Birth Year-Dependent Increase in Axial Length of Japanese Adult.

PURPOSE: To determine whether the correlations between the axial length and the aging-dependent and birth year-dependent age are significant. DESIGN: Retrospective cross-sectional study. METHODS: This study included Japanese patients ≥50 years who had undergone cataract surgery at numerous clinics from 2002 to 2020. Only 1 eye/patient was analyzed. The axial length was measured with the IOL Master. The age-dependent changes were determined by the significance of the correlation between the axial length and age by the birth year. The birth year-dependent changes were determined by the significance of the correlation between the axial length and birth year in the different age groups. The age refers to the age at the time of the cataract surgery. Spearman correlations were calculated. The turning points were identified by the LOESS, NLIN, and HPMIXED procedures. RESULTS: A total of 62,362 eyes (35,508 women, 26,854 men) were studied. The mean age was 72.9 ± 8.4 (standard deviation) years (range, 50-101 years), and the mean axial length was 23.90 ± 1.66 mm (standard deviation) (range, 19.20-37.07 mm). The birth year ranged from 1908 to 1970. Analyses of the birth year-dependent changes showed significant positive correlations in 48 of 81 (59.3%) groups for women and men. The increase in the axial length was birth year-dependent, and the turning point was 1939.4 for women and 1936.7 for men. CONCLUSIONS: The negative and significant correlation between the axial length and age is due to birth year-dependent changes. A birth year-dependent increase in axial length might have continued for several decades from the birth year of the late 1930s.

Intraocular pressure elevation is a delayed-onset complication after successful vitrectomy for stages 4 and 5 retinopathy of prematurity.

PURPOSE: To determine the incidence and risk factors for delayed-onset intraocular pressure (IOP) elevations after vitrectomy for Stages 4 and 5 retinopathy of prematurity and, in addition, to determine the results of treating the IOP elevations. METHODS: Fifty-five consecutive eyes with successful retinal reattachment and at least 24 months of follow-up after vitrectomy were studied. The ophthalmic examinations included slit-lamp biomicroscopy, wide-field digital retinal imaging, and IOP measurements. Eyes were classified into 2 groups: eyes with a postoperative IOP elevation to ≥ 21 mmHg and eyes whose IOP was always <21 mmHg. RESULTS: Eight eyes (14.5%) developed an IOP elevation to ≥ 21 mmHg from 2 months to 4 months (median: 2.5 months) after the vitrectomy. In two of these eyes, the IOP was controlled with antiglaucoma medications. In the other six eyes, trabeculotomy for eyes with open angles and trabeculectomy or goniosynechialysis for eyes with closed angles were performed. The IOPs were successfully controlled after an average of 1.5 glaucoma surgeries. Multivariate logistic regression analyses identified that a young gestational age (odds ratio = 1.147, 95% confidence interval: 1.024-1.346) and lensectomy (odds ratio = 8.795, 95% confidence interval: 1.262-183.3) were significantly associated with the IOP elevation. CONCLUSION: Delayed-onset IOP elevation after vitrectomy for retinopathy of prematurity occurs in 14.5% of the eyes, and it is significantly associated with a young gestational age and presence of lensectomy.

Prognostic factor analysis in pars plana vitrectomy for retinal detachment attributable to macular hole in high myopia: a multicenter study.

PURPOSE: To detect the prognostic factors associated with initial reattachment after primary pars plana vitrectomy (PPV) with gas tamponade for retinal detachment attributable to macular hole (MHRD). DESIGN: Retrospective, multicenter, interventional case series. METHODS: This study included 49 eyes of 48 patients with MHRD in high myopia (axial length more than 28.0 mm). All eyes underwent PPV with gas tamponade. We retrospectively reviewed the medical records and performed univariate analysis to detect the presence of any difference between eyes with a successful initial reattachment and those that failed. We performed multivariate logistic regression analysis to assess the influence of each preoperative factor on initial success. RESULTS: Success rate of initial reattachment was 69%. Postoperative best-corrected visual acuity (BCVA) of 34 eyes with initial success was significantly better than those of 15 eyes with initial failure (P < .05); preoperative BCVA was not significantly different (P = .43). The axial length of eyes with initial success (29.26 +/- 0.94 mm) was shorter than that of eyes with initial failure (30.04 +/- 1.49 mm) with borderline significance (P = .049). There were no significant differences noted for other factors such as use of ILM peeling (P = .43) or type of tamponade gas (P = .99). Multiple logistic regression analysis using preoperative factors indicated that only axial length was significantly associated with initial success (odds ratio, 0.49; 95% confidence interval, 0.26 to 0.93; P < .05). CONCLUSIONS: Initial reattachment is important for visual prognosis, and axial length is a prognostic factor for initial reattachment after PPV with gas tamponade for MHRD in high myopia.

Large blunt scleral rupture without retinal detachment.

Eyes with scleral rupture after blunt trauma are often complicated by proliferative vitreoretinopathy. A 56-year-old man sustained blunt trauma to his left eye. Visual acuity was light perception. The fundus was obscured by hyphema. Computed tomography imaging and the presence of extensive subconjunctival hemorrhage suggested scleral rupture. Prompt primary surgery to repair a 25-mm scleral rupture was performed under general anesthesia. No retinal detachment developed. Two years postoperatively, visual acuity increased to 12/20. This case shows that retinal detachment and proliferative vitreoretinopathy may not complicate extensive scleral ruptures under certain circumstances.

Copper foreign body in the lens without damage of iris and lens capsule.

PURPOSE: The objective is to report a rare case of asymptomatic penetrating injury with a copper foreign body found during an examination for cataract surgery. METHOD: A case report. RESULTS: A 73-year-old woman had vision loss. Examination by pupil dilation disclosed a dark-brown metallic mass located under the anterior capsule of the lens, as well as nuclear sclerosis of the lens. Although no history of traumatic injury was reported by the patient, careful examination revealed a dot corneal opacity. This finding, and the past history of the patient that she had worked in the fabrication of copper wire, suggested previous penetrating injury. The iris had no scar. No inflammatory reaction was observed in the posterior segment of the eye. Phacoemulsification and implantation of an intraocular lens were performed. After continuous curvilinear capsulorrhexis (CCC), the foreign body was extracted with a microforceps. The anterior capsule overlying the foreign body was intact, with normal light reflex. Qualitative analysis showed that the foreign body extracted contained pure copper at the center. Nevertheless, visual acuity of the right eye improved from 20/50 to 20/20 without any copper-related retinal damage. CONCLUSION: In this case, copper localized under the anterior capsule of the lens had been able to stay in the eye without causing severe inflammatory reaction.

Cancer-associated retinopathy associated with invasive thymoma.

PURPOSE: To report a case of cancer-associated retinopathy associated with invasive thymoma. DESIGN: Interventional case report. METHOD: A 41-year-old Japanese woman was observed between February 1998 and May 2001. Ophthalmologic examinations and systemic examinations were performed. The patient received treatment including corticosteroid pulse therapy, plasmapheresis, and thymectomy. RESULTS: The patient developed progressive visual dysfunction including bilateral visual acuity loss, concentric contraction of visual fields, and color vision loss. In both eyes, retinal vessel attenuation and retinal pigment epithelium degeneration were observed with fundus ophthalmoscopy and fluorescein angiography. Response in electroretinogram was reduced, suggesting both rod and cone dysfunction. Autoantibody against 23-kD cancer-associated retinopathy (CAR) antigen (antirecoverin antibody) was detected in the patient's serum. A mediastinal tumor that was histopathologically diagnosed as invasive thymoma was detected and was surgically resected. During more than 3 years of follow-up, no other malignancy was detected despite extensive systemic evaluation. The patient also suffered from subclinical myasthenia gravis. Although temporary improvement of visual function was observed after treatment with steroid pulse therapy and plasmapheresis' light perception of each eye was lost in the end. CONCLUSIONS: The patient was diagnosed as having CAR. Invasive thymoma was considered to be the causative tumor because there had been no evidence that suggested other systemic malignancy during more than 3 years of follow-up.

Oxybuprocaine induces a false-positive response in immunochromatographic SAS Adeno Test.

OBJECTIVE: To investigate whether a solution of oxybuprocaine hydrochloride, 0.4%, results in a false-positive response in an immunochromatographic SAS Adeno Test. DESIGN: Experimental study. CONTROLS: Physiologic saline and 2% lidocaine. TESTING: Each chemical (100 microl) was diluted in a transport medium. Five drops (200 microl) of the resultant solution were dispensed into the round sample well of a test device. Fifteen samples were tested in each group. MAIN OUTCOME MEASURES: Ten minutes after the start of the test, a colored line in the "specimen" portion of the test membrane was visually read as positive or negative by a masked technician. RESULTS: No positive reaction was observed in the control groups (physiologic saline and lidocaine). A false-positive reaction was observed in six samples (33.3%) in the oxybuprocaine group. The positive rate was significantly higher in the oxybuprocaine group compared with those in control groups (P = 0.0062, Fisher's extract probability test). CONCLUSIONS: Oxybuprocaine may induce a false-positive reaction in an immunochromatographic SAS Adeno Test. We recommend the use of lidocaine, instead of oxybuprocaine, for local anesthesia in taking eye swabs from patients with suspected adenovirus infection.