Minamiaoyama Eye Clinic

To predict multiple postoperative parameters following implantable collamer lens (ICL) surgery with generative artificial intelligence, using preoperative anterior segment optical coherence tomography (AS-OCT) images as the input. Daikanyama Eye Clinic, Tokyo, Japan; Miyata Eye Hospital, Miyazaki, Japan; Nagoya Eye Clinic, Nagoya, Japan; Yokohama Sky Eye Clinic, Kanagawa, Japan. Retrospective Study. Our research involved paired preoperative and postoperative AS-OCT images from 1010 patients (1585 eyes) who underwent horizontal ICL implantation, and 86 patients (86 eyes) who received vertical implantation from four clinical centers. A Generative Adversarial Network, ICL-GAN, was employed to predict postoperative structures based on preoperative AS-OCT slice from each eye. Postoperative parameters, including vault, AOD500, and TIA500, were measured from the predicted postoperative structures. The prediction error was evaluated using the mean absolute error (MAE) and root mean square error (RMSE). The correlation and agreement between the prediction and the achieved values were also analyzed. The vaults measured from the predictions of postoperative anatomical structure have a strong correlation with the achieved values on horizontal data (r=0.659, p<0.01 for ICL size of 12.1mm, r=0.799, p<0.01 for 12.6mm, and r=0.737, p<0.01 for 13.2mm) and when compared with the NK-formula and KS-formula achieved the minimum prediction errors (MAE are 105 μm, 114 μm, and 111 μm). ICL-GAN also performed best on the vertical implantation data. The AOD500 and TIA500 also showed good correlation and agreement with the achieved values. The generative artificial intelligence demonstrates the capability to predict multiple postoperative parameters following ICL surgery.

This prespecified subpopulation analysis aimed to assess the efficacy and safety of once-weekly tirzepatide versus placebo alongside lifestyle intervention in Japanese adults with obesity or overweight. Data from 102 Japanese adults in the SURMOUNT-1 trial with BMI ≥ 30 kg/m2 or ≥ 27 kg/m2 and ≥ 1 weight-related comorbidity were analyzed. Coprimary endpoints were mean percent change in body weight and the proportion of participants who achieved ≥ 5% body weight reduction at week 72. Participants in the tirzepatide 5-, 10-, and 15-mg groups had a statistically significantly greater (all p < 0.001) least squares mean (standard error) percent change in body weight compared with those in the placebo group: -12.0% (1.7%), -22.4% (1.7%), -22.1% (1.6%), and -0.3% (1.6%), respectively. Overall, 91.7%, 100%, and 96.6% of participants in the tirzepatide 5-, 10-, and 15-mg groups, respectively, had ≥ 5% weight reduction at week 72, compared with 15.4% in the placebo group. Significant improvements in cardiometabolic measures were also observed with tirzepatide at week 72 compared to placebo. No new safety concerns were identified. Once-weekly treatment with tirzepatide demonstrated significant reductions in body weight and prespecified cardiometabolic measures compared with placebo in Japanese adults with obesity or overweight. ClinicalTrials.gov identifier: NCT04184622 https://clinicaltrials.gov/study/NCT04184622.

Background: Major depressive disorder (MDD) is often accompanied by generalized anxiety disorder (GAD), a comorbidity linked to greater illness burden and potentially poorer outcomes. Repetitive transcranial magnetic stimulation (rTMS) and intermittent theta-burst stimulation (iTBS) are established treatments for MDD, yet the impact of comorbid GAD and concomitant medications remains unclear. This study aimed to compare rTMS/iTBS treatment outcomes between patients with MDD with and without comorbid GAD, and to examine the association between concomitant psychotropic medication use, stimulation protocol, and treatment response in a real-world clinical setting. Methods: We conducted a retrospective observational analysis using registry data from 108 patients (MDD + GAD: n = 36; MDD only: n = 72). Patients received either Left-iTBS or Right-rTMS. Baseline severity, percentage change in Montgomery-Åsberg Depression Rating Scale (MADRS) and Hamilton Depression Rating Scale (HAMD-17) scores, response, and remission were assessed. Logistic and linear regression models adjusted for age, sex, and baseline severity were applied. Sensitivity analyses stratified by stimulation protocol and benzodiazepine (BDZ) use were performed. Results: Baseline severity did not differ between groups. MADRS reduction was numerically lower in the comorbid GAD group (48.3% vs. 52.7%, p = 0.09), whereas HAMD-17 reduction was comparable. Response and remission rates did not differ significantly. Medication use and stimulation protocol did not show statistically significant independent associations with outcomes. Sensitivity analyses confirmed equivalent outcomes between Left-iTBS and Right-rTMS. BDZ users showed a non-significant trend toward lower MADRS improvement and remission. Conclusions: rTMS/iTBS produced substantial clinical improvement and was well tolerated in both patients with MDD and those with MDD comorbid with GAD. Although comorbid anxiety showed a modest tendency to attenuate MADRS score reduction, overall response and remission rates were comparable between groups. Neither concomitant medications nor stimulation protocol significantly affected treatment outcomes, while the potential influence of BDZ exposure warrants further investigation.

While Clareon monofocal intraocular lens (IOL) has been reported to be free from surface light scattering and glistenings, it remains unknown whether Clareon PanOptix IOL develops these optical phenomena. This study aimed to evaluate one-year surgical outcomes of this IOL, with a focus on visual function, patient-reported satisfaction, and clarity of IOL optics. A prospective study was conducted in 78 eyes of 39 patients undergoing bilateral implantation of toric or non-toric Clareon PanOptix IOLs. Postoperative examinations were conducted at 1, 6, and 12 months. At 12 months, bilateral uncorrected visual acuity (BUCVA) and bilateral distance-corrected visual acuity (BDCVA) were better than 20/20 at 40 cm, 60 cm, and 5 m. No cases of surface light scattering or glistenings were observed. Spectacle independence was achieved in 84.2% of patients. While patient satisfaction with vision in daily life and daytime driving was high, approximately half of the patients reported some difficulty with night driving. The Clareon PanOptix provided satisfactory surgical outcomes, with no formation of surface light scattering or glistenings during the one-year follow-up period.Supplementary InformationThe online version contains supplementary material available at 10.1038/s41598-026-35603-5.

To evaluate the efficacy of a self-supervised learning Vision Transformer (ViT) for classification of the nucleus, cortex, and posterior capsule cataract severity utilizing anterior segment optical coherence tomography (AS-OCT) images. Artificial intelligence (AI) model training. Overall, 1,693 eyes were imaged using AS-OCT, with 1,023 classified according to the Lens Opacities Classification System III for supervised training at the Department of Ophthalmology, University of Tsukuba Hospital, Japan. Five AI models were compared: ResNet18, ViT with/without ImageNet pre-training, and Self-Supervised ViT (SS-ViT) constructed using AS-OCT images from 670 eyes. These models were evaluated across five classification tasks: nuclear cataract 2-class (N1 vs. N2≥), 3-class (N1, N2-N3, N4≥), and 6-class classifications; and 2-class classifications for both cortical (C1 vs. C2≥) and posterior subcapsular cataracts (P1 vs. P2≥). Performance was measured using Area Under the Precision-Recall Curve (AUPRC). In the nuclear cataract 2-class classification, ResNet18, ViT, and SS-ViT, which were pre-trained on ImageNet, demonstrated the highest AUPRC of 0.999. For the nuclear cataract 3-class classification, SS-ViT exhibited the highest AUPRC of 0.939. In the 6-class classification of nuclear cataract, SS-ViT attained the highest value with an AUPRC of 0.788. In the 2-class classification of cortical cataract, SS-ViT demonstrated the highest performance with an AUPRC of 0.774, while in the 2-class classification of posterior subcapsular cataract, SS-ViT exhibited the most favorable performance with an AUPRC of 0.506. Our findings demonstrate the effectiveness of a self-supervised ViT model for severity classification of nuclear, cortical, and posterior subcapsular cataracts on AS-OCT.

BackgroundConventional amblyopia treatment involves the occlusion of the fellow eye using an eye patch. However, this approach imposes a substantial psychological and physical burden on pediatric patients with amblyopia, resulting in low adherence and suboptimal visual outcomes. As responsiveness to therapy declines beyond early childhood, treatments that can enhance adherence and improve efficacy are needed. We developed a virtual reality dichoptic training app (VR app) that integrates gamification and hand-eye coordination training in pediatric patients with amblyopia.ObjectiveThis study investigated the effect of a VR app on visual acuity improvement in pediatric patients with amblyopia compared with conventional occlusion therapy using an eye patch.MethodsThis is a multicenter, open-label, prospective, randomized controlled trial that will be conducted at 3 centers in Tokyo, Japan. Pediatric patients aged 3-10 years with anisometropic, strabismic, or refractive amblyopia will be enrolled. Participants will be assigned 1:1 to a VR app group or a control group. The VR app group will use the VR app at home for 1 hour per day for 6 months. The control group will undergo conventional occlusion therapy with an eye patch for 6 months. Each group will comprise 15 participants (30 participants in total). Ophthalmologic examinations will be performed at baseline and at weeks 4, 8, 12, 16, 20, and 24. The primary endpoint will be the change in the best-corrected visual acuity in the amblyopic eye from baseline to week 12. Secondary endpoints will include changes in best-corrected visual acuity, stereopsis, and ocular deviation through week 24. We will also assess treatment adherence, defined as the ratio of the cumulative actual treatment time to the cumulative prescribed time; record adverse events, and evaluate usability in the VR app group. Longitudinal changes in outcome measures will be analyzed using a mixed-effects model.ResultsParticipant enrollment will start from January 1, 2026, to September 30, 2026. The data analysis will begin on October 1, 2026, and the results will be reported by March 31, 2027.ConclusionsThis study will clarify the effectiveness of the newly developed VR app in improving treatment outcomes and adherence among pediatric patients with amblyopia. By addressing the limitations of conventional occlusion therapy and providing a potentially more efficacious and acceptable treatment option, the VR app may enhance clinical outcomes and represent a paradigm shift in the treatment of pediatric amblyopia.

BackgroundChronic constipation, common in clinical practice, requires treatment to enhance quality of life and possibly extend life expectancy. However, predictors of treatment efficacy remain largely unexplored. This study aimed to identify factors predicting treatment success in patients with chronic constipation.MethodsA multicenter, prospective observational study evaluated patients with moderate to severe chronic constipation using the Chronic Constipation-Therapeutic Efficacy and Satisfaction Test (CC-TEST) questionnaire. Symptoms were assessed before treatment and at 2 and 4 weeks post-treatment. Multivariate analyses identified predictive factors based on three treatment efficacy assessment criteria: patient’s impression, numeric rating scale (NRS) for symptom intensity, and spontaneous bowel movement (SBM) frequency status.ResultsConstipation medications were administered to 97 patients, with significant symptom improvements observed at 2 and 4 weeks (CC-TEST). The greatest effects were seen in hard stools, difficulty in defecation, and infrequent bowel movements. In the multiple regression analysis, baseline clinical characteristics and symptom profiles were not significant predictors of treatment response. Incorporating 2-week treatment responsiveness revealed that non-responsiveness at 2 weeks (β = 0.487), and a lower stool symptom subscale score (β = -0.344), were associated with poorer patient’s impression. For the NRS, non-responsiveness at 2 weeks (β = 0.279) was a significant predictor. For SBM, non-responsiveness at 2 weeks (β = -0.274) predicted outcomes. Including 2-week non-responsiveness improved the predictive accuracy for 4-week efficacy.ConclusionsThe therapeutic response at 2 weeks is the most significant predictor of subsequent treatment response at 4 weeks in patients with chronic constipation.