Canadian journal of ophthalmology. Journal canadien d'ophtalmologie最新文献_第2页

Clinical characteristics and management outcomes of pediatric full-thickness macular holes. 小儿全层黄斑孔的临床特点及治疗结果。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-03 DOI: 10.1016/j.jcjo.2025.10.007

Ayush A Parikh, Sandra Hoyek, Bertan Cakir, Celine Chaaya, Shizuo Mukai, Nimesh A Patel

Objective: To report the etiologies, clinical course, and management outcomes of pediatric full-thickness macular holes (MH).

Design: A retrospective observational case series.

Participants: Patients under the age of 18 years with confirmed full-thickness MH and a minimum of 3 months of follow-up, examined between January 1, 2025, and December 31, 2023, at a tertiary eye care center.

Methods: Data from all subjects were obtained from initial and follow-up visits, including demographic data, best-corrected visual acuity (BCVA), key examination and imaging findings, MH etiology, MH aperture, and base diameters based on optical coherence tomography (OCT) imaging (Spectralis; Heidelberg Engineering, Heidelberg, Germany), spontaneous closure rate, time to closure, surgical technique, surgical success rate for hole closure, postoperative complications, additional surgical procedures performed, and duration of follow-up.

Main outcome measures: Spontaneous closure rate versus surgical closure rate and BCVA at final follow-up.

Results: Forty-seven eyes from 47 patients were included, the majority of which were Caucasian males. The mean age was 13 ± 3.17 years, and blunt trauma was the most common etiology (n = 41, 87%). The median MH aperture diameter was 222 μm (IQR 156, range: 110-565; n=25). Of those opting for watchful waiting, spontaneous closure was observed in 26 eyes (63%), and median closure time was 45 days from the date of initial diagnosis (IQR: 66.5, range: 8-302). Eighteen eyes (38%) underwent surgical intervention, on average 134 days (range: 4-553 days) from initial diagnosis. Of those undergoing surgery, MH closure was noted postoperatively in 13 eyes (72%). Two surgical complications (11%) were reported: a postoperative cataract that required subsequent extraction, and a reopening of MH within 1 year in a patient with X-linked retinoschisis (XLRS). For patients who underwent surgery, the mean BCVA improved from 20/315 (logMAR 1.20) at presentation to 20/70 (logMAR 0.54) at final follow-up (p < 0.05). For patients who underwent watchful waiting, the mean BCVA improved from 20/230 (logMAR 1.06) to 20/50 (logMAR 0.40) (p < 0.05). There was no statistically significant difference in BCVA at presentation or final follow-up between the surgical intervention group and the spontaneous closure group.

Conclusions: Macular holes in the pediatric population are most often the result of blunt trauma. Watchful waiting for spontaneous closure and surgical intervention both appear to have comparable outcomes on closure and vision recovery.

目的：报道小儿全层黄斑孔（MH）的病因、临床过程及治疗结果。设计：回顾性观察性病例系列。参与者：年龄在18岁以下的确诊全层MH患者，至少随访3个月，于2025年1月1日至2023年12月31日在三级眼科保健中心进行检查。方法：所有受试者的资料均来自首次和随访，包括人口统计学资料、最佳矫正视力（BCVA）、关键检查和影像学发现、MH病因、MH孔径和基于光学相干断层扫描（OCT）成像的基底直径(Spectralis；Heidelberg Engineering, Heidelberg, Germany)，自发闭合率，闭合时间，手术技术，闭合孔的手术成功率，术后并发症，进行的其他手术以及随访时间。主要观察指标：最终随访时的自发闭合率、手术闭合率和BCVA。结果：纳入47例患者的47只眼，以白人男性居多。平均年龄13±3.17岁，钝性创伤是最常见的病因（n = 41.87%）。中位MH孔径为222 μm （IQR 156，范围：110 ~ 565；n=25）。在选择观察等待的患者中，26只眼（63%）自发闭合，中位闭合时间为自初次诊断之日起45天（IQR: 66.5，范围：8-302）。18只眼（38%）接受手术干预，平均134天（范围：4-553天）从最初诊断。在接受手术的患者中，术后有13只眼（72%）出现MH闭合。报告了两个手术并发症（11%）：术后白内障需要后续摘除，以及x连锁视网膜裂（XLRS）患者在1年内重新开放MH。对于接受手术的患者，平均BCVA从入院时的20/315 （logMAR 1.20）改善到最终随访时的20/70 (logMAR 0.54) （p < 0.05）。观察等待组患者的平均BCVA由20/230 （logMAR 1.06）改善至20/50 (logMAR 0.40) （p < 0.05）。手术干预组与自发闭合组在首发或最终随访时的BCVA无统计学差异。结论：儿童黄斑裂孔多由钝性外伤引起。观察等待自发闭合和手术干预似乎在闭合和视力恢复方面都有相当的结果。

{"title":"Clinical characteristics and management outcomes of pediatric full-thickness macular holes.","authors":"Ayush A Parikh, Sandra Hoyek, Bertan Cakir, Celine Chaaya, Shizuo Mukai, Nimesh A Patel","doi":"10.1016/j.jcjo.2025.10.007","DOIUrl":"10.1016/j.jcjo.2025.10.007","url":null,"abstract":"<p><strong>Objective: </strong>To report the etiologies, clinical course, and management outcomes of pediatric full-thickness macular holes (MH).</p><p><strong>Design: </strong>A retrospective observational case series.</p><p><strong>Participants: </strong>Patients under the age of 18 years with confirmed full-thickness MH and a minimum of 3 months of follow-up, examined between January 1, 2025, and December 31, 2023, at a tertiary eye care center.</p><p><strong>Methods: </strong>Data from all subjects were obtained from initial and follow-up visits, including demographic data, best-corrected visual acuity (BCVA), key examination and imaging findings, MH etiology, MH aperture, and base diameters based on optical coherence tomography (OCT) imaging (Spectralis; Heidelberg Engineering, Heidelberg, Germany), spontaneous closure rate, time to closure, surgical technique, surgical success rate for hole closure, postoperative complications, additional surgical procedures performed, and duration of follow-up.</p><p><strong>Main outcome measures: </strong>Spontaneous closure rate versus surgical closure rate and BCVA at final follow-up.</p><p><strong>Results: </strong>Forty-seven eyes from 47 patients were included, the majority of which were Caucasian males. The mean age was 13 ± 3.17 years, and blunt trauma was the most common etiology (n = 41, 87%). The median MH aperture diameter was 222 μm (IQR 156, range: 110-565; n=25). Of those opting for watchful waiting, spontaneous closure was observed in 26 eyes (63%), and median closure time was 45 days from the date of initial diagnosis (IQR: 66.5, range: 8-302). Eighteen eyes (38%) underwent surgical intervention, on average 134 days (range: 4-553 days) from initial diagnosis. Of those undergoing surgery, MH closure was noted postoperatively in 13 eyes (72%). Two surgical complications (11%) were reported: a postoperative cataract that required subsequent extraction, and a reopening of MH within 1 year in a patient with X-linked retinoschisis (XLRS). For patients who underwent surgery, the mean BCVA improved from 20/315 (logMAR 1.20) at presentation to 20/70 (logMAR 0.54) at final follow-up (p < 0.05). For patients who underwent watchful waiting, the mean BCVA improved from 20/230 (logMAR 1.06) to 20/50 (logMAR 0.40) (p < 0.05). There was no statistically significant difference in BCVA at presentation or final follow-up between the surgical intervention group and the spontaneous closure group.</p><p><strong>Conclusions: </strong>Macular holes in the pediatric population are most often the result of blunt trauma. Watchful waiting for spontaneous closure and surgical intervention both appear to have comparable outcomes on closure and vision recovery.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145562702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethnic disparities in inherited retinal degenerations 遗传性视网膜变性的种族差异。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.04.007

Kirk A.J. Stephenson, Shanil R. Dhanji, Olubayo U. Kolawole, Cheryl Y. Gregory-Evans, Kevin Gregory-Evans

Objective

Inherited retinal degenerations (IRD) are clinically heterogeneous. There has been little study of the influence of ethnicity on IRD phenotypes. We aim to assess clinical and genetic variability between differing ethnic groups affected by IRD.

Design

Retrospective cohort study.

Participants

Patients with genetically resolved IRD (ABCA4, USH2A, RPGR) at a single centre (University of British Columbia).

Methods

Clinical and genetic data were contrasted between ethnic groups (Caucasian, East Asian, South Asian, Indigenous, African) and between Caucasians and non-Caucasians.

Results

143 patients met the inclusion criteria. Caucasians were over-represented (76%). For ABCA4, East Asians most commonly had bullseye maculopathy, while classic Stargardt disease predominated in other ethnicities; cataract was less prevalent in non-Caucasians (p = 0.001). For USH2A, most non-Caucasians had non-syndromic IRD, while Caucasians were 50% isolated and 50% Usher syndrome. Hyperautofluorescent rings were more common in non-Caucasians (p = 0.027). In RPGR, best-corrected visual acuity was worse for Caucasians (logMAR 0.76 ± 0.69) than non-Caucasians (0.49 ± 0.30; p = 0.047), and myopia was greatest in South Asians (–9.56 ± 0.27 D vs −3.82 ± 4.05 D; p < 0.001). Twenty-one novel genetic variants were identified, and only 3.3% (5/154) of genetic variants were shared between ethnic groups.

Conclusions

Clinical and genetic differences are apparent between ethnic groups, even within “common” IRD genotypes. Awareness of these different retinal and extra-retinal (e.g., myopia, less favourable VA) features is critical to facilitate diagnostic accuracy and optimal clinical care, including access to novel therapies. Further work to expand the genetic reference databases for non-Caucasian ethnic groups is needed to facilitate equitable access to diagnosis and treatment for IRD.

目的：遗传性视网膜变性（IRD）具有临床异质性。关于种族对IRD表型影响的研究很少。我们的目的是评估受IRD影响的不同种族群体之间的临床和遗传变异。设计：回顾性队列研究。参与者：在单一中心（不列颠哥伦比亚大学）的遗传解决的IRD （ABCA4, USH2A， RPGR）患者。方法：对比不同种族（高加索人、东亚人、南亚人、土著人、非洲人）以及高加索人和非高加索人的临床和遗传资料。结果：143例患者符合纳入标准。白种人的比例过高（76%）。对于ABCA4，东亚人最常见的是靶心黄斑病变，而经典的Stargardt病在其他种族中占主导地位；白内障在非白种人中发病率较低（p = 0.001）。对于USH2A，大多数非白种人患有非综合征性IRD，而白种人50%为孤立性，50%为Usher综合征。超自体荧光环在非白种人中更为常见（p = 0.027）。在RPGR中，白种人的最佳矫正视力（logMAR 0.76±0.69）低于非白种人（0.49±0.30）；p = 0.047)，南亚人近视发生率最高(-9.56±0.27 D vs -3.82±4.05 D；P < 0.001)。共鉴定出21个新的遗传变异，只有3.3%（5/135）的遗传变异在族群间共享。结论：不同种族之间的临床和遗传差异是明显的，即使在“共同”的IRD基因型中也是如此。了解这些不同的视网膜和视网膜外（例如，近视，不太有利的视网膜）特征对于促进诊断准确性和最佳临床护理至关重要，包括获得新的治疗方法。需要进一步扩大非高加索族裔群体的遗传参考数据库，以促进公平获得IRD的诊断和治疗。

{"title":"Ethnic disparities in inherited retinal degenerations","authors":"Kirk A.J. Stephenson, Shanil R. Dhanji, Olubayo U. Kolawole, Cheryl Y. Gregory-Evans, Kevin Gregory-Evans","doi":"10.1016/j.jcjo.2025.04.007","DOIUrl":"10.1016/j.jcjo.2025.04.007","url":null,"abstract":"<div><h3>Objective</h3><div>Inherited retinal degenerations (IRD) are clinically heterogeneous. There has been little study of the influence of ethnicity on IRD phenotypes. We aim to assess clinical and genetic variability between differing ethnic groups affected by IRD.</div></div><div><h3>Design</h3><div>Retrospective cohort study.</div></div><div><h3>Participants</h3><div>Patients with genetically resolved IRD (<em>ABCA4, USH2A, RPGR</em>) at a single centre (University of British Columbia).</div></div><div><h3>Methods</h3><div>Clinical and genetic data were contrasted between ethnic groups (Caucasian, East Asian, South Asian, Indigenous, African) and between Caucasians and non-Caucasians.</div></div><div><h3>Results</h3><div>143 patients met the inclusion criteria. Caucasians were over-represented (76%). For <em>ABCA4</em>, East Asians most commonly had bullseye maculopathy, while classic Stargardt disease predominated in other ethnicities; cataract was less prevalent in non-Caucasians (<em>p</em> = 0.001). For <em>USH2A</em>, most non-Caucasians had non-syndromic IRD, while Caucasians were 50% isolated and 50% Usher syndrome. Hyperautofluorescent rings were more common in non-Caucasians (<em>p</em> = 0.027). In <em>RPGR</em>, best-corrected visual acuity was worse for Caucasians (logMAR 0.76 ± 0.69) than non-Caucasians (0.49 ± 0.30; <em>p</em> = 0.047), and myopia was greatest in South Asians (–9.56 ± 0.27 D vs −3.82 ± 4.05 D; <em>p</em> < 0.001). Twenty-one novel genetic variants were identified, and only 3.3% (5/154) of genetic variants were shared between ethnic groups.</div></div><div><h3>Conclusions</h3><div>Clinical and genetic differences are apparent between ethnic groups, even within “common” IRD genotypes. Awareness of these different retinal and extra-retinal (e.g., myopia, less favourable VA) features is critical to facilitate diagnostic accuracy and optimal clinical care, including access to novel therapies. Further work to expand the genetic reference databases for non-Caucasian ethnic groups is needed to facilitate equitable access to diagnosis and treatment for IRD.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 6","pages":"Pages e869-e878"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

True muscle transplantation for the management of third nerve palsy 真肌移植治疗第三神经麻痹。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.04.008

Ahmed Awadein, Christina S. Farag, Sara Maher

Objective

To describe and report the results of 2 different techniques for true muscle transplantation for management of exotropia in patients with third nerve palsy.

Methods

A retrospective chart review was conducted on patients with third nerve palsy in whom true muscle transplantation was performed. The resected segment of the medial rectus (MR) muscle was used to lengthen the lateral rectus (LR) muscle before recession. The transplantation was performed using either a free graft technique or a modified continuous graft technique. Ductions, versions, and angles of deviation were evaluated before and after surgery.

Results

A total of 7 patients were identified (mean age: 32 ± 17 years). Two patients had prior LR recession. The mean preoperative angle of deviation was 53 ± 13 PD, and the mean preoperative limitation of adduction was −4. The free graft and the continuous graft techniques were used in 3 and 4 cases, respectively. The median amount of LR recession was 8 mm, and the amount of MR resection ranged from 6 to 8 mm. The mean follow-up was 6.0 ± 4.2 months. Postoperatively, 5 patients had residual exotropia <10 PD. The remaining 2 cases had residual exotropia 15 PD. The mean postoperative limitation of adduction improved to −2.3 ± 0.5. The postoperative limitation of abduction was −1 or less in 6 patients.

Conclusions

True muscle transplantation can be used to correct large exotropia in partially recovered or recurrent third nerve palsy without causing significant limitation of abduction. Undercorrection is associated with smaller amounts of MR resection.

目的：描述和报道两种不同的真肌移植技术治疗第三神经麻痹患者外斜视的结果。方法：对行真肌移植的第三神经性麻痹患者进行回顾性分析。切除的内直肌（MR）段在收缩前用于延长外直肌（LR）。移植采用自由移植技术或改良的连续移植技术。在手术前和术后评估导管、形态和偏离角度。结果：共发现7例患者，平均年龄32±17岁。2例患者既往有LR衰退。术前平均偏斜角为53±13 PD，内收限制为-4 PD。游离移植3例，连续移植4例。中位LR退行量为8 mm， MR切除量为6 ~ 8 mm。平均随访6.0±4.2个月。结论：真肌移植可用于矫正部分恢复或复发性第三神经麻痹患者的大外斜视，且对外展无明显限制。校正不足与较小的MR切除有关。

{"title":"True muscle transplantation for the management of third nerve palsy","authors":"Ahmed Awadein, Christina S. Farag, Sara Maher","doi":"10.1016/j.jcjo.2025.04.008","DOIUrl":"10.1016/j.jcjo.2025.04.008","url":null,"abstract":"<div><h3>Objective</h3><div>To describe and report the results of 2 different techniques for true muscle transplantation for management of exotropia in patients with third nerve palsy.</div></div><div><h3>Methods</h3><div>A retrospective chart review was conducted on patients with third nerve palsy in whom true muscle transplantation was performed. The resected segment of the medial rectus (MR) muscle was used to lengthen the lateral rectus (LR) muscle before recession. The transplantation was performed using either a free graft technique or a modified continuous graft technique. Ductions, versions, and angles of deviation were evaluated before and after surgery.</div></div><div><h3>Results</h3><div>A total of 7 patients were identified (mean age: 32 ± 17 years). Two patients had prior LR recession. The mean preoperative angle of deviation was 53 ± 13 PD, and the mean preoperative limitation of adduction was −4. The free graft and the continuous graft techniques were used in 3 and 4 cases, respectively. The median amount of LR recession was 8 mm, and the amount of MR resection ranged from 6 to 8 mm. The mean follow-up was 6.0 ± 4.2 months. Postoperatively, 5 patients had residual exotropia <10 PD. The remaining 2 cases had residual exotropia 15 PD. The mean postoperative limitation of adduction improved to −2.3 ± 0.5. The postoperative limitation of abduction was −1 or less in 6 patients.</div></div><div><h3>Conclusions</h3><div>True muscle transplantation can be used to correct large exotropia in partially recovered or recurrent third nerve palsy without causing significant limitation of abduction. Undercorrection is associated with smaller amounts of MR resection.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 6","pages":"Pages e836-e843"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of social determinants of health and medication burden on quality of life and disease severity in glaucoma 青光眼患者健康和药物负担的社会决定因素对生活质量和疾病严重程度的影响

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.06.002

Sakshi Shiromani , Jenny Bui , Grace Nguyen , David M. Reed , Sachin Kedar , Deepta Ghate

Background

The interplay between social determinants of health (SDH), peripheral field loss in glaucoma, frailty, and medication burden impacts treatment outcomes and quality of life (QoL).

Objective

To evaluate the interaction between SDH, glaucoma characteristics, frailty, QoL in an Atlanta cohort with peripheral field loss.

Methods

Cross-sectional study including primary glaucoma subjects satisfying inclusion criteria. Electronic medical records provided age, zip code (for area deprivation, crime rate, poverty), visual acuity, binocular Visual Field Index (OU VFI), and number of medications. Glaucoma severity was classified by OU VFI: mild (>95%), mild to moderate (81–95%), moderate to severe (50–80%), and severe (<50%). Subjects completed surveys on demographics (race, sex, income, occupation, education), QoL (Short Form-36 and National Eye Institute-Visual Function Questionnaires), and frailty (FRAIL questionnaire).

Results

Among 139 subjects (mean age 67 ± 11 years), glaucoma severity was greater in Black versus White individuals (OU VFI: 72 ± 25% vs 83 ± 19%; p = 0.01), and in men versus women (OU VFI: 72 ± 26% vs 83 ± 19%; p = 0.004). Severity correlated with visual acuity (ANOVA: p < 0.001); QoL (NEI-VFQ scores: r = 0.6; p < 0.001). Neither zip code indices nor frailty were associated with severity/QoL. Multivariate modeling identified glaucoma severity as the sole predictor of QoL; medication burden had no independent impact.

Conclusions

Black race, male sex, visual acuity, and medication burden were associated with glaucoma severity. QoL was associated solely with glaucoma severity; medication burden had no independent impact. These findings inform glaucoma management strategies in Atlanta’s diverse community.

背景：健康的社会决定因素（SDH）、青光眼外周视野丧失、虚弱和药物负担之间的相互作用影响治疗结果和生活质量（QoL）。目的：评价SDH、青光眼特征、虚弱和生活质量在亚特兰大外周视野丧失队列中的相互作用。方法：纳入符合纳入标准的原发性青光眼患者进行横断面研究。电子医疗记录提供了年龄、邮政编码（针对贫困地区、犯罪率、贫困率）、视力、双眼视野指数（OU VFI）和药物数量。根据OU VFI将青光眼严重程度分为轻度（bb0 95%）、轻度至中度（81-95%）、中度至重度（50-80%）和重度(结果：139例受试者（平均年龄67±11岁）中，黑人青光眼严重程度高于白人(OU VFI: 72±25% vs 83±19%；p = 0.01)，男性vs女性(OU VFI: 72±26% vs 83±19%； = 0.004页)。严重程度与视力相关（方差分析：p < 0.001）；QoL (NEI-VFQ评分：r = 0.6；P < 0.001)。邮政编码指数和虚弱与严重程度/生活质量均无相关性。多变量模型确定青光眼严重程度是生活质量的唯一预测因子；用药负担无独立影响。结论：黑人种族、男性、视力和药物负担与青光眼严重程度相关。生活质量仅与青光眼严重程度相关；用药负担无独立影响。这些发现为亚特兰大不同社区的青光眼治疗策略提供了信息。

{"title":"Impact of social determinants of health and medication burden on quality of life and disease severity in glaucoma","authors":"Sakshi Shiromani , Jenny Bui , Grace Nguyen , David M. Reed , Sachin Kedar , Deepta Ghate","doi":"10.1016/j.jcjo.2025.06.002","DOIUrl":"10.1016/j.jcjo.2025.06.002","url":null,"abstract":"<div><h3>Background</h3><div>The interplay between social determinants of health (SDH), peripheral field loss in glaucoma, frailty, and medication burden impacts treatment outcomes and quality of life (QoL).</div></div><div><h3>Objective</h3><div>To evaluate the interaction between SDH, glaucoma characteristics, frailty, QoL in an Atlanta cohort with peripheral field loss.</div></div><div><h3>Methods</h3><div>Cross-sectional study including primary glaucoma subjects satisfying inclusion criteria. Electronic medical records provided age, zip code (for area deprivation, crime rate, poverty), visual acuity, binocular Visual Field Index (OU VFI), and number of medications. Glaucoma severity was classified by OU VFI: mild (>95%), mild to moderate (81–95%), moderate to severe (50–80%), and severe (<50%). Subjects completed surveys on demographics (race, sex, income, occupation, education), QoL (Short Form-36 and National Eye Institute-Visual Function Questionnaires), and frailty (FRAIL questionnaire).</div></div><div><h3>Results</h3><div>Among 139 subjects (mean age 67 ± 11 years), glaucoma severity was greater in Black versus White individuals (OU VFI: 72 ± 25% vs 83 ± 19%; <em>p</em> = 0.01), and in men versus women (OU VFI: 72 ± 26% vs 83 ± 19%; <em>p</em> = 0.004). Severity correlated with visual acuity (ANOVA: <em>p</em> < 0.001); QoL (NEI-VFQ scores: <em>r</em> = 0.6; <em>p</em> < 0.001). Neither zip code indices nor frailty were associated with severity/QoL. Multivariate modeling identified glaucoma severity as the sole predictor of QoL; medication burden had no independent impact.</div></div><div><h3>Conclusions</h3><div>Black race, male sex, visual acuity, and medication burden were associated with glaucoma severity. QoL was associated solely with glaucoma severity; medication burden had no independent impact. These findings inform glaucoma management strategies in Atlanta’s diverse community.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 6","pages":"Pages 368-377"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144504914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Investigating drug-induced optic nerve hypoplasia and septo-optic dysplasia from the FDA adverse events database 从FDA不良事件数据库中调查药物性视神经发育不全和视隔发育不良。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.05.005

Ayesh Ali , Jamal O. Azhari , Ryan Gise , Omar Solyman , Paul H. Phillips , Abdelrahman M. Elhusseiny

Objective

To identify potential teratogenic medication associated with optic nerve hypoplasia (ONH) and/or septo-optic dysplasia (SOD), by screening the Food and Drug Administration Adverse Events Reporting System (FAERS) database.

Design

Retrospective pharmacovigilance study using disproportionality signal detection methods.

Participants

Adverse event reports submitted to FAERS between Q1 2004 and Q3 2024. Reports were included if ONH or SOD was listed as an adverse event and drug exposure occurred in utero.

Methods

A qualitative assessment evaluated patient demographics, and a disproportionality analysis covered pharmacovigilance signal detection and drug-event reporting frequencies. Pharmacovigilance algorithms that were applied to determine the statistical significance of signals included the proportional reporting ratio (PRR), chi-squared with Yates’ correction (χ²), reporting odds ratio (ROR), empirical Bayes geometric mean (EBGM), and information component (IC).

Results

A total of 103 adverse event reports for ONH and/or SOD were identified. The 75 cases reporting prenatal medication exposure were included. Twenty-three reports were of male patients, 13 reports of female patients, and 39 of unspecified gender. Thirty drugs were implicated as primary suspect drugs. Diazepam was the most reported primary suspect medication (n = 15; 20%) followed by methadone and citalopram (n = 8; 11%). The disproportionality analysis showed a positive signal with one medication: diazepam (n = 15; PRR = 82.24; χ² = 1008.66, ROR 95% CI: 102.55 [56.75–185.33], EBGM [EBGM05]: 48.45 [28.16], IC [IC05]: 4.46 [3.67]).

Conclusions

A possible association was found between prenatal diazepam exposure and ONH/SOD. Further investigation is required to confirm this relationship and drug safety profiles.

目的：通过筛选美国食品和药物管理局不良事件报告系统（FAERS）数据库，确定与视神经发育不全（ONH）和/或视隔-视神经发育不良（SOD）相关的潜在致畸药物。设计：采用歧化信号检测方法进行回顾性药物警戒研究。参与者：2004年第一季度至2024年第三季度期间向FAERS提交的不良事件报告。如果ONH或SOD被列为不良事件，并且药物暴露发生在子宫内，则纳入报告。方法：定性评估患者人口统计学特征，歧化分析包括药物警戒信号检测和药物事件报告频率。用于确定信号统计学显著性的药物警戒算法包括比例报告比（PRR）、叶茨校正卡方（χ2）、报告优势比（ROR）、经验贝叶斯几何平均（EBGM）和信息分量（IC）。结果：共发现103例ONH和/或SOD不良事件报告。包括75例报告产前药物暴露的病例。23例为男性患者，13例为女性患者，39例性别不详。30种毒品被认为是主要的嫌疑毒品。地西泮是报告最多的主要可疑药物(n = 15；20%)，其次是美沙酮和西酞普兰(n = 8；11%)。歧化分析显示一种药物：地西泮(n = 15；PRR = 82.24;1008.66χ2 = ROR 95% CI: 102.55 (56.75 - -185.33), EBGM [EBGM05]: 48.45 (28.16), IC [IC05]: 4.46[3.67])。结论：产前地西泮暴露与ONH/SOD之间可能存在关联。需要进一步的调查来证实这种关系和药物安全性概况。

{"title":"Investigating drug-induced optic nerve hypoplasia and septo-optic dysplasia from the FDA adverse events database","authors":"Ayesh Ali , Jamal O. Azhari , Ryan Gise , Omar Solyman , Paul H. Phillips , Abdelrahman M. Elhusseiny","doi":"10.1016/j.jcjo.2025.05.005","DOIUrl":"10.1016/j.jcjo.2025.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>To identify potential teratogenic medication associated with optic nerve hypoplasia (ONH) and/or septo-optic dysplasia (SOD), by screening the Food and Drug Administration Adverse Events Reporting System (FAERS) database.</div></div><div><h3>Design</h3><div>Retrospective pharmacovigilance study using disproportionality signal detection methods.</div></div><div><h3>Participants</h3><div>Adverse event reports submitted to FAERS between Q1 2004 and Q3 2024. Reports were included if ONH or SOD was listed as an adverse event and drug exposure occurred in utero.</div></div><div><h3>Methods</h3><div>A qualitative assessment evaluated patient demographics, and a disproportionality analysis covered pharmacovigilance signal detection and drug-event reporting frequencies. Pharmacovigilance algorithms that were applied to determine the statistical significance of signals included the proportional reporting ratio (PRR), chi-squared with Yates’ correction (χ<sup>2</sup>), reporting odds ratio (ROR), empirical Bayes geometric mean (EBGM), and information component (IC).</div></div><div><h3>Results</h3><div>A total of 103 adverse event reports for ONH and/or SOD were identified. The 75 cases reporting prenatal medication exposure were included. Twenty-three reports were of male patients, 13 reports of female patients, and 39 of unspecified gender. Thirty drugs were implicated as primary suspect drugs. Diazepam was the most reported primary suspect medication (n = 15; 20%) followed by methadone and citalopram (n = 8; 11%). The disproportionality analysis showed a positive signal with one medication: diazepam (n = 15; PRR = 82.24; χ<sup>2</sup> = 1008.66, ROR 95% CI: 102.55 [56.75–185.33], EBGM [EBGM05]: 48.45 [28.16], IC [IC05]: 4.46 [3.67]).</div></div><div><h3>Conclusions</h3><div>A possible association was found between prenatal diazepam exposure and ONH/SOD. Further investigation is required to confirm this relationship and drug safety profiles.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 6","pages":"Pages e851-e857"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Flieringa scleral fixation ring-assisted Descemet membrane endothelial keratoplasty in complex eyes 巩膜固定环辅助下角膜内皮移植术在复杂眼中的应用。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.07.003

Gabriele Gallo Afflitto , Shafi Balal , Francesco Aiello , Vincenzo Maurino

引用次数: 0

Relapse of B-cell acute lymphoblastic leukemia revealed by multiple ocular locations 多眼部位显示的b细胞急性淋巴细胞白血病复发。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.06.012

Lauriana Solecki , Anne Sophie Gauthier , Arnaud Sauer

引用次数: 0

Anterior chamber paracentesis for increased intraocular pressure with intravitreal injections: systematic review and meta-analysis 前房穿刺术治疗玻璃体内注射升高眼压：系统回顾和荟萃分析。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.06.003

Michele Zaman , Sarah Alowedi , Sanjay Sharma

Objective

Intravitreal injections (IVIs) can cause a transient asymptomatic spike in intraocular pressure (IOP), which may cause irreversible damage to the patient’s optic nerve. Anterior chamber paracentesis (ACP) is a well-established method to lower IOP. We aim to systematically review the literature, assessing the safety and efficacy of ACP for increased IOP with IVI of antivascular endothelial growth factor medications.

Methods

The following databases were used: MEDLINE, EMBASE, and CINAHL. Articles were included if they had human participants and discussed the use of ACP for increased IOP during IVIs. Key terms searched were anterior chamber paracentesis, intravitreal injections, and intraocular pressure.

Results

Our search captured 236 articles, and ultimately 13 studies were included in our review. Six studies were included in our meta-analysis of studies that reported the IOP after 30 minutes post-ACP. Ten included studies reported that ACP is a safe and effective procedure that lowers the IOP of patients during the IVI process. The overall pooled effect size is significant for IOP measurements 30 minutes after ACP is −1.54 with a 95% CI of −2.20 to −0.88 mm Hg, 5 minutes after ACP is −2.37 with a 95% CI of −2.77 to −1.97 mm Hg and 2 minutes after ACP is −5.09 with a 95% CI of −8.48 to −1.70 mm Hg.

Conclusions

In conclusion, performing an ACP is a safe and effective way to reduce the transient spike in IOP after IVIs. However, this procedure is not without the potential for complications.

目的：玻璃体内注射（IVIs）可引起短暂的无症状眼压（IOP）峰值，这可能对患者视神经造成不可逆的损害。前房穿刺术（ACP）是一种行之有效的降低IOP的方法。我们的目的是系统地回顾文献，评估ACP对抗血管内皮生长因子药物IVI升高IOP的安全性和有效性。方法：采用MEDLINE、EMBASE、CINAHL数据库。如果有人类参与者的文章被纳入，并且讨论了在ivi期间使用ACP提高IOP。搜索的关键词是前房穿刺术、玻璃体内注射和眼压。结果：我们检索了236篇文章，最终纳入了13项研究。我们的荟萃分析纳入了6项报告acp后30分钟IOP的研究。10项纳入的研究报告ACP是一种安全有效的手术，可在IVI过程中降低患者的IOP。整个混合效应的大小是重要的眼压测量30分钟后ACP是-1.54,95%可信区间为-2.20至-0.88毫米汞柱,5分钟后ACP是-2.37 95%可信区间为-2.77至-1.97毫米汞柱和2分钟后ACP是-5.09,95%可信区间-8.48到-1.70毫米Hg.Conclusions:总之,执行ACP是安全的和有效的方法来减少新后眼压的瞬时峰值。然而，这种手术并非没有潜在的并发症。

{"title":"Anterior chamber paracentesis for increased intraocular pressure with intravitreal injections: systematic review and meta-analysis","authors":"Michele Zaman , Sarah Alowedi , Sanjay Sharma","doi":"10.1016/j.jcjo.2025.06.003","DOIUrl":"10.1016/j.jcjo.2025.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>Intravitreal injections (IVIs) can cause a transient asymptomatic spike in intraocular pressure (IOP), which may cause irreversible damage to the patient’s optic nerve. Anterior chamber paracentesis (ACP) is a well-established method to lower IOP. We aim to systematically review the literature, assessing the safety and efficacy of ACP for increased IOP with IVI of antivascular endothelial growth factor medications.</div></div><div><h3>Methods</h3><div>The following databases were used: MEDLINE, EMBASE, and CINAHL. Articles were included if they had human participants and discussed the use of ACP for increased IOP during IVIs. Key terms searched were anterior chamber paracentesis, intravitreal injections, and intraocular pressure.</div></div><div><h3>Results</h3><div>Our search captured 236 articles, and ultimately 13 studies were included in our review. Six studies were included in our meta-analysis of studies that reported the IOP after 30 minutes post-ACP. Ten included studies reported that ACP is a safe and effective procedure that lowers the IOP of patients during the IVI process. The overall pooled effect size is significant for IOP measurements 30 minutes after ACP is −1.54 with a 95% CI of −2.20 to −0.88 mm Hg, 5 minutes after ACP is −2.37 with a 95% CI of −2.77 to −1.97 mm Hg and 2 minutes after ACP is −5.09 with a 95% CI of −8.48 to −1.70 mm Hg.</div></div><div><h3>Conclusions</h3><div>In conclusion, performing an ACP is a safe and effective way to reduce the transient spike in IOP after IVIs. However, this procedure is not without the potential for complications.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 6","pages":"Pages e934-e945"},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Management of orbital invasion at the caruncle by conjunctival squamous cell carcinoma 结膜鳞状细胞癌侵犯眼眶的治疗。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.08.016

Maria Valeria Da Silva , Normand Laperriere , Hatem Krema

引用次数: 0

Geographic distribution of ophthalmology residency matches: a comparison of pre- and post-virtual interview cycles in Canada. 眼科住院医师匹配的地理分布：加拿大虚拟面试前后周期的比较。

IF 2.8 4区医学 Q1 OPHTHALMOLOGY

Canadian journal of ophthalmology. Journal canadien d'ophtalmologie

Pub Date : 2025-12-01 DOI: 10.1016/j.jcjo.2025.11.005

Daiana R Pur, Karanvir Gill, Amadeo R Rodriguez

Objective: To determine the impact of virtual interviews on the geographic distribution of matched ophthalmology residency applicants.

Design: A retrospective database review.

Participants: A total of 334 residents commencing ophthalmology training from 2016 to 2024 in 15 Canadian ophthalmology residency programs.

Methods: We gathered publicly available information to compare match outcomes pre-virtual (2016-2019) to virtual interviews (2020-2024). Variables collected included resident names, medical school, and residency program location. Chi-squared tests were conducted to determine whether there was a significant difference in the proportion of applicants matching in the same region, province, and institution as their medical schools in pre-virtual versus virtual interview cycles.

Results: A total of 292 residents (88% completion rate) were identified. Home program matches were similar between the pre-virtual (51.18%) and virtual cohorts (49.70%). Same-province but different-school matches decreased slightly (18.90% pre-virtual vs 16.36% virtual), while same-region but different-province matches (6.30% vs 6.06%) were similar. Conversely, inter-regional matches increased from 23.62% pre-virtual to 27.88% virtual. Chi-squared analysis showed no statistically significant difference in geographic placement between the two groups (χ² = 0.80; p = 0.85).

Conclusions: The transition to virtual interviews in Canadian ophthalmology residency programs did not significantly alter the geographic distribution of matched applicants. While concerns exist that virtual interviews might limit applicants' ability to explore programs outside their home institutions, our findings suggest that other virtual engagement methods, such as online networking, mentorship programs, and social media, may have helped maintain geographic mobility. Future studies could assess whether these trends persist over time and whether similar strategies could enhance applicant program exposure in other specialties.

目的：探讨虚拟面试对匹配眼科住院医师申请人地理分布的影响。设计：回顾性数据库审查。参与者：从2016年到2024年，共有334名住院医师在加拿大15个眼科住院医师项目中接受眼科培训。方法：我们收集公开信息，比较虚拟前（2016-2019）和虚拟面试（2020-2024）的比赛结果。收集的变量包括住院医师姓名、医学院和住院医师项目所在地。进行卡方检验以确定在虚拟前与虚拟面试周期中，申请人在同一地区、省份和机构与其医学院匹配的比例是否存在显着差异。结果：共识别居民292人，完成率88%。家庭节目匹配在虚拟前（51.18%）和虚拟队列（49.70%）之间相似。同省不同学校的比赛略有下降（虚拟前18.90% vs虚拟后16.36%），而同省不同地区的比赛（6.30% vs 6.06%）相似。相反，区域间的匹配从虚拟前的23.62%增加到虚拟后的27.88%。卡方分析显示两组患者地理位置差异无统计学意义（χ² = 0.80;p = 0.85）。结论：加拿大眼科住院医师项目向虚拟面试的过渡并没有显著改变匹配申请人的地理分布。尽管有人担心虚拟面试可能会限制申请人在本国院校之外探索项目的能力，但我们的研究结果表明，其他虚拟参与方法，如在线网络、指导项目和社交媒体，可能有助于保持地域流动性。未来的研究可以评估这些趋势是否会持续一段时间，以及类似的策略是否可以提高申请人在其他专业的项目曝光率。

{"title":"Geographic distribution of ophthalmology residency matches: a comparison of pre- and post-virtual interview cycles in Canada.","authors":"Daiana R Pur, Karanvir Gill, Amadeo R Rodriguez","doi":"10.1016/j.jcjo.2025.11.005","DOIUrl":"10.1016/j.jcjo.2025.11.005","url":null,"abstract":"<p><strong>Objective: </strong>To determine the impact of virtual interviews on the geographic distribution of matched ophthalmology residency applicants.</p><p><strong>Design: </strong>A retrospective database review.</p><p><strong>Participants: </strong>A total of 334 residents commencing ophthalmology training from 2016 to 2024 in 15 Canadian ophthalmology residency programs.</p><p><strong>Methods: </strong>We gathered publicly available information to compare match outcomes pre-virtual (2016-2019) to virtual interviews (2020-2024). Variables collected included resident names, medical school, and residency program location. Chi-squared tests were conducted to determine whether there was a significant difference in the proportion of applicants matching in the same region, province, and institution as their medical schools in pre-virtual versus virtual interview cycles.</p><p><strong>Results: </strong>A total of 292 residents (88% completion rate) were identified. Home program matches were similar between the pre-virtual (51.18%) and virtual cohorts (49.70%). Same-province but different-school matches decreased slightly (18.90% pre-virtual vs 16.36% virtual), while same-region but different-province matches (6.30% vs 6.06%) were similar. Conversely, inter-regional matches increased from 23.62% pre-virtual to 27.88% virtual. Chi-squared analysis showed no statistically significant difference in geographic placement between the two groups (χ² = 0.80; p = 0.85).</p><p><strong>Conclusions: </strong>The transition to virtual interviews in Canadian ophthalmology residency programs did not significantly alter the geographic distribution of matched applicants. While concerns exist that virtual interviews might limit applicants' ability to explore programs outside their home institutions, our findings suggest that other virtual engagement methods, such as online networking, mentorship programs, and social media, may have helped maintain geographic mobility. Future studies could assess whether these trends persist over time and whether similar strategies could enhance applicant program exposure in other specialties.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145602503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0