Faculty Profiles - MORIZANE Yuki

Papers - MORIZANE Yuki

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裂孔原性網膜剥離眼の網膜感度と術前剥離の有無および術後網膜外層構造との関連

野田拓志, 木村修平, 森實祐基, 細川海音, 塩出雄亮, 土居真一郎, 高橋耕介, 的場亮, 神崎勇希, 藤原篤之, 白神史雄

眼科臨床紀要 13 ( 10 ) 679 - 679 2020.10

【疫学研究のアップデート】わかりやすい臨床講座視覚障害の原因疾患の推移

的場亮, 森實祐基

日本の眼科 91 ( 10 ) 1386 - 1390 2020.10

Language：Japanese Publisher：(公社)日本眼科医会

視覚障害は生活の質を著しく低下させ、社会生活の維持にも大きな影響を及ぼす。日本では、厚生労働省が新規視覚障害認定数の全国調査を毎年実施している。しかし、年齢、原因疾患については調査されていない。そこで、これらの項目の実態を把握することを目的として、われわれ(厚生労働省難治性疾患等政策研究事業、網膜脈絡膜・視神経萎縮症に関する調査研究班)は全都道府県の全自治体を対象にした視覚障害の実態調査を2015年度に行った。本稿ではこの調査結果について概説すると共に、わが国の視覚障害の原因疾患の推移について考察する。(著者抄録)

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【定着するのか!?最新の術式】黄斑円孔・分層黄斑円孔・黄斑前膜

的場亮, 森實祐基

Retina Medicine 9 ( 2 ) 118 - 123 2020.10

Language：Japanese Publisher：(株)先端医学社

黄斑円孔、分層黄斑円孔、黄斑前膜に対して近年さまざまな術式が考案されている。難治性黄斑円孔に対しては内境界膜や水晶体嚢、自家感覚網膜を活用する術式が考案され、分層黄斑円孔に対しては病態に応じて術式を使い分けることの重要性が提唱されている。黄斑前膜に対しては、内境界膜を剥離することの是非について議論がつづいている。各術式の長所と短所を理解したうえで術式を選択する必要がある。(著者抄録)

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Real-world management of treatment-naïve diabetic macular oedema in Japan: two-year visual outcomes with and without anti-VEGF therapy in the STREAT-DME study. International journal

Masahiko Shimura, Shigehiko Kitano, Daisuke Muramatsu, Harumi Fukushima, Yoshihiro Takamura, Makiko Matsumoto, Masahide Kokado, Jiro Kogo, Mariko Sasaki, Yuki Morizane, Osamu Kotake, Takashi Koto, Shozo Sonoda, Takao Hirano, Hiroto Ishikawa, Yoshinori Mitamura, Fumiki Okamoto, Takamasa Kinoshita, Kazuhiro Kimura, Masahiko Sugimoto, Kenji Yamashiro, Yukihiko Suzuki, Taiichi Hikichi, Noriaki Washio, Tomohito Sato, Kishiko Ohkoshi, Hiroki Tsujinaka, Sentaro Kusuhara, Mineo Kondo, Hitoshi Takagi, Toshinori Murata, Taiji Sakamoto

The British journal of ophthalmology 104 ( 9 ) 1209 - 1215 2020.9

Language：English Publishing type：Research paper (scientific journal)

BACKGROUND/AIMS: To investigate real-world outcomes for best-corrected visual acuity (BCVA) after 2-year clinical intervention for treatment-naïve, centr-involving diabetic macular oedema (DME). METHODS: Retrospective analysis of longitudinal medical records obtained from 27 institutions specialising in retinal diseases in Japan. A total of 2049 eyes with treatment-naïve DME commencing intervention between 2010 and 2015 who were followed for 2 years were eligible. Interventions for DME included anti-vascular endothelial growth factor (VEGF) therapy, local corticosteroid therapy, macular photocoagulation and vitrectomy. Baseline and final BCVA (logMAR) were assessed. Eyes were classified by the treatment pattern, depending on whether anti-VEGF therapy was used, into an anti-VEGF monotherapy group (group A), a combination therapy group (group B) and a group without anti-VEGF therapy (group C). RESULTS: The mean 2-year improvement of BCVA was -0.04±0.40 and final BCVA of >20/40 was obtained in 46.3% of eyes. Based on the treatment pattern, there were 427 eyes (20.9%) in group A, 807 eyes (39.4%) in group B and 815 eyes (39.8%) in group C. Mean improvement of BCVA was -0.09±0.39, -0.02±0.40 and -0.05±0.39, and the percentage of eyes with final BCVA of >20/40 was 49.4%, 38.9%, and 52.0%, respectively. CONCLUSION: Following 2-year real-world management of treatment-naïve DME in Japan, BCVA improved by 2 letters. Eyes treated by anti-VEGF monotherapy showed a better visual prognosis than eyes receiving combination therapy. Despite treatment for DME being selected by specialists in consideration of medical and social factors, a satisfactory visual prognosis was not obtained, but final BCVA remained >20/40 in half of all eyes.

DOI： 10.1136/bjophthalmol-2019-315199

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Inverted Internal Limiting Membrane Flap versus Internal Limiting Membrane Peeling for Macular Hole Retinal Detachment in High Myopia. International journal

Hiroshi Matsumae, Yuki Morizane, Shin Yamane, Shuichiro Yanagisawa, Toshiya Sakurai, Akira Kobori, Hisanori Imai, Yuki Kanzaki, Etsuji Suzuki, Kazuaki Kadonosono, Atsushi Hayashi, Fumio Shiraga, Shoji Kuriyama

Ophthalmology. Retina 4 ( 9 ) 919 - 926 2020.9

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To compare surgical outcomes between the inverted internal limiting membrane (ILM) flap technique and ILM peeling for macular hole retinal detachment (MHRD) in eyes with high myopia. DESIGN: Multicenter cohort study. PARTICIPANTS: We retrospectively reviewed medical records of consecutive patients treated between June 2008 and September 2018 at 7 hospitals and included 100 eyes with MHRD associated with high myopia in our study. All eyes underwent vitrectomy with the inverted ILM flap technique (57 eyes) or ILM peeling (43 eyes) and were followed up for more than 6 months. METHODS: We estimated odds ratios and their 95% confidence intervals (CIs) for macular hole (MH) closure using multivariate logistic regression analysis. We also examined factors associated with the postoperative best-corrected visual acuity (BCVA) at the final visit using multiple linear regression analysis. MAIN OUTCOME MEASURES: Macular hole closure and postoperative BCVA at the final visit. RESULTS: The MH closure rate was significantly higher in the inverted ILM flap group (80.7%) than in the ILM peeling group (37.2%; P < 0.001). Moreover, postoperative BCVA at the final visit was significantly better in the former group (0.88 ± 0.48 vs. 0.99 ± 0.48; P = 0.03). The retinal attachment rate (ILM flap, 91.2%; ILM peeling, 79.5%; P = 0.229) and recovery rates for the external limiting membrane and ellipsoid zone line (ILM flap, 10.9%; ILM peeling, 0%; P = 0.12) showed no significant intergroup differences. After adjustment for age, axis, tamponade substance, and dye for ILM staining, the inverted ILM flap technique was associated strongly and positively with MH closure (odds ratio, 7.14; 95% CI, 2.72-18.7; P = 0.001). Moreover, the inverted ILM flap technique and preoperative BCVA were associated significantly and positively with the postoperative BCVA at the final visit. CONCLUSIONS: Our findings suggest that the MH closure rate and postoperative visual outcome for eyes with high myopia-associated MHRD are better with the inverted ILM flap technique than with ILM peeling. Thus, vitrectomy with the inverted ILM flap technique should be considered as the initial surgery for MHRD associated with high myopia.

DOI： 10.1016/j.oret.2020.03.021

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視覚障害認定の全国調査結果の都道府県別検討

森實祐基, 守本典子, 川崎良, 藤原篤之, 的場亮, 山下英俊, 小椋祐一郎, 白神史雄

日本眼科学会雑誌 124 ( 9 ) 697 - 704 2020.9

Language：Japanese Publisher：(公財)日本眼科学会

目的:視覚障害認定の全国調査結果を都道府県別に検討する.対象と方法:2015年度の視覚障害の新規認定の全国調査のデータを用いて,人口10万人あたりの認定者数(認定者割合)と原因疾患を都道府県別に検討した.また,総人口に占める65歳以上の割合(高齢化率),人口10万人あたりの身体障害者福祉法第15条指定医師である眼科医数(指定医師割合),人口10万人あたりの眼科専門医数(専門医割合),県民1人あたりの所得(県民所得),社会福祉費,老人福祉費と認定者割合との関連,および高齢化率と主要な原因疾患による認定者割合との関連について,線形回帰分析を行った.結果:都道府県別の認定者割合の平均(±標準偏差)は13.3±2.6人であった.高齢化率と指定医師割合は認定者割合に有意に関連した(順に,p=0.001,回帰係数0.26,95%信頼区間0.11〜0.41.p=0.023,回帰係数0.31,95%信頼区間0.05〜0.57).専門医割合,県民所得,社会福祉費,老人福祉費は認定者割合に関連しなかった.92.1%の都道府県において原因疾患の1位は緑内障であり,高齢化率は緑内障による認定者割合に有意に関連した(p=0.005,回帰係数0.16,95%信頼区間0.05〜0.27).結論:都道府県別の認定者割合には高齢化率と指定医師割合が関連した.緑内障による認定者割合には高齢化率が関連した.(著者抄録)

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EN FACE IMAGE-BASED ANALYSIS OF RETINAL TRACTION CAUSED BY EPIRETINAL MEMBRANE AND ITS RELATIONSHIP WITH VISUAL FUNCTIONS. International journal

Masayuki Hirano, Yuki Morizane, Yuki Kanzaki, Shuhei Kimura, Mio Hosokawa, Yusuke Shiode, Shinichiro Doi, Shinji Toshima, Kosuke Takahashi, Mika Hosogi, Atsushi Fujiwara, Ippei Takasu, Fumio Shiraga

Retina (Philadelphia, Pa.) 40 ( 7 ) 1262 - 1271 2020.7

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To evaluate the relationship between retinal traction caused by epiretinal membrane and visual functions. METHODS: In this institutional study, en face swept-source optical coherence tomography images of 141 eyes of 130 patients with epiretinal membrane were analyzed to investigate maximum depth of retinal folds, which represents retinal traction strength and the distribution pattern of retinal folds. We investigated the relationships between the maximum depth and distribution pattern of retinal folds and visual functions as well as the effects of membrane peeling. RESULTS: Maximum retinal fold depth was significantly correlated with the metamorphopsia score (P < 0.001). Fifteen eyes showed retinal folds radially extending from the macular epiretinal membrane (radiating folds group), whereas 126 eyes showed a multidirectional pattern of retinal folds (multidirectional folds group). The radiating folds group showed a significantly lower metamorphopsia score (P = 0.014). Multiple regression analysis revealed that the metamorphopsia score was significantly related to maximum retinal fold depth (P = 0.003), distribution pattern (P = 0.015), and central retinal thickness (P < 0.001). One month after membrane peeling, parafoveal retinal folds resolved completely in all cases, and both visual acuity (P < 0.001) and average metamorphopsia score (P = 0.036) were significantly improved. CONCLUSION: Both the strength and the distribution pattern of retinal traction are significantly related to metamorphopsia in epiretinal membrane patients.

DOI： 10.1097/IAE.0000000000002569

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Vision loss, tractional retinal detachment, and profound anemia due to rectal carcinoma. International journal

Akira Yamamoto, Yoshito Nishimura, Mikako Obika, Yuki Morizane, Fumio Otsuka

Clinical case reports 8 ( 7 ) 1304 - 1305 2020.7

【サージカルレティナ最前線】黄斑手術における内境界膜剥離の有用性と課題

的場亮, 森實祐基

あたらしい眼科 37 ( 7 ) 797 - 806 2020.7

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

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 2020.6

Language：English Publishing type：Research paper (scientific journal)

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 2020.6

Language：English Publishing type：Research paper (scientific journal)

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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KCNJ13 Gene Deletion Impairs Cell Alignment and Phagocytosis in Retinal Pigment Epithelium Derived from Human-Induced Pluripotent Stem Cells. International journal

Yuki Kanzaki, Hirofumi Fujita, Keita Sato, Mio Hosokawa, Hiroshi Matsumae, Fumio Shiraga, Yuki Morizane, Hideyo Ohuchi

Investigative ophthalmology & visual science 61 ( 5 ) 38 - 38 2020.5

Language：English Publishing type：Research paper (scientific journal)

Purpose: The purpose of this study was to establish and analyze a cell model of Leber congenital amaurosis type 16 (LCA16), which is caused by mutations in the KCNJ13 gene encoding Kir7.1, an inward-rectifying potassium ion channel. Methods: The two guide RNAs specific to the target sites in the KCNJ13 gene were designed and KCNJ13 knock-out (KO) human-induced pluripotent stem cells (hiPSCs) were generated using the CRISPR/Cas9 system. The KCNJ13-KO hiPSCs were differentiated into retinal pigment epithelial cells (hiPSC-RPEs). The KCNJ13-KO in hiPSC-RPEs was confirmed by immunostaining. Phagocytic activity of hiPSC-RPEs was assessed using the uptake of fluorescently labeled porcine photoreceptor outer segments (POSs). Phagocytosis-related genes in RPE cells were assessed by quantitative polymerase chain reaction. Results: Most of the translated region of the KCNJ13 gene was deleted in the KCNJ13-KO hiPSCs by the CRISPR/Cas9 system, and this confirmed that the Kir7.1 protein was not present in RPE cells induced from the hiPSCs. Expression of RPE marker genes such as BEST1 and CRALBP was retained in the wild-type (WT) and in the KCNJ13-KO hiPSC-RPE cells. However, phagocytic activity and expression of phagocytosis-related genes in the KCNJ13-null hiPSC-RPE cells were significantly reduced compared to those of WT. Conclusions: We succeeded in generating an RPE model of LCA16 using hiPSCs. We suggest that Kir7.1 is required for phagocytosis of POSs by RPE cells and that impaired phagocytosis in the absence of Kir7.1 would be involved in the retinal degeneration found in LCA16.

DOI： 10.1167/iovs.61.5.38

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ADVERSE EFFECT OF MACULAR INTRARETINAL HEMORRHAGE ON THE PROGNOSIS OF SUBMACULAR HEMORRHAGE DUE TO RETINAL ARTERIAL MACROANEURYSM RUPTURE. International journal

Shinichiro Doi, Shuhei Kimura, Yuki Morizane, Mio M Hosokawa, Yusuke Shiode, Masayuki Hirano, Shinji Toshima, Kosuke Takahashi, Mika Hosogi, Atsushi Fujiwara, Toshio Okanouchi, Yasushi Inoue, Fumio Shiraga

Retina (Philadelphia, Pa.) 40 ( 5 ) 989 - 997 2020.5

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To investigate the clinical course of submacular hemorrhage associated with ruptured retinal arterial macroaneurysm using swept-source optical coherence tomography. METHODS: This study included 23 eyes of 23 consecutive patients diagnosed with submacular hemorrhage associated with ruptured retinal arterial macroaneurysm. Cases underwent displacement of submacular hemorrhage (vitrectomy + subretinal injection of tissue plasminogen activator + air tamponade) and were followed up for 6 months after surgery. Localization of the preoperative hemorrhage and its effect on preoperative and postoperative best-corrected visual acuity, central retinal thickness, and continuity of the ellipsoid zone were measured. RESULTS: Macular intraretinal hemorrhage (IRH) was observed in 17 eyes (73.9%, IRH [+] group) and was not observed in 6 eyes (26.1%, IRH [-] group). The IRH (+) group showed worse postoperative best-corrected visual acuity values compared with the IRH (-) group (0.89 ± 0.47 in logarithm of the minimal angle of resolution units, Snellen equivalent 20/155 and 0.16 ± 0.23, 20/29, respectively; P < 0.01), smaller central retinal thickness values (97.7 ± 53.5 μm, 173.0 ± 32.3 μm, respectively; P < 0.01), and a higher rate of ellipsoid zone disruption (100%, 33.3%, respectively; P < 0.01). CONCLUSION: Patients with preoperative macular IRH showed lower postoperative visual acuity and worse macular contour after submacular hemorrhage displacement compared with patients without macular IRH.

DOI： 10.1097/IAE.0000000000002460

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Interocular symmetry of the foveal avascular zone area in healthy eyes: a swept-source optical coherence tomography angiography study.

Mengxuan Liu, Atsushi Fujiwara, Yuki Morizane, Ryo Kawasaki, Shuhei Kimura, Mio Morizane-Hosokawa, Yusuke Shiode, Masayuki Hirano, Shinichiro Doi, Shinji Toshima, Kosuke Takahashi, Mika Hosogi, Xiang Ma, Fumio Shiraga

Japanese journal of ophthalmology 64 ( 2 ) 171 - 179 2020.3

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: To determine the presence or absence of interocular differences in the foveal avascular zone (FAZ) area in healthy eyes. STUDY DESIGN: Cross-sectional study. METHODS: We examined 236 healthy eyes of 118 consecutive subjects (mean age, 39.1 ± 18.9 years). We used swept-source optical coherence tomography angiography (OCTA) images of the FAZ to measure its area from both the superficial capillary plexus (SCP-FAZ) and the whole retinal capillary plexus (WCP-FAZ). We also investigated the relationship between interocular differences in SCP-FAZ and other factors such as: axial length, spherical equivalent, central retinal thickness, and retinal vascular density. RESULTS: There was no significant difference in the FAZ area between the right and left eyes in either the SCP-FAZ (P = 0.61) or WCP-FAZ (P = 0.80), and the FAZ areas of both eyes showed significant positive correlations (SCP-FAZ; P < 0.001, R2 = 0.884, WCP-FAZ; P < 0.001, R2 = 0.856). Bland-Altman plots showed that the mean interocular difference in SCP-FAZ area was 0.002 ± 0.037 mm2 (95% confidence interval, -0.072-0.075 mm2), and in the WCP-FAZ area, 0.050 ± 0.044 mm2 (95% confidence interval, -0.036-0.137 mm2). Multivariate regression analysis showed that none of the investigated factors were significantly associated with interocular differences in SCP-FAZ (P = 0.61, R2 = 0.138). CONCLUSIONS: There was no significant interocular difference in SCP- and WCP-FAZ areas in healthy eyes. The normal range of values for interocular difference in SCP-FAZ area was 0.002 ± 0.037 mm2 and in the WCP-FAZ area, 0.050 ± 0.044 mm2.

DOI： 10.1007/s10384-020-00719-2

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重力と頭部の振動を利用して中心窩下に迷入したパーフルオロカーボンを除去した一例

高橋耕介, 森實祐基, 木村修平, 細川海音, 塩出雄亮, 土居真一郎, 的場亮, 神崎勇希, 藤原篤之, 白神史雄

日本眼科学会雑誌 124 ( 臨増 ) 208 - 208 2020.3

内科的治療に支援される硝子体手術黄斑下血腫

森實祐基

日本眼科学会雑誌 124 ( 臨増 ) 141 - 141 2020.3

KCNJ13遺伝子欠損がヒト多能性幹細胞由来網膜色素上皮細胞の貪食能に及ぼす影響

神崎勇希, 藤田洋史, 佐藤恵太, 細川海音, 松前洋, 白神史雄, 森實祐基, 大内淑代

日本眼科学会雑誌 124 ( 臨増 ) 187 - 187 2020.3

網膜橋渡し研究アップデート視覚身体障害の全国調査

森實祐基

眼科 62 ( 3 ) 265 - 272 2020.3

【加齢と眼疾患-健康長寿を目指して】わが国の視覚障害認定の原因疾患の推移

森實祐基

カレントテラピー 38 ( 2 ) 108 - 113 2020.2

Language：Japanese Publisher：(株)ライフメディコム

視覚障害は生活の質(QOL)を著しく低下させ、社会生活の維持にも大きな影響を及ぼす。視覚障害を減らす、もしくは視覚障害の重症化を防ぐためには、病態の解明や有効な治療法の開発に加えて予防が重要であり、医療福祉行政が担う役割は大きい。視覚障害に対する医療福祉行政を推進していくためには、わが国における視覚障害の実態を知り、どの眼疾患を対象として医療福祉行政を行うべきかを見極めることが重要である。われわれ(厚生労働省難治性疾患等政策研究事業、網膜脈絡膜・視神経萎縮症に関する調査研究班)は、2015年度に、本邦で初めてとなる全都道府県の全自治体を対象にした視覚障害の実態調査を行った。本稿ではこの調査結果について概説すると共に、わが国の失明原因の推移について考察する。(著者抄録)

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Shape analysis of rectus extraocular muscles with age and axial length using anterior segment optical coherence tomography. International journal

Kiyo Shibata, Atsushi Fujiwara, Ichiro Hamasaki, Takehiro Shimizu, Reika Kono, Keisuke Kanenaga, Masanori Nakazawa, Yuki Morizane

PloS one 15 ( 12 ) e0243382 2020

Language：English Publishing type：Research paper (scientific journal)

PURPOSE: This study aimed to evaluate the shape of the extraocular muscles (EOMs) in normal subjects using the en-face images of anterior segment optical coherence tomography (AS-OCT). The EOM insertion and the direction of the muscle fibers were investigated. SUBJECTS AND METHODS: A total of 97 healthy normal subjects (194 eyes) at Okayama University Hospital (age, 47.1±21.5 years; range, 8-79 years) participated in the study. A series of 256 tomographic images of the rectus EOMs were captured using the C-scan function of the AS-OCT (CASIA2, TOMEY Co., Japan), and the images were converted to en-face images in multi-TIFF format. The anterior chamber angle to EOM insertion distance (AID) and the angle of the muscle fibers from the insertion site (angle of muscles) were measured from the images. The correlations of AID and angle of muscles with age and axial length were investigated and evaluated. RESULTS: AID and angle of muscles were significantly correlated with age or axial length in some EOMs. The AIDs of medial rectus (MR) (P = 0.000) and superior rectus (SR) (P = 0.005) shortened with age. The AIDs of MR (P = 0.001) and inferior rectus (IR) (P = 0.035) elongated with axial length, whereas lateral rectus (LR) (P = 0.013) shortened. The angles of MR (P = 0.001) and LR (P = 0.000) were found to have a more downward direction toward the posterior in older subjects. CONCLUSION: En-face images can be created by AS-OCT, and the shape of the EOMs in normal subjects using these image measurements was available. With the ability to assess the EOMs, AID and angle of muscles are expected give useful information for treating and diagnosing strabismus-related diseases.

DOI： 10.1371/journal.pone.0243382

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