Japanese Journal of Ophthalmology (Jpn J Ophthalmol)

Publisher: Nihon Ganka Gakkai, Springer Verlag

Journal description

The Japanese Journal of Ophthalmology, published since 1957, provides a peer-reviewed interdisciplinary forum for bimonthly publication of basic science and clinical research papers in all fields of ophthalmology. The Japanese Ophthalmological Society is dedicated to the preventive care and treatment of the eye, and to scientific research regarding all aspects of ophthalmology. To further these goals, the Society has designated the Japanese Journal of Ophthalmology its official English language publication from January 1997. The purpose of this scientific journal is to disseminate the significant results of study by ophthalmologists worldwide. To help us fulfill our purpose, we encourage you to submit your original papers concerning any area of ophthalmology, as well as Rapid Communications or Letters to the Editor. We welcome your suggestions and criticism.

Current impact factor: 1.80

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 1.795
2012 Impact Factor 1.274
2011 Impact Factor 0.924
2010 Impact Factor 1.054
2009 Impact Factor 1.272
2008 Impact Factor 1.257
2007 Impact Factor 0.888
2006 Impact Factor 0.77
2005 Impact Factor 0.667
2004 Impact Factor 0.667
2003 Impact Factor 0.543
2002 Impact Factor 0.64
2001 Impact Factor 0.602
2000 Impact Factor 0.479
1999 Impact Factor 0.5
1998 Impact Factor 0.421
1997 Impact Factor 0.348
1996 Impact Factor 0.35
1995 Impact Factor 0.336
1994 Impact Factor 0.369
1993 Impact Factor 0.426
1992 Impact Factor 0.324

Impact factor over time

Impact factor

Additional details

5-year impact 1.49
Cited half-life 7.80
Immediacy index 0.16
Eigenfactor 0.00
Article influence 0.52
Website Japanese Journal of Ophthalmology website
Other titles Japanese journal of ophthalmology (Online), Japanese journal of ophthalmology, JJO
ISSN 1613-2246
OCLC 56124539
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Springer Verlag

  • Pre-print
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  • Conditions
    • Author's pre-print on pre-print servers such as arXiv.org
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    • Author's post-print on any open access repository after 12 months after publication
    • Publisher's version/PDF cannot be used
    • Published source must be acknowledged
    • Must link to publisher version
    • Set phrase to accompany link to published version (see policy)
    • Articles in some journals can be made Open Access on payment of additional charge
  • Classification
    ​ green

Publications in this journal

  • Tomoaki Higashiyama · Yasuhiro Nishida · Masahito Ohji
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    ABSTRACT: To evaluate the changes of orbital tissue volumes and proptosis after methylprednisolone pulse therapy in thyroid-associated ophthalmopathy (TAO). The cross-sectional areas of orbital tissues and proptosis were measured with magnetic resonance imaging in 40 orbits of 20 patients with TAO before and after methylprednisolone pulse therapy. The volumes of the whole orbit, orbital fatty tissue, and extraocular muscles were calculated. The volumes and proptosis were compared before and after treatment using a paired t test. Before treatment, the mean volumes were 33.0 ± 4.8 cm(3) in the whole orbit, 19.9 ± 4.1 cm(3) in the orbital fatty tissue, and 4.6 ± 1.2 cm(3) in the total extraocular muscles. After treatment, the mean volumes were 32.5 ± 4.4 cm(3) in the whole orbit, 19.9 ± 3.7 cm(3) in the orbital fatty tissue, and 4.0 ± 1.0 cm(3) in the total extraocular muscles. The mean volumes of the whole orbit (P = 0.17) and orbital fatty tissue (P = 0.82) were not significantly decreased after treatment, while the mean volume of total extraocular muscles was significantly decreased (P < 0.001). The mean proptosis value was 18.9 ± 2.8 mm before treatment and 18.6 ± 3.4 mm after treatment. The mean proptosis value was not significantly decreased after treatment (P = 0.30). The volume of orbital fatty tissue seemed to be unchanged after methylprednisolone pulse therapy while that of total extraocular muscles was decreased. The proptosis value seemed to be unchanged after treatment.
    Japanese Journal of Ophthalmology 09/2015; DOI:10.1007/s10384-015-0410-4
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    ABSTRACT: To determine the prevalence of vitreous cysts in patients with retinitis pigmentosa (RP). We retrospectively reviewed the charts of 435 consecutive patients diagnosed as having typical RP. Vitreous cysts were diagnosed in 37 eyes of 28 patients with RP (13 males and 15 females; mean age 47.0 ± 19.8 years; range 15-79 years), for an overall prevalence of 6.4 %. The cysts were observed bilaterally in nine of the patients (32.1 %). Among these 28 patients, 11 (39.3 %) were younger than 40 years. In all, 81.8 % of the vitreous cysts were detected around the optic nerve head. We demonstrated that the prevalence of vitreous cysts was 6.4 % in patients with RP. These cysts were considered to be asymptomatic.
    Japanese Journal of Ophthalmology 08/2015; DOI:10.1007/s10384-015-0405-1
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    ABSTRACT: To evaluate the correlation between central retinal thickness (CRT) after vitreous surgery and final visual outcome in eyes with idiopathic macular holes (MH). A prospective analysis was performed of patients who had undergone surgical treatment for MH. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) parameters including CRT, minimum and base diameters of the MHs were analyzed pre- and postoperatively. The relationships between final visual outcome and the OCT parameters were examined by single and multiple regression analysis. Forty-one MHs cases were successfully closed postoperatively. BCVA gradually improved, and CRT decreased during the observation period following MH surgery. There were significant positive correlations between CRT at 1 month and visual acuity at 12 months after vitreous surgery (P < 0.0001). MH diameter was positively correlated with CRT at 1 month after surgery and negatively with postoperative visual acuity. CRT at 1 month after MH surgery was related to preoperative MH diameter and visual acuity at 12 months postoperatively. Our data suggest that the increased CRT at the early postoperative period may result in better visual prognosis.
    Japanese Journal of Ophthalmology 08/2015; DOI:10.1007/s10384-015-0406-0
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    ABSTRACT: To retrospectively assess the proportion of patients affected by a central island (CI) and its effect on visual recovery after phototherapeutic keratectomy (PTK). This retrospective study evaluated 30 eyes of 21 consecutive patients (mean age ± standard deviation, 69.6 ± 6.8 years) undergoing PTK for the treatment of band keratopathy or granular corneal dystrophy. We investigated the rate of CI formation, which was defined as a steepening area of 3 D, 1.5 mm in diameter, on each corneal videokeratograph (ATLAS 9000; Carl Zeiss Meditec), and its effect on visual recovery at 3 months and at 1 year postoperatively. A CI was found in 22 of 30 eyes (73 %) 3 months postoperatively and in 14 of 25 eyes (56 %) 1 year postoperatively. The degree of CI was significantly correlated with the change in logMAR corrected visual acuity (Spearman correlation coefficient r = 0.445, P = 0.026). The degree of CI in eyes with band keratopathy was significantly larger than that in eyes with granular dystrophy 1 year postoperatively (Mann-Whitney test, P = 0.045). The degree of CI was not significantly correlated with the ablation depth (Spearman correlation coefficient r = 0.116, P = 0.582) or the residual corneal thickness (r = -0.235, P = 0.278). CI formation was found in as many as 73 and 56 % of patients 3 months and 1 year after PTK, respectively, using the VISX Star S4 excimer laser system, and significantly affected the improvement of visual acuity. The anti-CI program should be applied by the manufacturer, not only for corneal refractive surgery but also for PTK in a clinical setting.
    Japanese Journal of Ophthalmology 08/2015; DOI:10.1007/s10384-015-0403-3
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    ABSTRACT: To report the results of scleral buckling (SB) with or without photocoagulation (PC) and intravitreal bevacizumab (IVB) for stage 4 retinopathy of prematurity (ROP) eyes. Forty-two eyes of 28 patients with SB and/or PC or IVB were studied. Twenty-nine eyes had stage 4A and 13 eyes had stage 4B ROP. Seventeen eyes underwent SB combined with additional intraoperative or postoperative treatments (combined group). Twenty-five eyes underwent SB without additional therapy (non-combined group). The concentrations of vascular endothelial growth factor (VEGF) in the aqueous humor determined by enzyme-linked immunosorbent assay were compared between the two groups. The initial and final reattachment rates were also compared. The gestational age and birth weight were 25.0 ± 2.0 weeks and 786 ± 222 g in the combined group, and 25.5 ± 2.1 weeks and 899 ± 315 g in the non-combined group. The postmenstrual age at the time of initial surgery was 38.0 ± 1.9 in the combined and 44.1 ± 4.0 weeks in the non-combined group (P < 0.001). The initial reattachment rate was 92 % in stage 4A and 75 % in stage 4B of ROP eyes in the combined group, and the rate was 93 % in stage 4A and 33 % in stage 4B of ROP eyes in the non-combined group. The mean VEGF concentration in aqueous humor was 1923 ± 779 pg/ml in the combined group and 985 ± 303 pg/ml in the non-combined group (P < 0.05). Our results show that the retinal reattachment rate after combined therapy was comparable to that in the non-combined group. We conclude that combined therapy may be effective even in ROP eyes with high activity.
    Japanese Journal of Ophthalmology 08/2015; DOI:10.1007/s10384-015-0401-5
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    ABSTRACT: To investigate the process of retinal degeneration by analyzing the functional and morphological findings in transgenic rabbits with a Pro347Leu rhodopsin mutation. Wild-type (WT) and transgenic (Tg) rabbits at ages 4, 8 and 12 months were used. We conducted functional evaluation by recording the changes in the pupil response to red and blue light stimulation and the amplitude of the electroretinography (ERG). Morphologically, rod and cone distribution was examined using light and electron microscopy. Immunostaining for the identification of retinal ganglion cells (RGCs) was also confirmed by injecting a TUJ-1 monoclonal antibody. Pupil constriction for infrared pupillography and the a- and b-waves for ERG in Tg rabbits decreased with increasing age; the differences were compared to the age-matched WT rabbits. The subnormal ERG in the Tg rabbits, especially the a-wave decrease and pupil constriction with a long latency time, was induced only during exposure to blue light stimulation at 12 months. Light and electron microscopic findings showed a progressive loss of photoreceptor cells over time manifesting by 8 months in the peripheral retina. Moreover, pyknotic nuclei of the outer nuclear layer in the center of the visual streak were observed. At 12 months, there was disappearance of the rods and ballooning degeneration of the cones. Some remaining RGCs had large cell bodies with long branching dendrites. The changes in the pupil light response and amplitude of the ERG could be used to predict the state of retinal degeneration in the Tg rabbit.
    Japanese Journal of Ophthalmology 08/2015; DOI:10.1007/s10384-015-0400-6
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    ABSTRACT: To investigate the surgical results for consecutive exotropia with or without insertion abnormalities on the basis of the position of the lateral rectus muscle at surgery. Patients with consecutive exotropia who had undergone medial rectus recession as a primary procedure or advancement of previously recessed medial rectus muscles from 2002 to 2012 were included in the study. The characteristics, postoperative courses, and final results were compared among 3 patient groups. The patients' characteristics including sex, refractive error, and age at the initial surgery were compared. The main outcome measures were the angles of deviation in the primary position and the average divergent drift per month after the exotropia surgery. Twenty-four eyes of 23 patients were investigated. The patients were divided into 3 groups according to insertion status: with normal muscle insertion (4 men, 4 women), slipped muscles (9 women), and stretched scars (2 men, 4 women). The preoperative angles of deviation at near differed significantly between the slipped muscle group and the normal muscle insertion group (P = 0.02). Only patients with normal insertions had significantly greater hyperopia in the nondominant eye (0.95 D) than in the dominant eye (0.53 D). The postoperative divergent shift per month was similar among the groups (0.3, 0.1, and 0.2 prism diopters per month in the slipped muscle, stretched scar, and normal muscle insertion groups, respectively; P = 0.70). Hyperopic anisometropia is an important factor in the natural course of outward drift. The postoperative course of advancement of the medial rectus muscle was equally stable in all 3 patient groups.
    Japanese Journal of Ophthalmology 08/2015; DOI:10.1007/s10384-015-0395-z
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    ABSTRACT: To evaluate diurnal curves of intraocular pressure (IOP) in eyes affected with unilateral acute primary angle closure (APAC) after laser peripheral iridotomy (LPI), and fellow eyes. The medical records of 22 female patients (44 eyes) with unilateral APAC and LPI performed OU were reviewed along with those of 48 normal control subjects (48 eyes). None of the subjects used glaucoma medications after LPI. IOP was measured with a Goldman applanation tonometer during waking hours and in a sitting position every 2 h between 09:00 and 23:00. IOP profiles were compared including the means, peaks, trough IOPs, and IOP fluctuations of the affected, fellow, and normal eyes. The IOPs of the affected eyes were significantly higher than those of normal eyes at every time point measured, including peak and trough IOPs. The diurnal IOPs of fellow eyes were higher than those of normal eyes, though not significantly. There were no significant differences in IOP fluctuation between the affected, fellow, and normal eyes. IOP diurnal curves for APAC affected, fellow, and normal eyes were not statistically different (repeated measures ANOVA, p = 0.865). The mean coefficient of IOP in affected and fellow eyes ranged from 0.486 to 0.604. There were no clinically significant differences among the three groups in terms of IOP diurnal curves, and thus LPI did not have a significant effect on diurnal patterns of IOP. Though the diurnal IOPs of affected eyes after LPI was significantly higher than those of normal eyes, the IOP range was not acute.
    Japanese Journal of Ophthalmology 08/2015; DOI:10.1007/s10384-015-0399-8
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    ABSTRACT: To verify, by use of data collected by the Japan Glaucoma Society Survey of Bleb-related Infection (JGSSBI), that bleb morphology changes within 12 months of the development of bleb-related infection. JGSSBI data from 57 eyes of 57 patients with primary open-angle glaucoma and normal tension glaucoma who developed a bleb-related infection were analyzed. Morphological features of the blebs were graded by use of a predetermined grading system. Multiple logistic regression analysis was conducted to identify factors relating to bleb morphology which were associated with poor outcome. Bleb sizes, including both circumferential and tangential lengths, were significantly smaller for stage IIIa/IIIb infections than for stage I/II bleb infections (P = 0.009 and P = 0.026 for the circumferential and tangential lengths, respectively; Fisher's direct probability test). The bleb wall also became significantly thicker during stage IIIa/IIIb infections (P = 0.003). After infection, intraocular pressure (IOP) increased significantly for all cases but was no different in the three subgroups (i.e. stage I, stage II, and stage IIIa/IIIb bleb infections). Multiple logistic regression analysis revealed that a stage III infection was significantly associated with a poor outcome for the bleb. This study revealed that the filtering bleb became smaller, both tangentially and circumferentially, and thicker, after stage III infections than after stage I or II infections.
    Japanese Journal of Ophthalmology 07/2015; DOI:10.1007/s10384-015-0398-9
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    ABSTRACT: To evaluate the therapeutic efficacy of a novel surgical procedure for diffuse diabetic macular edema (DME), performed in conjunction with conventional vitrectomy. This prospective, interventional case series involved 20 eyes of 18 consecutive DME patients with best-corrected visual acuities (BCVAs) between 0.301 and 1.221 logarithm of the minimal angle of resolution (logMAR) units and central retinal thicknesses (CRTs) greater than 275 μm. After vitrectomy, a small retinal detachment was made in the macula by injecting 50-100 μl balanced salt solution into the subretinal space using a 38-gauge needle. Before finishing the surgery, fluid-air exchange was performed. Patients were asked to remain in prone position for 1 day postoperatively. The main outcome measures were CRT and BCVA. The mean CRT of 554.6 ± 152.7 μm before surgery significantly decreased to 295.6 ± 92.5 μm (p < 0.0001) 1 week after surgery and to 185.8 ± 67.4 μm (p < 0.0001) at 6 months after surgery. The CRT was less than 250 μm in 18 eyes (90 %) at 6 months after surgery. The mean BCVA before surgery (0.706 ± 0.348) significantly improved at 6 months after surgery (0.431 ± 0.392, p < 0.0001). Postoperative BCVAs improved by more than 0.3 logMAR units in 13 eyes (65 %), remained unchanged in six eyes (30 %) and worsened in one eye (5 %). Macular edema recurred in three eyes (15 %) 2 months after surgery. This novel planned foveal detachment technique facilitated a rapid resolution of DME and contributed to improved visual acuity.
    Japanese Journal of Ophthalmology 07/2015; DOI:10.1007/s10384-015-0390-4
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    ABSTRACT: To evaluate the outcomes of intravitreal liposomal amphotericin B (L-AmB) for treatment of endogenous candida endophthalmitis. Medical records of four patients with endogenous candida endophthalmitis treated with intravitreal L-AmB injection alone or combined with vitrectomy were reviewed. Endogenous candida endophthalmitis developed in two patients after gastrointestinal surgery, in one patient with sepsis, and in one patient undergoing systemic chemotherapy for metastatic breast cancer. Three eyes of two patients exhibited toxic uveitis following repetitive intravitreal injection of amphotericin B deoxycholate (AmB-D, 10 μg/0.1 ml). The other patients had general health issues that restricted the use of AmB-D due to the potential risk of systemic toxicity. Seven eyes underwent intravitreal injection of L-AmB (10 μg/0.1 ml) with or without vitrectomy. In these patients, intraocular inflammation and vitreous opacities resolved, and chorioretinal infiltrates evolved into fibrotic scars. Visual acuity improved and stabilized in all eyes during the follow-up period. Intravitreal L-AmB seems to be well tolerated and effective in the treatment of endogenous candida endophthalmitis, and may be a reasonable alternative for patients who cannot endure the side effects or toxicity associated with conventional AmB-D therapy.
    Japanese Journal of Ophthalmology 07/2015; DOI:10.1007/s10384-015-0397-x
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    ABSTRACT: To investigate the outcomes of unilateral medial rectus resection (UMR-res) for the treatment of small to moderate angles of recurrent exotropia in children followed up for a minimum of 6 months. This study is a retrospective, consecutive, interventional case series in which 48 children who underwent UMR-res (range 4.0-7.5 mm) for recurrent exotropia [range 12-25 prism diopters (PD)] between January 2009 and February 2013 were enrolled. Of these 48 children, 32 had recurrent intermittent exotropia, and 16 had recurrent constant exotropia. A successful surgical alignment was defined as +5 to -10 PD of orthophoria in the primary position while viewing distant or near targets. At a mean follow-up of 12 months, the surgical success rate was 75 % (36/48), and the undercorrection rate was 25 % (12/48). No patient exhibited overcorrection. The success rates of the UMR-res in the recurrent intermittent exotropia group and recurrent constant exotropia group were 78 % and 69 %, respectively, and were not significantly different (P = 0.50). In the initial surgical procedure groups, the success rates of patients with bilateral lateral rectus recession, unilateral lateral rectus recession, and unilateral lateral rectus recession combined with medial rectus resection were 81.8 % (18/22), 81.25 % (13/16), and 50 % (5/10), respectively. The surgical success rates did not differ among these three groups (P = 0.122). Based on our results, UMR-res would appear to be an effective and safe procedure for the treatment of intermittent or constant recurrent exotropia of ≤25 PD in children.
    Japanese Journal of Ophthalmology 07/2015; DOI:10.1007/s10384-015-0393-1
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    ABSTRACT: To compare the outcomes of 23-gauge (G) and 25G vitrectomy to 20G vitrectomy on eyes with severe proliferative diabetic retinopathy (PDR). The medical records of 424 eyes of 347 patients with severe PDR were reviewed. There were 80 eyes that had 23G, 174 eyes that had 25G, and 170 eyes that had 20G vitrectomy. The incidences of postoperative vitreous hemorrhage, intraoperative retinal breaks, retinal detachment, and neovascular glaucoma were compared. The incidence of intraoperative retinal breaks was significantly lower in the 23G group (21 %) than in the 20G group (35 %, P = 0.03) but not in the 25G group (26 %, P = 0.057). The incidence of postoperative retinal detachment was not significantly different among the three groups (P = 0.73). The incidence of postoperative vitreous hemorrhage that developed ≥1 month after vitrectomy was not different whether the eyes had panretinal photocoagulation or not (P = 0.15). The incidence of postoperative neovascular glaucoma was significantly lower in the 25G group (3 %) than in the 20G group (11 %, P = 0.01) but not significant compared with that in the 23G group (8 %, P = 0.72). The lower incidence of intraoperative retinal breaks and postoperative neovascular glaucoma after microincision vitrectomy indicates that microincision vitrectomy should be considered for eyes with severe PDR.
    Japanese Journal of Ophthalmology 07/2015; DOI:10.1007/s10384-015-0396-y
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    ABSTRACT: To evaluate the occurrence of hyperemia with, and efficacy of, bimatoprost 0.01 % for patients in Korea previously treated for open-angle glaucoma (OAG; including normal tension glaucoma) or ocular hypertension (OHT). In this multicenter, observational study (Asia Pacific Patterns from Early Access of Lumigan 0.01 % in Korea; APPEAL Korea), patients with unachieved target intraocular pressure (IOP) despite previous treatment received bimatoprost 0.01 % daily for 12 weeks. The primary endpoint was incidence of hyperemia and its severity, graded using the standard 5-point photographic scale and grouped as "none to mild" and "moderate to severe". Hyperemia shifts were reported. IOP and adverse events (AEs) were recorded. Of 800 patients (intent-to-treat/safety population), 248 were switched from previous treatment to bimatoprost 0.01 % monotherapy. Hyperemia shifts from baseline at weeks 6 and 12 were unchanged (84.8, 89.8 %), improved (4.4, 4.8 %), or worsened (10.8, 5.4 %), respectively. The shift was significant at week 6 (P < 0.0001). Hyperemia did not worsen significantly in patients previously receiving a prostaglandin analog or prostamide (PGA/PSD). Baseline mean IOP ± SD was 17.0 ± 5.7 mmHg, decreasing to 14.6 ± 3.8 mmHg (P < 0.0001) after 6 weeks, and to 14.7 ± 3.6 mmHg (P < 0.0001) after 12 weeks. Patients switched from PGA or PSD (excluding bimatoprost 0.03 %) to bimatoprost 0.01 % experienced significant IOP reductions from baseline. Treatment-related ocular AEs were reported by 37 patients, the most common being hyperemia (7.3 %). This subanalysis of the APPEAL Korea study supports use of bimatoprost 0.01 % for previously treated patients with OAG (including normal tension glaucoma) or OHT who did not reach target IOP or were intolerant of previous treatment.
    Japanese Journal of Ophthalmology 07/2015; DOI:10.1007/s10384-015-0392-2
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    ABSTRACT: To clarify the characteristics and outcomes of unusual retinal pigment epithelial detachments (PEDs). These PEDs had one or several sites of apparent thinning of the RPE, or no RPE at all, as shown on optical coherence tomography (OCT). Eight cases with PEDs showed apparent thinning of the RPE in the roof of the PED at one or more sites on OCT. Color fundus photographs, fundus examination records, fluorescein angiograms (FAs) and/or indocyanine green angiograms (ICGAs), obtained with simultaneous OCT using Spectralis(®), and fundus autofluorescence were evaluated. Macular findings, prior to baseline PED detection, were investigated in three cases. Follow-up results were also reviewed in three cases. Well-delineated grayish-white lesions at the level of the choroid observed through a hypo- or unpigmented area corresponding to the area of thinning in the RPE on OCT. These lesions showed intense hyperfluorescence due to staining on both FAs and ICGAs as well as hypofluorescence on fundus autofluorescence. In three eyes, smaller PEDs had been observed at the same locations and were thus taken as the baseline PEDs on images obtained 22-94 months before this study. In two of the three eyes followed up for at least 35 months from baseline, the PEDs collapsed, leaving RPE-choriocapillaris atrophy in one eye and RPE tear in the other. Lesions corresponding to the area of thinning in the RPE on OCT may indicate hypo- or unpigmented RPE, possibly as a result of focal damage due to longstanding PEDs. These PEDs may lead to unexpected complications during long-term follow-up.
    Japanese Journal of Ophthalmology 07/2015; DOI:10.1007/s10384-015-0391-3
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    ABSTRACT: To compare short-term outcomes of Descemet's stripping automated endothelial keratoplasty (DSAEK) using a graft prepared with either a femtosecond laser or a microkeratome. Thirty-eight patients underwent DSAEK with grafts prepared with either a femtosecond laser (f-DSAEK; 21 eyes) or a microkeratome (m-DSAEK; 17 eyes). Visual acuity, endothelial cell density, regular astigmatism and irregular astigmatism were compared between the two groups preoperatively and at 1, 3, and 6 months post-operatively. Fourier analysis was conducted to calculate astigmatism of the anterior and posterior surfaces, and total cornea, using anterior segment optical coherence tomography (AS-OCT). Visual acuity (logMAR) improved from 1.20 ± 0.60 to 0.43 ± 0.25 after m-DSAEK (P < 0.001) and from 1.20 ± 0.57 to 0.77 ± 0.33 after f-DSAEK (P = 0.0028) at 6 months following DSAEK. Visual acuity after m-DSAEK was significantly better than after f-DSAEK at 1, 3, and 6 months (P < 0.05). AS-OCT corneal images revealed greater irregularities on the posterior surfaces of f-DSAEK grafts compared to m-DSAEK grafts. Irregular astigmatism of the total cornea and the posterior surface was significantly larger after f-DSAEK than after m-DSAEK, although there was no significant difference in irregular astigmatism of the anterior surface at 6 months. Postoperative visual acuity was significantly correlated with the postoperative irregular astigmatism of the total cornea (r = 0.6657 and P < 0.001) and the anterior (r = 0.416, P = 0.016) and posterior surfaces (r = 0.7046, P < 0.001). Visual outcomes after f-DSAEK were poor compared to conventional m-DSAEK due to an increase in irregular astigmatism caused by posterior surface irregularities.
    Japanese Journal of Ophthalmology 06/2015; DOI:10.1007/s10384-015-0388-y
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    ABSTRACT: To examine the prognosis of patients with diabetic macular edema (DME) before Japanese approval of antivascular endothelial growth factor (VEGF). This retrospective study included 135 eyes of 115 patients who received treatments (photocoagulation, pharmacological treatments, vitrectomy) for DME between January 2003 and August 2012. The best-corrected visual acuity (BCVA) before and 1, 3, 6, 12, and 24 months after treatment was examined. BCVA was classified based on the decimal value of BCVA before treatment as good (BCVA > 0.7, BCVA = 0.7), moderate (BCVA > 0.7 but <0.2), or poor (BCVA < 0.2, BCVA = 0.2), and each prognosis of BCVA was investigated. Thirty-five (25.9 %) patients were classified with good BCVA, while 69 (51.1 %) had moderate and 31 (23.0 %) poor BCVA. Following 24 months of treatment, the averaged good BCVA maintained its value (0.0513 ± 0.0954 to 0.0773 ± 0.258). Similarly, the averaged moderate BCVA maintained its value (0.449 ± 0.169 to 0.441 ± 0.431), whereas the averaged poor BCVA significantly improved (1.070 ± 0.291 to 0.879 ± 0.361: p < 0.001). Specifically, the averaged BCVA of patients who initially received vitrectomy increased 0.380 logMAR after 24 months (0.859 ± 0.414 to 0.479 ± 0.549). DME patients with good BCVA at the time of initial treatment generally maintained the averaged BCVA at 24 months, while patients with moderate BCVA did not significantly improve without a standard regimen of anti-VEGF therapy. However, the results indicate that early vitrectomy is a potential treatment option for DME patients with poor BCVA.
    Japanese Journal of Ophthalmology 05/2015; DOI:10.1007/s10384-015-0384-2
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    ABSTRACT: To examine the clinical utility of femtosecond laser-assisted astigmatic keratotomy (FSL-AK) for eyes after cataract surgery. Eight eyes of 6 patients with an intraocular lens and corneal astigmatism of 2.0 diopters (D) or more underwent FSL-AK. The mean preoperative manifest cylindrical refraction was 2.88 ± 0.64 D and the mean corneal astigmatism was 2.84 ± 0.83 D. Paired symmetrical arcuate incisions were created with the same settings, except for the incision depth. Uncorrected distance visual acuity (UDVA), manifest cylindrical power, and surgically induced astigmatism (SIA) were measured at 1 day, 1 week, and 1 month postoperatively. Fourier analysis of corneal topography and incision depths measured with anterior-segment optical coherence tomography were evaluated 1 month postoperatively. In all eyes, the UDVA improved at 1 week and 1 month postoperatively, and the manifest cylinder also decreased postoperatively, while the SIA showed overcorrections in 6 eyes. Fourier analysis showed decreases in spherical and regular astigmatic components and increases in higher-order irregularity. The mean incision depth was measured as 60 µm deeper than the intended depth. The FSL-AK effectively reduced corneal astigmatism and improved the UDVA, although it was demonstrated that the deeper incisions led to overcorrection.
    Japanese Journal of Ophthalmology 05/2015; 59(4):209-215. DOI:10.1007/s10384-015-0383-3