To evaluate contrast sensitivity (CS) in eyes with idiopathic focal choroidal excavation (iFCE) and to investigate its association with morphological imaging findings. A retrospective, cross-sectional observational study. This retrospective observational study included 13 eyes of 12 patients with iFCE and 13 eyes of 13 age-matched healthy controls. CS was measured at six spatial frequencies (0.64 - 6.3 cycles per degree [cpd]) under glare-on and glare-off conditions, and the area under the log contrast sensitivity function (AULCSF) was calculated. In addition, associations between CS and optical coherence tomography (OCT) parameters, including maximum FCE diameter, FCE depth, and foveal choroidal thickness (FCT), as well as fundus autofluorescence (FAF) findings, were analyzed in eyes with iFCE. Best-corrected visual acuity (BCVA) was well preserved in eyes with iFCE. After Holm correction, AULCSF was significantly lower in the iFCE group than in the control group under both glare-on and glare-off conditions (adjusted p = 0.0010 and 0.0056, respectively). Under glare-on conditions, contrast thresholds were significantly higher in the iFCE group at all six spatial frequencies. Under glare-off conditions, significant differences remained at 2.5, 1.0, and 0.64 cpd after Holm correction. No association between AULCSF and the clinical or imaging variables remained statistically significant after correction. Nominal negative correlations were observed between FCT and glare-off contrast thresholds at 6.3 and 4.0 cpd; however, neither association remained statistically significant after Holm correction. Eyes with iFCE showed reduced contrast performance despite preserved visual acuity. These preliminary findings require confirmation in larger studies.
Seasonal variations in intraocular pressure (IOP) are reported in glaucoma, but differences between subtypes and the influence of filtration surgery remain unclear. This study examined seasonal IOP patterns in primary open-angle glaucoma (POAG) and exfoliation glaucoma (EXG) using electronic medical records analyzed with a Bidirectional Encoder Representations from Transformers (BERT)–based natural language processing system. Retrospective observational study. We analyzed 1,679 visits from 352 patients (238 with POAG and 114 with EXG) at a Japanese university hospital between August 2020 and May 2023. Clinical parameters were extracted from electronic medical records using a validated BERT-based natural language processing model. Seasonal IOP differences between winter and summer and factors associated with IOP were evaluated using mixed-effects regression analysis. Both POAG and EXG patients demonstrated significantly higher IOP in winter than in summer (POAG: 12.4 ± 3.3 mmHg vs. 12.0 ± 3.1 mmHg, p < 0.001; EXG: 12.4 ± 5.4 mmHg vs. 11.8 ± 4.2 mmHg, p < 0.001). The magnitude of seasonal IOP variations did not differ between glaucoma subtypes (p = 0.833); approximately 70
Little data exist on clinically relevant pupil diagnostic values for detecting early presbyopia (accommodative amplitude [AA]< 2.50D). This study aimed to determine the optimal cutoff value of pupil diameters for screening early presbyopia. Cross-sectional observational study 115 individuals aged ≥20 with visual acuity ≥20/25 who had attended one of two healthcare facilities in Japan between December 2020 and December 2021 were included. AA and near and distance pupillary diameters were measured by auto kerato-refractometer (ARK-1s; NIDEK Co.). Optimal cutoff values for early presbyopia were determined by receiver operating characteristic plots based on the Youden index. Among the pupil-related parameters (near or distance alone, or the difference between these), the difference between near and distance pupil diameters of 0.95 mm yielded the best results, with 82.4
Relapsing polychondritis (RPC) is a rare, chronic inflammatory disorder that affects cartilaginous tissues throughout the body. Although RPC may also be associated with ocular manifestations, comprehensive clinical studies on these findings are limited. This study aimed to characterize the ocular manifestations, clinical features, and treatment outcomes in patients with RPC. Retrospective observational case series. We retrospectively reviewed five consecutive patients diagnosed with RPC based on the Damiani and Levine criteria, at the Department of Ophthalmology, Kochi Medical School Hospital, and its affiliated hospitals. Clinical characteristics, ophthalmic findings, treatments, and visual outcomes were analyzed. Five patients (three men and two women) with a mean age of 65 years were included. Neuro-ophthalmic manifestations were identified in three patients (60
Purpose Topical ganciclovir (GCV) reduces intraocular pressure (IOP) in patients with cytomegalovirus (CMV) anterior uveitis. Because increased angle pigmentation may contribute to aqueous outflow resistance, we investigated the relationship between angle pigmentation and the IOP-lowering effects of topical GCV. Study design Retrospective study. Methods We reviewed the medical records of 31 eyes of 31 patients diagnosed with CMV anterior uveitis using aqueous humor PCR and treated with 2% topical GCV at the University of Tokyo Hospital. The best-corrected visual acuity (BCVA), IOP, topical steroids, and glaucoma medication scores were evaluated at baseline, 1, 4, 12, and 24 weeks after GCV initiation. Pre-treatment angle pigmentation was graded and analyzed in relation to IOP. Survival analysis was performed, with failure defined as an IOP > 21 mmHg, or the need for glaucoma surgery. Results Topical GCV improved BCVA with gradual reductions in IOP, steroid use, and glaucoma medication. Angle pigmentation was lower in CMV-affected eyes than in fellow eyes in patients with a shorter disease duration. Higher angle pigmentation was significantly correlated with a longer disease duration (rho = 0.51, p = 0.003). The greater-pigmentation group showed significantly less IOP reduction and lower survival rates than the less-pigmentation group. Conclusion Angle pigmentation was lower in the affected eyes than in the fellow eyes in patients with a shorter disease duration. In contrast, patients with greater angle pigmentation exhibited longer disease duration and a reduced IOP-lowering response to topical GCV treatment. Therefore, pre-treatment angle pigmentation evaluation may assist in predicting glaucoma outcomes.
