Japanese Journal of Ophthalmology最新文献

{"title":"Real-world practice patterns for dry eye diagnosis: a multicenter observational study in Taiwan.","authors":"Shu-Wen Chang, Shiuh-Liang Hsu, Chih-Chien Hsu","doi":"10.1007/s10384-025-01175-6","DOIUrl":"10.1007/s10384-025-01175-6","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the concordance between Asia Dry Eye Society (ADES) diagnostic criteria and real-world hospital-based practice, and to analyze the clinical characteristics of patients with dry eye disease (DED), in Taiwan.</p><p><strong>Study design: </strong>Noninterventional, cross-sectional, retrospective clinical study.</p><p><strong>Methods: </strong>Data were analyzed for adults with newly diagnosed DED from three tertiary hospitals. The primary endpoint was the proportion of patients diagnosed with DED who fulfilled ADES criteria for DED. Other outcomes were DED classification and severity, tear breakup time (TBUT), Schirmer's test, corneal fluorescein staining (CFS) severity, 12-item Ocular Surface Disease Index (OSDI) questionnaire scores, and presence of meibomian gland dysfunction (MGD).</p><p><strong>Results: </strong>A total of 213 patients, mean (SD) age 54.3 (15.0) years, 79.8% female, were evaluated. Mean TBUT of 3.0 (2.6) sec and mean OSDI score of 36.5 (21.0) indicated severe DED at diagnosis. Most patients (87.3%) had a TBUT ≤5 sec, fulfilling ADES diagnostic criteria. Short TBUT (≤5 sec) and OSDI ≥13 had high sensitivity for diagnosing DED (87.3% and 90.1%, respectively), whereas an abnormal Schirmer's test (69.5%) and abnormal CFS (42.3%) were less sensitive. MGD was diagnosed in 56.3% of patients. Dry eye-related characteristics in the non-short TBUT (>5 sec) group diverged for objective but not subjective clinical tests. Most common first treatments were artificial tears (95.8%) and corticosteroids (85.0%).</p><p><strong>Conclusions: </strong>DED diagnosis in routine hospital practice in Taiwan is highly concordant (87.3%) with ADES diagnostic criteria. TBUT appears to be an effective diagnostic tool for identifying dry eye in patients across symptom severity, etiology and age.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of punctal metrics and tear meniscus height in epiphora: clinical insights and diagnostic potential.","authors":"Neslihan Sevimli, Ece İren, Güneş Taydaş, Muhammed Kaan Azarbaz","doi":"10.1007/s10384-025-01182-7","DOIUrl":"10.1007/s10384-025-01182-7","url":null,"abstract":"<p><strong>Purpose: </strong>To use anterior segment optical coherence tomography (AS-OCT) to investigate differences in punctal dimensions, tear meniscus height (TMH), and cornea among epiphora patients and healthy individuals; to assess its utility in screening and diagnosing epiphora; and to examine its effects on the cornea.</p><p><strong>Study design: </strong>Prospective, cross-sectional METHODS: A total of 43 patients (31 women) with epiphora (Munk score >2) and 58 healthy individuals (38 women) without ocular symptoms were enrolled in this study. AS-OCT (Maestro, Topcon) was used to measure TMH, outer punctal diameter (OPD), punctal depth (PD), and corneal epithelial thickness (CET). Corneal topography (Pentacam, Oculus) was used to assess corneal topographic parameters and corneal volume (CV). Correlations among OPD, TMH, and corneal parameters were analyzed.</p><p><strong>Results: </strong>No significant differences were found in age and sex among the groups (P = .909 and P = .482, respectively). Patients with epiphora exhibited significantly narrower OPD (229.6 ± 150.1 μm) and higher TMH (592.5 ± 315.3 μm) (both P <.001). CV was notably lower in the epiphora group (P = .015). The lower cutoff of OPD for epiphora was found to be 200 μm, and the lower cutoff of TMH for epiphora, 445 μm. Positive correlations were observed between OPD and CV (P = .001).</p><p><strong>Conclusions: </strong>Patients with epiphora demonstrated narrower OPD, higher TMH, and lower CV than those of healthy individuals. These findings highlight the utility of AS-OCT in assessing epiphora and its effects on corneal health.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143582252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study protocol for a prospective natural history registry investigating the relationships between inflammatory markers and disease progression in retinitis pigmentosa: the RP-PRIMARY study.","authors":"Yusuke Murakami, Takahiro Hisai, Sakurako Shimokawa, Masatoshi Fukushima, Kohta Fujiwara, Akie Hirata, Atsushi Takada, Fuyuka Miyahara, Naoki Nakashima, Yuko Kobayakawa, Mitsuru Arima, Go Mawatari, Masataka Ishizu, Tomoko Kaida, Kazunori Miyata, Yasuhiro Ikeda, Koh-Hei Sonoda","doi":"10.1007/s10384-025-01179-2","DOIUrl":"https://doi.org/10.1007/s10384-025-01179-2","url":null,"abstract":"<p><strong>Purpose: </strong>The Retinitis Pigmentosa Progression and Inflammatory Marker Registry (RP-PRIMARY) is intended as a prospective observational study aimed at establishing sensitive outcome measures to detect the efficacy of anti-inflammatory agents in future clinical trials. The following is the RP-PRIMARY study protocol.</p><p><strong>Study design: </strong>Prospective, multicenter study.</p><p><strong>Methods: </strong>We will recruit 100 patients with typical RP (any genetic mutation) and the following characteristics: age 20-70 years; mean retinal sensitivity ≥ 10 dB at 12 central points on Humphrey 10-2 visual field tests; central foveal thickness ≤ 250 μm on optical coherence tomography (OCT); and no ocular complications unrelated to RP or serious systemic complications. Early Treatment Diabetic Retinopathy Study (ETDRS). visual acuity, Humphrey 10-2 visual field tests, OCT, and fundus autofluorescence imaging will be performed every 3 months for 2 years. Inflammatory indices such as aqueous flare values, high-sensitivity C-reactive protein (CRP), serum IL-8, and CD14/16 inflammatory monocyte proportion will be measured every year. The primary endpoint will be the progression rate of retinal sensitivity loss on the Humphrey 10-2 visual field tests. The secondary endpoints will be the rate of decline of each parameter and its association with inflammatory indices. Standard-operation-procedure documents were prepared for all study procedures, and consultations with the regulatory agency were conducted to ensure the data reliability for future use in clinical trials.</p><p><strong>Conclusions: </strong>Detailed registry data on the natural history and inflammatory profile of RP will be useful in designing study protocols for anti-inflammatory therapy for RP and as natural history data for drug applications.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autologous retina transplantation for refractory highly myopic macular holes: a long-term follow-up.","authors":"Matteo Mario Carlà, Carlos Mateo","doi":"10.1007/s10384-025-01169-4","DOIUrl":"https://doi.org/10.1007/s10384-025-01169-4","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate long-term anatomical and functional outcomes of autologous retinal transplantation (ART) in refractory highly myopic macular holes (HMMHs).</p><p><strong>Study design: </strong>Retrospective interventional analysis of 9 eyes with refractory HMMH undergoing ART.</p><p><strong>Methods: </strong>Best-corrected visual acuity (BCVA, Snellen) and optical coherence tomography (OCT) were performed at baseline and each follow-up visit (1, 3, 6, 12, 24 months and the most recent). Preoperatively, we collected minimum linear diameter (MLD) and basal diameter (BD). Post-operatively, central macular thickness (CMT), external limiting membrane (ELM)/ellipsoid zone (EZ) visibility, macular edema (ME) and retinal pigmented epithelium (RPE) atrophy were evaluated.</p><p><strong>Results: </strong>Mean follow-up duration was 46.0 ± 19.6 months. Anatomical success was reached in 7/9 eyes (78%). Median BCVA went from 0.05 (IQR 0.065) at baseline to 0.075 (IQR 0.069) at final follow-up (p = 0.25). Only one eye showed a 2-lines improvement, while BCVA was stable in 4/9 (44%) and worsened in 1 eye (12%). CMT progressively thickened in the first 6 months (177 ± 68 μm), but then decreased to 122 ± 50 μm at final follow-up. Graft merging with the surrounding retina was visible in two eyes, showing partial ELM/EZ recovery and good outcomes. Microcystic-like refractory ME (33%) and long-term RPE atrophy (22%) were reported, while delayed displacement of the graft was seen in one case 6 months after first surgery.</p><p><strong>Conclusion: </strong>ART offered acceptable anatomical success but no visual improvement in our cohort. Lack of graft merging with the surrounding retina, persistent microcystic-like ME, RPE atrophy and hole recurrence were the most frequent shortfalls.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Longitudinal renal function changes during real-world anti-vascular endothelial growth factor therapy for diabetic macular edema in Japan.","authors":"Ayumi Usui-Ouchi, Shuta Kishishita, Yoshihito Sakanishi, Keitaro Mashimo, Kazunori Tamaki, Moe Matsuzawa, Meiko Kimura, Riyu Ikari, Shuu Morita, Ishin Ninomiya, Toshiro Sakuma, Nobuyuki Ebihara, Shintaro Nakao","doi":"10.1007/s10384-025-01170-x","DOIUrl":"https://doi.org/10.1007/s10384-025-01170-x","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective observational study aimed to investigate the longitudinal changes in renal function and central macular thickness (CMT) and their impact on visual outcomes during anti-vascular endothelial growth factor (anti-VEGF) therapy for diabetic macular edema (DME).</p><p><strong>Study design: </strong>This study employed a retrospective observational design and analyzed data from treatment-naive patients with DME (62 cases, 100 eyes) receiving anti-VEGF therapy for 36 months. Baseline and follow-up assessments were conducted at 12, 24, and 36 months.</p><p><strong>Methods: </strong>Best corrected visual acuity (BCVA), CMT, number of anti-VEGF injections, HbA1c, serum creatinine (Cre), blood urea nitrogen (BUN), estimated glomerular filtration rate (eGFR), urinary protein levels, and chronic kidney disease (CKD) stage were measured at each time point.</p><p><strong>Results: </strong>The study population had a mean age of 60.7 ± 12.2 years, with 41 men and 21 women. Over the 36-month period, the mean number of anti-VEGF injections per eye was 5.3 ± 3.3. Maximum CMT significantly decreased at each time point, and final BCVA showed significant improvement (logMAR: - 0.07). HbA1c levels remained stable, BUN and Cre levels increased, and eGFR decreased significantly over time. CKD stage 3+ at 36 months significantly resulted in worse CMT.</p><p><strong>Conclusion: </strong>This retrospective observational study provides valuable insights into the longitudinal changes in renal function and CMT during anti-VEGF therapy for DME. Our findings emphasize the importance of monitoring renal function. This study contributes to our understanding of the complex relationship between renal function, DME, and anti-VEGF therapy, thereby facilitating improved management and outcomes in patients with DME.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corneal Fourier harmonic analysis in prostaglandin-associated periorbitopathy patients with blepharoptosis.","authors":"Tatsuya Yunoki, Yuto Uozumi, Naoki Tojo, Mitsuya Otsuka, Atsushi Hayashi","doi":"10.1007/s10384-025-01177-4","DOIUrl":"https://doi.org/10.1007/s10384-025-01177-4","url":null,"abstract":"<p><strong>Purpose: </strong>Prostaglandin-associated periorbitopathy (PAP), which causes skin hardening, ptosis, and deepening of the upper eyelid sulcus (DUES), has been suggested to affect corneal shape due to increased eyelid pressure. In this study, we performed a corneal shape analysis using anterior segment optical coherence tomography (AS-OCT) in patients with PAP accompanied by blepharoptosis.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Fourier harmonic corneal shape analysis using anterior segment OCT was performed in patients with a margin reflex distance-1 (MRD-1) of 2 mm or less (176 eyes of 101 cases). Cases with congenital ptosis, neurogenic ptosis, facial nerve palsy, thyroid eye disease, history of eyelid surgery, vitrectomy, glaucoma tube shunt surgery or filtration surgery were excluded. Patients were divided into two groups based on the presence or absence of prostaglandin analog (PGA) eye drops, and a comparative analysis was conducted.</p><p><strong>Results: </strong>In the comparison between the PGAs group (n=47) and the non-PGAs group (n=129), no significant differences were observed in age, gender, MRD-1, or levator function. However, the PGAs group exhibited significantly larger values for both regular and irregular astigmatism. Additionally, in the PGAs group, when the severity of PAP was classified (grades 0 to 3), there was a correlation between PAP grade and both regular and irregular astigmatism.</p><p><strong>Conclusion: </strong>Patients with PAP who developed ptosis exhibited significant increases in both regular and irregular astigmatism, with a correlation observed between PAP grade and astigmatism. It is suggested that the increased eyelid pressure due to PAP may influence corneal shape.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Retinal displacement using optical coherence tomography angiography and metamorphopsia in eyes undergoing macular hole surgery.","authors":"Shun Tsukahara, Asuka Takeyama, Masahiro Ishida","doi":"10.1007/s10384-025-01176-5","DOIUrl":"https://doi.org/10.1007/s10384-025-01176-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between metamorphopsia and retinal structural changes using optical coherence tomography angiography (OCTA) images before and after macular hole (MH) surgery.</p><p><strong>Study design: </strong>Retrospective, consecutive, case series.</p><p><strong>Methods: </strong>Twenty-seven eyes of 27 patients undergoing MH surgery with internal limiting membrane peeling were studied. M-CHARTS (MC) was used to evaluate metamorphopsia. Retinal distances were measured between two sets of retinal vessel bifurcations that cross the macula vertically and horizontally near and distal to the macula using OCTA 3x3 mm en face images. The rate of change in retinal distance was defined as retinal displacement%. Basal and minimum MH diameters and retinal thicknesses were measured using Spectralis.</p><p><strong>Results: </strong>The vertical and horizontal MC scores improved postoperatively (P<0.001). The retinal distance decreased in all periods (P<0.001), and retinal displacements% was greater near than distal to the center of the macula (P<0.001). Retinal displacement% was correlated with basal MH diameter (r_s=-0.419 to -0.280, P<0.001 to 0.045). The horizontal MH diameter was a significant factor related to vertical MC score at baseline and 6 months postoperatively (P value range: P=0.002-0.004). The rates of change in outer retinal thickness and retinal displacement% near the center of the macula were significant factors related to horizontal MC scores at 6 months (P<0.001).</p><p><strong>Conclusion: </strong>Retinal displacement near the macular region contributes to MH closure after surgery. The larger the MH diameter, the greater the retinal displacement near the macula and the degree of residual postoperative metamorphopsia.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identification and structural analysis of pathogenic variants in MYOC and CYP1B1 genes in Indian JOAG patients.","authors":"Manoj Yadav, Mukesh Kumar, Chand Singh Dhull, Sumit Sachdeva, Aarti Bhardwaj, Anshu Yadav, Vishal Panghal, Pradeep Sharma, Ankit Kumari, Ritu Yadav, Mayank Singh, Rakesh Kumar, Anupama Deora, Manisha Rathi, Punit Kaur, Mukesh Tanwar","doi":"10.1007/s10384-025-01173-8","DOIUrl":"https://doi.org/10.1007/s10384-025-01173-8","url":null,"abstract":"<p><strong>Purpose: </strong>Juvenile onset open-angle glaucoma (JOAG) manifests in individuals under the age of 40, resulting in elevated intraocular pressure and significant optic nerve damage. To broaden the spectrum of mutations associated with JOAG and to determine their specific structural implications, we examined Myocilin and Cytochrome P450 1B1 gene in a cohort of 111 unrelated North Indian patients diagnosed with JOAG.</p><p><strong>Study design: </strong>A clinical and experimental study.</p><p><strong>Methods: </strong>PCR-DNA sequencing screened the coding exons and intron-exon junctions of the MYOC and CYP1B1 genes in 111 unrelated JOAG patients and 100 controls. Identified sequence variations were searched in the ClinVar database, HGMD, and dbSNP. Six different online available algorithms including rare exome variant ensemble learner (REVEL), Sorting Intolerant From Tolerant (SIFT), Mutation Taster, SNAP2, IMutant2.0, and MutPred2 were used for the pathogenicity prediction of missense variations. The Structural consequences of detected possible pathogenic variations were predicted by using PyMol, Chimera and MD simulation of these changes.</p><p><strong>Results: </strong>Potentially-pathogenic variations were observed in thirty patients (27.02%) within the MYOC and CYP1B1 genes, encompassing both novel and previously documented variants. Structural predictions of novel potentially-pathogenic mutations indicate altered stability and flexibility.</p><p><strong>Conclusion: </strong>Analysis reveals a higher prevalence of CYP1B1 gene variants (22.5%) relative to MYOC gene variants (4.5%), suggesting that CYP1B1 is the predominant gene implicated in JOAG among Indian patients. Our findings enhance the understanding of mutation spectra and frequencies of MYOC and CYP1B1gene in JOAG among the North Indian population. Structural predictions of novel pathogenic mutations could enhance the understanding of JOAG pathogenesis and support subsequent functional analysis.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term outcomes and prognosis in vitrectomy with autologous platelet concentrate injection for large, high myopic, or recurrent macular holes.","authors":"Seo-Yeon Hong, Sang Un Yi, Mirinae Kim, Young-Hoon Park","doi":"10.1007/s10384-025-01166-7","DOIUrl":"https://doi.org/10.1007/s10384-025-01166-7","url":null,"abstract":"<p><strong>Purpose: </strong>This study investigated the long-term efficacy and safety of Autologous Platelet Concentrate (APC) injection as an adjunct to pars plana vitrectomy (PPV) in the treatment of macular holes (MHs) with a high risk of surgical failure, including large, highly myopic, or recurrent MHs.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>This study included patients who underwent PPV with or without APC injection for MHs at Seoul St. Mary's Hospital between March 2017 and February 2020, with a minimum postoperative follow-up period of 3 years. Anatomical success rates, alterations in foveal microstructure, and improvements in best-corrected visual acuity (BCVA) were evaluated.</p><p><strong>Results: </strong>Fifty-four patients were included, exhibiting a trend toward enhanced anatomical success in the PPV with APC group (95.0%) compared to the PPV with flap techniques (85.7%) and PPV without the adjunct of flap techniques or APC injection (84.6%), though not statistically significant. Significant findings included increased glial proliferation within the PPV with APC group, sustained for up to one year (P < 0.01), and a significant correlation between glial proliferation and MH closure (P = 0.032). Improvements in BCVA were substantial and found to be significantly associated with preoperative BCVA, the reconstruction of the external limiting membrane (ELM) and ellipsoid zone (EZ) (P = 0.008, 0.010, and 0.047, respectively).</p><p><strong>Conclusion: </strong>The use of APC as adjuvant to PPV can be advantageous in cases of challenging MHs, reflecting comparable anatomical success rates, potential for glial proliferation critical for hole closure, and established safety profile.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographics, clinical features and prognosis of patients with primary malignant conjunctival tumors at a tertiary hospital in Japan.","authors":"Hiroshi Goto, Masaki Asakage, Erina Niidime, Naoyuki Yamakawa, Hiroyuki Komatsu, Kinya Tsubota, Kazuhiko Umazume, Yoshihiko Usui, Hideki Mori","doi":"10.1007/s10384-025-01165-8","DOIUrl":"https://doi.org/10.1007/s10384-025-01165-8","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the demographic characteristics, clinical features and prognosis of patients with primary malignant conjunctival tumors diagnosed at a single tertiary hospital in Japan.</p><p><strong>Study design: </strong>Retrospective, observational case series.</p><p><strong>Methods: </strong>Patients with malignant conjunctival tumors diagnosed histopathologically at Tokyo Medical University Hospital between 2010 and 2022 were retrospectively reviewed. The demographic profile, clinical features and treatment outcomes were analyzed.</p><p><strong>Results: </strong>A total of 359 patients with histopathologically proven malignant conjunctival tumors were included. All patients were Japanese. The most common malignant conjunctival tumor was lymphoma (n = 197, 54.9%), followed by squamous cell carcinoma (SCC) (n = 97, 27.0%), melanoma (n = 60, 16.7%), and others (n = 5, 1.4%). The mean age of patients at the time of diagnosis was 60.5 ± 17.4 years for lymphoma, 60.2 ± 15.8 years for SCC, and 65.8 ± 15.7 years for melanoma. Among 197 patients with lymphoma, 89.3% had extranodal marginal zone lymphoma (EMZL). Lymphomas were treated with external beam radiation therapy in 52.8%, surgical resection with or without cryopexy in 40.1%, and systemic chemotherapy in 4.0%. During an observation period of more than 12 months, recurrence was observed in 8.4% and extraocular lymphoma occurred in 1.7%. In SCC and melanoma, common surgical resection with sufficient safety margin, cryopexy, and application of 0.04% mitomycin C were performed as eye-preserving therapy. Orbital exenteration was performed in advanced cases. Recurrence rates and regional lymph node metastasis rates during an observation period of more than 12 months were, respectively, 30.1% and 6.2% in SCC. Recurrence rates and regional lymph node or distant organ metastasis rates during an observation period of more than 24 months for melanoma were 29% for both. Tumor-related mortality was 16% in melanoma, but 0% in lymphoma and SCC.</p><p><strong>Conclusions: </strong>Lymphoma was the major malignant conjunctival tumor in a Japanese ophthalmology referral center, which may reflect a unique epidemiological trend in Japan compared to Western countries. The prognosis of lymphoma and SCC after appropriate treatment was favorable, except for some cases of advanced SCC.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}