Japanese Journal of Ophthalmology最新文献

{"title":"Two-year outcomes of treat-and-extend regimen with intravitreal faricimab for treatment-naïve neovascular age-related macular degeneration.","authors":"Junki Hoshino, Hidetaka Matsumoto, Saki Numaga, Kosuke Nakamura, Hideo Akiyama","doi":"10.1007/s10384-025-01204-4","DOIUrl":"10.1007/s10384-025-01204-4","url":null,"abstract":"<p><strong>Purpose: </strong>We previously reported 1-year outcomes of a treat-and-extend (TAE) regimen with intravitreal faricimab (IVF) for treatment-naïve neovascular age-related macular degeneration (nAMD). Herein, we evaluated the second-year results of this TAE regimen with IVF in eyes completing the first-year treatment.</p><p><strong>Study design: </strong>Retrospective, interventional case series.</p><p><strong>Methods: </strong>We retrospectively studied 30 eyes with treatment-naïve nAMD that had completed the initial year of treatment, assessing best-corrected visual acuity (BCVA), foveal thickness (FT), central choroidal thickness (CCT), total number of injections over 2 years, and intended injection interval at the last visit.</p><p><strong>Results: </strong>Twenty-five eyes completed the 2-year IVF treatment. There was no significant difference between pre-treatment and 2 years post-treatment BCVA. FT and CCT both showed significant reductions, maintained during the 2-year study period. The total number of injections was 10.1 ± 1.2 over the 2 years. The intended injection interval at the last visit was 13.0 ± 3.4 weeks. Of 5 eyes not completing 2 years of IVF treatment, 4 were switched to other anti-vascular endothelial growth factor (VEGF) agents due to persistent fluids despite IVF at 8-week intervals. In the remaining eye, IVF treatment was discontinued due to suspected faricimab-related intraocular inflammation.</p><p><strong>Conclusions: </strong>The TAE regimen with IVF for treatment-naïve nAMD was effective during a 2-year period for improving exudative changes and maintaining visual acuity. Although IVF was found to be a relatively safe treatment for nAMD, there were cases requiring a switch to other anti-VEGF agents due to inadequate fluid control effect.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"521-528"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020582","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":"Choroidal circulation time by wide-field indocyanine green angiography in central serous chorioretinopathy.","authors":"Akiyuki Kawamura, Ryusaburo Mori, Koji Tanaka, Yu Wakatsuki, Kyoko Fujita, Hiroyuki Nakashizuka","doi":"10.1007/s10384-025-01188-1","DOIUrl":"10.1007/s10384-025-01188-1","url":null,"abstract":"<p><strong>Purpose: </strong>Asymmetric dilated vortex veins (ADVV) extending continuously to the vortex ampullae seen on Indocyanine green angiography (ICGA) findings, are thought to indicate choroidal venous congestion in central serous chorioretinopathy (CSC). In addition, the sclera is thickened compared to normal eyes, suggesting that obstruction of the scleral passage is the pathophysiological mechanism of CSC. The purpose of this study was to examine the choroidal circulation in and around the vortex vein ampulla.</p><p><strong>Study design: </strong>Single-center retrospective study.</p><p><strong>Methods: </strong>The subjects were 23 CSC eyes with macular central serous detachment (SRD) undergoing wide-field ICGA with Spectralis^®. Choroidal circulation time was defined as the time from the onset of filling in the choroidal artery to the first appearance of dye in the vortex vein ampulla. The choroidal circulation time in the superior and inferior vortex veins were measured separately. The relationship between the ADVV and the choroidal circulation time was investigated.</p><p><strong>Results: </strong>The mean choroidal circulation time was 4.44 seconds for the superior temporal side and 4.33 seconds for the inferior temporal side, with no significant difference (p=0.494). The mean choroidal circulation time was 3.89 seconds on the ADVV side and 4.88 seconds on the non-ADVV side, with a shorter mean circulation time on the ADVV side (p=0.00005). In 21 of 23 eyes, there was a time difference in the filling of the choroidal veins entering the vortex vein ampulla.</p><p><strong>Conclusion: </strong>On the side of the ADVV, no obstruction to the passage of the sclera is thought to have occurred.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"536-542"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005538","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 presentation and prognostic factors of eyelid sebaceous carcinoma.","authors":"Yukiko Aihara, Masachika Ikegami, Yoshiyuki Suehara, Takane Watanabe, Seiichi Yoshimoto, Taisuke Mori, Hiroyuki Mano, Shinji Kohsaka, Shigenobu Suzuki","doi":"10.1007/s10384-025-01187-2","DOIUrl":"10.1007/s10384-025-01187-2","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the demographics, clinical features, outcomes, and prognostic factors of Japanese patients with eyelid sebaceous carcinoma.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Fifty-two patients with eyelid sebaceous carcinoma diagnosed histopathologically at the National Cancer Center Hospital in Japan between 2013 and 2023 were reviewed and their outcomes were examined.</p><p><strong>Results: </strong>There were 21 men and 31 women. The median age at diagnosis was 73 (range 39-95) years old. The tumor was located in the upper eyelid in 33 patients (63%), in the lower eyelid in 16 patients (31%), and in both eyelids in 3 patients (6%). The initial curative treatment included surgical resection with or without eyelid reconstruction in 41 cases (79%), orbital exenteration in 4 cases (8%), and radiation therapy in 7 cases (13%). Two- and five-year adjusted survival rates were 97.4% and 93.7%, respectively. Local recurrence occurred in 15 cases (29%). Lymph node metastasis was confirmed in 13 cases (27%), distant metastasis in 5 cases (10%), and 3 patients (6%) died of lung metastasis. T2b or more advanced T stage was associated with a risk of shorter overall survival (HR = 5.3, 95% CI = 1.2-23, p = 0.024) compared with T2a or earlier stage, as well as lymph node metastasis (HR = 82, 95% CI = 2.6-2.6e+03, p = 0.013). A positive surgical margin increased the risk of local recurrence (HR = 37, 95% CI = 5.9- 235, p = 0.00012).</p><p><strong>Conclusion: </strong>Proper diagnosis and margin-free resection are necessary before eyelid sebaceous carcinoma can further develop.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"595-605"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142587","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":"Association between the retinal age gap and systemic diseases in the Japanese population: the Nagahama study.","authors":"Takuro Kamei, Masahiro Miyake, Keina Sado, Kazuya Morino, Yuki Mori, Yasuharu Tabara, Fumihiko Matsuda, Hiroshi Tamura, Akitaka Tsujikawa","doi":"10.1007/s10384-025-01205-3","DOIUrl":"10.1007/s10384-025-01205-3","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the retinal age gap, defined as the difference between deep learning-predicted retinal age and chronological age, as a potential biomarker of systemic health in the Japanese population.</p><p><strong>Study design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Data from the Nagahama Study, a large-scale Japanese cohort study, were used. Participants were divided into fine-tuning (n=2,261) and analysis (n=6,070) cohorts based on their visit status across the two periods. The fine-tuning cohort only included individuals without a history of systemic or cardiovascular diseases. A deep learning model, originally released in the Japan Ocular Imaging Registry, was fine-tuned using a fine-tuning cohort to predict retinal age from images. This refined model was then applied to the analysis cohort to calculate retinal age gaps. We conducted cross-sectional and longitudinal analyses to examine the association of these gaps with systemic and cardiovascular diseases.</p><p><strong>Results: </strong>The retinal age-prediction model achieved a mean absolute error of 3.00-3.42 years. Cross-sectional analysis revealed significant associations between the retinal age gap and a history of diabetes (β = 1.08, p < 0.001) and hyperlipidemia (β = -0.67, p < 0.001). Longitudinal analysis showed no significant association between the baseline retinal age gap and disease onset. However, onset of hypertension (β = 0.35, p = 0.049) and hyperlipidemia (β = 0.34, p = 0.035) showed marginal associations with an increase in retinal age gap over time.</p><p><strong>Conclusion: </strong>The retinal age gap is a promising biomarker for systemic health, particularly in relation to diabetes, hypertension, and hyperlipidemia.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"616-623"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339582/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005537","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":"Evaluation of factors relating to the development of multiple subepithelial corneal infiltrates of adenoviral keratoconjunctivitis using categorical data analysis program.","authors":"Nobuyoshi Kitaichi, Ryosuke Dei, Rikutaro Hinokuma, Ippei Yoshikawa, Miki Hiraoka, Kazuo Nakajima","doi":"10.1007/s10384-025-01194-3","DOIUrl":"10.1007/s10384-025-01194-3","url":null,"abstract":"<p><strong>Purpose: </strong>Adenoviral keratoconjunctivitis is the most common infectious disease in ophthalmology. Its clinical forms include epidemic keratoconjunctivitis (EKC) and pharyngoconjunctival fever (PCF). EKC can be complicated by multiple subepithelial infiltrates (MSI) of the cornea, which affect visual outcomes. As at present, artificial intelligence and machine learning are becoming increasingly important not only in the diagnostic imaging field but also in the clinical data science field, we investigated a predictive model for the development of corneal MSI in adenoviral keratoconjunctivitis.</p><p><strong>Study design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>One hundred and forty cases of adenovirus keratoconjunctivitis diagnosed at Hinokuma Eye Clinic were enrolled. The dependent variable was corneal MSI, and the independent variables were adenovirus genotype, bilaterality, subconjunctival hemorrhage, eyelid swelling, conjunctival edema, conjunctival opacity, pseudomembrane, corneal epithelial findings, preauricular lymphadenopathy, eye discharge, lacrimation, eye pain, foreign body sensation, and itchy eye, which were analyzed by a categorical data analysis program (CATDAP).</p><p><strong>Results: </strong>For single independent variables, corneal epithelial findings (Akaike information criterion, AIC=-6.46) and type 54 (AIC=-4.30) showed high predictive performance. In the combination of multiple independent variables, Type 56 or Type 37 with corneal epithelial damage also showed high predictive performance.</p><p><strong>Conclusion: </strong>Predicting the occurrence of corneal MSI has until now been considered difficult. When a patient with EKC has marginal corneal epithelial or subepithelial opacities at initial presentation, it is presumed that the patient has a relatively high risk of developing MSI. Knowing the prevalent virus type in advance, would prove helpful in the diagnosis.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"590-594"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144142564","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":"Refractive error and axial length prediction using fundus parameters of normal eyes in the Kumejima population study.","authors":"Takehiro Yamashita, Ryo Asaoka, Aiko Iwase, Hiroshi Sakai, Hiroto Terasaki, Taiji Sakamoto, Makoto Araie","doi":"10.1007/s10384-025-01192-5","DOIUrl":"10.1007/s10384-025-01192-5","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the accuracy of predictive refractive error (RE) and axial length (AL) using regression analysis of fundus parameters in the Kumejima study and to identify RE- or AL-related fundus changes.</p><p><strong>Study design: </strong>Prospective cross-sectional observational population study.</p><p><strong>Methods: </strong>Non-mydriatic color fundus photographs (CFPs) from 1,646 right eyes of healthy Kumejima participants were analyzed. Mean red (R), green (G), and blue (B) intensities at eight locations around the optic disc and fovea were quantified, and the tessellation fundus index was calculated as R/(R + G + B). Optic disc ovality ratio, papillomacular angle, and retinal vessel angle were measured. Least absolute shrinkage and selection operator regression with leave-one-out cross-validation predicted RE and AL, validated using Pearson's correlation coefficient.</p><p><strong>Results: </strong>The mean ± standard deviation actual RE and AL of participants (834 men and 812 women) were -0.14±1.62 diopter and 23.50±0.88 mm. The mean ± standard deviation predicted RE and AL based on fundus parameters was -0.14±1.05 diopter and 23.50±0.48 mm, with a mean absolute error of 0.91 diopter and 0.59 mm, and the correlation coefficients between actual and predicted RE and AL were 0.63 and 0.51 (p<0.001). Eyes with a longer AL had narrower temporal vessel angles, weaker green intensities, stronger blue intensities, and increased tessellation of the fundus color (p<0.001).</p><p><strong>Conclusion: </strong>RE and AL could be predicted using CFP parameters; the RE- or AL-related changes in the fundus, such as vessel angles and peripapillary color intensity, may enhance our understanding of myopia mechanisms.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"606-615"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12339627/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144247903","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":"Neuro-ophthalmic findings of Visual Snow Syndrome in Korea.","authors":"Ha Eun Park, Hyun Jin Shin, Andrew G Lee","doi":"10.1007/s10384-025-01196-1","DOIUrl":"10.1007/s10384-025-01196-1","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the neuro-ophthalmologic characteristics, potential triggers, and treatment responses of visual snow syndrome (VSS) in a Korean population.</p><p><strong>Study design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>We retrospectively reviewed the data of patients diagnosed with VSS at a tertiary hospital from March 2021 to February 2024. Data on visual and nonvisual symptoms, self-reported events that caused VSS, and medical and psychiatric comorbidities were chart-reviewed. Neuroimaging findings from MRI and ¹⁸F-FDG PET were evaluated, along with treatment responses to pharmacological interventions and filter glasses.</p><p><strong>Results: </strong>The sample comprised 27 men and 36 women, with a mean age of 27±11 years (mean±SD) and onset age of 22.4±11 years. Common symptoms included floaters, palinopsia, anxiety, and depression. Fourteen participants attributed VSS onset to specific ophthalmic events (e.g. refractive surgery or ophthalmic examinations with bright-light). ¹⁸F-FDG PET scans showed hypermetabolism in the visual cortices (81.8%), with no significant MRI abnormalities. Lamotrigine (18.9%), alprazolam (20%), and filter glasses (32.1%) showed modest efficacy in reducing the intensity of VSS.</p><p><strong>Conclusion: </strong>Korean patients with VSS exhibited clinical features, neuroimaging findings, and treatment responses similar to those reported in Western populations. Ophthalmic procedures, such as refractive surgery and bright-light examinations, may act as potential triggers in susceptible individuals. Although functional imaging, including ¹⁸F-FDG PET, may be useful for evaluating VSS, further studies with healthy controls and quantitative analyses are needed to validate its diagnostic value. Given the modest treatment efficacy, a multidisciplinary approach combining pharmacological intervention, filter glasses, and psychological support is essential to optimize outcomes.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"568-576"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024150","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":"Clarity of surgical field displayed on 3D monitor with local dimming technology during heads-up surgery.","authors":"Kosuke Nakajima, Jun Takeuchi, Tadashi Yokoi, Masaharu Mizuno, Takashi Koto, Tomoka Ishida, Hitomi Ozawa, Makoto Inoue","doi":"10.1007/s10384-025-01202-6","DOIUrl":"10.1007/s10384-025-01202-6","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clarity of images displayed on a 3D local dimming technology (LDT) monitor (LMD-XH550MT) to that on a conventional 3D monitor (LMD-X550MT) integrated into the Artevo 800^® system.</p><p><strong>Study design: </strong>Laboratory investigation METHODS: Six vitreoretinal surgeons evaluated the clarity of the surgical field on photographs displayed simultaneously on 2 monitors during cataract and vitreous surgery by the Artevo 800^® system. The visibility scores were made on a 5-point scale for images recorded during anterior capsulotomy, phacoemulsification, cortex aspiration, core vitrectomy, and peeling an epiretinal membrane or an internal limiting membrane (ILM). The skewness and kurtosis of the images during anterior and posterior segment surgery were evaluated.</p><p><strong>Results: </strong>The mean visibility scores were significantly higher with the LDT monitor at 4.7±0.1 than with the conventional monitor at 2.9±0.1 (P<0.001). The visibility scores for anterior capsulotomy (P=0.034), phacoemulsification (P=0.036), cortex aspiration (P=0.036), core vitrectomy (P=0.035), peeling of epiretinal membrane (P=0.036), and ILM (P=0.036) were significantly higher with the LDT monitor than with the conventional monitor. The absolute value of skewness during anterior segment surgery was significantly lower with the LDT monitor (0.20±0.05) than with the conventional monitor (-0.44±0.06, P=0.03).</p><p><strong>Conclusion: </strong>Higher contrast with the LDT monitor was attained by adjusting the backlight brightness according to the brightness of the images, which provided better image clarity for 3D heads-up cataract and vitreous surgery.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"633-638"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983182","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":"A single center experience of intraocular pressure control with glaucoma drainage device use in pediatric and adult patients.","authors":"Armin Garmany, Sepideh Jamali Dogahe, Kit Knier, Felix Kung, Jason Sargent, David Hodge, Cheryl Khanna","doi":"10.1007/s10384-025-01214-2","DOIUrl":"10.1007/s10384-025-01214-2","url":null,"abstract":"<p><strong>Purpose: </strong>This retrospective cohort compared the cumulative probability of success for glaucoma drainage device (GDD) implantation in pediatric and adult patients.</p><p><strong>Study design: </strong>This retrospective study enrolled adult and pediatric patients who had received a GDD between January 1, 1985 and December 31, 2017.</p><p><strong>Methods: </strong>Kaplan-Meier method was used to estimate the cumulative probability of success in the pediatric and adult patients. Successful intraocular pressure (IOP) control was defined as (i) a 20% reduction from baseline and (ii) IOP>6 and <18. Inadequate IOP control and failure were defined as a violation of these two criteria over two consecutive visits. Cox proportional hazards models enabled assessing the influence of sex, GDD location, and GDD type on IOP control.</p><p><strong>Results: </strong>A total of 425 adult eyes from 372 individuals and 41 pediatric eyes from 28 individuals were included. The median follow-up time was 55 months for adults and 87 months for children. Superior temporal GDD placement was most employed for both (p=0.16). Adults were more likely to receive a Baerveldt 350 (p=0.04) and children were more likely to receive an Ahmed S2 (p<0.001). Adults and children had a median survival time of 2.99 and 0.82, respectively, and did not have a statistically significant difference in GDD failure rate (p=0.18). Additionally, sex, GDD location, and GDD type did not affect the success rate.</p><p><strong>Conclusions: </strong>Children and adults had a similar cumulative probability of success following GDD implantation. This study found that GDD type, GDD location, and glaucoma type did not influence the probability of successful IOP control.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"583-589"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144340116","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":"Association of postoperative delirium with visual acuity after ophthalmic surgeries under local anesthesia.","authors":"Yusuke Koga, Koji Kitazawa, Gen Shinozaki, Kengo Yoshii, Jun-Wei B Hughes, Yohei Yamashita, Kentaro Kojima, Morio Ueno, Shigeru Kinoshita, Chie Sotozono","doi":"10.1007/s10384-025-01200-8","DOIUrl":"10.1007/s10384-025-01200-8","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence rate and risk factors for postoperative delirium (POD) following ophthalmic surgery under local anesthesia.</p><p><strong>Study design: </strong>A retrospective study METHODS: We retrospectively investigated the incidence rate of POD in 4658 patients who underwent vitrectomy or glaucoma surgery between January 2009 to March 2023 and analyzed the risk factors with multivariate logistic regression compared to non-delirium patients. Risk indices included age, sex, operation time, preoperative best-corrected visual acuity (pre-BCVA), comorbidity of dementia, and the use of sedative or hypnotic drugs.</p><p><strong>Results: </strong>POD developed in 19 out of 4658 patients (0.41%). POD was more prevalent in older patients and those with dementia (P < 0.001 and P < 0.001, respectively). However, sex, longer operation time, the use of sedative or hypnotic drugs were not associated with POD. The low pre-BCVA in either operated eye or fellow eye was more likely observed in patients with POD (P = 0.003 and P = 0.001, respectively). The multivariate logistic regression analysis revealed that age (odds ratio [OR], 1.06; 95% confidence interval [CI], 1.00-1.12; P = 0.04), dementia (OR, 34.95; 95% CI, 12.32-99.15; P < 0.001), pre-BCVA in the operated eye (OR, 2.00; 95% CI, 1.13-3.53; P = 0.02) and pre-BCVA in the fellow eye (OR, 1.83; 95% CI, 1.16-2.89; P = 0.01) were significantly associated with developing POD.</p><p><strong>Conclusions: </strong>POD developed following ophthalmic surgery under local anesthesia. Identified risk factors included older age, comorbid dementia and low pre-BCVA.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"495-503"},"PeriodicalIF":1.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996592","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}