Saneikai Tsukazaki Hospital

Himeji, Japan

Saneikai Tsukazaki Hospital

Himeji, Japan
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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.


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 | Mori E.,Saneikai Tsukazaki Hospital | Yamamoto M.,Saneikai Tsukazaki Hospital | Tsushima Y.,Saneikai Tsukazaki Hospital | And 2 more authors.
Optometry and Vision Science | Year: 2013

PURPOSE: To evaluate the congruity of intraocular pressure (IOP) measurements from supine patients, which were obtained using four portable tonometers. METHODS: Intraocular pressure measurements were obtained from the right eye of 72 supine patients. We used the iCare (Tiolat Oy, Helsinki, Finland) rebound tonometer, the Diaton (BICOM Inc., Long Beach, NY) transpalpebral tonometer, the Tonopen XL (Reichert inc., Depew, NY), and a Kowa hand-held applanation tonometer (HAT; Kowa Company, Ltd., Nagoya, Japan). Relationships between mean IOPs were evaluated using Pearson correlation coefficients, and the mean differences between tonometers, using one-way analysis of variance followed by Tukey-Kramer post-hoc analysis. Levels of agreement were evaluated using Bland-Altman analysis. RESULTS: The mean IOPs (mean ± SD) were 18.2 ± 3.5 mm Hg for iCare, 14.8 ± 3.4 mm Hg for Diaton, 16.7 ± 3.7 mm Hg for Tonopen XL, and 16.8 ± 2.8 mm Hg for Kowa HAT. Pearson correlation coefficients between iCare, Tonopen XL, and Kowa HAT ranged from 0.382 to 0.577, whereas those between Diaton and other tonometers ranged from 0.041 to 0.286. Post-hoc analysis indicated significant differences between all pairs except Tonopen XL and Kowa HAT. The mean difference between measurements from iCare and Diaton was 3.39 ± 3.39 mm Hg; iCare and Tonopen XL, 1.47 ± 3.52 mm Hg; iCare and Kowa HAT, 1.49 ± 2.90 mm Hg; Diaton and Tonopen XL, -1.93 ± 4.90 mm Hg; Diaton and Kowa HAT, -1.90 ± 4.15 mm Hg; and Tonopen XL and Kowa HAT, 0.02 ± 3.61 mm Hg. Computation of the width of the 95% limits of agreement resulted in a wide bias range when comparing Diaton with all tonometers. Relatively good agreements were observed between iCare, Tonopen XL, and HAT. CONCLUSIONS: Intraocular pressure measurements obtained in a supine position by four portable tonometers were not interchangeable. Although iCare and Tonopen XL significantly overestimated IOP values in eyes with a higher IOP when compared with Kowa HAT, the agreements between iCare, Tonopen XL, and Kowa HAT were at clinically acceptable levels. Copyright © 2013 American Academy of Optometry.


Nakakura S.,Saneikai Tsukazaki Hospital | Mori E.,Saneikai Tsukazaki Hospital | Yamamoto M.,Saneikai Tsukazaki Hospital | Tsushima Y.,Saneikai Tsukazaki Hospital | And 2 more authors.
Journal of Glaucoma | Year: 2015

Purpose: The aim of the study was to investigate the agreement between a new portable tonometer, Icare PRO, and the Tonopen XL and Kowa hand-held applanation tonometers (HAT). Methods: The right eyes of 127 healthy subjects were enrolled. Intraocular pressure (IOP) was measured in both sitting and supine positions using the Icare PRO, Tonopen XL, and Kowa HAT tonometers. The repeatability of the IOP measurements was evaluated by calculating intraclass correlation coefficients. Between-method agreements of tonometer measurements were evaluated using Bland-Altman analysis. Results: Intradevice agreement: The intraclass correlation coefficients (sitting, supine) of Icare PRO, Tonopen XL, and Kowa HAT were (0.863, 0.656), (0.845, 0.819), and (0.957, 0.956), respectively. Interdevice agreement: The Bland-Altman analysis revealed that, in the sitting position, the mean differences between Icare PRO and Tonopen XL, and between Icare PRO and Kowa HAT were-0.43 and 0.43 mm Hg, respectively (95% limits of agreement:-6.24 to 5.34 mm Hg,-4.04 to 4.90 mm Hg). In the supine position, the corresponding mean differences were-0.88 and 0.14 mm Hg (95% limits of agreement:-5.66 to 3.91 mm Hg,-4.06 to 4.33 mm Hg). IOP differences between Icare PRO and the other tonometers were unaffected by central corneal thickness. Conclusions: The repeatability of Icare PRO was slightly lower in the supine position than in the sitting position. Although Icare PRO underestimated IOP values in eyes with higher IOP when compared with Tonopen XL and Kowa HAT in both positions, we observed good interdevice agreement between Icare PRO and both Tonopen XL and Kowa HAT. © 2013 Wolters Kluwer Health, Inc.


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.


PubMed | Hiroshima University, Saneikai Tsukazaki Hospital and University of Tokyo
Type: Journal Article | Journal: PloS one | Year: 2016

It is important to compare the results of Corneal Visualization Scheimpflug Technology instrument (CST) measurements and Reichert Ocular Response Analyzer (ORA) parameters. The purpose of the study was to investigate the association between CST measurements and ORA parameters in ninety-five patients with primary open-angle glaucoma. Measurements of CST, ORA, axial length (AL), average corneal curvature (CC), central corneal thickness (CCT) and intraocular pressure (IOP) with Goldmann applanation tonometry (GAT) were carried out. The association between CST and ORA parameters was assessed using linear regression analysis, with model selection based on the second order bias corrected Akaike Information Criterion index. Measurements from ORA (corneal hysteresis [CH] and corneal response factor [CRF]) had high intraclass correlation coefficients (ICC) and low coefficients of variation, but some CST parameters showed much lower reproducibility, namely: A1 length, A2 length, highest concavity time and peak distance. Of 12 CST parameters tested, 8 were significantly correlated with CH and 10 were significantly correlated with CRF, however, the magnitude of the correlation coefficients were weak to moderate at best. The optimal model to explain CH using CST measurements was given by: CH = -76.3 + 4.6*A1 time + 1.9*A2 time + 3.1 * highest concavity deformation amplitude + 0.016*CCT (R2 = 0.67, p <0.001). Similarly, the optimal model for CRF was given by: CRF = -53.5 + 4.2*A1 time + 1.9*A1 length + 20.8*A1 deformation amplitude + 0.8*A2 time + 0.017*CCT (R2 = 0.73, p <0.001). ORA parameters show higher reproducibility than CST measurements. Although many CST parameters are significantly related to ORA parameters, the strengths of these relationships are weak to moderate.


PubMed | Hiroshima University, Saneikai Tsukazaki Hospital and University of Tokyo
Type: | Journal: Scientific reports | Year: 2017

Corneal Visualization Scheimpflug Technology (CST) and Ocular Response Analyzer (ORA) measurements were carried out in 105 eyes of 69 patients with primary open-angle glaucoma. All patients had axial length (AL), central corneal thickness (CCT), intraocular pressure (IOP) with Goldmann applanation tonometry (GAT) and eight visual fields (VF)s with the Humphrey Field Analyzer. VF progression was summarized using a time trend analysis of mean total deviation (mTD) and the association between mTD progression rate and a number of ocular parameters (including CST and ORA measurements) was assessed using mixed linear regression analysis. The optimal model of VF progression selected based on the corrected Akaike Information Criteria (AICc) included ORAs corneal hysteresis (CH) parameter as well as a number of CST measurements: mTD progression rate=1.2-0.070 * mean GAT+0.090 * CH-1.5 * highest concavity deformation amplitude with CST+9.4 * A1 deformation amplitude with CST-0.05 * A2 length with CST (AICc=125.8). Eyes with corneas that experience deep indentation at the maximum deformation, shallow indentation at the first applanation and wide indentation at the second applanation in the CST measurement are more likely to experience faster rates of VF progression.


Takahashi Y.,Aichi Medical University | Takahashi E.,Aichi Medical University | Nakakura S.,Saneikai Tsukazaki Hospital | Kitaguchi Y.,Aichi Medical University | And 2 more authors.
American Journal of Ophthalmology | Year: 2016

Purpose To identify risk factors for local recurrence and metastasis of sebaceous gland carcinoma (SGC) after wide excision with paraffin section control. Design Retrospective, observational case-control study. Methods SETTING: Single institution. PATIENT POPULATION: Thirty-four patients with SGC who had undergone excision with 5-mm surgical margins and paraffin section pathologic analysis. OBSERVATIONAL PROCEDURES: The following were considered potential risk factors for local recurrence/metastasis of SGC: patient's sex, patient's age, initial diagnosis at other clinics, topical treatments at other clinics, interval between appearance of symptoms and referral to our institution, tumor location, tumor origin, tumor presentation pattern, T category, tumor size, presence/or absence of pagetoid spread, tumor differentiation, mitosis grade, growth pattern. Logistic regression analysis was performed to identify the actual risk factors. MAIN OUTCOME MEASURES: Risk factors for local recurrence or metastasis of SGC after wide excision with paraffin section control. Results Involvement of both upper and lower eyelids, topical treatments at other clinics, multicentric origin, diffuse pattern, stage T3a, large tumor size, and a nonlobular pattern significantly influenced local recurrence/metastasis (P <.050). Pagetoid spread tended to affect local recurrence/metastasis (P =.052). The other items did not significantly influence local recurrence/metastasis (P >.050). Conclusions This study identified risk factors for local recurrence or metastasis of SGC after wide excision with paraffin section pathologic analysis. The results of this study will be helpful to surgeons when planning additional management, such as map biopsy or adjuvant treatment. © 2016 Elsevier Inc.


Nagasawa T.,Saneikai Tsukazaki Hospital | Mitamura Y.,Saneikai Tsukazaki Hospital | Katome T.,Saneikai Tsukazaki Hospital | Shinomiya K.,Saneikai Tsukazaki Hospital | And 5 more authors.
Investigative ophthalmology & visual science | Year: 2013

PURPOSE: We evaluated the choroidal thickness and volume in healthy pediatric individuals by swept-source optical coherence tomography (SS-OCT) and compared the findings to those of adults.METHODS: We examined 100 eyes of 100 healthy pediatric volunteers (3-15 years) and 83 eyes of 83 healthy adult volunteers (24-87 years) by SS-OCT with a tunable long wavelength laser source. The three-dimensional raster scan protocol was used to construct a choroidal thickness map. When the built-in software delineated an erroneous chorioscleral border in the B-scan images, manual segmentation was used.RESULTS: The central choroidal thickness and volume within a 1.0-mm circle were significantly larger in the children (260.4 ± 57.2 μm, 0.205 ± 0.045 mm(3)) than in the adults (206.1 ± 72.5 μm, 0.160 ± 0.056 mm(3), both P < 0.0001). In the children, the mean choroidal thickness of the nasal area was significantly thinner than that of all other areas (P < 0.005). Pediatric choroidal thinning with increasing age in the central area was faster than that in the outer areas. Stepwise regression analysis showed that the axial length and body mass index had the highest correlation with the choroidal thickness (R(2) = 0.313, P < 0.0001).CONCLUSIONS: The macular choroidal thickness and volume in the pediatric individuals were significantly larger than those in the adults. The pediatric choroidal thinning with increasing age is more rapid in the central area. Pediatric choroidal thickness is associated with several systemic or ocular parameters, especially the axial length and body mass index. These differences should be remembered when the choroidal thickness is evaluated in pediatric patients with retinochoroidal diseases.


PubMed | Saneikai Tsukazaki Hospital
Type: Journal Article | Journal: Rinsho shinkeigaku = Clinical neurology | Year: 2016

An 83-year-old man with chronic renal failure was referred to our hospital because of subacute progressive right hemiparesis. A brain MRI showed high-intensity lesions in bilateral middle cerebellar peduncles and white matter of the left frontal lobe on T

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