Details of a Researcher - Negishi, Kazuno

Papers - Negishi, Kazuno

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Corneal crosslinking for keratoconus in Japanese populations: one year outcomes and a comparison between conventional and accelerated procedures

Kato, N., Konomi, K., Shinzawa, M., Kasai, K., Ide, T., Toda, I., Sakai, C., Negishi, K., Tsubota, K. and Shimazaki, J.

Jpn J Ophthalmol (Japanese Journal of Ophthalmology) 62 ( 5 ) 560 - 567 2018.07

ISSN 1613-2246

PURPOSE: We retrospectively investigated the efficacy of corneal crosslinking (CXL) on progressive keratoconus in a Japanese population and compared the outcomes of conventional and accelerated CXL. STUDY DESIGN: A retrospective cohort study METHODS: A total of 108 consecutive eyes in 95 patients (75 men; 21.9 +/- 6.2 years) with progressive keratoconus were enrolled. The epithelium was ablated in all eyes. After presoaking the corneal stroma in riboflavin, UV-A was irradiated at 3.0 mW/cm(2) (conventional CXL) for 30 min on 23 eyes and 18.0 mW/cm(2) for 5 min (accelerated CXL) on 85 eyes. Best spectacle-corrected visual acuity (BSCVA), manifest refraction, keratometric value, corneal thickness, corneal endothelial cell density (ECD), intraocular pressure, and complications were evaluated at 1, 3, 6, and 12 months after the procedure. RESULTS: BSCVA, manifest refraction, ECD, and corneal thickness did not change significantly after both procedures. The keratometric value was significantly decreased from the preoperative value at 12 months (p < 0.001). Progression to more than 1.0 D after CXL was observed in 10 eyes (9.3%). The DeltaKmax was negatively associated with preoperative Kmax (p < 0.001) and positively associated with preoperative thinnest corneal thickness (p < 0.001). Both treatment modules showed no significant difference in all parameters. CONCLUSION: CXL was as effective in treating keratoconus in Japanese patients as in individuals of other ethnicities. Overall, CXL could be performed using either the conventional or accelerated approach to halt the progression of keratoconus in Japanese populations.

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Refractive outcomes of intraocular lens power calculation using different corneal power measurements with a new optical biometer

Savini, G., Negishi, K., Hoffer, K. J. and Schiano Lomoriello, D.

J Cataract Refract Surg (Journal of Cataract and Refractive Surgery) 44 ( 6 ) 701 - 708 2018.06

ISSN 1873-4502

PURPOSE: To evaluate the results of intraocular lens (IOL) power calculation using different corneal power measurements provided by an optical biometer combined with a dual Scheimpflug analyzer and a Placido disk topographer (Galilei G6). SETTING: G.B. Bietti Foundation, Rome, Italy, and Keio University Hospital, Tokyo, Japan. DESIGN: Evaluation of diagnostic technology. METHODS: Consecutive patients having cataract surgery were enrolled. The IOL power was calculated with the Barrett Universal II, Haigis, Hoffer Q, Holladay 1, and SRK/T formulas. Different options were used to calculate the corneal power: simulated keratometry (K) based on anterior corneal surface measurements only and total corneal power (TCP) based on ray tracing through both corneal surfaces. Three TCP measurements (TCP1, TCP2, and TCP-IOL) were evaluated. RESULTS: The study analyzed 118 eyes. The mean values of simulated K (43.74 diopters [D] +/- 1.40 [SD]), TCP1 (43.13 +/- 1.35 D), TCP2 (41.87 +/- 1.30 D), and TCP-IOL (42.62 +/- 1.35 D) were significantly different (P < .0001). The best results were obtained using simulated K: the median absolute error ranged between 0.22 D and 0.29 D and the percentage of eyes with a prediction error of +/-0.50 D or less, between 76.2% and 84.7%, depending on the formula. After constant optimization, the results using any TCP value and simulated K were similar with no statistically significant differences. CONCLUSIONS: Biometric measurements provided by the Scheimpflug-Placido optical biometer can be used to accurately calculate the IOL power. Simulated K and TCP led to similar outcomes after constant optimization.

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Effects of Cataract Opacity and Surgery on Sleep Quality

Kokune-Takahashi, A., Ayaki, M., Tsubota, K. and Negishi, K.

Rejuvenation Res (Rejuvenation Research) 21 ( 1 ) 53 - 60 2018.02

ISSN 1557-8577

This study aimed to identify the type of cataract opacity associated with subjective sleep quality for cataract patients. A total of 180 consecutive patients (average age 74.2 years) underwent cataract surgery with implantation of an ultraviolet-blocking or blue light-blocking intraocular lens. The participants' subjective sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI) before and at 2 months after surgery. Patients were divided into two groups for analysis: normal sleepers (preoperative PSQI </=5) and poor sleepers (preoperative PSQI >/=6). The preoperative and postoperative PSQI scores were 2.8 +/- 1.5 and 3.2 +/- 2.0, respectively, for normal sleepers (n = 99), and 8.5 +/- 2.9 and 7.4 +/- 3.3, respectively, for poor sleepers (n = 81). The improvement in PSQI was significant in poor sleepers (p < 0.0001, Wilcoxon's test) with measured values of 0.22 +/- 0.96 hours extension in sleep duration and 0.16 +/- 0.62 hours shortening in sleep latency. Patients with posterior subcapsular cataract (PSC) and nuclear opacity showed the greatest improvement in PSQI score, with regression analysis identifying PSC as having a significant effect on improvement in PSQI. Significant correlations were found between the subjective sleep and cataract opacity in cataract patients. Ophthalmic personnel should therefore be aware that cataract patients with PSC have a greater potential for disability and predictable benefits from surgery in vision and subjective sleep.

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Patients' satisfaction and subjective happiness after refractive surgery for myopia

Matsuguma, S., Negishi, K., Kawashima, M., Toda, I., Ayaki, M. and Tsubota, K.

Patient Prefer Adherence (Patient Preference and Adherence) 12 1901 - 1906 2018

ISSN 1177-889X

Purpose: The purpose of this study was to assess patients' satisfaction and change in subjective happiness after laser-assisted in situ keratomileusis (LASIK). Patients and methods: This was a retrospective cross-sectional study of 307 patients (mean age, 34.3 years; range, 20-63 years) who underwent bilateral LASIK surgery and ocular examinations, including subjective refraction and visual acuity axial length measurements at Minamiaoyama Eye Clinic. Patients also completed questionnaires on their satisfaction with the surgery, and on the subjective happiness scale (SHS) within 1 month before and 1 month after surgery. A multiple regression analysis was performed to determine the independent predictors of the SHS score. Results: In total, 91.2% of the patients were satisfied with surgery (very satisfied: n=155; satisfied: n=125). The SHS score increased postoperatively from 5.2+/-0.9 to 5.3+/-0.9 (P<0.001). The multiple regression analysis revealed that the preoperative SHS score (beta=0.77; P<0.001) and satisfaction with surgery (beta=-0.11; P=0.05) were predictors of postoperative SHS score. Conclusion: LASIK may contribute to increased patient happiness.

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Gender differences in adolescent dry eye disease: a health problem in girls

Ayaki, M., Kawashima, M., Uchino, M., Tsubota, K. and Negishi, K.

Int J Ophthalmol (International Journal of Ophthalmology) 11 ( 2 ) 301 - 307 2018

ISSN 2222-3959

AIM: To evaluate the signs and symptoms of dry eye disease (DED) in adolescents. METHODS: This was a cross-sectional, case-control study and outpatients aged 10 to 19y were recruited from six eye clinics of various practices and locations in Japan, and 253 non-DED subjects and 70 DED patients were enrolled. Participants were examined for DED-related signs. Patients were also interviewed to ascertain the presence or absence of six common DED-related symptoms: dryness, irritation, pain, eye fatigue, blurring, and photophobia. Main outcome measures were differences in signs and symptoms of dry eye disease between boys and girls. RESULTS: Of the 323 adolescents recruited, 70 (21.7%) were diagnosed with DED. Significant differences between the non-DED and DED groups were found for short tear break-up time (BUT; </=5s; P=0.000) and superficial punctate keratopathy (SPK; staining score >/=3; P=0.000). Late adolescent girls reported fewer symptoms than late adolescent boys, although their DED-related signs were worse compared to other groups. The prevalence and severity of DED were similar in the Tokyo area compared with suburban and local areas but myopic errors were worse. CONCLUSION: We find that adolescents reported symptoms of DED similar to those found in adults, and the majority have short BUT-type DED. The prevalence and severity of DED in late adolescent girls is comparable with adults. Adolescents with DED are underserved and we believe that DED is a hidden but potentially serious health problem for this age group.

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Strengths use as a secret of happiness: Another dimension of visually impaired individuals' psychological state

Matsuguma, S., Kawashima, M., Negishi, K., Sano, F., Mimura, M. and Tsubota, K.

PLoS One (PLoS ONE) 13 ( 2 ) e0192323 2018

ISSN 1932-6203

It is well recognized that visual impairments (VI) worsen individuals' mental condition. However, little is known about the positive aspects including subjective happiness, positive emotions, and strengths. Therefore, the purpose of this study was to investigate the positive aspects of persons with VI including their subjective happiness, positive emotions, and strengths use. Positive aspects of persons with VI were measured using the Subjective Happiness Scale (SHS), the Scale of Positive and Negative Experience-Balance (SPANE-B), and the Strengths Use Scale (SUS). A cross-sectional analysis was utilized to examine personal information in a Tokyo sample (N = 44). We used a simple regression analysis and found significant relationships between the SHS or SPANE-B and SUS; on the contrary, VI-related variables were not correlated with them. A multiple regression analysis confirmed that SUS was a significant factor associated with both the SHS and SPANE-B. Strengths use might be a possible protective factor from the negative effects of VI.

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Dry eye, sleep quality, and mood status in glaucoma patients receiving prostaglandin monotherapy were comparable with those in non-glaucoma subjects

Ra, S., Ayaki, M., Yuki, K., Tsubota, K. and Negishi, K.

PLoS One (PLoS ONE) 12 ( 11 ) e0188534 2017.11

ISSN 1932-6203

PURPOSE: Prior studies suggested that glaucoma patients suffer worse dry eye and mood and sleep disorders than non-glaucoma subjects. Prostaglandin analogues are first-line therapy for glaucoma, inducing few instillation problems and sufficient pressure-reduction effects. This study compared dry eye, sleep quality, and mood status between glaucoma patients receiving prostaglandin monotherapy and non-glaucoma subjects. METHODS: This cross-sectional study evaluated 1520 patients (579 males and 941 females) for glaucoma status and dry eye-related symptoms (dryness, eye fatigue, photophobia, pain, blurring) and signs (Schirmer test, tear break-up time, corneal staining scores). Of the total cohort, 93 patients were also evaluated by Pittsburgh sleep quality index (PSQI) and hospital anxiety and depression score (HADS). Inclusion criteria were consecutive patients >/= 51 years of age and best-corrected visual acuity >/= 20/25. Glaucoma patients included those treated with prostaglandin or a fixed combination including prostaglandin. Exclusion criteria were history of ocular surgery within one month. Data were analyzed using the chi-square or Mann-Whitney U tests, at 5% significance. RESULTS: There were no significant differences in dry eye-related signs and symptoms between the control (n = 1431, mean age of 66.9 years) and glaucoma groups (n = 89, 67.9 years). The psychiatric sub-analysis of the control (n = 61, 66.2 years) and glaucoma groups (n = 32, 67.3 years) revealed mean scores of 5.02 +/- 3.10 and 5.16 +/- 3.46 for PSQI (normal range </= 5), 9.47 +/- 5.61 and 9.42 +/- 7.36 for HADS (normal range </= 10), 4.84 +/- 3.22 and 4.71 +/- 3.45 for anxiety (normal range </= 5), and 4.63 +/- 3.05 and 4.71 +/- 4.40 for depression (normal range </= 5), respectively, without statistical significance. CONCLUSIONS: Our results were comparable between glaucoma patients on prostaglandin monotherapy and non-glaucoma subjects for dry eye-related clinical manifestations, sleep quality, and mood status.

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Violet Light Transmission is Related to Myopia Progression in Adult High Myopia

Torii, H., Ohnuma, K., Kurihara, T., Tsubota, K. and Negishi, K.

Sci Rep (Scientific Reports) 7 ( 1 ) 14523 2017.11

ISSN 2045-2322

Myopia is increasing worldwide. Although the exact etiology of myopia is unknown, outdoor activity is one of the most important environmental factors for myopia control. We previously reported that violet light (VL, 360-400 nm wavelength), which is abundant in the outdoor environment, suppressed myopia progression for individuals under 20 years of age. However, whether VL is also effective for adult high myopia, which can be sight-threatening, has remained unknown. To investigate the influence of VL for adult myopia, we retrospectively compared the myopic progression and the axial length elongation over five years in adult high myopic patients over 25 years of age after two types (non-VL transmitting and VL transmitting) of phakic intraocular lens (pIOL) implantation. We found that high myopic patients with the non-VL transmitting pIOLs implanted are almost two times more myopic in the change of refraction and four times longer in the change of axial length, compared to those implanted with the VL transmitting pIOLs. This result indicated that the VL transmitting pIOL suppressed myopia progression and axial length elongation compared with the non-VL transmitting one. In conclusion, our study showed the VL possibly has an anti-myopia effect for human adults with high myopia.

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Possible association between subtypes of dry eye disease and seasonal variation

Ayaki, M., Kawashima, M., Uchino, M., Tsubota, K. and Negishi, K.

Clin Ophthalmol (Clinical Ophthalmology) 11 1769 - 1775 2017.09

ISSN 1177-5467

PURPOSE: The purpose of this study was to evaluate the influence of seasons on the signs and symptoms of dry eye disease (DED). METHODS: This is a cross-sectional, case-control study, and participants were non-DED subjects (n=1,916, mean age 54.4+/-14.4 years) and DED patients (n=684, 54.2+/-12.1 years) visiting six eye clinics at various practices and locations in Japan. We evaluated the signs and symptoms of DED and the seasons with the most severe results were compared to those with the least severe results in both groups. Main outcome measures were differences in the severity of the signs and symptoms of DED between the most and least severe seasons. RESULTS: The majority of DED symptoms were most severe during spring and least severe in summer. Significant differences between these two seasons were found for irritation (P=0.001), pain (P=0.007), blurring (P=0.000), and photophobia (P=0.007) in the DED group. Superficial punctate keratopathy (P=0.001) and tear break-up time (BUT; P=0.000) results also indicated that DED was most severe in spring. In contrast, fewer patients had low Schirmer test results in spring, although this was not statistically significant (P=0.061). CONCLUSION: Our results demonstrated that the severity of DED is seasonal, which may explain the increase of short BUT-type DED cases observed in spring when air pollen counts are highest.

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A multicenter retrospective survey of refractive surgery in 78,248 eyes

Kamiya K., Igarashi A., Hayashi K., Negishi K., Sato M., Bissen-Miyajima H.

Journal of Refractive Surgery (Journal of Refractive Surgery) 33 ( 9 ) 598 - 602 2017.09

ISSN 1081597X

Copyright © SLACK Incorporated. PURPOSE: To retrospectively evaluate the current practice, trends, and outcomes of refractive surgery in Japan. METHODS: This multicenter survey comprised 78,248 eyes of 39,727 consecutive patients who underwent refractive surgery at 45 major institutions in Japan. The corresponding ophthalmologists responded to a self-administered questionnaire. The authors especially evaluated the safety, efficacy, predictability, stability, and adverse events of LASIK and phakic intraocular lens (IOL) implantation 3 months postoperatively. RESULTS: The most common refractive surgery was LASIK (90.9%), followed by corneal inlay (5.0%), posterior chamber phakic IOL implantation (1.3%), laserassisted subepithelial keratomileusis (1.0%), refractive lens exchange (0.9%), photorefractive keratectomy (0.3%), and refractive lenticule extraction (0.2%). For subgroup analysis, 69,987 eyes (99.5%) and 67,512 eyes (95.9%) achieved corrected and uncorrected distance visual acuity of 20/20 or better, respectively, after LASIK, and 935 eyes (98.8%) and 890 eyes (94.1%), respectively, after phakic IOL implantation. There were 69,176 eyes (98.3%) and 908 eyes (96.0%) within ±1.00 diopter (D) of the attempted correction after LASIK and phakic IOL implantation, respectively. There were 1,926 eyes (2.7%) and 1 eye (0.1%) with changes in refraction of 1.00 D or less from 1 week to 3 months after LASIK and phakic IOL implantation, respectively. No vision-threatening complications occurred in any case. CONCLUSIONS: According to this survey, LASIK remains the most prevalent surgical technique in Japan. Both LASIK and phakic IOL implantation offered good safety and efficacy outcomes, yielding predictable and stable results.

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Suppression of presbyopia progression with pirenoxine eye drops: experiments on rats and non-blinded, randomized clinical trial of efficacy

Tsuneyoshi, Y., Higuchi, A., Negishi, K. and Tsubota, K.

Sci Rep (Scientific Reports) 7 ( 1 ) 6819 2017.07

ISSN 2045-2322

Various methods can correct presbyopia, but all require devices or surgeries. Recently, supplements or warming devices to relieve presbyopic symptoms have been developed, but no eye drops have been developed. We screened certain compounds possibly related to lens degeneration and identified pirenoxine, which has been used for cataracts, as a possible new pharmacologic treatment for presbyopia. We first researched the anti-presbyopic activity of pirenoxine in rats. The lens elasticity significantly (p = 0.028) increased with exposure to tobacco smoke for 12 days, and pirenoxine eye drops significantly (p < 0.001) suppressed lens hardening, which causes presbyopia in humans. In a parallel randomized controlled clinical study of the subjects in their fifth decade of life, the objective accommodative amplitude (AA) decreased significantly (p < 0.01) by 0.16 diopter (D) in the control group, and there was no detectable change in the treatment group after a 6-month treatment period, suggesting that pirenoxine eye drops might prevent progression of presbyopia. Subjects in their sixth decade of life, in whom the AA was already nearly 0 D, did not show similar results. Pirenoxine eye drops might be a new and the first pharmacologic treatment for preventing progression of presbyopia.

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Evaluation of a paper-based visual acuity questionnaire

Uchino, M., Kawashima, M., Kaido, M., Suwaki, K., Uchino, Y., Kawachi, I., Negishi, K. and Tsubota, K.

Clin Ophthalmol (Clinical Ophthalmology) 11 1213 - 1217 2017.06

ISSN 1177-5467

PURPOSE: To validate a paper-based visual acuity (PBVA) questionnaire. METHODS: In 2015, a cross-sectional survey was conducted among 301 young and middle-aged, mostly male, Japanese subjects. The participants were asked to self-rate their visual acuity (VA) on a scale from 1 to 5. Self-ratings of VA were categorized into three groups: good (1 and 2), normal (3), and poor (4 and 5). For objective validation, we performed a functional VA (FVA) assessment in the same subjects. RESULTS: A total of 301 subjects answered the PBVA and completed the FVA test including initial VA. We found out that the result of PBVA was significantly correlated with FVA test and initial VA (r=0.33, P<0.0001, r=0.273, P<0.0001). The trend test analysis between PBVA and FVA also showed statistically significant (P<0.0001). CONCLUSION: There was a significant statistical correlation between the PBVA and the FVA, as well as the initial VA. This short questionnaire on VA might be a sensitive tool that is easy to implement and utilized in large epidemiological and clinical researches.

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Tsuneyoshi Y.,Negishi K.,Tsubota K.

Am J Ophthalmol 178 - 188 2017.06

Importance of Accommodation and Eye Dominance for Measuring Objective Refractions

Tsuneyoshi, Y., Negishi, K. and Tsubota, K.

Am J Ophthalmol (American Journal of Ophthalmology) 177 69 - 76 2017.05

ISSN 1879-1891

PURPOSE: To explore factors affecting the difference between objective refractive data measured under monocular closed-field viewing and binocular open-field viewing. DESIGN: Prospective observational case series. METHODS: setting: Institutional. STUDY POPULATION: Twenty-nine healthy volunteers (58 eyes; mean age, 38.4 +/- 10.0 years; range, 25-60 years). OBSERVATION PROCEDURES: Objective monocular refractions (MR) measured with the Nidek Auto Ref/Keratometer ARK-730A; objective binocular refractions (BR) and objective accommodative amplitude (AA) measured with the Grand Seiko Auto Ref/Keratometer WAM-5500; ocular dominance measured using the hole-in-the-card test; presence and magnitude of far/near (30 cm) phoria evaluated by the cover test and alternating cover test using a prism bar. MAIN OUTCOME MEASURE: The difference between objective refractive data measured under monocular closed-field viewing and binocular open-field viewing. RESULTS: The spherical equivalent (SE) of the BR was significantly (P < .001) more hyperopic by 0.51 +/- 0.33 diopter (D) than the MR. The difference (BR minus MR) tended to decline with increasing age and decreasing AA (r = -0.231, P = .08; r = 0.223, P = .092, respectively). The correlation between age and difference in SE was significant in dominant eyes (r = -0.372, P = .047) but not in nondominant eyes (r = -0.102, P = .60). In nondominant eyes, the amount of near phoria was correlated significantly (r = 0.403, P = .03) with the difference in SE. The correlation was strong (r = 0.598, P = .01) in 17 subjects with more than 3 D of AA. CONCLUSIONS: Binocular assessment of refraction is important for precise refractive therapy.

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Comparative analysis of the visual and refractive outcomes of a refractive segmented multifocal intraocular lens with and without toricity: 1-year results

Shodai, R., Negishi, K., Arai, H., Toda, I., Torii, H. and Tsubota, K.

Jpn J Ophthalmol (Japanese Journal of Ophthalmology) 61 ( 2 ) 142 - 149 2017.03

ISSN 1613-2246

PURPOSE: To compare the visual and refractive outcomes up to 1 year postoperatively following implantation of a refractive segmented or a refractive segmented toric multifocal intraocular lens (IOL). METHODS: This retrospective study included 108 eyes of 64 patients who underwent cataract surgery with implantation of a refractive segmented multifocal IOL (Lentis Mplus LS-313 MF30 IOL) (LM group) and 81 eyes of 49 patients with implantation of a refractive segmented toric multifocal IOL (Lentis Mplus LU-313 MF30T IOL) (LMT group). The visual and refractive postoperative outcomes and the rate of additional refractive procedures were evaluated up to 1 year postoperatively. RESULTS: The uncorrected distance visual acuity (VA) and uncorrected near VA exceeded 1.0 and 0.60 in decimal VA, respectively, and both were stable postoperative groups. The postoperative subjective refractive astigmatism was also stable and the postoperative refraction was near emmetropia in both groups. No significant differences were found in the need for additional surgical refractive procedures. CONCLUSION: The outcomes with a refractive segmented toric multifocal IOL were comparable to those with a non-toric model despite higher preoperative corneal astigmatism.

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A Multicenter Prospective Cohort Study on Refractive Surgery in 15 011 Eyes

Kamiya, K., Igarashi, A., Hayashi, K., Negishi, K., Sato, M. and Bissen-Miyajima, H.

Am J Ophthalmol (American Journal of Ophthalmology) 175 159 - 168 2017.03

ISSN 1879-1891

PURPOSE: To assess the clinical outcomes of currently used refractive surgery procedures performed in 2015. DESIGN: Prospective, multicenter cohort study. METHODS: This prospective study included 15 011 eyes of 7622 consecutive patients who underwent laser in situ keratomileusis (LASIK), surface ablation, refractive lenticule extraction (ReLEx), or phakic intraocular lens (IOL) implantation at 42 major institutions. We determined the safety, efficacy, predictability, stability, and adverse events of these surgeries preoperatively and at 1 week and 1 and 3 months postoperatively. RESULTS: Mean logMAR corrected distance visual acuity 3 months after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, or iris-supported phakic IOL implantation was -0.18 +/- 0.07, -0.16 +/- 0.08, -0.17 +/- 0.09, -0.21 +/- 0.08, and -0.10 +/- 0.12, respectively; the corresponding values for logMAR uncorrected distance visual acuity were -0.15 +/- 0.11, -0.12 +/- 0.12, -0.12 +/- 0.13, -0.15 +/- 0.12, and 0.01 +/- 0.21, respectively. The percentages within +/-1.0 diopter (D) of the attempted correction were 96%, 93%, 97%, 99%, and 84% after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, and iris-supported phakic IOL implantation, respectively. Refractive change from 1 week to 3 months was -0.08 +/- 0.07, 0.21 +/- 0.63, -0.04 +/- 0.41, 0.01 +/- 0.31, and 0.01 +/- 0.46 D, respectively. No vision-threatening complications occurred during the observation period. CONCLUSIONS: Although more prolonged follow-up is still necessary, currently used refractive surgery procedures have good safety and efficacy outcomes, yielding predictable and stable results. Contemporary LASIK, surface ablation, ReLEx, and phakic IOL implantation appear to be feasible options for the treatment of refractive errors.

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Violet Light Exposure Can Be a Preventive Strategy Against Myopia Progression

Torii, H., Kurihara, T., Seko, Y., Negishi, K., Ohnuma, K., Inaba, T., Kawashima, M., Jiang, X., Kondo, S., Miyauchi, M., Miwa, Y., Katada, Y., Mori, K., Kato, K., Tsubota, K., Goto, H., Oda, M. and Hatori, M.

EBioMedicine (EBioMedicine) 15 210 - 219 2017.02

ISSN 2352-3964

Prevalence of myopia is increasing worldwide. Outdoor activity is one of the most important environmental factors for myopia control. Here we show that violet light (VL, 360-400nm wavelength) suppresses myopia progression. First, we confirmed that VL suppressed the axial length (AL) elongation in the chick myopia model. Expression microarray analyses revealed that myopia suppressive gene EGR1 was upregulated by VL exposure. VL exposure induced significantly higher upregulation of EGR1 in chick chorioretinal tissues than blue light under the same conditions. Next, we conducted clinical research retrospectively to compare the AL elongation among myopic children who wore eyeglasses (VL blocked) and two types of contact lenses (partially VL blocked and VL transmitting). The data showed the VL transmitting contact lenses suppressed myopia progression most. These results suggest that VL is one of the important outdoor environmental factors for myopia control. Since VL is apt to be excluded from our modern society due to the excessive UV protection, VL exposure can be a preventive strategy against myopia progression.

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The large-scale integration built in tablet screen for blue light reduction under optimized color and contrast;the effects on sleep and ocular parameters

Ayaki M.,Hattori A.,Maruyama Y.,Tsubota K.,Negishi K.

Cogent Biol 3 ( 1 ) 1294550 2017

Sleep and mood disorders in women with dry eye disease

Ayaki, M., Kawashima, M., Negishi, K., Kishimoto, T., Mimura, M. and Tsubota, K.

Sci Rep (Scientific Reports) 6 35276 2016.10

ISSN 2045-2322

The aim of the present study was to evaluate sleep and mood disorders in women aged 30-69 with dry eye disease (DED). All subjects underwent corneal examinations, with 890 completing a questionnaire regarding symptoms of DED and 213 completing both the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) questionnaires. Subjects were then divided into three groups based on age (younger [30-45 years], perimenopausal [46-55 years], and older [56-69 years]), and comparisons were made among groups in subjects with and without DED. PSQI scores were significantly worse in subjects with (6.1 +/- 2.9) than without (4.9 +/- 2.7) DED (P = 0.003) and, in the younger group, HADS scores were worse in those with (13.2 +/- 6.0) than without DED (9.7 +/- 6.0) (P = 0.020). In contrast, there were no differences in mood indices between those with and without DED in the other groups. PSQI score was significantly correlated with HADS rather than ocular findings. In conclusion, sleep quality had deteriorated in women with DED. However, mood problems contributed more to sleep quality than ocular status, especially in those with DED in the younger group.

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Decreased sleep quality in high myopia children

Ayaki, M., Torii, H., Tsubota, K. and Negishi, K.

Sci Rep (Scientific Reports) 6 33902 2016.09

ISSN 2045-2322

The aim of the present study was to evaluate sleep quality in myopic children and adults. This cross sectional study surveyed 486 participants aged from 10 to 59 years with refractive errors using a questionnaire containing the Pittsburgh Sleep Quality Index (PSQI) and Hospital Anxiety and Depression Scale (HADS). Children (< 20 years) in the high myopia group exhibited the poorest PSQI scores (P < 0.01), while the adults showed no such correlations. Subscales of PSQI and HADS in children disclosed that the high myopia groups had the shortest sleep duration (P < 0.01), worst subjective sleep scores (P < 0.001), and latest bedtime (P < 0.05). Regression analyses in children significantly correlated myopic errors with PSQI (P < 0.05), sleep duration (P < 0.01), and bedtime (P < 0.01). Sleep efficacy (P < 0.05) and daytime dysfunction (P < 0.05) were significantly better in contact-lens users compared to the respective non-user groups across all participants. In conclusion, sleep quality in children was significantly correlated with myopic error, with the high myopia group worst affected.

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