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Effects of trabeculectomy on the postoperative central visual field as revealed by refraction values. 小梁切除术对术后中心视野的影响,从屈光度值可以看出。
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-08 DOI: 10.1007/s10384-024-01139-2
Kosuke Nakajima, Rei Sakata, Shiroaki Shirato, Makoto Aihara

Purpose: 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.

Study design: Retrospective case series.

Methods: 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.

Results: 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.

Conclusions: 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.

目的:评估小梁切除术对屈光值显示的正常张力青光眼(NTG)患者中心视野(VF)恶化率的影响:研究设计:回顾性病例系列:我们对 28 只眼睛进行了回顾性分析,其中包括 12 只高度近视眼(球面等效[SE] < - 6 斜度,无病理性近视)和 16 只非高度近视眼(SE ≥ - 6 斜度)。通过对 30 -2 和 10 -2 VF 测试进行线性回归分析,确定 VF 下降率(分贝/年)。Wilcoxon 符号秩检验用于比较组间的恶化率。为了评估手术后初始效应的影响,在有术后初始 VF 检查数据和没有术后初始 VF 检查数据的情况下进行了统计分析:结果:小梁切除术明显降低了近视眼(14.1 至 9.0 mmHg,P ≤ 0.01)和非近视眼(13.4 至 9.5 mmHg,P ≤ 0.01)的眼压。术后,近视眼(- 1.31 到 - 0.55 dB/年,P = 0.01)和非近视眼(- 0.80 到 - 0.30 dB/年,P = 0.03)的 10-2 VF 恶化率显著下降。剔除术后第一次视力检查,恶化率分别为- 0.51 ± 0.24 dB/年和- 0.54 ± 0.89 dB/年,表明对视力进展评估的影响较小:小梁切除术可减轻近视 NTG 患者中心 VF 的恶化,强调了及时手术干预的潜在益处。需要进一步研究以确定最佳手术时机。
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引用次数: 0
Relationships between tilt angles of rectus muscles and positions of rectus muscle pulleys in patients with sagging eye syndrome.
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2025-02-04 DOI: 10.1007/s10384-024-01141-8
Reika Kono, Ichiro Hamasaki, Fumiko Kishimoto, Kiyo Shibata, Shin Morisawa, Yuki Morizane

Purpose: To examine the relationship between the rectus muscle (RM) angle and RM pulley displacement in patients with sagging eye syndrome (SES) without myopia.

Study design: Retrospective cross-sectional case series.

Methods: 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.

Results: 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.

Conclusion: 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.

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引用次数: 0
Outcomes, efficacy and risk factors of 27-Gauge vitrectomy for diabetic tractional retinal detachment in Japanese patients. 27号玻璃体切割术治疗日本糖尿病牵引性视网膜脱离的结果、疗效和风险因素。
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-06 DOI: 10.1007/s10384-024-01135-6
Risa Nishigushi, Ayumi Usui-Ouchi, Yoshihito Sakanishi, Kazunori Tamaki, Keitaro Mashimo, Rei Ito, Toshiro Sakuma, Nobuyuki Ebihara, Shintaro Nakao

Purpose: 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.

Study design: Retrospective study.

Methods: 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.

Results: 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.

Conclusion: 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.

目的:糖尿病视网膜病变会导致危及视力的并发症,如增殖性糖尿病视网膜病变和牵引性视网膜脱离(TRD),是全球关注的主要健康问题。尽管玻璃体切割技术不断进步,但在控制术后并发症和长期视力方面仍存在挑战。本研究旨在评估27号玻璃体旁切除术(27 g PPV)治疗糖尿病TRD的术后效果,并确定相关风险因素:研究设计:回顾性研究:本研究纳入了2017年7月至2022年9月期间在日本顺天堂大学浦安医院接受27 g PPV治疗糖尿病TRD的74名患者的94只眼睛。研究考察了患者的人口统计学特征、术前特征、术中细节和术后结果。通过统计分析确定影响术后视力的因素:平均随访时间为(23.1 ± 14.6)个月。术后视力(LogMAR)从 1.34 ± 0.82 显著提高到 0.65 ± 0.79(P < 0.0001)。术后并发症包括持续性玻璃体出血(15%)和新生血管性青光眼(4%)。最终视网膜重接率为 97%。术前黄斑脱离(P < 0.0001)和 IV 级 TRD(P < 0.0001)严重程度与最终最佳矫正视力差(P < 0.0001)显著相关。通过多变量分析发现,术前黄斑脱离(P < 0.0001)、IV 级 TRD(P < 0.0001)、术中先天性破损(P = 0.031)和术后新生血管性青光眼(P < 0.0001)是术后视力不良的重要预测因素:本研究强调了 27 克 PPV 在改善糖尿病 TRD 患者视力方面的疗效。尽管结果良好,但关注术前风险因素和精细的手术技术对于优化这些患者的长期视力预后仍然至关重要。
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引用次数: 0
2021 trends in the treatment of patients with strabismus in Japan. 日本治疗斜视患者的 2021 年趋势。
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-12-16 DOI: 10.1007/s10384-024-01144-5
Keiko Kunimi, Toshiaki Goseki, Sachiko Nishina, Takashi Negishi, Miho Sato

Purpose: To clarify the actual status of strabismus surgery and botulinum toxin (BTX) therapy in Japan in the year 2021.

Study design: Cross-sectional study.

Methods: We conducted a national survey of strabismus treatment in 2021 using a questionnaire consistent with a previous 2013 survey, incorporating additional questions about BTX therapy.

Results: Among the 378 responding institutions, strabismus surgery or BTX therapy, or both, was performed at 185 institutions (49%; total cases, 10,767). In 151 (40%), 32 (8%), and 2 (1%) institutions, surgery only, surgery and BTX therapy, and BTX therapy only were performed, respectively. The distribution of institutions where strabismus surgery was performed consisted of 4 prefectures, accounting for 48% of the total, whereas no strabismus surgery was performed at any institution in 3 prefectures. Although the highest percentage of patients (23%) was aged between 10 and 19 years, 48.2% of the patients were aged 20 years or older, and 17% of them were aged 60 years or older. Exotropia (XT) was the most common type of strabismus (55%) followed by esotropia (ET) (24%). In terms of complex surgeries, 80.2% (more than 100 cases) were performed at institutions with more than 100 cases. Of the 34 institutions where BTX therapy was performed, 52% were performed at a single institution, and 18% were performed at 2 institutions where no strabismus surgery was performed. Patients with scarring in the extraocular muscles, such as thyroid eye disease, were the most treated, followed by those with ET, who were mainly given injection treatment.

Conclusion: Institutions where strabismus surgery and BTX therapy could be performed were concentrated and limited.

目的:明确2021年日本斜视手术和肉毒毒素(BTX)治疗的实际状况:研究设计:横断面研究:我们使用与2013年调查一致的问卷,对2021年的斜视治疗情况进行了全国性调查,并增加了有关BTX疗法的问题:在 378 家做出答复的机构中,有 185 家机构(49%;病例总数 10,767 例)实施了斜视手术或 BTX 治疗,或两者兼有。分别有 151 家(40%)、32 家(8%)和 2 家(1%)机构只进行了手术、手术和 BTX 治疗,以及只进行了 BTX 治疗。实施斜视手术的机构分布在 4 个都道府县,占总数的 48%,而在 3 个都道府县的任何机构中都没有实施斜视手术。虽然 10 至 19 岁的患者比例最高(23%),但 20 岁及以上的患者占 48.2%,60 岁及以上的患者占 17%。外斜(XT)是最常见的斜视类型(55%),其次是内斜(ET)(24%)。就复杂手术而言,80.2%(超过 100 例)的手术是在拥有 100 例以上病例的机构进行的。在 34 家进行过 BTX 治疗的机构中,52% 在一家机构进行,18% 在两家未进行过斜视手术的机构进行。甲状腺眼病等眼外肌瘢痕患者接受治疗的最多,其次是ET患者,他们主要接受注射治疗:结论:可开展斜视手术和 BTX 治疗的机构较为集中且有限。
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引用次数: 0
Surgical outcomes after trabeculotomy for primary congenital glaucoma.
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI: 10.1007/s10384-024-01152-5
Ayaka Edo, Kazuyuki Hirooka, Hideaki Okumichi, Asayo Yoshinaka, Shintaro Kohno, Yoshiaki Kiuchi

Purpose: To investigate outcomes after trabeculotomy in Japanese patients with primary congenital glaucoma (PCG), and to identify risk factors for multiple glaucoma surgery procedures.

Study design: Retrospective observational study.

Methods: Surgical outcomes were investigated in Japanese patients with PCG who underwent their first glaucoma surgery at Hiroshima University Hospital between January, 2006, and December, 2021. The data included in this study were divided into single- and multiple-surgery groups, and risk factors for requiring multiple surgery procedures were evaluated using multivariate analysis.

Results: Twenty eyes of 20 patients were included. All eyes underwent ab externo trabeculotomy as the first surgery. The mean follow-up period was 75.7 ± 44.8 months. The cumulative success rate for up to 3 trabeculotomies at 5 years after the first surgery was 89.7%. The glaucoma in 11 eyes (55.0%) was controllable with just one surgery, whereas 9 eyes (45.0%) required 2 or more glaucoma surgical procedures. The single-surgery group had a significantly better mean best-corrected visual acuity at the last visit than the multiple-surgery group (0.1 ± 0.1 versus 0.9 ± 1.1, respectively, p = 0.001) and a smaller mean cylindrical power (- 0.8 ± 0.8 versus - 2.2 ± 1.0, respectively, p = 0.01). In multivariate logistic analysis, a 1-mm increase in corneal diameter was associated with a 16-fold increase in the risk of multiple glaucoma surgical procedures (p = 0.047).

Conclusion: The glaucoma in most PCG eyes can be controlled with up to three trabeculotomies. Corneal-diameter enlargement was a significant risk factor for multiple surgical procedures.

{"title":"Surgical outcomes after trabeculotomy for primary congenital glaucoma.","authors":"Ayaka Edo, Kazuyuki Hirooka, Hideaki Okumichi, Asayo Yoshinaka, Shintaro Kohno, Yoshiaki Kiuchi","doi":"10.1007/s10384-024-01152-5","DOIUrl":"10.1007/s10384-024-01152-5","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate outcomes after trabeculotomy in Japanese patients with primary congenital glaucoma (PCG), and to identify risk factors for multiple glaucoma surgery procedures.</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>Surgical outcomes were investigated in Japanese patients with PCG who underwent their first glaucoma surgery at Hiroshima University Hospital between January, 2006, and December, 2021. The data included in this study were divided into single- and multiple-surgery groups, and risk factors for requiring multiple surgery procedures were evaluated using multivariate analysis.</p><p><strong>Results: </strong>Twenty eyes of 20 patients were included. All eyes underwent ab externo trabeculotomy as the first surgery. The mean follow-up period was 75.7 ± 44.8 months. The cumulative success rate for up to 3 trabeculotomies at 5 years after the first surgery was 89.7%. The glaucoma in 11 eyes (55.0%) was controllable with just one surgery, whereas 9 eyes (45.0%) required 2 or more glaucoma surgical procedures. The single-surgery group had a significantly better mean best-corrected visual acuity at the last visit than the multiple-surgery group (0.1 ± 0.1 versus 0.9 ± 1.1, respectively, p = 0.001) and a smaller mean cylindrical power (- 0.8 ± 0.8 versus - 2.2 ± 1.0, respectively, p = 0.01). In multivariate logistic analysis, a 1-mm increase in corneal diameter was associated with a 16-fold increase in the risk of multiple glaucoma surgical procedures (p = 0.047).</p><p><strong>Conclusion: </strong>The glaucoma in most PCG eyes can be controlled with up to three trabeculotomies. Corneal-diameter enlargement was a significant risk factor for multiple surgical procedures.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"123-130"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143032684","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}
引用次数: 0
Modulation of the peak velocities and gains of abduction and adduction saccades according to head position. 根据头部位置调节外展和内收扫视的峰值速度和增益。
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2025-01-03 DOI: 10.1007/s10384-024-01132-9
Hana Mino, Hiromasa Sawamura, Koji Takahashi, Hiroya Hara, Yosuke Kudo, Kenzo Yamanaka, Tomoko Kaida, Kazunori Miyata, Makoto Aihara, Ken Johkura

Purpose: To assess the effects of modifying head position and of static ocular counter-rolling (OCR) on abduction and adduction in saccadic eye movements using a head-mounted video-oculographic device.

Study design: A clinical observational study.

Methods: The peak velocities and amplitude gains of visually guided 12° saccades were binocularly measured in 21 healthy volunteers with their heads in the upright vertical (0°) and horizontal (± 90°, bilateral side-lying) postures, and in 6 participants with their head positions bilaterally tilted by 30°. The rotation angles of eyeballs generated via OCR in the bilateral 30° and 90° head positions were evaluated in five participants.

Results: Peak velocities and gains were significantly higher with the head in the 0° position compared to ± 90°. The decreases in peak velocities and gains at ± 90° were not affected by the apogeotropic or geotropic directions. Faster peak velocities and greater gains on abduction, rather than adduction, were observed under each test condition. The tendencies toward faster peak velocity and greater gain in the 0° head position rather than bilaterally tilted at 30° were preserved. The absolute rotation angles at ± 90° were larger than those at 30°.

Conclusions: Head position affected the peak velocities and gains of both abduction and adduction saccades. The findings suggest that modified force vectors exerted by different eye muscles recruited during OCR play a role. Our research provides valuable insights for assessing eye movements across various head positions.

目的:应用头戴式视像仪评估头部位置改变和眼球静止反转(OCR)对跳眼运动外展和内收的影响。研究设计:临床观察性研究。方法:用双眼测量21名头部垂直(0°)和水平(±90°,双侧卧)和6名头部侧倾30°的健康受试者的视觉引导下12°扫视的峰值速度和振幅增益。评估了5名受试者在双侧30°和90°头部位置时通过OCR生成的眼球旋转角度。结果:与±90°相比,头部处于0°位置时峰值速度和增益明显更高。在±90°处峰值速度的减小和增益不受向地性和向地性方向的影响。在每个测试条件下,观察到更快的峰值速度和更大的外展增益,而不是内收。保持了在0°头部位置比在30°两侧倾斜时更快的峰值速度和更大的增益趋势。±90°绝对旋转角度大于30°绝对旋转角度。结论:头位影响外展和内收扫视的峰值速度和增益。研究结果表明,在OCR过程中,不同眼肌施加的修正力矢量发挥了作用。我们的研究为评估不同头部位置的眼球运动提供了有价值的见解。
{"title":"Modulation of the peak velocities and gains of abduction and adduction saccades according to head position.","authors":"Hana Mino, Hiromasa Sawamura, Koji Takahashi, Hiroya Hara, Yosuke Kudo, Kenzo Yamanaka, Tomoko Kaida, Kazunori Miyata, Makoto Aihara, Ken Johkura","doi":"10.1007/s10384-024-01132-9","DOIUrl":"10.1007/s10384-024-01132-9","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the effects of modifying head position and of static ocular counter-rolling (OCR) on abduction and adduction in saccadic eye movements using a head-mounted video-oculographic device.</p><p><strong>Study design: </strong>A clinical observational study.</p><p><strong>Methods: </strong>The peak velocities and amplitude gains of visually guided 12° saccades were binocularly measured in 21 healthy volunteers with their heads in the upright vertical (0°) and horizontal (± 90°, bilateral side-lying) postures, and in 6 participants with their head positions bilaterally tilted by 30°. The rotation angles of eyeballs generated via OCR in the bilateral 30° and 90° head positions were evaluated in five participants.</p><p><strong>Results: </strong>Peak velocities and gains were significantly higher with the head in the 0° position compared to ± 90°. The decreases in peak velocities and gains at ± 90° were not affected by the apogeotropic or geotropic directions. Faster peak velocities and greater gains on abduction, rather than adduction, were observed under each test condition. The tendencies toward faster peak velocity and greater gain in the 0° head position rather than bilaterally tilted at 30° were preserved. The absolute rotation angles at ± 90° were larger than those at 30°.</p><p><strong>Conclusions: </strong>Head position affected the peak velocities and gains of both abduction and adduction saccades. The findings suggest that modified force vectors exerted by different eye muscles recruited during OCR play a role. Our research provides valuable insights for assessing eye movements across various head positions.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"144-151"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142921688","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}
引用次数: 0
First-year real-world experience of intravitreal brolucizumab injection for refractory neovascular age-related macular degeneration. 玻璃体内注射肉毒杆菌治疗难治性新生血管性年龄相关性黄斑变性的第一年真实体验。
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-11-05 DOI: 10.1007/s10384-024-01134-7
Jeong Hyun Lee, Joo Young Shin, Jeeyun Ahn

Purpose: To investigate the first-year real-world anatomical and functional outcomes of intravitreal brolucizumab injection in eyes with refractory neovascular age-related macular degeneration (nAMD).

Study design: Retrospective observational study.

Methods: nAMD patients who showed poor response to previous anti-vascular endothelial growth factor (VEGF) agents were switched to brolucizumab. Functional and anatomical outcomes were evaluated at initial treatment of nAMD, after treatment with other anti-VEGF agents and after switching and treating with brolucizumab for 1 year. Safety profile was also evaluated after brolucizumab injection. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and the presence of fluid in different compartments (intraretinal fluid [IRF], subretinal fluid [SRF], pigment epithelial detachment [PED]) were assessed at each time point.

Results: A total of 40 eyes of 40 patients were included in the study. BCVA remained unchanged throughout treatment (p > 0.05). CFT did not change after treatment with other anti-VEGF agents (p = 0.588) but decreased after switching to brolucizumab (p < 0.001). SFCT decreased after treatment with other anti-VEGF agents (p = 0.025) but not after switching to brolucizumab (p = 0.236). Presence of SRF (p = 0.001) and PED (p = 0.001) decreased significantly after switching to brolucizumab, despite their persistence with prior treatments using other anti-VEGF agents. However, IRF persisted even after switching to brolucizumab (p = 0.745). Intraocular inflammation (IOI)-related adverse events were reported in 3 eyes (7.14%).

Conclusion: Analysis of first-year real-world outcomes after switching to brolucizumab in nAMD patients refractory to other anti-VEGF agents showed improved anatomic outcomes, limited functional improvement and low incidence of IOI-related adverse events.

目的:调查难治性新生血管性年龄相关性黄斑变性(nAMD)患者玻璃体内注射博路单抗第一年的实际解剖和功能效果:研究设计:回顾性观察研究。方法:对之前的抗血管内皮生长因子(VEGF)药物反应不佳的 nAMD 患者改用肉毒杆菌。在最初治疗 nAMD 时、使用其他抗血管内皮生长因子药物治疗后以及换用肉毒杆菌单抗并治疗 1 年后,对功能和解剖结果进行评估。此外,还评估了注射博卢单抗后的安全性。在每个时间点评估最佳矫正视力(BCVA)、中心眼窝厚度(CFT)、眼窝下脉络膜厚度(SFCT)以及不同区域的积液情况(视网膜内积液[IRF]、视网膜下积液[SRF]、色素上皮脱落[PED]):研究共纳入了 40 名患者的 40 只眼睛。在整个治疗过程中,BCVA 保持不变(P > 0.05)。在使用其他抗 VEGF 药物治疗后,CFT 没有变化(p = 0.588),但在改用博路单抗治疗后,CFT 有所下降(p 结论:博路单抗的治疗效果与其他抗 VEGF 药物相同:对其他抗血管内皮生长因子药物难治的 nAMD 患者改用肉毒珠单抗治疗后第一年的实际疗效分析表明,解剖结果有所改善,功能改善有限,与 IOI 相关的不良事件发生率较低。
{"title":"First-year real-world experience of intravitreal brolucizumab injection for refractory neovascular age-related macular degeneration.","authors":"Jeong Hyun Lee, Joo Young Shin, Jeeyun Ahn","doi":"10.1007/s10384-024-01134-7","DOIUrl":"10.1007/s10384-024-01134-7","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the first-year real-world anatomical and functional outcomes of intravitreal brolucizumab injection in eyes with refractory neovascular age-related macular degeneration (nAMD).</p><p><strong>Study design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>nAMD patients who showed poor response to previous anti-vascular endothelial growth factor (VEGF) agents were switched to brolucizumab. Functional and anatomical outcomes were evaluated at initial treatment of nAMD, after treatment with other anti-VEGF agents and after switching and treating with brolucizumab for 1 year. Safety profile was also evaluated after brolucizumab injection. Best-corrected visual acuity (BCVA), central foveal thickness (CFT), subfoveal choroidal thickness (SFCT), and the presence of fluid in different compartments (intraretinal fluid [IRF], subretinal fluid [SRF], pigment epithelial detachment [PED]) were assessed at each time point.</p><p><strong>Results: </strong>A total of 40 eyes of 40 patients were included in the study. BCVA remained unchanged throughout treatment (p > 0.05). CFT did not change after treatment with other anti-VEGF agents (p = 0.588) but decreased after switching to brolucizumab (p < 0.001). SFCT decreased after treatment with other anti-VEGF agents (p = 0.025) but not after switching to brolucizumab (p = 0.236). Presence of SRF (p = 0.001) and PED (p = 0.001) decreased significantly after switching to brolucizumab, despite their persistence with prior treatments using other anti-VEGF agents. However, IRF persisted even after switching to brolucizumab (p = 0.745). Intraocular inflammation (IOI)-related adverse events were reported in 3 eyes (7.14%).</p><p><strong>Conclusion: </strong>Analysis of first-year real-world outcomes after switching to brolucizumab in nAMD patients refractory to other anti-VEGF agents showed improved anatomic outcomes, limited functional improvement and low incidence of IOI-related adverse events.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"43-48"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11821690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142575955","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}
引用次数: 0
Assessment of the transscleral removal technique for subretinal proliferative tissues during vitrectomy for rhegmatogenous retinal detachment.
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2025-01-23 DOI: 10.1007/s10384-024-01143-6
Tomoyuki Ishibashi, Ryo Inoue, Hiroshi Nakashima, Kazuyuki Emi

Purpose: To provide insights into the transscleral removal technique for subretinal proliferative tissues (SRP).

Study design: Retrospective, single-center case series.

Methods: Patients who underwent transscleral removal of SRP during vitrectomy for rhegmatogenous retinal detachment (RRD) were included. The preoperative RRD extent, SRP distribution, intraoperative maneuvers, complications, and surgical outcomes were assessed.

Results: Seven eyes of seven patients were enrolled for surgery. The RRD extent involved four quadrants in two eyes, three quadrants in three eyes, and two quadrants in the remaining two eyes. SRP were widely distributed beneath the detached retina in all the cases, with submacular SRP present in six cases. In these six cases, all the SRP, including the submacular SRP, could be removed without creating retinotomies via 1 or 2 subretinal trocars. However, peripheral SRP with extensive and strong adhesion to the retina required multiple retinotomies and conventional bimanual removal in one case. Surgical failure, attributable to the transscleral technique, occurred in one case due to a missed retinal puncture that occurred during subretinal trocar insertion, resulting in recurrent RRD. This patient had RRD within two quadrants, and the subretinal space could not be adequately dilated before insertion. All the patients had achieved retinal reattachment without deterioration of visual acuity at the final follow-up visit.

Conclusion: The transscleral removal technique was suitable for the removal of SRP, including the posterior pole area, with minimal retinal damage. However, this technique may not be appropriate for SRP removal with extensive and strong adhesions or for cases with relatively nonextensive RRD.

{"title":"Assessment of the transscleral removal technique for subretinal proliferative tissues during vitrectomy for rhegmatogenous retinal detachment.","authors":"Tomoyuki Ishibashi, Ryo Inoue, Hiroshi Nakashima, Kazuyuki Emi","doi":"10.1007/s10384-024-01143-6","DOIUrl":"10.1007/s10384-024-01143-6","url":null,"abstract":"<p><strong>Purpose: </strong>To provide insights into the transscleral removal technique for subretinal proliferative tissues (SRP).</p><p><strong>Study design: </strong>Retrospective, single-center case series.</p><p><strong>Methods: </strong>Patients who underwent transscleral removal of SRP during vitrectomy for rhegmatogenous retinal detachment (RRD) were included. The preoperative RRD extent, SRP distribution, intraoperative maneuvers, complications, and surgical outcomes were assessed.</p><p><strong>Results: </strong>Seven eyes of seven patients were enrolled for surgery. The RRD extent involved four quadrants in two eyes, three quadrants in three eyes, and two quadrants in the remaining two eyes. SRP were widely distributed beneath the detached retina in all the cases, with submacular SRP present in six cases. In these six cases, all the SRP, including the submacular SRP, could be removed without creating retinotomies via 1 or 2 subretinal trocars. However, peripheral SRP with extensive and strong adhesion to the retina required multiple retinotomies and conventional bimanual removal in one case. Surgical failure, attributable to the transscleral technique, occurred in one case due to a missed retinal puncture that occurred during subretinal trocar insertion, resulting in recurrent RRD. This patient had RRD within two quadrants, and the subretinal space could not be adequately dilated before insertion. All the patients had achieved retinal reattachment without deterioration of visual acuity at the final follow-up visit.</p><p><strong>Conclusion: </strong>The transscleral removal technique was suitable for the removal of SRP, including the posterior pole area, with minimal retinal damage. However, this technique may not be appropriate for SRP removal with extensive and strong adhesions or for cases with relatively nonextensive RRD.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"66-73"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023487","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}
引用次数: 0
Surgical outcomes of non-fovea-sparing internal limiting membrane peeling using a double-staining technique for symptomatic myopic foveoschisis: a retrospective study.
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2025-02-03 DOI: 10.1007/s10384-024-01158-z
Tadashi Mizuguchi, Masayuki Horiguchi, Atsuhiro Tanikawa, Yasuki Ito

Purpose: To investigate the incidence of postoperative macular hole (MH), visual acuity, and anatomical recovery in patients who underwent a non-fovea-sparing technique using a double-staining method for symptomatic myopic foveoschisis without pre-existing macular holes.

Study design: A retrospective study.

Methods: We evaluated 39 eyes from 39 consecutive patients diagnosed with myopic foveoschisis from May 2017 to September 2022 at Fujita Health University Hospital. All patients underwent non-fovea-sparing internal limiting membrane peeling using a double-staining method and were monitored for 6 months postoperatively. Best-corrected visual acuity (BCVA) as measured by the logarithm of the minimum angle of resolution (logMAR), central retinal thickness (CRT), and the presence of foveoschisis were assessed using optical coherence tomography (OCT) preoperatively (pre) and at 1 month (1 M), 3 months (3 M), and 6 months (6 M) postoperatively.

Results: No cases of postoperative rhegmatogenous retinal detachment were observed. A postoperative MH developed in one eye. The mean logMAR values at pre, 1 M, 3 M, and 6 M were 0.38 ± 0.37, 0.23 ± 0.33, 0.18 ± 0.25, and 0.13 ± 0.29, respectively (all P < 0.001). The mean CRTs at pre, 1 M, 3 M, and 6 M were 384.6 ± 177.2, 262.2 ± 84.4, 200.3 ± 64.9, and 185.6 ± 61.0 μm, respectively (all P < 0.001). Foveoschisis was observed in all 39 eyes (100%) preoperatively and in 17 eyes (43.6%) at 1 M, nine eyes (34.6%) at 3 M, and zero eyes (0%) at 6 M postoperatively.

Conclusion: The non-fovea-sparing double-staining technique was effective in treating myopic foveoschisis without MH, leading to significant improvements in both visual function and anatomical recovery. This method may be a promising surgical option for managing myopic foveoschisis.

{"title":"Surgical outcomes of non-fovea-sparing internal limiting membrane peeling using a double-staining technique for symptomatic myopic foveoschisis: a retrospective study.","authors":"Tadashi Mizuguchi, Masayuki Horiguchi, Atsuhiro Tanikawa, Yasuki Ito","doi":"10.1007/s10384-024-01158-z","DOIUrl":"10.1007/s10384-024-01158-z","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the incidence of postoperative macular hole (MH), visual acuity, and anatomical recovery in patients who underwent a non-fovea-sparing technique using a double-staining method for symptomatic myopic foveoschisis without pre-existing macular holes.</p><p><strong>Study design: </strong>A retrospective study.</p><p><strong>Methods: </strong>We evaluated 39 eyes from 39 consecutive patients diagnosed with myopic foveoschisis from May 2017 to September 2022 at Fujita Health University Hospital. All patients underwent non-fovea-sparing internal limiting membrane peeling using a double-staining method and were monitored for 6 months postoperatively. Best-corrected visual acuity (BCVA) as measured by the logarithm of the minimum angle of resolution (logMAR), central retinal thickness (CRT), and the presence of foveoschisis were assessed using optical coherence tomography (OCT) preoperatively (pre) and at 1 month (1 M), 3 months (3 M), and 6 months (6 M) postoperatively.</p><p><strong>Results: </strong>No cases of postoperative rhegmatogenous retinal detachment were observed. A postoperative MH developed in one eye. The mean logMAR values at pre, 1 M, 3 M, and 6 M were 0.38 ± 0.37, 0.23 ± 0.33, 0.18 ± 0.25, and 0.13 ± 0.29, respectively (all P < 0.001). The mean CRTs at pre, 1 M, 3 M, and 6 M were 384.6 ± 177.2, 262.2 ± 84.4, 200.3 ± 64.9, and 185.6 ± 61.0 μm, respectively (all P < 0.001). Foveoschisis was observed in all 39 eyes (100%) preoperatively and in 17 eyes (43.6%) at 1 M, nine eyes (34.6%) at 3 M, and zero eyes (0%) at 6 M postoperatively.</p><p><strong>Conclusion: </strong>The non-fovea-sparing double-staining technique was effective in treating myopic foveoschisis without MH, leading to significant improvements in both visual function and anatomical recovery. This method may be a promising surgical option for managing myopic foveoschisis.</p>","PeriodicalId":14563,"journal":{"name":"Japanese Journal of Ophthalmology","volume":" ","pages":"74-80"},"PeriodicalIF":2.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080037","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}
引用次数: 0
One-year results of trabeculectomy with emphasis on the effect of patients' age. 强调患者年龄影响的小梁切除术一年结果。
IF 2.1 3区 医学 Q2 OPHTHALMOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-14 DOI: 10.1007/s10384-024-01131-w
Yuto Iwaki, Sotaro Mori, Mina Okuda-Arai, Fumio Takano, Kaori Ueda, Mari Sakamoto, Yuko Yamada-Nakanishi, Makoto Nakamura

Purpose: This study investigated the association between one-year surgical outcomes following trabeculectomy and age, accounting for confounding factors.

Study design: Retrospective observational study.

Method: Analyzing data from 305 patients undergoing initial trabeculectomy from 2019 onward, we employed three approaches to adjust variables: stratified analysis, regression analysis, and propensity score matching. Surgical success at 1-year post-surgery was defined by two criteria: achieving intraocular pressure of between 5 and 15 mmHg with a ≥ 20% reduction compared to pre-surgery levels and no additional glaucoma surgery (Criterion A); achieving intraocular pressure of between 5 and 12 mmHg with a ≥ 30% reduction compared to pre-surgery levels and no additional glaucoma surgery (Criterion B).

Results: Stratified analysis by age unveiled a significant increase in exfoliation glaucoma (XFG) and a trend towards shorter axial lengths with advancing age (both p < 0.0001). Older age groups were more likely to experience surgical failure in both Criterion A and B (p = 0.21, < 0.01). Univariate analysis showed age as a significant factor in surgical failure for Criterion A (p < 0.05) and a nearly significant factor for Criterion B (p = 0.12). However, this trend was not evident in multivariate analysis (p = 0.23/0.88), where XFG became a significant factor for surgical failure (both p < 0.001) in Criteria A and B. Propensity score matching revealed no significant differences in surgical success rates for Criteria A and B between younger and older patients (p = 1.00 and 0.88).

Conclusion: Age is not a primary determinant of failure in trabeculectomy; however, the increasing incidence of XFG with aging suggests a potential for poorer outcomes.

目的:本研究调查了小梁切除术后一年手术结果与年龄之间的关系,并考虑了混杂因素:回顾性观察研究:我们采用了三种方法来调整变量:分层分析、回归分析和倾向得分匹配。术后1年的手术成功率由两个标准定义:眼压达到5至15 mmHg,与术前水平相比降低≥20%,且未再进行青光眼手术(标准A);眼压达到5至12 mmHg,与术前水平相比降低≥30%,且未再进行青光眼手术(标准B):结果:按年龄进行的分层分析显示,随着年龄的增长,剥脱性青光眼(XFG)显著增加,轴长呈缩短趋势(均为 p 结论:年龄不是决定青光眼发病率的主要因素:年龄并不是小梁切除术失败的主要决定因素;但是,随着年龄的增长,XFG的发生率也在增加,这表明可能会出现较差的结果。
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Japanese Journal of Ophthalmology
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