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To investigate the concordance between angle-closure assessments based on GS-1 gonioscope images and those obtained with anterior-segment optical coherence tomography. Retrospective clinical study. We included 33 patients (53 eyes) who visited Chukyo Eye Clinic during 2020-2024, were suspected of having angle closure, and underwent anterior-segment optical coherence tomography (CASIA2 Advance STAR Analyzer) and GS-1 examinations. The 16-directional images captured with the GS-1 were divided into two halves, creating 32 directions, which were rearranged to correspond with those obtained via anterior-segment optical coherence tomography. Agreement between evaluations was analyzed using Cohen's κ, and the area under the receiver operating characteristic curve was evaluated. Anterior-segment optical coherence tomography images were manually corrected, and eyes with areas classified as \"narrow\" or \"closed\" were categorized as angle closure. With the GS-1, two glaucoma specialists independently reviewed the images. Areas in which the posterior trabecular meshwork was obscured in more than half of the image (Scheie classification grades III-IV) were judged indicative of angle closure. We included 1,660 directions from 53 eyes in the agreement analysis. The proportion of directions judged as angle closure was 57.0% with anterior-segment optical coherence tomography and 46.1% with the GS-1. Cohen's κ for inter-test agreement was 0.173 (95% confidence interval: 0.128-0.218), and the area under the receiver operating characteristic curve was 0.588 (95% confidence interval: 0.561-0.615). Analyses using anterior-segment optical coherence tomography yielded more frequent classifications of angle closure than evaluations based on GS-1 gonioscopic images.

The IMOvifa™ perimeter with a 24plus (1-2) testing mode has additional measurement points within the central 10 degrees, which may help evaluate the visual field within this area. Here, we comparatively evaluated the IMOvifa™ 24plus (1-2) and HFA 10-2 for the first time. We included 30 patients (48 eyes) who underwent HFA 24-2 Swedish Interactive Threshold Algorithm Standard and IMOvifa™ 24plus (1-2) Ambient Interactive Zippy Estimated tests on the same day and HFA 10-2 within six months. We used Spearman's rank correlation coefficient to analyze the mean deviation (MD) and pattern standard deviation (PSD) between HFA 10-2 and IMOvifa™. The central 10-degree visual field was divided into four sectors, and concordance of visual field defects between IMOvifa™ 24plus (1-2) and HFA 10-2 was evaluated using kappa analysis. Additionally, all sectors showing a sensitivity of 0 dB on the HFA 24-2 were assessed for the presence and agreement of residual visual field in HFA 10-2 and IMOvifa™ 24plus (1-2). The MD (0.843/0.804) and PSD (0.852/0.763) of IMOvifa™ 24plus (1-2) and HFA 24-2 correlated strongly with those of HFA 10-2. Regarding the ability to detect visual field defects within the central 10 degrees, agreement with HFA 10-2 was κ = 0.715 (0.611,0.819) and 0.754 (0.654,0.854) for IMOvifa™ 24plus (1-2) and HFA 24-2, respectively. In the evaluation of residual visual field, IMOvifa™ 24plus (1-2) detected residual visual function in 100% of cases where HFA 10-2 indicated residual function. The IMOvifa™ 24plus (1-2) may have a higher ability to detect defects in certain areas of the visual field, compared with HFA 24-2, and may also detect residual visual function. However, the IMOvifa™ 24plus (1-2) is difficult to substitute for the 10-2 test, as the 10-2 test is necessary for evaluating visual field defects within the central 10 degrees.

To predict the anterior chamber volume (ACV) after implantable collamer lens (ICL) implantation based on ICL size and parameters of anterior segment optical coherence tomography (AS-OCT). Retrospective study. This study included 222 eyes of 222 patients who underwent ICL implantation at Nagoya Eye Clinic. The patients were divided into two groups: prediction group, for creating the prediction equation (148 eyes, mean age: 32.11 ± 8.04 years), and verification group, for verifying the equation (74 eyes, mean age: 33.03 ± 6.74 years). The angle opening distance (AOD), anterior chamber width (ACW), ACV, anterior chamber depth, lens vault, angle-to-angle distance, angle recess area, and trabecular iris space area were calculated using AS-OCT. A stepwise multiple regression analysis was performed. After the creation of the prediction equation, its accuracy was verified in the verification group. The ACV, AOD750, ACW, and ICL size were selected as explanatory variables to predict postoperative ACV. Mean predicted (114.2 ± 21.83 mm3) and actual postoperative ACVs (116.1 ± 25.41 mm3) were not significantly different (P = 0.269); absolute error was 10.59 ± 9.13 mm3. In addition, there was high correlation between actual and predictive ACV (adjusted R2 = 0.6996, p < 0.0001). Bland-Altman plot revealed that there was no addition or proportional error between predicted and actual postoperative ACV. Postoperative ACV was accurately predicted using AS-OCT parameters and ICL size. This prediction equation may be useful for making decisions regarding ICL size.

To compare the efficacy and invasiveness of manual gonioscopy and automated 360-degree gonioscopy. Manual and automated gonioscopy were performed on 70 patients with glaucoma. Manual gonioscopy was performed by a glaucoma specialist and an ophthalmology resident, and automated gonioscopy (GS-1) was performed by orthoptists. We compared the examination time for acquiring gonioscopic images (GS-1: 16 directions; manual gonioscopy: 8 directions). Furthermore, we compared the pain and discomfort scores during the examination using the Individualized Numeric Rating Scale. Among the images acquired by automated gonioscopy, we also evaluated the percentages of acquired images that could be used to determine the angle opening condition. The examination time was not significantly different between manual (80.2±28.7) and automated gonioscopy (94.7±82.8) (p = 0.105). The pain score of automated gonioscopy (0.22±0.59) was significantly lower than that of manual gonioscopy (0.55±1.11) (p = 0.025). The discomfort score was not significantly different between manual (1.34±1.90) and automated gonioscopy (1.06±1.50) (p = 0.165). Automated gonioscopy successfully acquired clear gonioscopic images in 93.4% of the total images. Automated gonioscopy is comparable in examination time and invasiveness to manual gonioscopy and may be useful for 360-degree iridocorneal angle evaluation.

Wheel loaders are construction machines that are mainly used for excavating and loading sedimented ground into dump trucks. The objects to be excavated range from large materials, such as blast rock and crushed stone, to small materials, such as gravel, slag, and coal ash. Therefore, the excavation operation of wheel loaders requires a high skill level to cope with various terrains and soil types. As worker numbers at quarry sites decline, developing highly automated technology to replace operators is crucial. In particular, the geometry of the ground to be excavated by the wheel loader changes with each excavation, so the control parameters must be adapted sequentially during automated excavation. In this study, we proposed an online learning method using Bayesian optimization to search for control parameters from multiple trials and modify them sequentially. In particular, we formulate a multi-objective optimization problem maximizing a weighted linear combination of the payload and workload as an objective function. To validate the proposed method, we constructed an environment in which repeated digging tests can be performed using a robot manipulator with a bucket attached. Through comparative tests between feed-forward control, in which the robot moves along a fixed trajectory independent of the digging reaction force, and off-line control, in which the robot modifies the digging trajectory in response to the digging reaction force, we compared the ability of these methods to cope with terrain volume that is different from that of the optimization trial.

ABSTRACT In eyes with a scleral‐fixated IOL, intravitreal triamcinolone may migrate into the anterior chamber, resulting in early‐onset elevation of IOP, even at small volumes. Prompt slit lamp and gonioscopic evaluation is recommended for patients with prior vitrectomy or posterior capsule defects to ensure timely detection and treatment.

Hemophilia B is an X-linked recessive bleeding disorder caused by abnormalities of the coagulation factor IX gene ( F9 ). Insertion mutations in F9 ranging from a few to more than 100 base pairs account for only a few percent of all hemophilia B cases. We investigated F9 to elucidate genetic abnormalities causing severe hemophilia B in a Japanese subject. We performed PCR-mediated analysis of F9 and identified a large insertion in exon 6. Next, we carried out direct sequencing of a PCR clone of the whole insert using nested deletion by exonuclease III and S1 nuclease. We identified an approximately 2.5-kb SINE-VNTR-Alu (SVA)-F element flanked by 15-bp duplications in the antisense orientation in exon 6. Additionally, we carried out exontrap analysis to assess the effect of this retrotransposition on mRNA splicing. We observed that regular splicing at exons 5 and 6 of F9 was disturbed by the SVA retrotransposition, suggesting that abnormal FIX mRNA may be reduced by nonsense-mediated mRNA decay. In conclusion, this is the first report of SVA retrotransposition causing severe hemophilia B; only five cases of LINE-1 or Alu retrotranspositions in F9 have been reported previously.

A 53-year-old woman was diagnosed with a Crawford II thoracoabdominal aortic aneurysm involving the right-sided descending aorta. The patient underwent aortic replacement via a thoracoabdominal approach. The right-sided descending thoracic aortic aneurysm was excluded. The patient had a favorable postoperative course. The excluded thoracic aneurysm had completely thrombosed without intercostal inflow. The right-sided descending aorta is a rare malformation. The exclusion technique was appropriate because there was no retrograde flow from the intercostal arteries and the Adamkiewicz artery originated from the lumbar region.

Key Clinical Message Visual field disorders caused by cerebral aneurysms are diverse, nonspecific, and vary in their degree of compression. They should be distinguished from those caused by other common diseases, such as glaucoma.

Background Leiomyosarcoma is classified as a soft tissue sarcoma. In adults, leiomyosarcoma is the most common malignancy affecting the vascular system; however, vascular leiomyosarcoma in children is extremely rare as most pediatric soft tissue tumors are rhabdomyosarcomas. The survival rate is very low, and incomplete resection is a poor prognostic factor. There is also a high rate of distant recurrence, with the lungs and liver being the most common sites of metastasis. There is no established effective chemotherapy, and complete surgical resection is the only potentially curative treatment for leiomyosarcoma. Case presentation A 15-year-old female patient with no significant medical history presented with severe upper abdominal pain and was admitted. Abdominal contrast-enhanced computed tomography and magnetic resonance imaging showed a large retroperitoneal tumor protruding into the lumen of the inferior vena cava behind the liver and multiple small nodules, and metastasis to the liver was suspected. The tumor was 6 × 4 × 5 cm in diameter, located just behind the hepatic hilar structures, and was suspected to infiltrate into the right portal vein. The tumor was diagnosed as a leiomyosarcoma through an open tumor biopsy. As the multiple liver metastases were located only in the right lobe of the liver on imaging, we performed tumor resection with right hepatectomy and replacement of the inferior vena cava (IVC). The postoperative course was uneventful; however, on postoperative day 51, distant metastatic recurrences were found in the remaining liver and right lung. The patient was immediately started on chemotherapy and trabectedin proved to be the most effective drug in the treatment regimen; however, severe side effects, such as hepatotoxicity, prevented timely administration, and the patient passed away 19 months after surgery. Conclusions IVC resection and reconstruction combined with right hepatectomy were able to be safely performed even in a pediatric case. To improve the prognosis of leiomyosarcoma with multiple metastases, an effective treatment strategy combining surgical treatment and chemotherapy, including molecularly targeted drugs, should be established as early as possible.