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Takahashi Y.,Aichi Medical University | Kitaguchi Y.,Aichi Medical University | Nakakura S.,Saneikai Tsukazaki Hospital | Mito H.,Aichi Medical University | And 2 more authors.
PLoS ONE | Year: 2016

Purpose: To examine the characteristics of excyclotropia correction through surgery on the inferior rectus muscle in patients with thyroid eye disease. Methods: This was a retrospective, observational study at a single institution. We reviewed 36 patients who had undergone unilateral inferior rectus muscle recession, with or without nasal inferior rectus muscle transposition. The following factors were investigated as possibly influencing excyclotropia correction: inferior rectus muscle thickness, degree of adipose change in the inferior rectus muscle, smoking status, history of orbital radiotherapy, and the amount of inferior rectus muscle recession. Using T1-weighted coronal magnetic resonance imaging, we measured the cross-sectional area of the inferior rectus muscle at its largest point, as well as the bright-signal area of the inferior rectus muscle, which reflects intermuscular adipose change. We then calculated the percentage internal bright-signal area at the point of the largest inferior rectus muscle cross-sectional area. The history of orbital radiotherapy was graded using a binary system. We evaluated correlations among excyclotropia correction, the amount of nasal inferior rectus muscle transposition, and the possible influencing factors listed, using stepwise multiple regression analyses. Results: The multiple regression model demonstrated a significant relationship among excyclotropia correction, amount of nasal inferior rectus muscle transposition, and the amount of inferior rectus muscle recession (YCORRECTION = 8.546XTENDON WIDTH + 0.405XRECESSION- 0.908; r = 0.844; adjusted r2 = 0.695; P < 0.001). Conclusions: Excyclotropia correction was correlated with the amount of nasal inferior rectus muscle transposition and the amount of inferior rectus muscle recession, but not with the other factors. The regression model presented in this study will enable us to determine more precisely the amount of nasal inferior rectus muscle transposition in patients with excyclotropia of various angles. © 2016 Takahashi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Nakakura S.,Saneikai Tsukazaki Hospital | Kiuchi Y.,Hiroshima University | Kaneko M.,Osaka University | Mochizuki H.,Hiroshima University | And 4 more authors.
Investigative Ophthalmology and Visual Science | Year: 2013

PURPOSE. We investigated the extent of corneal displacement and factors associated with the measurement of IOP during the early and late phases of noncontact tonometry. METHODS. One eye in each of 61 healthy volunteers was studied. In each case, the cornea was photographed in profile using a high-speed camera during noncontact tonometry. The extent of displacement at the corneal center, and at the midperipheral corneal areas at 13.2 and 30.0 ms after the application of an air puff was recorded. For each measurement point, multiple regression analyses were performed against age, sex, axial length, corneal curvature, IOP, and central corneal thickness (CCT) to determine the independent predictors of corneal displacement. Multiple comparison tests were used to determine whether the displacement differences were associated with age or sex. RESULTS. Our results showed that the factors most associated with corneal displacement were the IOP (P < 0.001) and CCT (P = 0.02) at the corneal center at 13.2 ms, the CCT (P = 0.041) at the corneal midperiphery at 13.2 ms, age (P < 0.01) at the corneal center at 30.0 ms, and age (P = 0.04) and IOP (P = 0.04) at the corneal midperiphery at 30.0 ms. Young females had the smallest amounts of corneal displacement at all measurement points, and elderly females had largest amounts of displacement at the late phase of tonometry. CONCLUSIONS. The amount of corneal displacement is affected by an individual's IOP, age, and CCT. Our findings indicated that the corneas of females may be more susceptible to aging than those of males. © 2013 The Association for Research in Vision and Ophthalmology, Inc.

Nakakura S.,Saneikai Tsukazaki Hospital | Tabuchi H.,Saneikai Tsukazaki Hospital | Baba Y.,Baba Eye Clinic | Maruiwa F.,Baba Eye Clinic | And 3 more authors.
Clinical Ophthalmology | Year: 2012

Objective: To compare the safety and effectiveness of fixed-combination regimes (latanoprost- timolol and brinzolamide 1% compared to dorzolamide 1%/timolol and latanoprost) in open-angle glaucoma patients after switching from a combination of three topical antiglaucoma eye drops. Methods: We conducted an open, randomized 12-week multicenter prospective study. We randomly allocated 39 patients who had been treated with three antiglaucoma eye drops (prostaglandin F 2α analogues plus beta-blockers and carbonic anhydrase inhibitors) into two groups. Group A (n = 20) were treated with latanoprost-timolol and brinzolamide 1% therapy and Group B (n = 16) were treated with dorzolamide 1%/timolol and latanoprost. Thirty-six patients completed all 12 weeks of this study. The major clinical parameters measured were intraocular pressure (IOP), conjunctive hyperemia, superficial punctate keratopathy and hyperpigmentation of eyelid at baseline, 4, and 12 weeks. Additionally noted were adverse events and patient preferences, measured using a questionnaire at study initiation and at 12 weeks. Results: At baseline, IOPs were (Group A: 14.1 ± 2.9 mmHg, B: 14.5 ± 2.9 mmHg; P = 0.658), (Group A: 13.8 ± 2.6 mmHg, B: 14.3 ± 2.8 mmHg; P = 0.715) at 4 weeks, and (Group A: 14.1 ± 2.7 mmHg, B: 14.2 ± 2.7 mmHg; P = 0.538) at 12 weeks. Among the groups, there was no significant difference at any time point after baseline (P = 0.923, 0.951, respectively). All adverse events were not remarkably different after therapy. In regards to patient preference before and after switching therapy, 10 patients (50%) in Group A and 10 patients (63%) in Group B preferred using fixed-combination eye drop therapy. Conclusions: Effectiveness and safety were maintained in both groups after switching therapy. Overall, patients generally preferred using a fixed-combination therapy. © 2012 Nakakura et al, publisher and licensee Dove Medical Press Ltd.

Nakakura S.,Saneikai Tsukazaki Hospital | Tabuchi H.,Saneikai Tsukazaki Hospital | Kiuchi Y.,Hiroshima University
Optometry and Vision Science | Year: 2011

Purpose.: To report clinical results of switching to latanoprost therapy in patients with deepening of the upper eyelid sulcus caused by travoprost and bimatoprost. Methods.: Prospective, clinical, observational case reports. Four patients presented with eyelid changes giving the eye a sunken eye appearance; two were being treated with travoprost and two with bimatoprost. Both patients on bimatoprost and one of the patients on travoprost therapy were switched to latanoprost while the eyelid sign was evident. The other patient discontinued the travoprost therapy for 4 months and switched to latanoprost therapy 1 month later, i.e., 5 months after discontinuing travaprost therapy. The physical changes in the eyelids were documented by photography and the intraocular pressure by Goldmann applanation tonometry. Results.: Three patients had a resolution of the sunken eye appearance 2 to 3 months after switching to latanoprost. The one patient who switched to latanoprost after recovery of the sunken eye had no recurrence during a 6 months follow-up period. There were no significant changes in the intraocular pressure in any of the subjects. Conclusions.: A deepening of the upper eyelid sulcus is a complication of prostaglandin F2α analogs. However, this side effect may be less common with latanoprost and eyes with this side effect caused by travoprost or bimatoprost may tolerate latanoprost therapy. Copyright © 2011 American Academy of Optometry.

Nakakura S.,Saneikai Tsukazaki Hospital | Mori E.,Saneikai Tsukazaki Hospital | Nagatomi N.,Saneikai Tsukazaki Hospital | Tabuchi H.,Saneikai Tsukazaki Hospital | Kiuchi Y.,Hiroshima University
Journal of Cataract and Refractive Surgery | Year: 2012

Purpose: To evaluate the congruity of anterior chamber depth (ACD) measurements using 4 devices. Setting: Saneikai Tsukazaki Hospital, Himeji City, Japan. Design: Comparative case series. Methods: In 1 eye of 42 healthy participants, the ACD was measured by 3-dimensional corneal and anterior segment optical coherence tomography (CAS-OCT), partial coherence interferometry (PCI), Scheimpflug imaging, and ultrasound biomicroscopy (UBM). The differences between the measurements were evaluated by 2-way analysis of variance and post hoc analysis. Agreement between the measurements was evaluated using Bland-Altman analysis. To evaluate the true ACD using PCI, the automatically calculated ACD minus the central corneal thickness measured by CAS-OCT was defined as PCI true. Two ACD measurements were also taken with CAS-OCT. Results: The mean ACD was 3.72 mm ± 0.23 (SD) (PCI), 3.18 ± 0.23 mm (PCI true), 3.24 ± 0.25 mm (Scheimpflug), 3.03 ± 0.25 mm (UBM), 3.14 ± 0.24 mm (CAS-OCT auto), and 3.12 ± 0.24 mm (CAS-OCT manual). A significant difference was observed between PCI biometry, Scheimpflug imaging, and UBM measurements and the other methods. Post hoc analysis showed no significant differences between PCI true and CAS-OCT auto or between CAS-OCT auto and CAS-OCT manual. Strong correlations were observed between all measurements; however, Bland-Altman analysis showed good agreement only between PCI true and Scheimpflug imaging and between CAS-OCT auto and CAS OCT manual. Conclusion: The ACD measurements obtained from PCI biometry, Scheimpflug imaging, CAS-OCT, and UBM were significantly different and not interchangeable except for PCI true and CAS-OCT auto and CAS-OCT auto and CAS-OCT manual. © 2012 ASCRS and ESCRS.

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