Japanese Journal of Ophthalmology最新文献

{"title":"Effects of vascular endothelial growth factor and angiopoietin-2 inhibitions on intraretinal hyperreflective foci in neovascular age-related macular degeneration.","authors":"Yuta Nakanishi, Masahiro Akada, Ryosuke Tamiya, Midori Ideyama, Takahiro Kogo, Ai Ichioka, Akinari Yamamoto, Naoko Ueda-Arakawa, Hiroshi Tamura, Manabu Miyata, Ayako Takahashi, Ai Kido, Yuki Muraoka, Masahiro Miyake, Sotaro Ooto, Akitaka Tsujikawa, Masayuki Hata","doi":"10.1007/s10384-026-01392-7","DOIUrl":"10.1007/s10384-026-01392-7","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association of hyperreflective foci (HRFs) with disease activity in treatment-naïve neovascular age-related macular degeneration (nAMD) and to compare the effects of anti-vascular endothelial growth factor (VEGF) therapy versus dual VEGF-A/angiopoietin-2 (Ang-2) inhibition on HRFs.</p><p><strong>Study design: </strong>Retrospective, single-center, interventional study METHODS: This study included 72 eyes with treatment-naïve nAMD. Thirty-two consecutive eyes received aflibercept 2mg and 40 consecutive eyes received faricimab, each undergoing three monthly loading injections. HRF presence and area, central retinal thickness (CRT), best-corrected visual acuity (BCVA), and associated parameters were evaluated at baseline and after loading. HRFs were quantified using binarized spectral-domain optical coherence tomography (SD-OCT) images with automated assistance.</p><p><strong>Results: </strong>At baseline, 45 eyes (62.5%) exhibited HRFs, all in the outer retina, with 10 eyes (13.9%) also showing inner retinal HRFs. Outer HRF area positively correlated with CRT and the maximum height of serous retinal detachment (SRD), while inner HRFs were associated with intraretinal fluid. Both treatments significantly improved BCVA and CRT. HRF presence and area decreased after treatment, primarily in the outer retina. After adjustment for baseline HRF area and clinical parameters, faricimab achieved a more substantial reduction in total, outer, and inner HRF areas than aflibercept.</p><p><strong>Conclusions: </strong>HRFs correlated with layer-specific exudative change. Faricimab resulted in a more pronounced reduction in HRFs than aflibercept despite comparable anatomical improvements, suggesting superior control of inflammation-related retinal changes.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"1165-1173"},"PeriodicalIF":2.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13615986/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470573","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":"Improvement of the detection ability for zonular weakness before cataract surgery by comparing predicted and measured left-right differences in anterior chamber depth.","authors":"Machi Iso, Kouhei Hashizume, Shota Kamei, Tetsuya Hashiura, Toshiyasu Imaizumi, Daijiro Kurosaka","doi":"10.1007/s10384-026-01411-7","DOIUrl":"https://doi.org/10.1007/s10384-026-01411-7","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether comparing the predicted left-right difference in anterior chamber depth (p-ΔACD) derived from left-right difference in the lens thickness (ΔLT) and axial length (ΔAL) with the measured ΔACD (m-ΔACD) can improve the detection ability for zonular weakness before cataract surgery.</p><p><strong>Study design: </strong>Retrospective observational study METHODS: Patients with cataract who underwent phacoemulsification and intraocular lens (IOL) implantation at Iwate Medical University Hospital were enrolled. Using surgical videos and records, these eyes were classified either as eyes with normal zonuls (NZ) or weak zonuls (WZ). To clarify the effects of ΔLT and ΔAL on m-ΔACD in the NZ group, multiple linear regression analysis was performed. Using this regression equation, the p-ΔACD was calculated for all cases. ΔACD residual was calculated by subtracting the p-ΔACD from the m-ΔACD.</p><p><strong>Results: </strong>Of the 1286 patients, 56 eyes were classified as having WZ. The ACD and ΔACD in the WZ group were significantly shallower and larger than those in the NZ group, respectively. The absolute ΔACD residuals of the WZ group were significantly larger than those of the NZ group. The absolute ΔACD residuals were greater as the degree of zonular weakness increased. ROC curve analysis revealed that the AUC of absolute ΔACD residual for detection of WZ was 0.743, superior to that of ACD (0.631) and ΔACD (0.623). Moreover, the AUC for the negative ΔACD residual group was 0.830.</p><p><strong>Conclusions: </strong>These findings suggest that comparing the p-ΔACD with the m-ΔACD may improve the detection ability for zonular weakness.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793167","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 and prognostic factors associated with recurrence in periocular basal cell carcinoma in a Taiwanese population.","authors":"So-Hung Yeh, Che-Chia Chang, Yi-Hsuan Wei, Henry Bair, Shu-Lang Liao","doi":"10.1007/s10384-026-01404-6","DOIUrl":"10.1007/s10384-026-01404-6","url":null,"abstract":"<p><strong>Purpose: </strong>Basal cell carcinoma (BCC) is the most common malignancy of the eyelid, with a significant risk of local recurrence despite its low metastatic potential. Understanding prognostic factors for recurrence is essential for optimizing treatment and improving patient outcomes. This study aimed to analyze the clinical characteristics and prognostic factors associated with recurrence in periocular BCC in a Taiwanese population.</p><p><strong>Study design: </strong>This was a retrospective, single-center cohort study conducted at a tertiary medical center in Taiwan.</p><p><strong>Methods: </strong>We reviewed 46 patients diagnosed with periocular BCC at National Taiwan University Hospital between 2000 and 2023. Data on demographics, tumor characteristics, surgical margins, and recurrence outcomes (both clinical and pathological) were collected. Recurrence-free survival was assessed using Kaplan-Meier analysis, and statistical analyses, including chi-square tests, Fisher's exact tests, and multivariate logistic regression, were performed to identify significant prognostic factors.</p><p><strong>Results: </strong>The mean age at diagnosis was 72.3 years, with a slight female predominance (54.4%). Tumors predominantly affected the lower eyelid (84.8%). The study identified a clinical recurrence rate of 30.4% with a 10-year recurrence-free survival (RFS) of 67.4%. Upon strict histological confirmation, the pathological recurrence rate was 23.9%, corresponding to an RFS of 73.7%. Multivariate analysis identified two robust independent predictors across both definitions. Compromised surgical margins were strongly associated with recurrence (Clinical: OR = 5.70, p < 0.001; Pathological: OR = 15.56, p < 0.05). Similarly, delayed surgical intervention (>12 months) significantly increased recurrence risk (Clinical: OR = 5.21, p = 0.001; Pathological: OR = 14.21, p < 0.05). Tumor size and thickness were correlated with recurrence in univariate analysis but did not reach statistical significance in the multivariate models.</p><p><strong>Conclusion: </strong>Compromised surgical margins and delayed treatment are robust, major risk factors for recurrence in periocular BCC, regardless of whether a clinical or pathological definition is applied. While the clinical recurrence rate highlights the burden of re-operation, the pathological recurrence rate underscores the biological aggressiveness in neglected cases. Notably, achieving free margins resulted in excellent long-term control. These findings emphasize the critical need for early diagnosis and complete excision to improve patient outcomes.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722565","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":"Descemet membrane endothelial keratoplasty versus descemet's stripping automated endothelial keratoplasty following glaucoma filtering surgery: clinical outcomes and immunologic considerations.","authors":"Hirotsugu Kasamatsu, Shizuka Koh, Yukari Yagi-Yaguchi, Daisuke Tomida, Takefumi Yamaguchi","doi":"10.1007/s10384-026-01398-1","DOIUrl":"https://doi.org/10.1007/s10384-026-01398-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the clinical outcomes and immunologic implications following Descemet membrane endothelial keratoplasty (DMEK) and Descemet's stripping automated endothelial keratoplasty (DSAEK) in eyes with prior glaucoma filtering surgery (GFS).</p><p><strong>Study design: </strong>Retrospective comparative case series.</p><p><strong>Methods: </strong>This study included 29 eyes with prior GFS that underwent DMEK (n=7) or DSAEK (n=22). Outcomes include host central corneal thickness (CCT), short-term complications (graft detachment, rebubbling, and primary graft failure [PGF]), corrected distance visual acuity (CDVA), immunologic graft rejection, endothelial cell loss (ECL), and graft survival.</p><p><strong>Results: </strong>DMEK showed significantly faster recovery of host CCT compared to DSAEK on postoperative day 1 (573.2 ± 93.3 μm vs. 773.0 ± 40.7 μm; p = 0.02) and day 3 (591.1 ± 93.2 μm vs. 721.5 ± 108.9 μm; p = 0.003). Graft detachment rates were similar between the groups; rebubbling and PGF occurred only after DSAEK (14% and 9%). CDVA at 1 month (0.5 ± 0.5 vs. 1.0 ± 0.5) and at 3 months (0.4 ± 0.4 vs. 0.8 ± 0.4) was significantly better in the DMEK group (both p = 0.04). The 2-year cumulative rejection rates (14% in both groups), 2-year ECL (70 ± 17% vs. 71 ± 15%), and 2-year graft survival rate (100% vs. 81 ± 10%) were comparable.</p><p><strong>Conclusions: </strong>DMEK appears to be a viable option after GFS, given its favorable clinical profile. However, the relatively high incidence of immunologic events in both groups suggests that alterations in the ocular immune environment following GFS may influence postoperative outcomes.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630461","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":"Six-month outcomes with a reduced two-injection induction (2+TAE) regimen of aflibercept 8 mg in treatment-naive neovascular age-related macular degeneration.","authors":"Nozomu Hashiya, Ichiro Maruko, Koji Tanaka, Junichiro Honjo, Yasunori Miyara, Yuto Watanabe, Ruka Maruko, Ayaka Nakai, Yu Wakatsuki, Kanako Itagaki, Marina Maehira, Nobuhiro Terao, Keiko Kataoka, Annabelle A Okada, Hideki Koizumi, Ryo Mukai, Tetsuju Sekiryu, Ryusaburo Mori, Tomohiro Iida","doi":"10.1007/s10384-026-01401-9","DOIUrl":"10.1007/s10384-026-01401-9","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate 6-month outcomes of aflibercept 8 mg administered with two monthly injections followed by a treat-and-extend (TAE) regimen in treatment-naïve neovascular age-related macular degeneration (nAMD).</p><p><strong>Study design: </strong>Multicenter retrospective study.</p><p><strong>Methods: </strong>This study included 107 treatment-naïve eyes with nAMD, of which 91 eyes of 90 patients (mean age, 74.7 ± 9.4 years) followed for 6 months were analyzed. All eyes received two consecutive monthly injections of aflibercept 8 mg (induction), followed by TAE. Best-corrected visual acuity (BCVA, logMAR), optical coherence tomography (OCT)-based anatomical outcomes, and adverse events were assessed.</p><p><strong>Results: </strong>Sixteen eyes were excluded, mainly due to being lost-to-follow-up or having had treatment changed to an alternative drug. No serious adverse events were observed. Mean BCVA improved from 0.43 ± 0.36 at baseline to 0.37 ± 0.42 at 6 months (P = 0.032). Retinal thickness, pigment epithelial detachment height, and subfoveal choroidal thickness significantly improved (all P < 0.05). The mean number of injections over 6 months was 3.4 ± 0.5, and the mean treatment interval at the end of 6 months was 11.6 ± 2.2 weeks. A dry macula was achieved in 70.3% of eyes, with a higher rate in eyes achieving a dry macula after a two-injection induction than in those requiring a three-injection induction (80.0% vs 51.6%, P < 0.01).</p><p><strong>Conclusions: </strong>Eyes achieving a dry macula after two injections had higher 6-month dry rates than those requiring a third injection. Early treatment response may help predict treatment burden and guide individualized management strategies.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148630563","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 AIZE-EX and SITA-standard visual field measurements in patients with glaucoma.","authors":"Kiyoshi Kano, Hiroki Nomoto, Chota Matsumoto, Shunji Kusaka, Yasuaki Kuwayama","doi":"10.1007/s10384-026-01395-4","DOIUrl":"https://doi.org/10.1007/s10384-026-01395-4","url":null,"abstract":"<p><strong>Purpose: </strong>To compare visual field test results between the AIZE-EX strategy of the imo perimeter and Humphrey field analyzer (HFA) Swedish interactive threshold algorithm (SITA)-standard in glaucoma patients.</p><p><strong>Study design: </strong>Prospective cross-sectional study METHODS: This study included 52 eyes of 26 patients with glaucoma. Binocular testing with imo 24plus (1-2) AIZE-EX (78 test points) and HFA 30-2 SITA-Standard (76 test points) results obtained within 3 months were compared. Mean deviation (MD) and patter standard deviation (PSD) were recalculated from the 24-2 test points (54 points) and compared between devices. Agreement was assessed using cluster-robust t-test, Bland-Altman analysis, and equivalence testing using two one-sided tests (TOST); margin ±1.5 dB).</p><p><strong>Results: </strong>MD was -7.89 ± 6.86 dB for AIZE-EX and -8.24 ± 7.13 dB for SITA-Standard (bias: +0.35 dB; 95% LoA: -4.04 to +4.73 dB; p = 0.342). PSD was 8.52 ± 4.15 and 8.20 ± 4.72 dB, respectively (bias: +0.32 dB; 95% LoA: -2.94 to +3.58 dB; p = 0.190). TOST confirmed equivalence for both MD (90% CI: -0.26 to +0.95 dB; p = 0.002) and PSD (90% CI: -0.09 to +0.72 dB; p < 0.001). Proportional bias was absent for MD (p = 0.405) but present for PSD (p = 0.012). Test time for both eyes was significantly shorter with AIZE-EX (7 min 39 s vs. 15 min 24 s; p < 0.001).</p><p><strong>Conclusion: </strong>MD and PSD values were comparable between the AIZE-EX and SITA-Standard derived from 24-2 test points, demonstrating clinical equivalence. Test time was substantially shorter with the AIZE-EX despite a greater number of points, supporting its use in routine glaucoma follow-up.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591731","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":"Microbial contamination of donor corneoscleral rims and storage medium in keratoplasty.","authors":"Atsuhiko Fukuto, Suzu Deie, Yurie Shimizu, Hirokazu Sakaguchi, Taiichiro Chikama","doi":"10.1007/s10384-026-01402-8","DOIUrl":"https://doi.org/10.1007/s10384-026-01402-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the prevalence and spectrum of microbial contamination of donor corneoscleral rims and storage medium in keratoplasty and to report a case of donor-derived fungal keratitis.</p><p><strong>Study design: </strong>Single-center, retrospective study.</p><p><strong>Methods: </strong>We reviewed 285 eyes that underwent keratoplasty at Hiroshima University Hospital between October 2022 and January 2025. Donor corneas were preserved using Optisol^®-GS. The donor rim and storage medium were separately cultured intraoperatively, and the minimum inhibitory concentrations (MICs) were determined.</p><p><strong>Results: </strong>Culture positivity was identified in 10 of the 285 eyes (3.5%): six from donor rims and four from storage media, with no eye yielding positive results in both. All tested bacterial isolates were Gram-positive; three of six tested were not susceptible to levofloxacin and gatifloxacin (MIC ≥4 μg/mL), including methicillin-resistant Staphylococcus aureus, but retained susceptibility to vancomycin and meropenem. All fungal isolates were Candida with low MICs for voriconazole and micafungin. C. albicans and C. glabrata were recovered from the mate corneas of a single donor; the recipient of the cornea contaminated with C. albicans developed keratitis requiring repeat penetrating keratoplasty, whereas the recipient of the C. glabrata-contaminated cornea did not.</p><p><strong>Conclusion: </strong>Adding storage medium to the rim culture improved the detection of donor-associated microorganisms. When donor-derived C. albicans keratitis developed, susceptibility data from contemporaneous cultures enabled prompt targeted antifungal therapy and globe preservation, although repeated penetrating keratoplasty was ultimately required.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148591754","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":"Aflibercept 8mg for neovascular age related macular degeneration refractory to faricimab.","authors":"Juliana H Moribe, Misa Masaoka, Kenji Yamashiro","doi":"10.1007/s10384-026-01407-3","DOIUrl":"https://doi.org/10.1007/s10384-026-01407-3","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the short-term efficacy of intravitreal aflibercept 8 mg in patients with neovascular age-related macular degeneration (nAMD) who exhibited persistent or recurrent exudation two months after faricimab treatment during the maintenance phase following anti-vascular endothelial growth factor (VEGF) loading therapy.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>Twenty-seven eyes with nAMD were included. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) biomarkers-including intraretinal fluid (IRF), subretinal fluid (SRF), and sub-retinal pigment epithelium (sub-RPE) fluid at the subfoveal and macular areas-were evaluated before and two months after treatment with faricimab and aflibercept 8 mg. Subgroup analyses were performed according to AMD subtype (typical nAMD vs. polypoidal choroidal vasculopathy [PCV]) and pachychoroid characteristics (pachychoroid vs. non-pachychoroid).</p><p><strong>Results: </strong>BCVA did not show significant changes after either faricimab or aflibercept 8 mg treatment. However, aflibercept 8 mg resulted in a significant reduction in subfoveal SRF (from 44.4% to 11.1%, P = 0.014) and macular SRF (from 85.2% to 29.6%, P < 0.0001), whereas faricimab did not produce significant anatomical improvements. No significant changes were observed in IRF or sub-RPE fluid with either treatment, possibly due to the low prevalence of the fluid at baseline. Subgroup analyses demonstrated no substantial differences in treatment response between typical nAMD and PCV, or between pachychoroid and non-pachychoroid eyes.</p><p><strong>Conclusion: </strong>Intravitreal aflibercept 8 mg may provide short-term anatomical benefits, particularly in reducing subretinal fluid, in eyes with nAMD showing persistent or recurrent exudation after faricimab treatment during the maintenance phase, regardless of nAMD subtype or pachychoroid status.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548966","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":"Beyond mild myopia: a pilot randomized trial of 0.01% atropine in school-aged children with myopia ≤ -4.50 D.","authors":"Eizo Tanaka, Yuki Morizane, Seiko Fujii, Mari Yaida, Weiying Sun, Satoshi Hasebe","doi":"10.1007/s10384-026-01399-0","DOIUrl":"https://doi.org/10.1007/s10384-026-01399-0","url":null,"abstract":"<p><strong>Purpose: </strong>To conduct an exploratory randomized trial evaluating the efficacy of 0.01% atropine in schoolchildren with myopia ≤ -4.50 D.</p><p><strong>Study design: </strong>Open-label, randomized crossover pilot trial.</p><p><strong>Methods: </strong>In this 24-month trial, 19 children were assigned to atropine/control (n = 9) or control/atropine (n=10) sequences, with crossover at 12 months. During the atropine periods, participants instilled 0.01% atropine nightly. Spherical equivalent refraction (SER) and axial length (AL) were measured at baseline and 6, 12, 18, and 24 months. Twelve-month eye-level changes in periods (0-12 and 12-24 months) were analyzed using linear regression with treatment (atropine vs control) and period as fixed effects and participant-clustered robust standard errors. Mixed-effects models were used to describe trajectories.</p><p><strong>Results: </strong>Baseline SER ranged from -11.02 to -4.50 D. Mean (±SD) 12-month SER progression was -1.02 ± 0.52 D/year under control and -0.75 ± 0.47 D/year under atropine, yielding an adjusted treatment effect of +0.26 D/year (95% CI, +0.08 to +0.45; p = 0.005; 26% inhibition). Mean AL elongation was +0.40 ± 0.18 mm/year under control and +0.34 ± 0.18 mm/year under atropine, with an adjusted difference of -0.05 mm/year (95% CI, -0.11 to +0.00; p = 0.065; 14% inhibition). Treatment-by-period interactions were not significant for either SER or AL, but rebound could not be excluded given the small sample size.</p><p><strong>Conclusions: </strong>In the present cohort, 0.01% atropine suppressed myopia progression over 12 months, with inhibition ratios similar to previous trials involving mild to moderate myopia. These findings support the feasibility of low-dose atropine for advanced myopia and justify full-scale trials.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148535853","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":"Endoluminal lacrimal duct recanalization for pediatric lacrimal duct obstruction: etiologic spectrum and surgical outcomes.","authors":"Nozomi Matsumura, Tomoko Ohno, Jutaro Nakamura, Satoshi Goto","doi":"10.1007/s10384-026-01400-w","DOIUrl":"https://doi.org/10.1007/s10384-026-01400-w","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the clinical characteristics and etiologic diversity of pediatric lacrimal duct obstruction in children aged ≥1 year requiring surgical treatment under general anesthesia and to evaluate the outcomes of endoluminal lacrimal duct recanalization (ELDR).</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>All pediatric lacrimal surgical procedures performed under general anesthesia at our institution between 2011 and July 2025 were reviewed. All cases underwent dacryoendoscopic evaluation and treatment. Clinical characteristics, etiologies, and surgical outcomes were analyzed.</p><p><strong>Results: </strong>The study included 245 patients (338 eyes). Thirty-four eyes (10.1%) had a history of failed probing. Congenital obstruction accounted for 259 eyes (76.6%), acquired obstruction for 38 eyes (11.2%), and syndromic cases for 41 eyes (12.1%). Approximately one-third of all eyes had simple congenital nasolacrimal duct obstruction (CNLDO) caused by membranous distal obstruction. Post-epidemic keratoconjunctivitis obstruction accounted for approximately 10% of cases, for which favorable outcomes were demonstrated following ELDR with intubation. In nonsyndromic cases (congenital and acquired), the success rate, defined as complete resolution, was 97.6% (290/297 eyes). In contrast, syndromic cases demonstrated a significantly lower success rate of 56.1% (23/41 eyes; P < 0.001). No major complications were observed.</p><p><strong>Conclusions: </strong>The obstruction of the lacrimal duct in pediatric patients requiring surgery under general anesthesia includes a broad spectrum of pathologies beyond simple CNLDO. In patients without congenital malformation syndromes, ELDR was associated with a high success rate and appears to be a safe and effective treatment option for pediatric lacrimal duct obstruction.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497597","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}