研究者詳細 - 森澤　伸

論文 - 森澤　伸

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Relationships among eye dimensions in magnetic resonance images by sex, age, and strabismus type in Japanese patients with acquired strabismus and high myopia.

Reika Kono, Ichiro Hamasaki, Fumiko Kishimoto, Takehiro Shimizu, Hiroya Kindo, Kiyo Shibata, Shin Morisawa, Yuki Morizane

Japanese journal of ophthalmology 68 ( 6 ) 641 - 650 2024年11月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To investigate the relationships among eye dimensions in magnetic resonance imaging (MRI) scans by sex, age, and strabismus type in Japanese patients with acquired strabismus and high myopia. STUDY DESIGN: Retrospective clinical case series. METHODS: We included 58 eyes of 29 patients with acquired strabismus and high myopia (mean age ± standard deviation: 60.2 ± 14.7 years, axial length [AL]: 28.69 ± 2.12 mm). For all eyes, the equatorial diameter of the globe/AL ratio (EAR) and the globe/orbit volume ratio (GOR) were measured using MRI. EAR and GOR values were compared between the following groups: 9 men vs. 20 women; 8 younger (< 56 years) vs. 21 older (≥ 56 years) patients; and non-esotropia strabismus (NES: 7 patients) vs. esotropia (ET: 13 patients) vs. restrictive strabismus (RS: 9 patients) groups. RESULTS: Female patients had a smaller EAR (0.87 ± 0.07) and larger GOR (0.38 ± 0.04) than male patients (0.92 ± 0.05 and 0.35 ± 0.03, both P < 0.01). Older patients had a smaller EAR (0.87 ± 0.07) than younger ones (0.93 ± 0.04, P < 0.01), without significant differences in GOR. EAR (NES: 0.92 ± 0.06, ET: 0.86 ± 0.06, RS: 0.89 ± 0.09) significantly differed among the three strabismus groups (P = 0.02: post-hoc test: NES vs. ET, P = 0.02; NES vs. RS, P = 0.49; RS vs. ET, P = 0.67), but no significant differences in GOR were found (P = 0.12). CONCLUSIONS: Among patients with acquired strabismus and high myopia, women, older patients, and those with esotropia exhibit a smaller EAR and longer sphere shape with AL as the major axis. The parameter EAR might be useful for evaluating the pathogenesis of strabismus associated with high myopia.

DOI： 10.1007/s10384-024-01133-8

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Analysis of temporal changes in thickness from conjunctiva to sclera after plication of the medial rectus muscle measured by anterior segment optical coherence tomography.

Takehiro Shimizu, Ichiro Hamasaki, Kiyo Shibata, Shin Morisawa, Reika Kono, Keisuke Kanenaga, Yuki Morizane

Japanese journal of ophthalmology 67 ( 5 ) 612 - 617 2023年9月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: We evaluated long-term changes in conjunctival bulge after medial rectus muscle (MR) tightening using the plication method. STUDY DESIGN: Retrospective and observational. METHODS: Patients who underwent MR plication for exotropia from December 2016-March 2020 at Okayama University Hospital were included. Thirty two eyes of 27 patients were enrolled. The thickness from the conjunctiva to sclera (TCS) at the limbus and insertion sites were measured using anterior segment optical coherence tomography preoperatively and 1 month, 4 months, and 12 months postoperatively. Correlations between the 1- and 12 month postoperative TCS and amount of MR tightening were analyzed. RESULTS: Preoperative and 4 month postoperative TCS at the limbus site were not significantly different (P=0.07). The 12 month postoperative TCS at the insertion site was significantly thinner than at 1 month postoperative (P<0.01), although significantly thicker than the preoperative TCS (P<0.01). No significant correlations were found between the amount of MR tightening (in mm) and 1- or 12 month postoperative TCS at the limbus (P=0.62 and P=0.98, respectively) and insertion (P=0.50 and P=0.24, respectively) sites. CONCLUSION: The TCS at the insertion site peaked at 1 month postoperatively, continued to decrease for longer than 4 months postoperatively, continuing until 12 months postoperatively. The TCS at the insertion site 12 months postoperatively is thicker than preoperatively. The TCS at both the limbus and insertion sites was not related to the amount of medial rectus muscle tightening.

DOI： 10.1007/s10384-023-01006-6

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Double-under muscle transposition: an effective surgical option for large-angle paralytic strabismus. 国際誌

Takashi Furuse, Shin Morisawa, Rie Kobashi, Hiroshi Ohtsuki, Satoshi Hasebe

Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus 25 ( 4 ) 209.e1-209.e6 2021年8月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To describe our surgical outcomes using a novel muscle transposition procedure, or double-under muscle transposition (DUT), in the treatment of paralytic strabismus. METHODS: In this surgery, the split halves of the superior and inferior rectus muscles opposite the paralyzed muscle are disinserted, crossed under both the remaining half and the paralyzed muscle, and anchored at opposite corners of the insertion of the paralyzed muscle. The medical records of consecutive patients who underwent DUT were retrospectively reviewed. Outcome measures were angle of deviation and duction deficit. RESULTS: Seven patients were included. Diagnoses included WEBINO (n = 1), rupture of the medial rectus muscle (n = 1), and abducens nerve palsy (n = 5). DUT alone was performed in 3 patients; DUT combined with antagonist muscle recession, in 4 patients. One patient underwent the surgery bilaterally. Mean follow-up was 17 ± 18+ months (range, 7-57). Preoperative angles of distance deviation ranged from 25Δ to 142Δ in magnitude. All except a single patient had duction limitation of grade -5. The mean change in distance deviation for DUT alone for each operated eye was 60Δ ± 6Δ (53Δ-65Δ); for combined surgery, 69Δ ± 23Δ (range, 52Δ-103Δ). Final mean angle of deviation at distance was +2Δ ± 3Δ (-4Δ to 0Δ), although an additional surgery was required for large overcorrections in 2 patients. Duction limitation improved in all patients. One patient experienced a postoperative vertical deviation. CONCLUSIONS: DUT may be an alternative for patients with severely paralytic strabismus not likely to resolve with previously reported muscle transposition surgeries. Overcorrection may occur in some cases.

DOI： 10.1016/j.jaapos.2021.02.012

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Adverse reactions to 1% cyclopentolate eye drops in children: an analysis using logistic regression models. 国際誌

Toshihiro Imai, Satoshi Hasebe, Takashi Furuse, Shin Morisawa, Kayoko Hasebe, Yuka Nagata, Tomoki Tokutake, Yumiko Moriyama

Ophthalmic & physiological optics : the journal of the British College of Ophthalmic Opticians (Optometrists) 41 ( 2 ) 424 - 430 2021年3月

記述言語：英語掲載種別：研究論文（学術雑誌）

PURPOSE: To determine the frequency, symptoms and risk factors for adverse reactions to two-times instillation of 1% cyclopentolate in children. STUDY DESIGN: Prospective, observational study. METHODS: The subjects were 646 patients who underwent cycloplegic refraction with cyclopentolate (mean age; 7.0 ± 3.5 years, age range; 0-15 years). Five minutes after instillation of 0.4% oxybuprocaine hydrochloride, a 1% cyclopentolate eye drop was instilled twice, with an interval of 10 min. Fifty minutes later, two certified orthoptists evaluated adverse reactions using a questionnaire and interviewed the patients' guardians. The relationship between the adverse reaction rates and age, gender, additional instillation, complications of the central nervous system (CNS), time of day and season were analysed using binominal and polytomous logistic regression models. RESULTS: The overall frequency of adverse reactions was 18.3% (118/646 patients). The main symptoms included conjunctival injection (10.5%, 68/646), drowsiness (6.8%, 44/646) and facial flush (2.2%, 14/646). The odds ratio (OR) of conjunctival injection increased with patient's age (p < 0.05), in boys (p < 0.01) and in winter (p < 0.001). In contrast, the OR of drowsiness decreased with age (p < 0.001). Facial flush was observed mostly in children younger than 4 years. CNS complications were not a significant risk factor for any of the symptoms. CONCLUSIONS: Adverse reactions to 1% cyclopentolate eye drops were more frequent than previously expected, but all were mild and transient. The probability of each symptom was associated with a clear age-specific trend.

DOI： 10.1111/opo.12773

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Risk factors for excessive postoperative exo-drift after unilateral lateral rectus muscle recession and medial rectus muscle resection for intermittent exotropia. 国際誌

Shin Morisawa, Ichiro Hamasaki, Kiyo Shibata, Takehiro Shimizu, Reika Kono, Manabu Miyata, Takashi Furuse, Satoshi Hasebe, Hiroshi Ohtsuki, Yuki Morizane, Fumio Shiraga

BMC ophthalmology 20 ( 1 ) 216 - 216 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

BACKGROUND: To detect significant factors associated with excessive postoperative exo-drift in young patients with intermittent exotropia who had undergone unilateral lateral rectus muscle recession and medial rectus muscle resection. METHODS: We retrospectively examined the records of 64 consecutive patients < 18 years old who underwent surgery between April 2004 and December 2011. We sought risk factors for excessive postoperative exo-drift among patients' demographic and clinical characteristics using univariate and multivariable linear regression analysis. RESULTS: Younger patients (P = 0.007), and those with larger preoperative exo-deviation at distance (P = 0.033), a lower incidence of peripheral fusion at distance (P = 0.021) or a greater postoperative initial eso-deviation (P = 0.001), were significantly more likely to have an excessive postoperative exo-drift (> 20 prism diopters). Univariate analysis revealed significant associations between excessive postoperative exo-drift and age at surgery (P = 0.004), preoperative exo-deviation at distance (P = 0.017) and postoperative initial eso-deviation at distance (P < 0.001). Multivariable linear regression analysis showed that postoperative initial eso-deviation at distance (P = 0.008) was significantly associated with postoperative exo-drift. CONCLUSIONS: Postoperative exodrift in unilateral RR is predicted by the initial postoperative eso-deviation, which may offset the overcorrection. However, the exo-drift is greater in cases with a large preoperative exo-deviation and/or at a younger age, and should be followed carefully.

DOI： 10.1186/s12886-020-01484-z

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Formulas to Estimate Appropriate Surgical Amounts of Unilateral Recession-Resection in Intermittent Exotropia with Distance-Near Disparity.

Kiyo Shibata, Ichiro Hamasaki, Shinji Toshima, Takehiro Shimizu, Reika Kono, Manabu Miyata, Shin Morisawa, Takashi Furuse, Satoshi Hasebe, Hiroshi Ohtsuki, Yuki Morizane, Fumio Shiraga

Acta medica Okayama 74 ( 3 ) 229 - 236 2020年6月

記述言語：英語掲載種別：研究論文（学術雑誌）

The purpose of this study was to derive new formulas to provide an optimal surgical procedure and optimal amount of recession-resection (RR) surgery in intermittent exotropia (IXT) with a disparity in angle of deviation depending on the fixation distance. The records of 117 consecutive patients with IXT who underwent RR surgery between March 2008 and December 2011 at Okayama University Hospital were retrospectively examined. Multivariable linear regression analysis was performed using the observed corrective angle of deviation at distance or near fixation as the dependent variable, and amounts of lateral rectus muscle (LR) recession (mm) and medial rectus muscle (MR) resection, and age at surgery (years) as independent variables. Two simultaneous formulas were derived: corrective angle of deviation at distance fixation (°)=1.8×recession (mm)+1.6× resection (mm)+0.15×age (years)-6.6, and corrective angle at near fixation (°)=1.5×recession (mm)+1.7× resection (mm)+0.18×age (years)-3.8. Comparisons of coefficient values of the formulas between distance and near fixation revealed that LR recession was more affected by the corrective angle in distance than near fixation. MR resection was more affected at near than distance fixation. We found that our new formulas estimated the appropriate amount of unilateral RR surgery.

DOI： 10.18926/AMO/59956

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片眼内直筋後転術のParks量定からの逸脱片眼外直筋後転術との比較

森澤伸, 古瀬尚, 小橋理栄, 長谷部聡

眼科臨床紀要 12 ( 7 ) 571 - 572 2019年7月

Hummelsheim変法により再建可能であった外傷性内直筋断裂の1例

森澤伸, 小橋理栄, 古瀬尚, 長谷部聡

あたらしい眼科 36 ( 6 ) 826 - 829 2019年6月

記述言語：日本語出版者・発行元：(株)メディカル葵出版

目的:新しく考案されたHummelsheim変法により再建可能であった外傷性内直筋完全断裂の一症例を報告する。方法:症例は1歳、女子。外傷による左眼内直筋断裂で、術前、遠見60Δの外斜視とGrade 5の内転制限がみられた。上・下直筋の耳側1/2を分離、付着部より切離したうえで、鼻側1/2の下をくぐらせ、さらに反対側の内直筋付着部端に吊り下げ法にて通糸、移動した筋が水平経線上で互いに接する位置まで前転させ結紮した。結果:術後は著明な眼位改善が得られ、最終検査時(術後4年)には、眼鏡による遠視矯正下で遠見眼位は正位、内転制限は完治した。遠近とも両眼単一視がみられた。結論:Hummelsheim変法は単独手術として、矯正効果が強く、張り合い筋の後転を併用することがむずかしい筋断裂を原因とする大角度の麻痺性斜視に有効な術式である。(著者抄録)

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その他リンク： https://search-tp.jamas.or.jp/index.php?module=Default&action=Link&pub_year=2019&ichushi_jid=J01784&link_issn=&doc_id=20190703250025&doc_link_id=%2Fah9atgke%2F2019%2F003606%2F024%2F0826-0829%26dl%3D0&url=https%3A%2F%2Fwww.medicalonline.jp%2Fjamas.php%3FGoodsID%3D%2Fah9atgke%2F2019%2F003606%2F024%2F0826-0829%26dl%3D0&type=MedicalOnline&icon=https%3A%2F%2Fjk04.jamas.or.jp%2Ficon%2F00004_2.gif

Effect of 0.01% atropine ophthalmic solution on the lag of accommodation

Eizo Tanaka, Tomoki Tokutake, Shin Morisawa, Rie Kobashi, Takashi Furuse, Satoshi Hasebe

Japanese Journal of Clinical Ophthalmology 73 ( 3 ) 279 - 284 2019年3月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Igaku-Shoin Ltd

Purpose : To report the effect of 0.01% atropine ophthalmic solution on the lag of accommodation and to evaluate the safety as a preventive treatment of myopia progression. Method • This study was made on 9 persons aged from 18 to 22 years. They showed no eye disease except minor refractive errors. The state of accommodation was measured with the target located 33 or 20 cm in front of the eye before and one, 6, and 24 hours after instillation of 0.01% atropine using an open-field autorefractometer. Results • The mean ( ± SE) kg of accommodation for the 33 and 20 cm target was 0.68 ± 0.10D and 1.03 ± 0.18D, respectively, and maintained throughout the follow-up period. Simultaneous measurements of near point of accommodation and pupillary diameter showed significant fluctuations as reported in previous studies. Conclusion Instillation of 0.01 % atropine does not influence the accuracy of accommodation at least at the viewing distance of 20 cm. Clear vision is expected with the wear of single-vision-lens spectacles.

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Plication法を用いた短縮術と筋切除術を施行した外斜視の術後1年成績と戻りの比較

柴田貴世, 濱崎一郎, 清水壯洋, 河野玲華, 森澤伸, 古瀬尚, 長谷部聡, 大月洋, 森實祐基, 白神史雄

日本眼科学会雑誌 123 ( 臨増 ) 233 - 233 2019年3月

Differences in the Stability and Amount of Postoperative Exodrift with Age after Unilateral Lateral Rectus Muscle Recession and Medial Rectus Muscle Resection of Intermittent Exotropia.

Ichiro Hamasaki, Kiyo Shibata, Takehiro Shimizu, Shin Morisawa, Shinji Toshima, Manabu Miyata, Takashi Furuse, Satoshi Hasebe, Hiroshi Ohtsuki, Yuki Morizane, Fumio Shiraga

Acta medica Okayama 72 ( 5 ) 487 - 492 2018年10月

記述言語：英語掲載種別：研究論文（学術雑誌）

We investigated variances in the stability and amount of postoperative exodrift among age groups of intermittent exotropia (XPT) patients who underwent unilateral lateral rectus muscle recession and medial rectus muscle resection. We analyzed the cases of 110 consecutive patients who underwent the surgery in 2004-2011, dividing the patients into groups by their age at surgery: <10, 10-19, and ≥20 years. We performed a regression analysis (dependent variable: postoperative exodrift (°); independent variable: number of days post-surgery) using the formula of curve lines. When the tangent line slope was = 0.01 (°/days) for each group, we defined the numbers of days until alignment became stable as the 'stable days.' We evaluated the between-group differences in the amount of exodrift calculated for the stable days. The coefficients and coefficients of determination for the fitting curves were: <10 year group: f(x)=12.2 (1-e-0.0183x) (r2=0.588, p<0.05); 10-19 year group: f(x)=10.0 (1-e-0.0178x) (r2=0.453, p<0.05); ≥20 year group: f(x)=3.40 (1-e-0.0382x) (r2=0.217, p<0.05). There were 389 , 388, and 153 stable days, and the estimated postoperative exodrift with long-term follow-up was 11.5±3.7°, 9.3±4.4°, and 4.1±3.6° for the < 10 year, 10-19 year, and ≥ 20 year groups, respectively (≥20 year vs. other 2 groups, p<0.05). Longer periods and more postoperative exodrift were associated with younger age at surgery. The postoperative evaluation was approx. ≥ 1 year post-surgery in patients aged < 20. These findings may contribute to evaluating XPT's success rate and prognoses.

DOI： 10.18926/AMO/56246

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A new small-incision strabismus surgery by using conjunctival tassel method

Kiyo Shibata, Ichiro Hamasaki, Takehiro Shimizu, Shin Morisawa, Takashi Furuse, Satoshi Hasebe, Hiroshi Ohtsuki, Fumio Shiraga

Japanese Journal of Clinical Ophthalmology 71 ( 10 ) 1519 - 1525 2017年10月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Igaku-Shoin Ltd

Purpose: To describe and evaluate our new method of conjunctival incision for strabismus surgery. Method i According to this tassel method, the conjunctiva is incised longitudinally over the rectus muscle. The surgical field is bared by fixating the conjunctiva and the Tenon capsule to the lid opener by means of a suture. This method was applied to a case operated for strabismus and was compared to another case who received surgery by incision along and perpendicular to the corneal limbus. Result ' The tassel method produced the same area for surgery as the conventional incision. Surgery was performed in shorter duration, resulted in smaller scar with better cosmetic appearance, and less pain after surgery. Conclusion: The tassel provided enough surgical field and resulted in better cosmetic outcome. It is expected to be useful in strabismus surgery needing no special instrument or surgical skill.

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WEBINO症候群に対する筋移動術の2症例

森澤伸, 小橋理栄, 古瀬尚, 長谷部聡, 大月洋

眼科臨床紀要 10 ( 4 ) 338 - 339 2017年4月

A case of abducens palsy due to metastasis of rectal cancer to the brain

Rie Kobashi, Satoshi Hasebe, Takashi Furuse, Shin Morisawa, Hiroshi Ohtsuki

Japanese Journal of Clinical Ophthalmology 71 ( 3 ) 349 - 355 2017年3月

記述言語：日本語掲載種別：研究論文（学術雑誌）出版者・発行元：Igaku-Shoin Ltd

Objective: Report of a rapidly progressing case of distant metastasis of rectal cancer to the cavernous sinus causing abducens nerve palsy. Case: The patient was a 41-year-old woman who presented to our department with diplopia. She was found to have right abducens nerve palsy, which progressed to bilateral abduces nerve paralysis over a period of about 3 months, resulting in fatal outcome in 10 months. She had a history of colorectal cancer, and we suspected distant metastases to the brain from the initial consultation. However, initial noncontrast MRI revealed no obvious abnormalities, and she did not develop paralysis involving other eyemovement nerves. Therefore, we could not diagnose distant metastasis of the tumor to the cavernous sinus until its expansion and progression. Conclusion: It is diagnostically imperative to perform contrast-enhanced MRI when distant metastasis is suspected.

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間欠性外斜視の前後転術後の戻りの大きさに関係する因子の調査

森澤伸, 濱崎一郎, 戸島慎二, 宮田学, 古瀬尚, 長谷部聡, 大月洋, 白神史雄

日本眼科学会雑誌 119 ( 臨増 ) 290 - 290 2015年3月

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