To evaluate the outcomes of micropulse transscleral cyclophotocoagulation (MP-CPC) for refractory glaucoma in children. Retrospective study. We evaluated the data from children with refractory glaucoma who underwent MP-CPC from July 2022 to December 2024 at the National Center for Child Health and Development and who were followed up for at least 3 months. The retrospective analysis included age; glaucoma type; history of glaucoma surgery; intraocular pressure (IOP) at baseline and at 1, 3, and 6 months postoperatively; medication score administered before and after surgery; visual acuity; and complications. Twenty-nine eyes of 24 patients (average age, 101.3 ± 68.1 months) were included in this study. The most common types of glaucoma were glaucoma associated with nonacquired ocular anomalies and glaucoma after cataract surgery, accounting for 11 eyes (37.9%). The average number of glaucoma surgeries performed before treatment was 1.9 ± 1.6. The average follow-up period was 16.1 ± 7.9 months. Using a mixed-effects model, the mean IOP decreased by -9.8 mm Hg at 1 month (P <.01), -7.5 mm Hg at 3 months (P <.01), and -7.4 mm Hg at 6 months (P <.01). The median medication score (interquartile range) decreased from 5 (4-6) preoperatively to 4 (3-5) at 1, 3, and 6 months postoperatively. After undergoing the first MP-CPC, 19 eyes (65.5%) required reoperation for glaucoma. Eleven eyes (37.9%) required reoperation within 6 months postoperatively, and 17 eyes (58.6%) required reoperation within 1 year. MP-CPC effectively reduces IOP in children with refractory glaucoma without causing visual impairment or serious complications.

To evaluate the clinical performance of "Direct Strip PCR," a multiplex solid-phase real-time polymerase chain reaction (PCR) kit, for diagnosing infectious uveitis. Multicenter, prospective, diagnostic accuracy study METHODS: We analyzed 475 ocular-fluid samples (336 aqueous humor and 139 vitreous fluid) from 29 sites in Japan. Direct Strip PCR, an IVD-grade multiplex real-time PCR kit targeting HSV-1, HSV-2, VZV, EBV, CMV, HHV-6, HTLV-1, Toxoplasma gondii, and Treponema pallidum requiring no DNA extraction and incorporating internal controls, was compared with quantitative PCR (qPCR) for concordance and DNA copy-number correlation. All 9 of the target pathogens were detected. Direct Strip PCR showed excellent agreement with qPCR, with percent positive agreement (PPA), percent negative agreement (PNA), and percent overall agreement (POA) in aqueous humor of 98.0%, 99.2%, and 98.5%, respectively, and in vitreous fluid of 95.7%, 97.1%, and 96.4%, respectively, indicating high concordance for positive and negative results. All the values exceeded predefined 90% thresholds agreed upon with the Pharmaceuticals and Medical Devices Agency, meeting the required performance criteria. Discordant results were infrequent (10/4275 targets) and involved low-copy samples near the detection limit. The DNA copy numbers correlated strongly between the methods (r = 0.948-0.996). No adverse events were reported. Direct Strip PCR demonstrated high concordance with qPCR, reliably detected major pathogens of infectious uveitis, and yielded quantitative results that correlated with the qPCR results, supporting disease monitoring. Its solid-phase, extraction-free, and per-run calibration-free format provides a practical basis for regulatory submissions and global dissemination of multiplex PCR.

To establish normative apparent diffusion coefficient (ADC) values of the lacrimal gland in a large cohort of healthy subjects and to compare the results with previously reported data. Retrospective cohort study. Brain magnetic resonance (MR) images of 260 healthy individuals were retrospectively analyzed. ADC measurements were performed bilaterally using a standardized region of interest (ROI) technique. The values were compared according to age and sex. To ensure normalization and standardization, vitreous ADC measurements were performed using the same ROI used for lacrimal gland measurements. Lacrimal gland ADC values were divided by vitreous ADC values. The lacrimal gland ADCmean value was 1.29 ± 0.14 ×10⁻3 mm2/s. No significant difference was observed in terms of ADC measurements between the right and left glands (p > 0.05). Sex had no statistically significant effect on ADC values (p > 0.05). The mean vitreous ADC value was 3.08 ± 0.20 ×10⁻3 mm2/s. The lacrimal gland/vitreous ADCmean ratio was 0.42 ± 0.05. Correlation analysis revealed weak positive correlations between age and lacrimal gland ADCmean (r = 0.185, p = 0.003) and ADCmax (r = 0.260, p < 0.001). This study presents a large series on normative ADC values of the lacrimal gland in healthy individuals. The results provide reliable reference data that may assist in the differential diagnosis of inflammatory and neoplastic pathologies.

To characterize choroidal circulation in the vortex veins in central serous chorioretinopathy. Single-center retrospective study. The study included 22 eyes with central serous chorioretinopathy from 22 patients with serous retinal detachment at the macula (18 men and four women, mean age 47.3 years). Ultra-widefield indocyanine green angiography was performed using Optos®California, and images were taken intermittently from the early to the late phase (> 20 min of contrast) to examine late images of the vortex veins. Findings in the affected and contralateral eyes were also compared. In 13 of the 22 eyes, the vortex veins were hypofluorescent in all quadrants and continuous with the vortex ampullae. In five eyes, only the asymmetric dilated vortex vein was hypofluorescent, and in four eyes, the vortex veins were not hypofluorescent. Of the 22 contralateral eyes examined, 20 eyes exhibited identical findings in the vortex veins to those observed in the affected eye. Of the four eyes that did not exhibit hypofluorescence of the vortex veins in the affected eye, two eyes had partial hypofluorescence of some vortex veins in the contralateral eye, showing different findings. In the late phase, some eyes showed hypofluorescence due to the washout of indocyanine green dye in the vortex veins and others did not, suggesting that obstruction of the scleral passage in the choroidal venous outflow is not the main cause of the syndrome.

Although Japan has an established welfare system for individuals with visual impairments, medical-welfare coordination remains limited. To address this gap, the Low Vision Care Hub (LVCH) was established within a university hospital. We evaluated the impact of LVCH on visitor satisfaction before and after consultation STUDY DESIGN: A single-center, one-group pre-post study METHODS: Individuals with self-reported functional vision difficulties who visited LVCH between July 1 and December 20, 2024 were included. Consultation was provided based on seven domains of low vision care outlined by the Japan Society for Low-Vision Research and Rehabilitation. Satisfaction was measured on a custom 6-point ordinal scale (0-5) pre/post consultation. Changes in satisfaction scores were analyzed using the Wilcoxon signed-rank test. Multivariable logistic regression adjusted for potential confounders RESULTS: Ninety-three participants were included. Satisfaction scores significantly increased after consultation (p < .001) and improvements were consistent across sex, age groups, and visual impairment classification using the International Council of Ophthalmology (ICO) criteria (all p < .001). Notably, participants not meeting the ICO-defined low vision criteria also improved (p < .001). On multivariable logistic regression, only older age (≥ 60 years) remained significantly associated with a markedly improved satisfaction score (OR = 2.98, 95% CI 1.10-8.05, p = .03) CONCLUSION: Consultations provided at LVCH significantly improved visitor satisfaction, including those who did not meet the ICO low vision criteria. Consultation may be particularly effective in individuals aged over 60 years. Overall, early-stage intervention through structured consultation may benefit individuals with functional vision difficulties.

To evaluate the biomechanical and tomographic characteristics of keratoconic corneas undergoing accelerated cross-linking (CXL) for over one year and to assess the impact of cone localization on postoperative biomechanical behavior. Prospective-comparative. This study included 68 eyes of 68 patients with progressive keratoconus. Based on cone location, the patients were divided into two groups: group 1 (central cone; 34 eyes) and group 2 (paracentral cone; 34 eyes). Scheimpflug imaging was used to assess the corneal thickness, anterior and posterior Kmean, Kmax, and astigmatism. The Ocular Response Analyzer (ORA) measures corneal compensated intraocular pressure (IOPcc), Goldmann-correlated pressure (IOPg), corneal hysteresis (CH), and corneal resistance factor (CRF). All the baseline measurements were repeated at 1, 6, and 12 months. Demarcation line (DL) depth was assessed at 1 month using anterior segment optical coherence tomography. Best corrected visual acuity was recorded at each visit. At 1year, anterior Kmean, posterior Kmean and Kmax showed significant reductions (p < 0.01). No significant differences in CH or CRF changes were found between the central and peripheral cones (p = 0.22, p = 0.33). Visual improvement and reduction in spherical equivalent were greater in the central cone group (p = 0.03, p = 0.03). DL depth correlated positively with CH and CRF at 1 month (p = 0.02, p = 0.008), but not at 1 year. Accelerated CXL improves corneal shape, but may not produce detectable changes in ORA-derived biomechanics. Regional stiffening may not be captured by global indices, and the cone location appears to be more influential on visual recovery than biomechanical parameters.

OQrimo® is a robotic assistant system that supports vitreoretinal surgery by holding an intraocular endoscope or illumination device to assist the surgeon. In April 2023, Japan approved this system, and as the world's first clinical institution to implement OQrimo®, we aimed to evaluate its safety and clinical utility. Retrospective case series METHODS: The study analyzed all vitreoretinal surgery utilizing OQrimo® at Kyushu University Hospital between December 1, 2023 and November 31, 2024. Data collection included patient demographics, preoperative diagnoses, surgical procedures, equipment used, surgical records, and perioperative complications. We analyzed OQrimo's safety profile and patterns of clinical use based on these data. Eight eyes from eight patients were included. Preoperative diagnoses included proliferative vitreoretinopathy, panuveitis, acute retinal necrosis, macular hole, and secondary glaucoma due to uveitis. The purpose of pars plana vitrectomy included silicone oil removal, vitreous biopsy, internal limiting membrane peeling, and Ahmed valve implantation via pars plana. OQrimo® maintained stable endoscope positioning in all cases, enabling observation of the peripheral retina without scleral indentation. In seven cases, OQrimo's endoscopic visualization and a wide-viewing system were used simultaneously. No intraoperative or postoperative complications were observed in any case. We confirmed the safety of OQrimo® during its initial clinical application. The system facilitated the observation of the peripheral retina using an intraocular endoscope without scleral indentation.

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.

This study investigated the relationship between watercleft localization in crystalline lenses and higher-order aberrations. Single-center, retrospective, observational study METHODS: The study included 131 right eyes from 131 patients. The patients underwent complete ophthalmic examinations, swept-source anterior-segment optical coherence tomography (Tomey Corporation), and wavefront analysis with a wavefront analyzer (Topcon Corporation). Waterclefts were classified according to the Kanazawa Medical University Cataract Classification and Grading System. On the basis of their location, the central and peripheral watercleft types were further categorized as anterior waterclefts (AWC) or posterior cortical waterclefts (PWC). The total cross-sectional areas and volumes of the central waterclefts were 7.722 ± 5.926 mm2 and 1.413 ± 1.357 mm3 for the C-AWC and 2.443 ± 2.422 mm2 and 0.214 ± 0.286 mm3 for the C-PWC, respectively. The size (area and volume) of the C-AWC was significantly larger than that of the C-PWC. Both eyes exhibited significantly higher levels of higher-order aberrations and lower visual acuity than did the clear eye in both cases (P <.05). Central-type waterclefts caused visual deterioration, with a significant correlation between size and visual function. For the same cross-sectional area and volume, the effects on higher-order aberrations and visual acuity were greater with C-PWC than with C-AWC.