Congenital nasolacrimal duct obstruction: clinical guideline.


FIVE-YEAR VISUAL OUTCOME OF TREATMENT FOR RETINOPATHY OF PREMATURITY IN INFANTS WEIGHING <500 G AT BIRTH: A Multicenter Cohort Study From J-CREST.

One-quarter of the eyes exhibited good visual acuity (Snellen BCVA of 20/20) 5 years after retinopathy of prematurity treatment. Refractive errors were common. Anti-vascular endothelial growth factor therapy may be superior to laser therapy in myopic refractive error.


後天性内斜視に対する片眼直近後後転術の効果

後天性内斜視に対する片眼直近後後転術の効果

Folia japonica de ophthalmologica clinica


A Case of Osteopetrosis with Orbital Inflammation Secondary to Maxillary Osteomyelitis.

This is a rare case of maxillary osteomyelitis associated with osteopetrosis, causing orbital inflammation.


Comparison of long-term treatment outcomes of laser and anti-VEGF therapy in retinopathy of prematurity: a multicentre study from J-CREST group.

In zone I ROP, anti-VEGF therapy led to better visual acuity and less myopic refractive error than laser treatment.

The initial treatment procedure was not associated with any specific treatment outcome. Subgroup analysis of patients with zone I ROP revealed that the anti-VEGF-treated eyes had significantly better BCVA and higher SE than laser-treated eyes (p = 0.004, p = 0.009, respectively). Female patients presented significantly better BCVA, less amblyopia and less strabismus than male patients (p < 0.001, p = 0.029, p = 0.008, respectively).


Effect of foveal morphology on visual acuity in 4-6-year-old children with retinopathy of prematurity: a J-CREST study.

Laser therapy is the most effective treatment considered for retinopathy of prematurity (ROP). We compared the foveal morphology of the retina in eyes with a history of ROP to that of full-term children. This cross-sectional comparative study included 74 patients with a history of ROP, aged 4-6 years. Among them, 41 underwent laser treatment for ROP. The clinical findings and retinal morphology in these patients were compared to that of 33 patients who had spontaneous ROP regression and 30 age-matched full-term controls. All the patients with ROP had 20/40 or better best-corrected visual acuity (BCVA). The foveal thickness was significantly thicker in laser-treated ROP eyes than in regressed ROP eyes and controls. The outer nuclear layer was significantly thicker, and the inner segment (IS) of the photoreceptors and the inner retinal layer were significantly thicker in the laser-treated ROP eyes than that in the control eyes. In the patients with ROP and controls, better BCVA was associated positively with deeper foveal depression, which was associated with a later gestational age. Our results suggest that prematurity and laser treatment affect the foveal morphology and BCVA.


Depth Perception with a Newly Developed Microscope Stereotest.

Depth perception under the microscope is more accurate under the binocular than in the monocular condition, indicating the potential role of stereopsis. Anisometropia deteriorates depth perception, suggesting that refractive error should be corrected during microscopic work, such as during ophthalmic surgery.


眼窩内異物摘出に際し外眼角切開が有用であった1例

眼窩内異物摘出に際し外眼角切開が有用であった1例

Japanese Journal of Clinical Ophthalmology


Effect of optical correction on choroidal structure in children with anisohypermetropic amblyopia.

The aim of this study was to assess the effect of wearing optical correction on the choroidal structure in eyes of children with anisohypermetropic amblyopia. This study was conducted at the Nara Medical University Hospital and at the Tokushima University Hospital. Twenty-nine anisohypermetropic amblyopic eyes and their fellow eyes of 29 amblyopic patients (mean age, 5.7 ± 1.7 years, range 3- to 8-years) and twenty eyes of 20 age-similar control children (4.9 ± 0.8 years, range 4- to 6-years) were studied. All patients wore optical correction and 15 patients had both optical correction and patching. The values at the baseline were compared to that at one year later. The binarization method was used to determine the total, luminal, and stromal areas of the choroid in the enhanced depth imaging optical coherence tomographic images. The best-corrected visual acuity (BCVA) of the amblyopic eyes was significantly improved after the one-year period. A large luminal area was characteristic of the amblyopic eye at the baseline, and it was significantly reduced after the optical treatment. The stromal area widened significantly in the amblyopic and fellow eyes after one year whereas there were no significant changes in the choroid of the control eyes after one year. After one-year of optical correction, the luminal/stromal ratios in the amblyopic and fellow eyes were decreased and were then not significantly different from that of the normal control eyes. There was a significant and positive correlation between the improvement of the BCVA and the stromal area at the baseline (r = 0.64, P = 0.001). Wearing corrective lenses on the amblyopic eyes improves the BCVA, and the choroidal structure of the amblyopic eye becomes closer to that of the control eyes. The narrowed luminal area is a specific response of the amblyopic eye associated with the correction of the refractive error. The larger stromal area in the amblyopic eyes at the baseline is a predictive factor for improvements of the BCVA.


眼科手術中のラテックスアレルギーによるアナフィラキシーショック

眼科手術中のラテックスアレルギーによるアナフィラキシーショック


全身麻酔手術中にラテックスアレルギーによるアナフィラキシーショックをきたした一例


Changes in choroidal thickness in healthy pediatric individuals: A longitudinal study

To investigate the changes in the choroidal thickness in healthy pediatric children in a longitudinal study, and to determine the ocular and systemic parameters that were significantly correlated with the changes in the choroidal thickness. This study included 64 eyes of 34 healthy Japanese children with a mean age (±SD) of 4.4 (±0.4)y (range, 3.6-5.8y) at baseline. Swept-source optical coherence tomography (SS-OCT) was used to record images of the retina and choroid at the baseline and after a mean follow-up period of about 1.5y. The 3D raster scan protocol was used to construct the choroidal thickness map. Mean choroidal thickness was calculated for each of the nine sectors of the Early Treatment Diabetic Retinopathy Study grid. Best-corrected visual acuity, axial length, body height, and weight were also measured. Changes in measurements were defined as the baseline values subtracted from the values at the final visit. A generalized estimating equation was used to eliminate the effect of within-subject intereye correlations. The mean central choroidal thickness was significantly reduced during the follow-up period (baseline, 301.8±8.6 µm; final visit, 286.6±8.0 µm, <0.001). The decrease in the choroidal thickness was greatest in the central sector, followed by the sectors of the inner and outer rings. The inner and outer rings had diameters of 1 to 3 mm and 3 to 6 mm, respectively. The changes in the choroidal thickness in the central, inner ring, and outer ring sectors were significantly and negatively correlated with the age, baseline body height, baseline body weight, and elongation of the axial length. These results indicate that the choroidal thickness among preschool-aged Japanese children decreased significantly during the follow-up period. The choroidal thinning is significantly associated with the elongation of axial length. These characteristics should be considered in the evaluation of choroidal thickness in younger children with retinochoroidal disorders.


Observation of Ciliary Body Changes during Accommodation Using Anterior OCT.

To evaluate the anatomical changes in the ciliary body (CB) during naturally stimulated accommodation in children using anterior segment optical coherence tomography (OCT). This study was a prospective, observational, noncomparative case series included 18 eyes of 9 children (8 males and 1 female) aged from 4 to 10 years. Ciliary body thickness (CBT) was measured temporally by Anterior OCT at 1, 2 and 3 mm posterior to the scleral spur. Measurements were performed in the accommodated state and the unaccommodated state (with cycloplegia). The mean CBT significantly increased by accommodation at 1 mm posterior to the scleral spur from 751 42 to 818 40 μm (P 0.001) and significantly decreased at 2 and 3 mm from 506 66 to 445 59 μm and from 290 54 to 240 50 μm respectively (P 0.001). During accommodation, the anterior portion of the ciliary body thickens, while the posterior portion decreases in thickness. These findings imply that the circular ciliary muscles are mainly involved in accommodation and not the longitudinal muscles. J. Med. Invest. 65:60-63, February, 2018.

The Journal of Medical Investigation : JMI


Effect of optical correction on subfoveal choroidal thickness in children with anisohypermetropic amblyopia.

The purpose of this study was to determine the effect of optical correction on the best-corrected visual acuity (BCVA) and subfoveal choroidal thickness (CT) in the eyes of children with anisohypermetropic amblyopia. Twenty-four anisohypermetropic amblyopic eyes and their fellow eyes of 24 patients and twenty-three eyes of 23 age-matched control children were studied. After one year of optical correction, the BCVA in the anisohypermetropic amblyopic eyes was significantly improved. Before the treatment, the mean subfoveal CT in the amblyopic eyes was 351.9 ± 59.4 μm which was significantly thicker than that of control eyes at 302.4 ± 63.2 μm. After the treatment, the amount of change in the subfoveal CT in the amblyopic and fellow eyes was greater than that in the control eyes. The amblyopic and fellow eyes with thicker choroids had a greater thinning of the choroid whereas eyes with thinner choroids had a greater thickening of the choroid. We conclude that wearing corrective lenses improves the visual acuity, and induces changes of the subfoveal CT in eyes with anisohypermetropic amblyopia.


Review of retinopathy of prematurity in Tokushima University Hospital

徳島大学病院における未熟児網膜症の検討

Folia japonica de ophthalmologica clinica


徳島大学ロービジョン外来の現状

徳島大学ロービジョン外来の現状


オクルパッド弱視訓練器)の使用経験

オクルパッド弱視訓練器)の使用経験


Diurnal variations in luminal and stromal areas of choroid in normal eyes

To determine the diurnal variations of the luminal and stromal areas of the choroid in normal eyes. This was a prospective observational study of 38 eyes of 38 normal subjects. The blood pressure, heart rate, intraocular pressure and enhanced depth imaging optical coherence tomographic (EDI-OCT) images were recorded every 3 hours between 6:00 and 21:00 hours. The horizontal EDI-OCT images of the subfoveal choroid were converted to binary images. The central choroidal thickness (CCT), total cross-sectional choroidal area, the luminal areas, stromal areas and the ratio of luminal area to total choroidal area (L/C ratio) were determined. There were significant diurnal variations in the CCT, total choroidal area, luminal area and L/C ratio with the maximum values at 6:00 hours and the minimum values at 15:00 hours (p<0.001 for the CCT, p=0.011 for the total choroidal area, p<0.001 for the luminal area and p=0.014 for the L/C ratio). There was no significant variation in the stromal area (p=0.216). The range of fluctuation in the CCT was significantly correlated with that in the luminal area and the total choroidal area (p<0.001). However, there was no significant correlation between the fluctuation range in the CCT and that in the stromal area (p=0.095). There was no statistical relationship between the systemic parameters and the choroidal parameters. The changes in the luminal area are most likely responsible for the diurnal change in the CCT and subfoveal choroidal area. UMIN000019060, Pre-results.


Choroidal structure in children with anisohypermetropic amblyopia determined by binarization of optical coherence tomographic images

To compare the choroidal structure of the subfoveal area in the eyes of children with anisohypermetropic amblyopia to that of the fellow eyes and to age-matched controls using a binarization method of the images obtained by enhanced depth imaging optical coherence tomography (EDI-OCT). This study was performed at Nara Medical University Hospital, Tokushima University Hospital, and Kagoshima University Hospital, Japan. Forty amblyopic eyes with anisohypermetropic amblyopia and their fellow eyes (5.9 ± 2.1 years, mean ± standard deviation), and 103 age-matched controls (6.7 ± 2.4 years) were studied. The control eyes were divided into myopic, emmetropic, and hyperopic eyes. The total choroidal area, luminal area and stromal area of the subfoveal choroid were measured by the binarization method. The luminal/stromal ratio and the axial length of the amblyopic eyes were compared to that of the control eyes. The total choroidal area in the amblyopic eyes was significantly larger than that of the fellow eyes (P = 0.005). The luminal/stromal ratio was significantly larger in the amblyopic eyes than that of the fellow eyes (P<0.001) and the control hyperopic eyes (P<0.001). There was a significant negative correlation between the luminal/stromal ratio and the axial length in the control eyes (r = -0.30, P = 0.001), but no significant correlation was found in the amblyopic eyes. The choroidal structure of the amblyopic eyes was different from that of the fellow and the control hyperopic eyes. The choroidal changes are related to amblyopia.


A case of metastatic orbital tumor with severe pain

激痛を伴いマイラゲルの合併症と鑑別を要した転移性眼窩腫瘍の1例

Japanese Journal of Clinical Ophthalmology


Effectiveness of 16 gauge sheath in the treatment of dacryolith in the lacrimal sac

結石の処理に16ゲージシースが有用であった涙囊内結石症例


Surgical removal and conservative management of bilateral hyperplastic persistent papillary membrane with amblyopia

左右差のある両眼性瞳孔膜遺残に対し観血的切除術と弱視治療で良好な視力を得た1例


A case of X-pattern exotropia undergoing recession of both lateral rectus muscles

両眼外直筋後転術を施行したX型外斜視の1例


Optical Coherence Tomography Reveals New Insights into the Accommodation Mechanism.

Purpose. To evaluate the movement of the anterior and posterior lens poles during naturally stimulated accommodation in children using anterior segment optical coherence tomography (OCT). Methods. This is a prospective, observational, noncomparative case series including 18 eyes of nine children. Analysis of the anterior segment in the accommodated and unaccommodated state (with cycloplegia) was done using anterior segment OCT. The main outcome measures were the position of the anterior and posterior lens poles (in relation to the cornea) and lens thickness (LT). Results. A Statistically significant forward movement of the anterior lens pole and backward movement of the posterior lens pole with an increase in LT were found during accommodation (P < 0.001). There was no significant difference between the degree of movement of the anterior lens pole and the posterior lens pole during accommodation (P = 0.944). Conclusions. Anterior segment OCT provides a rapid noncontact method for studying accommodation in children. The backward movement of the posterior lens pole during accommodation nearly equals the forward movement of its anterior pole. These data minimize the theoretical hydraulic effect of the vitreous during accommodation, adding more support to the capsular theory of Helmholtz.


Palliative radiotherapy was effective in a case of sebaceous carcinoma of presumed lacrimal gland origin

緩和的放射線治療が有用であった涙腺原発と思われる脂腺癌の1例


A case of head tilt due to orbital floor fracture

斜頚をきたした眼窩下壁骨折の小児例


Bilateral optic neuropathy in a case of hypertrophic pachymeningitis

臨床報告 肥厚性硬膜炎による両眼視神経症の1例


A case of congenital corneal anesthesia with the VACTERL association

繰り返す角膜障害から先天性角膜知覚麻痺を合併していると考えられたVACTERL連合の1例


Visual function of congenital blepharoptosis

先天性眼瞼下垂症例の視機能

Folia japonica de ophthalmologica clinica


Analyses of the characteristics of potential and cross-talk at each electrode in electro-oculogram.

We placed negative electrodes on the body and positive electrodes at the medial and lateral canthi, measured their potentials separately, evaluated their characteristics, and analyzed cross-talk. We recorded EOG in 6 normal subjects and found the following. The potential at the medial was lower than that at the lateral canthus in the bilateral eyes. The polarity of waves at the lateral was reverse to that at the medial canthus in the bilateral eyes. We recorded EOG in 6 patients with unilateral anophthalmia and found the following. On the anophthalmia side, the potential at the lateral was considerably lower than that at the medial canthus. The polarity of the potential was the same between the medial and lateral canthi. The mean cross-talk to the medial canthus on the anophthalmia side was 8.7%-54.0% of the potential at the medial canthus on the normal side. The mean cross-talk to the lateral canthus on the anophthalmia side was 4.4%-16.9%. The influence of cross-talk of the other eye was marked at the medial but slight at the lateral canthus. In EOG recording, results with minimum errors due to cross-talk can be obtained by paying attention to the potential at the lateral canthus.

The Journal of Medical Investigation : JMI


裂孔原性網膜剥離に対するインプラント手術後のバックル感染症の検討

裂孔原性網膜剥離に対するインプラント手術後のバックル感染症の検討


Review of ocular complications of epiblepharon

睫毛内反症患者における眼合併症の検討


調節性内斜視の合併の有無による屈折異常弱視の比較検討

調節性内斜視の合併の有無による屈折異常弱視の比較検討


Analysis after removal cross-talk improves electro-oculogram usefulness

改良した眼球電図測定法によるクロストークの解析


Health problems due to personal computers (IT eye syndrome)

【環境と日常生活】 パソコン等使用による健康障害(IT眼症)

IT stands for information technology, and the chance to use IT equipments such as personalcomputers and game machines has been increasing dramatically. IT eye syndromes are referredto unpleasant symptoms of the eye because of these. They are mainly due to asthenopia by ocularmovement and accommodation, and dry eye.It is important to take a proper rest in computer-aided works, and to put the display on anappropriate position for the prevention of IT eye syndrome. When glasses or contact lens areused, it is necessary to check whether they are appropriate or not. It is preferable to reviewworking environment, and person who engage in personal computer works for a long time shouldreceive regular health screenings for the prevention of IT eye syndrome.


Therapeutic outcome of hyperopic anisometropic amblyopia at Tokushima University Hospital

徳島大学病院における遠視性不同視弱視の治療成績


徳島大学における屈折異常弱視と不同視弱視の検討

徳島大学における屈折異常弱視と不同視弱視の検討

Japanese Journal of Clinical Ophthalmology


3歳児健診での要精査児の受診結果と問題点

3歳児健診での要精査児の受診結果と問題点


An atypical case of retinoschisis in posterior staphvloma

特異な形態の後部ぶどう腫内網膜分離症の1例


Renal failure caused by eyedrops containing phenylephrine in a case of retinopathy of prematurity

The patient was a low birth weight infant with a history of renal failure. She was referred to our department 29 days after birth to undergo fundus examination. She experienced renal failure after undergoing a mydriatic test and needed medical treatment. Eyedrops containing phenylephrine were instilled several times and additional drops were also instilled during the fundal examination using an eyelid retractor, therefore the blood concentration of the drug was elevated sufficiently to contract the renal vessels, ultimately inducing renal failure. The present case suggests that since the use of mydriatic eyedrops in low birth weight infants could induce renal failure, the following points should be considered: 1) Mydriatic eyedrops should be used with caution by monitoring mydriasis and avoiding excessive instillation; 2) After instillation, the lacrimal region should be compressed to prevent the flow of mydriatic drops to the nasolacrimal canal; and 3) Vital signs should be monitored to check the onset of any adverse reactions for 12 hours after fundal examination.


Traumatic rhegmatogenous retinal detachment due to bungee jumping

バンジージャンプによって外傷性網膜剥離を起こした1例


Two Cases of Therapeutic Penetrating Keratoplasty using Fresh Donor Cornea for Non-traumatic Corneal Perforation

非外傷性角膜穿孔に対し新鮮角膜を用いた治療的全層角膜移植術を施行した2症例


Penetrating Keratoplasty Using Intentional Double Anterior Chamber

意図的二重前房を用いた全層角膜移植術


Induction of Gene into the Rabbit Eye by Iontophoresis:Preliminary Report

To assess the transfer of 6-carboxyfluorescein (6-FAM)-labeled phosphorothioate oligonucleotides(S-ODNs) into the ocular tissues, their stability, and possibility of injury to the ocular tissues. The S-ODNs(2 mL/eye)were transduced noninvasively into albino rabbit eyes.The iontophoresis group consisted of 6 rabbits (12 eyes); the control group consisted of 2 rabbits (4 eyes) given eye drops containing S-ODNs. Aqueous humor and vitreous humor were collected after iontophoresis, subjected to electrophoresis with a fluorescence DNA sequencer and analyzed by the Gene Scan program. Frozen sections, 10-microm thick, were prepared for observation under a fluorescence microscope. A plasmid 4.7 kbp in size that expresses green fluorescent protein (GFP) was induced into the 18 eyes of 9 rabbits by the same procedure. In the iontophoresis group, S-ODNs were detected in the anterior chamber 5 minutes after electrophoresis began and in the vitreous after 10 minutes. These S-ODNs maintained the same length as at the initial synthesis. The S-ODNs could also be detected in the posterior retina 20 minutes after electrophoresis. No evidence of degeneration or inflammation due to the above procedure was found in the ocular tissues. Fluorescence showing GFP gene expression was found in the cornea, the anterior chamber angle, and the ciliary subepithelial tissues. These findings show that iontophoresis is an effective method to induce genes into the rabbit eye.


Induction of Genes into the Rabbit Eye by Iontophoresis

イオントホレーゼによる家兎眼への遺伝子導入

After inducing 6-carboxyfluorescein (6-FAM)-labeled phosphorothioate oligonucleotides (S-ODNs) noninvasively into albino rabbit eyes by iontophoresis, we assessed the transfer of S-ODNs into the ocular tissues, their stability, and the possible presence of injury to the ocular tissues. The iontophoresis group consisted of 12 eyes of 6 rabbits and the control group consisted of 4 eyes of 2 rabbits given eye drops containing S-ODNs. Aqueous humor and vitreous humor were collected after iontophoresis, subjected to electrophoresis with a fluorescent DNA sequencer and analyzed by the Gene Scan program. Frozen sections at 10 microns were prepared for observations under a fluorescent microscope. A plasmid 4.7 kbp in size that expresses green fluorescent protein (GFP) was induced into 18 eyes of 9 rabbits by the same procedure. In the iontophoresis group, S-ODNs were detected in the anterior chamber 5 minutes after electrophoresis and in the vitreous 10 minutes after. These S-ODNs maintained the same length as at the initial synthesis. S-ODNs could also be detected in the posterior retina 20 minutes after electrophoresis. No evidence of degeneration or inflammation due to the above procedure was found in the ocular tissues. Fluorescence showing GFP gene expressions were found in the cornea, the anterior chamber angle, and the ciliary subepithelial tissues. These findings show that iontophoresis is an effective method to induce gene into rabbit eyes.

Acta Societatis Ophthalmologicae Japonicae


A Case of Herpetic Keratitis Associated With Keratomycosis

角膜ヘルペスと角膜真菌症を合併した1例


円滑な支援を目的とした視覚情報提供書(みるしるレター)の使用経験

円滑な支援を目的とした視覚情報提供書(みるしるレター)の使用経験

Folia japonica de ophthalmologica clinica


内視鏡下鼻内手術に伴う眼窩内損傷

内視鏡下鼻内手術に伴う眼窩内損傷


SS-OCTを用いた，健常日本人小児における脈絡膜厚の経時的変化の検討(会議録)


脈絡膜2階調化による小児遠視性不同視弱視眼の眼鏡治療前後の比較検討(会議録)

脈絡膜2階調化による小児遠視性不同視弱視眼の眼鏡治療前後の比較検討(会議録)


Sarcoidosis successfully treated with allopurinol

【肉芽腫症】 アロプリノールが有効であったサルコイドーシスの1例


Review of a nosocomical outbreak of epidemic keratoconjuntivitis

流行性角結膜炎の院内感染の検討

Japanese Journal of Clinical Ophthalmology