Japanese Journal of Ophthalmology

To study the characteristics of patients with advanced open-angle glaucoma. A hospital-based retrospective study was performed. Advanced glaucoma was defined as visual acuity of 0.3 or less, or mean deviation of −24 dB or less. First, we screened patients with advanced glaucoma and classified their glaucoma types. For patients with open-angle glaucoma (OAG), including both primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG), disc types were classified into four groups: focal ischemic (FI), myopic glaucomatous (MY), senile sclerotic (SS), and generalized cup enlargement (GE). After checking the medical history of 750 glaucoma patients, we classified 141 (18.8%) as having the advanced stage of the disease. The proportion of patients with advanced OAG was 47% (28% POAG, 19% NTG). The classification of optic disc appearances in OAG patients showed that in patients with POAG the predominant disc type was GE (P = 0.0012) and in those with NTG it was MY (P < 0.0001). In OAG patients in this study with severe glaucomatous damage, the predominant disc phenotype was GE in patients with POAG and MY in those with NTG.

To evaluate the clinical findings of different types of Duane retraction syndrome (DRS). Retrospective. This study was performed on 691 patients with DRS who underwent surgery. Clinical examinations included laterality, abnormal head posture (AHP), corrected distance visual acuity (CDVA), refractive error, amblyopia, deviation, overshoots, and type of surgery. The mean age of patients with DRS was 16.7 ± 12.5 (range 1.0–73) years. The patients included 396 (57.3%) women and 295 (42.7%) men (P < 0.001). DRS type I, was observed in 429 (62.1%), II in 168 (24.3%), III in 88 (12.7%) and IV in 6 (0.9%) patients. Unilateral DRS was observed OS in 628 (90.9%) [471 (%78.9) and OD in 157 (21.1%) eyes (P < 0.001)]. O ther clinical findings were AHP (n = 522, 78.1%), overshoot (n = 236, 34.2%) and amblyopia (n = 118, 17.1%). The prevalence of overshoot in types I, II, and III was 17.5% (75/429), 60.7% (102/168) and 64.8% (57/88), respectively (P < 0.001). The prevalence of amblyopia was significantly lower in patients with AHP (80/522, 15.3%) compared to patients with normal head posture (38/169, 22.5%) (P = 0.023). The mean angle of deviation in the primary position (PP) at distance was 21.7 ± 11.5 △ for esotropic group and 17.8 ± 12.4 △ for exotropic group. Sixty-two (9.0%) patients required second surgery for resolving residual misalignment (1.1 surgeries for each patient). About two-thirds of DRS patients had AHP, one-third had overshoots, and one-sixth had amblyopia. The results show that different types of DRS are associated with different epidemiological and clinical characteristics.