Japanese Journal of Ophthalmology最新文献

{"title":"Comparative study of retinal ganglion cell complex thinning by visual field patterns following post-geniculate lesions.","authors":"Toshio Kurokawa, Rumi Kobayashi, Naoko Ueda, Takekazu Ohi","doi":"10.1007/s10384-025-01174-7","DOIUrl":"10.1007/s10384-025-01174-7","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the relationship between retinal ganglion cell complex (GCC) thinning following post-geniculate lesions and the time elapsed since cerebrovascular disorder (CVD) onset.</p><p><strong>Study design: </strong>Retrospective study.</p><p><strong>Methods: </strong>Forty-seven patients with hemianopic visual field defects (VFD) due to post-geniculate lesions were retrospectively enrolled from our clinical optical coherence tomography (OCT) database. GCC thickness was measured using spectral-domain OCT, with a 6 mm circle centered on the fovea divided into hemianopic and unaffected sides. The decline rate (DR) was calculated as the percentage reduction in GCC thickness on the hemianopic side relative to the unaffected side.</p><p><strong>Results: </strong>Patients were grouped based on VFD patterns: complete homonymous hemianopia (A), homonymous hemianopia with macular sparing (B), homonymous scotomatous defects (C), superior quadrantanopia (D), and inferior quadrantanopia (E). A positive correlation (r = 0.581, p < 0.001) was found between the time elapsed since CVD onset and DR. More than 5% DR was observed in 29 of 47 cases (61.7%). Significant differences were noted between group A (specifically, the temporal lobe lesion) and group B (p = 0.0183), as well as between group A and group C (p = 0.0378).</p><p><strong>Conclusion: </strong>A significant correlation was observed between DR and the time elapsed. Several factors, such as lesion location, type, size, and the involvement of gray or white matter, influence retrograde trans-synaptic degeneration (RTSD). Our findings suggest that RTSD is influenced by the distance from the lateral geniculate nucleus (LGN).</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"268-278"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811469","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":"Demographics, clinical features and prognosis of patients with primary malignant conjunctival tumors at a tertiary hospital in Japan.","authors":"Hiroshi Goto, Masaki Asakage, Erina Niidime, Naoyuki Yamakawa, Hiroyuki Komatsu, Kinya Tsubota, Kazuhiko Umazume, Yoshihiko Usui, Hideki Mori","doi":"10.1007/s10384-025-01165-8","DOIUrl":"10.1007/s10384-025-01165-8","url":null,"abstract":"<p><strong>Purpose: </strong>To clarify the demographic characteristics, clinical features and prognosis of patients with primary malignant conjunctival tumors diagnosed at a single tertiary hospital in Japan.</p><p><strong>Study design: </strong>Retrospective, observational case series.</p><p><strong>Methods: </strong>Patients with malignant conjunctival tumors diagnosed histopathologically at Tokyo Medical University Hospital between 2010 and 2022 were retrospectively reviewed. The demographic profile, clinical features and treatment outcomes were analyzed.</p><p><strong>Results: </strong>A total of 359 patients with histopathologically proven malignant conjunctival tumors were included. All patients were Japanese. The most common malignant conjunctival tumor was lymphoma (n = 197, 54.9%), followed by squamous cell carcinoma (SCC) (n = 97, 27.0%), melanoma (n = 60, 16.7%), and others (n = 5, 1.4%). The mean age of patients at the time of diagnosis was 60.5 ± 17.4 years for lymphoma, 60.2 ± 15.8 years for SCC, and 65.8 ± 15.7 years for melanoma. Among 197 patients with lymphoma, 89.3% had extranodal marginal zone lymphoma (EMZL). Lymphomas were treated with external beam radiation therapy in 52.8%, surgical resection with or without cryopexy in 40.1%, and systemic chemotherapy in 4.0%. During an observation period of more than 12 months, recurrence was observed in 8.4% and extraocular lymphoma occurred in 1.7%. In SCC and melanoma, common surgical resection with sufficient safety margin, cryopexy, and application of 0.04% mitomycin C were performed as eye-preserving therapy. Orbital exenteration was performed in advanced cases. Recurrence rates and regional lymph node metastasis rates during an observation period of more than 12 months were, respectively, 30.1% and 6.2% in SCC. Recurrence rates and regional lymph node or distant organ metastasis rates during an observation period of more than 24 months for melanoma were 29% for both. Tumor-related mortality was 16% in melanoma, but 0% in lymphoma and SCC.</p><p><strong>Conclusions: </strong>Lymphoma was the major malignant conjunctival tumor in a Japanese ophthalmology referral center, which may reflect a unique epidemiological trend in Japan compared to Western countries. The prognosis of lymphoma and SCC after appropriate treatment was favorable, except for some cases of advanced SCC.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"316-325"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441028","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":"Comparison of intraocular pressure changes in Japanese patients with neovascular age-related macular degeneration treated with aflibercept or faricimab.","authors":"Junichiro Honjo, Ryo Mukai, Kanako Itagaki, Keiichiro Tanaka, Koki Norikawa, Yutaka Kato, Akihito Kasai, Yukinori Sugano, Tetsuju Sekiryu","doi":"10.1007/s10384-024-01155-2","DOIUrl":"10.1007/s10384-024-01155-2","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the short-term changes in intraocular pressure (IOP) following intravitreal injections of aflibercept or faricimab in Japanese patients with neovascular age-related macular degeneration (nAMD).</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>This retrospective observational study included 161 eyes from 160 Japanese patients diagnosed with nAMD. Of these, 127 eyes (127 patients) were treated with 2 mg/0.05 mL aflibercept, and 34 eyes (33 patients) received 6 mg/0.05 mL faricimab. Each group underwent three consecutive monthly injections. The IOP in each treated eye was measured using non-contact tonometry at each visit over a 3-month period following the initial injection.</p><p><strong>Results: </strong>The mean baseline IOP in the aflibercept group was 14.4 ± 2.8 mmHg, decreasing to 13.2 ± 3.0 mmHg after 3 months (P < 0.001), whereas the mean baseline IOP in the faricimab group was 13.8 ± 2.1 mmHg, with a change to 13.5 ± 1.5 mmHg after 3 months (P = 0.1873).</p><p><strong>Conclusion: </strong>The loading phase treatment with aflibercept resulted in a decrease in IOP. Faricimab showed a similar trend, there was no significant difference between the two treatments.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"230-235"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143615611","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":"Predictive value of enhanced corneal biomechanical parameters for ectasia progression.","authors":"Shizuka Koh, Renato Ambrósio, Ryota Inoue, Michael W Belin, Naoyuki Maeda, Kohji Nishida","doi":"10.1007/s10384-024-01149-0","DOIUrl":"10.1007/s10384-024-01149-0","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether corneal biomechanical parameters can predict ectasia progression.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>The baseline corneal biomechanical parameters of 64 eyes of 41 young patients (age, < 25 years at the first visit) who were diagnosed with keratoconus (KC) or suspected KC at Osaka University Hospital and followed up for more than two years were reviewed. Suspected KC was defined as borderline cases with no definitive clinical or topographical abnormalities in both eyes. The eyes were divided into progressed (P) and non-progressed (NP) groups using the ABCD grading system of Scheimpflug-based tomography. The Scheimpflug-based corneal biomechanical parameters evaluated included deformation amplitude ratio within 2 mm, integrated radius, Ambrósio relational thickness to the horizontal profile, stiffness parameter at the first applanation, stress-strain index, E-staging, and Corvis Biomechanical Index. The optimized tomographic/biomechanical index (TBIv2), Belin/Ambrósio Enhanced Ectasia Deviation (BAD-D), and inferior-superior axial steepening values from Scheimpflug-based tomography were also evaluated.</p><p><strong>Results: </strong>Twenty-three and 41 eyes were categorized into the P and NP groups, respectively. Logistic regression analysis showed that age, BAD-D, and TBIv2 could predict ectasia progression. The specificity, sensitivity, and area under the receiver operating characteristic curve (AUROC) values for BAD-D combined with age were 0.82, 0.60, and 0.83, respectively, whereas those for TBIv2 combined with age were 0.65, 0.82, and 0.82, respectively.</p><p><strong>Conclusions: </strong>Baseline TBIv2 is a potentially useful predictive marker for ectasia progression in young patients, whereas baseline BAD-D could be used for establishing a definitive diagnosis.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"174-181"},"PeriodicalIF":2.1,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12003495/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005462","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":"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":"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":"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":"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}