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Ramsewak S, Deomansingh F, Winford B, Bartholomew D, Maharaj V, Fraser A, Singh D, Suratt K, Tripathi V, McNally K, Sharma S, Bascaran C, Ramsewak SS, Bourne RRA, Braithwaite T. Sight impairment registration in Trinidad: trend in causes and population coverage in comparison to the National Eye Survey of Trinidad and Tobago. Eye (Lond) 2024; 38:2134-2142. [PMID: 38326486 PMCID: PMC11269719 DOI: 10.1038/s41433-024-02943-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Revised: 01/04/2024] [Accepted: 01/16/2024] [Indexed: 02/09/2024] Open
Abstract
BACKGROUND Little was known about the population coverage and causes of sight impairment (SI) registration within the Caribbean, or the extent to which register studies offer insights into population eye health. METHODS We compared causes of SI registration in the Trinidad and Tobago Blind Welfare Association (TTBWA) register with findings from the 2014 National Eye Survey of Trinidad and Tobago (NESTT), and estimated registration coverage. Cross-sectional validation studies of registered clients included interviews, visual function and cause ascertainment in July 2013, and interviews and visual function in July 2016. RESULTS The TTBWA register included 863 people (all ages, 48.1%(n = 415) male) registered between 1951 and 2015. The NESTT identified 1.1%(75/7158) people aged ≥5years eligible for partial or severe SI registration, of whom 49.3%(n = 37) were male. Registration coverage was approximately 7% of the eligible population of Trinidad. Nevertheless, there was close agreement in the causes of SI comparing the register and population-representative survey. Glaucoma was the leading cause in both the register (26.1%,n = 225) and population-based survey (26.1%, 18/69 adults), followed by cataract and diabetic retinopathy. In the validation studies combined, 62.6%(93/151) clients had severe SI, 28.5%(43/151) had partial SI and 9.9%(15/151) did not meet SI eligibility criteria. SI was potentially avoidable in at least 58%(n = 36/62) adults and 50%(n = 7/14) children. CONCLUSION We report very low register coverage of the SI population, but close agreement in causes of SI to a contemporaneous national population-based eye survey, half of which resulted from preventable or treatable eye disease.
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Affiliation(s)
- Shivaa Ramsewak
- The Medical Eye Unit, Ophthalmology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK.
| | | | | | - Debra Bartholomew
- Ophthalmology Department, Port of Spain General Hospital, Port-of-Spain, Trinidad and Tobago
| | - Vedatta Maharaj
- Richmond University Medical Center, Staten Island, NY, USA
- Department of Optometry, The University of the West Indies, St Augustine Campus, St. Augustine, Trinidad and Tobago
| | - Amandi Fraser
- Department of Optometry, The University of the West Indies, St Augustine Campus, St. Augustine, Trinidad and Tobago
| | - Deo Singh
- Caribbean Eye Institute, Valsayn, Trinidad, Trinidad and Tobago
| | - Kenneth Suratt
- Trinidad and Tobago Blind Welfare Association, Port-of-Spain, Trinidad and Tobago
| | - Vrijesh Tripathi
- Department of Mathematics and Statistics, The University of the West Indies, St Augustine Campus, St. Augustine, Trinidad and Tobago
| | - Kevin McNally
- Low vision service, Ophthalmology, Kettering General NHS Foundation Trust, England, UK
| | - Subash Sharma
- Department of Optometry, The University of the West Indies, St Augustine Campus, St. Augustine, Trinidad and Tobago
| | | | - Samuel S Ramsewak
- Faculty of Medical Science, The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Rupert R A Bourne
- Vision and Eye Research Institute, School of Medicine, Anglia Ruskin University, Cambridge, UK
- Department of Ophthalmology, Cambridge University Hospitals, Cambridge, UK
| | - Tasanee Braithwaite
- The Medical Eye Unit, Ophthalmology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
- School of Population and Life course Sciences, King's College London, London, UK
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Sugihara Y, Takamura Y, Yamada Y, Morioka M, Gozawa M, Kato K, Hirano T, Murao F, Shimizu M, Kusuhara S, Murakami T, Takenaka Y, Okabe N, Jujo T, Terasaki H, Nagasato D, Dong Z, Yoshida S, Ogura S, Yasuda K, Ishigooka G, Sawada O, Higashijima F, Inatani M. Characterization of the visually impaired patients with diabetes mellitus in Japan. J Diabetes Investig 2024; 15:882-891. [PMID: 38534040 PMCID: PMC11215670 DOI: 10.1111/jdi.14195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 02/19/2024] [Accepted: 03/12/2024] [Indexed: 03/28/2024] Open
Abstract
AIMS/INTRODUCTION To conduct a multicenter survey of visually impaired patients with diabetes mellitus (DM) and to identify the physical and ocular characteristics that lead to blindness in Japan. MATERIALS AND METHODS Visually impaired patients with diabetes mellitus in Japan were divided into blind and low-vision groups according to the World Health Organization classification. Data on parameters related to diabetes mellitus and ocular complications in the right and left eyes were collected from 19 highly advanced medical facilities and compared between the two groups. RESULTS Among 408 visually impaired persons (blind group: 257, low-vision group: 151), 72.1% were under 70 years of age. The rates of neovascular glaucoma (NVG) (right eye, P = 0.041; left eye, P = 0.0031) or proliferative diabetic retinopathy (PDR) (right eye: P = 0.014, left eye: P = 0.0047) and the rate of proliferative membrane beyond half of the retinal area (right eye: P = 0.0263, left eye: P = 0.037) were significantly higher in the blind group. The direct cause of visual impairment was retinal atrophy, common in both groups. Neovascular glaucoma and diabetic macular edema were equally prevalent in the blind and low-vision groups, respectively. CONCLUSIONS In Japan, blind patients with diabetes mellitus are characterized by severe conditions such as neovascular glaucoma and progressive proliferative diabetic retinopathy upon their initial visit to an advanced care facility. These results highlight the importance of monitoring retinopathy through regular ophthalmological examinations, internal medicine, and appropriate therapeutic intervention.
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Affiliation(s)
- Yuka Sugihara
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology, Faculty of Medical SciencesUniversity of FukuiYoshidaJapan
| | - Yoshihiro Takamura
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology, Faculty of Medical SciencesUniversity of FukuiYoshidaJapan
| | - Yutaka Yamada
- Department of Ophthalmology, Faculty of Medical SciencesUniversity of FukuiYoshidaJapan
| | - Masakazu Morioka
- Department of Ophthalmology, Faculty of Medical SciencesUniversity of FukuiYoshidaJapan
| | - Makoto Gozawa
- Department of Ophthalmology, Faculty of Medical SciencesUniversity of FukuiYoshidaJapan
| | - Kumiko Kato
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology, Graduate School of MedicineMie UniversityTsuJapan
| | - Takao Hirano
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology, School of MedicineShinshu UniversityMatsumotoJapan
| | - Fumiko Murao
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologyTokushima University Graduate SchoolTokushimaJapan
| | - Miho Shimizu
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologySapporo City General HospitalSapporoJapan
| | - Sentaro Kusuhara
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Division of Ophthalmology, Department of Surgery, Graduate School of MedicineKobe UniversityKobeJapan
| | - Tomoya Murakami
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology, Faculty of MedicineUniversity of TsukubaTsukubaJapan
| | - Yuki Takenaka
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologyNational Defense Medical CollegeTokorozawaJapan
| | - Naoko Okabe
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologyNara Medical UniversityKashiharaJapan
| | - Tatsuya Jujo
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologySt Marianna University School of MedicineKawasakiJapan
| | - Hiroto Terasaki
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology, Graduate School of Medical and Dental SciencesKagoshima UniversityKagoshimaJapan
| | - Daisuke Nagasato
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologySaneikai Tsukazaki HospitalHimejiJapan
| | - Zhenyu Dong
- Department of Ophthalmology, Faculty of Medicine and Graduate School of MedicineHokkaido UniversitySapporoJapan
| | - Shigeo Yoshida
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologyKurume University School of MedicineKurumeJapan
| | - Shuntaro Ogura
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology and Visual ScienceNagoya City University Graduate School of Medical SciencesNagoyaJapan
| | - Kanako Yasuda
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologyTokyo Medical University Hachioji Medical CenterTokyoJapan
| | - Gaku Ishigooka
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologyOsaka Medical and Pharmaceutical UniversityTakatsukiJapan
| | - Osamu Sawada
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of OphthalmologyShiga University of Medical ScienceOtsuJapan
| | - Fumiaki Higashijima
- J‐CREST (Japan Clinical REtina STudy group)KagoshimaJapan
- Department of Ophthalmology, School of MedicineYamaguchi UniversityUbeJapan
| | - Masaru Inatani
- Department of Ophthalmology, Faculty of Medical SciencesUniversity of FukuiYoshidaJapan
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Ando M, Kato A, Kimura M, Ogura S, Kuwayama S, Kominami A, Kuwayama S, Obayashi T, Ando R, Monoe T, Morita H, Yasukawa T. Effects of Combination Therapy with Intravitreal Ranibizumab and Tissue Plasminogen Activator for Neovascular Age-Related Macular Degeneration. J Clin Med 2024; 13:2417. [PMID: 38673690 PMCID: PMC11050793 DOI: 10.3390/jcm13082417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 04/09/2024] [Accepted: 04/17/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Subretinal hyper-reflective material (SHRM) sometimes causes vision loss in spite of anti-vascular endothelial growth factor (VEGF) therapy in eyes with neovascular age-related macular degeneration (nvAMD). We evaluated the impacts of combination therapy with intravitreal ranibizumab (IVR) and tissue plasminogen activator (tPA) in eyes with nvAMD accompanying SHRM. Methods: In total, 25 eyes of 25 patients (16 men and 9 women, 76.7 years old), who underwent IVR/tPA for nvAMD with SHRM and were followed up for at least 12 months, were retrospectively reviewed. In total, 15 eyes were treatment-naïve and 10 eyes had previous treatment for nvAMD. Results: In total, 16 eyes had type 2 macular neovascularization (MNV), 5 eyes type 1 MNV with fibrovascular pigment epithelial detachment and 4 eyes polypoidal choroidal vasculopathy. At month 12, SHRM regressed or reduced in 18 eyes (72%) and the best-corrected visual acuity (BCVA) improved in 6 eyes (24%) and was unchanged in 14 eyes (56%), while the mean BCVA was just stabilized. The mean central retinal thickness, macular volume and SHRM thickness significantly improved from 408 µm to 287 µm, from 11.9 mm3 to 9.6 mm3, from 369 µm to 165 µm, respectively (p < 0.01). Conclusions: The combination therapy with IVR/tPA for nvAMD with SHRM may help preserve vision by prompt regression of SHRM.
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Affiliation(s)
- Michiko Ando
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
- Department of Ophthalmology, Ogaki Tokushukai Hospital, 6-85-1 Hayashimachi, Ogaki 503-0015, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
| | - Masayo Kimura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
| | - Shuntaro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
| | - Soichiro Kuwayama
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
- Department of Ophthalmology, Inazawa Kosei Hospital, 7 Sobuechojitchono, Inazawa 495-8531, Japan
| | - Aoi Kominami
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
| | - Satoshi Kuwayama
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
- Department of Ophthalmology, Ogaki Tokushukai Hospital, 6-85-1 Hayashimachi, Ogaki 503-0015, Japan
| | - Tomohiro Obayashi
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
- Department of Ophthalmology, Daido Hospital, 9 Hakusui-cho, Minami-ku, Nagoya 457-8511, Japan
| | - Ryota Ando
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
- Department of Ophthalmology, Nagoya City University East Medical Center, 1-2-23 Wakamizu, Chikusa-ku, Nagoya 464-8547, Japan
| | - Takafumi Monoe
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
- Department of Ophthalmology, Central Japan International Medical Center, 1-1 Kenkonomachi, Minokamo 505-8510, Japan
| | - Hiroshi Morita
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan; (M.A.); (M.K.); (S.O.); (S.K.); (A.K.); (S.K.); (T.O.); (R.A.); (T.M.); (H.M.); (T.Y.)
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Tokunaga T, Takegawa R, Ueta Y, Manabe Y, Fushiki H. Assessing fall risk and equilibrium function in patients with age-related macular degeneration and glaucoma: An observational study. PLoS One 2024; 19:e0301377. [PMID: 38558077 PMCID: PMC10984400 DOI: 10.1371/journal.pone.0301377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 03/14/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND Falls in older adults are a significant public health concern, and age-related macular degeneration (AMD) and glaucoma have been identified as potential visual risk factors. This study was designed to assess equilibrium function, fall risk, and fall-related self-efficacy (an individual's belief in their capacity to act in ways necessary to reach specific goals) in patients with AMD and glaucoma. METHODS This observational study was performed at the Otorhinolaryngology Department of Shinseikai Toyama Hospital. The cohort comprised 60 participants (AMD; n = 30; median age, 76.0 years; and glaucoma; n = 30; median age, 64.5 years). Visual acuity and visual fields were assessed using the decimal best-corrected visual acuity and Humphrey visual field tests, respectively. The evaluation metrics included pathological eye movement analysis, bedside head impulse test, single-leg upright test, eye-tracking test, optokinetic nystagmus, and posturography. Furthermore, we administered questionnaires for fall risk determinants including the Dizziness Handicap Inventory, Activities-Specific Balance Confidence Scale, Falls Efficacy Scale-International, and Hospital Anxiety and Depression Scale. The collected data were analyzed using descriptive statistics, and Spearman's correlation analysis was employed to examine the interrelations among the equilibrium function, fall risk, and other pertinent variables. RESULTS Most participants exhibited standard outcomes in equilibrium function evaluations. Visual acuity and field deficits had a minimal impact on subjective dizziness manifestations, degree of disability, and fall-related self-efficacy. Both groups predominantly showed high self-efficacy. No significant correlation was observed between visual acuity or field deficits and body equilibrium function or fall risk. However, greater peripheral visual field impairment was associated with a tendency for sensory reweighting from visual to somatosensory. CONCLUSION Self-efficacy was higher and fall risk was relatively lower among patients with mild-to-moderate visual impairment, with a tendency for sensory reweighting from visual to somatosensory in those with greater peripheral visual field impairment. Further studies are required to validate these findings.
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Affiliation(s)
| | - Rinako Takegawa
- Otorhinolaryngology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Yoshiki Ueta
- Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Yasuhiro Manabe
- Otorhinolaryngology, Shinseikai Toyama Hospital, Imizu, Japan
| | - Hiroaki Fushiki
- Otolaryngology, Mejiro University Ear Institute Clinic, Saitama, Japan
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Fujiwara K, Ueda E, Hata J, Nakano S, Hashimoto S, Nakamura S, Murakami Y, Kubota T, Yoshitomi T, Ninomiya T, Sonoda KH. Association between corneal hysteresis and glaucoma in a Japanese population: the Hisayama Study. Br J Ophthalmol 2024:bjo-2023-323987. [PMID: 38471749 DOI: 10.1136/bjo-2023-323987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/22/2024] [Indexed: 03/14/2024]
Abstract
AIMS To investigate the association between corneal hysteresis and the presence of glaucoma and its subtypes in a general Japanese population. METHODS We analysed the data of 2338 Japanese community-dwellers aged ≥40 years (1059 men, 1279 women) who underwent an eye examination in 2018 as part of the population-based, cross-sectional Hisayama Study. Participants were divided into quartile levels of corneal hysteresis, which had been measured with an ocular response analyzer. Glaucoma was defined based on the International Society of Geographical and Epidemiological Ophthalmology criteria. We conducted a logistic regression analysis to determine the ORs and their 95% CIs for the presence of outcomes according to the corneal hysteresis quartiles. RESULTS Glaucoma was diagnosed in 154 participants: primary open-angle glaucoma (POAG), n=115; primary angle-closure glaucoma, n=17; exfoliation glaucoma, n=21 and secondary glaucoma without exfoliation glaucoma, n=1. After adjustment for confounders, the OR for prevalent glaucoma was significantly increased in the participants in the first corneal-hysteresis quartile compared with those in the fourth quartile (OR: 1.80; 95% CI: 1.03 to 3.17). Regarding glaucoma subtypes, the first-quartile participants had significantly greater likelihoods of the presence of POAG (OR: 1.63; 95% CI: 1.02 to 2.61) and exfoliation glaucoma (OR: 6.49; 95% CI: 1.44 to 29.30) compared with those in the third and fourth quartiles after adjustment for potential confounders. CONCLUSIONS These results demonstrated a significant inverse association between corneal hysteresis and the likelihood of glaucoma, suggesting that the measurement of corneal hysteresis would provide useful information for elucidating the aetiology of glaucoma.
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Affiliation(s)
- Kohta Fujiwara
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Emi Ueda
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Jun Hata
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Satoko Nakano
- Department of Ophthalmology, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
| | - Sawako Hashimoto
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shun Nakamura
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Murakami
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Toshiaki Kubota
- Department of Ophthalmology, Oita University Faculty of Medicine, Yufu-City, Oita, Japan
| | - Takeshi Yoshitomi
- Department of Orthoptics, Fukuoka International University of Health and Welfare, Fukuoka, Japan
| | - Toshiharu Ninomiya
- Department of Epidemiology and Public Health, Kyushu University, Fukuoka, Japan
- Center for Cohort Studies, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Yamanishi R, Yotsukura E, Hanyuda A, Uchino M, Yuki K, Negishi K, Yasuda N, Saito I, Kato T, Arima K, Aoyagi K, Tanno K, Yamagishi K, Muraki I, Yamaji T, Iwasaki M, Inoue M, Tsugane S, Sawada N. Relation between a history of glaucoma and subjective happiness: the JPHC-Next study. BMJ Open Ophthalmol 2024; 9:e001553. [PMID: 38373803 PMCID: PMC10882359 DOI: 10.1136/bmjophth-2023-001553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Accepted: 01/31/2024] [Indexed: 02/21/2024] Open
Abstract
OBJECTIVE This population-based, cross-sectional study was performed to investigate the relationship between a history of glaucoma and subjective happiness. METHODS AND ANALYSIS We conducted a cross-sectional questionnaire-based survey of 92 397 Japanese men and women aged 40-74 who participated in the Japan Public Health Center-based Prospective Study for the Next Generation study. A multivariable logistic regression model was used to estimate the ORs of glaucoma associated with subjective happiness and their two-sided 95% CIs. RESULTS Among 40 727 men and 51 670 women, 1733 participants (635 men, 1098 women) had a history of glaucoma. The odds of unhappiness in male participants with a history of glaucoma were higher (OR 1.26; 95% CI 1.05 to 1.51) than in female participants (OR 1.05; 95% CI 0.90 to 1.23). In a subgroup analysis stratified by age, among participants with a history of glaucoma, males in the younger group (40-59 years) showed the most robust association with unhappiness (OR 1.40; 95% CI 1.04 to 1.88). CONCLUSIONS These findings suggest that a history of glaucoma is related with subjective unhappiness, especially in men.
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Affiliation(s)
- Ryutaro Yamanishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Erisa Yotsukura
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Miki Uchino
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Nobufumi Yasuda
- Department of Public Health, Kochi University Medical School, Kochi, Japan
| | - Isao Saito
- Department of Public Health and Epidemiology, Faculty of Medicine, Oita University, Oita, Japan
| | - Tadahiro Kato
- Center for Education and Educational Research, Faculty of Education, Ehime University, Matsuyama, Japan
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kozo Tanno
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kazumasa Yamagishi
- Department of Public Health Medicine, Insitute of Medicine, and Health Services Research and Development Center, University of Tsukuba, Tsukuba, Japan
- Ibaraki Western Medical Center, Chikusei, Japan
| | - Isao Muraki
- Department of Social Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Taiki Yamaji
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Motoki Iwasaki
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- Division of Epidemiology, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Manami Inoue
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
| | - Shoichiro Tsugane
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Norie Sawada
- Division of Cohort Research, National Cancer Center Institute for Cancer Control, Tokyo, Japan
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Morita S, Sakanishi Y, Riyu I, Watanabe S, Ebihara N. Comparative evaluation of iStent versus iStent inject W combined with phacoemulsification in open angle glaucoma. PLoS One 2024; 19:e0297514. [PMID: 38315707 PMCID: PMC10843132 DOI: 10.1371/journal.pone.0297514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 12/29/2023] [Indexed: 02/07/2024] Open
Abstract
PURPOSE The study aimed to compare the 12-month post-operative outcomes of iStent and iStent inject W (inject W), and the factors associated with their success in open-angle glaucoma. METHODS This single-center, retrospective comparative case series evaluated the medical records of patients who underwent iStent (comprising 1 stent) or inject W (comprising 2 stents) implantation with cataract surgery for primary open-angle glaucoma and normal tension glaucoma between January 2019 and March 2022. The 12-month post-operative efficacy outcomes included intraocular pressure (IOP), glaucoma medications, and survival analysis of the probability of success. "Failure" was defined as any of the following conditions compared to baseline: 1) IOP elevation, 2) increased glaucoma medication, or 3) IOP decline not exceeding 20% when glaucoma medication scores were comparable, and 4) need for additional glaucoma surgery. The safety outcomes included intra- and post-operative adverse events and changes in the best-corrected visual acuity and visual field. RESULTS The study comprised 55 eyes in the iStent and 105 in the inject W groups. At 12 months, treatment success was achieved in 66.0% of iStent and 78.4% of inject W eyes. The mean IOP was lower, and the percent reduction from baseline was equal in iStent-treated eyes (8.0% reduction, 14.8 mmHg to 13.7 mmHg, P<0.01) and inject W-treated eyes (11.9% reduction, 15.0 mmHg to 13.8 mmHg, P<0.01) (between-group comparison, P = 0.23). The mean medication burden decreased significantly from 2.5 to 1.1 for iStent (55.0% reduction, P<0.01) and 2.9 to 1.7 for iStent inject (46.8% reduction, P<0.01), with no significant differences between the two groups (P = 0.17). Both devices exhibited excellent safety. CONCLUSIONS Both devices significantly reduced IOP and glaucoma medication 12 months post-operatively. The outcome measures did not differ significantly between the two groups, and lower baseline IOP was predictive of surgical failure.
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Affiliation(s)
- Shuu Morita
- Department of Ophthalmology, Juntendo University Urayasu Hospital, Tiba, Japan
| | - Yoshihito Sakanishi
- Department of Ophthalmology, Juntendo University Urayasu Hospital, Tiba, Japan
| | - Ikari Riyu
- Department of Ophthalmology, Juntendo University Urayasu Hospital, Tiba, Japan
| | - Satoshi Watanabe
- Department of Ophthalmology, Juntendo University Urayasu Hospital, Tiba, Japan
| | - Nobuyuki Ebihara
- Department of Ophthalmology, Juntendo University Urayasu Hospital, Tiba, Japan
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Tsutsui S, Murakami Y, Fujiwara K, Koyanagi Y, Akiyama M, Takeda A, Ikeda Y, Sonoda KH. Genotypes and clinical features of RHO-associated retinitis pigmentosa in a Japanese population. Jpn J Ophthalmol 2024; 68:1-11. [PMID: 38070066 DOI: 10.1007/s10384-023-01036-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/12/2023] [Indexed: 01/12/2024]
Abstract
PURPOSE To report the genotypes and clinical features of RHO-associated retinitis pigmentosa (RHO-RP) in the Kyushu region of Japan. STUDY DESIGN Retrospective, single-center study. METHODS Sixteen RP patients with pathogenic RHO variants seen at Kyushu University Hospital were investigated. Clinical data including age, best-corrected visual acuity (BCVA) in logarithm of the minimum angle of resolution (logMAR) units, visual field, fundus photography, and optical coherence tomography were retrospectively obtained. Visual outcomes were compared between classical and sector phenotypes and among genetic variants. RESULTS The mean age at the first visit was 54.0 ± 15.7 years, with a mean follow-up of 7.6 ± 4.0 years. Fourteen patients (87.5%) showed the classical RP phenotype, of whom four were associated with p.[Pro23Leu] and two had p.[Pro347Leu] variants. In addition, two patients with the sector phenotype harbored p.[Ala164Val] variants. Among the classical RHO-RP patients, the mean BCVA decreased from 0.60 to 1.08 logMAR over the follow-up period (7.4 ± 4.1 years) whereas BCVA was preserved at 0.04 logMAR in sector RHO-RP patients (9.0 ± 3.0 years). Genotype-to-phenotype analysis demonstrated that p.[Pro347Leu] was associated with severe vision loss at an earlier age. Macular complications such as epiretinal membrane and cystoid macular edema were observed in 5 classical RHO-RP patients. CONCLUSION p.[Pro23Leu], but not p.[Pro23His], was a frequent variant causing RHO-RP in the Kyushu region of Japan. As reported in previous studies, patients with the p.[Pro347Leu] variant showed a more severe phenotype, and variants causing sector RHO-RP were associated with a good prognosis.
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Affiliation(s)
- Saki Tsutsui
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Yusuke Murakami
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
| | - Kohta Fujiwara
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Yoshito Koyanagi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Masato Akiyama
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
- Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Atsunobu Takeda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
| | - Yasuhiro Ikeda
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, 889-1692, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan
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Hidaka T, Chuman H, Ikeda Y. Evaluation of inner retinal function at different stages of primary open angle glaucoma using the photopic negative response (PhNR) measured by RETeval electroretinography. Graefes Arch Clin Exp Ophthalmol 2024; 262:161-169. [PMID: 37535182 DOI: 10.1007/s00417-023-06193-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 06/28/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023] Open
Abstract
PURPOSE To investigate the objective function of the inner retinal layer in each stage of primary open angle glaucoma (POAG) using the photopic negative response (PhNR) measured by RETeval full-field electroretinography (ERG), and to identify which PhNR parameter is the most useful. METHODS Ninety eyes of 90 patients with POAG (30 with mild POAG (mean deviation (MD) ≥ -6 dB) and 60 with moderate-to-advanced POAG (MD < -6 dB)) and 76 eyes of 76 control cases were examined. We investigated six PhNR parameters and their relationships with the results of the Humphrey 30-2 visual field test and the thickness of the circumpapillary retinal nerve fiber layer (cpRNFL) obtained from optical coherence tomography. The following PhNR parameters were assessed: base-to-trough (BT), peak-to-trough (PT), 72msPhNR, the W-ratio, P-ratio, implicit time (IT), and a-wave and b-wave amplitudes on ERG. RESULTS All PhNR parameters other than IT significantly differed between the all POAG (all stages) and control groups and between the moderate-to-advanced POAG and control groups. BT and 72msPhNR in the mild POAG group, significantly differed from those in the control group. Regarding the relationships between PhNR parameters and the visual field and between these parameters and cpRNFL thickness, correlations were observed between all PhNR parameters, except PT and IT, and both the visual field and cpRNFL thickness in the all and moderate-to-advanced POAG groups. 72msPhNR correlated with cpRNFL thickness in the mild POAG group. The area under the receiver operating characteristic curve was greater for BT than for the other PhNR parameters in both the mild and moderate-to-advanced POAG groups. The discriminant linear function for examining the presence or absence of POAG and the threshold for diagnosis were quantitatively obtained as follows. Regarding BT: discriminant = 0.505 × BT + 2.017; threshold = positive for POAG, negative for no POAG; correct answer rate = 80.7%. Concerning 72msPhNR: discriminant = 0.533 × 72msPhNR + 1.553; threshold = positive for POAG and negative for no POAG; correct answer rate = 77.1%. CONCLUSION RETeval-measured PhNR parameters were useful for an objective evaluation of visual function in moderate-to-advanced POAG. BT appeared to be the most diagnostically useful parameter.
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Affiliation(s)
- Takako Hidaka
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki Prefecture, 889-1692, Japan.
| | - Hideki Chuman
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki Prefecture, 889-1692, Japan
| | - Yasuhiro Ikeda
- Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, 5200 Kihara, Kiyotake, Miyazaki City, Miyazaki Prefecture, 889-1692, Japan
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Sada K, Yoshida Y, Shibuta K, Kimoto K, Miyamoto S, Ozeki Y, Okamoto M, Gotoh K, Masaki T, Yokoyama K, Kubota T, Shibata H. Associations of Diabetic Retinopathy Severity With High Ambulatory Blood Pressure and Suppressed Serum Renin Levels. J Clin Endocrinol Metab 2023; 108:e1624-e1632. [PMID: 37319371 DOI: 10.1210/clinem/dgad358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Revised: 06/07/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023]
Abstract
CONTEXT The relationships between serum renin levels, severity of diabetic retinopathy (DR), and 24-hour blood pressure (BP) have not been previously reported. OBJECTIVE To explore causes for DR and the relationships of 24-hour ambulatory BP, and hormone levels with the severity of DR. METHODS The diabetic patients were classified as having no DR, simple DR, or severe DR (preproliferative DR plus proliferative DR) based on funduscopic examination, and we measured 24-hour BP, serum active renin (ARC), aldosterone (SAC), adrenocorticotropic hormone, and cortisol levels in each group. RESULTS Compared to those with no DR or simple DR, patients with severe DR showed significantly higher 24-hour BPs, including daytime and nighttime systolic and diastolic BP levels, independent of diabetic duration and HbA1c levels. The variability of nighttime systolic BP was greater in patients with severe DR than in those with nonsevere DR, although nocturnal BP reduction was similar between the groups. The ambulatory BPs were significantly inversely associated with ARC. The ARC was significantly lower in severe DR patients than in those with no DR or simple DR (3.2 [1.5-13.6] vs 9.8 [4.6-18.0] pg/mL, P < .05), but there were no differences in SAC in patients taking calcium channel blockers and/or α-blockers. No associations were found between DR severity and other hormone levels. CONCLUSION Severe DR was associated with higher 24-hour BPs and suppressed ARC. These findings suggest that mineralocorticoid receptor overactivation may play a role in higher BP levels and severe DR in diabetic patients.
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Affiliation(s)
- Kentaro Sada
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Yuichi Yoshida
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Kanako Shibuta
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Kenichi Kimoto
- Department of Ophthalmology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Shotaro Miyamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Yoshinori Ozeki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Mitsuhiro Okamoto
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Koro Gotoh
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Takayuki Masaki
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Katsuhiko Yokoyama
- Department of Ophthalmology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Toshiaki Kubota
- Department of Ophthalmology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
| | - Hirotaka Shibata
- Department of Endocrinology, Metabolism, Rheumatology and Nephrology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan
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Kashiwagi K, Ouchi K, Shibasaki Y, Suginaka M. Persistence of the carteolol hydrochloride/latanoprost fixed-combination ophthalmic solution, compared with the other β-blocker/prostanoid FP receptor agonist fixed-combination ophthalmic solutions. Jpn J Ophthalmol 2023; 67:658-667. [PMID: 37596443 DOI: 10.1007/s10384-023-01020-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 07/06/2023] [Indexed: 08/20/2023]
Abstract
PURPOSE To investigate the treatment persistence of carteolol hydrochloride/latanoprost fixed-combination ophthalmic solution (CAR/LAT) and other β-blocker/prostanoid FP receptor agonist fixed-combination ophthalmic solutions (BB/FP) in the treatment of glaucoma. STUDY DESIGN Retrospective observational cohort study. METHODS A retrospective observational cohort study using JMDC Claims Database. Patients aged 20 years or older diagnosed with glaucoma between February 1, 2017, and March 31, 2020, and prescribed CAR/LAT or another BB/FP were included. RESULTS A total of 16,612 patients (7423 in the CAR/LAT group and 9189 in the other BB/FP group) were included. The cumulative treatment persistence rate at the end of follow-up was 42.0% (64.9% at 1 year, 53.4% at 2 years, 45.0% at 3 years, and 42.0% at 4 years) in the CAR/LAT group and 34.7% (54.8% at 1 year, 43.6% at 2 years, 37.1% at 3 years, and 34.7% at 4 years) in the other BB/FP group. Treatment persistence was significantly longer in the CAR/LAT group compared to that in the other BB/FP group (hazard ratio 0.747, p < 0.0001). Over the treatment period, the number of patients who discontinued treatment was 3281 (44.2%) in the CAR/LAT group and 4926 (53.6%) in the other BB/FP group; the median duration of treatment was 135 days and 97 days, respectively. CONCLUSION The study results suggest that persistence rates vary depending on the BB/FP and CAR/LAT appears to be more persistent than other BB/FP.
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Affiliation(s)
- Kenji Kashiwagi
- Department of Ophthalmology, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi, 409-3898, Japan.
| | - Kentaro Ouchi
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan
| | | | - Masaki Suginaka
- Medical Affairs, Otsuka Pharmaceutical Co., Ltd., Tokyo, Japan
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12
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Emoto Y, Hollό G, Kita Y, Saito T, Kita R. Influence of Refractive Error on Circumpapillary Structure-Function Versus Vessel Density-Function Relationships in Open Angle Glaucoma. J Glaucoma 2023; 32:640-646. [PMID: 37314189 DOI: 10.1097/ijg.0000000000002251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 06/02/2023] [Indexed: 06/15/2023]
Abstract
PRCIS In Japanese open angle glaucoma (OAG) eyes correlation of 30-degree visual field mean deviation (MD) and visual field index (VFI) with circumpapillary vessel density is systematically stronger than that with circumpapillary retinal nerve fiber layer thickness (RNFLT), and is preserved in myopia and high myopia. PURPOSE The purpose of this study was to investigate the influence of refractive error on the relationship between circumpapillary retinal nerve fiber layer thickness (cpRNFLT) and circumpapillary vessel density (cpVD), respectively, and global visual field parameters in Japanese open angle glaucoma (OAG) eyes. MATERIAL AND METHODS One eye of 81 Japanese OAG patients (spherical equivalent refractive error: +3.0 to -9.0 D) underwent 360-degree cpRNFLT and cpVD measurements with Cirrus HD 5000-AngioPlex optical coherence tomography and 30-2 Humphrey visual field testing for mean deviation (MD) and visual field index (VFI) within 1 month. Correlations were determined for the whole population and each refractive error subgroups, separately: emmetropia/hyperopia (n=24), mild (n=18), moderate (n=20), and high myopia (n=19). RESULTS For the total population, significant strong to very strong correlations were found between MD, VFI, and both cpRNFLT and cpVD, respectively, with consistently higher r -values for cpVD (highest r -values: 0.532 for cpRNFLT, P <0.001; 0.722 for cpVD, P <0.001). Of the refractive subgroups, statistically significant correlations between cpRNFLT and the visual field parameters were maintained only in the hyperopia/emmetropia and moderate myopia groups. In contrast, statistically significant, strong to very strong correlations between cpVD and both MD and VFI, always exceeding the corresponding r -values found for cpRNFLT were found in all refractive subgroups, with r -values ranging between 0.548 ( P =0.005) and 0.841 ( P <0.001). CONCLUSIONS Our results suggest that in Japanese OAG eyes the relationship of MD and VFI with cpVD is strong. It is systematically stronger than that with cpRNFLT and preserved in each conventional refractive error category including high myopia.
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Affiliation(s)
- Yoshinobu Emoto
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Gábor Hollό
- Tutkimusz Ltd, Solymár
- Eye Center, Prima Medica Health Centers, Budapest, Hungary
| | - Yoshiyuki Kita
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Tsunehiro Saito
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
| | - Ritsuko Kita
- Department of Ophthalmology, Kyorin University School of Medicine, Tokyo, Japan
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13
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Wada I, Nakao S, Fukuda Y, Shiose S, Takeda A, Kannan R, Sonoda KH. Persistence of vascular empty sleeves in choroidal neovascularization after VEGF therapy in both animal models and humans. Graefes Arch Clin Exp Ophthalmol 2023; 261:2189-2197. [PMID: 36869890 DOI: 10.1007/s00417-023-06018-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 02/08/2023] [Accepted: 02/18/2023] [Indexed: 03/05/2023] Open
Abstract
PURPOSE Choroidal neovascularization (CNV) often recurs during anti-vascular endothelial growth factor (VEGF) therapy; however, little is known about the mechanism of vascular regrowth. Vascular regrowth along the empty sleeves of basement membranes was proposed as a mechanism for recurrence after the reversal of VEGF inhibition in tumors. This study investigated whether the proposed mechanism is involved in CNV during VEGF therapy. METHODS We made two observations using a mice model, as well as patients with CNV. Laser-induced CNV mice were used to examine the vascular empty sleeves of the basement membrane and CNV with the immunohistochemistry of type IV collagen and CD31, respectively. A retrospective cohort study included 17 eyes from 17 patients with CNV treated with anti-VEGF treatment. Vascular regrowth during anti-VEGF treatment was assessed using optical coherence tomography angiography (OCTA). RESULTS In the CNV mouse model, the CD31+ vascular endothelium area was decreased during anti-VEGF treatment compared with the IgG control (33516.7 ± 10864.7 vs. 10745.9 ± 5755.9 μm2, P < 0.05), whereas a significant difference was not observed in the area of type IV collagen+ vascular empty sleeve after the treatment compared with the control (29135.0 ± 7432.9 vs. 24592.0 ± 5935.3 μm2, P = 0.7). The proportions of CD31+ to type IV collagen+ areas were significantly decreased after the treatment (38.7 ± 7.4% vs. 17.1 ± 5.4%, P < 0.05). In the OCTA observations, the follow-up period in the retrospective cohort study was 58.2 ± 23.4 months. CNV regrowth was observed in 682 neovessels of the 17 eyes. In group 1, CNV regression and regrowth are in the same form (129 neovessels, 18.9%). In group 2, CNV regression and regrowth are in a different form (170 neovessels, 24.9%). In group 3, CNV regrowth is with a different form without the regression (383 neovessels, 56.2%). CONCLUSIONS Parts of CNV regrowth may occur along the vascular empty sleeve, which remain after anti-VEGF treatment.
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Affiliation(s)
- Iori Wada
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Doheny Eye Institute, Pasadena, CA, USA
- Stein Eye Institute, Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Shintaro Nakao
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
- Department of Ophthalmology, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
- Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan.
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan.
| | - Yosuke Fukuda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
- Department of Ophthalmology, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
- Clinical Research Institute, National Hospital Organization, Kyushu Medical Center, Fukuoka, Japan
| | - Satomi Shiose
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Atsunobu Takeda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ram Kannan
- Doheny Eye Institute, Pasadena, CA, USA
- Stein Eye Institute, Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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Maeda T, Takahashi M. iPSC-RPE in Retinal Degeneration: Recent Advancements and Future Perspectives. Cold Spring Harb Perspect Med 2023; 13:a041308. [PMID: 36690464 PMCID: PMC10411862 DOI: 10.1101/cshperspect.a041308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Regenerative medicine is a great hope for patients suffering from diseases for which no effective treatment is available. With the creation of induced pluripotent stem cells (iPSCs) in 2006, research and development has accelerated expeditiously, reaching a practical stage worldwide. The iPSC-regenerative medicine in ophthalmology is one of the pioneers, which has kicked off clinical application ahead of other fields owing to its advantages. The clinical safety issues of iPSC-derived retinal pigment epithelial (iPSC-RPE) transplantation for exudative age-related macular degeneration have been addressed to a certain extent. Preparations are being made for the next clinical study based on the improvement of its therapeutic effects and expansion of indications globally. Steady progress toward the practical applications of regenerative medicine for the treatment of retinal disorders is expected in the future while strengthening global cooperation amid various research areas, clinical fields, and regulations.
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Affiliation(s)
- Tadao Maeda
- Research Center, Kobe City Eye Hospital, Kobe 6500-047, Japan
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe 6500-047, Japan
- Vision Care Cell Therapy, Kobe 650-0047, Japan
| | - Masayo Takahashi
- Research Center, Kobe City Eye Hospital, Kobe 6500-047, Japan
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe 6500-047, Japan
- Vision Care Cell Therapy, Kobe 650-0047, Japan
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15
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Sakaeda Y, Kato A, Kuwayama S, Hirahara S, Suzuki N, Ogura Y, Nakazawa Y, Yasukawa T. Long-Term Prognosis of Patients with Polypoidal Choroidal Vasculopathy Treated with Photodynamic Therapy. J Clin Med 2023; 12:4707. [PMID: 37510825 PMCID: PMC10381275 DOI: 10.3390/jcm12144707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 07/05/2023] [Accepted: 07/14/2023] [Indexed: 07/30/2023] Open
Abstract
We evaluated the long-term prognosis of the eyes of patients with polypoidal choroidal vasculopathy (PCV) treated with photodynamic therapy (PDT). In total, 60 eyes of 57 patients diagnosed with PCV and treated with PDT were reviewed retrospectively in real-world settings. The best-corrected visual acuity (BCVA), central retinal thickness (CRT), anatomical findings (vision-threatening findings), and treatment history were assessed. In total, 38 eyes underwent PDT as the initial treatment (initial PDT group) and 22 eyes underwent PDT as a rescue treatment (rescue PDT group). In the initial PDT group, 11 eyes (29%) did not require additional therapy throughout the observation period and maintained good BCVA. A total of 27 eyes (71%) underwent additional treatments and the mean BCVA was only stabilized for 2 years; thereafter, decreased vision occurred even with additional treatments. In the rescue PDT group, 22 eyes (95%) required additional treatment. Hard exudate, serous pigment epithelial detachment, and the total vision-threatening score were related to worse BCVA. Initial PDT may be effective in about 30% of cases with preservation of good vision and no need for additional treatment. However, patients with received rescue PDT needed additional treatment in most cases and the vision decreased in many cases.
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Affiliation(s)
- Yukinori Sakaeda
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Soichiro Kuwayama
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Shuichiro Hirahara
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Norihiro Suzuki
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Yuichiro Ogura
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
| | - Yoko Nakazawa
- Department of Ophthalmology, Nagoya City University, West Medical Center, 1-1-1 Hirate-cho, Kita-ku, Nagoya 462-8508, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi, Mizuho-cho, Mizuho-ku, Nagoya 467-8601, Japan
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Ozawa Y, Ohgami K, Sasaki K, Hirano K, Sunaya T. Long-term surveillance provides real-world evidences of safety and effectiveness in intravitreal aflibercept treatment for age-related macular degeneration. Sci Rep 2023; 13:10597. [PMID: 37391547 PMCID: PMC10313657 DOI: 10.1038/s41598-023-37584-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 06/23/2023] [Indexed: 07/02/2023] Open
Abstract
This prospective, multicentre, postmarketing surveillance were conducted to report on the long-term safety and effectiveness of intravitreal aflibercept (IVT-AFL) treatment in clinical practice of Japanese patients with neovascular age-related macular degeneration (nAMD) who newly initiated IVT-AFL treatment. The primary outcomes were the incidence of adverse events (AEs) and of adverse drug reactions (ADRs) over 36 months. Number of injections, timing of ADR occurrence, and some effectiveness index were also summarised. A total of 3,872 patients received 7.2 ± 5.8 (mean ± standard deviation) injections, and AEs occurred in 5.73% of patients. ADRs were reported in 2.76% of patients, with ocular and nonocular ADRs in 2.07% and 0.72% of patients, respectively. Most vitreo-retinal events developed within 6 months of initial IVT-AFL treatment, and most instances of increased intraocular pressure and cerebral infarction developed after 6 months of follow-up. Mean best-corrected visual acuity and central retinal thickness were numerically better throughout the follow-up period compared with baseline. These results indicated acceptable tolerability and effectiveness of IVT-AFL treatment in patients with nAMD in clinical practice in Japan. Information regarding the risk and the timing of ADRs is valuable for safe and effective long-term treatment of patients with nAMD.Trial registration number: NCT01756248.
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Affiliation(s)
- Yoko Ozawa
- Department of Clinical Regenerative Medicine Eye Center, Fujita Medical Innovation Center Tokyo, Fujita Health University School of Medicine, Tokyo, Japan.
- Department of Ophthalmology, St. Luke's International Hospital, Tokyo, Japan.
- Department of Ophthalmology, St. Luke's International University, Tokyo, Japan.
- Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
| | - Kazuhiro Ohgami
- Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Koji Sasaki
- Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Kazufumi Hirano
- Medical Affairs and Pharmacovigilance, Bayer Yakuhin, Ltd., Osaka, Japan
| | - Toshiyuki Sunaya
- Research and Development Japan, Bayer Yakuhin, Ltd., Osaka, Japan
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Kawabe A, Uesawa Y. Analysis of Corticosteroid-Induced Glaucoma Using the Japanese Adverse Drug Event Reporting Database. Pharmaceuticals (Basel) 2023; 16:948. [PMID: 37513860 PMCID: PMC10386210 DOI: 10.3390/ph16070948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 06/26/2023] [Accepted: 06/28/2023] [Indexed: 07/30/2023] Open
Abstract
Glaucoma is the most common cause of blindness, which significantly reduces quality of life. Most glaucoma cases are primary glaucoma; nevertheless, many patients suffer from glaucoma caused by drugs, such as corticosteroids. A comprehensive review of the risks associated with corticosteroid-induced glaucoma is limited. Therefore, we used the Japanese Adverse Drug Event Reporting Database (JADER) published by the Pharmaceuticals and Medical Devices Agency (PMDA) to analyze the risk factors associated with glaucoma and the trends and characteristics of corticosteroid-induced glaucoma. We did not find sex or age differences associated with the onset of glaucoma. Hierarchical clustering and principal component analysis revealed that triamcinolone acetonide and betamethasone sodium phosphate, which are used around the eyes in Japan, are more likely to induce intraocular pressure (IOP) elevation compared with other corticosteroids. Increased IOP is a direct cause of glaucoma. Based on these findings, it may be necessary to limit or avoid the use of these corticosteroids.
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Affiliation(s)
- Ayano Kawabe
- Department of Medical Molecular Informatics, Meiji Pharmaceutical University, Tokyo 204-8588, Japan
| | - Yoshihiro Uesawa
- Department of Medical Molecular Informatics, Meiji Pharmaceutical University, Tokyo 204-8588, Japan
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Watanabe K, Aouadj C, Hiratsuka Y, Yamamoto S, Murakami A. Quality of Life and Economic Impacts of Retinitis Pigmentosa on Japanese Patients: A Non-interventional Cross-sectional Study. Adv Ther 2023; 40:2375-2393. [PMID: 36947329 PMCID: PMC10032244 DOI: 10.1007/s12325-023-02446-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/26/2023] [Indexed: 03/23/2023]
Abstract
INTRODUCTION Retinitis pigmentosa (RP) is an inherited progressive disease, characterized by a loss of photoreceptors, and is the second leading cause of visual impairment in Japan. RP is currently incurable and can result in complete blindness, with affected patients typically experiencing a gradual loss of light sensitivity, visual field, and visual acuity. Identification of any unmet medical needs of patients with this condition requires an understanding of the impacts of RP; in this study, we surveyed Japanese patients with RP to investigate the quality of life and economic impacts of visual impairment. METHODS This non-interventional, cross-sectional study surveyed Japanese patients with RP. Economic impact was measured using an original questionnaire that assessed out-of-pocket cost (e.g., vision aids and medical services), salary gap with the general public, and the cost of depression and anxiety. Worker productivity was assessed using the Work Productivity and Activity Impairment Questionnaire (WPAI). Quality of life was evaluated using the Health Utilities Index Mark 3 (HUI3), the National Eye Institute Visual Function Questionnaire-25 (VFQ-25), and the 5-level EQ-5D version (EQ-5D-5L). The primary outcome was direct and indirect costs of visual impairment or blindness during the lifetime of patients with RP. RESULTS Among 122 surveyed patients with RP, the estimated annual cost per patient was 218,520 yen (2176 USD), and the estimated lifetime cost per patient was 18,523,909 yen (184,501 USD). Additional robustness testing increased the estimated annual cost and lifetime cost per patient to 783,176 yen (7801 USD) and 66,389,827 yen (661,253 USD), respectively. In working patients, work productivity loss was 26.2% per person and impairment of daily activities was 31.6% per person. The mean VFQ-25, HUI3, and EQ-5D-5L scores were 42.0, 0.393, and 0.833, respectively. CONCLUSION RP imposed a heavy economic burden and negative quality of life impacts in Japanese patients.
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Affiliation(s)
- Katsuhiko Watanabe
- Ophthalmology Medical Franchise Department, Novartis Pharma K.K., Toranomon Hills Mori Tower 23-1, Toranomon 1-chome Minato-ku, Tokyo, 105-6333, Japan.
| | | | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
| | | | - Akira Murakami
- Department of Ophthalmology, Juntendo University, Graduate School of Medicine, Tokyo, Japan
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Ishikawa K, Hasegawa N, Yokoyama A, Sakaki Y, Akagi H, Kawata A, Mani H, Asaka T. Effects of the Loss of Binocular and Motion Parallax on Static Postural Stability. SENSORS (BASEL, SWITZERLAND) 2023; 23:4139. [PMID: 37112477 PMCID: PMC10146252 DOI: 10.3390/s23084139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 04/15/2023] [Accepted: 04/18/2023] [Indexed: 06/19/2023]
Abstract
Depth information is important for postural stability and is generated by two visual systems: binocular and motion parallax. The effect of each type of parallax on postural stability remains unclear. We investigated the effects of binocular and motion parallax loss on static postural stability using a virtual reality (VR) system with a head-mounted display (HMD). A total of 24 healthy young adults were asked to stand still on a foam surface fixed on a force plate. They wore an HMD and faced a visual background in the VR system under four visual test conditions: normal vision (Control), absence of motion parallax (Non-MP)/binocular parallax (Non-BP), and absence of both motion and binocular parallax (Non-P). The sway area and velocity in the anteroposterior and mediolateral directions of the center-of-pressure displacements were measured. All postural stability measurements were significantly higher under the Non-MP and Non-P conditions than those under the Control and Non-BP conditions, with no significant differences in the postural stability measurements between the Control and Non-BP conditions. In conclusion, motion parallax has a more prominent effect on static postural stability than binocular parallax, which clarifies the underlying mechanisms of postural instability and informs the development of rehabilitation methods for people with visual impairments.
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Affiliation(s)
- Keita Ishikawa
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (K.I.); (A.Y.); (Y.S.); (H.A.); (A.K.)
| | - Naoya Hasegawa
- Department of Rehabilitation Sciences, Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan;
| | - Ayane Yokoyama
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (K.I.); (A.Y.); (Y.S.); (H.A.); (A.K.)
| | - Yusuke Sakaki
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (K.I.); (A.Y.); (Y.S.); (H.A.); (A.K.)
| | - Hiromasa Akagi
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (K.I.); (A.Y.); (Y.S.); (H.A.); (A.K.)
| | - Ami Kawata
- Graduate School of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan; (K.I.); (A.Y.); (Y.S.); (H.A.); (A.K.)
| | - Hiroki Mani
- Faculty of Welfare and Health Science, Oita University, Oita 870-1124, Japan;
| | - Tadayoshi Asaka
- Department of Rehabilitation Sciences, Faculty of Health Sciences, Hokkaido University, Sapporo 060-0812, Japan;
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20
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Matoba R, Morimoto N, Kawasaki R, Fujiwara M, Kanenaga K, Yamashita H, Sakamoto T, Morizane Y. A nationwide survey of newly certified visually impaired individuals in Japan for the fiscal year 2019: impact of the revision of criteria for visual impairment certification. Jpn J Ophthalmol 2023; 67:346-352. [PMID: 37067634 DOI: 10.1007/s10384-023-00986-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 02/05/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE To determine the status of visual impairment certification in Japan in the fiscal year 2019 and the impact of revising the criteria for visual impairment certification implemented in 2018. STUDY DESIGN Observational cross-sectional study. METHODS We requested welfare offices throughout Japan to submit data of age, sex, causative diseases, and visual impairment grades for newly certified visually impaired individuals aged ≥ 18 years during the fiscal year 2019. The certification was based on criteria of the Act on Welfare of Physically Disabled Persons. RESULTS Altogether, data were collected for 16,504 newly certified visually impaired individuals. The most common age group was 80-89 years (29.6%), followed by 70-79 (28.2%) and 60-69 (15.3%) years. The most common causative disease was glaucoma (40.7%), followed by retinitis pigmentosa (13.0%), diabetic retinopathy (10.2%), and macular degeneration (9.1%). The most common impairment grade was grade 2 (40.8%), followed by 5 (21.2%) and 1 (17.0%). Compared to the fiscal year 2015, there was a considerable increase in the number of individuals certified with glaucoma in the fiscal year 2019. Moreover, there was a significant increase in the number of individuals with certified grades 1 and 2 visual impairment, with a decrease in the number of individuals with certified grade 6 visual impairment. CONCLUSION The changes revealed in this study were primarily due to the revised certification criteria implemented in July 2018, indicating that it is important to review the certification criteria and to repeat surveys similar to the present study.
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Affiliation(s)
- Ryo Matoba
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan
| | - Noriko Morimoto
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan
| | - Ryo Kawasaki
- Department of Vision Informatics, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Miyuki Fujiwara
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan
| | - Keisuke Kanenaga
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan
| | | | - Taiji Sakamoto
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Yuki Morizane
- Department of Ophthalmology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1, Shikata-cho, Okayama, 700-8558, Japan.
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21
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Watanabe K, Hiratsuka Y, Yamamoto S, Murakami A. Economic Impacts and Quality of Life for Caregivers of Patients with Retinitis Pigmentosa: A Cross-Sectional Japanese Study. Healthcare (Basel) 2023; 11:healthcare11070988. [PMID: 37046915 PMCID: PMC10093847 DOI: 10.3390/healthcare11070988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/03/2023] Open
Abstract
Retinitis pigmentosa (RP) is the second leading cause of visual impairment in Japan and causes progressive vision loss in affected patients. Caregiving for patients with RP is associated with socioeconomic impacts; however, data on the magnitude and scope of these impacts are lacking. This cross-sectional study surveyed informal caregivers of patients with RP in Japan. The questionnaire assessed the socioeconomic status of participants; work impacts through the Work Productivity and Activity Impairment Questionnaire adapted for caregivers; and quality of life impacts through the Japanese version of the Caregiver Reaction Assessment (CRA) and the 5-level EQ-5D version (EQ-5D-5L). Of the 37 participating caregivers, 28 (75.7%) were employed. Among those, the average annual income was 2,722,080 yen (n = 20) and the mean loss of work productivity was 6.6%. The mean EQ-5D-5L index score was 0.882, and the mean CRA total score was 2.1. A mild to very severe impact on family life, leisure and hobbies, social life, and mental health was experienced by 83.8%, 78.4%, 75.7%, and 70.3%, respectively. These results suggest that caregivers of patients with RP may be disadvantaged in terms of employment and income and may experience wide-ranging impacts on their quality of daily life.
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Affiliation(s)
- Katsuhiko Watanabe
- Medical Affairs Division, Novartis Pharma K.K., Tokyo 105-6333, Japan
- Correspondence: ; Tel.: +81-80-3026-4262
| | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
| | | | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-8421, Japan
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22
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Efficacy, durability, and safety of faricimab with extended dosing up to every 16 weeks in Japanese patients with diabetic macular edema: 1-year results from the Japan subgroup of the phase 3 YOSEMITE trial. Jpn J Ophthalmol 2023; 67:264-279. [PMID: 36897413 PMCID: PMC9999055 DOI: 10.1007/s10384-023-00979-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Accepted: 01/18/2023] [Indexed: 03/11/2023]
Abstract
PURPOSE To evaluate efficacy, durability, and safety of faricimab in Japanese patients with diabetic macular edema (DME). STUDY DESIGN Subgroup analysis of 2 global, multicenter, randomized, double-masked, active-comparator-controlled, phase 3 trials (YOSEMITE, NCT03622580; RHINE, NCT03622593). METHODS Patients with DME were randomized 1:1:1 to intravitreal faricimab 6.0 mg every 8 weeks (Q8W), faricimab 6.0 mg per personalized treatment interval (PTI), or aflibercept 2.0 mg Q8W through week 100. Primary endpoint was best-corrected visual acuity (BCVA) change from baseline at 1 year, averaged over weeks 48, 52, and 56. This is the first time 1-year outcomes between Japanese patients (only enrolled into YOSEMITE) and the pooled YOSEMITE/RHINE cohort (N = 1891) have been compared. RESULTS The YOSEMITE Japan subgroup included 60 patients randomized to faricimab Q8W (n = 21), faricimab PTI (n = 19), or aflibercept Q8W (n = 20). Consistent with global results, the adjusted mean (95.04% confidence interval) BCVA change at 1 year in the Japan subgroup was comparable with faricimab Q8W (+11.1 [7.6-14.6] letters), faricimab PTI (+8.1 [4.4-11.7] letters), and aflibercept Q8W (+6.9 [3.3-10.5] letters). At week 52, 13 (72%) patients in the faricimab PTI arm achieved ≥ Q12W dosing, including 7 (39%) patients receiving Q16W dosing. Anatomic improvements with faricimab were generally consistent between the Japan subgroup and pooled YOSEMITE/RHINE cohort. Faricimab was well tolerated; no new or unexpected safety signals were identified. CONCLUSION Consistent with global results, faricimab up to Q16W offered durable vision gains and improved anatomic and disease-specific outcomes among Japanese patients with DME.
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23
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Nishida K, Morimoto T, Terasawa Y, Sakaguchi H, Kamei M, Miyoshi T, Fujikado T, Nishida K. The influence of stimulating electrode conditions on electrically evoked potentials and resistance in suprachoroidal transretinal stimulation. Jpn J Ophthalmol 2023; 67:182-188. [PMID: 36626079 DOI: 10.1007/s10384-022-00972-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 11/17/2022] [Indexed: 01/11/2023]
Abstract
PURPOSE To determine the influence of stimulating electrode conditions on the amplitudes and latencies of electrically evoked potentials (EEPs) and the resistance at the electrode-tissue interface in the suprachoroidal transretinal stimulation (STS) system. STUDY DESIGN Experimental study. METHODS A scleral pocket (3 × 5 mm) was created just over the visual streak in anesthetized pigmented rabbits (weight, 1.9-2.7 kg), and STS stimulating electrodes were implanted into the pocket. Measurements were obtained with stimulating electrodes of different lengths (0.3 or 0.5 mm) and different surface characteristics (smooth or porous). EEPs elicited with a fixed current under each set of electrode conditions were recorded; three measurement sessions were performed for each rabbit. The resistance at each electrode-tissue interface was measured. RESULTS The latencies and amplitudes of the EEPs did not differ significantly with changes in the height and surface characteristics of the stimulating electrodes, but the resistances at the electrode-tissue interface differed significantly (P = 0.001; the resistance values for the 0.3-mm-long electrode with a porous surface was 5.24 ± 0.67 kΩ and with the 0.3- and 0.5-mm-long electrodes with smooth surfaces were 7.63 ± 0.12 kΩ and 6.77 ± 0.20 kΩ). CONCLUSION Being shorter did not affect the EEPs of the stimulating electrodes with a porous surface while decreasing the resistance at the electrode-tissue interface.
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Affiliation(s)
- Kentaro Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, #E7, Suita, 565-0871, Japan.
| | - Takeshi Morimoto
- Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, #E7, Suita, 565-0871, Japan
| | - Yasuo Terasawa
- R&D Division, Artificial Vision Institute, NIDEK Co., Ltd., Gamagori, Japan
| | - Hirokazu Sakaguchi
- Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, #E7, Suita, 565-0871, Japan.,Department of Ophthalmology, Gifu University Graduate School of Medicine, Yanagido, Gifu, Japan
| | - Motohiro Kamei
- Department of Ophthalmology, Aichi Medical University, Nagakute, Japan
| | - Tomomitsu Miyoshi
- Department of Integrative Physiology, Osaka University Graduate School of Medicine, Suita, Japan
| | - Takashi Fujikado
- Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, #E7, Suita, 565-0871, Japan
| | - Kohji Nishida
- Department of Ophthalmology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, #E7, Suita, 565-0871, Japan.,Integrated Frontier Research for Medical Science Division, Institute for Open and Transdisciplinary Research Initiatives (OTRI), Osaka University, 2-2 Yamadaoka, Suita, Osaka, Japan
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Novel Vertical Cup-to-Disc Classification to Identify Normal Eyes That Maintain Non-Glaucoma Status: A 10-Year Longitudinal Study. J Glaucoma 2023; 32:127-132. [PMID: 36001508 DOI: 10.1097/ijg.0000000000002109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Accepted: 07/21/2022] [Indexed: 01/28/2023]
Abstract
PRCIS We propose a new classification model to serve as a control for future genomic studies of glaucoma by distinguishing normal subjects maintaining non-glaucoma status for 10 years using the vertical cup-to-disc ratio (VCDR). PURPOSE This study aimed to develop a classification for distinguishing subjects maintaining non-glaucoma status for 10 years using the VCDR. PARTICIPANTS AND METHODS Among 842 volunteers 40 years and older, 421 volunteers participated in the second ophthalmic examination 10 years after their first examination. Each volunteer was diagnosed either as healthy normal or glaucoma suspect (GS) in the first glaucoma screening examinations. The former was further classified into the 3 grades of N1, N2, and N3. Specifically, N1 represented (1) VCDR <0.3; (2) no notching or nerve fiber layer defect; and (3) no undermining, N2 indicated 0.3≤VCDR<0.6 and conditions (2) and (3) of N1; and N3 represented 0.3≤VCDR<0.6 with undermining and condition (2), or 0.6≤VCDR<0.7 and condition (2) of N1. Glaucoma transition rates (GTRs) were evaluated in 421 volunteers who returned to participate after a 10-year period. RESULTS GTRs were calculated as 1.3% in both N1 and N2, 3.9% in N3, and 18.2% in GS. The ratio of volunteers in the same category maintenance rate increased from N1 to N3. CONCLUSION GTRs were lower in N1 and N2 than in N3 or GS during the 10-year study period. This novel classification of healthy non-glaucoma subjects may help identify those, especially Japanese males, who maintain a non-glaucoma status for an extended period of 10 years.
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25
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Tobimatsu Y, Ogihara R, Endo N, Hirose A, Takeda R, Babazono T, Kitano S. Comparison of the Effect of Bromfenac versus Betamethasone Ophthalmic Solutions in Patients with Diabetic Macular Edema. Curr Eye Res 2023; 48:80-85. [PMID: 36331099 DOI: 10.1080/02713683.2022.2140438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
PURPOSE To examine the effect of 0.1% bromfenac (BF) ophthalmic solution and 0.1% betamethasone (BM) ophthalmic solution on diabetic macular edema (DME). METHODS This was a prospective trial. Nineteen patients (mean age of 66.6 ± 10.1 years) with DME and mean retinal thickness within a diameter of 1 mm from the fovea (central subfield thickness: CST) of 250-500 µm were randomized and instilled with BF or BM. CST, best-corrected visual acuity (BCVA), and intraocular pressure (IOP) were measured at 4, 8, and 12 weeks after administration. RESULTS CST at baseline (p = .128) and that at 4, 8, and 12 weeks of administration was not significantly different between the BF (10 patients) and BM groups (9 patients). In patients with glycated hemoglobin (HbA1c) <8.0%, CST, compared with baseline, was significantly decreased in the BF group (seven patients) at 8 (p = .025) and 12 weeks (p = .043) of administration. When compared with the baseline, no significant changes in BCVA were observed at any point in time in either group. Baseline IOP was comparable between the groups. In the BM group, the values of change in IOP from baseline significantly increased at 8 (p = .025) and 12 weeks (p = .044) of administration, with no significant changes in IOP over the 12 weeks of administration in the BF group. CONCLUSIONS BF did not affect IOP even after 12 weeks of administration, suggesting its effect in reducing CST in DME with good glycemic control. TRIAL REGISTRATION University Hospital Medical Information Network (UMIN-CTR); UMIN000026201, February 18, 2017; Japan Registry of Clinical Trials; jRCTs031180308, March 15, 2019.
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Affiliation(s)
- Yui Tobimatsu
- Diabetes Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Rie Ogihara
- Diabetes Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Naoko Endo
- Diabetes Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Akira Hirose
- Minami Diabetes Clinical Research Center, Fukuoka, Japan
| | - Ryuji Takeda
- Kansai University of Welfare Sciences, Osaka, Japan
| | - Tetsuya Babazono
- Diabetes Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Shigehiko Kitano
- Diabetes Center, Tokyo Women's Medical University Hospital, Tokyo, Japan
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26
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Ma Y, Wang X, Li R. AIRE gene mutation predisposing chronic mucocutaneous candidiasis and pigmented retinitis in two kids from a Chinese family. Emerg Microbes Infect 2022; 11:1705-1706. [PMID: 35722705 PMCID: PMC9246000 DOI: 10.1080/22221751.2022.2090860] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022]
Affiliation(s)
- Yubo Ma
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, People's Republic of China.,Research Center for Medical Mycology, Peking University, Beijing, People's Republic of China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, People's Republic of China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, People's Republic of China
| | - Xiaowen Wang
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, People's Republic of China.,Research Center for Medical Mycology, Peking University, Beijing, People's Republic of China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, People's Republic of China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, People's Republic of China
| | - Ruoyu Li
- Department of Dermatology and Venerology, Peking University First Hospital, Beijing, People's Republic of China.,Research Center for Medical Mycology, Peking University, Beijing, People's Republic of China.,Beijing Key Laboratory of Molecular Diagnosis on Dermatoses, Beijing, People's Republic of China.,National Clinical Research Center for Skin and Immune Diseases, Beijing, People's Republic of China
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27
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Nishitsuka K, Nishi K, Yamashita H. Effectiveness of intraoperative optical coherence tomography on vitrectomy for proliferative diabetic retinopathy. Jpn J Ophthalmol 2022; 66:527-533. [PMID: 36318355 DOI: 10.1007/s10384-022-00944-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 07/21/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE We sought to verify the effect of intraoperative optical coherence tomography (iOCT) on vitrectomy for the treatment of proliferative diabetic retinopathy (PDR). STUDY DESIGN Retrospective study. METHODS We reviewed 178 eyes with PDR treated with 25-gauge vitrectomy by a single surgeon between April 2013 and December 2017. In total, 98 eyes of 77 patients with PDR (mean age, 52.5 ± 11.7 years) treated with vitrectomy using iOCT (iOCT group) and 80 eyes of 60 patients with PDR (mean age, 53.1 ± 10.9 years) treated without iOCT (non-iOCT group) were included in the study. To determine the effects of combining vitrectomy with iOCT, a comparison was made of patients treated with this combination and patients treated with vitrectomy without iOCT. The effects of these treatments were assessed on the basis of intraoperative complications, reoperation ratios, postoperative complications, operation times, and postoperative visual acuity. RESULTS The operation time was significantly reduced for the iOCT group (72.9 ± 23.9 min) when compared with the non-iOCT group (91.3 ± 31.2 min) (P = .001). The incidences of intraoperative complications, reoperation, and postoperative complications did not differ significantly between the 2 groups (P = .542, 0.258, and 0.860 respectively). Six months after surgery, the postoperative visual acuity did not differ significantly between the 2 groups (P = .508). Multiple linear regression analysis revealed that the operation time was significantly correlated with iOCT (beta [standard partial regression coefficient] = - 0.28, P < .001), the fibrovascular proliferative membrane (beta = 0.17, P = .009), cataract surgery (beta = 0.22, P = .016), preoperative retinal photocoagulation (beta = - 0.14, P = .021), intraoperative complications (beta = 0.16, P = .023), and posterior vitreous detachment (beta = - 0.14, P = .04). CONCLUSION Use of iOCT reduced the operation time without affecting the incidence rates of intraoperative and postoperative complications, reoperation ratios, or postoperative visual acuities in patients who underwent vitreous surgery for PDR.
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Affiliation(s)
- Koichi Nishitsuka
- Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, Japan.
| | - Katsuhiro Nishi
- Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Hidetoshi Yamashita
- Department of Ophthalmology and Visual Sciences, Yamagata University Faculty of Medicine, Yamagata, Japan
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Inoue N, Kato A, Araki T, Kimura T, Kinoshita T, Okamoto F, Murakami T, Mitamura Y, Sakamoto T, Miki A, Takamura Y, Matsubara H, Tsujinaka H, Gomi F, Yasukawa T. Visual prognosis of submacular hemorrhage secondary to age-related macular degeneration: A retrospective multicenter survey. PLoS One 2022; 17:e0271447. [PMID: 35862313 PMCID: PMC9302799 DOI: 10.1371/journal.pone.0271447] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Accepted: 06/25/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose
To investigate the clinical features, treatment options, and visual outcomes of submacular hemorrhage (SMH) secondary to neovascular age-related macular degeneration (nAMD).
Design
A retrospective, observational case series.
Methods
Setting: Multicenter institutional setting. Patient Population: A total of 127 patients (127 eyes; 88 men, 39 women; (mean age, 74.2 years)) diagnosed with AMD-associated SMHs exceeding 2 disc diameters involving the fovea. Observation: The AMD types, previous treatments, treatment options, anatomic findings, and best-corrected visual acuity (BCVA) were assessed. Main Outcome Measures: Clinical features, treatment options, and visual outcomes of SMHs secondary to nAMD.
Results
Thirty-two eyes had typical AMD, 94 eyes polypoidal choroidal vasculopathy (PCV), and one eye retinal angiomatous proliferation. Eighty-five eyes were treatment-naïve; 42 eyes were treated previously: anti-vascular endothelial growth factor (VEGF) therapy (n = 26), photodynamic therapy (n = 3), and combined therapy (n = 13). Treatment of SMHs included vitrectomy (36 eyes), pneumatic displacement (49 eyes), and anti-VEGF monotherapy (42 eyes). The final BCVA improved significantly in treatment-naïve cases from 0.86 to 0.62 logarithm of the minimal angle of resolution (logMAR) unit (Snellen equivalent from 20/145 to 20/83) and from 0.80 to 0.56 (Snellen equivalent from 20/126 to 20/73) in PCV cases. Meanwhile, the BCVA logMAR values improved from 1.15 to 0.75 (Snellen equivalent from 20/283 to 20/112) and from 0.87 to 0.63 (Snellen equivalent from 20/148 to 20/85) in eyes that underwent vitrectomy or pneumatic displacement, respectively. In eyes with BCVAs between 20/133 to 20/40 at SMH onset, the final VA in the pneumatic displacement group was better than in the anti-VEGF monotherapy group. One eye had a retinal detachment and 1 eye had a macular hole in the vitrectomy group, and 5 eyes had a vitreous hemorrhage in the pneumatic displacement group.
Conclusions
The recommended treatment for SMHs secondary to nAMD exceeding 2 disc area and with BCVA below 20/40 is vitrectomy or pneumatic displacement for visual improvement.
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Affiliation(s)
- Naomi Inoue
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
| | - Aki Kato
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- * E-mail:
| | - Takashi Araki
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takeshi Kimura
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Takamasa Kinoshita
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan
| | - Fumiki Okamoto
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Tomoya Murakami
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshinori Mitamura
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Taiji Sakamoto
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
| | - Akiko Miki
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Surgery, Division of Ophthalmology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Yoshihiro Takamura
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, Yoshida, Japan
| | - Hisashi Matsubara
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Mie University Graduate School of Medicine, Tsu, Japan
| | - Hiroki Tsujinaka
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Nara Medical University School of Medicine, Kashihara, Japan
| | - Fumi Gomi
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
- Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Japan
| | - Tsutomu Yasukawa
- Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
- J-CREST (Japanese Clinical Retina Study) Group, Kagoshima, Japan
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Inatani M, Kohama I, Chu A. iStent Trabecular Micro-bypass Stent Implantation Combined with Phacoemulsification for Open-Angle Glaucoma: A 2-Year Post-marketing Surveillance Study in Japan. Adv Ther 2022; 39:4076-4093. [PMID: 35790641 PMCID: PMC9402767 DOI: 10.1007/s12325-022-02207-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/24/2022] [Indexed: 11/18/2022]
Abstract
Introduction We report 2-year outcomes after implantation of iStent trabecular micro-bypass stent with phacoemulsification, in Japanese patients with mild–moderate open-angle glaucoma (OAG). Methods This was a 24-month, prospective, longitudinal, observational, post-marketing study conducted between July 2017 and September 2020. Patients consisted of adults with OAG on antiglaucoma medications who had cataract surgery combined with one iStent implantation. Outcome measures included intraocular pressure (IOP), antiglaucoma medications, treatment success rates (defined as eyes having lower IOP with same or reduced number of medications from baseline, or same IOP with reduced number of medications from baseline, and not requiring secondary glaucoma surgeries postoperatively), and safety. Outcomes were analyzed in the overall cohort and in glaucoma subtypes: primary OAG, normal-tension glaucoma, and exfoliative glaucoma. Results Overall, 232 eyes were enrolled. At 24 months, mean ± standard deviation IOP decreased from 17.6 ± 4.0 mmHg preoperatively to 14.3 ± 3.0 mmHg (p < 0.05), and mean number of medications reduced from 2.2 ± 1.2 preoperatively to 0.7 ± 1.2 (p < 0.05). Similar trends were observed across glaucoma subtypes. In the overall cohort, 96.7%, 95.3%, and 93.7% of patients achieved treatment success at 6, 12, and 24 months, respectively. There were 67.6% medication-free eyes at 24 months compared to 3.2% medication-free eyes preoperatively (p < 0.0001). Safety profile was favorable over the 2-year period. Conclusions Following iStent implantation with phacoemulsification, clinically relevant and statistically significant reductions in IOP and number of medications were observed in Japanese eyes with OAG over 2 years, with favorable safety profile. These reductions were observed across all glaucoma subtypes. Supplementary Information The online version contains supplementary material available at 10.1007/s12325-022-02207-0.
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Affiliation(s)
- Masaru Inatani
- Department of Ophthalmology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji, Yoshida, Fukui, 910-1193, Japan.
| | | | - Alice Chu
- Glaukos Corporation, Singapore, Singapore
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Effects of Epigenetic Modification of PGC-1α by a Chemical Chaperon on Mitochondria Biogenesis and Visual Function in Retinitis Pigmentosa. Cells 2022; 11:cells11091497. [PMID: 35563803 PMCID: PMC9099608 DOI: 10.3390/cells11091497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/13/2022] [Accepted: 04/27/2022] [Indexed: 11/17/2022] Open
Abstract
Retinitis pigmentosa (RP) is a hereditary blinding disease characterized by gradual photoreceptor death, which lacks a definitive treatment. Here, we demonstrated the effect of 4-phenylbutyric acid (PBA), a chemical chaperon that can suppress endoplasmic reticulum (ER) stress, in P23H mutant rhodopsin knock-in RP models. In the RP models, constant PBA treatment led to the retention of a greater number of photoreceptors, preserving the inner segment (IS), a mitochondrial- and ER-rich part of the photoreceptors. Electroretinography showed that PBA treatment preserved photoreceptor function. At the early point, ER-associated degradation markers, xbp1s, vcp, and derl1, mitochondrial kinetic-related markers, fis1, lc3, and mfn1 and mfn2, as well as key mitochondrial regulators, pgc-1α and tfam, were upregulated in the retina of the models treated with PBA. In vitro analyses showed that PBA upregulated pgc-1α and tfam transcription, leading to an increase in the mitochondrial membrane potential, cytochrome c oxidase activity, and ATP levels. Histone acetylation of the PGC-1α promoter was increased by PBA, indicating that PBA affected the mitochondrial condition through epigenetic changes. Our findings constituted proof of concept for the treatment of ER stress-related RP using PBA and revealed PBA’s neuroprotective effects, paving the way for its future clinical application.
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Combining Optical Coherence Tomography and Fundus Photography to Improve Glaucoma Screening. Diagnostics (Basel) 2022; 12:diagnostics12051100. [PMID: 35626256 PMCID: PMC9139676 DOI: 10.3390/diagnostics12051100] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 12/29/2022] Open
Abstract
We aimed to evaluate the accuracy of glaucoma screening using fundus photography combined with optical coherence tomography and determine the agreement between ophthalmologists and ophthalmology residents. We used a comprehensive ophthalmologic examination dataset obtained from 503 cases (1006 eyes). Of the 1006 eyes, 132 had a confirmed glaucoma diagnosis. Overall, 24 doctors, comprising two groups (ophthalmologists and ophthalmology residents, 12 individuals/group), analyzed the data presented in three screening strategies as follows: (1) fundus photography alone, (2) fundus photography + optical coherence tomography, and (3) fundus photography + optical coherence tomography + comprehensive examination. We investigated the diagnostic accuracy (sensitivity and specificity). The respective sensitivity and specificity values for the diagnostic accuracy obtained by 24 doctors, 12 ophthalmologists, and 12 ophthalmology residents were as follows: (1) fundus photography: sensitivity, 55.4%, 55.4%, and 55.4%; specificity, 91.8%, 94.0%, and 89.6%; (2) fundus photography + OCT: sensitivity, 80.0%, 82.3%, and 77.8%; specificity, 91.7%, 92.9%, and 90.6%; and (3) fundus photography + OCT + comprehensive examination: sensitivity 78.4%, 79.8%, and 77.1%; specificity, 92.7%, 94.0%, and 91.3%. The diagnostic accuracy of glaucoma screening significantly increased with optical coherence tomography. Following its addition, ophthalmologists could more effectively improve the diagnostic accuracy than ophthalmology residents. Screening accuracy is improved when optical coherence tomography is added to fundus photography.
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Maeda T, Mandai M, Sugita S, Kime C, Takahashi M. Strategies of pluripotent stem cell-based therapy for retinal degeneration: update and challenges. Trends Mol Med 2022; 28:388-404. [DOI: 10.1016/j.molmed.2022.03.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/28/2022] [Accepted: 03/01/2022] [Indexed: 12/12/2022]
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Matsumoto H, Hoshino J, Mukai R, Nakamura K, Kishi S, Akiyama H. Clinical characteristics and pachychoroid incidence in Japanese patients with neovascular age-related macular degeneration. Sci Rep 2022; 12:4492. [PMID: 35296769 PMCID: PMC8927155 DOI: 10.1038/s41598-022-08666-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 03/11/2022] [Indexed: 11/09/2022] Open
Abstract
The phenotypes of neovascular age-related macular degeneration (nAMD) are recognized as differing between Caucasian and Asian patients. Pachychoroid is thought to be more prevalent in Asians than in Caucasians, and may be involved in the development of nAMD in Asian patients. Therefore, we investigated the clinical characteristics and pachychoroid incidence in Japanese patients with nAMD. We retrospectively analyzed 385 eyes of 370 consecutive Japanese patients with treatment naïve nAMD. According to the nAMD nomenclature, type 1 macular neovascularization (MNV) was observed in 132 eyes (34.3%), polypoidal choroidal vasculopathy (PCV) in 137 (35.6%), mixed type 1 and type 2 MNV in 32 (8.3%), type 2 MNV in 43 (11.2%), and type 3 MNV in 41 (10.6%). Pachychoroid was seen in 58.3% of type 1 MNV, 75.2% of PCV, 34.4% of mixed type 1 and type 2 MNV, 14.0% of type 2 MNV, and 0% of type 3 MNV. Compared to nAMD patients without pachychoroid (188 eyes), those who had nAMD with pachychoroid (197 eyes) were significantly younger, had a higher proportion of males, greater central choroidal thickness, and a higher frequency of macular vortex vein anastomoses (all P < 0.001). Furthermore, drusen subtypes differed significantly between the two groups (P < 0.001). These results suggest that most Japanese nAMD patients might have type 1 MNV or PCV. Moreover, in approximately half of patients, nAMD might be associated with pachychoroid, and choroidal congestion may be involved in the development of MNV in these cases.
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Affiliation(s)
- Hidetaka Matsumoto
- Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan.
| | - Junki Hoshino
- Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Ryo Mukai
- Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Kosuke Nakamura
- Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Shoji Kishi
- Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
| | - Hideo Akiyama
- Department of Ophthalmology, Gunma University Graduate School of Medicine, 3-39-15 Showa-machi, Maebashi, Gunma, 371-8511, Japan
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Mut SR, Mishra S, Vazquez M. A Microfluidic Eye Facsimile System to Examine the Migration of Stem-like Cells. MICROMACHINES 2022; 13:mi13030406. [PMID: 35334698 PMCID: PMC8954941 DOI: 10.3390/mi13030406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Revised: 02/24/2022] [Accepted: 02/24/2022] [Indexed: 02/05/2023]
Abstract
Millions of adults are affected by progressive vision loss worldwide. The rising incidence of retinal diseases can be attributed to damage or degeneration of neurons that convert light into electrical signals for vision. Contemporary cell replacement therapies have transplanted stem and progenitor-like cells (SCs) into adult retinal tissue to replace damaged neurons and restore the visual neural network. However, the inability of SCs to migrate to targeted areas remains a fundamental challenge. Current bioengineering projects aim to integrate microfluidic technologies with organotypic cultures to examine SC behaviors within biomimetic environments. The application of neural phantoms, or eye facsimiles, in such systems will greatly aid the study of SC migratory behaviors in 3D. This project developed a bioengineering system, called the μ-Eye, to stimulate and examine the migration of retinal SCs within eye facsimiles using external chemical and electrical stimuli. Results illustrate that the imposed fields stimulated large, directional SC migration into eye facsimiles, and that electro-chemotactic stimuli produced significantly larger increases in cell migration than the individual stimuli combined. These findings highlight the significance of microfluidic systems in the development of approaches that apply external fields for neural repair and promote migration-targeted strategies for retinal cell replacement therapy.
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Affiliation(s)
- Stephen Ryan Mut
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, 599 Taylor Rd, Piscataway, NJ 08854, USA;
| | - Shawn Mishra
- Regeneron, 777 Old Saw Mill River Rd, Tarrytown, NY 10591, USA;
| | - Maribel Vazquez
- Department of Biomedical Engineering, Rutgers, The State University of New Jersey, 599 Taylor Rd, Piscataway, NJ 08854, USA;
- Correspondence:
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Eighteen-year trends in the management of patients with diabetes in the Shiga Diabetes Clinical Survey: overall trends and differences by age group. Diabetol Int 2022; 13:566-574. [PMID: 35693988 PMCID: PMC9174363 DOI: 10.1007/s13340-022-00573-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 02/02/2022] [Indexed: 10/19/2022]
Abstract
Aim To examine the trends in the management of patients with diabetes over an 18-year period in Japan. Participants and methods We recorded the height, body mass, laboratory data, diabetes treatment, and screening status of diabetic complications from the data collected during the Shiga Diabetes Clinical Survey, which has been performed every 6 years since 2000. We then evaluated the management of patients with diabetes in Shiga Prefecture. The study included 17,870, 18,398, 24,243, and 26,624 participants in each of the 4 years of measurements. Results The mean age and body mass index (BMI) of the participants gradually increased. The percentage of patients with BMI of ≥ 25 kg/m2 was higher in younger patients. Glycemic control significantly improved over 18 years (hemoglobin A1c: 7.3% ± 1.4% in 2000 to 7.1% ± 1.1% in 2018, P for trend < 0.001). The mean hemoglobin A1c levels were higher in younger patients than in elderly patients and increased from 2012 to 2018 in patients aged ≥ 65 years. The proportion of participants who underwent screening for albuminuria and diabetic retinopathy increased. The mean blood pressure and low-density lipoprotein cholesterol concentration decreased. Conclusions Glycemic control has been maintained at an acceptable level since the previous survey. Although glycemic control has become less strict in elderly patients with diabetes, glycemic control is poorer in younger patients than in elderly patients. Obesity is an increasingly important problem, particularly in younger patients. The frequency of screening for diabetic complications and the control of blood pressure should be improved. Supplementary Information The online version contains supplementary material available at 10.1007/s13340-022-00573-2.
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Inaba A, Yoshida A, Maeda A, Kawai K, Kosugi S, Takahashi M. Perception of genetic testing among patients with inherited retinal disease: Benefits and challenges in a Japanese population. J Genet Couns 2022; 31:860-867. [PMID: 35106875 DOI: 10.1002/jgc4.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 01/10/2022] [Accepted: 01/15/2022] [Indexed: 11/10/2022]
Abstract
Inherited retinal disease (IRD) is clinically and genetically heterogeneous. Awareness of the importance of genetic testing for IRD in the clinical setting is increasing with the recent development of new therapeutic strategies, such as gene therapy. Here, the perception of genetic testing, including its benefits and potential challenges, among patients with IRD was investigated to establish strategies for IRD genetic testing and counseling practices that can meet the requirements of the patients in Japan. An anonymous self-administered questionnaire was distributed to 275 patients with IRD who underwent genetic testing after clinical consultation and genetic counseling to investigate the motivations for genetic testing, benefits, challenges, status of communication of results to family, and attitude to timing of genetic testing. In total, 228 (82.9%) responses were analyzed. Several major motivations for genetic testing were identified, including gaining information on future treatment options and clarification of the inheritance pattern, among others. No association was found between the sharing of results with family members and the results of genetic testing. Moreover, according to patients who received positive results, the benefits of genetic testing included information on the inheritance pattern, additional information on the diagnosis, and mental preparation for the future. Even patients who received negative or inconclusive (variant of uncertain significance) results reported certain informative and psychological benefits. Altogether, these findings suggest that provisions for genetic testing and genetic counseling are necessary within a certain period after clinical diagnosis and it is necessary to facilitate appropriate family communication about genetic testing results while paying attention to the background of family relationships. Moreover, the benefits of genetic testing can be influenced by the careful interpretation and information provided on the test results during genetic counseling and consultation.
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Affiliation(s)
- Akira Inaba
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan.,Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Akiko Yoshida
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Akiko Maeda
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Kanako Kawai
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
| | - Shinji Kosugi
- Department of Medical Ethics, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masayo Takahashi
- Department of Ophthalmology, Kobe City Eye Hospital, Kobe, Japan.,Laboratory for Retinal Regeneration, RIKEN, Center for Biosystems Dynamics Research, Kobe, Japan
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Seasonal Variation and Trend of Intraocular Pressure Decrease Over a 20-Year Period in Normal-Tension Glaucoma Patients. Am J Ophthalmol 2022; 234:235-240. [PMID: 34648775 DOI: 10.1016/j.ajo.2021.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 10/04/2021] [Accepted: 10/06/2021] [Indexed: 11/22/2022]
Abstract
PURPOSE To investigate the trend of seasonal variation of intraocular pressure (IOP) in patients with normal-tension glaucoma over a 20-year period by retrospectively analyzing the Kyoto Prefectural University of Medicine Glaucoma Registry database as real-world data. DESIGN Retrospective cohort study. METHODS Data points (n = 49,007) were extracted retrospectively from the medical records of 1774 patients with normal-tension glaucoma (665 male patients and 1109 female patients; mean ± SD age was 59.8 ± 14.4 years; and mean ± SD observation period was 5.6 ± 4.4 years) seen over the 20-year period. We first calculated the mean IOP from all available data of each month from January 1997 through December 2016. The data were then categorized into 5 groups of 4 consecutive years each (1997-2000, 2001-2004, 2005-2008, 2009-2012, and 2013-2016) and the mean IOP of each month within the group was calculated. Seasonal variations of IOP over the 20-year study period and in the 5 consecutive groups were then investigated via nonlinear multiple regression analysis. RESULTS A continuous decrease of IOP was detected throughout the 20-year period (P < .001), with distinct seasonal variation. The annual mean ± SD IOP was highest (13.9 ± 2.7 mm Hg) in the oldest group (1997-2000), with a gradual decrease in each subsequent group, finally becoming lowest (12.3 ± 2.7 mm Hg) in the most recent group (2013-2016) (P < .001), and all of them were accompanied by distinct seasonal variation (P < .001). CONCLUSIONS Based on the Kyoto Prefectural University of Medicine Glaucoma Registry real-world longitudinal data, our findings revealed a continuous decrease and distinct seasonal variation of IOP in patients with normal-tension glaucoma throughout the 20-year study period.
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Tamura H, Akune Y, Hiratsuka Y, Kawasaki R, Kido A, Miyake M, Goto R, Yamada M. Real-world effectiveness of screening programs for age-related macular degeneration: amended Japanese specific health checkups and augmented screening programs with OCT or AI. Jpn J Ophthalmol 2022; 66:19-32. [PMID: 34993676 DOI: 10.1007/s10384-021-00890-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/18/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To investigate the effectiveness of screening and subsequent intervention for age-related macular degeneration (AMD) in Japan. STUDY DESIGN Best-case-scenario analysis using a Markov model. METHODS The clinical effectiveness and cost-effectiveness of screening for AMD were assessed by calculating the reduction proportion of blindness and the incremental cost-effectiveness ratio (ICER). The Markov model simulation began at screening at the age of 40 years and ended at screening at the age of 90 years. The first-eye and second-eye combined model assumed annual state-transition probabilities in the development and treatment of AMD. Data on prevalence, morbidity, transition probability, utility value, and treatment costs were obtained from previously published reports. Sensitivity analysis was performed to assess the influence of the parameters. RESULTS In the base-case analysis, screening for AMD every 5 years, beginning at age 40 years and ending at age 74 years (reflecting the screening ages of the current Japanese legal "Specific Health Checkups") showed a decrease of 40.7% in the total number of blind patients. The screening program reduced the number of blind people more than did the additional AREDS/AREDS2 formula supplement intake. However, the ICER of screening versus no screening was ¥9,846,411/QALY, which was beyond what people were willing to pay (WTP) in Japan. Sensitivity analysis revealed that neither OCT nor AI improved the ICER, but the scenario in which the prevalence of smoking decreased by 30% improved the ICER (¥4,655,601/QALY) to the level under the WTP. CONCLUSIONS Ophthalmologic screening for AMD is highly effective in reducing blindness but is not cost-effective, as demonstrated by a Markov model based on real-world evidence from Japan.
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Affiliation(s)
- Hiroshi Tamura
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.
- Center for Innovative Research and Education in Data Science, Institute for Liberal Arts and Sciences, Kyoto University, Kyoto, Japan.
| | - Yoko Akune
- Graduate School of Health Management, Keio University, Tokyo, Japan
| | - Yoshimune Hiratsuka
- Department of Ophthalmology, Juntendo University School of Medicine, Tokyo, Japan
| | - Ryo Kawasaki
- Artificial Intelligence Center for Medical Research and Application, Osaka University Hospital, Suita, Japan
| | - Ai Kido
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Rei Goto
- Graduate School of Business Administration, Keio University, Tokyo, Japan
| | - Masakazu Yamada
- Department of Ophthalmology, Kyorin University School of Medicine, Mitaka, Japan
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Wang J, Li M, Geng Z, Khattak S, Ji X, Wu D, Dang Y. Role of Oxidative Stress in Retinal Disease and the Early Intervention Strategies: A Review. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:7836828. [PMID: 36275903 PMCID: PMC9586758 DOI: 10.1155/2022/7836828] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 08/05/2022] [Accepted: 08/11/2022] [Indexed: 02/05/2023]
Abstract
The retina, owing to its cellular anatomy and physical location, is susceptible to generating reactive oxygen species (ROS), which are associated with several major retinal diseases. When ROS exceeds the body's natural antioxidants, the retina is in a state of oxidative stress, which is recognized as the pathogenesis of retinal diseases. The early stage of the pathogenic process is an adaptive change in which oxidative stress and endogenous defense mechanisms occur. If no treatment is applied, the retinal diseases will progress to the pathological stage with neuronal and vascular dysfunction or damage and even blindness. This review summarizes the role of oxidative stress in several common retinal diseases, including retinitis pigmentosa, age-related macular degeneration, diabetic retinopathy, glaucoma, and retinopathy of prematurity. In addition, we discuss the early intervention strategies for these diseases. An outline is provided to identify potential intervention targets for further research. Early intervention for retinal diseases is necessary and urgent and may offer hope to improve patients' quality of life through functional vision.
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Affiliation(s)
- Jun Wang
- School of Basic Medical Sciences, Henan University, Kaifeng, China
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, China
| | - Mengling Li
- College of Acu-Moxibustion and Massage, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Ziyue Geng
- School of Clinical Medicine, Henan University, Kaifeng, Henan, China
| | - Saadullah Khattak
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, China
| | - Xinying Ji
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, China
| | - Dongdong Wu
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, China
| | - Yalong Dang
- Henan International Joint Laboratory for Nuclear Protein Regulation, Henan University, Kaifeng, China
- Sanmenxia Central Hospital, Sanmenxia, Henan, China
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Kaur G, Singh NK. The Role of Inflammation in Retinal Neurodegeneration and Degenerative Diseases. Int J Mol Sci 2021; 23:ijms23010386. [PMID: 35008812 PMCID: PMC8745623 DOI: 10.3390/ijms23010386] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Revised: 12/24/2021] [Accepted: 12/28/2021] [Indexed: 12/19/2022] Open
Abstract
Retinal neurodegeneration is predominantly reported as the apoptosis or impaired function of the photoreceptors. Retinal degeneration is a major causative factor of irreversible vision loss leading to blindness. In recent years, retinal degenerative diseases have been investigated and many genes and genetic defects have been elucidated by many of the causative factors. An enormous amount of research has been performed to determine the pathogenesis of retinal degenerative conditions and to formulate the treatment modalities that are the critical requirements in this current scenario. Encouraging results have been obtained using gene therapy. We provide a narrative review of the various studies performed to date on the role of inflammation in human retinal degenerative diseases such as age-related macular degeneration, inherited retinal dystrophies, retinitis pigmentosa, Stargardt macular dystrophy, and Leber congenital amaurosis. In addition, we have highlighted the pivotal role of various inflammatory mechanisms in the progress of retinal degeneration. This review also offers an assessment of various therapeutic approaches, including gene-therapies and stem-cell-based therapies, for degenerative retinal diseases.
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Affiliation(s)
- Geetika Kaur
- Integrative Biosciences Center, Wayne State University, Detroit, MI 48202, USA;
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI 48202, USA
| | - Nikhlesh K. Singh
- Integrative Biosciences Center, Wayne State University, Detroit, MI 48202, USA;
- Department of Ophthalmology, Visual and Anatomical Sciences, Wayne State University School of Medicine, Detroit, MI 48202, USA
- Correspondence:
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Kido A, Miyake M, Akagi T, Ikeda HO, Kameda T, Suda K, Hasegawa T, Hiragi S, Yoshida S, Tsujikawa A, Tamura H, Kawakami K. Association between topical β-blocker use and asthma attacks in glaucoma patients with asthma: a cohort study using a claims database. Graefes Arch Clin Exp Ophthalmol 2021; 260:271-280. [PMID: 34370066 DOI: 10.1007/s00417-021-05357-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 04/16/2021] [Accepted: 07/27/2021] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To investigate the association between the use of topical β-blockers and subsequent asthma attacks in glaucoma patients with asthma. METHODS This was a retrospective longitudinal cohort study using an administrative claims database. All patients aged 20 years or older who were registered in the health insurance claims database updated and managed by JMDC Inc. (Tokyo, Japan). Patients who were newly prescribed eye drops for glaucoma treatment were identified between 2011 and 2017. The patients with glaucoma were divided into two groups: β-blocker users and non-β-blocker users, based on the presence of a β-blocker in the prescribed eye drops. We investigated whether the incidence of asthma attacks in patients with previously treated asthma differed between the two groups. RESULTS We categorized 17,666 patients in the β-blocker-user group and 12,609 patients in the non-β-blocker-user group. A total of 580 patients in the β-blocker group (3.28%) and 847 in the non-β-blocker group (6.72%) underwent asthma treatment before the prescription of anti-glaucoma eye drops (P < 0.001). Furthermore, 94 patients in the β-blocker-user group (0.53%) and 278 in the non-β-blocker user group (2.20%) were undergoing current treatment for asthma (P < 0.001). The adjusted hazard ratios of asthma attacks were 0.73 (95% confidence interval, 0.46-1.16, P = 0.18) in patients with a history of asthma treatment and 1.22 (95% confidence interval, 0.56-2.70, P = 0.62) in patients with current asthma treatment, compared to the non-β-blocker-user group. CONCLUSION Our results clarified that several patients with asthma were prescribed topical β-blockers for glaucoma treatment. However, asthma attacks may not be significantly attributed to topical β-blockers, even in glaucoma patients under current asthma treatment. The administration of topical β-blockers to asthma patients could be a treatment option in the absence of other treatment options, if adequate informed consent is obtained. Further studies are needed to draw a firm conclusion on this clinical question.
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Affiliation(s)
- Ai Kido
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Masahiro Miyake
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tadamichi Akagi
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hanako Ohashi Ikeda
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Takanori Kameda
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kenji Suda
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tomoko Hasegawa
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Shusuke Hiragi
- Division of Medical Information Technology and Administration Planning, Kyoto University Hospital, Kyoto, Japan
| | - Satomi Yoshida
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Tamura
- Department of Ophthalmology and Visual Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Koji Kawakami
- Department of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto University, Yoshida-Konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan.
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Guzmán Mendoza NA, Homma K, Osada H, Toda E, Ban N, Nagai N, Negishi K, Tsubota K, Ozawa Y. Neuroprotective Effect of 4-Phenylbutyric Acid against Photo-Stress in the Retina. Antioxidants (Basel) 2021; 10:1147. [PMID: 34356380 PMCID: PMC8301054 DOI: 10.3390/antiox10071147] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 07/12/2021] [Accepted: 07/14/2021] [Indexed: 02/06/2023] Open
Abstract
Exposure to excessive visible light causes retinal degeneration and may influence the progression of retinal blinding diseases. However, there are currently no applied treatments. Here, we focused on endoplasmic reticulum (ER) stress, which can cause cellular degeneration and apoptosis in response to stress. We analyzed functional, histological, and molecular changes in the light-exposed retina and the effects of administering an ER-stress inhibitor, 4-phenylbutyric acid (4-PBA), in mice. We found that light-induced visual function impairment related to photoreceptor cell loss and outer segment degeneration were substantially suppressed by 4-PBA administration, following attenuated photoreceptor apoptosis. Induction of retinal ER stress soon after light exposure, represented by upregulation of the immunoglobulin heavy chain binding protein (BiP) and C/EBP-Homologous Protein (CHOP), were suppressed by 4-PBA. Concurrently, light-induced oxidative stress markers, Nuclear factor erythroid 2-related factor 2 (Nrf2) and Heme Oxygenase 1 (HO-1), and mitochondrial apoptotic markers, B-cell lymphoma 2 apoptosis regulator (Bcl-2)-associated death promoter (Bad), and Bcl-2-associated X protein (Bax), were suppressed by 4-PBA administration. Increased expression of glial fibrillary acidic protein denoted retinal neuroinflammation, and inflammatory cytokines were induced after light exposure; however, 4-PBA acted as an anti-inflammatory. Suppression of ER stress by 4-PBA may be a new therapeutic approach to suppress the progression of retinal neurodegeneration and protect visual function against photo-stress.
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Affiliation(s)
- Naymel Alejandra Guzmán Mendoza
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (N.A.G.M.); (K.H.); (H.O.); (E.T.); (N.B.); (N.N.)
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
| | - Kohei Homma
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (N.A.G.M.); (K.H.); (H.O.); (E.T.); (N.B.); (N.N.)
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
| | - Hideto Osada
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (N.A.G.M.); (K.H.); (H.O.); (E.T.); (N.B.); (N.N.)
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
| | - Eriko Toda
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (N.A.G.M.); (K.H.); (H.O.); (E.T.); (N.B.); (N.N.)
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
| | - Norimitsu Ban
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (N.A.G.M.); (K.H.); (H.O.); (E.T.); (N.B.); (N.N.)
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
| | - Norihiro Nagai
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (N.A.G.M.); (K.H.); (H.O.); (E.T.); (N.B.); (N.N.)
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
- Department of Ophthalmology, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
- Laboratory of Retinal Cell Biology, St. Luke’s International University, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
| | - Kazuo Tsubota
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
| | - Yoko Ozawa
- Laboratory of Retinal Cell Biology, Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (N.A.G.M.); (K.H.); (H.O.); (E.T.); (N.B.); (N.N.)
- Department of Ophthalmology, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan; (K.N.); (K.T.)
- Department of Ophthalmology, St. Luke’s International Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
- Laboratory of Retinal Cell Biology, St. Luke’s International University, 9-1 Akashi-cho, Chuo-ku, Tokyo 104-8560, Japan
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Saito Y, Kizaki J, Wada Y, Shibasaki Y, Kishimoto N, Aihara M. Comparison of the 24-h efficacy and safety of fixed combination carteolol/latanoprost and timolol/latanoprost in patients with primary open-angle glaucoma and ocular hypertension: a prospective crossover study. Jpn J Ophthalmol 2021; 65:598-607. [PMID: 34279749 DOI: 10.1007/s10384-021-00856-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/22/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE To evaluate the 24-h efficacy and safety of fixed combination carteolol/latanoprost (LCFC) and timolol/latanoprost (LTFC) in patients with primary open-angle glaucoma and ocular hypertension. STUDY DESIGN Prospective, randomized, crossover study METHODS: Twenty-two patients pretreated with a prostaglandin analog at baseline were randomly assigned at a 1:1 ratio to either LCFC or LTFC treatment. The patients received the assigned study drug in both eyes daily in the evening (20:00). Each treatment group crossed over after a 2-month treatment period. The 24-h curves of intraocular pressure (IOP), pulse rate, and blood pressure were evaluated. Safety was also assessed. RESULTS The changes in mean daytime IOP from baseline at the end of the 2-month treatment period in the LCFC and LTFC groups were - 0.93 and - 1.15 mmHg, respectively. The changes in peak IOP in the 2 groups were - 0.91 and - 0.68 mmHg, respectively. The nighttime pulse rate in the LCFC group increased; that in the LTFC group was lower at all time points. The changes in pulse rate from baseline at 22:00, 2:00, 4:00, and 6:00 differed statistically between the 2 groups. No differences in changes from baseline in systolic and diastolic blood pressures were found between the groups. CONCLUSION The 24-h IOP curve of patients in the LCFC group was similar to that of the LTFC group, but on the basis of the pulse rate findings, the effect of LCFC on the cardiovascular system over 24 h was less than that of LTFC.
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Affiliation(s)
- Yuta Saito
- Shinanozaka Clinic, Tokyo, Japan. .,Department of Ophthalmology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan.
| | - Junichiro Kizaki
- Shinanozaka Clinic, Tokyo, Japan.,Department of Ophthalmology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | - Yoshihiro Wada
- Shinanozaka Clinic, Tokyo, Japan.,Department of Ophthalmology, Showa University School of Medicine, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo, 142-8555, Japan
| | | | - Nobuharu Kishimoto
- Department of Medical Affairs, Otsuka Pharmaceutical Co., Ltd, Tokyo, Japan
| | - Makoto Aihara
- Department of Ophthalmology, University of Tokyo Graduate School of Medicine, Tokyo, Japan
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Nakamura K, Honda R, Soeda S, Nagai N, Takahashi O, Kadonosono K, Ozawa Y. Factors associated with achieving intraocular pressure lower than 15 mmHg by Trabectome surgery in primary open-angle glaucoma. Sci Rep 2021; 11:14308. [PMID: 34253788 PMCID: PMC8275622 DOI: 10.1038/s41598-021-93711-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 06/28/2021] [Indexed: 11/15/2022] Open
Abstract
To assess good prognostic factors of Trabectome surgery in primary open-angle glaucoma (POAG), clinical records of patients with POAG who underwent Trabectome surgery with/without cataract surgery as the first additive therapy to eye drops between January 2015 and March 2018 were retrospectively reviewed. Overall, data of 79 eyes (79 patients; 50 men; mean age, 68.0 years) up to postoperative 24 months were analyzed. Their mean intraocular pressure (IOP) was 20.4 ± 6.0 mmHg at baseline. Forty-two eyes (53.2%) achieved an IOP < 15 mmHg and ≥ 20% reduction from baseline without additional treatments. Phakic eyes had a better survival probability than pseudophakic eyes after adjusting for age, sex, baseline IOP, best-corrected visual acuity, and eye drop score (hazard ratio 3.096; 95% confidence interval [95% CI] 1.367–7.013; P = 0.007). Phakic eyes treated with combined Trabectome and cataract surgeries (mean survival time, 22.250 months; 95% CI 17.606–26.894) had a better survival probability than pseudophakic eyes treated with Trabectome surgery only (mean survival time, 12.111 months; 95% CI 8.716–15.506; P = 0.009) after the adjustment. Among the eyes treated with Trabectome surgery only, phakic eyes required significantly less additional treatments than pseudophakic eyes (P = 0.04). Trabectome surgery may be indicated for phakic eyes with POAG in addition to eye-drop therapy.
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Affiliation(s)
- Kentaro Nakamura
- Department of Ophthalmology, St. Luke's International University and Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.,Department of Ophthalmology and Micro-Technology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Rio Honda
- Department of Ophthalmology, St. Luke's International University and Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Shoichi Soeda
- Department of Ophthalmology, St. Luke's International University and Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Norihiro Nagai
- Department of Ophthalmology, St. Luke's International University and Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.,Laboratory of Retinal Cell Biology, Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan.,Laboratory of Retinal Cell Biology, St. Luke's International University, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Osamu Takahashi
- Graduate School of Public Health, St. Luke's International University, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan
| | - Kazuaki Kadonosono
- Department of Ophthalmology and Micro-Technology, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa, 232-0024, Japan
| | - Yoko Ozawa
- Department of Ophthalmology, St. Luke's International University and Hospital, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan. .,Laboratory of Retinal Cell Biology, Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjukuku, Tokyo, 160-8582, Japan. .,Laboratory of Retinal Cell Biology, St. Luke's International University, 9-1 Akashi-cho, Chuo-ku, Tokyo, 104-8560, Japan.
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Akimoto H, Takahashi Y, Asai S. [Effects of Fibrates on Risk of Development of Diabetic Retinopathy in Japanese Working Age Patients with Type 2 Diabetes and Dyslipidemia: a Retrospective Cohort Study]. YAKUGAKU ZASSHI 2021; 141:761-769. [PMID: 33952760 DOI: 10.1248/yakushi.20-00259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aims of the present study were to investigate the effects of fenofibrate and bezafibrate on the risk of development of diabetic retinopathy (DR) in patients with type 2 diabetes and dyslipidemia. Japanese working age patients with type 2 diabetes and dyslipidemia were extracted from the Nihon University School of Medicine Clinical Data Warehouse. These patients were divided into three groups: control group (n=2549), fenofibrate group (n=40), and bezafibrate group (n=135). Multivariate logistic regression analysis was performed to assess the association between fibrates and the development of DR. After adjustment for covariates, fenofibrate showed no association with the risk of DR [adjusted odds ratio (OR), 0.160; 95% CI, 0.021-1.209; p=0.0758]. Bezafibrate also showed no association with the risk of DR (adjusted OR, 0.731; 95% CI, 0.411-1.299; p=0.2855). However, poor control of hemoglobin A1c (HbA1c ≥8.0%; adjusted OR, 3.623; 95% CI, 2.649-4.956; p<0.0001) and high low-density lipoprotein cholesterol (LDL-C ≥140 mg/dL; adjusted OR, 1.399; 95% CI, 1.013-1.932; p=0.0415) within the follow-up period of type 2 diabetes and dyslipidemia increased the risk of DR. Our results suggested that to prevent development of DR in patients with type 2 diabetes and dyslipidemia, controlling LDL-C levels as well as HbA1c levels under coexistence type 2 diabetes and dyslipidemia is more important than the selection of fibrate.
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Affiliation(s)
- Hayato Akimoto
- Department of Biomedical Sciences, Nihon University School of Medicine
| | - Yasuo Takahashi
- Clinical Trials Research Center, Nihon University School of Medicine
| | - Satoshi Asai
- Department of Biomedical Sciences, Nihon University School of Medicine
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Fujinami-Yokokawa Y, Ninomiya H, Liu X, Yang L, Pontikos N, Yoshitake K, Iwata T, Sato Y, Hashimoto T, Tsunoda K, Miyata H, Fujinami K. Prediction of causative genes in inherited retinal disorder from fundus photography and autofluorescence imaging using deep learning techniques. Br J Ophthalmol 2021; 105:1272-1279. [PMID: 33879469 PMCID: PMC8380883 DOI: 10.1136/bjophthalmol-2020-318544] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Revised: 03/12/2021] [Accepted: 03/28/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND/AIMS To investigate the utility of a data-driven deep learning approach in patients with inherited retinal disorder (IRD) and to predict the causative genes based on fundus photography and fundus autofluorescence (FAF) imaging. METHODS Clinical and genetic data from 1302 subjects from 729 genetically confirmed families with IRD registered with the Japan Eye Genetics Consortium were reviewed. Three categories of genetic diagnosis were selected, based on the high prevalence of their causative genes: Stargardt disease (ABCA4), retinitis pigmentosa (EYS) and occult macular dystrophy (RP1L1). Fundus photographs and FAF images were cropped in a standardised manner with a macro algorithm. Images for training/testing were selected using a randomised, fourfold cross-validation method. The application program interface was established to reach the learning accuracy of concordance (target: >80%) between the genetic diagnosis and the machine diagnosis (ABCA4, EYS, RP1L1 and normal). RESULTS A total of 417 images from 156 Japanese subjects were examined, including 115 genetically confirmed patients caused by the three prevalent causative genes and 41 normal subjects. The mean overall test accuracy for fundus photographs and FAF images was 88.2% and 81.3%, respectively. The mean overall sensitivity/specificity values for fundus photographs and FAF images were 88.3%/97.4% and 81.8%/95.5%, respectively. CONCLUSION A novel application of deep neural networks in the prediction of the causative IRD genes from fundus photographs and FAF, with a high prediction accuracy of over 80%, was highlighted. These achievements will extensively promote the quality of medical care by facilitating early diagnosis, especially by non-specialists, access to care, reducing the cost of referrals, and preventing unnecessary clinical and genetic testing.
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Affiliation(s)
- Yu Fujinami-Yokokawa
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,UCL Institute of Ophthalmology, UCL, London, UK.,Graduate School of Health Management, Keio University, Tokyo, Japan
| | - Hideki Ninomiya
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan
| | - Xiao Liu
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Lizhu Yang
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Nikolas Pontikos
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.,UCL Institute of Ophthalmology, UCL, London, UK.,Division of Inherited Eye Disease, Medical Retina, Moorfields Eye Hostpial, London, UK
| | - Kazutoshi Yoshitake
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Takeshi Iwata
- Division of Molecular and Cellular Biology, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Yasunori Sato
- Graduate School of Health Management, Keio University, Tokyo, Japan.,Department of Preventive Medicine and Public Health, Keio University School of Medicine, Tokyo, Japan
| | - Takeshi Hashimoto
- Graduate School of Health Management, Keio University, Tokyo, Japan.,Sports Medicine Research Center, Keio University, Tokyo, Japan
| | - Kazushige Tsunoda
- Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan
| | - Hiroaki Miyata
- Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.,Graduate School of Health Management, Keio University, Tokyo, Japan
| | - Kaoru Fujinami
- Laboratory of Visual Physiology, Division of Vision Research, National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan .,UCL Institute of Ophthalmology, UCL, London, UK.,Division of Inherited Eye Disease, Medical Retina, Moorfields Eye Hostpial, London, UK
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Shirai C, Tsuda S, Tarasawa K, Fushimi K, Fujimori K, Nakazawa T. Risk factors leading to trabeculectomy surgery of glaucoma patient using Japanese nationwide administrative claims data: a retrospective non-interventional cohort study. BMC Ophthalmol 2021; 21:153. [PMID: 33781215 PMCID: PMC8008563 DOI: 10.1186/s12886-021-01897-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 03/09/2021] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Early recognition and management of baseline risk factors may play an important role in reducing glaucoma surgery burdens. However, no studies have investigated them using real-world data in Japan or other countries. This study aimed to clarify the risk factors leading to trabeculectomy surgery, which is the most common procedure of glaucoma surgery, of glaucoma patient using the Japanese nationwide administrative claims data associated with the diagnosis procedure combination (DPC) system. METHODS It was a retrospective, non-interventional cohort study. Data were collected from patients who were admitted to DPC participating hospitals, nationwide acute care hospitals and were diagnosed with glaucoma between 2012 to 2018. The primary outcome was the risk factors associated with trabeculectomy surgery. The association between baseline characteristics and trabeculectomy surgery was identified using multivariable logistic regression analysis by comparing patients with and without trabeculectomy surgery. Meanwhile, the secondary outcomes included the rate of comorbidities, the rate of concomitant drug use and the treatment patterns of glaucoma eye drops at the index admission. Among patients with trabeculectomy surgery, the risk factors leading to cataract surgery were also evaluated as subgroup analysis. RESULTS A total of 29,599 patients included in the analysis, 12,038 and 17,561 patients were in the glaucoma surgery and non-glaucoma surgery cohorts, respectively. The factors associated with the increase in trabeculectomy surgery were having allergies, taking concomitant drugs including cancer, depression, ischemic heart disease and peptic ulcer, being diagnosed with primary open-angle glaucoma and longer length of stay in hospital. In contrast, the factors associated with the decrease in trabeculectomy surgery were having hypertension, taking hypertension drug, age ≥ 80 and female. CONCLUSIONS Special focus on Japanese patients with glaucoma who have allergy-related comorbidities or take immune, nervous, circulatory or gastrointestinal system-related concomitant drugs seems to be desirable.
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Affiliation(s)
- Chikako Shirai
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Satoru Tsuda
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Kunio Tarasawa
- Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan
| | - Kiyohide Fushimi
- Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
| | - Kenji Fujimori
- Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
| | - Toru Nakazawa
- Department of Ophthalmology, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai, Miyagi, 980-8574, Japan.
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Yamamoto N, Hiramatsu N, Ohkuma M, Hatsusaka N, Takeda S, Nagai N, Miyachi EI, Kondo M, Imaizumi K, Horiguchi M, Kubo E, Sasaki H. Novel Technique for Retinal Nerve Cell Regeneration with Electrophysiological Functions Using Human Iris-Derived iPS Cells. Cells 2021; 10:cells10040743. [PMID: 33800535 PMCID: PMC8067101 DOI: 10.3390/cells10040743] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 03/23/2021] [Accepted: 03/24/2021] [Indexed: 12/11/2022] Open
Abstract
Regenerative medicine in ophthalmology that uses induced pluripotent stem cells (iPS) cells has been described, but those studies used iPS cells derived from fibroblasts. Here, we generated iPS cells derived from iris cells that develop from the same inner layer of the optic cup as the retina, to regenerate retinal nerves. We first identified cells positive for p75NTR, a marker of retinal tissue stem and progenitor cells, in human iris tissue. We then reprogrammed the cultured p75NTR-positive iris tissue stem/progenitor (H-iris stem/progenitor) cells to create iris-derived iPS (H-iris iPS) cells for the first time. These cells were positive for iPS cell markers and showed pluripotency to differentiate into three germ layers. When H-iris iPS cells were pre-differentiated into neural stem/progenitor cells, not all cells became positive for neural stem/progenitor and nerve cell markers. When these cells were pre-differentiated into neural stem/progenitor cells, sorted with p75NTR, and used as a medium for differentiating into retinal nerve cells, the cells differentiated into Recoverin-positive cells with electrophysiological functions. In a different medium, H-iris iPS cells differentiated into retinal ganglion cell marker-positive cells with electrophysiological functions. This is the first demonstration of H-iris iPS cells differentiating into retinal neurons that function physiologically as neurons.
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Affiliation(s)
- Naoki Yamamoto
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa 920-0293, Japan; (N.H.); (S.T.); (E.K.); (H.S.)
- Graduate School of Health Sciences, Fujita Health University, Aichi 470-1192, Japan
- Correspondence: or ; Tel.: +81-762-286-2211
| | - Noriko Hiramatsu
- Research Promotion and Support Headquarters, Fujita Health University, Aichi 470-1192, Japan;
| | - Mahito Ohkuma
- Department of Physiology, School of Medicine, Fujita Health University, Aichi 470-1192, Japan; (M.O.); (E.-i.M.)
| | - Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa 920-0293, Japan; (N.H.); (S.T.); (E.K.); (H.S.)
| | - Shun Takeda
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa 920-0293, Japan; (N.H.); (S.T.); (E.K.); (H.S.)
| | - Noriaki Nagai
- Faculty of Pharmacy, Kindai University, Osaka 577-8502, Japan;
| | - Ei-ichi Miyachi
- Department of Physiology, School of Medicine, Fujita Health University, Aichi 470-1192, Japan; (M.O.); (E.-i.M.)
- Department of Food Science and Nutrition, Nagoya Women’s University, Aichi 467-8610, Japan
| | - Masashi Kondo
- Department of Respiratory Medicine, School of Medicine, Fujita Health University, Aichi 470-1192, Japan; (M.K.); (K.I.)
| | - Kazuyoshi Imaizumi
- Department of Respiratory Medicine, School of Medicine, Fujita Health University, Aichi 470-1192, Japan; (M.K.); (K.I.)
| | - Masayuki Horiguchi
- Department of Ophthalmology, School of Medicine, Fujita Health University, Aichi 470-1192, Japan;
| | - Eri Kubo
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa 920-0293, Japan; (N.H.); (S.T.); (E.K.); (H.S.)
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa 920-0293, Japan; (N.H.); (S.T.); (E.K.); (H.S.)
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Kakihara S, Hirano T, Imai A, Kurenuma T, Chiku Y, Murata T. Micropulse laser trabeculoplasty under maximal tolerable glaucoma eyedrops: treatment effectiveness and impact of surgical expertise. Int J Ophthalmol 2021; 14:388-392. [PMID: 33747814 DOI: 10.18240/ijo.2021.03.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 09/30/2020] [Indexed: 02/08/2023] Open
Abstract
AIM To evaluate the effectiveness of micropulse laser trabeculoplasty (MLT) for eyes with open angle glaucoma (OAG) under maximal tolerable glaucoma eyedrops and to assess the effect of expertise performing MLT on its clinical effectiveness. METHODS Medical records of 42 consecutive eyes of 34 patients diagnosed with OAG who underwent MLT were retrospectively reviewed. The effectiveness was determined using the Kaplan-Meier survival analysis. Failure was defined as an intraocular pressure (IOP) reduction of <20% from baseline, an IOP >21 mm Hg during two consecutive follow-up visits, or surgical intervention for OAG. To determine the impact of MLT surgical expertise on clinical effectiveness, the eyes were divided into two groups according to whether the procedure was conducted by an experienced specialist (defined as a glaucoma specialist who had conducted at least ten MLT procedures) or a less experienced glaucoma specialist. The difference in expertise was determined using a log-rank test. RESULTS MLT was conducted by three glaucoma specialists. The overall survival rates were 0.76, 0.48, and 0.44 at 1, 3, and 6mo, respectively. The survival rates for MLT performed by a less experienced glaucoma specialist were 0.62, 0.31, and 0.25 (n=21 eyes) at 1, 3, and 6mo, respectively, whereas the survival rates for MLT performed by an experienced glaucoma specialist were 0.90, 0.64, and 0.64 (n=21 eyes) at 1, 3, and 6mo, respectively. The log-rank test showed a significant difference in the survival curves of the two groups (P=0.0061). CONCLUSION The 6-month effectiveness of MLT for controlling IOP is relatively limited in eyes with OAG using maximal tolerable glaucoma eyedrops. However, its effectiveness may be improved if performed by a glaucoma specialist with sufficient MLT experience.
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Affiliation(s)
- Shinji Kakihara
- Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
| | - Takao Hirano
- Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
| | - Akira Imai
- Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
| | - Taihei Kurenuma
- Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
| | - Yoshiaki Chiku
- Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
| | - Toshinori Murata
- Department of Ophthalmology, Shinshu University School of Medicine, Matsumoto, Nagano 390-8621, Japan
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50
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Koyanagi Y, Akiyama M, Nishiguchi KM, Momozawa Y, Kamatani Y, Takata S, Inai C, Iwasaki Y, Kumano M, Murakami Y, Komori S, Gao D, Kurata K, Hosono K, Ueno S, Hotta Y, Murakami A, Terasaki H, Wada Y, Nakazawa T, Ishibashi T, Ikeda Y, Kubo M, Sonoda KH. Regional differences in genes and variants causing retinitis pigmentosa in Japan. Jpn J Ophthalmol 2021; 65:338-343. [PMID: 33629268 DOI: 10.1007/s10384-021-00824-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 12/02/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE To investigate the regional differences in the genes and variants causing retinitis pigmentosa (RP) in Japan STUDY DESIGN: Retrospective multicenter study METHODS: In total, 1204 probands of each pedigree clinically diagnosed with nonsyndromic RP were enrolled from 5 Japanese facilities. The regions were divided into the Tohoku region, the Kanto and Chubu regions, and the Kyushu region according to the location of the hospitals where the participants were enrolled. We compared the proportions of the causative genes and the distributions of the pathogenic variants among these 3 regions. RESULTS The proportions of genetically solved cases were 29.4% in the Tohoku region (n = 500), 29.6% in the Kanto and Chubu regions (n = 196), and 29.7% in the Kyushu region (n = 508), which did not differ statistically (P = .99). No significant regional differences in the proportions of each causative gene in genetically solved patients were observed after correction by multiple testing. Among the 29 pathogenic variants detected in all 3 regions, only p.(Pro347Leu) in RHO was an autosomal dominant variant; the remaining 28 variants were found in autosomal recessive genes. Conversely, 78.6% (275/350) of the pathogenic variants were detected only in a single region, and 6 pathogenic variants (p.[Asn3062fs] in EYS, p.[Ala315fs] in EYS, p.[Arg872fs] in RP1, p.[Ala126Val] in RDH12, p.[Arg41Trp] in CRX, and p.[Gly381fs] in PRPF31) were frequently found in ≥ 4 patients in the single region. CONCLUSION We observed region-specific pathogenic variants in the Japanese population. Further investigations of causative genes in multiple regions in Japan will contribute to the expansion of the catalog of genetic variants causing RP.
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Affiliation(s)
- Yoshito Koyanagi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Masato Akiyama
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. .,Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan. .,Department of Ocular Pathology and Imaging Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, 812-8582, Japan.
| | - Koji M Nishiguchi
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yukihide Momozawa
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan.,Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
| | - Sadaaki Takata
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Chihiro Inai
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Yusuke Iwasaki
- Laboratory for Genotyping Development, RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Mikako Kumano
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yusuke Murakami
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shiori Komori
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Dan Gao
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kentaro Kurata
- Department of Ophthalmology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Katsuhiro Hosono
- Department of Ophthalmology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Shinji Ueno
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Hotta
- Department of Ophthalmology, Hamamatsu University School of Medicine, Shizuoka, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hiroko Terasaki
- Department of Ophthalmology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Toru Nakazawa
- Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Tatsuro Ishibashi
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yasuhiro Ikeda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.,Department of Ophthalmology, Faculty of Medicine, University of Miyazaki, Miyazaki, Japan
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Kanagawa, Japan
| | - Koh-Hei Sonoda
- Department of Ophthalmology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
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