[Achievements and Future Challenges in the Support of the Balance of Work and Medical Treatment at the Hospital of the University of Occupational and Environmental Health, Japan, in 2018-2020].

The Japanese government is making full-scale efforts to support working people who suffer from cancer and/or other diseases, as it seeks to support a balance of work and receiving medical treatment. The Hospital of the University of Occupational and Environmental Health, Japan, opened its Support Center of Treatment and Work Balance in 2018. This is a multi-disciplinary department for supporting the balance of work and medical treatment. It also opened its Department of Occupational Medicine, the first such department in Japan to provide medical diagnosis and treatment dedicated to supporting that same balance. Our team has supported 704 patients through our activities over the past 3 years. The number of patients supported has increased each year, while the number of departments providing support has also trended upward. There has also been an increase in opinions by attending physicians regarding employment, as well as the number of cases covered by public medical insurance. Here we suggest two factors in our hospital's growth in these activities: (1) many of the clinicians are qualified as occupational physicians, and (2) the organizational strength of our team, which has a vision for balancing support and subsequently promotes that vision. We hope that this report will lead to the balance of support activities in Japan and contribute to the model internationally.

Analysis of Retinal Nerve Fibre Thickening in Progressive and Non-progressive Non-arteritic Anterior Ischaemic Optic Neuropathy Using Optical Coherence Tomography.

The study aims to investigate the longitudinal changes in the circumpapillary retinal nerve fibre layer thickness (cpRNFLT) in progressive and non-progressive non-arteritic anterior ischaemic optic neuropathy (NAION). This retrospective observational case series study analysed 17 eyes with NAION. Patients sustaining any additional visual loss (additional decrease in visual acuity (VA) ≥0.2 logMAR) within two months after initial onset of symptoms were classified as having progressive NAION. Of the 17 eyes with NAION, 13 (76.5%) were diagnosed as non-progressive and 4 (23.5%) were diagnosed as progressive. Compared with control eyes, eyes with non-progressive NAION showed greater cpRNFLT in all four optic disc quadrants at the initial visit (temporal and superior: P < .001; nasal and inferior: P = .002). In contrast, compared with control eyes, eyes with progressive NAION showed greater cpRNFLT in the superior and nasal quadrants (P = .004 and 0.028, respectively), but not in the temporal and inferior quadrants. During progression, eyes with progressive NAION showed a significant increase in cpRNFLT in the inferior quadrants; furthermore, there was significant increase in cpRNFLT in the nasal sector before visual loss developed after the initial visit. Progressive NAION showed development of the disc swelling from the superior to inferior portion of optic disc via the nasal swelling, suggesting that swollen axons in one ischaemic part may lead to secondary vascular infarction in another part of the optic disc. This enlargement could constitute the earliest sign of progressive NAION.