Publications by authors named "Ryo Kawasaki"

181 Publications

Retinal arteriolar calibre and venular fractal dimension predict progression of proliferative diabetic retinopathy 6 months after panretinal photocoagulation: a prospective, clinical interventional study.

BMJ Open Ophthalmol 2021 22;6(1):e000661. Epub 2021 Mar 22.

Department of Ophthalmology, Odense Universitetshospital, Odense, Denmark.

Objective: We examined the hypothesis that baseline retinal vascular geometry in patients with proliferative diabetic retinopathy (PDR) predicts disease activity 6 months after panretinal photocoagulation (PRP).

Methods And Analysis: We included 47 eyes from 40 patients with treatment-naïve PDR in a 6-month prospective study. Diagnosis of PDR and disease activity was evaluated by wide-field fluorescein angiography (Optomap, Optos, Dunfermline, Scotland, UK). At baseline and 6-month follow-up, the retinal vessel geometry was measured on optic disc centred images using semiautomated software Vessel Assessment and Measurement Platform for Images of the Retina (VAMPIRE, Dundee, Scotland).

Results: At baseline, mean age and duration of diabetes was 51.6 and 21.4 years, and 62.5% were men. Seventeen eyes (36.2%) had progression of PDR during follow-up. At baseline, we found higher retinal arteriolar calibre (31.3±0.8 vs 28.8±0.8 pixels, p=0.02) and venous fractal dimension (F) (1.257±0.011 vs 1.222±0.011, p=0.02) in eyes with progression of PDR as compared with eyes with non-progression. In a multiple logistic regression model, both higher retinal arteriolar calibre (OR 1.34, 95% CI, 1.09 to 1.64, p<0.01) and venular F (OR 1.15, 95% CI, 1.04 to 1.27, p<0.01) predicted progression of PDR. Venular calibre was seen to increase from baseline to month six regardless of disease progression (non-progression 45.0±0.7 vs 52.7±1.8 pixels, p<0.01; progression 46.2±0.8 vs 51.0±1.7 pixels, p<0.01).

Conclusion: Our prospective study showed that arteriolar calibre and venular F at baseline were predictive of disease activity 6 months after PRP treatment in patients with treatment-naïve PDR.
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http://dx.doi.org/10.1136/bmjophth-2020-000661DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7986874PMC
March 2021

Flow pattern and perforating vessels in three different phases of myopic choroidal neovascularization seen by swept-source optical coherence tomography angiography.

Graefes Arch Clin Exp Ophthalmol 2021 Mar 9. Epub 2021 Mar 9.

Department of Ophthalmology, Osaka University Medical School, 2-2 Yamadaoka, 565-0871, Suita, Osaka, Japan.

Purpose: To compare the choroidal neovascularization (CNV) flow patterns and the relationship between perforating vessels (PVs) and CNV in the three different stages of networks in myopic CNV (mCNV) using swept-source optical coherence tomography angiography (SS-OCTA).

Methods: This retrospective study included 28 eyes with mCNV that was divided into three phases (active, scar, and atrophic) and observed by SS-OCTA. SS-OCTA findings, with special focus on the relationship between the PVs and CNV, were compared among the three phases.

Results: Overall, the CNV signal was detected in 31 of the 34 areas of CNV (91%); in the active, scar, and atrophic phases, respectively, CNV signals were detected in eight of eight areas of CNV (100%), 10 of 11 areas of CNV (91%), and 13 of 15 areas of CNV (86%). Two signal patterns were observed in each phase, i.e., dense and loop; in the atrophic phase, seven eyes were unclassifiable. The ratio between the dense and loop patterns did not differ significantly among the phases. In 30 of 34 areas of CNV for which clear images were obtained, the PVs and CNV were connected directly or indirectly in 19 area of CNV, and in five areas of CNV, trunk-like vessels were connected to the PVs within the CNV. The numbers of foveal or parafoveal CNVs accompanied by PVs were significantly (p=0.0048) greater than those of the extrafoveal CNV.

Conclusions: OCTA provides detailed observation of mCNV and the relationship between CNV and PVs. Although the CNV signal pattern does not differ depending on the degree of atrophy, there are cases in which only the trunk-like vessels connect to the PVs within the CNV in the atrophic phase without CNV flow signal.
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http://dx.doi.org/10.1007/s00417-021-05134-yDOI Listing
March 2021

Sodium Intake and Incidence of Diabetes Complications in Elderly Patients with Type 2 Diabetes-Analysis of Data from the Japanese Elderly Diabetes Intervention Study (J-EDIT).

Nutrients 2021 Feb 21;13(2). Epub 2021 Feb 21.

Department of Endocrinology and Metabolism, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakaecho, Itabashi-ku, Tokyo 173-0015, Japan.

This study investigates the associations between sodium intake and diabetes complications in a nationwide cohort of elderly Japanese patients with type 2 diabetes aged 65-85. Data from 912 individuals regarding their dietary intake at baseline is analyzed and assessed by the Food Frequency Questionnaire based on food groups. Primary outcomes are times to diabetic retinopathy, overt nephropathy, cardiovascular disease (CVD), and all-cause mortality during six years. We find that mean sodium intake in quartiles ranges from 2.5 g to 5.9 g/day. After adjustment for confounders, no significant associations are observed between sodium intake quartiles and incidence of diabetes complications and mortality, except for a significant trend for an increased risk of diabetic retinopathy ( = 0.039). Among patients whose vegetable intake was less than the average of 268.7 g, hazard ratios (HRs) for diabetic retinopathy in patients in the second, third, and fourth quartiles of sodium intake compared with the first quartile were 0.87 (95% CI, 0.31-2.41), 2.61 (1.00-6.83), and 3.70 (1.37-10.02), respectively. Findings indicate that high sodium intake under conditions of low vegetable intake is associated with an elevated incidence of diabetic retinopathy in elderly patients with type 2 diabetes.
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http://dx.doi.org/10.3390/nu13020689DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7926689PMC
February 2021

Systematic review of clinical research on regenerative medicine for the cornea.

Jpn J Ophthalmol 2021 Mar 16;65(2):169-183. Epub 2021 Feb 16.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Purpose: To conduct a systematic review of clinical research on the use of regenerative medicine for the cornea in human patients.

Methods: A systematic literature search of MEDLINE and the Cochrane Library was performed in May 2020.

Results: Forty-two articles were identified. Thirty-eight of those articles focused on the treatment for limbal stem cell deficiency (LSCD), of which 17 articles involved autologous cultured limbal epithelial cell sheet transplantation (CLET), 13 involved allogeneic CLET, and 14 involved autologous cultured oral mucosal epithelial cell sheet transplantation (COMET). For autologous CLET, the median ocular surface reconstruction rate, visual recovery rate, incidence of immunologic rejection, infectious keratitis, and ocular hypertension/glaucoma were 74.1%, 54.5%, 0%, 4.6%, and 6.3%, respectively. For allogeneic CLET, they were 71.4%, 71.4%, 7.1%, 12.0%, and 7.1%, respectively. For autologous COMET, they were 66.7%, 66.7%, 0%, 5.3%, and 8.1%, respectively. Systemic immunosuppressants and steroid medications were predominantly used following allogeneic CLET, whereas they were not routinely used after autologous CLET. Three studies focused on the treatment of keratoconus using autologous adipose-derived adult stem cells and reported no marked adverse events. One study reported on the treatment of bullous keratopathy using allogeneic cultured corneal endothelial cells. All patients achieved an endothelial cell density of >500 cells, and the corrected distance visual acuity improved in 82% of the treated eyes.

Conclusions: The results show that regenerative medicine for the cornea demonstrated a satisfactory efficacy and safety. Through translational research, we are expecting to establish a new treatment for waiting patients.
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http://dx.doi.org/10.1007/s10384-021-00821-zDOI Listing
March 2021

Efficacy and safety of 5-fluorouracil in infrared monitor guided bleb revision.

BMC Ophthalmol 2021 Feb 8;21(1):75. Epub 2021 Feb 8.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Room E7, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Purpose: Infrared monitor-guided bleb revision (IRGBR), an alternative needling system, visualizes anterior-segment tissues around the bleb not visible during needle revision after trabeculectomy. This study determined the safety and efficiency of 5-fluorouracil (5-FU) as an adjunctive anti-metabolite in IRGBR.

Methods: We retrospectively analyzed 43 consecutive eyes (40 patients; 14 eyes, primary open-angle; 29 eyes, secondary glaucoma) treated with IRGBR for failing filtering blebs. The patients were divided into two groups. The first one had IRGBR without adjunctive 5-FU subconjunctival injection, and the second one had IRGBR with 5-FU. We performed Kaplan-Meier survival analysis using log-rank tests after 2 years of follow-up and Cox proportional hazards regression model to analyze the dependence of the survival time on predictor variables. Two failure criteria were defined as the need for additional surgery for intraocular pressure (IOP) reduction and the IOP at two consecutive follow-up visits based on definition 1, IOP ≧22 mmHg and definition 2, IOP ≧17 mmHg.

Results: Thirty eyes (29 cases) underwent IRGBR with subconjunctival 5-FU injection (group A in the second term) and 13 eyes (11 cases) without 5-FU (group B in the first term). The success rates 24 months after IRGBR were 73.3 and 23.1%, respectively, in groups A and B based on the definition 1 failure and 56.7 and 7.7% based on the definition 2 failure. Complications included transient bleb leaks (group A, 3 eyes; group B, none) and choroidal detachment (group A, 1 eye; group B, none). No use of 5-FU and IOPs ≧10 mmHg 1 week after IRGBR were significant risk factors.

Conclusions: Adjunctive 5-FU in IRGBR achieved a better success rate for failing trabeculectomy blebs.
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http://dx.doi.org/10.1186/s12886-021-01843-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869480PMC
February 2021

Treatment patterns for retinal diseases in patients newly-treated with anti-VEGF agents: A retrospective analysis of claims data from the Japan Medical Data Center database.

Jpn J Ophthalmol 2021 Mar 9;65(2):215-226. Epub 2021 Jan 9.

Department of Visual Sciences, Nagoya City University, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.

Purpose: To describe treatment patterns in patients diagnosed with neovascular age-related macular degeneration (nAMD), retinal vein occlusion (RVO), or diabetic macular edema (DME), newly-treated with anti-vascular endothelial growth factor (anti-VEGF) agents as recorded in the Japanese Medical Data Center (JMDC) database.

Study Design: This non-interventional, descriptive, retrospective, observational cohort study included insured Japanese patients aged ≥ 21 and ≤ 75 years at index date (anti-VEGF treatment initiation).

Methods: Patients with minimum one claim in JMDC database with a diagnosis code for nAMD, RVO, or DME between October 2007-May 2015 and with minimum of one claim for anti-VEGF agents on or after the date of diagnosis were included. Frequency and proportion of claims submitted for anti-VEGF injections were assessed during 12 months post-index date.

Results: The median (interquartile range) number of claims for anti-VEGF injections during 12 months post-index date were 3 (1, 4) for nAMD (n = 255), 2 (1, 3) for RVO (n = 223) and 2 (1, 4) for DME (n = 125) patients. Frequencies of nAMD, RVO and DME patients with one or more claims for a retinal disease treatment other than an anti-VEGF agent were 4 (1.57%), 59 (26.46%) and 68 (54.40%) during the 12 months pre-index date and 21 (8.24%), 85 (38.12%) and 62 (49.60%) in the 12 months post-index date, respectively.

Conclusions: The median number of anti-VEGF injections per patient was lower than those reported in clinical trials. Although various pre- and concomitant treatments were used in RVO and DME, anti-VEGF monotherapy was the first-line treatment in > 90% of nAMD patients.
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http://dx.doi.org/10.1007/s10384-020-00802-8DOI Listing
March 2021

Detection of Glaucoma and Other Vision-Threatening Ocular Diseases in the Population Recruited at Specific Health Checkups in Japan.

Clin Epidemiol 2020 17;12:1381-1388. Epub 2020 Dec 17.

Japan Ophthalmologist Association, Tokyo, Japan.

Background: The efficacy of vision screening for adults has not been well established. The present study aimed to investigate the prevalence of vision-threatening ocular diseases, including glaucoma, among subjects who participated in specific health checkups in Japan.

Methods: This cross-sectional study included 1360 individuals who underwent comprehensive ophthalmic examinations at 16 ophthalmology clinics located in three municipalities. We surveyed the study participants using a questionnaire. The participants also underwent visual acuity and refraction tests, intraocular pressure tests, slit-lamp microscopy, fundus examinations, fundus photography, optical coherence tomography, and static perimetry.

Results: The mean age of the subjects was 63.7 ± 8.7 years (range, 40-74 years). Among the 1360 participants, 168 (12.4%) were diagnosed with glaucoma and 33 (2.4%) with preperimetric glaucoma. Cataracts were seen in 741 participants (54.5%), and 77 (5.7%) were diagnosed with clinically significant cataracts. Retinal diseases included macular degeneration (1.2%), diabetic retinopathy (1.0%), chorioretinal atrophy (0.5%), macular epiretinal membrane (2.9%), branch retinal vein occlusion (0.7%), and others (2.0%). Regarding the type of glaucoma, 93.5% of participants with glaucoma were diagnosed with open-angle glaucoma in a broad sense (81.0% with normal-tension glaucoma and 12.5% with primary open-angle glaucoma). Multivariate analysis showed that male sex, age, systemic comorbidities, and myopia were significant risk factors for open-angle glaucoma.

Conclusion: Many adults with ocular diseases were screened by ophthalmic checkups. The addition of simultaneous ophthalmic checkups to specific health checkups could be an effective measure for the prevention of visual impairment in the older population.
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http://dx.doi.org/10.2147/CLEP.S273016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7751581PMC
December 2020

Retinal vascular oxygen saturation in response to a less extensive laser treatment in proliferative diabetic retinopathy.

Acta Ophthalmol 2020 Dec 23. Epub 2020 Dec 23.

Department of Ophthalmology, Odense University Hospital, Odense, Denmark.

Purpose: The purpose of this study was to evaluate the association between retinal laser burden and vascular oxygen saturation in patients with proliferative diabetic retinopathy (PDR) treated with different extent of retinal laser.

Methods: The study was a prospective, interventional study of patients with treatment-naïve PDR. Patients were treated with navigated retinal laser (Navilas , OD-OS GmbH, Teltow, Germany) in different doses. Retinal oximetry was obtained at baseline (BL) prior to laser and after 6 months (M6). Patients were divided into three groups according to total laser spots applied: <1500 spots (Group 1), 1500-2000 spots (Group 2), and >2000 spots (Group 3).

Results: We included 33 eyes of 28 patients with treatment-naïve PDR. The groups did not differ according in BL characteristics. Between BL and M6, retinal arteriolar oxygen saturation did not change but retinal venular oxygen saturation (median with interquartile range) decreased in Groups 1 and 2 (1: 65.5 ± 8.8% versus 60.5 ± 9.5%, p = 0.04; 2: 65.3 ± 7.3% versus 63.0 ± 13.5%, p = 0.04). Focal retinal venular oxygen saturation, located to quadrants with retinal neovascularization, decreased in Group 2 from BL to M6 (67.5 ± 13.3% versus 61.5 ± 8.8%, p = 0.04). Retinal venular diameter decreased from BL to M6 in Group 1 (174.5 ± 15.3 μm versus 165.1 ± 28.7 μm, p = 0.01).

Conclusions: In this study of patients with treatment-naïve PDR, we showed that a less extensive laser treatment caused a reduction in retinal venular oxygen saturation and diameter 6 months after treatment. Our results suggest that less extensive laser treatment may be sufficient to improve the retinal metabolic environment conducive to PDR regression.
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http://dx.doi.org/10.1111/aos.14727DOI Listing
December 2020

Optical coherence tomography angiography measured area of retinal neovascularization is predictive of treatment response and progression of disease in patients with proliferative diabetic retinopathy.

Int J Retina Vitreous 2020 Nov 4;6(1):49. Epub 2020 Nov 4.

Department of Ophthalmology, Odense University Hospital, Kloevervaenget 5, indgang 132, 5000, Odense C, Denmark.

Background: The purpose of this study was to evaluate the area of retinal neovascularization in patients with treatment-naïve proliferative diabetic retinopathy (PDR) as measured by optical coherence tomography angiography (OCT-A) as a marker of subsequent treatment response after panretinal photocoagulation (PRP), and to examine if this area correlated with area of retinal neovascularization as measured by fluorescein angiography (FA).

Methods: En face OCT-A scans (4.5 × 4.5 mm) of neovascularizations were obtained at baseline (BL) before PRP and at month (M) 3 and M6 after treatment. Progression of PDR were defined as lesion growth (assessed by ophthalmoscopy and wide-field fundus photo) or increasing leakage by Optos ultra-widefield FA, and patients were divided into two groups; progression or non-progression. Mann-Whitney U test and Wilcoxon signed-rank test were used to analyse differences between groups and between time points. Areas of retinal neovascularizations (OCT-A and FA) were calculated by algorithms developed in Python (version 3.6.8, The Python Software Foundation, USA).

Results: Of 21 eyes included, 14 had progression of disease. Median OCT-A area did not differ between the two groups (progression vs. non-progression) at BL (76.40 ± 162.03 vs. 72.62 ± 94.15, p = 0.43) but were statistically significantly larger in the progression group at M6 (276.69 ± 168.78 vs. 61.30 ± 70.90, p = 0.025). Median FA area did not differ in the progression vs. the non-progression group at BL (111.42 ± 143.08 vs. 60.80 ± 54.83, p = 0.05) or at M6 (200.12 ± 91.81 vs. 123.86 ± 162.16, p = 0.62). Intraclass correlation between area by OCT-A and FA was -5.99 (95% CI: -35.28-0.993), p = 0.71.

Conclusions: In this study of patients with treatment-naïve PDR, we showed that increasing area of retinal neovascularizations measured by OCT-A at M6 indicated progression of disease after PRP treatment. Our results suggest that area by OCT-A reflects disease activity and that it can be used as an indicator to monitor the progression of PDR over time, and to evaluate treatment response six months after PRP. Trial registration https://clinicaltrials.gov (identifier: NCT03113006). Registered April 13, 2017.
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http://dx.doi.org/10.1186/s40942-020-00249-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7640645PMC
November 2020

New severity grading system for Fuchs endothelial corneal dystrophy using anterior segment optical coherence tomography.

Acta Ophthalmol 2020 Nov 30. Epub 2020 Nov 30.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Purpose: To report a new severity grading system for Fuchs endothelial corneal dystrophy (FECD) using anterior segment optical coherence tomography (AS-OCT).

Methods: This observational case series included 75 eyes of 43 patients with FECD and 33 eyes of 33 healthy subjects. Pachymetry and posterior elevation maps were used to determine the AS-OCT-based grading scores. FECD severity was graded from 0-3 as follows: 0, normal; 1, guttae only; 2, stromal oedema; and 3, epithelial and stromal oedema. We further investigated the central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior and posterior best-fit spheres (BFS), and the distance between the central cornea and the thinnest point.

Results: Thirty-three eyes were graded as 0, four as 1, thirteen as 2, fourteen as 3, twenty-nine as 4, eleven as 5 and four as 6 by the modified Krachmer grade. Thirty-three, 41, 30 and 4 eyes were graded as 0, 1, 2 and 3, respectively, by the AS-OCT-based grading system. The inter-observer agreement was 100% for the AS-OCT-based grading system. The CCT, TCT, posterior BFS, and distance between the central cornea and thinnest point were significantly different between AS-OCT-based grades (p = 0.0001, 0.0001, 0.0036 and 0.0001, respectively). Anterior BFS was not significantly different with the AS-OCT-based grades (p = 0.1184).

Conclusion: We devised a new severity grading using only objective evaluation and quantitatively demonstrated corneal thickening, predominant flattening of the posterior corneal surface compared with the anterior surface, and displacement of the thinnest point away from the central cornea with FECD progression.
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http://dx.doi.org/10.1111/aos.14690DOI Listing
November 2020

Association between the retinal vascular network and retinal nerve fiber layer in the elderly: The Montrachet study.

PLoS One 2020 21;15(10):e0241055. Epub 2020 Oct 21.

Department of Ophthalmology, University Hospital, Dijon, France.

Purpose: To investigate the association between the characteristics of the retinal vascular network in the elderly and retinal nerve fiber layer (RNFL) thickness in a population-based study.

Methods: We conducted a population-based study, the Montrachet study (Maculopathy Optic Nerve, nuTRition neurovAsCular, and HEarT disease), in participants aged ≥ 75 years. RNFL thickness was assessed with spectral-domain optical coherence tomography (SD-OCT). Analysis of the retinal vascular network was performed by means of the Singapore "I" Vessel Assessment (SIVA) software based on fundus photography.

Results: Data from 970 participants were suitable for analysis. Patients with optic neuropathy were excluded. In multivariable analysis, each standard deviation (SD) decrease in the caliber of the six largest arterioles and veins in zone B and the six largest arterioles and veins in zone C was associated with a decrease in global RNFL thickness (β = -1.62 μm, P = 0.001; β = -2.39 μm, P < 0.001; β = -1.56 μm, P = 0.002; and β = -2.64 μm, P < 0.001, respectively).

Conclusions: Our study found that decreased retinal vessels caliber were associated with a decreased RNFL thickness in the elderly without optic neuropathy.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0241055PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7577490PMC
December 2020

Six-months primary success rate for retinal detachment between vitrectomy and scleral buckling.

Retina 2020 Oct 14. Epub 2020 Oct 14.

Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Purpose: To compare clinical outcomes between pars plana vitrectomy (PPV), scleral buckling (SB) and PPV+SB for Rhegmatogenous Retinal Detachment (RRD) in the Japan-RD Registry.

Methods: This is a nation-wide, multi-center, observational study based on the registry data between 2016 and 2017. The failure levels were defined as level 1 (a failure of RD repair), level 2 (remaining silicone oil), and level 3 (multiple surgeries to achieve reattachment). We compared cases treated by SB or PPV in the subgroup of simple RRD using multivariate Cox proportional hazard models.

Results: A total of 2,775 cases were included. Overall, 6-months any levels of failure in total, SB, PPV, and PPV+SB were 9.2% (n=256), 6.9% (n=48), 8.2% (n=157), and 21.3% (n=51), respectively. Poor visual acuity at baseline in SB and Inferior RRD and larger retinal tear in PPV were associated with higher risk of failure. PPV was associated with higher chance of achieving primary success in cases with simple RDD especially for cases with superior RDD (adjusted hazard ratio 3.61, 95%CI 2.22 to 5.94, P<0.001).

Conclusions: In this nationwide study, surgical anatomic outcomes were equally successful in either SB or PPV. There were different baseline characteristics associated with primary success between SB and PPV.
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http://dx.doi.org/10.1097/IAE.0000000000002994DOI Listing
October 2020

Fourier Analysis on Regular and Irregular Astigmatism of Anterior and Posterior Corneal Surfaces in Fuchs Endothelial Corneal Dystrophy.

Am J Ophthalmol 2021 03 8;223:33-41. Epub 2020 Oct 8.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.

Purpose: To conduct Fourier analysis on regular and irregular astigmatism of the anterior and posterior corneal surfaces using anterior segment optical coherence tomography in patients with Fuchs endothelial corneal dystrophy (FECD) DESIGN: Observational case series.

Methods: This study included 75 eyes of 43 FECD patients and 34 eyes of 34 healthy subjects in Osaka University Hospital. Corneal dioptric data from the central 6-mm zone of the anterior and posterior corneal surface were expanded into spherical, regular astigmatism, asymmetry, and higher-order irregularity components using Fourier analysis. We analyzed the association between each component and modified Krachmer grade.

Results: There were significant differences in regular astigmatism, asymmetry, and higher-order irregularity components of the anterior corneal surface, and spherical, regular astigmatism, asymmetry, and higher-order irregularity components of the posterior corneal surface among modified Krachmer grades (P = .036, <.001, <.001, <.001, <.001, <.001, and <.001, respectively). Asymmetry component of the anterior and posterior corneal surfaces gradually increased with FECD progression. Higher-order irregularity components of the anterior and posterior corneal surfaces drastically increased in Grade 6. Many eyes had an axis of 0°-180° for the asymmetry component of the anterior surface and 180°-360° for that of the posterior surface.

Conclusion: Patients with severe FECD had a larger amount of asymmetry and higher-order irregularity components of the anterior and posterior corneal surfaces. Patients with FECD up to Grade 5 were characterized by anterior and posterior flattening in the inferior cornea, and those with Grade 6 showed irregularity in the anterior and posterior corneal surfaces.
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http://dx.doi.org/10.1016/j.ajo.2020.09.045DOI Listing
March 2021

Incorporating Optical Coherence Tomography Macula Scans Enhances Cost-effectiveness of Fundus Photography-Based Screening for Diabetic Macular Edema.

Diabetes Care 2020 12 1;43(12):2959-2966. Epub 2020 Oct 1.

Royal Free Hospital, London, U.K.

Objective: To compare four screening strategies for diabetic macular edema (DME).

Research Design And Methods: Patients attending diabetic retinopathy screening were recruited and received macular optical coherence tomography (OCT), in addition to visual acuity (VA) and fundus photography (FP) assessments, as part of the standard protocol. Two retina specialists provided the reference grading by independently assessing each subject's screened data for DME. The current standard protocol (strategy A) was compared for sensitivity, specificity, quality-adjusted life-year (QALY) gained, and incremental cost-effectiveness ratio (ICER) with three alternative candidate protocols using a simulation model with the same subjects. In strategy B, macular hemorrhage or microaneurysm on FP were removed as surrogate markers for possible DME. Strategy C used best-corrected instead of habitual/pinhole VA and added central subfield thickness (CST) >290 μm on OCT in suspected cases as a confirmation marker for possible DME. Strategy D used CST >290 μm OCT in all subjects as a surrogate marker for suspected DME.

Results: We recruited 2,277 subjects (mean age 62.80 ± 11.75 years, 43.7% male). The sensitivities and specificities were 40.95% and 86.60%, 22.86% and 95.63%, 32.38% and 100%, and 74.47% and 98.34% for strategies A, B, C, and D, respectively. The costs (in U.S. dollars) of each QALY gained for strategies A, B, C, and D were $7,447.50, $8,428.70, $5,992.30, and $4,113.50, respectively.

Conclusions: The high false-positive rate of the current protocol generates unnecessary referrals, which are inconvenient for patients and costly for society. Incorporating universal OCT for screening DME can reduce false-positive results by eightfold, while improving sensitivity and long-term cost-effectiveness.
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http://dx.doi.org/10.2337/dc17-2612DOI Listing
December 2020

Cohort Profile: The Network (GEN), a Network of Japanese Ophthalmological Epidemiology Studies.

Ophthalmic Epidemiol 2021 Jun 13;28(3):237-243. Epub 2020 Sep 13.

Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan.

Purpose: Japan has been known as a super-aged society, and ageing is a well-known risk factor for blinding eye diseases. However, epidemiological studies in ophthalmology are still scarce in Japan, and the sizes of the cohorts are relatively small. "Ganka-Ekigaku Network" (GEN, an acronym for the epidemiological network in ophthalmology in Japanese) is established to develop a capacity to boost each epidemiological study and enrich a potential inter-study collaboration to identify risk factors of visual impairment in aged society.

Methods: We reviewed cohort studies in Japan with the inclusion criteria as: (1) at least n = 1000 at baseline, (2) multiple modalities of ophthalmic data, and (3) diagnosis reviewed by ophthalmologist(s), and (4) ophthalmologists are involved in the investigators group. As of January 2020, GEN includes 4 individual Japanese epidemiological studies namely, Hisayama study, Yamagata Study (Funagata), Tsuruoka Metabolomics Cohort study, and the Nagahama Prospective Genome Cohort for Comprehensive Human Bioscience.

Results: GEN includes approximately 25,000 Japanese participants. The baseline surveys started from 1998 to 2012, and since then the data has been prospectively collected approximately every 5 years. A variety of ophthalmic measurements and other factors have been collected in each study in GEN: ophthalmic measurements (fundus photography, optical coherence tomography, etc.), systemic conditions (laboratory data, etc.), and others (DNA, etc.).

Conclusion: GEN is an open platform for observational ophthalmic epidemiological studies to share standardized methodologies. While each study in GEN pursues specific and original research questions, standardization of the methods will enable us to conduct reliable meta-analysis/pooled data analyses.
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http://dx.doi.org/10.1080/09286586.2020.1815803DOI Listing
June 2021

Quantitative Analysis of the Association Between Follow-Up Duration and Severity of Limbal Stem Cell Deficiency or Visual Acuity in Aniridia.

Invest Ophthalmol Vis Sci 2020 06;61(6):57

,.

Purpose: This study aimed to quantitatively analyze the association between follow-up duration and the severity of limbal stem cell deficiency (LSCD) or visual acuity in patients with aniridia.

Methods: A total of 52 eyes of 27 patients with aniridia were enrolled at Osaka University Hospital. Medical records were retrospectively reviewed to obtain information on the severity of LSCD and corrected distance visual acuity (CDVA). LSCD severity was based on a modified severity grading scale. We used an ordered logistic regression model to examine the association between follow-up duration and LSCD severity, and a linear regression model with a generalized linear mixed model for the association between follow-up duration and visual acuity.

Results: The mean follow-up duration was 5.2 ± 6.3 years. The mean age at the last follow-up visit was 40.5 ± 18.9 years. The mean CDVA was 1.52 ± 1.09 logMAR. At the last follow-up, 1 examined eye (1.9%) was categorized as stage 0, 7 (13.5%) as Ia, 9 (17.3%) as Ib, 5 (9.6%) as Ic, 2 (3.8%) as IIb, 12 (23.1%) as IIc, and 11 (21.2%) as III. Five eyes (9.6%) were unclassifiable. There was a significant association between follow-up duration and LSCD severity (odds ratio per +1 year, 1.41; P < 0.001). CDVA significantly decreased as follow-up duration increased. Each increase of 1 year in the follow-up duration was associated with a mean difference of +0.021 logMAR (95% confidence interval [CI] 0.01-0.03; P < 0.001).

Conclusion: We quantitatively demonstrate that LSCD severity and visual impairment significantly progress as follow-up duration increases.
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http://dx.doi.org/10.1167/iovs.61.6.57DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7415892PMC
June 2020

Effect of peripapillary tilt direction and magnitude on central visual field defects in primary open-angle glaucoma with high myopia.

Jpn J Ophthalmol 2020 Jul 22;64(4):414-422. Epub 2020 Jun 22.

Department of Ophthalmology E7, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan.

Purpose: To evaluate the relationship between peripapillary tilt and visual field (VF) defects in glaucomatous eyes with axial myopia.

Study Design: Retrospective cross-sectional study.

Patients And Methods: One hundred four eyes of 104 patients with primary open-angle glaucoma (POAG) with myopia were included (52 eyes with high myopia [HM], 26.5 mm ≤ axial length [AL] < 30.0 mm; and 52 eyes without HM, 24.0 mm < AL < 26.5 mm). The direction and magnitude of the peripapillary tilt were evaluated using optical coherence tomography. The eyes were divided into 12 groups according to the tilt directions defined by clock-hour sectors in a clockwise direction in the right eyes and in a counterclockwise direction in the left eyes. The mean deviation (MD) and central VF (CVF) values, ie, the mean threshold values of 4 paracentral points within 5 degrees of the Swedish Interactive Threshold Algorithm 30-2 test, were evaluated.

Results: The direction of the tilt was toward sector 9 (47.1%) and sector 8 (34.6%). The MD and CVF values were significantly worse (P = 0.013 and P = 0.019, respectively) in the sector 9 group than in the sector 8 group. Furthermore, the smaller peripapillary tilt magnitude in the sector 9 group was negatively correlated (P = 0.0019) with the CVF but not with the MD (P = 0.1) among the POAG eyes with HM. In contrast, the ovality index in the sector 9 group was not significantly correlated with the MD (P = 0.4) or the CVF (P = 0.36).

Conclusion: A smaller temporal peripapillary tilt correlated with CVF defects in POAG eyes with HM. The peripapillary tilt direction and magnitude affect the CVF defect in POAG eyes with HM.
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http://dx.doi.org/10.1007/s10384-020-00747-yDOI Listing
July 2020

Preoperative factors to select vitrectomy or scleral buckling for retinal detachment in microincision vitrectomy era.

Graefes Arch Clin Exp Ophthalmol 2020 Sep 19;258(9):1871-1880. Epub 2020 May 19.

Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.

Background: To determine the preoperative factors associated with selecting scleral buckling (SB) or pars plana vitrectomy (PPV) to treat rhegmatogenous retinal detachments (RRDs) in the era of microincision vitrectomy surgery.

Methods: A nationwide, multicenter, observational study in the Japan Retinal Detachment Registry was done. From February 2016 to March 2017, 3446 cases were registered, and 3219 among them were analyzed. The factors related to the patient or surgeon were selected; the surgeon's factor included years of experience, number of cases registered, and current activity. The odds ratio (OR) for factors associated with SB or PPV was estimated by a mixed logistic regression model.

Results: SB was selected in 24.2% (779/3219), PPV was in 71.5% (2238/3219), and PPV+SB was in 6.3% (202/3219). Multivariate analysis showed that age [< 70 years old, OR 4.27, 95% confidence interval (CI) 2.34-7.79, P < 0.001], visual acuity [1.0+ (OR 7.41, 95% CI 3.47-15.82, P < 0.001)], pseudo-phakia (OR 4.83, 95%CI 2.11-10.56, P < 0.001), retinal tear (OR 6.92, 95% CI 4.83-9.92, P < 0.001), breaks at/near the vitreous base (OR 8.07, 95% CI 3.50-18.62, P < 0.001), 90+° retinal tear (OR 108.24, 95% CI 7.44-1574.34, P < 0.001), and number of breaks 4+ (OR 3.15, 95% CI 1.95-5.09, P < 0.001), were significantly associated with selecting PPV over SB. The surgeons' activity defined as the number of cases experienced during the registry period was related to the selection of PPV (OR 3.83, 95% CI 2.11-6.93, P < 0.001).

Conclusions: The choice of PPV for the RRD was associated not only with patients' preoperative factors but also the surgeon's activity. Active surgeons selected PPV more than SB.
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http://dx.doi.org/10.1007/s00417-020-04744-2DOI Listing
September 2020

Prevalence and Pattern of Geographic Atrophy in Asia: The Asian Eye Epidemiology Consortium.

Ophthalmology 2020 10 25;127(10):1371-1381. Epub 2020 Apr 25.

Singapore Eye Research Institute, Singapore National Eye Centre, Singapore; Ganka Ekigaku Network, Osaka, Japan; Department of Ophthalmology, Asahikawa Medical University, Hokkaido, Japan. Electronic address:

Purpose: Although there have been many population-based studies of age-related macular degeneration (AMD), only limited information is available in Asia on the epidemiology of geographic atrophy (GA). We aimed to determine the prevalence and patterns of GA through an analysis of multiple studies conducted within the Asian Eye Epidemiology Consortium (AEEC).

Design: Cross-sectional meta-analyses.

Participants: A total of 97 213 individuals aged 40 years and older.

Methods: Data from 22 population-based studies from countries belonging to the AEEC were included. In all studies, AMD was defined on the basis of standardized grading systems. Geographic atrophy was defined as an area of pallor in the fundus with visibility of the underlying choroidal blood vessels and sharply defined borders. Random-effects meta-analysis was performed to estimate overall and age-, gender-, and region-specific pooled prevalence of GA.

Main Outcome Measures: Prevalence of GA per 1000 persons.

Results: The mean age was 60.8 ± 10.0 years, and 42 673 (43.9%) were male. Overall, a total of 223 individuals (0.2%) had GA. The pooled overall prevalence of GA was 1.57 per 1000 persons (95% confidence interval [CI], 1.04-2.10), which was 3 times less than that of neovascular AMD of 5.20 per 1000 persons (95% CI, 3.97-6.43). Compared with those aged 50 to 59 years, the prevalence of GA increased from 0.34 per 1000 persons (95% CI, 0.07-0.62) to 2.90 per 1000 persons (95% CI, 1.55-4.25) in those aged ≥70 years. The GA prevalence per 1000 persons was similar between urban (2.22; 95% CI, 1.22-3.23) and rural residents (1.33; 95% CI, 0.70-1.96). Geographic atrophy was more prevalent in South Asia (based on studies from India and Nepal, 3.82 per 1000 persons; 95% CI, 1.72-5.93) compared with East Asia (based on studies from China, Korea, Hong Kong, Taiwan, and Japan, and the Singapore Chinese Eye Study, 0.76 per 1000 persons; 95% CI, 0.31-1.22, P = 0.005).

Conclusions: Geographic atrophy is uncommon in Asian populations compared with those of European ancestry. Even within Asia, geographic differences in GA prevalence were seen. The findings of this meta-analysis suggest that better dissection of risk factors in the Asian population for GA may provide insights into the biological pathways that drive these late-stage manifestations, thus suggesting better targets for prevention.
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http://dx.doi.org/10.1016/j.ophtha.2020.04.019DOI Listing
October 2020

Efficacy and Side Effects of Individualized Panretinal Photocoagulation.

Ophthalmol Retina 2020 06 14;4(6):642-644. Epub 2020 Feb 14.

Department of Ophthalmology, Odense University Hospital, Odense, Denmark; Research Unit of Ophthalmology, Department of Clinical Research, Faculty of Health Science, University of Southern Denmark, Denmark; Steno Diabetes Center Odense, Odense University Hospital, Odense, Denmark.

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http://dx.doi.org/10.1016/j.oret.2020.02.006DOI Listing
June 2020

Association between serum uric acid levels and mortality: a nationwide community-based cohort study.

Sci Rep 2020 04 8;10(1):6066. Epub 2020 Apr 8.

Steering Committee of Research on Design of the Comprehensive Health Care System for Chronic Kidney Disease (CKD) Based on the Individual Risk Assessment by Specific Health Checkup, Fukushima, Japan.

Hyperuricemia is associated with all-cause and cardiovascular mortality. However, the threshold value of serum uric acid levels for increased risk of mortality has not been determined. This large-scale cohort study used a nationwide database of 500,511 Japanese subjects (40-74 years) who participated in the annual health checkup and were followed up for 7 years. The association of serum uric acid levels at baseline with cardiovascular and all-cause mortality was examined. The Cox proportional hazard model analysis with adjustment for possible confounders revealed that the all-cause and cardiovascular mortality showed a J-shaped association with serum uric acid levels at baseline in both men and women. A significant increase in the hazard ratio for all-cause mortality was noted with serum uric acid levels ≥ 7 mg/dL in men and ≥ 5 mg/dL in women. A similar trend was observed for cardiovascular mortality. This study disclosed that even a slight increase in serum uric acid levels was an independent risk factor for all-cause and cardiovascular mortality in both men and women in a community-based population. Moreover, the threshold values of uric acid for mortality might be different for men and women.
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http://dx.doi.org/10.1038/s41598-020-63134-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7142123PMC
April 2020

Effects of Lutein Supplementation in Japanese Patients with Unilateral Age-Related Macular Degeneration: The Sakai Lutein Study.

Sci Rep 2020 04 6;10(1):5958. Epub 2020 Apr 6.

Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan.

This prospective randomized double-masked study investigated the effects of 20 mg lutein supplementation with two different capsules (beeswax or glycerol fatty acid esters) for 6 months on the fellow eyes of 39 Japanese patients with unilateral age-related macular degeneration, and assessed the factors associated with baseline plasma lutein concentration via lifestyle interviews. Macular pigment optical density (MPOD), determined with the two-wavelength autofluorescence method, increased over time in the beeswax group (ANOVA, p = 0.0451), although the increase from 3 months to 6 months was only marginally significant. No significant increase was observed in the glycerol fatty acid esters group (ANOVA, p = 0.7396). Plasma lutein concentrations significantly increased at 3 and 6 months from baseline in both groups (both p < 0.01). In a multiple regression model, age was negatively associated with higher plasma lutein concentration (p = 0.0305), while consumption of green vegetables was positively associated with baseline plasma lutein concentration (p = 0.0322). In conclusion, a significant increase in MPOD was not fully confirmed with 6 months intake duration despite a significant increase in plasma lutein concentrations. Consumption of green vegetable was confirmed to be associated with plasma lutein concentration after adjusting for other potential factors including age.
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http://dx.doi.org/10.1038/s41598-020-62483-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7136219PMC
April 2020

Visual outcomes after surgery for primary rhegmatogenous retinal detachment in era of microincision vitrectomy: Japan-Retinal Detachment Registry Report IV.

Br J Ophthalmol 2021 02 3;105(2):227-232. Epub 2020 Apr 3.

Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan

Background/aim: To determine the preoperative ocular factors and surgical methods that led to best-corrected visual acuity (BCVA) after pars plana vitrectomy (PPV) or scleral buckling (SB) for rhegmatogenous retinal detachment (RRD).

Methods: This was a prospective, nationwide, multicentre, observational study. Data from the Japanese Retina and Vitreous Society registry from 2016 to 2017 were used to determine the association between preoperative clinical factors, surgical procedures and postoperative BCVA at 6 months. Japanese individuals >40 years of age were included. Eyes with proliferative vitreoretinopathy were included. The primary outcome was the percentage of eyes that achieved 20/25 vision.

Results: Of the 3219 registered cases, 2192 met the inclusion criteria (344 SB, 1738 PPV, 110 PPV+SB). Cases with preoperative BCVA (≤0 logarithm of the minimum angle of resolution (logMAR) units) had good postoperative BCVA (OR=3.97, CI 2.87 to 5.51). Older age (>70 years), low intraocular pressure (<10 mm Hg), high myopia (<-5 dioptres), multiple retinal breaks (>4), giant retinal tear (>90°), wide retinal detachment (>3 quadrants) and macula-off detachment were associated with less probability of postoperative 20/25 vision (OR=0.39, 0.64, 0.62, 0.60, 0.12, 0.51 and 0.36, respectively). Postoperative BCVA was 0.03±0.23 and 0.10±0.32 logMAR units after SB and PPV, respectively. The percentage of cases that achieved 20/25 vision was not significantly different after PPV or SB if cases that had concurrent cataract surgery were excluded (p=0.251).

Conclusions: Better BCVA in patients with RRD who had undergone PPV was observed. However, if concurrent cataract surgery is not performed, BCVA will be comparable with either PPV or SB.
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http://dx.doi.org/10.1136/bjophthalmol-2020-315945DOI Listing
February 2021

Dietary Saturated Fatty Acid Intake and Early Age-Related Macular Degeneration in a Japanese Population.

Invest Ophthalmol Vis Sci 2020 03;61(3):23

,.

Purpose: To assess the association of dietary saturated fatty acid (SFA) intake with the presence of early AMD in a Japanese population.

Methods: The population-based Tsuruoka Metabolomics Cohort Study enrolled general population individuals aged 35 to 74 years from among participants in annual health check-up programs that included fundus photographs in Tsuruoka, Japan. A total of 4010 individuals participated in the baseline survey. After excluding nonresponders to a dietary survey and participants with suboptimal fundus image quality, 3988 participants (median age, 62.4 years) were included in this cross-sectional analysis. Dietary intake was assessed by a validated food frequency questionnaire. Fatty acids intake was adjusted for total energy intake by the residuals method. The association between fatty acid intake and presence of early AMD was assessed by logistic regression models.

Results: Median daily SFA intake was 11.3 g (interquartile range, 9.6, 13.0 g). After adjustments for potential confounding factors, participants in the highest quartile of SFA intake were less likely to have early AMD, compared with the lowest quartile (odds ratio, 0.71; 95% confidence interval: 0.52-0.96). A significant trend for decreased risk of early AMD with increasing SFA intake was noted (P = 0.011). There was no significant association between poly-unsaturated fatty acid (PUFA) including n3-PUFA intake and early AMD.

Conclusions: We found that increased SFA intake was associated with reduced risk of early AMD in a Japanese population with low SFA intake. Adequate fatty acid intake may be required to maintain retinal homeostasis and prevent AMD.
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http://dx.doi.org/10.1167/iovs.61.3.23DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7401844PMC
March 2020

Interocular symmetry of the foveal avascular zone area in healthy eyes: a swept-source optical coherence tomography angiography study.

Jpn J Ophthalmol 2020 Mar 3;64(2):171-179. Epub 2020 Feb 3.

Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-2 Shikata-cho Kita-ku, Okayama, 700-8558, Japan.

Purpose: To determine the presence or absence of interocular differences in the foveal avascular zone (FAZ) area in healthy eyes.

Study Design: Cross-sectional study.

Methods: We examined 236 healthy eyes of 118 consecutive subjects (mean age, 39.1 ± 18.9 years). We used swept-source optical coherence tomography angiography (OCTA) images of the FAZ to measure its area from both the superficial capillary plexus (SCP-FAZ) and the whole retinal capillary plexus (WCP-FAZ). We also investigated the relationship between interocular differences in SCP-FAZ and other factors such as: axial length, spherical equivalent, central retinal thickness, and retinal vascular density.

Results: There was no significant difference in the FAZ area between the right and left eyes in either the SCP-FAZ (P = 0.61) or WCP-FAZ (P = 0.80), and the FAZ areas of both eyes showed significant positive correlations (SCP-FAZ; P < 0.001, R = 0.884, WCP-FAZ; P < 0.001, R = 0.856). Bland-Altman plots showed that the mean interocular difference in SCP-FAZ area was 0.002 ± 0.037 mm (95% confidence interval, -0.072-0.075 mm), and in the WCP-FAZ area, 0.050 ± 0.044 mm (95% confidence interval, -0.036-0.137 mm). Multivariate regression analysis showed that none of the investigated factors were significantly associated with interocular differences in SCP-FAZ (P = 0.61, R = 0.138).

Conclusions: There was no significant interocular difference in SCP- and WCP-FAZ areas in healthy eyes. The normal range of values for interocular difference in SCP-FAZ area was 0.002 ± 0.037 mm and in the WCP-FAZ area, 0.050 ± 0.044 mm.
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http://dx.doi.org/10.1007/s10384-020-00719-2DOI Listing
March 2020

Characterization of the Progression Pattern in Retinopathy of Prematurity Subtypes.

Ophthalmol Retina 2020 03 21;4(3):231-237. Epub 2019 Nov 21.

Department of Ophthalmology, Osaka University Graduate School of Medicine, Osaka, Japan.

Purpose: To evaluate differences in the progression pattern among subtypes of retinopathy of prematurity (ROP).

Design: Retrospective cohort study.

Participants: Premature infants screened for ROP.

Methods: Medical records of 578 premature infants who were screened at the neonatal intensive care unit from September 2009 through March 2016 were reviewed. We matched for the number of patients, gestational age at birth, and postmenstrual age at the first examination between infants with spontaneously regressed ROP and those with treated ROP. A total of 133 premature infants who were born before 27 weeks' gestation were included.

Main Outcome Measures: The mean age at onset of any ROP and the duration from the initial examination to onset were compared between infants with regressed ROP and those with treated ROP. The mean age at treatment and the duration from onset to treatment were compared between infants with type 1 ROP and those with aggressive posterior ROP (AP-ROP). Data were analyzed for 1 randomly selected eye for each infant.

Results: Of 133 premature infants with any ROP, 67 regressed spontaneously, 43 demonstrated type 1 ROP, and 23 demonstrated AP-ROP. Individual trajectories of ROP progression over time showed that AP-ROP progressed through the stages in a steep linear manner in most cases. In contrast, the type 1 ROP and regressed ROP developed in a slower, stepwise manner.

Conclusions: In infants with ROP, the disease trajectories across ROP stages are different based on the ROP subtype, despite postmenstrual age at onset being comparable across subtypes. Our findings could be useful for managing follow-up screening.
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http://dx.doi.org/10.1016/j.oret.2019.11.015DOI Listing
March 2020

Relationship between nerve fiber layer defect and the presence of epiretinal membrane in a Japanese population: The JPHC-NEXT Eye Study.

Sci Rep 2020 01 21;10(1):779. Epub 2020 Jan 21.

Department of Public Health Medicine, Faculty of Medicine, and Health Services Research and Development Center, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, 305-8575, Japan.

The study subjects were residents of Chikusei city, Japan, aged 40 years or older who attended annual health check-up programs and participated in the JPHC-NEXT Eye Study which performed non-mydriatic fundus photography of both eyes. The relationship of glaucomatous fundus changes such as optic disc cupping (cup to disc ratio ≥ 0.7) and retinal nerve fiber layer defect (NFLD) with the presence of epiretinal membrane (ERM) were examined cross-sectionally. A total of 1990 persons gave consent to participate in this study in 2013. The overall prevalence of ERM was 12.9%. Of these, 1755 had fundus photographs of sufficient quality and no history of intraocular surgery (mean age: 62.3 ± 10.0 years). After adjusting for age, sex and refractive error, NFLD was positively associated with the presence of ERM (odds ratio [OR]: 2.48; 95% confidence interval [CI]: 1.24, 4.96; P = 0.010), but optic disc cupping was not (OR: 1.33; CI: 0.71, 2.48; P = 0.37). The results did not necessarily suggest an association between glaucoma and ERM, but indicated an association between NFLD and ERM.
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http://dx.doi.org/10.1038/s41598-019-57260-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6972763PMC
January 2020

Retinal Neovascularization-Simulating Retinal Capillary Reperfusion in Branch Retinal Vein Occlusion, Imaged by Wide-Field Optical Coherence Tomography Angiography.

JAMA Ophthalmol 2020 02;138(2):216-218

Department of Ophthalmology, Osaka University Graduate School of Medicine, Yamadaoka, Suita, Osaka, Japan.

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http://dx.doi.org/10.1001/jamaophthalmol.2019.5018DOI Listing
February 2020