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Yoshiaki Kabata,1 Tetsutaro Oki,1 Tadashi Nakano2 1Department of Ophthalmology, Jikei University School of Medicine, Daisan Hospital, Tokyo, Japan; 2Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, JapanCorrespondence: Yoshiaki Kabata, Department of Ophthalmology, Jikei University School of Medicine, Daisan Hospital, 4-11-1 Izumihontyou, Komae-si, Tokyo, 125-8506, Japan, Tel +81334801151, Fax +81334805700, Email kabata22122@gmail.comPurpose: To evaluate the refractive prediction error in flanged intrascleral intraocular lens (IOL) fixation using the SRK/T formula and compare the axial length using a single IOL.Methods: Seventy-six eyes from 70 patients (45 males and 25 females) were included in this study. The mean age at the time of surgery was 73.4 ± 12.3 years. The patients underwent flanged IOL fixation using a PN6A (Kowa). All surgeries were performed by two surgeons (Y. K. and T. O.) between Jan 2020 and Dec 2022 at Jikei University Daisan Hospital. IOL power was calculated using the SRK/T formula with IOL Master 700 (Carl Zeiss) as the bag power. The recommended value of 119.0 was used for the A-constant. The actual refractive spherical equivalent was calculated and compared with preoperative predictions. Refractive prediction errors were defined as the deviation of the actual postoperative spherical equivalent refraction in diopters from the predicted preoperative spherical equivalent refraction. The patients were divided into three groups according to axial length: < 22.0 mm (short eyes), 22.0– 24.5 mm (medium eyes), and > 24.5 mm (long eyes), and the refractive prediction errors and mean absolute errors were compared.Results: The mean refractive prediction error was − 0.20 ± 0.52D. The mean absolute error was 0.44 ± 0.33D. The mean refractive prediction errors were not significantly different between the 22.0– 24.5 mm (medium eyes) and > 24.5 mm (long eyes) groups. (P=0.06) The mean absolute errors were not significantly different between the two groups (P=0.10).Conclusion: The SRK/T formula worked well regardless of whether the eyes were medium or long according to the axial length in the flanged intrascleral IOL fixation.Keywords: flanged intrascleral IOL fixation, refractive prediction error, SRK/T formula, axial length

Chiharu Wada-Koike,1,&ast; Ryo Terauchi,1,&ast; Kota Fukai,2 Kei Sano,1 Euido Nishijima,1 Koji Komatsu,1 Kyoko Ito,3 Tomohiro Kato,3 Masayuki Tatemichi,2 Yoshiaki Kabata,4,&ast; Tadashi Nakano1 1Department of Ophthalmology, The Jikei University School of Medicine, Tokyo, Japan; 2Department of Preventive Medicine, Tokai University School of Medicine, Isehara, Japan; 3Centre for Preventive Medicine, The Jikei University School of Medicine, Tokyo, Japan; 4Department of Ophthalmology, Jikei University School of Medicine, Daisan Hospital, Tokyo, Japan&ast;These authors contributed equally to this workCorrespondence: Yoshiaki Kabata, Department of Ophthalmology, Jikei University School of Medicine, Daisan Hospital, 4-11-1 Izumihontyou, Komae-si, Tokyo, 125-8506, Japan, Tel +81 3 3480 1151, Fax +81 3 3480 5700, Email kabata22122@gmail.comPurpose: To examine the variability in glaucoma screening using fundus images among physicians, including non-ophthalmologists.Patients and Methods: Sixty-nine eyes from 69 patients, including 25 eyes with glaucoma, were included from the Jikei University Hospital from July 2019 to December 2022. Fundus images were captured using TRC-NW8 (Topcon Corporation, Tokyo, Japan), and were interpreted by 10 non-ophthalmologists, 10 non-specialist ophthalmologists, and 9 specialists for diagnostic accuracy. We analyzed differences in diagnostic accuracy among the three groups. Sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and Kappa coefficient were compared, using the Kruskal–Wallis test followed by a post hoc Dunn’s test.Results: The sensitivity and specificity were 0.22 and 0.92 for non-ophthalmologists, 0.49 and 0.83 for non-specialist ophthalmologists, and 0.68 and 0.87 for specialists, respectively. Both specialists and non-specialist ophthalmologists showed significantly higher sensitivity than non-ophthalmologists (Dunn’s test, P< 0.001 and P=0.031). There was no significant difference in specificity among the three groups (Kruskal–Wallis test, P=0.086). The PPV did not differ significantly between the groups (Kruskal–Wallis test, P=0.108), while the NPV was significantly higher in specialists compared to non-ophthalmologists (Dunn’s test, P< 0.001). Specialists also had a significantly higher Kappa coefficient than non-ophthalmologists and non-specialist ophthalmologists (Dunn’s test, P< 0.001 and P=0.024).Conclusion: Diagnostic accuracy varied significantly based on the physician’s background.Keywords: glaucoma, fundus images, sensitivity, specificity, health checkup

Noriko Kato,1,2 Genichiro Takahashi,1,2 Koichi Kumegawa,1,2 Yoshiaki Kabata,1,2 Hiroshi Tsuneoka1 1Department of Ophthalmology, Jikei University, School of Medicine, 2Katsushika Medical Center, Tokyo, Japan Background: We investigated indications and early postoperative treatment for Ex-PRESS® insertion for glaucoma by comparing postoperative outcomes with those for standard trabeculectomy. Methods: Ex-PRESS insertion was performed in 21 eyes and standard trabeculectomy (TLE) in 22 eyes. Mean intraocular pressure (IOP) in the 6 months after surgery, success rate for postoperative IOP decline, postoperative complications, postoperative treatment, filtering blebs, and indications were then retrospectively investigated. Results: Mean postoperative IOP did not differ significantly between the groups at any observation time for 6 months after surgery. Further, it did not differ between either the groups of patients with primary open-angle glaucoma (POAG) and neovascular glaucoma (NTG), or the patients with primary open-angle glaucoma and NTG in the Ex-PRESS group. Comparison of success rates in reduction of postoperative IOP between the groups under the following four survival conditions showed no significant differences: postoperative IOP

Yoshiaki Kabata,1 Genichiro Takahashi,1 Hiroshi Tsuneoka21Department of Ophthalmology, Jikei University School of Medicine, Katsushika Medical Center, 2Department of Ophthalmology, Jikei University School of Medicine, Tokyo, JapanBackground: The purpose of this study was to examine neodymium:yttrium-aluminum garnet (Nd:YAG) capsulotomy rates after combined cataract surgery with implantation of a three-piece 4% water content hydrophobic acrylic intraocular lens (X-70, Eternity®) and vitrectomy, and compare diabetic retinopathy with nondiabetic retinopathy.Methods: Nd:YAG capsulotomy rates were evaluated for 72 eyes of 72 patients with diabetic retinopathy and 81 eyes of 81 patients with nondiabetic retinopathy (50 eyes with retinal detachment, 13 eyes with macular hole, nine eyes with epiretinal membrane, seven eyes with branch retinal vein occlusion, and two eyes with uveitis) who underwent combined cataract surgery and vitrectomy and implantation of X-70.Results: Two years after combination surgery, four of 72 eyes (5.6%) in the diabetic retinopathy group and four of 81 eyes (5.0%) in the nondiabetic retinopathy group required Nd:YAG capsulotomies. Kaplan–Meier survival analysis showed no statistically significant differences between the two groups (P=0.30, Mantel–Cox log-rank test).Conclusion: The rate of Nd:YAG capsulotomy did not significantly differ between diabetic retinopathy and nondiabetic retinopathy after combined cataract surgery with implantation of the X-70 and vitrectomy. X-70 is an acceptable intraocular lens for patients undergoing combined cataract surgery and vitrectomy.Keywords: Nd:YAG capsulotomy rates, combined surgery, diabetic retinopathy, hydrophobic acrylic intraocular lens

Yoshiaki Kabata1, Genichiro Takahashi1, Hiroshi Tsuneoka21Department of Ophthalmology, Jikei University School of Medicine, Katsushika Medical Center, Katsushika, Tokyo, Japan; 2Department of Ophthalmology, Jikei University School of Medicine, Minato, Tokyo, JapanAbstract: A case of cytomegalovirus (CMV) retinitis in a patient with Wegener’s granulomatosis treated with oral valganciclovir as maintenance therapy is reported. A 68-year-old male patient with anti-proteinase-3 ANCA-positive Wegener’s granulomatosis who was receiving immunosuppressive therapy with methylprednisolone, cyclophosphamide, and azathioprine developed CMV retinitis. The patient received intravenous ganciclovir as induction therapy and oral valganciclovir as maintenance therapy. The patient responded to treatment and showed no recurrence for 8 months. There were no serious adverse effects associated with oral valganciclovir. Oral valganciclovir is convenient and effective for the management of CMV retinitis in the patient with Wegener’s granulomatosis.Keywords: cytomegalovirus retinitis, Wegener’s granulomatosis, valganciclovir, ganciclovir, maintenance therapy

The patients in this manuscript have given written informed consent to publication of their case details. We diagnosed the patient with dermatitis herpetiformis (DH). [Extracted from the article]

Epidermolysis bullosa simplex (EBS) is a genetic skin disorder characterized by mechanical fragility and blistering of the skin. Direct sequencing of the I KRT5 i and I KRT14 i genes revealed heterozygous mutations c.1432G>T and c.1433A>T in the I KRT5 i gene in both the proband and his mother (Fig. c). Epidermolysis bullosa simplex-generalized severe type due to keratin 5 p.Glu477Lys mutation: genotype-phenotype correlation and in silico modeling analysis. [Extracted from the article]

Erythema dyschromicum perstans (EDP) is an uncommon, slowly progressive dermatosis characterized by ashy grey-coloured macules and patches that are variably sized and shaped. Dermoscopic examination of a lesion in his left axilla showed pigmentation in crista cutis, accompanied by small brown dots which had a Wagyu beef-like appearance (Fig. b). (b) Dermoscopy of the lesion in the left axilla shows pigmentation in crista cutis with small brown dots. [Extracted from the article]

Background: The purpose of this study was to report the basic profile of the Miyagi Prefecture part of a repeated center-based survey during the second period of the Tohoku Medical Megabank Community-Based Cohort Study (TMM CommCohort Study), as well as the participants' characteristics based on their participation type in the baseline survey., Methods: The second period survey, conducted from June 2017 to March 2021, included participants of the TMM CommCohort Study (May 2013 to March 2016). In addition to the questionnaire, blood, urine, and physiological function tests were performed during the second period survey. There were three main ways of participation in the baseline survey: Type 1, Type 1 additional, or Type 2 survey. The second period survey was conducted in the same manner as the Type 2 survey, which was based on the community support center (CSC)., Results: In Miyagi Prefecture, 29,383 (57.7%) of 50,967 participants participated in the second period survey. The participation rate among individuals who had visited the CSC was approximately 80%. Although some factors differed depending on the participation type in the baseline survey, the second period survey respondents in the Type 1 and Type 2 survey groups at baseline had similar traits., Conclusion: The second period survey of the TMM CommCohort Study provided detailed follow-up information. Following up on the health conditions of the participants will clarify the long-term effects of disasters and contribute to personalized prevention.

Background: Atopic dermatitis (AD) is a common chronic eczematous skin disease with severe pruritus. Several new therapeutic agents for AD such as dupilumab, an anti-IL-4Rα antibody, have been developed in recent years. We need to predict which agent is the best choice for each patient, but this remains difficult., Objective: Our aim was to examine clinical background factors and baseline biomarkers that could predict the achievement of improved clinical outcomes in patients with AD treated with dupilumab., Methods: A multicenter, prospective observational study was conducted on 110 patients with AD. The Eczema Area and Severity Index was used as an objective assessment, and the Patient-Oriented Eczema Measure and Numerical Rating Scale for Pruritus were used as patient-reported outcomes. In addition, some clinical background factors were evaluated., Results: The achievement of an absolute Eczema Area and Severity Index of 7 or less was negatively associated with current comorbidity of food allergy and baseline serum lactate dehydrogenase (LDH) levels. There were negative associations between achievement of a Patient-Oriented Eczema Measure score of 7 or less and duration of severe AD and between achievement of an itching Numerical Rating Scale for Pruritus score of 1 or less and current comorbidity of allergic conjunctivitis or baseline serum periostin level. Furthermore, signal detection analysis showed that a baseline serum LDH level less than 328 U/L could potentially be used as a cutoff value for predicting the efficacy of dupilumab., Conclusion: Baseline biomarkers such as LDH and periostin and clinical background factors such as current comorbidity of food allergy and a long period of severe disease may be useful indicators when choosing dupilumab for systemic treatment for AD, as they can predict the efficacy of dupilumab., Competing Interests: Supported by 10.13039/100004339Sanofi and 10.13039/100009857Regeneron (grant SGZ-2018-11996). These companies had no influence on the design of the study, collection and analysis of the data, or decision to publish the article. Disclosure of potential conflict of interest: K. Izuhara has received grants and personal fees from Shino-test Co, Ltd. H. Saeki has received lecture fees, research costs, or scholarship donations from Mitsubishi Tanabe Pharma, Taiho Pharmaceutical, 10.13039/100016730Torii Pharmaceutical, Maruho, Kyowa Kirin, Sanofi, AbbVie, Novartis Pharma, Eli Lilly Japan, Kyorin Pharmaceutical, Eisai, Tokiwa Pharmaceutical, Japan Tobacco, and LEO Pharma. Y. Kataoka has received lecturer honoraria from Sanofi and AbbVie and research funding from Sanofi, Leo Pharma, Pfizer, Maruho, Lilly, AbbVie, and Otsuka. S. Kaneko has received grants as an investigator from Eli Lilly Japan and honoraria as a speaker from Eli Lilly Japan. A. Tanaka has received honoraria from Eli Lilly, Kaken Seiyaku, Sanofi, Taiho Pharma, AbbVie, Kyorin Pharmaceutical, Mitsubishi-Tanabe, Torii Pharmaceutical, and Maruho as a speaker and research grants from Eli Lilly, Sanofi, Teijin Pharma, Taiho Pharma, Mitsubishi-Tanabe, Torii Pharmaceutical, and Maruho. M. Hide has received lecture and/or consultation fees from AbbVie, Eli Lilly, Kaken Pharmaceutical, Kyowa Kirin, Kyorin Pharmaceutical, Maruho, Mitsubishi-Tanabe Pharma, MSD, Novartis, Sanofi, Taiho Pharma, Teikoku Seiyaku, Torii, and Uriach. R. Tamagawa-Mineoka has received research grants from Maruho and 10.13039/501100012351Mitsubishi Tanabe Pharma. K. Masuda has received honoraria as a speaker for Sanofi and grants as an investigator for Eli Lilly Japan. T. Takeichi has received grants paid to his institution (10.13039/501100004823Nagoya University) from Boehringer Ingelheim. M. Akiyama has received research support from Novartis and Boehringer Ingelheim; personal fees from Maruho and Sanofi; and grants paid to his institution (Nagoya University) from Mitsubishi-Tanabe, Taiho, AbbVie, Maruho, Ono, and Sun Pharma. Y. Ishiuji has received honoraria as a speaker for Eli Lilly Japan. Y. Hatano has received honoraria and consultancies to sponsoring organizations from 10.13039/100004339Sanofi, Taiho Pharma, Janssen Pharma, Maruho, Pfizer Japan, Sun Pharma Japan, Torii Pharmaceutical, AbbVie, KAKEN, and UCB Japan. N. Katoh has received honoraria as a speaker/consultant for Sanofi, Maruho, AbbVie, Eli Lilly Japan, and Leo Pharma and grants as an investigator from Maruho, Eli Lilly Japan, Sun Pharma, Taiho Pharmaceutical, Torii Pharmaceutical, Boehringer Ingelheim Japan, and Leo Pharma. Takeshi Nakahara has received lecture fees and research costs from Mitsubishi Tanabe Pharma, Taiho Pharmaceutical, Torii Pharmaceutical, Maruho, Sanofi, AbbVie, Eli Lilly Japan, and Sun Pharma. The rest of the authors declare that they have no relevant conflicts of interest., (© 2024 Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology.)

The Lamc2jeb junctional epidermolysis bullosa (EB) mouse model has been used to demonstrate that significant genetic modification of EB symptoms is possible, identifying as modifiers Col17a1 and six other quantitative trait loci, several with strong candidate genes including dystonin (Dst/Bpag1). Here, CRISPR/Cas9 was used to alter exon 23 in mouse skin specific isoform Dst-e (Ensembl GRCm38 transcript name Dst-213, transcript ID ENSMUST00000183302.5, protein size 2639AA) and validate a proposed arginine/glutamine difference at amino acid p1226 in B6 versus 129 mice as a modifier of EB. Frame shift deletions (FSD) in mouse Dst-e exon 23 (Dst-eFSD/FSD) were also identified that cause mice carrying wild-type Lamc2 to develop a phenotype similar to human EB simplex without dystonia musculorum. When combined, Dst-eFSD/FSD modifies Lamc2jeb/jeb (FSD+jeb) induced disease in unexpected ways implicating an altered balance between DST-e (BPAG1e) and a rarely reported rodless DST-eS (BPAG1eS) in epithelium as a possible mechanism. Further, FSD+jeb mice with pinnae removed are found to provide a test bed for studying internal epithelium EB disease and treatment without severe skin disease as a limiting factor while also revealing and accelerating significant nasopharynx symptoms present but not previously noted in Lamc2jeb/jeb mice., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Sproule 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.)

Background: To develop precision medicine for atopic dermatitis (AD), it is critical to establish relevant biomarkers. However, the characteristics of various biomarkers have not been fully understood. We previously carried out the Biomarkers to Predict Clinical Improvement of AD in Patients Treated with Dupilumab (B-PAD) study, a comprehensive nationwide study in Japan, to explore biomarkers for AD., Objective: The aim of this study is to find biomarkers associated with objective and subjective clinical findings in patients with moderate-to-severe AD based on the B-PAD study and to identify biomarkers sensitive enough to assess the severity of AD., Methods: We performed the B-PAD study as a consortium composed of 19 medical facilities in Japan, enrolling 110 patients with moderate-to-severe AD. We evaluated the Eczema Area and Severity Index (EASI) for objective assessment as well as the Patient-Oriented Eczema Measure (POEM) and a numeric rating scale for pruritus (pruritis-NRS) for subjective assessment, measuring 19 biomarkers at baseline., Results: We found that 12, 6, and 7 biomarkers showed significant and positive associations with the EASI, POEM, and pruritis-NRS, respectively. Most of the biomarkers associated with either the POEM or the pruritis-NRS were included among the biomarkers associated with EASI. Of the biomarkers examined, CCL26/eotaxin-3 and SCCA2 were the most capable of assessing severity for EASI, as shown by the 2 kinds of receiver operating characteristic analyses, respectively, whereas lactate dehydrogenase was the best for both the POEM and pruritis-NRS, again using the 2 analyses., Conclusion: We found biomarkers associated with the EASI, POEM, and pruritis-NRS, respectively, based on the B-PAD study. Moreover, we identified CCL26/eotaxin-3 and/or SCCA2 as the biomarkers having the greatest ability to assess severity in the EASI; lactate dehydrogenase did the same for the POEM and pruritis-NRS. These findings will be useful in treating patients with moderate-to-severe AD., (© 2023 The Author(s).)