations (r= -0.088, P and log MAR best spectacle-corrected visual acuity (BSCVA) showed no correlation with third-order (r = 0.063, P = 0.762) and fourth-order aberrations (r = -0.282, P = 0.165).
Conclusions In eyes with keratoconus, there is significant correlation between contrast sensitivity and ocular higher-order aberrations.

DOI： 10.1038/sj.eye.6702902

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To investigate prospectively the time course of changes in ocular higher-order aberration and contrast sensitivity after overnight orthokeratology.
METHODS. Data from 34 eyes of 17 patients who completed 1-year follow-up examinations were analyzed. The manifest refraction was -2.17 +/- 0.86 D at baseline. Ocular higher-order aberrations for a 4-mm pupil were measured, and the root-mean-square (RMS) of the third-, fourth-, and total higher-order aberrations were determined. Contrast sensitivity was assessed at four spatial frequencies, and the area under the log contrast sensitivity function (AULCSF) was calculated. These examinations were performed before and 1, 2, 3, 6, and 12 months after commencement of the procedure.
RESULTS. The treatment significantly increased third-, fourth-, and total higher-order RMS (all P &lt; 0.0001, paired t-test). Log contrast sensitivity significantly decreased at all four spatial frequencies, and AULCSF was also significantly reduced after the treatment (P &lt; 0.0001). To assess the time course of changes in these parameters, posttreatment data were analyzed by using repeated-measures analysis of variance. There were no significant fluctuations in manifest refraction; uncorrected visual acuity; third-, fourth-, and total higher-order RMS; and AULCSF (all P &gt; 0.05). In addition, there was no significant variance in log contrast sensitivity at each spatial frequency during the 1-year follow-up period (all P &gt; 0.05).
CONCLUSIONS. The initial reduction in optical quality of the eye and quality of vision after the procedure is stable during the treatment period of at least 1 year, and the reduction does not worsen further after 1 month. Orthokeratology candidates should be fully informed of these changes.

DOI： 10.1167/iovs.07-1586

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To evaluate the vision,related quality of life (VR-QOL) in patients with pituitary adenoma.
DESIGN: Prospective, consecutive, comparative case series.
METHODS: A VR-QOL questionnaire was distributed to 154 patients with pituitary adenoma. and 81 normal controls. These were presurgical patients. VR-QOL was measured using the 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25). The influence of various factors on VFQ-25 score was assessed, including age, logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA), critical flicker fusion frequency, Humphrey static perimetry scores, and the duration of ocular symptoms.
RESULTS: The VFQ-25 composite score was significantly lower in patients with pituitary adenoma than in the normal controls (P &lt; .001), with significant differences in all subscales except for color vision. The VFQ- 25 composite score in patients with pituitary adenoma was significantly correlated with logMAR BCVA, mean deviation (MD) and corrected pattern standard deviation (CPSD) of Humphrey perimetry, critical flicker fusion frequency, and the duration of ocular symptoms. Stepwise multiple regression analysis revealed that MD score in the better-seeing eye (r = 0.69; P &lt; .001) and the duration of ocular symptoms associated with pituitary adenoma. (r = -0.36; P &lt; .001) were significantly related to the VFQ-25 composite score.
CONCLUSIONS: The VR-QOL is significantly deteriorated in patients with pituitary adenoma. The degree of visual field defect in the better-seeing eye and duration of ocular symptoms were found to be significantly related to the decline of VR-QOL in these patients.

DOI： 10.1016/j.ajo.2008.04.018

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To compare the vision-related quality of life (VR QOL) after rhegmatogenous retinal detachment (RD) surgery with that of normal controls and to investigate the relationship between the VR QOL and visual function after surgery for RD.
DESIGN: Prospective consecutive, comparative case series.
METHODS: The 25-Item National Eye Institute Visual Function Questionnaire (VFQ,25) was self-administered by 51 RD patients at six months after surgery. Among the patients with RD, 33 underwent pars plana vitrectomy and 18 received scleral buckling. We examined the logarithm of the minimum angle of resolution (logMAR) best,corrected visual acuity (BCVA), contrast sensitivity with the CSV-1000E (Vector Vision Co, Greenville, Ohio, USA), and low contrast visual acuity (VA) with the CSV-1000LanC10% (Vector Vision Co). From the data obtained by CSV-1000E, the area under the log contrast sensitivity function (AULCSF) was calculated. The VFQ-25 also was administered to the 46 age-matched normal controls.
RESULTS: The VFQ-25 composite score and the sub-scales associated with near activities, mental health, dependency, and peripheral vision were significantly lower in the RD group than in the normal controls (P &lt;.05). The VFQ-25 composite score significantly correlated with AULCSF (gamma = 0.354; P &lt;.05) and low, contrast VA (gamma = -0-475; P &lt; 0.001), whereas there was no correlation between the VFQ,25 composite score and logMAR BCVA (gamma = 0.172; P =.229).
CONCLUSIONS: The VR QOL is significantly impaired in patients after surgery for RD. The disturbance in VR QOL was significantly associated with deterioration of postoperative contrast sensitivity.

DOI： 10.1016/j.ajo.2008.02.011

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Purpose: To evaluate changes in higher-order aberrations (HOAs) after scleral buckling surgery for the treatment of rhegmatogenous retinal detachment (RD).
Design: Prospective observational comparative case series.
Participants: The study included 67 eyes of 67 rhegmatogenous RD patients undergoing scleral buckling surgery, and the fellow normal eyes comprised the control group. Twenty-seven eyes were treated with the segmental buckling procedure and 40 eyes received the encircling buckling procedure alone.
Methods: Hartmann-Shack wavefront analysis was performed at 2 weeks, 1 month, and 3 months post-operatively.
Main Outcome Measure: Time course of changes in HOAs.
Results: Scleral buckling surgery significantly increased HOAs at 2 weeks (P&lt;0.0001), 1 month (P&lt;0.0005), and 3 months (P&lt;0.05) postoperatively as compared with the control group. At 3 months postoperatively, the HOAs were significantly lower in the encircling group than in the segmental buckling group (P&lt;0.05). The vertical coma (Zernike Z(3)(-1)) became negative (significantly lower than zero, P&lt;0.01) in patients who received segmental buckling in the upper quadrant. The ocular HOAs and logarithm of the minimum angle of resolution best-corrected visual acuity significantly correlated at 3 months postoperatively (third-order root mean square [RMS]: r = 0.445, P&lt;0.0005; fourth-order RMS: r = 0.489, P&lt;0.0001).
Conclusions: Scleral buckling surgery significantly increased HOAs. The segmental buckling procedure increased the HOAs to a greater extent and for a longer duration than the encircling procedure. The direction of coma aberration corresponded to the location of the segmental buckle. The increase in HOAs can be one of the factors responsible for visual disturbances after scleral buckling surgery.

DOI： 10.1016/j.ophtha.2007.09.016

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To evaluate the vision-related quality of life (VR-QOL) and visual function following vitrectomy for proliferative diabetic retinopathy (PDR).
DESIGN: Prospective, interventional, consecutive, comparative case series.
METHODS: The 25-Item National Eye Institute Visual Function Questionnaire (VFQ-25) was answered by 51 patients with PDR before and three months after 20,gauge pars plana vitrectomy. Among the patients with PDR, 30 underwent combined cataract surgery and vitrectomy. Clinical data were collected, including logarithm of minimal angle of resolution (logMAR) best,corrected visual acuity (BCVA), letter contrast sensitivity, and metamorphopsia. The VFQ-25 was also administered to 46 age-matched normal controls.
RESULTS: The preoperative VFQ-25 composite score was significantly lower in the PDR patients (56.3 +/- 18.8, mean +/- standard deviation) than in the normal controls (85.2 +/- 10.3; P &lt; .0001). Vitrectomy significantly improved VFQ-25 composite score (P &lt; .005) and eight of 12 subscales (P &lt; .05). The preoperative VFQ-25 composite score significantly correlated with preoperative logMAR BCVA in the better, seeing eye (P &lt; .001). The postoperative VFQ-25 composite score exhibited significant correlation with postoperative logMR BCVA in the worse,seeing eye (P &lt; .0001) as well as the better,seeing eye (P &lt; .0001). Similar significant correlations were also observed between the VFQ-25 composite score and letter contrast sensitivity.
CONCLUSIONS: Vitrectomy for PDR significantly improves VR-QOL. The current study quantitatively indicates that VR-QOL in PDR patients depends on visual acuity and contrast sensitivity in the better-seeing eye preoperatively and in both the better,seeing and worse, seeing eyes postoperatively.

DOI： 10.1016/j.ajo.2008.02.006

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：WILEY-BLACKWELL  

Purpose: The efficacy and toxicity of triamcinolone acetonide and other lipid formulae - calcium palmitate, cholesterol and 11-deoxycortisol -in the visualization of the prolapsed vitreous body in the anterior chamber after posterior capsule rupture were investigated in animal models.
Methods: in porcine eyes, a suspension of calcium palmitate, cholesterol, triamcinolone acetonide and 11-deoxycortisol was injected into the anterior chamber after intentionally creating posterior capsule rupture. Following gentle irrigation and aspiration, the vitreous body prolapsed in the anterior chamber was removed using an anterior vitrectomy cutter. In phakic rabbit eyes, the side-effects of the reagents were assessed for biomicroscopic appearance, intraocular pressure (IOP) and corneal histology.
Results: The suspension of calcium palmitate, cholesterol, triamcinolone acetonide and 11-deoxycortisol was effective in the visualization of the vitreous body prolapsed in the anterior chamber after posterior capsule rupture. When cholesterol and calcium palmitate were injected into the anterior chamber, they remained there; this induced a significant increase in IOP and corneal oedema. In contrast, most of the triamcinolone acetonide and 11-deoxycortisol that was injected into the anterior chamber had disappeared a day after the injection without affecting IOP or corneal endothelial density. When injected into the intravitreous cavity, triamcinolone led to a significant increase in IOP 2 and 4 weeks after the injection. However, calcium palmitate, cholesterol and 11-deoxycortisol injected into the vitreous cavity had no effect on IOP at 4 weeks.
Conclusion: The suspension of triamcinolone acetonide and 11-deoxycortisol was effective in visualizing the vitreous body prolapsed in the anterior chamber after posterior capsule rupture. However, the amount of the reagent must be kept to a minimum to prevent the potential risk of ocular toxicities and postoperative late-onset ocular hypertension.

DOI： 10.1111/j.1600-0420.2007.01058.x

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Language：English   Publishing type：Research paper (international conference proceedings)   Publisher：SPIE-INT SOC OPTICAL ENGINEERING  

Two pathologic cases are evaluated by high-penetration optical coherence tomography (HP-OCT) to demonstrate its clinical significance. The HP-OCT is based on a swept-source OCT (SS-OCT) technology with a probe wavelength of 1.06 Am. The depth resolution is 10.4 mu m in tissue, and the measurement speed is 28,000 depth-scans/sec. A single case of age-related macular degeneration and a single case of Vogt-Koyanagi-Harada disease are examined by HP-OCT.

DOI： 10.1117/12.762548

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Purpose: To evaluate the changes in regular and irregular corneal astigmatism after 25-gauge transconjunctival sutureless vitrectomy and 20-gauge standard vitrectomy.
Design: Prospective observational comparative case series.
Participants: Thirty-two eyes of 32 patients undergoing 25-gauge transconjunctival sutureless vitrectomy and 25 eyes of 24 patients undergoing 20-gauge standard vitrectomy.
Methods: Corneal topography was obtained preoperatively and at 2 weeks and 1 month postoperatively.
Main Outcome Measures: The dioptric data of the central 3-mm zone of the cornea were decomposed using Fourier harmonic analysis into spherical power, regular astigmatism, asymmetry, and higher-order irregularity. Results: None of the 4 Fourier indices changed throughout the observation period in the 25-gauge group. In the 20-gauge group, regular astigmatism, asymmetry, and higher-order irregularity were increased significantly at 2 weeks after vitrectomy (P&lt;0.05, Wilcoxon signed-ranks test) and returned to preoperative levels by 1 month. The spherical power in the 20-gauge group did not change after surgery. For regular astigmatism, asymmetry, and higher-order irregularity, the 20-gauge group showed significantly greater surgically induced changes than the 25-gauge group (P&lt;0.05, Mann-Whitney U test).
Conclusions: Twenty-five-gauge transconjunctival sutureless vitrectomy does not induce significant changes in corneal topography and exerts little influence on the optical quality of the cornea.

DOI： 10.1016/j.ophtha.2007.01.034

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Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：眼科臨床医報会  

CiNii Books

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Other Link： http://search.jamas.or.jp/link/ui/2008073700

Language：Japanese   Publishing type：Research paper (scientific journal)   Publisher：メディカル葵出版  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: To evaluate the efficacy of subconjunctival injection of micafungin in the treatment of experimental Candida albicans keratitis in rabbits compared with fluconazole.
Methods: In 1 eye of 24 New Zealand white rabbits, C. albicans (5 X 10(4) yeast cells) was inoculated in the corneal stroma. The animals were randomly assigned to 3 groups and received subconjunctival injection of 0.5 mL of 0.1% micafungin, 0.2% fluconazole, or physiologic saline once a day for 3 weeks. The eyes were examined slit-lamp biomicroscopically and histopathologically. The clinical course of fungal keratitis was compared among the 3 groups. In another 36 rabbits, a microbiological examination was performed using a quantitative isolate recovery technique, and the numbers of colony-forming units were compared among groups.
Results: The clinical scores were significantly lower in the micafungin group than in the other 2 groups throughout the study period (P &lt; 0.0001 similar to P = 0.0027, Bonferroni multiple comparison). The fluconazole group showed significantly lower clinical scores than the saline group on day 18 (P = 0.0343). At the end of the study period, there were significant differences between the saline and micafungin groups (P &lt; 0.0001), the saline and fluconazole groups (P = 0.0072), and the fluconazole and micafungin groups (P = 0.0013). Histopathologically, similar results were obtained. Moreover, the results of the microbiological examination nearly matched the clinical and histopathologic findings.
Conclusions: Subconjunctival administration of micafungin was effective in the treatment of experimental Candida keratitis. Local application of micafungin to the eye would be a feasible treatment option for clinical fungal keratitis.

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Language：English   Publishing type：Research paper (scientific journal)  

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：LIPPINCOTT WILLIAMS & WILKINS  

Purpose: To review changes in the optical quality of the cornea induced by overnight orthokeratology for myopia. Methods: Sixty-four eyes of 39 patients who underwent overnight orthokeratology for myopia were prospectively examined. Inclusion criteria were uncorrected visual acuity of 20/20 or better after treatment and a minimum follow-up of 3 months. To quantitatively assess changes in corneal regular and irregular astigmatism, videokeratography data were decomposed into spherical component, regular astigmatism, asymmetry, and higher-order irregularity using Fourier analysis. In addition, corneal wavefront aberrations were calculated by expanding anterior corneal height data from videokeratography into a set of orthogonal Zernike polynomials. Results: Although orthokeratology significantly reduced manifest refraction and improved uncorrected visual acuity, the asymmetry component, which is one of the features of irregular astigmatism, increased significantly from 0.35 +/- 0.22 to 0.64 +/- 0.40 D after treatment (P < 0.000 1, paired t test). The increases in the asymmetry component significantly correlated with the amount of myopic correction (Pearson correlation coefficient, R = 0.40, P = 0.0009). Furthermore, the root-mean-square of third-order (coma-like) and fourth-order (spherical-like) aberrations significantly increased after orthokeratology (P < 0.0001, paired t test), and these increases showed significant positive correlations with the amount of myopic correction (Pearson correlation coefficient, R = 0.452, P = 0.0001 and R = 0.381, P = 0.0017, respectively). Conclusion: Corneal irregular astigmatism and higher-order aberrations significantly increased even in clinically successful orthokeratology, and the increases correlated with the magnitude of myopic correction. A large myopic correction by orthokeratology should be avoided to not decrease corneal optical quality.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：B M J PUBLISHING GROUP  

Aims: To assess the retention and removal properties of a new viscous dispersive ophthalmic viscosurgical device (OVD), DisCoVisc, in comparison with those of cohesive (Provisc), dispersive (Viscoat), and viscoadaptive (Healon5) OVDs.
Methods: In 20 porcine eyes, cataract surgery was simulated using one of the four OVDs which were stained with fluorescein for better visualisation. Three parameters were measured. Firstly, the presence/absence of OVDs in the chamber at the completion of phacoemulsification was recorded. Secondly, the time until the OVDs were completely removed from the anterior chamber using the phaco needle was measured. Thirdly, after intraocular lens (IOL) implantation, the time needed to completely remove the OVDs from the chamber with irrigation/aspiration tip was recorded.
Results: At the completion of phacoemulsification, the OVDs retained in 0% (0/5) for Provisc, 80% (4/5) for Healon5, 100% (5/5) for DisCoVisc, and 100% (5/5) for Viscoat. The retention of OVDs during phacoemulsification was greatest with Viscoat followed by, in descending order, DisCoVisc, Healon5, and Provisc. The removal of OVDs after IOL implantation took longest with Viscoat followed by Healon5, DisCoVisc, and Provisc.
Conclusion: The viscous dispersive DisCoVisc showed excellent retention during phacoemulsification, while its removal after IOL implantation was very easy. When compared with the viscoadaptive Healon5, DisCoVisc was retained better in the chamber and was easier to remove. These features of DisCoVisc should be highly advantageous when considering covering the entire cataract surgery procedure with a single OVD.

DOI： 10.1136/bjo.2005.085969

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：SPRINGER  

Background: Advanced glycation end products (AGEs) are known to be deposited in the target organ of ageing. In addition, the deposition of AGEs accelerate the process of ageing. We investigated the immunohistochemical localization of AGEs in pinguecula, one of the ocular changes related with ageing process. Methods: Surgical specimens of conjunctiva with or without pinguecula were prepared from nine patients, respectively. Immunohistochemical localization of AGEs was investigated using monoclonal antibodies to N-epsilon -( carboxymethyl) lysine, pentosidine, imidazolone, and pyrraline. Results: Moderate to strong immunoreactivities to AGEs were detected in the subepithelial amorphous deposits of all the surgical specimens with pinguecula. In contrast, no or weak immunoreactivities to AGEs were detected in the surgical specimens without pinguecula. Conclusions: Pinguecula is an aggregation of AGEs-modified proteins. The presence of pinguecula would be an index of local irradiation of ultraviolet rays and decreased antioxidant activities.

DOI： 10.1007/s00417-005-0047-y

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

An 82-year-old woman with age-related cataract and high myopia had uneventful phacoemulsification and intraocular lens (IOL) implantation. Preoperative visual acuity was 20/60 with -16.00 -3.00 x 70 and axial length was 29.29 mm. An IOL (MA60MA, Alcon) of +5.0 diopters (D) was selected with target refraction of -1.5 D. The next day, visual acuity was 20/15 with +5.50 -2.00 x 60. It was found that an IOL of -5.0 D was inadvertently inserted instead of +5.0 D because of an identical package appearance of the opposite-diopter IOLs except for a small negative sign before the diopter label. The -5.0 D IOL was surgically replaced with +5.0 D IOL, and visual acuity became 20/15 with -0.50 -2.00 x 70. When selecting an IOL for highly myopic patients, attention should be paid to the extreme resemblance of the package of opposite-diopter IOLs.

DOI： 10.1016/j.jcrs.2005.11.020

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Purpose: Choroidal detachment and anterior chamber (AC) shallowing develop in some cases after scleral buckling surgery for rhegmatogenous retinal detachment (RD). Postoperative angle-closure glaucoma has been reported to occur in 4% of cases. It is supposed that compression by the local scleral buckling induces ciliary body edema and angle narrowing. This study aimed to evaluate quantitatively the time course of changes in ciliary body thickness and AC depth (ACD) before and after the scleral buckling procedure using ultrasound biomicroscopy.
Design: Prospective consecutive case series.
Participants: Forty-six eyes of 44 patients (43.7 +/- 18.1 years old [mean +/- standard deviation]) undergoing rhegmatogenous RD surgery.
Methods: Ciliary body thickness and ACID were measured before and 3, 7, 14, and 28 days after the procedure. Ultrasound biomicroscopy was used to evaluate ACID and ciliary body thickness.
Main Outcome Measure: Time course of changes in ciliary body thickness and ACID.
Results: The surgery caused significant increases in ciliary body thickness at 3, 7, and 14 days postoperatively (P &lt; 0.0001, Bonferroni multiple comparison). Ciliary body edema reached its peak 3 days after surgery, followed by a gradual decrease thereafter. Ciliary body thickness in the encircling group was statistically greater than in the segmental buckling group at 3 and 7 days postoperatively (P &lt; 0.001, Student's t test). The ciliary body was significantly thicker in the direction of buckling than on the opposite side 3 days after surgery (P = 0.0079). In the encircling group, retinal reattachment surgery significantly decreased ACID 3 days after surgery (P = 0.018), whereas no significant fluctuations were found in the buckling group.
Conclusions: Even without apparent choroidal detachment and a shallow AC, subclinical ciliary edema existed in all directions of all eyes for at least 1 month after the scleral buckling procedure. The ciliary body in the direction of scleral buckling showed greater edema than the other areas. Eyes treated with the encircling band showed greater ciliary edema than those treated with segmental buckling alone.

DOI： 10.1016/j.ophtha.2005.09.023

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

Purpose: To compare the temperature profiles of 3 popular phacoemulsification units (Alcon AdvanTec Legacy, Bausch & Lomb Millennium, and AMO Sovereign WhiteStar) under similar operating conditions in air.
Setting: Jules Stein Eye Institute and the Department of Ophthalmology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, California, USA.
Methods: Phacoemulsification probes from the 3 units were placed side-by-side in air and imaged in the infrared using an FUR model P60 ThermaCAM. The highest temperature produced by each probe was measured 10 and 30 seconds after power application. Testing was performed under conditions that might produce a corneal burn. Irrigation flow was set at 1 cc/min to simulate a tight incision. Aspiration flow was set at 0 cc/min to simulate occlusion. Wound compression was simulated by suspending 22.6-gram weights from the silicone sleeves. The Alcon AdvanTec Legacy and Bausch & Lomb Millennium were operated in pulse mode at 15 Hertz; 50% duty cycle; and 10%, 30% and 50% power. The AMO Sovereign WhiteStar was operated in both C/F (56 Hz, 33% duty cycle) and C/L (33 Hz, 20% duty cycle) modes.
Results: The Millennium and the Sovereign generated higher temperatures than the Legacy with almost all experimental conditions (at 10%, 30%, and 50% powers; with and without sleeve compression; with manufacturers' and identical irrigating sleeves; and in continuous and pulse modes).
Conclusions: The Bausch & Lomb Millennium and the AMO Sovereign WhiteStar, operating in both pulse and continuous modes, generated higher peak temperatures than the Alcon AdvanTec Legacy with very controlled operating conditions in air and with a variety of power, load, and duty-cycle settings.

DOI： 10.1016/j.jers.2004.10.059

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：MARY ANN LIEBERT INC  

There have been no reports of the topical application of micafungin to the eye. The aim of this study was to evaluate the safety of topical instillation of 0.1% micafungin ophthalmic solution in rabbit eyes. In New Zealand white rabbits (n = 6), 50 mu L of 0.1% micafungin solution was topically instilled to 1 eye, and 50 mu L of sterile saline was applied to the other eye. Both eyedrops were administered hourly from 7 A.M. for 7 days. Measurements were conducted on corneal thickness, intraocular pressure, endothelial cell density, and lactate dehydrogenase (LDH) activity of tear samples. The eyes were examined slit-lamp biomicroscopically and histopathologically. Topical micafungin application for 1 week did not induce any changes in intraocular pressure, endothelial cell density, and tear LDH. Corneal thickness after instillation was slightly, but significantly, smaller in the micafungin group than in the control group (P = 0.0156, paired t test), but this difference disappeared within 24 hours after the final instillation. Biomicroscopy and histopathology revealed no significant toxic influence of micafungin application on the cornea. Topical instillation of micafungin solution had no apparent toxicity to the cornea. These results warrant future studies on the efficacy of micafungin ophthalmic solution against corneal fungal infection.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ELSEVIER SCIENCE INC  

PURPOSE: To evaluate corneal higher-order aberrations induced by overnight orthokeratology for myopia.
DESIGN: Prospective, noncomparative, consecutive, interventional case series.
METHODS: A prospective study was conducted in 64 eyes of 39 patients with overnight orthokeratology for myopia, who were followed up for at least 3 months and attained uncorrected visual acuity of 20/20 or better. Corneal height data were obtained with computerized videokeratography (TMS-2N, Tomey), and wavefront aberration was derived using Zernike polynomials. Higher-order aberrations of the cornea were calculated for 3- and 6-mm pupils.
RESULTS: Orthokeratology significantly reduced manifest refraction from -2.60 +/- 1.13 (mean +/- SD) diopters to -0.17 +/- -0.31 diopters (P &lt; .0001, paired t test). Root-mean-square (RMS) of third-order (coma-like) aberrations significantly increased by orthokeratology for both 3-mm (P &lt; .0001, paired t test) and 6-mm (P &lt; .0001) pupils. Fourth-order RMS (spherical-like) aberrations increased significantly by the treatment for both 3-mm (P &lt; .0001) and 6-mm (P &lt; .0001) pupils. Vertical coma significantly changed from positive to negative for both 3-mm (P = .0323) and 6-mm (P &lt; .0001) pupils. Horizontal coma significantly increased to the positive direction for both 3-mm (P &lt; .0001) and 6-mm (P &lt; .0001) pupils. Increases in the third- and fourth-order RMS showed significant positive correlations with the amount of myopic correction for 3-mm (Pearson correlation coefficient, r = .452, P = .0001 for third-order RMS, r = .381, P = .0017 for fourth-order RMS) and 6-mm (r = .499, P &lt; .0001, r = .455, P = .0001) pupils.
CONCLUSIONS: Corneal higher-order aberrations significantly increased, even in clinically successful orthokeratology cases. The increases in the higher-order aberrations correlated with the magnitude of myopic correction. (c) 2005 by Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ajo.2004.10.006

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PURPOSE: To compare corneal sensation, corneal barrier function, tear secretion, and tear film stability after photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK).
DESIGN: Prospective, nonrandomized clinical trial.
METHODS: In a prospective study, 28 eyes of 15 patients underwent PRK and 115 eyes of 59 patients underwent LASIK to correct myopia. Corneal sensation, corneal epithelial barrier function, tear secretion, and tear film stability were examined preoperatively and 1 week and 1, 3, 6, and 12 months postsurgery.
RESULTS: Both PRK and LASIK significantly compromised corneal sensation, increased epithelial barrier function, reduced tear secretion, and deteriorated tear film stability (P &lt; .05, Wilcoxon signed-rank test). Deterioration of corneal sensation was significantly greater after LASIK than after PRK by 3 months postoperatively (P &lt; .05, Wilcoxon rank sum test). Increases in corneal epithelial permeability were more prolonged after LASIK than after PRK. A significant intergroup difference in permeability was observed I month after surgery (P &lt; .01). Tear breakup time was significantly shorter in the LASIK group than in the PRK group up to 3 months after surgery (P &lt; .045).
CONCLUSIONS: LASIK induces greater and more prolonged damage to corneal sensation, corneal barrier function, and tear film stability than PRK. (C) 2005 by Elsevier Inc. All rights reserved.

DOI： 10.1016/j.ajo.2004.08.039

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Lippincott Williams & Wilkins  

[PURPOSE] To evaluate the influence of overnight orthokeratology on the corneal endothelium.
[METHODS] Fifty-two eyes of 31 patients undergoing overnight orthokeratology for myopia were examined. They wore the lens every night and were followed up for at least 1 year. The corneal endothelium was examined with specular microscopy to calculate mean endothelial cell density, coefficient of variation of cell area, and percentage of hexagonal cells. Data obtained at 1-year follow-up examinations were compared with those at the baseline examinations using a paired t test.
[RESULTS] Orthokeratology significantly reduced manifest refraction from -2.32 +/- 1.18 D (mean +/- standard deviation) to -0.16 +/- 0.33 D (P < 0.0001) and improved uncorrected visual acuity from 0.77 +/- 0.29 to -0.07 +/- 0.10 logMAR (P < 0.0001). The endothelial cell density did not change significantly (2879 +/- 231 cells/mm before and 2864 +/- 260 cells/mm after treatment, P = 0.252). The coefficient of variation of cell area was 22.3 +/- 2.7 at baseline and 22.1 +/- 2.4 at 1-year posttreatment, which did not change significantly (P = 0.537). The percentage of hexagonal cells was 72.8 +/- 10.2% pretreatment and 72.5 +/- 10.9% posttreatment (P = 0.800).
[CONCLUSIONS] Overnight orthokeratology for 1 year did not influence the density or morphology of corneal endothelial cells.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

PURPOSE. To investigate prospectively the relation between induced changes in higher-order aberrations of the eye and changes in contrast sensitivity by conventional laser in situ keratomileusis (LASIK) for myopia.
METHODS. In 200 eyes of 110 consecutive patients (mean age, 32.7 +/- 8.4 years) undergoing LASIK, ocular aberrations and contrast sensitivity function were determined before and 1 month after surgery. The amount of myopic correction was 5.2 +/- 2.8 D (range, 1.0 - 13.0). Ocular higher-order aberrations were measured for a 4-mm pupil using the Hartmann-Shack wavefront analyzer (KR-9000PW; Topcon, Tokyo, Japan). The root mean square (RMS) of the third- and fourth-order Zernike coefficients was used to represent coma- and spherical-like aberrations, respectively. Total higher-order aberrations were calculated as the RMS of the third- and fourth-order coefficients. Contrast sensitivity and low-contrast visual acuity were measured. From the contrast sensitivity data, the area under the log contrast sensitivity function (AULCSF) was calculated.
RESULTS. LASIK significantly improved logMAR best corrected visual acuity (Wilcoxon signed-rank test, P &lt; 0.001), but significantly reduced AULCSF (P &lt; 0.001) and low-contrast visual acuity (P = 0.007). Total higher-order (P &lt; 0.001), coma-like (P &lt; 0.001), and spherical-like (P &lt; 0.001) aberrations were significantly increased after LASIK. The greater the amount of achieved myopia correction was, the more the changes in contrast sensitivity function and ocular higher-order aberrations were. The induced changes in AULCSF by LASIK showed significant correlations with changes in total higher-order (Pearson r = -0.221, P = 0.003), coma-like (r = -0.205, P = 0.006), and spherical-like (r = -0.171, P = 0.022) aberrations. The changes in logMAR low-contrast visual acuity by surgery significantly correlated with changes in total higher-order (r = 0.222, P = 0.003), coma-like (r = 0.201, P = 0.007), and spherical-like (r = 0.207, P = 0.005) aberrations.
CONCLUSIONS. Conventional LASIK significantly increases ocular higher-order aberrations, which compromise the postoperative contrast sensitivity function.

DOI： 10.1167/iovs.04-0629

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Background: Malignant melanoma of the uveal tract occurs rarely in Asian populations, and melanoma of the ciliary body is extremely rare. We treated an Asian man with uveal melanoma, relying on ultrasound biomicroscopy (UBM) findings for diagnosis and evaluation of the tumor.
Case: A 65-year-old man with uveal melanoma was examined by slit-lamp microscopy, UBM, and magnetic resonance imaging (MRI), and histopathological examinations were performed as well.
Observations: Slit-lamp examination and MRI gave rough images of the tumor, but the exact origin and margin of the mass could not be determined. UBM clearly characterized the tumor as a medium echoic solid mass with acoustic hollowing attached to the ciliary body by a thin stem. Ciliary body detachment at the pars plicata was also found by UBM. Histopathological examination confirmed that the tumor was an epithelioid cell malignant melanoma of the ciliary body.
Conclusions: UBM is useful in detecting, diagnosing, and evaluating a malignant melanoma of the ciliary body. (C) Japanese Ophthalmological Society 2004.

DOI： 10.1007/s/10384-003-0066-3

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Purpose: To quantitatively assess changes in regular and irregular corneal astigmatism in patients having overnight orthokeratology.
Setting: Matsumoto Eye Clinic, Ibaraki, Japan.
Methods: A prospective study was conducted of 64 eyes of 39 patients having overnight orthokeratology for myopia. Inclusion criteria were an uncorrected visual acuity (UCVA) of 20/20 or better after treatment and a minimum follow-up of 3 months. Using Fourier series harmonic analysis, videokeratography data were decomposed into spherical component, regular astigmatism, asymmetry (tilt or decentration), and higher-order irregularity.
Results: Orthokeratology significantly reduced the manifest refraction from -2.60 diopters (D) +/- 1.13 (SD) to -0.17 +/- 0.31 D (P&lt;.0001, paired t test) and improved the UCVA from 0.82 &PLUSMN; 0.30 to -0.11 &PLUSMN; 0.06 logMAR (P&lt;.0001). Regular astigmatism increased significantly from 0.53 +/- 0.23 D preoperatively to 0.63 +/- 0.40 D postoperatively (P=.0206). The asymmetry component increased significantly from 0.35 +/- 0.22 D to 0.64 +/- 0.40 D (P&lt;.0001). Higher-order irregularity did not change significantly: 0.14 &PLUSMN; 0.11 D before treatment and 0.17 &PLUSMN; 0.20 D after treatment (P=.2166). The amount of myopic correction correlated significantly with the increase in the asymmetry component (Pearson correlation coefficient, R = 0.40, P=.0009) but not with the increase in regular astigmatism (R = 0.24, P=.055).
Conclusions: Irregular corneal astigmatism significantly increased, even in clinically successful orthokeratology cases. The effect of the changes on visual function should be studied further.

DOI： 10.1016/j.jcrs.2004.02.049

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PURPOSE: To describe the ultrasound biomicroscopic features of eyes with aniridia.
DESIGN: Observational case series.
METHODS: Nineteen eyes of 10 patients with aniridia (six males and four females) ranging in age from 3 months to 53 years (21.0 +/- 16.4, mean +/- SD), and 50 normal subjects (30 men and 20 women) ranging from 16 to 5 6 years (31.1 +/- 13.2) were evaluated. Ultrasound biomicroscopic findings were recorded in the 3,, 6,, 9,, and 12-o'clock directions. Adult patients (aged 16 years or older) with aniridia were compared with the aged matched controls. 0
RESULTS: Ultrasound biomicroscopy (UBM) detected extremely tiny irises in all eyes with aniridia. The eyes with aniridia showed significantly smaller values than the controls in ciliary body length (4.49 +/- 0.63 versus 5.79 +/- 0.44 mm, P &lt;.001, unpaired Student t test), ciliary body thickness (0.75 +/- 0.17 versus 1.24 +/- 0.22 mm, P &lt;.001), iris root thickness (0.47 +/- 0.14 versus 0.61 +/- 0.07 mm, P &lt;.001), scleral,ciliary process angle (31.7 +/- 3.26 versus 43.1 +/- 4.48 degree, P &lt;.001), and anterior chamber depth (1.99 +/- 0.43 versus 2.94 +/- 0.34 mm, P &lt;.001). In the aniridia eyes, there was a significantly positive correlation between iris thickness and ciliary body thickness (Pearson r = 0.829, P=.001).
CONCLUSION: Ultrasound biomicroscopic imaging demonstrated that not only iris hypoplasia but also ciliary body hypoplasia exist in aniridia. Anterior inclination of the ciliary process was also found, which was thought to be at least partly responsible for the shallow anterior chamber.

DOI： 10.1016/j.ajo.2003.12.014

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：B M J PUBLISHING GROUP  

Aims: To compare central corneal thickness measurements of three pachymetry devices in eyes after laser in situ keratomileusis ( LASIK).
Methods: Central corneal thickness was measured in 203 eyes after myopic LASIK. Orbscan II scanning slit topography (Bausch & Lomb), SP-2000P non-contact specular microscopy (Topcon), and ultrasonic pachymetry (Tomey) were used in this sequence.
Results: Three devices gave significantly different corneal thickness readings (p&lt; 0.0001, repeated measure analysis of variance). The measurements of Orbscan II (445.6 (SD 60.0) &mu;m) were significantly smaller than those of noncontact specular microscopy (467.9 (SD 40.2) mm; p&lt; 0.0001, Tukey multiple comparison) and ultrasonic pachymetry (478.8 (SD 41.9) mm; p&lt; 0.0001). The value obtained with SP-2000P non- contact specular microscopy was significantly smaller than that taken with ultrasonic pachymetry (p&lt; 0.001). There were significant linear correlations between scanning slit topography and non- contact specular microscopy (Pearson's correlation coefficient r= 0.912, p&lt; 0.0001), non- contact specular microscopy and ultrasonic pachymetry (r = 0.968, p&lt; 0.0001), and ultrasonic pachymetry and scanning slit topography ( r = 0.933, p&lt; 0.0001).
Conclusion: In post-LASIK eyes, Orbscan II scanning slit topography significantly underestimated corneal thickness. Non-contact specular microscopy gave smaller thickness readings than ultrasonic pachymetry, but these two units showed an excellent linear correlation.

DOI： 10.1136/bjo.2003.030361

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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[PURPOSE] To investigate long-term changes in the cornea after ionizing irradiation in rabbits.
[METHODS] Mature albino rabbits (n = 4) were unilaterally irradiated with 20 Gy of x-rays. The contralateral eye served as a control. The rabbits were examined with slit-lamp biomicroscopy for 5 years. The eyes were then enucleated for histopathologic examinations with light microscopy and transmission electron microscopy.
[RESULTS] On biomicroscopy, there was no corneal abnormality during the 5-year follow-up period. On histopathology, no abnormality was observed in the corneal epithelium. In the endothelium, a vacuole-like structure was recognized by light microscopy, and transmission electron microscopy revealed marked enlargement of intercellular space and anamorphosis of the nuclei.
[CONCLUSION] Moderate x-ray irradiation to rabbit eye did not induce any long-term damage to the corneal epithelium, but the endothelium demonstrated persistent and irreversible damage, which was observed even 5 years after irradiation.

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Lippincott Williams & Wilkins  

[PURPOSE] To describe a case of iron deposition in both eyes after overnight orthokeratology.
[METHODS] This is a case report of a 31-year-old man who underwent overnight orthokeratology. The subject was fitted with rigid gas-permeable contact lenses of reverse-geometry design to correct myopia.
[RESULTS] The prefitting manifest refraction was -4.75 -0.25 x 175 in the right eye and -4.50 -0.25 x 175 in the left eye. There was no corneal abnormality until 9 months after treatment, but development of corneal arcuate lines in both eyes was observed at the 1-year follow-up visit. Visual acuity was not affected. The deposition pattern corresponded to the outside border of central flatter zone, as shown on the corneal topography map.
[CONCLUSION] The current findings suggest that tear pooling between the corneal surface and the back surface of the contact lens plays a role in the development of corneal iron ring after orthokeratology with reverse-geometry contact lenses.

DOI： 10.1097/01.ico.0000136687.90275.87

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Springer Japan  

[BACKGROUND] Malignant melanoma of the uveal tract occurs rarely in Asian populations, and melanoma of the ciliary body is extremely rare. We treated an Asian man with uveal melanoma, relying on ultrasound biomicroscopy (UBM) findings for diagnosis and evaluation of the tumor. CASE. A 65-year-old man with uveal melanoma was examined by slit-lamp microscopy, UBM, and magnetic resonance imaging (MRI), and histopathological examinations were performed as well.
[OBSERVATIONS] Slit-lamp examination and MRI gave rough images of the tumor, but the exact origin and margin of the mass could not be determined. UBM clearly characterized the tumor as a medium echoic solid mass with acoustic hollowing attached to the ciliary body by a thin stem. Ciliary body detachment at the pars plicata was also found by UBM. Histopathological examination confirmed that the tumor was an epithelioid cell malignant melanoma of the ciliary body.
[CONCLUSIONS] UBM is useful in detecting, diagnosing, and evaluating a malignant melanoma of the ciliary body.

DOI： 10.1007/s10384-003-0066-3

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：Elsevier Inc.  

Objective To develop a new technique to visualize vitreous body prolapsed in the anterior chamber using 11-deoxycortisol. Study design Experimental study. Methods An animal model of posterior capsule rupture was developed to investigate the usefulness of 11-deoxycortisol, a precursor of cortisol without steroid activity. After the intentional creation of posterior capsule rupture, the suspension of 11-deoxycortisol was injected into the anterior chamber of rabbit eyes. After gentle irrigation and aspiration, the vitreous body that had prolapsed into the anterior chamber was removed using an anterior vitrectomy cutter. To investigate the safety of 11-deoxycortisol, the biomicroscopic appearance, intraocular pressure (IOP), corneal endothelial count, and microstructure of the corneal endothelium were examined in the rabbits that received injections of 11-deoxycortisol in the anterior chamber. Results In our posterior capsule rupture model, the vitreous in the anterior chamber became clearly visible, with 11-deoxycortisol showing white particles entrapped on its surface. The injection of 11-deoxycortisol facilitated the complete removal of the vitreous body from the anterior chamber. In intact rabbit eyes, most of the injected 11-deoxycortisol had disappeared from the anterior chamber by 12 hours after injection. The injection of 11-deoxycortisol had no effect on IOP, corneal endothelial density, or the microstructure of the corneal endothelium. Conclusions The injection of 11-deoxycortisol in the anterior chamber is useful in visualizing the vitreous body and has no significant side effects. This technique might reduce the intraoperative and postoperative complications of anterior vitrectomy after posterior capsule rupture. © 2004 by the American Academy of Ophthalmology.

DOI： 10.1016/j.ophtha.2003.11.011

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A 64-year-old woman with glaucoma had suprachoroidal hemorrhage approximately 6 hours after trabeculectomy. High-frequency ultrasonography revealed high reflectivity in the inner space of a kissing choroidal detachment, which facilitated the differential diagnosis of suprachoroidal hemorrhage resulting from serous choroidal detachment. The ciliary process and iris were anteriorly displaced due to the ciliary detachment and forward pressure of the anterior vitreous. On the basis of the diagnosis, transscleral choroidal drainage was performed without delay and the patient's vision was preserved. After surgery, suprachoroidal hemorrhage disappeared clinically, but high-frequency ultrasonography detected persistence of the choroidal detachment in the peripheral area.

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DOI： 10.1016/S0002-9394(02)02152-9

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Language：English   Publishing type：Research paper (scientific journal)   Publisher：BRITISH MED JOURNAL PUBL GROUP  

Aims: To establish a reliable method for measuring the axial length of the eye with incomplete filling of silicone oil in the vitreous cavity in order to determine the IOL power before executing combined cataract surgery and silicone oil removal.
Methods: 12 eyes of 12 patients undergoing combined cataract extraction and silicone oil removal between October 1998 and June 2000 were entered prospectively into this study. All eyes were examined using an x ray computed tomography (CT) scanner. Each axial length of a silicone oil injected eye was measured on the best CT slice among eyeball cuts, which showed both the insertions of the medial and lateral rectus Muscle, the thickest slice of the lens, and the optic nerve. The IOL power for the eyes was determined using the SRK/T formula based on the CT data. The deviation of postoperative refraction from the goal refraction was evaluated for each eye.
Results: The CT slices demonstrated that the vitreous cavity was not completely filled with the oil in all of the silicone oil injected eyes. The deviation of postoperative refraction from the goal refraction was less than 1 dioptre (D) error in six of 12 eyes (50%), and was less than 2 D error in nine eyes (75%). In the other three eyes having more than 2 D error, the axial length was 27 mm or more.
Conclusion: The CT measurement of axial eye length for determining IOL might be a useful method for evaluating silicone oil injected eyes before combined cataract surgery and silicone oil removal.

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Purpose: To evaluate the changes in aqueous flare in psoriasis patients and to identify the factors that influence the level of aqueous flare. Methods: We examined the 68 eyes of 34 psoriasis patients and the 68 eyes of 34 healthy subjects with a laser flare-cell meter. Complete dermatologic and ophthalmic examinations were performed on the psoriasis patients. Results: Flare was significantly higher in psoriasis patients than in normal controls (P &lt
.000l). The factors that increased flare significantly were age and Psoriasis Area and Severity Index. Flare was not significantly associated with sex, psoriasis type, duration of disease, and cyclosporin therapy. A flare increase was significantly correlated with serum total protein and immunoglobulin (Ig) A, but not with albumin, IgG, and IgM. Conclusions: Psoriasis patients, even without ocular symptoms, had slight damage to the blood-aqueous barrier. Multiple linear regression analysis showed that flare had the strongest correlation with the severity of psoriasis. Copyright © 2001 Japanese Ophthalmological Society.

DOI： 10.1016/S0021-5155(00)00359-2

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Two sets of monozygotic twins with mirror image myopic anisometropia are reported. The first set were two boys aged 1 year 8 months. There was a right eye myopic anisometropia in one twin, and a left eye myopic anisometropia in the other. The differences in refractive power between both eyes were 11.6 and 7.6 dpt, respectively (spherical equivalent). The second set were two 6-year-old boys. The right eye had myopic anisometropia in one twin, while the left eye was affected in the other. The differences in refractive power between both eyes were 6.5 and 3.7 dpt, respectively (spherical equivalent). Exotropia was recognized in 3 cases. Previously only two sets of monozygotic twins with mirror image myopic anisometropia have been reported. Monozygotic twins with mirror image myopic anisometropia are extremely rare. Copyright © 2001 S. Karger AG, Basel.

DOI： 10.1159/000050904

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Aims-To evaluate the clinical course and the characteristics of transient refractive error occurring during intensive glycaemic control of severe hyperglycaemia. Methods-28 eyes of patients with persistent diabetes were included in this prospective study. During the observation period, patients underwent general ophthalmological examination and A-mode scan ultrasonography was performed at each examination-at days 1, 3, and 7, and then once every week or every other week until recovery of hyperopia. Results-A transient hyperopic change occurred in all patients receiving improved control after hyperglycaemia. Hyperopic change developed a mean of 3.4 (SD 2.0) days after the onset of treatment, and reached a peak at 10.3 (6.1) days, where the maximum hyperopic change in an eye was 1.47 (0.87) D (range 0.50-3.75 D). Recovery of the previous refraction occurred between 14 and 84 days after the initial assessment. There was a positive correlation between the magnitude of the maximum hyperopic change and (1) the plasma glucose concentration on admission (p&lt
0.01), (2) the HbA(1c) level on admission (p&lt
0.005), (3) the daily rate of plasma glucose reduction over the first 7 days of treatment (p&lt
0.001), (4) the number of days required for hyperopia to reach its peak (p&lt
0.001), and (5) the number of days required for the development and resolution of hyperopic changes (p&lt
0.0001). There was a negative correlation between the maximum hyperopic change of an eye and baseline value of refraction (p&lt
0.01). During transient hyperopia, no significant changes were observed in the radius of the anterior corneal curvature, axial length, lens thickness, or depth of anterior chamber. Conclusions-The degree of transient hyperopia associated with rapid correction of hyperglycaemia is highly dependent on the rate of reduction of the plasma glucose level. A reduction of refractive index in intraocular tissues, especially in lens, appears to be responsible for this hyperopic change.

DOI： 10.1136/bjo.84.10.1097

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Other Link： http://search.jamas.or.jp/link/ui/2013237558

J-GLOBAL

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Language：Japanese   Publisher：(一社)日本糖尿病学会  

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Other Link： http://search.jamas.or.jp/link/ui/2005252072

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Language：English   Publishing type：Research paper, summary (international conference)   Publisher：ASSOC RESEARCH VISION OPHTHALMOLOGY INC  

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Language：Japanese   Publisher：眼科臨床医報会  

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Event date： 2020.2

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：つくば市  

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Event date： 2019.12

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Venue：USA San Diego  

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Venue：Vancouver, CANADA  

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Venue：Vancouver, CANADA  

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Event date： 2019.4 - 2019.5

Language：English   Presentation type：Oral presentation (general)  

Venue：Vancouver, CANADA  

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Event date： 2019.4 - 2019.5

Language：English   Presentation type：Oral presentation (general)  

Venue：Vancouver, CANADA  

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Event date： 2019.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京  

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Event date： 2019.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：東京  

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Event date： 2018.4 - 2018.5

Language：English   Presentation type：Poster presentation  

Venue：Honolulu, HI  

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Event date： 2018.4 - 2018.5

Language：English   Presentation type：Oral presentation (general)  

Venue：Honolulu, HI  

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Event date： 2018.4 - 2018.5

Language：English   Presentation type：Oral presentation (general)  

Venue：Honolulu, HI  

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Event date： 2016.11

Language：Japanese   Presentation type：Symposium, workshop panel (nominated)  

Venue：京都  

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Event date： 2016.8

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：水戸  

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Event date： 2016.8

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：土浦  

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Event date： 2016.8

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：東京  

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Event date： 2016.7

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：埼玉  

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Event date： 2016.6

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：徳島.  

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Event date： 2016.6

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：横須賀  

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Event date： 2016.6

Language：Japanese   Presentation type：Oral presentation (invited, special)  

Venue：つくば  

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Event date： 2016.6

Language：Japanese   Presentation type：Oral presentation (invited, special)  

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Event date： 2016.5

Language：Japanese   Presentation type：Oral presentation (invited, special)  

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Event date： 2016.4

Language：Japanese   Presentation type：Oral presentation (general)  

Venue：仙台.  

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Event date： 2016.2

Language：Japanese   Presentation type：Oral presentation (invited, special)  

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Event date： 2014.6

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Event date： 2014.6

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Event date： 2014.5

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Event date： 2014.5

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.5

Language：English   Presentation type：Poster presentation  

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.5

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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Event date： 2014.4

Language：English   Presentation type：Oral presentation (general)  

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