Papers - Torii, Hidemasa

Choroidal Resident Macrophage Depletion can Induce Myopia in Mice

J Hou, S Ikeda, K Mori, H Jeong, H Torii, K Negishi, K Tsubota, T Kurihara

Investigative Ophthalmology & Visual Science 64 (8), 851-851  2023

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臨床：白内障手術関連3編

Kizawa Junya, Torii Hidemasa, Nagata Mayumi

The Journal of The Japanese Society for Cataract Research (The Japanese Society for Cataract Research)  35 ( 1 ) 94 - 95 2023

Lead author, Last author, Corresponding author,  ISSN  09154302

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Motor

N Kato, T Inagaki, H Torii, K Nakaya, T Fujiwara

US Patent 11,699,935  2023

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Violet light is abundant outdoors but deficient indoors in modern lifestyle in Tokyo

K Tsubota, S Kondo, X Jiang, H Torii, K Mori, T Kurihara

Investigative Ophthalmology & Visual Science 64 (8), 4178-4178  2023

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The orientation of choroidal macrophage polarization significantly influences the development of myopia in murine models

J Hou, S Ikeda, K Mori, H Jeong, H Torii, K Negishi, K Tsubota, T Kurihara

bioRxiv, 2023.06. 12.544445  2023

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Sex differences in the relationship between axial length and dry eye in elderly patients

M Ayaki, H Torii, E Yotsukura, K Negishi

Frontiers in Medicine 10, 1170696 10   1170696 2023

Lead author, Last author, Corresponding author,  ISSN  2296-858X

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Pump device

N Kato, T Inagaki, K Nakaya, H Torii

US Patent 11,655,827  2023

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Clinical results and factors affecting visual function in eyes implanted with an enhanced monofocal intraocular lens

K Negishi, S Masui, M Ayaki, H Torii, E Yotsukura, Y Nishi

Clinical Ophthalmology, 3965-3973 17   3965 - 3973 2023

Lead author, Last author, Corresponding author,  ISSN  1177-5467

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Purpose: To compare the clinical results achieved with the enhanced monofocal intraocular lenses (IOLs) with those of the monofocal IOL and investigate factors affecting the distance, intermediate, and near vision. Patients and Methods: Patients were included who underwent bilateral consecutive cataract surgeries using the same IOLs with follow-up to 1 month postoperatively. Refractions, monocular UDVA and CDVA, and binocular distance-corrected functional visual acuity at 5 meters (BDCFVA), at 66 centimeters (BDCIFVA) and at 40 centimeters (DCNVA) were assessed. Multiple regression analysis was used to assess the factors affecting binocular BDCFVA, BDCIFVA, and BDCNFVA. Subjective symptoms were assessed using the Near Activity Visual Questionnaire (NAVQ) and visual analogue scale (VAS). Results: Sixty patients (120 eyes) implanted with the Tecnis Eyhance IOL (30 patients, 60 eyes) or the Tecnis monofocal IOL (30 patients, 60 eyes) were included. The Tecnis Eyhance IOL provided significantly better binocular BDCIFVA than the Tecnis monofocal IOL in patients under 70 years of age. Multiple regression analysis showed that age was the only factor affecting distance and intermediate visual function in eyes with the Tecnis Eyhance IOL; gender, pupillary diameter, axial length, and average keratometry were not significant. There were no significant differences in subjective symptoms. Conclusion: The comprehensive cohort analysis did not confirm the advantage on the intermediate vision of the Tecnis Eyhance IOL. Younger age may be an important factor to benefit from the unique optical characteristics of this IOL.

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増刊号 最新臨床研究から探る眼科臨床のギモンQ＆A 2　白内障・視覚矯正 小児の近視進行予防は,どれくらいの効果があるのでしょうか?

小川 護, 四倉 絵里沙, 鳥居 秀成

臨床眼科 (株式会社医学書院)  76 ( 11 ) 76 - 82 2022.10

Lead author, Last author, Corresponding author,  ISSN  03705579

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Short-term exposure to violet light emitted from eyeglass frames in myopic children: a randomized pilot clinical trial

H Torii, K Mori, T Okano, S Kondo, HY Yang, E Yotsukura, A Hanyuda, ...

Journal of clinical medicine 11 (20), 6000 (Journal of Clinical Medicine)  11 ( 20 )  2022.10

Lead author, Last author, Corresponding author,  ISSN  2077-0383

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Violet light (VL), 360–400 nm wavelength, is contained in the sunlight and is an effective element for myopia suppression. This study is to investigate the safety and efficacy of novel eyeglasses that emit VL from the frames. This is a double-masked, randomized, pilot clinical trial conducted in a clinic in Japan. Forty-three children with myopia were enrolled. Participants were randomly assigned to two groups, wearing VL-emitting eyeglass frames (VLf) that emitted VL of 310 μW/cm2 (VLf group, n = 22) or pseudo-placebo eyeglass frames with a minimal emission of VL (<10 μW/cm2) (control group, n = 21). The exposure time was 3 h per day. The primary outcomes were visual acuity, tear film break-up time, corneal endothelial cell density, and the slit-lamp/fundus examinations. The secondary outcome was the 6-month changes in the axial lengths and cycloplegic refractions. Forty-one (95%) participants were included; twenty-one in the VLf group and twenty in the control group. No significant differences were seen in any safety evaluation. Significant changes were seen in axial elongation, choroidal thickness, and cycloplegic refractions in the subgroup analysis of 8- to 10-year-old children (p < 0.05), but otherwise no significant differences were seen. The VLf showed short-term safety and effectiveness against myopia progression.

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Scleral PERK and ATF6 as targets of myopic axial elongation of mouse eyes

S Ikeda, T Kurihara, X Jiang, Y Miwa, D Lee, N Serizawa, H Jeong, K Mori, ...

Nature communications 13 (1), 5859 (Nature Communications)  13 ( 1 ) 5859 2022.10

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Axial length is the primary determinant of eye size, and it is elongated in myopia. However, the underlying mechanism of the onset and progression of axial elongation remain unclear. Here, we show that endoplasmic reticulum (ER) stress in sclera is an essential regulator of axial elongation in myopia development through activation of both PERK and ATF6 axis followed by scleral collagen remodeling. Mice with lens-induced myopia (LIM) showed ER stress in sclera. Pharmacological interventions for ER stress could induce or inhibit myopia progression. LIM activated all IRE1, PERK and ATF6 axis, and pharmacological inhibition of both PERK and ATF6 suppressed myopia progression, which was confirmed by knocking down above two genes via CRISPR/Cas9 system. LIM dramatically changed the expression of scleral collagen genes responsible for ER stress. Furthermore, collagen fiber thinning and expression of dysregulated collagens in LIM were ameliorated by 4-PBA administration. We demonstrate that scleral ER stress and PERK/ATF6 pathway controls axial elongation during the myopia development in vivo model and 4-PBA eye drop is promising drug for myopia suppression/treatment.

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Vascular endothelial growth factor from retinal pigment epithelium is essential in choriocapillaris and axial length maintenance

Y Zhang, H Jeong, K Mori, SI Ikeda, C Shoda, Y Miwa, A Nakai, J Chen, ...

PNAS nexus 1 (4), pgac166 1 ( 4 ) pgac166 2022.09

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Investigating the prediction accuracy of recently updated intraocular lens power formulas with artificial intelligence for high myopia

M Omoto, K Sugawara, H Torii, E Yotsukura, S Masui, Y Shigeno, Y Nishi, ...

Journal of Clinical Medicine 11 (16), 4848 (Journal of Clinical Medicine)  11 ( 16 )  2022.08

Lead author, Last author, Corresponding author,  ISSN  2077-0383

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The aim of this study was to investigate the prediction accuracy of intraocular lens (IOL) power formulas with artificial intelligence (AI) for high myopia. Cases of highly myopic patients (axial length [AL], >26.0 mm) undergoing uncomplicated cataract surgery with at least 1-month follow-up were included. Prediction errors, absolute errors, and percentages of eyes with prediction errors within ±0.25, ±0.50, and ±1.00 diopters (D) were compared using five formulas: Hill-RBF3.0, Kane, Barrett Universal II (BUII), Haigis, and SRK/T. Seventy eyes (mean patient age at surgery, 64.0 ± 9.0 years; mean AL, 27.8 ± 1.3 mm) were included. The prediction errors with the Hill-RBF3.0 and Kane formulas were statistically different from the BUII, Haigis, and SRK/T formulas, whereas there was not a statistically significant difference between those with the Hill-RBF3.0 and Kane. The absolute errors with the Hill-RBF3.0 and Kane formulas were smaller than that with the BUII formula, whereas there was not a statistically significant difference between the other formulas. The percentage within ±0.25 D with the Hill-RBF3.0 formula was larger than that with the BUII formula. The prediction accuracy using AI (Hill-RBF3.0 and Kane) showed excellent prediction accuracy. No significant difference was observed in the prediction accuracy between the Hill-RBF3.0 and Kane formulas.

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Children in Tokyo Have a Long Sustained Axial Length from Age 3 Years: The Tokyo Myopia Study

T Maruyama, E Yotsukura, H Torii, K Mori, M Inokuchi, M Tokumura, ...

Journal of Clinical Medicine 11 (15), 4413 (Journal of Clinical Medicine)  11 ( 15 )  2022.07

Lead author, Last author, Corresponding author,  ISSN  2077-0383

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Background: myopia prevalence is high among Japanese schoolchildren, but the underlying causes are unclear. Objective: To examine the distributions of ocular biometry and refraction and their associations with lifestyle variables among Japanese schoolchildren. Methods: This cross-sectional school-based study included 2140 children aged 3–14 years in Tokyo, Japan, and evaluated the distributions under non-cycloplegic conditions and the associated environmental factors. Results: The prevalence of spherical equivalent (SE) ≤−0.75 diopter among preschoolers (aged 3–6 years), elementary school students (aged 6–11 years), and junior high school students (aged 12–14 years) was 49.7%, 72.4%, and 87.7%, respectively. Multiple linear regression analyses showed that the time spent using digital devices was associated positively with lens thickness (β = 0.010; p < 0.050) but not SE, axial length, or vitreous chamber depth. The time spent reading was associated negatively with lens thickness (β = −0.012; p < 0.050), SE (β = −0.152; p < 0.010), axial length (β = 0.110; p < 0.001), and vitreous chamber depth (β = 0.110; p < 0.001). Conclusions: The data indicated that almost half of preschoolers may be myopic. The association with the lens thickness differed depending on the type of near work performed.

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Relation between dry eye and myopia based on tear film breakup time, higher order aberration, choroidal thickness, and axial length

D Hazra, E Yotsukura, H Torii, K Mori, T Maruyama, M Ogawa, A Hanyuda, ...

Scientific reports 12 (1), 10891 (Scientific Reports)  12 ( 1 ) 10891 2022.06

Lead author, Last author, Corresponding author,  ISSN  2045-2322

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The purpose of this study was to investigate the association between dry eye disease (DED) and myopia by evaluating higher order aberrations (HOAs) and choroidal thickness (CT). We recruited 72 myopic children with DED symptoms (mean age 12.8 years), measured the tear film breakup time (TBUT), corneal/intraocular/total ocular HOAs, CT, and axial length (AL), administered lifestyle questionnaires, and evaluated the relationships among TBUT, HOAs, CT, and AL. The TBUT was correlated significantly with the corneal HOAs and intraocular HOAs but not with the total ocular HOAs. Multiple regression analyses showed that the AL was associated significantly with the TBUT (β = − 0.067, P = 0.004), the intraocular HOAs, and total ocular HOAs but not with the corneal HOAs. The CT was associated significantly with the TBUT and AL (β = 9.15 and − 7.85, respectively; P < 0.001 and = 0.01, respectively). Our data suggested the association between DED and myopia might be independent of the HOAs. We showed that the TBUT was associated with the CT, which is related to the AL. Because the parasympathetic nervous system affects the lacrimal glands and CT, the parasympathetic nervous system might be a common upstream factor in the association between DED and myopia.

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Dry eye disease and high myopia in teenagers; a reciprocal relationship

OI Hirayama, M Ayaki, E Yotsukura, H Torii, K Negishi

Investigative Ophthalmology & Visual Science 63 (7), 1442–F0400-1442–F0400 63 ( 7 )  2022.06

Lead author, Last author, Corresponding author,  ISSN  0146-0404

Lipidomic analysis revealed n-3 polyunsaturated fatty acids suppressed choroidal thinning and myopia progression in mice.

Mori K, Kuroha S, Hou J, Jeong H, Ogawa M, Ikeda SI, Kang JX, Negishi K, Torii H, Arita M, Kurihara T, Tsubota K

FASEB journal : official publication of the Federation of American Societies for Experimental Biology (FASEB Journal)  36 ( 6 ) e22312 2022.06

Lead author, Last author, Corresponding author,  ISSN  0892-6638

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Myopia is increasing worldwide and its preventable measure should urgently be pursued. N-3 polyunsaturated fatty acids (PUFAs) have been reported to have various effects such as vasodilative and anti-inflammatory, which myopia may be involved in. This study is to investigate the inhibitory effect of PUFAs on myopia progression. A lens-induced myopia (LIM) model was prepared using C57B L6/J 3-week-old mice, which were equipped with a −30 diopter lens to the right eye. Chows containing two different ratios of n-3/n-6 PUFA were administered to the mice, and myopic shifts were confirmed in choroidal thickness, refraction, and axial length in the n-3 PUFA-enriched chow group after 5 weeks. To exclude the possibility that the other ingredients in the chow may have taken the suppressive effect, fat-1 transgenic mice, which can produce n-3 PUFAs endogenously, demonstrated significant suppression of myopia. To identify what elements in n-3 PUFAs took effects on myopia suppression, enucleated eyes were used for targeted lipidomic analysis, and eicosapentaenoic acid (EPA) were characteristically distributed. Administration of EPA to the LIM model confirmed the inhibitory effect on choroidal thinning and myopia progression. Subsequently, to identify the elements and the metabolites of fatty acids effective on myopia suppression, targeted lipidomic analysis was performed and it demonstrated that metabolites of EPA were involved in myopia suppression, whereas prostaglandin E2 and 14,15-dihydrotestosterone were associated with progression of myopia. In conclusion, EPA and its metabolites are related to myopia suppression and inhibition of choroidal thinning.

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Relationship between Dry Eye and Myopia in Children

K Tsubota, D Hazra, E Yotsukura, K Mori, T Maruyama, M Ogawa, ...

Investigative Ophthalmology & Visual Science 63 (7), 249–A0103-249–A0103 63 ( 7 )  2022.06

Lead author, Last author, Corresponding author,  ISSN  0146-0404

Relationship of choroidal thickness and axial length with posterior vitreous detachment in patients with high myopia

A Hanyuda, H Torii, K Hayashi, A Uchida, K Mori, E Yotsukura, M Ogawa, ...

Scientific reports 12 (1), 4093 (Scientific Reports)  12 ( 1 ) 4093 2022.03

Lead author, Last author, Corresponding author,  ISSN  2045-2322

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Although accumulating evidence suggests a higher prevalence of posterior vitreous detachment (PVD) in highly myopic eyes, the relation between ocular biometric features and PVD stages in such eyes remains unclear. Therefore, we enrolled 170 patients with high myopia (axial length ≥ 26.0 mm) to investigate the status of PVD regarding subfoveal choroidal thickness and axial length. Utilising swept-source optical coherence tomography, we classified the PVD status into five stages. The distribution of PVD grades increased as the choroidal thickness decreased and axial length increased (P < 0.01). On adjusting for age and sex, decreased choroidal thickness and increased axial length were associated with more advanced PVD stages: odds ratios with the highest vs. lowest groups were 0.31 (95% confidence interval [CI] 0.09–1.01; Ptrend = 0.009) for choroidal thickness and 5.16 (95% CI 1.34–19.80; Ptrend = 0.002) for axial length. The inverse association between choroidal thickness and PVD status seemed stronger in women than in men (Pinteraction = 0.05). In conclusion, we firstly observed a significant trend of decreased choroidal thickness, along with increased axial length, with increased grade of PVD, particularly among women with highly myopic eyes, suggesting that advanced morphological myopic changes contribute to PVD in middle-aged adults.

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綜説 多焦点眼内レンズ

四倉 絵里沙, 鳥居 秀成

眼科 (金原出版)  64 ( 2 ) 147 - 155 2022.02

Lead author, Last author, Corresponding author,  ISSN  00164488

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