Japanese Journal of Ophthalmology最新文献

{"title":"Changes in demographics and treatment trends in neovascular age-related macular degeneration during the COVID-19 pandemic in Japan.","authors":"Takaaki Sugisawa, Yuki Nishi, Hiroko Imaizumi, Shuichiro Aoki, Akiko Miki, Maya Kishi, Tomofusa Yamauchi, Daisuke Nagasato, Yoko Ozawa, Masatoshi Haruta, Nobuhiro Kato, Hisashi Matsubara, Tsutomu Yasukawa, Aki Kato, Hiroto Terasaki, Takao Hirano, Yasuhiro Iesato, Hiroki Tsujinaka, Tomoya Murakami, Yoshinori Mitamura, Makiko Wakuta, Kazuhiro Kimura, Masahiko Shimura, Fumi Gomi","doi":"10.1007/s10384-026-01422-4","DOIUrl":"https://doi.org/10.1007/s10384-026-01422-4","url":null,"abstract":"<p><strong>Purpose: </strong>To elucidate changes in the management of neovascular age-related macular degeneration (nAMD) in Japan during the COVID-19 pandemic .</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>We conducted a multicenter retrospective cohort study of patients newly examined at 16 retina specialist facilities from January 2017 to March 2021. Baseline findings and 3-year follow-up data were compared between pre-pandemic (2017-February 2020) and post-pandemic (March 2020-March 2021) groups.</p><p><strong>Results: </strong>Analysis of 2271 patients with nAMD revealed a significant decrease in the number of patients examined at hospitals during the COVID-19 pandemic period (p = 0.011), along with a higher proportion of patients who had received treatment within the previous year at local clinics. Baseline ocular findings showed no significant differences between the pre- and post-pandemic groups. Loss to follow-up increased through the second year of the pandemic period (first year, p = 0.0012; second year, p = 0.023). No significant differences were observed during follow-up in visual acuity, central retinal thickness, or number of anti-vascular endothelial growth factor injections. However, in the post-pandemic period the frequency of photodynamic therapy tended to decrease, and examination visits decreased significantly (p = 0.0038).</p><p><strong>Conclusion: </strong>The number of nAMD patients treated in hospitals was lower in the post-pandemic period, and the proportion managed initially in local clinics increased. Although baseline and follow-up characteristics remained largely similar, the use of photodynamic therapy and the number of follow-up visits declined. These findings suggest a shift in the initial nAMD management from hospitals to local clinics during the early post-pandemic period.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148919591","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":"Kindergarten type, preschool educational environment, and screening-defined myopia in Japanese preschool children.","authors":"Saiko Matsumura, Naoko Wada, Tomoko Fujita, Kazuhiko Dannoue, Yuichi Hori","doi":"10.1007/s10384-026-01420-6","DOIUrl":"https://doi.org/10.1007/s10384-026-01420-6","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the association between kindergarten type (public vs private) and screening-defined childhood myopia among Japanese preschool children, and to explore potential behavioral correlates of this association.</p><p><strong>Study design: </strong>Cross-sectional study.</p><p><strong>Methods: </strong>We analyzed data from 153 preschool children aged 3-6 years attending public (n=115) or private (n=38) kindergartens in urban Kawasaki City, Japan. Myopia was defined using non-cycloplegic refraction combined with age-specific visual acuity thresholds to reduce overestimation. Kindergarten type was the primary exposure. Prespecified covariates were age, sex, and parental myopia. Exploratory behavioral variables included weekday reading/writing time, screen time, and exercise time at kindergarten. Because only eight children had screening-defined myopia, penalized logistic regression was used.</p><p><strong>Results: </strong>Myopia prevalence was 1.7% (2/115) in public kindergarten attendees and 15.8% (6/38) in private kindergarten attendees. After adjustment for age and parental myopia, private kindergarten attendance was associated with higher odds of screening-defined myopia (odds ratio [OR], 6.50; 95% confidence interval [CI], 1.54-36.86). This association remained consistent in sensitivity analyses additionally adjusting for sex (OR, 7.93; 95% CI, 1.80-46.89) and recoding parental myopia as binary (OR, 8.95; 95% CI, 2.04-53.38). Exploratory analyses showed that private kindergarten attendance was associated with longer weekday reading/writing time and shorter exercise time at kindergarten, but not clearly with screen time.</p><p><strong>Conclusion: </strong>Private kindergarten attendance was associated with a higher prevalence of screening-defined myopia in this sample of Japanese preschool children. These findings suggest that differences in preschool educational environment and daily visual behavior may contribute to early myopia risk. Further multicenter longitudinal studies are warranted to confirm these findings and to identify modifiable environmental factors that may support future strategies for the early prevention of childhood myopia.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911919","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":"Birefringence and depolarization characteristics of myelinated retinal nerve fibers assessed with polarization-sensitive optical coherence tomography.","authors":"Shuichiro Aoki, Kaho Akiyama, Masahiro Yamanari, Hana Mino, Yurika Aoyama, Kohdai Kitamoto, Ryo Terao, Keiko Azuma, Hiromasa Sawamura, Hitomi Saito","doi":"10.1007/s10384-026-01419-z","DOIUrl":"https://doi.org/10.1007/s10384-026-01419-z","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify birefringence and depolarization features of myelinated retinal nerve fibers using polarization-sensitive optical coherence tomography and to evaluate their utility for noninvasive assessment.</p><p><strong>Study design: </strong>Retrospective observational case series.</p><p><strong>Methods: </strong>Seven eyes from 7 patients with clinically diagnosed myelinated retinal nerve fibers underwent polarization-sensitive optical coherence tomography. We quantified phase retardation (birefringence), polarimetric entropy (depolarization), and intensity within myelinated retinal nerve fibers and adjacent retinal nerve fiber layer. Optic-axis orientation maps were generated to infer myelin lamellar orientation relative to axons and to delineate depth-resolved lesion extent.</p><p><strong>Results: </strong>Myelinated retinal nerve fibers showed significantly higher phase retardation and polarimetric entropy than adjacent retinal nerve fiber layer (p = 0.02 and 0.008, respectively). Retardation and entropy exhibited greater variability than intensity across lesions (p < 0.05). Optic-axis orientation within lesions was consistently near-perpendicular to the local nerve fiber direction (all seven lesions; overall mean angle, 81°). Within lesions, greater depolarization and birefringence were associated with stronger posterior shadowing independent of lesion thickness. Optic-axis images also revealed segments in which nonmyelinated retinal nerve fiber layer overlaid portions of the lesion.</p><p><strong>Conclusion: </strong>Elevated birefringence, increased depolarization, and optic-axis orientation perpendicular to axons constitute distinctive optical signatures of retinal myelination. These contrasts may allow polarization-sensitive optical coherence tomography to delineate lesion boundaries and internal heterogeneity in three dimensions more precisely than conventional optical coherence tomography, supporting differential diagnosis, phenotyping, and longitudinal monitoring.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897358","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":"Epidemiology of macular dystrophy in Japan (2011-2020): a nationwide population-based study.","authors":"Hanako Ohashi Ikeda, Ai Otsuka, Takuro Kamei, Yuki Otsuka, Shogo Numa, Manabu Miyata, Akio Oishi, Shusuke Hiragi, Hiroaki Ueshima, Akitaka Tsujikawa, Masahiro Miyake, Hiroshi Tamura","doi":"10.1007/s10384-026-01410-8","DOIUrl":"https://doi.org/10.1007/s10384-026-01410-8","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the characteristics and prevalence of macular dystrophy using a comprehensive national claims database in Japan.</p><p><strong>Study design: </strong>Population-based retrospective study using a nationwide claims database.</p><p><strong>Methods: </strong>Approximately 126 million individuals covered by Japan's universal health coverage system were included. Health insurance claims from 2011 to 2020 stored in the National Database of Health Insurance Claims (NDB) of Japan were analyzed. Patients with macular dystrophy, including best vitelliform macular dystrophy (BVMD), Stargardt disease (STGD), cone/cone-rod dystrophy, or central areolar choroidal dystrophy (CACD), were identified using diagnostic codes recorded in the database. The population-based prevalence of diagnosed macular dystrophy was calculated, and age-standardized rates were derived using the WHO standard world population.</p><p><strong>Results: </strong>Between 2011 and 2020, 1,268 patients with BVMD, 460 with STGD, 5758 with cone/cone-rod dystrophy, and 280 with CACD were identified in the NDB. As of October 1, 2020, the corresponding prevalence rates were 10.05, 3.65, 45.65, and 2.35 per 1,000,000 persons, respectively.</p><p><strong>Conclusion: </strong>This nationwide study provides updated epidemiological estimates of macular dystrophy in Japan. These findings may inform clinical management, healthcare planning, and future research on macular dystrophy.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887311","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":"Safety profile of intravenous methylprednisolone therapy for thyroid eye disease: a multicenter retrospective study.","authors":"Taichi Higashida, Mizuki Tagami, Gen Kinari, Yusuke Haruna, Eri Ishikawa, Muhammad Abumanhal, Yasuhiro Takahashi, Shigeru Honda","doi":"10.1007/s10384-026-01413-5","DOIUrl":"https://doi.org/10.1007/s10384-026-01413-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety profile of intravenous methylprednisolone (IVMP) in patients with thyroid eye disease (TED) and identify factors associated with major adverse events (AEs), focusing on age.</p><p><strong>Study design: </strong>Multicenter retrospective study.</p><p><strong>Methods: </strong>We reviewed 369 patients with active TED treated with IVMP. AEs occurring during or within 1 month of treatment were classified as mild, severe, or life-threatening. Logistic regression analyses identified factors associated with hyperglycemia, liver dysfunction, and severe/life-threatening AEs, with age-based comparisons (≥70 vs <70 years). For severe/life-threatening AEs, Firth's penalized logistic regression was additionally performed as a sensitivity analysis.</p><p><strong>Results: </strong>AEs occurred in 240 patients (65.0%); 231 (62.6%) were mild, and 15 (4.1%) were severe or life-threatening. Hyperglycemia and liver dysfunction occurred in 10.6% and 7.9%, respectively. In exploratory multivariable analyses, older age, diabetes mellitus, and high cumulative dose (>6000 mg) were associated with hyperglycemia. For severe/life-threatening AEs, older age was the most consistent associated factor in exploratory analyses, and this finding was unchanged in a sensitivity analysis using Firth's penalized logistic regression. Patients aged ≥70 years had significantly higher risks of both hyperglycemia and severe/life-threatening AEs.</p><p><strong>Conclusion: </strong>IVMP for active TED is frequently associated with mild AEs, whereas severe or life-threatening events are uncommon but clinically important. Older age was the most consistent factor associated with severe/life-threatening AEs in exploratory analyses, and hyperglycemia risk was higher in older patients, patients with diabetes mellitus, and patients receiving higher cumulative doses. These findings support careful risk assessment and monitoring, particularly in elderly patients.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887361","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":"Glaucoma awareness survey and promoting a culture of eye care.","authors":"Noriko Himori, Airi Takagi, Maki Fukumoto, Kyoko Takagi, Masako Kudo, Mika Omori, Toru Nakazawa","doi":"10.1007/s10384-026-01406-4","DOIUrl":"https://doi.org/10.1007/s10384-026-01406-4","url":null,"abstract":"<p><strong>Purpose: </strong>Glaucoma is a leading cause of visual impairment in Japan. Because it is often asymptomatic in its early stages, many individuals with glaucoma remain unaware of their condition. To address this, we are promoting eye-care culture (memigaki bunka). As part of this initiative, we conducted a study to assess glaucoma awareness in Japan.</p><p><strong>Study design: </strong>Cross sectional, online panel survey.</p><p><strong>Methods: </strong>An online survey was conducted in Japan among men and women aged 30-69 years. Participants were stratified into four 10-year age groups (30-39, 40-49, 50-59, and 60-69 years) and by sex, with 100 men and 100 women recruited for each age group in each of the two study regions: (1) the cities of Sendai and Tomiya in Miyagi, and (2) all other 46 Japanese prefectures combined (excluding the 47th prefecture, Miyagi). The total sample comprised 1,600 participants, including 800 residents of Sendai/Tomiya and 800 residents of the remaining 46 prefectures. All participants answered the question: what do you know about glaucoma? using a 5-point Likert scale.</p><p><strong>Results: </strong>Residents of Sendai and Tomiya demonstrated significantly higher glaucoma awareness than those from other regions (p = 0.01). Women showed higher awareness than men (p = 0.03). In a sex-stratified analysis, regional differences were observed among women (p = 0.03) but not among men (p = 0.18). Path analysis revealed that willingness to undergo paid eye examinations was associated with being female, being a driver, having a sense of fear of glaucoma, and understanding glaucoma (p < 0.05).</p><p><strong>Conclusions: </strong>Glaucoma awareness was relatively higher among participants from Sendai and Tomiya than among participants from the other 46 prefectures. Women demonstrated higher levels of awareness than men. Future public health efforts should focus on improving awareness among men to promote early detection and treatment of glaucoma.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887313","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":"Epidemiology and treatment trends of retinopathy of prematurity: a multi-center study involving four Asian centers and one European center (2016-2023).","authors":"Yi-Hsuan Tseng, Tapas Ranjan Padhi, Souvik Bhunia, Sudarshan Seshasai, Andrew Shih-Hsiang Tsai, Gavin Siew-Wei Tan, Nirmal Kavalloor Visruthan, Connie Hong Yee Lai, Tin Yan Grace Hui, Rachel Sze-Wan Yiu, Susana Maria Pereira Teixeira, Tomas Reis da Costa, Pei-Liang Wu, Eugene Yu-Chuan Kang, Kuan-Jen Chen, Nan-Kai Wang, Yih-Shiou Hwang, Chi-Chun Lai, Wei-Chi Wu","doi":"10.1007/s10384-026-01390-9","DOIUrl":"10.1007/s10384-026-01390-9","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate regional differences in the epidemiology and treatment of retinopathy of prematurity (ROP) from 2016 to 2023.</p><p><strong>Study design: </strong>Retrospective multicenter cohort study METHODS: Premature infants screened for ROP at a single tertiary referral center in each of five countries/regions (Taiwan, Hong Kong, Singapore, India, and Portugal) during the study period. Demographic characteristics, incidences of ROP and type 1 ROP, and treatment modalities were analyzed. Screening criteria followed local protocols. Logistic regression was used to assess trends, and intergroup comparisons were performed using Kruskal-Wallis and chi-square tests.</p><p><strong>Results: </strong>A total of 15,031 premature infants were enrolled. Demographics varied significantly (p <0.001); India had the highest gestational age and birth weight, and the lowest proportion of very low birth weight and extremely low birth weight infants with type 1 ROP (p <0.001). Hong Kong had the lowest ROP incidence, while Singapore showed a significant increase over time (p = 0.003). Type 1 ROP rates were higher in Taiwan and India than in Hong Kong and Singapore, with a significant decline observed only in Taiwan (p = 0.005). Anti-Vascular Endothelial Growth Factor (Anti-VEGF) injections were increasingly preferred as initial treatment, with bevacizumab being the most frequently used (87.3%).</p><p><strong>Conclusion: </strong>From 2016 to 2023, ROP incidence and treatment showed significant regional differences. ROP increased in Singapore, while type 1 ROP decreased significantly in Taiwan. Although anti-VEGF therapy has become more common, laser treatment remains dominant in Hong Kong.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"1287-1295"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375687","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":"Clinical characteristics of angioid streaks in Japanese patients.","authors":"Ruka Maruko, Ichiro Maruko, Nozomu Hashiya, Taiji Hasegawa","doi":"10.1007/s10384-026-01387-4","DOIUrl":"10.1007/s10384-026-01387-4","url":null,"abstract":"<p><strong>Purpose: </strong>To characterize fundus findings and the presence of pseudoxanthoma elasticum (PXE) in Japanese patients with angioid streaks (AS).</p><p><strong>Study design: </strong>Retrospective, single-center observational study.</p><p><strong>Methods: </strong>This retrospective study included 33 patients (66 eyes) diagnosed with AS who underwent color fundus photography, optical coherence tomography, and fundus autofluorescence. The presence of PXE, peau d'orange, choroidal neovascularization (CNV), macular atrophy, comet tail lesions, pattern dystrophy-like changes, subretinal drusenoid deposits (SDD), outer retinal tubulation (ORT), and optic nerve head drusen were evaluated.</p><p><strong>Results: </strong>PXE was diagnosed in 15 of 33 patients (45.5%), whereas peau d'orange was observed in 36 eyes (54.5%). There were no significant differences in the prevalence of peau d'orange (P=1.00) or comet tail lesions (P=0.70) between patients with and without clinical PXE diagnosis. CNV and macular atrophy were each present in 31 eyes (47.0%). Comet tail lesions, pattern dystrophy-like changes, SDD, and ORT were found in 17 (25.8%), 21 (31.8%), 6 (9.1%), and 13 (19.7%) eyes, respectively; optic nerve head drusen were not detected. Most pattern dystrophy-like changes (81.0%), SDD (83.3%), and ORT (92.3%) were associated with CNV.</p><p><strong>Conclusion: </strong>Japanese patients with AS showed a high frequency of CNV, which is often accompanied by macular atrophy and photoreceptor-related structural changes. Furthermore, the prevalence of peau d'orange was higher than of clinically diagnosed PXE, suggesting possible underdiagnosis of PXE in this cohort.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"1147-1153"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13616008/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148375674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Geographic atrophy progression and subretinal drusenoid deposits in a real-world Japanese cohort.","authors":"Takuya Takayama, Hidenori Takahashi, Taiki Tsuge, Mayumi Chiba, Marieh Esmaeelpour, Satoru Inoda, Hironobu Tampo, Yuto Hashimoto, Kyouta Kimura, Yusuke Fukuju, Toshikatsu Kaburaki, Yasuo Yanagi","doi":"10.1007/s10384-026-01388-3","DOIUrl":"10.1007/s10384-026-01388-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the natural course of geographic atrophy (GA) in Japanese patients, with a focus on factors associated with the change of GA size over time and visual acuity decline.</p><p><strong>Study design: </strong>Retrospective, single-center observational study.</p><p><strong>Methods: </strong>We reviewed 40 eyes of 40 patients with GA and longitudinal fundus autofluorescence (FAF) imaging. Annual progression rates were calculated as square root-transformed (mm/year). Assessed factors included age, sex, smoking history, diabetes, hypertension, baseline best-corrected visual acuity (BCVA), baseline lesion size, foveal center involvement, choroidal thickness, FAF subtypes, and presence of subretinal drusenoid deposits (SDD). Visual outcomes were assessed as change in BCVA (ΔBCVA, logarithm of the minimum angle of resolution (logMAR)).</p><p><strong>Results: </strong>Median age was 75.5 years; 50% of eyes had SDD. The median annual GA progression rate was 0.16 mm/year in square root units. Baseline GA area and the presence of SDD were independent predictors of GA progression (β = -0.0837, p = 0.015; β = +0.3064, p = 0.009, respectively). In multivariable analysis, baseline GA area also remained a significant predictor of visual deterioration (β = +0.1369, p = 0.002). When stratified by FAF patterns, there was significant worsening of BCVA in the Diffuse (p = 0.0027) and Banded (p = 0.0117) subtypes, whereas the None and Other subtypes did not show significant changes in BCVA over one year.</p><p><strong>Conclusions: </strong>SDD was identified as a significant risk factor for GA progression in Japanese patients. These findings improve understanding of natural history of GA in Japanese population and may inform risk stratification.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"1154-1164"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615932/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148345247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute acquired comitant esotropia in the smartphone era: a narrative review.","authors":"Eizo Tanaka, Yuki Morizane, Seiko Fujii, Mari Yaida, Weiying Sun, Satoshi Hasebe","doi":"10.1007/s10384-026-01417-1","DOIUrl":"10.1007/s10384-026-01417-1","url":null,"abstract":"<p><strong>Purpose: </strong>Acute acquired comitant esotropia (AACE) has received increasing attention in the smartphone era, following numerous clinical reports suggesting an association with intensive and prolonged device use. However, it remains unclear whether smartphone use is a direct cause of AACE, a trigger in susceptible individuals, or a surrogate marker for broader modern lifestyle changes that may contribute to its pathogenesis.</p><p><strong>Study design: </strong>Focused narrative review.</p><p><strong>Methods: </strong>This article presents a focused narrative review of the literature on AACE in relation to intensive smartphone or other handheld digital-display use, with an emphasis on clinical evidence, exposure characteristics, potential sources of bias, and biologically plausible mechanisms.</p><p><strong>Results: </strong>Most of the available evidence comes from retrospective studies and uncontrolled visual hygiene trials, both of which are often limited by selection bias and inaccurate self-reporting of screen time. In addition, publication bias is a major concern; cases mentioning smartphone use may be more likely to be published than otherwise similar cases without reported smartphone exposure.</p><p><strong>Conclusions: </strong>Prolonged near-viewing on handheld digital displays is a biologically plausible contributing factor to AACE in some patients, particularly through sustained high vergence demand at short viewing distances. Nevertheless, current data are insufficient to establish a population-level causal relationship. Future studies should incorporate objective exposure metrics, standardized phenotyping, and explicit adjustment for age, refractive error, and objectively assessed near-work load to clarify the strength and nature of this association.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"1039-1045"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615991/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982685","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}