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Ryunosuke Fukushi,1 Atsushi Teramoto,1 Mitsunori Yoshimoto,1 Naohisa Miyakoshi,2 Daisuke Kudo,2 Makoto Emori,1 Yoichi Shimada,2 Toshihiko Yamashita1 1Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapporo, Japan; 2Department of Orthopaedic Surgery, Akita University School, Akita, JapanCorrespondence: Ryunosuke Fukushi, Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, S1 W16, Sapporo, Hokkaido, 060-8543, Japan, Tel +81-11-611-2111, Fax +81-11-621-8059, Email ryunosuke_fukushi_521@yahoo.co.jpPurpose: To assess the number of surgeries needed to acquire the necessary skills to perform spine surgery independently.Patients and Methods: A questionnaire on 12 different spinal procedures was sent to orthopedic surgeons affiliated with the spine teams of orthopedic departments at either the Akita University or Sapporo Medical University. Participants were asked to identify whether they (A) could independently perform each procedure, (B) could perform each procedure with the assistance of a senior doctor, or (C) were unable to perform each procedure. Those whose response was (A) were asked how many surgeries were required to acquire the necessary skills. Those who responded to (B) or (C) were asked how many surgeries they believed were required to acquire the skills necessary to operate independently. Participants also responded to 10 questions on surgical training techniques and rated the usefulness of each method.Results: A total of 55 spine surgeons responded to the questionnaire. Group A required significantly fewer surgeries in the following categories to become independent than required Group C: upper cervical spine surgery (7.3/19.3), anterior cervical decompression/fusion (6.7/28.8), posterior cervical decompression/fusion (9.5/27.3), lumbar discectomy (12.6/26.7), endoscopic lumbar discectomy (10.2/24.2), spinal tumor resection (6.5/37.2), and spinal kyphosis surgery (10.3/32.3). Over 80% of participants responded that the following were effective methods: “surgeries where a senior doctor is the main surgeon, and the respondent is the assistant and observer”; “surgeries where the respondent is the main surgeon, and a senior doctor is an assistant”; “self-study using surgery manuals, articles, and textbooks”; and “training through video surgery sessions”.Conclusion: Surgeons who do not perform specific procedures independently require more surgical experience than those who operate independently. Our results may help develop more efficient training methods for spine surgeons.Keywords: surgical experience, surgical training, training system, inexperienced spine surgeons

Masatoshi Tomita,* Takehiro Yamashita,* Hiroto Terasaki, Naoya Yoshihara, Naoko Kakiuchi, Taiji Sakamoto Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan*These authors contributed equally to this workCorrespondence: Hiroto Terasaki, Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan, Tel +81 99-275-5402, Fax +81 99-265-4894, Email teracchi@m2.kufm.kagoshima-u.ac.jpPurpose: To determine the success rate of swept-source optical coherence tomography (SS-OCT) biometry (OA-2000) in elementary school students.Methods: This was a prospective observational longitudinal study of 115 right eyes of elementary school students who were 8- to 9-years-old at the initial examination. Biometric measurements of the eyes were performed annually for three years, viz., during the third, fourth, and fifth grades. The success rates of obtaining data from optical biometric measurements of the axial length (AL), central corneal thickness (CCT), anterior chamber depth (ACD), lens thickness (LT), pupillary diameter (PD), corneal diameter (CD), and corneal curvature (CC) were determined.Results: The AL, CCT, and CC could be measured in all images at the three measurement times in all subjects. The success rate of the measurements of the ACD was 92.2% in the third grade and 100% in the fourth and fifth grade. The LT was successfully measured in 88.7% in the third grade, 99.1% in the fourth grade, and 100% in the fifth grade. The PD was successfully measured in 100% of the third grade, 96.0% of the fourth grade, and 100% in the fifth grade. The CD was successfully measured in 84.3% in the third grade, 66% in the fourth grade, and 100% in the fifth grade.Conclusion: SS-OCT can obtain accurate measures of all ocular parameters in the primary school students with high success rates. However, care should be taken especially in analyzing the ACD, LT, PD, and CD because errors can occur in some cases.Keywords: swept source optical coherence tomography, success rate, elementary school children

Yoshimasa Kosaka,1– 3 Toshiaki Saeki,2 Toshimi Takano,4,5 Tomoyuki Aruga,6 Toshinari Yamashita,7 Norikazu Masuda,8,9 Yukio Koibuchi,10 Akihiko Osaki,2 Junichiro Watanabe,11,12 Ryu Suzuki13 1Department of Breast and Endocrine Surgery, Kitasato University School of Medicine, Sagamihara-shi, Kanagawa, Japan; 2Department of Breast Oncology, Saitama Medical University International Medical Center, Hidaka-shi, Saitama, Japan; 3Department of Breast Oncology, Japanese Red Cross Sagamihara Hospital, Sagamihara-shi, Kanagawa, Japan; 4Department of Medical Oncology, Toranomon Hospital, Minato-ku, Tokyo, Japan; 5Breast Medical Oncology Department, Breast Oncology Center, Cancer Institute Hospital of Japanese Foundation for Cancer Research, Koto-ku, Tokyo, Japan; 6Department of Breast Surgery, Tokyo Metropolitan Center and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan; 7Department of Breast and Endocrine Surgery, Kanagawa Cancer Center, Yokohama-shi, Kanagawa, Japan; 8Department of Surgery, Breast Oncology, National Hospital Organization Osaka National Hospital, Osaka-shi, Osaka, Japan; 9Department of Breast and Endocrine Surgery, Nagoya University Graduate School of Medicine, Nagoya-shi, Aichi, Japan; 10Department of Breast and Endocrine Surgery, National Hospital Organization Takasaki General Medical Center, Takasaki-shi, Gunma, Japan; 11Division of Breast Oncology, Shizuoka Cancer Center, Sunto-gun, Shizuoka, Japan; 12Department of Breast Oncology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan; 13Pharmaceuticals Group, Nippon Kayaku Co., Ltd, Kita-ku, Tokyo, JapanCorrespondence: Yoshimasa Kosaka, Department of Breast Oncology, Japanese Red Cross Sagamihara Hospital, 256 Nakano, Midori-ku, Sagamihara-shi, Kanagawa, 252-0157, Japan, Tel +81-42-784-1101, Email y-kosaka@med.kitasato-u.ac.jpBackground: NK105 is a paclitaxel (PTX)-incorporating “core-shell-type” polymeric micellar nanoparticle formulation composed of block copolymers (polyethylene glycol and a polyamino acid). The efficacy and safety of NK105 and paclitaxel in advanced or recurrent breast cancer have never been compared at equivalent dose levels.Patients and Methods: Patients were randomly assigned to either NK105 or PTX in a 1:1 ratio. The study drug was administered on Day 1, 8, and 15 of a 28-day cycle with 80 mg/m2. The primary endpoint was overall response rate (ORR), secondary endpoints were progression-free survival (PFS), overall survival (OS), and adverse events.Results: A total of 123 patients (NK105, n=62; PTX, n=61) received one of the two drugs. There was no significant difference in ORR, the median PFS, or OS (NK105 group: 41.9%, 9.1, and 27.5 months, respectively; PTX group: 45.9%, 7.8, and 32.4 months, respectively). Neutropenia occurred more frequently in the NK105 group, but most patients did not require granulocyte-colony stimulating factor or dose-reduction. The median time to onset of peripheral sensory neuropathy (PSN) in the NK105 group was significantly longer than that in the PTX group (p=0.001), and PSN (≥ grade 3) was not observed in the NK105 group.Conclusion: Weekly NK105 administration was well-tolerated. Efficacy was similar in both groups. The PSN profile was better in the NK105 group.Keywords: polymeric micellar nanoparticles, chemotherapy-induced peripheral neuropathy, taxane, anti-polyethylene glycol antibodies, overall response rate

Hiroto Terasaki,1,&ast; Takehiro Yamashita,1,&ast; Ryo Asaoka,2– 5 Naoya Yoshihara,1 Naoko Kakiuchi,1 Taiji Sakamoto1 1Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; 2Department of Ophthalmology, Seirei Hamamatsu General Hospital, Shizuoka, Japan; 3Seirei Christopher University, Shizuoka, Japan; 4Nanovision Research Division, Research Institute of Electronics, Shizuoka University, Shizuoka, Japan; 5The Graduate School for the Creation of New Photonics Industries, Shizuoka, Japan&ast;These authors contributed equally to this workCorrespondence: Hiroto TerasakiDepartment of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, JapanTel +81 99-275-5402Fax +81 99-265-4894Email teracchi@m2.kufm.kagoshima-u.ac.jpPurpose: To determine the relationship between the ocular biometrics and axial length (AL) elongation and its rate in elementary school children.Methods: This is a prospective observational study of 102 right eyes of third-grade elementary school students who were 8 to 9 years old. All participants underwent measurements of the AL, anterior chamber depth (ACD), and lens thickness (LT) annually for 3 years. The AL elongation during the first half and second half was calculated by subtracting the AL of the 1st year from that at the 2nd year, and AL of the 3rd year minus 2nd year. The total AL elongation (TALE) was obtained by summing up the first and second half AL elongations. The growth rate change (GRC) was obtained by subtracting the first half AL elongation from second half AL elongation. Spearman correlations were used to determine the correlation between the 1st year ocular biometrics and the TALE and GRC.Results: The mean TALE was 0.54 ± 0.26 mm in boys and 0.46 ± 0.31 mm in girls. The mean GRC was 0.00 ± 0.16 mm in boys and − 0.04 ± 0.14 mm in girls. In boys and girls, the TALE was significantly larger in the eyes with myopic ocular biometrics such as a deeper ACD, thinner LT, and longer AL during the 1st year (|r|=0.41 to 0.46, P < 0.05). The GRC was significantly accelerated in the eyes of only the girls with hyperopic ocular biometrics such as a shallower ACD, thicker LT, and shorter AL during the 1st year (|r|=0.31 to 0.41, P< 0.05).Conclusion: In boys and girls, the TALE tends to be larger in eyes with myopic biometrics at the 1st year examination. The GRC tended to accelerate in the eyes with hyperopic ocular biometry during the 1st year only in girls.Keywords: axial elongation rate, axial length, school myopia

Tadashi Yamashita,1 Ramon Emilio Daniel Roces,2 Cecilia Ladines-Llave,2 Maria Teresa Reyes Tuliao,3 Mary Wanjira Kamau,4 Chika Yamada,5,6 Yuko Tanaka,7 Kyoko Shimazawa,1 Saori Iwamoto,1 Hiroya Matsuo6 1Kobe City College of Nursing, Kobe, Japan; 2Hospital of Muntinlupa, Muntinlupa, Philippines; 3City Health Office, City Government of Muntinlupa, Muntinlupa, Philippines; 4School of Nursing Sciences, University of Nairobi, Nairobi, Kenya; 5Department of Environment Coexistence, Center for Southeast Asian Studies, Kyoto University, Kyoto, Japan; 6Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan; 7Department of School Health Sciences, Institute of Biomedical Sciences, Tokushima University, Tokushima, JapanCorrespondence: Tadashi YamashitaKobe City College of Nursing, 3-4 Gakuennishi-Machi, Nishi-Ku, Kobe, 651-2103, JapanTel/Fax +81-78-794-8079Email tadashi_y_kobe@yahoo.co.jpPurpose: The World Health Organization advocates that all pregnant women in areas where anemia is prevalent receive supplements of iron and folic acid. However, owing to a myriad of factors, the uptake of iron and folic acid supplementation (IFAS) is still low in many countries. Therefore, this study was conducted to assess the prevalence of IFAS and its associated factors among pregnant women.Patients and Methods: A cross-sectional study was conducted at a hospital in Muntinlupa, Philippines, between March and August 2019 among 280 pregnant women. A systematic random sampling technique was used to select participants. Data were collected using interviewer-administered questionnaires. Multivariable logistic regression analyses were employed to identify factors associated with the prevalence of IFAS among pregnant women.Results: Among 280 pregnant women, a majority (85.6%, n= 238) took IFAS during pregnancy. Among the respondents, 128 (45.9%) women had knowledge about signs and symptoms of anemia, 126 (45.3%) had knowledge of the benefits associated with IFAS, and 42 (15.4%) had knowledge about side effects associated with IFAS. The main sources of information about IFAS were health care providers (41.8%), followed by community health workers (CHWs) (14.6%). Maternal knowledge concerning IFAS benefits (OR =  2.50, CI =  1.04– 5.97, p=0.04) was positively associated with the prevalence of IFAS.Conclusion: Maternal knowledge about the benefits of taking IFAS was significantly associated with the prevalence of IFAS among pregnant women in Muntinlupa, Philippines. There is a pressing need to improve health education on the benefits of IFAS among pregnant women to increase its prevalence. This emphasizes the necessity of increased involvement of health care providers and CHWs to increase women’s knowledge of IFAS benefits and support them through pregnancy.Keywords: anemia, pregnancy, health education, health care providers, community health workers

Yoshinori Terashima,1,2 Tsuneo Takebayashi,3 Shunsuke Jimbo,1 Izaya Ogon,1 Tatsuya Sato,2 Nobutoshi Ichise,2 Noritsugu Tohse,2 Toshihiko Yamashita1 1Department of Orthopaedic Surgery, School of Medicine, Sapporo Medical University, Sapporo 060-0061, Japan; 2Department of Cellular Physiology and Signal Transduction, School of Medicine, Sapporo Medical University, Sapporo 060-0061, Japan; 3Sapporo Maruyama Orthopaedic Hospital, Sapporo 060-0007, Japan Purpose: Radicular pain is a frequently observed symptom of lumbar disk herniation or lumbar spinal canal stenosis. Achieving radicular pain relief is difficult. This type of pain may progress to chronic neuropathic pain. Calcitonin (elcatonin [eCT]) has been used mainly for hypercalcemia and pain associated with osteoporosis. The purpose of this study was to investigate analgesic effects of repeated eCT administration on radicular pain in male rats and changes in mRNA-expression levels of voltage-dependent sodium channels in the dorsal root ganglion (DRG). Methods: Seventy male Sprague-Dawley rats were used. A right L5 hemilaminectomy and an L5–L6 partial facetectomy were performed to expose the right L5 nerve root. Under a microscope, the right L5 spinal nerve root was tightly ligated extradurally with 8-0 nylon suture proximally to the DRG to cause radicular pain in rats. Mechanical hyperalgesia, thermal hyperalgesia, and analgesic effects of eCT were compared among rats with radicular pain that received eCT, those that received the vehicle, and sham rats that received the vehicle. Real-time reverse-transcription PCR was performed to measure mRNA-expression levels of tetrodotoxin-sensitive (NaV1.3 and NaV1.6) and tetrodotoxin-resistant (NaV1.8 and NaV1.9) sodium channels in the DRG. Results: Mechanical and thermal hyperalgesic reactions occurring in rats with radicular pain significantly improved on days 5 and 9 of eCT administration, respectively. In rats with radicular pain, mRNA-expression levels of NaV1.3, NaV1.8, and NaV1.9 increased. After repeated eCT administration, mRNA-expression levels of these sodium channels in rats with radicular pain improved to the same levels as in sham rats. Conclusion: The present study demonstrated that repeated systemic eCT administration was effective for radicular pain. No serious side effects of eCT have been reported thus far. Therefore, calcitonin may be a preferred therapeutic option for patients with radicular pain or for those requiring long-term treatment. Keywords: radiculopathy, hyperalgesia, lumbar disk herniation, lumbar spinal canal stenosis, sodium channel, elcatonin

Shunsuke Jimbo,1 Yoshinori Terashima,1,2 Atsushi Teramoto,1 Tsuneo Takebayashi,3 Izaya Ogon,1 Kota Watanabe,4 Tatsuya Sato,2,5 Nobutoshi Ichise,2 Noritsugu Tohse,2 Toshihiko Yamashita1 1Department of Orthopaedic surgery, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; 2Department of Cellular Physiology and Signal Transduction, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan; 3Sapporo Maruyama Orthopaedic Hospital, Sapporo 060-0007, Japan; 4Department of Second Division of Physical Therapy, Sapporo Medical University School of Health Sciences, Sapporo 060-8556, Japan; 5Department of Cardiovascular, Renal and Metabolic Medicine, Sapporo Medical University School of Medicine, Sapporo 060-8556, Japan Purpose: Ankle osteoarthritis (OA) causes significant pain and debilitation; yet, its underlying mechanisms remain unclear. Clinically, hyaluronic acid (HA) is widely used to treat OA. The present study aimed to investigate the roles of HA in pain-related behavior, joint function, swelling, and pathological changes in cartilage in a rat model of monoiodoacetate (MIA)-induced ankle OA. Materials and methods: Male Sprague Dawley rats were assigned to three experimental groups as follows: 1) MIA rats injected with 1 mg MIA in the right tibiotarsal joint for two consecutive days; 2) sham rats injected with saline instead of MIA; and 3) MIA-HA rats injected with HA in the tibiotarsal joint at 7, 14, and 21 days after MIA injection. Joint swelling, range of motion (ROM), and pain-related behavior were evaluated 1 day before and on the 7th, 14th, 21st, and 28th day after MIA or saline injection. Pathological changes in the ankle joint were assessed 28 days after MIA or saline injection. Results: No significant difference in the degree of ankle swelling or ROM reduction was observed between MIA rats and MIA-HA rats. However, compared with those in MIA rats, mechanical and thermal hypersensitivity was significantly reduced and stride length significantly improved in MIA-HA rats. Histologic analysis revealed that cartilage degeneration was significantly suppressed in MIA-HA rats compared with that in MIA rats, reflecting the chondroprotective effects of HA. Conclusion: HA improved pain-related behavior and stride length and suppressed MIA-induced cartilage degeneration. HA may thus inhibit OA progression and suppress peripheral and/or central sensitization. Keywords: ankle osteoarthritis, monoiodoacetate, osteoarthritis pain, hyaluronic acid

Naoko Iida,1,2 Yoshihisa Wada,1,3 Tatsuhisa Yamashita,1,2,4 Michiko Aoyama,5,6 Kiyoshi Hirai,5,6 Jin Narumoto1 1Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 2Department of Child Psychiatry, Kyoto Prefectural Child Development Support Center, Kyoto, Japan; 3Fuchu-mikumari Hospital, Hiroshima, Japan; 4Department of Child and Adolescent Psychiatry, Yamashita Mental Health Clinic, Kyoto, Japan; 5Department of Pediatrics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan; 6Department of Pediatrics, Kyoto Prefectural Child Development Support Center, Kyoto, Japan Purpose: Raising a child with autism spectrum disorder (ASD) can be a stressor, and mothers of ASD children often present with high levels of stress and depression. Interventional steps to enhance parental coping skills and resiliency are more important for parental mental health and the family-centered care of children with ASD than merely reducing parental stress. Although the importance of stress-coping skills is well established, only a few studies have investigated interventional steps to improve parental coping or resiliency. Parent training (PT) is known to improve a mother’s mental health. Here, we aimed to assess the effectiveness of PT in improving the stress-coping style of mothers raising children with ASD.Patients and methods: Thirty mothers of children with ASD aged 4–11 years participated in this study. The mothers underwent PT based on the Hizen Parenting Skills Training in Japan, which comprised seven sessions. Each session included education on behavior therapy, individual consultation, and workshops in small groups. Sixteen mothers completed psychological assessment, including the Stress Coping Inventory, the Beck Depression Inventory Second Edition, the State–Trait Anxiety Inventory, and the Child Behavior Checklist conducted before and after 2 months of PT.Results: The outcomes before and after the PT program were compared using the paired t-test and Pearson’s correlation. After the PT program, the mothers’ stress-coping strategy “positive appraisal” significantly increased (P

Tadashi Yamashita,1 Maria Teresa Reyes Tuliao,2 Magdalena Concel Meana,2 Sherri Ann Suplido,3 Cecilia L Llave,4 Yuko Tanaka,5 Hiroya Matsuo6 1Kobe City College of Nursing, Kobe, Japan; 2Health Department of Muntinlupa, Muntinlupa, Philippines; 3Department of Obstetrics and Gynecology, Philippine General Hospital, Manila, Philippines; 4College of Medicine (CM), University of the Philippine (UP), Manila, Philippines; 5Department of School of Health Sciences, Faculty of Medicine, Tokushima University Graduate School, Tokushima, Japan; 6Department of International Health, Kobe University Graduate School of Health Sciences, Kobe, Japan Background: A low ratio of utilization of healthcare services in postpartum women may contribute to maternal deaths during the postpartum period. The maternal mortality ratio is high in the Philippines. The aim of this study was to examine the current utilization of healthcare services and the effects on the health of women in the Philippines who delivered at home. Methods: This was a cross-sectional analytical study, based on a self-administrated questionnaire, conducted from March 2015 to February 2016 in Muntinlupa, Philippines. Sixty-three postpartum women who delivered at home or at a facility were enrolled for this study. A questionnaire containing questions regarding characteristics, utilization of healthcare services, and abnormal symptoms during postpartum period was administered. To analyze the questionnaire data, the sample was divided into delivery at home and delivery at a facility. Chi-square test, Fisher’s exact test, and Mann–Whitney U test were used. Results: There were significant differences in the type of birth attendant, area of residence, monthly income, and maternal and child health book usage between women who delivered at home and those who delivered at a facility (P

Hideki Kajiwara,1 Yoshiyuki Ohira,1 Akiko Ikegami,1 Nao Hanazawa,1 Takako Masuyama,1,2 Tomoko Yamashita,1 Takeshi Kondo,1 Kiyoshi Shikino,1 Masatomi Ikusaka1 1Department of General Medicine, Chiba University Hospital, Chiba-shi, 2Department of General Medicine, Kimitsu Chuo Hospital, Kisarazu-shi, Chiba, Japan Introduction: Anxiety and depressive symptoms are seen in patients with anxiety and mood disorders but are also common in those with organic disorders. However, since physical symptoms are predominant complaints from patients who visit nonpsychiatric outpatient clinics, anxiety and depressive symptoms are often unrecognized. It is important for physicians to be aware of these issues concurrent with the physical symptoms. We therefore examined whether a self-administered medical questionnaire could identify anxiety and depressive symptoms.Patients and methods: A total of 453 patients on their first visit to the Department of General Medicine, Chiba University Hospital, Chiba, Japan, participated in this study. They were asked to complete a medical questionnaire and the Hospital Anxiety and Depression Scale questionnaire before examination. Data on age, sex, number of complaints, symptom duration, and number of previous physicians were extracted from the medical questionnaire. These data were used as independent variables in logistic regression analysis to develop a predictive model for the presence of anxiety and depressive symptoms.Results: Data from 358 (79.0%) patients were included in the analyses. Logistic regression analysis identified the following predictors: “three or more complaints” (odds ratio [OR] 2.39; 95% confidence interval [CI] 1.48–3.88) and “four or more previous physicians” (OR 1.72; 95% CI 1.10–2.69). In the predictive model for the presence of symptoms of anxiety and depression, the likelihood ratio was 2.40 (95% CI 1.33–4.34) in patients reporting both conditions and 1.35 (95% CI 1.04–1.77) in those reporting either condition.Conclusion: The presence of anxiety and depressive symptoms can be predicted from the items of a medical questionnaire in outpatients visiting a general medicine department of a university hospital. When patients report three or more complaints or four or more previous physicians on a medical questionnaire, physicians should consider the presence of anxiety or depression or both in differential diagnosis. Keywords: anxiety, depression, Hospital Anxiety and Depression Scale, HADS, complaint numbers, number of previous physicians, medical questionnaire

Takehiro Yamashita,1 Taiji Sakamoto,1 Hiroto Terasaki,1 Minoru Tanaka,1 Yuya Kii,1 Eisuke Uchino,1 Toshio Hisatomi,2 Kumiko Nakao1 1Department of Ophthalmology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan; 2Department of Ophthalmology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan Aim: To determine the relationship between the axial length (AL) and the retinal thickness in the posterior pole and to the optic disc-to-fovea (ODF) angle of healthy eyes. Procedures: A prospective, observational cross-sectional study (registration number, UMIN000006040) of 64 healthy right eyes (mean age 26.0±4.5 years) was performed. The thickness of the 64 areas within the central 24° area were measured in the Spectralis spectral domain–optical coherent tomographic images obtained by posterior pole scans. Each area was 3°×3°. The ODF angle was measured in each fundus photograph. The relationships between the AL and the retinal thickness of each of the 64 areas and the ODF angle were investigated by linear regression analyses. Results: The mean AL was 25.0±1.3 mm and the mean ODF angle was 17.2°±1.0°. The average retinal thickness of the four areas around the fovea was constant and not significantly correlated with the AL. However, the retinal thicknesses of 54 of the other 60 areas were significantly and negatively correlated with the AL (R=-0.25 to -0.56, P

Syunsuke Araki,1 Atsushi Miki,1,2 Tsutomu Yamashita,1,2 Katsutoshi Goto,1,2 Kazuko Haruishi,1 Yoshiaki Ieki,1 Junichi Kiryu1 1Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Japan; 2Department of Sensory Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, Kurashiki, Japan Purpose: To compare the macular retinal thickness and characteristics of optic nerve head (ONH) parameters in amblyopic and fellow eyes in patients with unilateral amblyopia.Patients and methods: A total of 21 patients with unilateral amblyopia (14 patients with anisometropic amblyopia, four patients with strabismic amblyopia, and three patients with both) were examined using spectral-domain optical coherence tomography. The mean age of the patients was 8.5±3.5 years. The examined parameters included the mean macular (full, inner, and outer), ganglion cell complex and circumpapillary retinal nerve fiber layer (cpRNFL) thicknesses, and ONH parameters (rim volume, nerve head volume, cup volume, rim area, optic disc area, cup area, and cup-to-disc area ratio).Results: The amblyopic eyes were significantly more hyperopic than the fellow eyes (P

Tsutomu Yamashita1, Atsushi Miki1,2,3, Yoshiaki Ieki2, Junichi Kiryu2, Kiyoshi Yaoeda3,4, Motohiro Shirakashi3,51Department of Sensory Science, Faculty of Health Science and Technology, Kawasaki University of Medical Welfare, 2Department of Ophthalmology, Kawasaki Medical School, Kurashiki, Okayama, Japan; 3Division of Ophthalmology and Visual Sciences, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan; 4Yaoeda Eye Clinic, Nagaoka, Japan; 5Kido Eye Clinic, Niigata, JapanPurpose: We investigated at which corneal region the intraocular pressure as measured by the Icare® rebound tonometer (Finland Oy, Espoo, Finland) (hereinafter referred to as IC) was closest to the intraocular pressure as measured by the Goldmann applanation tonometer (hereinafter referred to as GT). We also investigated which parameters would be best for preparing the most suitable model for predicting GT.Methods: A total of 102 normal eyes in 102 subjects were enrolled. IC measurements were carried out at the central, superior, inferior, temporal, and nasal regions of the cornea (ICC, ICS, ICI, ICT, and ICN, respectively), followed by GT calculations. Differences between GT and IC were analyzed using the Bland–Altman method. Stepwise multiple regression analysis was performed using GT as the objective variable, and age, laterality of eye, spherical equivalent refractive error, corneal radius, axial length, central corneal thickness, GT, ICC, ICS, ICI, ICT, and ICN as the explanatory variables.Results: IC was higher than GT at all of the corneal regions, but the region with the least bias was ICC, followed by ICT. In the multiple regression analysis, the following prediction formula was calculated: GT = (0.445 × ICC) + (0.198 × ICN) + 3.022. When ICC was excluded from the explanatory variables, ICT had the highest partial correlation coefficient with GT.Conclusion: ICC was closest to GT, but GT could be explained better by adding ICN to the prediction model. Moreover, in instances where ICC cannot be calculated or where reliability is clearly poor due to abnormal ocular rigidity, ICT was the closest to GT measured in the central corneal region.Keywords: IOP, Icare, Goldmann applanation tonometer, ocular rigidity