Japanese Journal of Ophthalmology最新文献

{"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":"HTRA1 and complement activation in neovascular age-related macular degeneration.","authors":"Keiichiro Tanaka, Tomoko Omori, Yasuharu Oguchi, Kanako Itagaki, Yutaka Kato, Junichiro Honjo, Koki Norikawa, Yukinori Sugano, Ryo Mukai, Yumi Ishida, Takeshi Machida, Hideharu Sekine, Tetsuju Sekiryu","doi":"10.1007/s10384-024-01153-4","DOIUrl":"https://doi.org/10.1007/s10384-024-01153-4","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between high temperature requirement A (HTRA1) and the local complement system, we measured HTRA1 and complement activation products in the aqueous humor of patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Study design: </strong>Surveys (cross-sectional studies).</p><p><strong>Methods: </strong>One hundred twenty-one eyes of 121 patients with nAMD and 55 control eyes were enrolled. HTRA1, complement activation products (C3a and C4a), and proinflammatory cytokines (vascular endothelial growth factor [VEGF] and monocyte chemoattractant protein-1) were measured. Genotyping of ARMS2 A69S, in linkage disequilibrium with the HTRA1 gene, was performed in all patients and controls.</p><p><strong>Results: </strong>The respective GG, GT, and TT genotypes for ARMS2 A69S were distributed as follows: 23 (19.0%), 54 (44.6%), and 44 (36.4%) in nAMD patients, and 26 (47.3%), 22 (40.0%), and 7 (12.7%) in controls, (p < 0.001). HTRA1 concentrations in the aqueous humor were higher in nAMD (994 pg/ml; interquartile range, 743-1450) than controls (794 pg/ml; 490-1325). The difference in the HTRA1 concentrations in the aqueous humor between each genotype of ARMS2 A69S was not significant (GG genotype: 857 pg/ml; 508-1115, GT genotype: 957 pg/ml; 758-1474, TT genotype: 1,141 pg/ml; 757-1663, p = 0.1417). VEGF and C3a concentrations in the eyes with the risk allele (T allele) were significantly higher than those with the non-risk allele (p = 0.0400 and p = 0.0197, respectively). HTRA1 concentration was correlated with only the VEGF concentration (ρ = 0.3651, p < 0.0001).</p><p><strong>Conclusion: </strong>Concentrations of HTRA1 in the aqueous humor were not increased in patients with the ARMS2 risk allele and did not correlate with C3a and C4a concentrations. HTRA1 concentrations in aqueous humor do not reflect local complement activation in nAMD.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399216","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":"Efficiency and safety comparison between 20,000 and 10,000 cuts per minute vitrectomy using a 27G cutter in rhegmatogenous retinal detachment: a prospective randomized controlled study.","authors":"Yu-Te Huang, I Wang, Po-Yu Chen, Chi-Lan Yang, San-Ni Chen","doi":"10.1007/s10384-025-01167-6","DOIUrl":"https://doi.org/10.1007/s10384-025-01167-6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficac and safety of a dual-blade 20,000 cuts per minute (cpm) vitrectomy probe with a single-blade 10,000 cpm probe for primary rhegmatogenous retinal detachment (RRD).</p><p><strong>Study design: </strong>Prospective, randomized controlled clinical trial.</p><p><strong>Methods: </strong>Evaluations were conducted preoperatively, intraoperatively, and at three months postoperatively. The main outcome measure focused on the duration of core vitrectomy, with secondary outcomes including peripheral vitreous shaving duration, balanced salt solution (BSS) consumption, anatomical and functional outcomes, as well as the incidence of surgical procedure-related complications.</p><p><strong>Results: </strong>Overall, 35 cases in the 20,000 cpm group and 37 cases in the 10,000 cpm group completed the trial without significant differences in baseline demographic characteristics. The 20,000 cpm group demonstrated significantly shorter core vitrectomy duration (161.6 ± 10.4 vs. 206.8 ± 10.1 s) (P = 0.003) and peripheral vitreous shaving time (446.3 ± 20.3 vs. 544.2 ± 22.2 s) (P = 0.002) compared to the 10,000 cpm group. BSS consumption was higher in the 20,000 cpm group but without statistical significance (P = 0.231). There were no significant differences in the need for scleral sutures and the incidence of iatrogenic retinal breaks (P = 0.331 and 0.523). At the 3-month follow-up, there were no statistically significant differences in primary success, final anatomical success, or mean visual acuity (P > 0.9, P = 0.326). Rates of complications, including ocular hypertension, epiretinal membrane formation, and endophthalmitis also showed no statistically significant differences (P > 0.6).</p><p><strong>Conclusion: </strong>The utilization of the new-generation 27-gauge system with a 20,000 cpm probe may herald a new paradigm of high-flow, smaller-diameter instrumentation, thereby enhancing the efficiency of the small gauge technique.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143028805","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":"Visualization of porcine and human aqueous humor outflow tract anatomies with transparency enhancement.","authors":"Yuichi Asahina, Makoto Aihara, Takashi Miyai, Asami Tanaka, Hiroshi Onodera","doi":"10.1007/s10384-024-01151-6","DOIUrl":"https://doi.org/10.1007/s10384-024-01151-6","url":null,"abstract":"<p><strong>Purpose: </strong>There is no established method for visualizing the three-dimensional (3D) structure of the aqueous humor outflow tract. This study attempted to visualize the 3D structures of porcine and human ocular tissues, particularly the aqueous humor outflow tract using a transparency reagent composed of 2, 2-thiodiethanol.</p><p><strong>Study design: </strong>Clinical and experimental.</p><p><strong>Methods: </strong>The porcine eyes were collected in Japan, and the human eyes were imported from the United States. The human eyes were obtained from a 64-year-old Caucasian woman, arriving 7 days after her death. The specimens were formalin-fixed upon arrival, fluorescently labeled, optically cleared using a transparency-enhancing reagent, and visualized using a confocal microscope.</p><p><strong>Results: </strong>Both porcine and human eyes were visualized to the extent that the choroidal vessels were observed on gross examination. The aqueous humor outflow tract was clearly observed as a luminal structure in the porcine eye, mainly depicted by autofluorescence, and in the human eyes as a luminal structure continuing from the trabecular meshwork without fluorescence.</p><p><strong>Conclusion: </strong>Observations using transparency-enhancing technology enabled us to obtain 3D images useful for visualizing ocular tissues, especially the aqueous humor outflow tract.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005483","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 and pathologic characteristics of inflamed juvenile conjunctival nevus and its treatment with immunosuppressant eye drops.","authors":"Ayako Tomoda, Kaoru Araki-Sasaki, Hiroto Obata, Shinji Ideta, Masahiko Kuroda, Koji Fujita, Yasuhiro Osakabe, Kanji Takahashi","doi":"10.1007/s10384-024-01140-9","DOIUrl":"10.1007/s10384-024-01140-9","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the clinical and pathologic findings of 7 patients with inflamed juvenile conjunctival nevus (IJCN) treated with tacrolimus.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Subjects and methods: </strong>The medical records of 7 male patients diagnosed with IJCN between February 2007 and October 2022 at the Kansai Medical University Hospital and Ideta Eye Hospital were retrospectively reviewed. The patients' mean age was 11.3 (8-20) years, and the average follow-up period was 18 months. The patients underwent anterior segment optical coherence tomography (AS-OCT) and anterior segment optical coherence tomography angiography (AS-OCTA). All the patients were treated with steroids or immunosuppressant eye drops, or both. Histopathologic examinations were performed on specimens resected from 2 patients.</p><p><strong>Results: </strong>The clinical characteristics of IJCN were as follows: (1) presence of cysts within a pigmented conjunctival mass, (2) tumor accompanied by feeder vessels, and (3) predominantly found in boys with allergic diseases. AS-OCT and AS-OCTA revealed the presence of a cystic structure with poor vascular signals within it and numerous vessels distributed on the sclera underlying the lesion. Immunosuppressant eye drops relieved the congestion, diminished the inflow vessels, and induced shrinkage of the cysts in all the patients. Histopathologic examinations revealed infiltration of inflammatory cells such as lymphocytes and macrophages and low proliferative activity of melanocytes with no division pattern.</p><p><strong>Conclusions: </strong>This study clarified the clinical and histologic characteristics of IJCN. Noninvasive AS-OCT and AS-OCTA might be useful for diagnosing IJCN. The histopathologic findings of this study indicate that immunosuppressive and antiallergic agents can effectively bring about disease remission.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"17-23"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821730/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644119","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":"Effects of trabeculectomy on the postoperative central visual field as revealed by refraction values.","authors":"Kosuke Nakajima, Rei Sakata, Shiroaki Shirato, Makoto Aihara","doi":"10.1007/s10384-024-01139-2","DOIUrl":"10.1007/s10384-024-01139-2","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effects of trabeculectomy on the rate of deterioration of the central visual field (VF) in patients with normal-tension glaucoma (NTG), as revealed by refraction values.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>We retrospectively analyzed 28 eyes, including 12 high myopic (spherical equivalent [SE] < - 6 diopters without pathological myopia) and 16 non-high myopic (SE ≥ - 6 diopters) eyes. The rate of VF deterioration (dB/year) was determined using linear regression analysis of 30 -2 and 10 -2 VF tests. The Wilcoxon signed-rank test was used to compare deterioration rates between groups. To assess the influence of initial post-surgery effects, statistical analyses were conducted with and without data from the initial postoperative VF exam.</p><p><strong>Results: </strong>Trabeculectomy significantly reduced intraocular pressure (IOP) in myopic (14.1 to 9.0 mmHg, P ≤ 0.01) and non-myopic (13.4 to 9.5 mmHg, P ≤ 0.01) eyes. Postoperatively, the 10-2 VF deterioration rate significantly decreased in myopic (- 1.31 to - 0.55 dB/year, P = 0.01) and non-myopic (- 0.80 to - 0.30 dB/year, P = 0.03) eyes. Excluding the first postoperative VF exam, the deterioration rates were - 0.51 ± 0.24 dB/year and - 0.54 ± 0.89 dB/year, respectively, indicating a minor impact on progression assessment.</p><p><strong>Conclusions: </strong>Trabeculectomy may mitigate central VF deterioration in myopic NTG patients, emphasizing the potential benefits of timely surgical intervention. Further studies are needed to determine the optimal timing for surgery.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"116-122"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821736/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604447","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":"Incidence of microbial keratitis associated with overnight orthokeratology: a multicenter collaborative study.","authors":"Takahiro Hiraoka, Saiko Matsumura, Yuichi Hori, Kazutaka Kamiya, Kazunori Miyata, Tetsuro Oshika","doi":"10.1007/s10384-024-01137-4","DOIUrl":"10.1007/s10384-024-01137-4","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence of microbial keratitis among Japanese patients wearing orthokeratology (ortho-k) lenses STUDY DESIGN: Retrospective multicenter study METHOD: This study was conducted at 4 hospitals in Japan and involved 1438 patients who had been prescribed ortho-k lenses and had worn them for at least 3 months. Data on patient demographics, lens characteristics, lens care systems, and presence of microbial keratitis were extracted from the medical records. Duration of ortho-k lens wear was calculated from the original fitting date to the patient's last visit, with the total years of lens wear used as person-years of lens wear. The incidence of microbial keratitis was calculated by dividing the number of infected cases by the total person-years of lens wear for all enrolled participants.</p><p><strong>Results: </strong>Among the 1438 patients, 753 were male and 685 were female, with a mean age of 12.7 ± 5.4 years. The mean duration of ortho-k lens wear was 5.2 ± 4.5 years, and the mean lens power was -3.52 ± 1.41 D. The total person-years of lens wear for all enrolled patients was 7415. Four cases of microbial keratitis were identified, resulting in an overall incidence of microbial keratitis of 5.4 (95% CI: 1.0-9.8) per 10,000 patient-years among ortho-k lens wearers.</p><p><strong>Conclusion: </strong>This study represents the largest sample size to date for estimating the incidence of microbial keratitis associated with ortho-k lenses. The incidence was similar to or slightly lower than that of previous studies on ortho-k-related microbial keratitis and also comparable to that of daily wear soft contact lenses.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"139-143"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142644121","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 choroidal detachment with and without hypotony after Ahmed valve implantation.","authors":"Sang Wook Jin, Jung Woo Heo, Hee Bae Ahn","doi":"10.1007/s10384-024-01138-3","DOIUrl":"10.1007/s10384-024-01138-3","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical manifestations of and risk factors for choroidal detachment (CD) with or without hypotony after Ahmed valve implantation (AVI).</p><p><strong>Study design: </strong>Retrospective, consecutive case series.</p><p><strong>Methods: </strong>We enrolled patients with glaucoma who underwent AVI, and divided them into CD and non-CD groups. The patients with CD were divided into those with and without hypotony. Data collected from the chart review before and after AVI included patient demographics and ocular characteristics. We analyzed the risk factors for CD development. The relationship between hypotony and CD development was also analyzed.</p><p><strong>Results: </strong>Among the 387 eyes, 63 developed CD. Among these 63 eyes, 42 had CD with hypotony and 21 had CD without hypotony. Multivariate regression analysis revealed that age (P < 0.001), lens status (P < 0.001), history of diabetes mellitus (DM) (P = 0.011), and history of hypertension (HTN) (P = 0.002) were significant predictors of CD development. Neovascular glaucoma (NVG) showed 42.9% of CD cases without hypotony. This rate was higher than primary open angle glaucoma (POAG) and exfoliative glaucoma (XFG). The rate of anterior chamber formation as treatment of CD was significantly higher in CD with hypotony than in CD without hypotony.</p><p><strong>Conclusions: </strong>Older age, pseudophakic eyes, DM, and HTN are significantly associated with CD development after AVI. NVG has higher incidence rates of CD without hypotony compared with POAG and XFG. Therefore, clinicians should pay attention to CD development after AVI especially in NVG, even if a patient is not in a hypotonic state.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"110-115"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604444","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":"Relationships between tilt angles of rectus muscles and positions of rectus muscle pulleys in patients with sagging eye syndrome.","authors":"Reika Kono, Ichiro Hamasaki, Fumiko Kishimoto, Kiyo Shibata, Shin Morisawa, Yuki Morizane","doi":"10.1007/s10384-024-01141-8","DOIUrl":"10.1007/s10384-024-01141-8","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the relationship between the rectus muscle (RM) angle and RM pulley displacement in patients with sagging eye syndrome (SES) without myopia.</p><p><strong>Study design: </strong>Retrospective cross-sectional case series.</p><p><strong>Methods: </strong>High-resolution quasi-coronal magnetic resonance imaging (MRI) data from 20 orbits of ten Japanese patients with SES but without high myopia were analyzed. The patients had no abduction deficiency. The RM angles were measured between the major axes of the horizontal and vertical RMs relative to the vertical and horizontal planes, respectively. The positions of the RM pulleys relative to the center of the globe were analyzed as previously described.</p><p><strong>Results: </strong>The mean age of the patients was 75.8 ± 4.5 years (standard deviation). The average axial length was 23.6 ± 0.6 mm. The lateral rectus (LR) muscle angle (22 ± 6°) had moderate negative correlations with the inferior displacement of the inferior rectus (IR), superior rectus (SR), and LR pulleys (r =- 0.63,- 0.45, and- 0.45, respectively); however, no change was observed in the medial rectus (MR) pulley (r =- 0.41). No correlations were found between the angles of the SR (4 ± 8°), IR (- 13 ± 8°), and MR (- 1 ± 6°) muscles and the positions of the RM pulleys.</p><p><strong>Conclusion: </strong>Given the correlation between increased LR muscle angle and inferior displacement of adjacent RM pulleys in SES, the LR muscle angle may serve as a diagnostic clue, even when inferior displacement is not identifiable on MRI. Further confirmation in larger studies is warranted.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189158","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":"Outcomes, efficacy and risk factors of 27-Gauge vitrectomy for diabetic tractional retinal detachment in Japanese patients.","authors":"Risa Nishigushi, Ayumi Usui-Ouchi, Yoshihito Sakanishi, Kazunori Tamaki, Keitaro Mashimo, Rei Ito, Toshiro Sakuma, Nobuyuki Ebihara, Shintaro Nakao","doi":"10.1007/s10384-024-01135-6","DOIUrl":"10.1007/s10384-024-01135-6","url":null,"abstract":"<p><strong>Purpose: </strong>Diabetic retinopathy leads to vision-threatening complications, such as proliferative diabetic retinopathy and tractional retinal detachment (TRD) and is a major global health concern. Despite advancements in vitrectomy techniques, challenges exist in managing postoperative complications and long-term visual acuity. This study aimed to evaluate postoperative outcomes of 27-gauge pars plana vitrectomy (27 g PPV) for diabetic TRD and identify associated risk factors.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>This study included 94 eyes of 74 patients who underwent 27 g PPV for diabetic TRD between July 2017 and September 2022 at Juntendo University Urayasu Hospital, Japan. Patient demographics, preoperative characteristics, intraoperative details, and postoperative outcomes were examined. Statistical analyses were performed to identify factors influencing postoperative visual acuity.</p><p><strong>Results: </strong>Mean follow-up duration was 23.1 ± 14.6 months. Postoperatively, visual acuity (LogMAR) improved significantly from 1.34 ± 0.82 to 0.65 ± 0.79 (P < 0.0001). Postoperative complications included persistent vitreous hemorrhage (15%) and neovascular glaucoma (4%). Final retinal reattachment rate was 97%. Preoperatively, macular detachment (P < 0.0001) and Grade IV TRD (P < 0.0001) severity were significantly associated with poor final best corrected visual acuity (P < 0.0001). Preoperative macular detachment (P < 0.0001), Grade IV TRD (P < 0.0001), intraoperative iatrogenic breaks (P = 0.031), and postoperative neovascular glaucoma (P < 0.0001) were identified as significant predictors of poor postoperative visual outcomes through multivariate analysis.</p><p><strong>Conclusion: </strong>This study highlights the efficacy of 27 g PPV in improving visual acuity in patients with diabetic TRD. Despite favorable outcomes, attention to preoperative risk factors and meticulous surgical techniques remain crucial for optimizing long-term visual prognosis in these patients.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"59-65"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821670/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582795","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}