Japanese Journal of Ophthalmology最新文献

{"title":"Optic nerve head abnormalities in primary open-angle glaucoma and their associations with axial length.","authors":"Hitomi Saito, Weiwei Wang, Kaho Akiyama, Shuichiro Aoki, Shiroaki Shirato, Rei Sakata, Makoto Aihara, Megumi Honjo","doi":"10.1007/s10384-026-01371-y","DOIUrl":"https://doi.org/10.1007/s10384-026-01371-y","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the frequency of peripapillary retinoschisis (PRS), lamina cribrosa defect (LCD), peripapillary intrachoroidal cavitation (PICC), and prelaminar schisis (PLS) in primary open-angle glaucoma (POAG) eyes and investigate their association with axial length (AXL).</p><p><strong>Study design: </strong>Retrospective cross-sectional METHODS: Optical coherence tomography scans of 263 POAG eyes were reviewed for PRS, LCD, PICC, and PLS. The frequency of each optic nerve head (ONH) abnormality was compared between eyes with and without high myopia (HM), defined as AXL > 26 mm. Associations with AXL were assessed using univariable and multivariable logistic regression, adjusting for gender, age, intraocular pressure, visual field mean deviation, circumpapillary retinal nerve fiber layer thickness and Bruch's membrane opening (BMO) area.</p><p><strong>Results: </strong>PRS, LCD, PICC, and PLS were observed in 11.8%, 31.6%, 18.3%, and 55.1% of all POAG eyes, respectively. 77.2% exhibited at least one abnormality, and 31.2% had multiple abnormalities. PRS, LCD, and PICC were more frequent in HM eyes (p = 0.001, 0.016 and <0.001, respectively) and associated with longer AXL in univariable analysis (p < 0.001). Multivariable analysis showed that PRS significantly associated with longer AXL (p < 0.001) and that LCD and PICC significantly associated with larger BMO area (p = 0.009, < 0.001). PLS was more frequent in eyes without HM (p = 0.026) and significantly associated with shorter AXL (p = 0.005).</p><p><strong>Conclusion: </strong>ONH abnormality was common in myopic POAG eyes with substantial overlaps. PRS, LCD and PICC were associated with longer AXL and myopic ONH structural change while PLS was associated with shorter AXL. These findings will be a foundation for further studies exploring their functional relevance.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837856","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":"Comparison of physician-assessed and patient-reported outcomes of using azithromycin eye drops in the treatment of bacterial blepharitis.","authors":"Takashi Suzuki, Ryohei Nejima, Tomoyuki Inoue, Yuichi Kaji, Takaaki Hattori, Saichi Hoshi, Daisuke Todokoro, Hiroshi Eguchi, Michikazu Nakai, Yoshitsugu Inoue","doi":"10.1007/s10384-026-01362-z","DOIUrl":"https://doi.org/10.1007/s10384-026-01362-z","url":null,"abstract":"<p><strong>Purpose: </strong>To compare physician-assessed and patient-reported outcomes quantified with the Japanese Ocular Surface Disease Index (J-OSDI) following the treatment of bacterial blepharitis and to evaluate the utility of the J-OSDI.</p><p><strong>Study design: </strong>Multicenter prospective observational study.</p><p><strong>Methods: </strong>Physicians assessed symptoms and findings, calculating clinical total scores at baseline (T0), 7 (T1) and 14 (T2) days post-treatment with 1% azithromycin ophthalmic solution, and 1 month after discontinuation (T3). Patients self-reported symptoms using the J-OSDI at these times. The J-OSDI score trends and differences in temporal changes between the J-OSDI and clinical total scores were analyzed by use of a linear mixed-effects model.</p><p><strong>Results: </strong>Forty-six eyes (46 patients; mean age, 71.8 years) were studied. The J-OSDI scores decreased significantly post-treatment for all the patients, with similar trends for both anterior and posterior blepharitis. For all the patients, the slope difference between the J-OSDI and clinical total scores was not significant in the T0-T1 period (P = .219), meaning that the J-OSDI scores reflected the clinical results, whereas it was significant in the T1-T2 (P = .004) and T2-T3 (P <.001) periods. The within-subject correlation between the 2 scores was 0.525 (95% CI 0.401-0.631). For anterior blepharitis, the slope differences were significant across all the periods, but for posterior blepharitis, no significant differences were observed in the T0-T1 or T1-T2 (P = .205, 0.06, respectively) periods, although significant differences were noted in the T2-T3 period (P = .018).</p><p><strong>Conclusion: </strong>The J-OSDI trajectory often diverges from physician-rated changes. Whilst the J-OSDI does not assess treatment response in anterior blepharitis, it may be partially reflective of improvement in posterior blepharitis.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837937","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":"Gender-based differences in work styles and career satisfaction in the retina subspecialty in Japan.","authors":"Maiko Maruyama-Inoue, Annabelle A Okada, Miho Nozaki, Hiroko Terashima, Yoko Miura","doi":"10.1007/s10384-026-01348-x","DOIUrl":"https://doi.org/10.1007/s10384-026-01348-x","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate differences in work styles and career satisfaction between women and men physicians in the retina subspecialty in Japan using a questionnaire survey.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>A web-based questionnaire was sent as an e-mail link to all 3,027 current members of the Japanese Retina and Vitreous Society in August 2023 with responses collected anonymously in September 2023. The questionnaire consisted of 4 main categories: baseline characteristics, job satisfaction, life events and career advancement, and suitability as a retina specialist and workplace gender equality.</p><p><strong>Results: </strong>Valid responses were received from 614 members, representing a response rate of 20.3%. One-fifth of men (19.0%) were \"very satisfied\" with their job, much higher than the same for women (7.5%) (P < 0.001). Furthermore, there was a significant difference between men and women who \"strongly agreed\" or \"agreed\" that life events were an impediment to one's career (44.3% vs 74.9%) (P < 0.001). There was also a significant difference between men and women who answered \"strongly agree\" when asked whether they felt they were suited to work in the retina subspecialty (31.0% vs 13.4%) (P < 0.001).</p><p><strong>Conclusions: </strong>Our study identified and quantified marked differences in work style and career satisfaction between women and men. Such differences highlight gender-based challenges in the retina subspecialty that could be improved in order to enhance career satisfaction and career longevity of women retina specialists in Japan.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147837913","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":"Fibrotic response after Baerveldt glaucoma drainage device surgery: an initial sight-threatening sign in eyes with refractory childhood glaucoma.","authors":"Rumi Kawashima, Kenji Matsushita, Masako Kurashige, Takahiro Matsui, Yuichi Motoyama, Takahiro Fujino, Eiichi Morii, Kohji Nishida","doi":"10.1007/s10384-026-01357-w","DOIUrl":"https://doi.org/10.1007/s10384-026-01357-w","url":null,"abstract":"<p><strong>Purpose: </strong>We report the pathological analysis of a postoperative fibrotic reaction as an initial sign of a sight-threatening complication observed during the 2-year outcomes follow up of Baerveldt glaucoma implant (BGI) surgery in eyes with refractory childhood glaucoma.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>Fifteen eyes of 10 patients with refractory childhood glaucoma underwent BGI surgery between 2013 and 2020 at the University of Osaka Hospital. Patients were followed for a minimum of 2 years postoperatively. We investigated the postoperative complications, and histopathologically analyzed the specimens obtained from three eyes with postoperative fibrous membranes on the irises.</p><p><strong>Results: </strong>Nine eyes (60%) had a postoperative fibrous membrane around the tube or on the iris close to the tube, whereas two eyes developed a tractional retinal detachment. The pathological results indicated the tissues were eosinophilic fibrous scar tissues that did not have inflammatory or neoplastic lesions.</p><p><strong>Conclusion: </strong>BGI surgery was effective in patients with refractory childhood glaucoma. However, clinicians should be alert to the potential for development of fibrotic ocular inflammation in refractory childhood glaucoma eyes.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147815156","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":"Double-encircling continuous suture technique for complete cyclodialysis: a consecutive case series.","authors":"Takashi Ueta, Rei Sakata, Megumi Honjo","doi":"10.1007/s10384-026-01367-8","DOIUrl":"https://doi.org/10.1007/s10384-026-01367-8","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and efficacy of a novel double-encircling continuous suture technique for the surgical repair of complete (360°) cyclodialysis.</p><p><strong>Study design: </strong>Retrospective interventional case series.</p><p><strong>Methods: </strong>Medical records of seven consecutive eyes from seven patients with complete cyclodialysis treated at the University of Tokyo Hospital between 2022 and 2025 were retrospectively reviewed. The extent of cyclodialysis and postoperative anatomical outcomes were assessed using anterior segment optical coherence tomography (OCT). Intraocular pressure (IOP) and best-corrected visual acuity (BCVA) were recorded both pre- and post-operatively. The surgical technique consisted of placing two laps of encircling continuous 10-0 polypropylene sutures at 3-4 mm and 2-3 mm posterior to the limbus. In phakic eyes, phacoemulsification with intraocular lens and capsular tension ring implantation were performed concurrently.</p><p><strong>Results: </strong>Four men and three women with a mean age of 43.6 ± 25.4 years were included. Cyclodialysis resulted from blunt trauma (n = 3) or surgical complications (n = 4). Preoperative IOP ranged from 2 to 8 mmHg, and hypotonic maculopathy was observed in all cases. Postoperatively, anatomical reattachment of the ciliary body and resolution of hypotony were achieved in six of seven eyes (85.7%). All eyes demonstrated improved BCVA, though the improvement depended on comorbid conditions such as glaucoma, pathologic myopia, and bullous keratopathy. IOP transiently elevated postoperatively, and additional glaucoma surgery was necessary in two cases with a history of glaucoma.</p><p><strong>Conclusion: </strong>Reproducible safety and efficacy were confirmed for the double-encircling continuous suture technique in repairing complete cyclodialysis, yielding anatomical success and functional improvement.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771158","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":"Secondary corneal amyloidosis in a patient with Meesmann corneal dystrophy.","authors":"Jini Qiu, Yue Li, Rongrong Cai, Chaoran Zhang","doi":"10.1007/s10384-026-01365-w","DOIUrl":"https://doi.org/10.1007/s10384-026-01365-w","url":null,"abstract":"<p><strong>Background: </strong>Meesmann corneal dystrophy (MCD) is a rare autosomal dominant corneal disorder characterized by recurrent epithelial erosions. While secondary corneal amyloidosis (SCA) is well-documented in chronic inflammatory disorders, its occurrence in MCD has not been previously described.</p><p><strong>Case: </strong>Here we first report a case of concurrent MCA and SCA, the diagnosis was confirmed through clinical evaluation, Anterior segment optical coherence tomography, in vivo laser confocal microscopy, and histopathological examination. Genetic testing identified a novel KRT12 mutation (c.1292G>C, p.R431P) in both the patient and her affected father, though the father exhibited no signs of SCA.</p><p><strong>Conclusions: </strong>SCA may develop as a rare complication in patients with long-standing MCD, potentially complicating the diagnosis.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771425","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":"Challenge to the concept of surgical dose-response for moderate to large angle exotropia.","authors":"Soh Youn Suh, Qingyu Meng, Ami Tamhaney, Joseph L Demer","doi":"10.1007/s10384-026-01344-1","DOIUrl":"https://doi.org/10.1007/s10384-026-01344-1","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether the effect of three muscle surgery for moderate to large angle exotropia can be better predicted by surgical dosage, or by pre-operative exotropia angle. We examined cases where identical surgical dose was performed for a wide range of preoperative angles 30 to 55Δ.</p><p><strong>Study design: </strong>Retrospective, interventional case study.</p><p><strong>Methods: </strong>Patients with exotropia 30-55Δ who underwent bilateral lateral rectus (BLR) muscle recession 7 mm and 4 mm unilateral medial rectus (UMR) muscle plication between 2014 and 2024 were included. Surgical effect was analyzed by linear regression against the amount of preoperative exotropia, as well as total millimeters of recession and plication. Success was defined as less than 10Δ exotropia or 5Δ esotropia.</p><p><strong>Results: </strong>Thirty-four patients were included with 32 ± 27 (standard deviation, SD) years mean age. Mean preoperative exotropia at distance was 42 ± 6Δ (range 30-55Δ), and 40 ± 16Δ (range 6-70Δ) at near. Surgical effect varied from 29Δ to 75Δ, averaging 42 ± 10Δ, giving a mean dose response of 2 ± 1Δ/mm. Linear regression showed that average surgical effect was equal to pre-operative deviation, accounting for 34-36% of variation in surgical effect. Success rate of this operation for all exotropia angles was 76% at 2 months mean followup.</p><p><strong>Conclusions: </strong>Surgical effect for moderate to large angle exotropia does not strongly depend on surgical dose, so that successful outcomes measured 2 months post-operatively are obtained by performing a numerically identical procedure regardless of the pre-operative angle exceeding 30Δ. Since outcome is attributable more to the biological response than to amount of surgery, pre-operative measurements require only sufficient precision to confirm that the angle is moderate to large.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147770689","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":"Incidence and risk factors related to ocular adverse effects caused by S-1 chemotherapy.","authors":"Tomoyuki Kamao, Masakazu Yamada, Atsushi Shiraishi, Jo Sakai, Yuichi Ohashi","doi":"10.1007/s10384-025-01318-9","DOIUrl":"https://doi.org/10.1007/s10384-025-01318-9","url":null,"abstract":"<p><strong>Purpose: </strong>This study aimed to identify the incidence and risk factors of corneal disorders (CDs) and lacrimal passage obstruction (LPO) caused by S-1 chemotherapy.</p><p><strong>Study design: </strong>Multicenter prospective cohort study.</p><p><strong>Methods: </strong>This study included patients who were administered S-1 for the first time and underwent ophthalmic evaluations for 1 year during the treatment. CD was defined as an increase of >2 points in the National Eye Institute classification. LPO was defined as an abnormality in lacrimal irrigation. Risk factors were identified via univariate and multivariate analyses.</p><p><strong>Results: </strong>This study enrolled 126 men and 49 women with a mean age of 68.1 (30-87) years. Over a mean follow-up of 169.6 ± 127.3 days, the incidence rates of CD and LPO were 24.6% and 14.0%, with 1-year cumulative incidence rates of 37.0% and 25.9%, respectively. The risk factors for CD were no previous use of eye drops (hazard ratio [HR] 3.45, p = 0.0955) and tear breakup time over 5 s prior to S-1 chemotherapy (HR 1.86, p = 0.0535). The risk factors for LPO were male sex (HR 5.00, p = 0.0311), primary tumor other than gastric cancer (HR 2.27, p = 0.0666), previous use of eye drops for dry eye (HR 21.16, p = 0.0035), and previous visual disturbance (HR 2.89, p = 0.0303).</p><p><strong>Conclusion: </strong>The high incidence of CD and LPO among patients undergoing S-1 chemotherapy warrants close monitoring of those with identified risk factors, especially within the first six months of chemotherapy.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771400","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":"Risk factors for tube exposure following Baerveldt glaucoma implantation and overlying tissue thickness assessed by anterior segment optical coherence tomography.","authors":"Natsumi Murata, Sachi Kojima, Yuji Takihara, Eri Takahashi, Kei-Ichi Nakashima, Toshihiro Inoue","doi":"10.1007/s10384-026-01366-9","DOIUrl":"https://doi.org/10.1007/s10384-026-01366-9","url":null,"abstract":"<p><strong>Purpose: </strong>We identified clinical factors associated with tube exposure following Baerveldt glaucoma implantation (BGI) and used anterior segment optical coherence tomography (AS-OCT) to assess postoperative tissue thickness over the tube.</p><p><strong>Study design: </strong>Retrospective, single-center cohort study.</p><p><strong>Methods: </strong>In this single-center retrospective cohort study, 405 eyes underwent BGI (BG101-350) with preserved scleral patch grafts between October 2014 and December 2022. Tube exposure was documented through clinical records and slit-lamp examination. Risk factors were evaluated using Firth's penalized logistic regression. Overlying tissue thickness at 1 year postoperatively was measured via AS-OCT, and its association with clinical variables was analyzed using linear regression.</p><p><strong>Results: </strong>The mean follow-up was 630.7 days, and tube exposure occurred in 12 eyes (2.96%). Neovascular glaucoma (NVG) (odds ratio [OR] 5.03, p = 0.033) and anterior chamber (AC) tube insertion (OR 6.07, p = 0.017) were independently associated with exposure. Overlying tissue was significantly thinner with AC insertion compared with ciliary sulcus or pars plana placement (Kruskal-Wallis with Bonferroni-adjusted Dunn's tests; AC vs sulcus, p = 0.039; AC vs pars plana, p < 0.001). Among eyes with AC insertion, prior micropulse transscleral cyclophotocoagulation (MP-CPC) was associated with greater tissue thickness (estimate 0.173; p = 0.032).</p><p><strong>Conclusion: </strong>AC insertion and NVG were associated with an increased risk of tube exposure after BGI. AS-OCT revealed thinner tissue over AC-placed tubes, providing a structural basis for this risk. Avoiding AC insertion may reduce exposure; the observed association between prior MP-CPC and thicker tissue requires prospective validation.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771359","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":"The potential role of the choroidal thickness-to-axial length ratio in primary angle-closure disease.","authors":"Mika Suda, Daphne Viel Tsuru, Kenji Kashiwagi","doi":"10.1007/s10384-026-01353-0","DOIUrl":"https://doi.org/10.1007/s10384-026-01353-0","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the role of choroidal thickness (CT) in primary angle-closure disease (PACD).</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>This retrospective observational study included fifty-one eyes-thirteen with acute primary angle-closure (APAC) with resolved glaucoma attack, twelve with primary angle-closure suspect (PACS), and twenty-six age- and sex-matched controls. Two blinded observers independently measured CT using swept-source optical coherence tomography (SS-OCT) at the subfovea and eight peripheral locations following the Margolis and Spaide method. In addition to routine ophthalmic examinations, the axial length (AL), anterior chamber depth (ACD), and lens vault (LV) were analyzed. Multivariable regression was used to identify associated factors, and the most effective parameters for discriminating PACD were investigated.</p><p><strong>Results: </strong>Subfoveal CT (SFCT) was significantly greater in the APAC (293.4 ± 103.7 µm) and PACS (283.8 ± 71.9 µm) groups than in the control group (210.8 ± 77.2 µm; p < 0.05). AL and age were each independently negatively associated with SFCT (p < 0.05). The CT/AL ratio was significantly greater in both PACD groups than in the control group. This ratio demonstrates superior discriminatory performance compared with absolute CT values in distinguishing eyes affected by PACD from normal eyes. The combination of ACD and LV yielded the highest diagnostic performance (area under the curve: 0.96), with a similar level of performance observed for the combination of the AL and the CT/AL ratio (area under the curve: 0.93).</p><p><strong>Conclusion: </strong>Compared with normal eyes, eyes affected by PACD exhibit increased CT and a significantly higher CT/AL ratio. The CT/AL ratio, a novel anatomical index, may provide a normalized metric reflecting choroidal expansion relative to globe size and may serve as a potential structural marker for PACD risk assessment.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771412","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}