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Lu Y, Ji Z, Jia J, Shi R, Liu Y, Shu Q, Lu F, Ge T, He Y. Progress in clinical characteristics of high myopia with primary open-angle glaucoma. Biotechnol Genet Eng Rev 2023:1-20. [PMID: 37243698 DOI: 10.1080/02648725.2023.2218765] [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: 04/11/2023] [Accepted: 05/21/2023] [Indexed: 05/29/2023]
Abstract
High myopia (HM) is a significant risk factor for the occurrence and progression of primary open-angle glaucoma (POAG). Identification with POAG in the HM population is an emergent challenge. Patients with HM have a significantly higher probability of complicating POAG than those without HM. When HM is associated with POAG, the changes to the fundus caused by both of them are confused with each other, making the diagnosis of early glaucoma difficult. This article reviews available researches on HM with POAG, summarizing the characteristics of the fundus structure such as epidemiology, intraocular pressure, optic disc, ganglion cell layer, retinal nerve fiber layer, vascular density, and visual field.
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Affiliation(s)
- Yao Lu
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Zhi Ji
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Jun Jia
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Rui Shi
- Department of Ophthalmology, Shaanxi Provincial People's Hospital, Xi'an, Shaanxi, China
| | - Ying Liu
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
| | - Qiong Shu
- The Xi'an Medical University, Xi'an, Shaanxi, China
| | - Fulin Lu
- The Xi'an Medical University, Xi'an, Shaanxi, China
| | - Teng Ge
- The Xi'an Medical University, Xi'an, Shaanxi, China
| | - Yuan He
- The Xi'an Medical University, Xi'an, Shaanxi, China
- The Second Affiliated Hospital of Xi'an Medical University, Xi'an, Shaanxi, China
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Chan PP, Zhang Y, Pang CP. Myopic tilted disc: Mechanism, clinical significance, and public health implication. Front Med (Lausanne) 2023; 10:1094937. [PMID: 36844216 PMCID: PMC9947511 DOI: 10.3389/fmed.2023.1094937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/23/2023] [Indexed: 02/11/2023] Open
Abstract
Myopic tilted disc is a common structural change of myopic eyes. With advancing ocular imaging technology, the associated structural changes of the eye, particularly the optic nerve head, have been extensively studied. These structural changes may increase patients' susceptibility to axonal damage and the risk of developing serious optic neuropathies including glaucoma. They also lead to diagnostic difficulties of disease suspects and treatment dilemmas of patients, which implicate clinical practice and subsequently the health care system. In the context of the mounting prevalence of myopia worldwide and its implications to irreversible visual impairment and blindness, it is essential to gain a thorough understanding of the structural changes of myopia. Myopic tilted disc has been extensively investigated by different study groups. However, generalizing the knowledge could be difficult because of the variable definitions of myopic tilted disc utilized in these studies and the complexities of the changes. The current review aimed to clarify the concepts and discuss various aspects of myopic tilted disc, including the definitions, association with other myopia-related changes, mechanism of tilted disc development, structural and functional changes, and clinical implications.
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Affiliation(s)
- Poemen P. Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Hong Kong Eye Hospital, Hong Kong, Hong Kong SAR, China,Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Department of Ophthalmology and Visual Sciences, The Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China,*Correspondence: Poemen P. Chan,
| | - Yuqiao Zhang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Chi Pui Pang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Jet King-Shing Ho Glaucoma Treatment and Research Centre, Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Hong Kong Hub of Pediatric Excellence, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR, China,Joint Shantou International Eye Centre of Shantou University, The Chinese University of Hong Kong, Shantou, Hong Kong SAR, China,Chi Pui Pang,
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Wu J, Hao J, Du Y, Cao K, Lin C, Sun R, Xie Y, Wang N. The Association between Myopia and Primary Open-Angle Glaucoma: A Systematic Review and Meta-Analysis. Ophthalmic Res 2021; 65:387-397. [PMID: 34883495 DOI: 10.1159/000520468] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 10/25/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Previous studies identified myopia as a risk factor for primary open-angle glaucoma (POAG). However, recent studies have shown different results, the definitive relationship between myopia and POAG remains controversial. OBJECTIVES To investigate the relationship between myopia and POAG. METHODS Published articles were searched from PubMed, Embase, and Scopus databases between 1970 and 2020. A pooled analysis of the ORs was performed using a random-effects model. RESULTS Data on the association between myopia and POAG, were obtained from 16 cross sectional studies, and the pooled OR was 2.26 (95% confidence interval [CI], 1.77 - 2.89, P < 0.001) in random effects model (I2 = 86%; P < 0.01). For the relationship of myopia and POAG progression, data from seven longitudinal cohort studies were included and the pooled OR was 0.85 (95% CI, 0.73 - 0.99, P = 0.042) in the random-effects model (I2 = 88%; P < 0.01). CONCLUSION Our findings demonstrated that myopia may be a risk factor associated with POAG and a possible protective factor for POAG progression. It may due to myopia with the presence of a lamina cribrosa defect slow down the visual field loss also POAG progression, further research for underlying mechanisms is still needed.
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Affiliation(s)
- Jian Wu
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Jie Hao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
| | - Yifan Du
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Kai Cao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
| | - Caixia Lin
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Runzhou Sun
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Yuan Xie
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
| | - Ningli Wang
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Beijing Key Laboratory of Ophthalmology and Visual Sciences, Capital Medical University, Beijing, China
- Beijing Institute of Ophthalmology, Beijing, China
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Kim SA, Park CK, Jung KI. The Structure-function Relationships between Two Different Optical Coherence Tomography in Patients with High Myopic Glaucoma. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2020. [DOI: 10.3341/jkos.2020.61.10.1194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Different Disc Characteristics Associated With High Myopia and the Location of Glaucomatous Damage in Primary Open-Angle Glaucoma and Normal-Tension Glaucoma. J Glaucoma 2020; 28:519-528. [PMID: 30789526 DOI: 10.1097/ijg.0000000000001217] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PRéCIS:: Disc tilt is a characteristic of high myopia and related to lower wedge-shaped retinal nerve fiber layer (RNFL) defects in normal-tension glaucoma (NTG). In primary open-angle glaucoma (POAG), the direction of disc torsion corresponds to the location of wedge-shaped RNFL defects. PURPOSE To evaluate the disc characteristics in high myopia and the relationships between disc tilt and torsion and the location of wedge-shaped RNFL defects in primary POAG and NTG. MATERIALS AND METHODS The differences in disc properties and clinical characteristics between POAG (n=53) and NTG (n=82), and between high myopic (<-6 D, n=77) and non-high myopic (≥-6 D, n=58) glaucoma, were investigated. The association between disc tilt and torsion and the location of wedge-shaped RNFL defects in POAG and NTG were assessed by univariate and multivariate logistic regression analyses. RESULTS In NTG, but not in POAG, high myopia eyes had significantly smaller discs, a lower tilt ratio (0.73±0.09), and more disc tilt (56.5%) than did non-high myopia eyes (0.80±0.09, 33.3%). In POAG, eyes with lower wedge-shaped RNFL defects had a significantly smaller torsion angle (-5.44±19.62 degrees, inferior disc torsion) than did eyes with upper defects (9.70±23.62 degrees, superior disc torsion; P=0.014). In NTG, a significantly decreased tilt ratio (0.74±0.93; P=0.001) and more disc tilt (55.9%, P=0.005) were found in eyes with lower wedge-shaped RNFL defects than in eyes with upper defects (0.81±0.09; 21.7%). The torsion degree and tilt ratio were the only factors associated with the location of wedge-shaped RNFL defects in POAG and NTG, respectively. CONCLUSIONS In NTG, smaller and tilted discs were the characteristics of high myopia. Disc tilt was associated with lower wedge-shaped RNFL defects. In POAG, the direction of disc torsion corresponded to the location of the wedge-shaped RNFL defects.
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Sawada Y, Araie M, Shibata H, Ishikawa M, Iwata T, Yoshitomi T. Differences in Retinal Nerve Fiber Layer Thickness as Assessed on the Disc Center and Bruch’s Membrane Opening Center in Myopic Eyes. ACTA ACUST UNITED AC 2019; 2:145-155. [DOI: 10.1016/j.ogla.2019.02.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 01/22/2019] [Accepted: 02/19/2019] [Indexed: 12/30/2022]
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Zhao W, Wang S, Qin T, Wang W. RETRACTED: Arbutin attenuates hydrogen peroxide-induced oxidative injury through regulation of microRNA-29a in retinal ganglion cells. Biomed Pharmacother 2019; 112:108729. [DOI: 10.1016/j.biopha.2019.108729] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 02/14/2019] [Accepted: 02/22/2019] [Indexed: 02/02/2023] Open
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Hung CH, Lee SH, Lin SY, Lin SL, Chen YC. The relationship between optic nerve head deformation and visual field defects in myopic eyes with primary open-angle glaucoma. PLoS One 2019; 13:e0209755. [PMID: 30596728 PMCID: PMC6312218 DOI: 10.1371/journal.pone.0209755] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 12/11/2018] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To investigate the relationship between the morphologic features of myopic optic nerve head (ONH) and visual field (VF) defects in myopic subjects with primary open-angle glaucoma (POAG) by intraindividual comparison. METHODS Myopic POAG subjects with unilateral glaucomatous VF defect were recruited. The morphologic features of myopic ONH, including optic disc tilt, optic disc rotation, and β-zone parapapillary atrophy (PPA) were measured from color fundus photographs. The comparisons were performed between the eyes with VF defects and the contralateral eyes without VF defects. Logistic regression analysis was performed to investigate the relationship between various ocular parameters and the presence of VF defects. RESULTS We retrospectively included 100 eyes of 50 myopic POAG subjects. (Mean age: 50.1 ± 10.0 years). The tilt ratio was similar between the paired eyes. The degree of optic disc rotation (12.96 ± 7.21°) in eyes with VF defects were statistically greater than the contralateral eyes (6.86 ± 4.30°; P < 0.001) without VF defect. The β-zone PPA-to-disc area ratio was significantly greater in eyes with VF defects than the contralateral eyes (P = 0.024) without VF defect. In multivariate logistic regression analysis, the greater degree of optic disc rotation was significantly associated with the presence of VF defects (P < 0.001). However, tilt ratio, β-zone PPA-to-disc area ratio, refractive error, and axial length were not associated with the presence of VF defects. CONCLUSIONS Among the morphologic features of myopic ONH, only the greater degree of the optic disc rotation was associated with the presence of VF defects in myopic subjects with POAG.
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Affiliation(s)
- Chih-Heng Hung
- Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan
| | - Shwu-Huey Lee
- Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan
| | - Szu-Yuan Lin
- Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan
| | - Shun-Ling Lin
- Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan
| | - Yi-Chun Chen
- Department of Ophthalmology, Cathay General Hospital, Taipei, Taiwan
- * E-mail:
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Tai ELM, Ling JL, Gan EH, Adil H, Wan-Hazabbah WH. Comparison of peripapillary retinal nerve fiber layer thickness between myopia severity groups and controls. Int J Ophthalmol 2018; 11:274-278. [PMID: 29487819 DOI: 10.18240/ijo.2018.02.16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 10/23/2017] [Indexed: 12/21/2022] Open
Abstract
AIM To compare the peripapillary retinal nerve fiber layer (RNFL) thickness measured via optical coherence tomography (OCT) between different groups of myopia severity and controls. METHODS This was a prospective cross-sectional study. All subjects underwent a full ophthalmic examination, refraction, visual field analysis and A-scan biometry. Myopic patients were classified as low myopia (LM) [spherical equivalent (SE) from greater than -0.5 D, up to -3.0 D], moderate myopia (MM; SE greater than -3.0 D, up to -6.0 D) and high myopia (HM; SE greater than -6.0 D). The control group consisted of emmetropic (EM) patients (SE from +0.5 D to -0.5 D). A Zeiss Cirrus HD-OCT machine was used to measure the peripapillary RNFL thickness of both eyes of each subject. The mean peripapillary RNFL thickness between groups was compared using both analysis of variance and analysis of covariance. RESULTS A total of 403 eyes of 403 subjects were included in this study. The mean age was 31.48±10.23y. There were 180 (44.7%) eyes with EM, 124 (30.8%) with LM, 73 (18.1%) with MM and 26 (6.5%) with HM. All groups of myopia severity had a thinner average RNFL than the EM group, but after controlling for gender, age, and axial eye length, only the HM group differed significantly from the EM group (P=0.017). Likewise, the superior, inferior and nasal RNFL was thinner in all myopia groups compared to controls, but after controlling for confounders, only the inferior quadrant RNFL was significantly thinner in the HM group, when compared to the EM group (P=0.017). CONCLUSION The average and inferior quadrant RNFL is thinner in highly myopic eyes compared to emmetropic eyes. Refractive status must be taken into consideration when interpreting the OCT of myopic patients, as RNFL thickness varies with the degree of myopia.
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Affiliation(s)
- Evelyn Li Min Tai
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Jiunn Loong Ling
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Eng Hui Gan
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Hussein Adil
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
| | - Wan-Hitam Wan-Hazabbah
- Department of Ophthalmology, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia.,Hospital Universiti Sains Malaysia, Kubang Kerian 16150, Kelantan, Malaysia
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Nakanishi H, Suda K, Yoshikawa M, Akagi T, Kameda T, Ikeda HO, Yokota S, Kurimoto Y, Tsujikawa A. Association of Bruch's membrane opening and optic disc morphology to axial length and visual field defects in eyes with primary open-angle glaucoma. Graefes Arch Clin Exp Ophthalmol 2018; 256:599-610. [PMID: 29305731 DOI: 10.1007/s00417-017-3874-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2017] [Revised: 12/03/2017] [Accepted: 12/11/2017] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To examine the morphology of Bruch's membrane opening (BMO), optic disc, and peripapillary atrophy (PPA) by scanning laser ophthalmoscopy (SLO) and spectral-domain optical coherence tomography (SD-OCT), and to determine their association with the axial length and visual field defects. METHODS This was a cross-sectional study of 94 eyes of 56 subjects; 77 eyes were diagnosed with primary open-angle glaucoma and 17 eyes as normal. The margins of the optic disc were determined in the SLO images, and that of the BMO in the SD-OCT images. The ovality and area of the BMO and the optic disc were measured. The beta and gamma-PPA areas were also measured. The association of each parameter with the axial length and the mean deviation (MD) of the visual field tests was determined by generalized estimating equations (GEEs). RESULTS The optic disc ovality was associated with the axial length and the MD (β = -0.47, P = 7.6 × 10-4 and β = 0.12, P = 0.040). The BMO ovality was not significantly associated with the axial length and the MD. The BMO area was associated with the axial length (β = 0.30, P = 0.029). A larger BMO area was associated with a thinner BMO-based neuroretinal rim width (BMO-MRW) after adjustments for the MD (β = -0.30, P = 2.1 × 10-4). The beta- and gamma-PPA areas were associated with the axial length (β = 0.50, P = 7.4 × 10-5 and β = 0.62, P = 4.2 × 10-6). CONCLUSIONS The optic disc ovality was associated with both the axial length and MD, whereas BMO ovality was not. Attention should be paid to the influence of the axial length-related enlargement of the BMO.
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Affiliation(s)
- Hideo Nakanishi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.
| | - Kenji Suda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Munemitsu Yoshikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Tadamichi Akagi
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Takanori Kameda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Hanako Ohashi Ikeda
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Satoshi Yokota
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
| | - Yasuo Kurimoto
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan.,Department of Ophthalmology, Kobe City Medical Center General Hospital, Minatojimaminamimachi 2-2-1, Chuo-ku, Kobe-city, Hyogo, 650-0047, Japan
| | - Akitaka Tsujikawa
- Department of Ophthalmology and Visual Sciences, Kyoto University Graduate School of Medicine, Shogoin Kawahara-cho 54, Sakyo-ku, Kyoto, 606-8507, Japan
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