Pub Date : 2025-02-01DOI: 10.1016/j.jcjo.2024.08.018
Gurkaran S. Sarohia , Vivian T. Yin , Sonia N. Yeung , Alfonso Iovieno
{"title":"Frontal periosteum flap: an approach for improved vascular supply for buccal membrane graft","authors":"Gurkaran S. Sarohia , Vivian T. Yin , Sonia N. Yeung , Alfonso Iovieno","doi":"10.1016/j.jcjo.2024.08.018","DOIUrl":"10.1016/j.jcjo.2024.08.018","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e163-e165"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280672","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jcjo.2024.05.013
David D. Chong , Christopher M. Maatouk , Jonathan Markle , Jacqueline K. Shaia , Rishi P. Singh , Katherine E. Talcott
<div><h3>Objective</h3><div><span>Assess 5-year all-cause mortality (ACM), hemorrhagic stroke, </span>ischemic stroke<span>, and myocardial infarction (MI) risks in nAMD patients receiving anti-VEGF injections compared with controls.</span></div></div><div><h3>Design</h3><div>Population-based retrospective cohort study using a U.S. federated health research network, containing de-identified data of 96 million patients from 1/1/2003 to 3/6/2023.</div></div><div><h3>Participants</h3><div><span>nAMD Patients with anti-VEGF injections. Controls included nAMD patients without anti-VEGF injections, non-exudative </span>AMD<span> patients, and patients without AMD.</span></div></div><div><h3>Methods</h3><div>Patients were identified using nAMD <em>ICD-10</em> and anti-VEGF <em>CPT</em> codes and matched for age, sex, and comorbidities. Five-year relative risk of ACM (RR<sub>1</sub><span>), hemorrhagic stroke (RR</span><sub>2</sub><span>), ischemic stroke (RR</span><sub>3</sub>), and MI (RR<sub>4</sub>) in nAMD patients receiving anti-VEGF injections were calculated.</div></div><div><h3>Results</h3><div>A total of 27,609 nAMD patients (mean diagnosis age [SD], [78.2 (10.3)]) received anti-VEGF injections; 769 nAMD patients without injections (75.8 [12.2]), 27,599 non-exudative AMD patients (78.2 [10.3]), and 21,902 no-AMD patients (76.1 [10.5]) were identified. After matching, nAMD patients receiving injections did not show increased risk versus nAMD patients without injections (RR<sub>1</sub>, 0.66; 95% CI [0.53, 0.82]), (RR<sub>2</sub>, 1.00 [0.42, 2.38]), (RR<sub>3</sub>, 1.70 [0.92,3.13]), (RR<sub>4</sub>, 0.63 [0.33, 1.18]). No increased risk was found compared to non-exudative AMD patients (RR<sub>1</sub>, 0.99 [0.95, 1.03]), (RR<sub>2</sub>, 0.94 [0.83,1.07]), (RR<sub>3</sub>, 1.04 [0.96, 1.12]), (RR<sub>4</sub>, 0.99 [0.91, 1.08]). Increased risk for ACM was observed versus no-AMD patients (RR<sub>1</sub>, 1.21 [1.15, 1.27]), but no other differences were found (RR<sub>2</sub>, 0.81 [0.70, 0.93]), (RR<sub>3</sub>, 1.00 [0.92, 1.09]), (RR<sub>4</sub>, 0.986 [0.90, 1.09]).</div></div><div><h3>Conclusion</h3><div>Anti-VEGF injections were not associated with major cardiovascular events in nAMD patients over 5 years.</div></div><div><h3>Objectif</h3><div>Évaluer le risque à 5 ans de mortalité toutes causes confondues (TCC), d'accident vasculaire cérébral (AVC) hémorragique, d'AVC ischémique et d'infarctus du myocarde (IM) chez des patients présentant une dégénérescence maculaire liée à l’âge néovasculaire (DMLAn) qui reçoivent des injections d'anti-VEGF (facteur de croissance endothélial vasculaire), comparativement aux sujets témoins.</div></div><div><h3>Nature</h3><div>Étude de cohorte populationnelle rétrospective fondée sur un réseau fédéré américain de recherche en santé comprenant les données dépersonnalisées de 96 millions de patients datées du 1<sup>er</sup> janvier 2003 au 6 mars 2023.</div></div><div><h3>Participants</h3><div>Patients qui p
{"title":"Cardiovascular risk in anti-VEGF treatment of neovascular age-related macular degeneration","authors":"David D. Chong , Christopher M. Maatouk , Jonathan Markle , Jacqueline K. Shaia , Rishi P. Singh , Katherine E. Talcott","doi":"10.1016/j.jcjo.2024.05.013","DOIUrl":"10.1016/j.jcjo.2024.05.013","url":null,"abstract":"<div><h3>Objective</h3><div><span>Assess 5-year all-cause mortality (ACM), hemorrhagic stroke, </span>ischemic stroke<span>, and myocardial infarction (MI) risks in nAMD patients receiving anti-VEGF injections compared with controls.</span></div></div><div><h3>Design</h3><div>Population-based retrospective cohort study using a U.S. federated health research network, containing de-identified data of 96 million patients from 1/1/2003 to 3/6/2023.</div></div><div><h3>Participants</h3><div><span>nAMD Patients with anti-VEGF injections. Controls included nAMD patients without anti-VEGF injections, non-exudative </span>AMD<span> patients, and patients without AMD.</span></div></div><div><h3>Methods</h3><div>Patients were identified using nAMD <em>ICD-10</em> and anti-VEGF <em>CPT</em> codes and matched for age, sex, and comorbidities. Five-year relative risk of ACM (RR<sub>1</sub><span>), hemorrhagic stroke (RR</span><sub>2</sub><span>), ischemic stroke (RR</span><sub>3</sub>), and MI (RR<sub>4</sub>) in nAMD patients receiving anti-VEGF injections were calculated.</div></div><div><h3>Results</h3><div>A total of 27,609 nAMD patients (mean diagnosis age [SD], [78.2 (10.3)]) received anti-VEGF injections; 769 nAMD patients without injections (75.8 [12.2]), 27,599 non-exudative AMD patients (78.2 [10.3]), and 21,902 no-AMD patients (76.1 [10.5]) were identified. After matching, nAMD patients receiving injections did not show increased risk versus nAMD patients without injections (RR<sub>1</sub>, 0.66; 95% CI [0.53, 0.82]), (RR<sub>2</sub>, 1.00 [0.42, 2.38]), (RR<sub>3</sub>, 1.70 [0.92,3.13]), (RR<sub>4</sub>, 0.63 [0.33, 1.18]). No increased risk was found compared to non-exudative AMD patients (RR<sub>1</sub>, 0.99 [0.95, 1.03]), (RR<sub>2</sub>, 0.94 [0.83,1.07]), (RR<sub>3</sub>, 1.04 [0.96, 1.12]), (RR<sub>4</sub>, 0.99 [0.91, 1.08]). Increased risk for ACM was observed versus no-AMD patients (RR<sub>1</sub>, 1.21 [1.15, 1.27]), but no other differences were found (RR<sub>2</sub>, 0.81 [0.70, 0.93]), (RR<sub>3</sub>, 1.00 [0.92, 1.09]), (RR<sub>4</sub>, 0.986 [0.90, 1.09]).</div></div><div><h3>Conclusion</h3><div>Anti-VEGF injections were not associated with major cardiovascular events in nAMD patients over 5 years.</div></div><div><h3>Objectif</h3><div>Évaluer le risque à 5 ans de mortalité toutes causes confondues (TCC), d'accident vasculaire cérébral (AVC) hémorragique, d'AVC ischémique et d'infarctus du myocarde (IM) chez des patients présentant une dégénérescence maculaire liée à l’âge néovasculaire (DMLAn) qui reçoivent des injections d'anti-VEGF (facteur de croissance endothélial vasculaire), comparativement aux sujets témoins.</div></div><div><h3>Nature</h3><div>Étude de cohorte populationnelle rétrospective fondée sur un réseau fédéré américain de recherche en santé comprenant les données dépersonnalisées de 96 millions de patients datées du 1<sup>er</sup> janvier 2003 au 6 mars 2023.</div></div><div><h3>Participants</h3><div>Patients qui p","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages 35-41"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141247642","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jcjo.2024.05.028
Ting-Chieh Ko , Shu-Lang Liao , Yi-Hsuan Wei
<div><h3>Objective</h3><div>This study aims to assess morphometric variations in bony nasolacrimal ducts (BNLDs) and sinonasal anatomy in Asian patients with unilateral primary acquired nasolacrimal duct obstruction (PANDO) through computed tomography (CT).</div></div><div><h3>Methods</h3><div>We enrolled 34 patients with unilateral PANDO who underwent endoscopic dacryocystorhinostomy, alongside 34 age- and sex-matched control patients without documented epiphora complaints. We compared BNLD and sinonasal parameters on CT images between the affected and unaffected sides of PANDO patients and the control group.</div></div><div><h3>Results</h3><div>The entrance area of the BNLD was larger on the affected side of unilateral PANDO patients compared to both the unaffected side (<em>p</em> = 0.012) and the control group (<em>p</em> = 0.046). The open angle in the coronal plane was greater on both the affected (<em>p</em> = 0.044) and unaffected side (<em>p</em> = 0.028) than in the control group. Minimal area and distal area in the axial plane showed no differences among the 3 groups. Paranasal parameters did not differ between the study and control groups. More patients in the study group had superiorly located nasal septum deviation than the control group (<em>p</em> = 0.048). A trend suggested that more patients in the study group had anteriorly located nasal septum deviation than the control group (<em>p</em> = 0.056), although not reaching statistical significance.</div></div><div><h3>Conclusion</h3><div>The increased angular tilt in PANDO patients could impede fluid drainage from a fluidics standpoint. The larger BNLD area on the affected side reflects inflammation-induced osteolysis. Additionally, sinonasal variations, particularly nasal septum deviation at the anterior and superior half, have been identified as contributing to a higher risk of PANDO.</div></div><div><h3>Objectif</h3><div>Notre étude a eu recours à la tomographie assistée par ordinateur pour évaluer les variations morphométriques du canal nasolacrymal osseux (CNLO) et de l'anatomie nasosinusienne chez des patients asiatiques présentant une sténose acquise non spécifique du canal lacrymonasal (PANDO, pour <em>primary acquired nasolacrimal duct obstruction</em>) unilatérale.</div></div><div><h3>Méthodes</h3><div>Nous avons recruté 34 patients atteints d'une PANDO unilatérale qui ont subi une dacryocystorhinostomie endoscopique ainsi que 34 sujets témoins sans larmoiement avéré et appariés pour l’âge et le sexe. Nous avons comparé le CNLO et les paramètres nasosinusiens sur les images tomographiques des patients du groupe PANDO (côtés atteints et normaux) et ceux du groupe témoin.</div></div><div><h3>Résultats</h3><div>Chez les patients qui présentaient une PANDO unilatérale, l'entrée du CNLO était plus évasée du côté atteint, comparativement à celle du côté normal (<em>p</em> = 0,012) et à celle des patients du groupe témoin (<em>p</em> = 0,046). L'angle ouvert du plan frontal éta
{"title":"Morphometric analysis of bony nasolacrimal canal and sinonasal anatomical variations in primary acquired nasolacrimal duct obstruction","authors":"Ting-Chieh Ko , Shu-Lang Liao , Yi-Hsuan Wei","doi":"10.1016/j.jcjo.2024.05.028","DOIUrl":"10.1016/j.jcjo.2024.05.028","url":null,"abstract":"<div><h3>Objective</h3><div>This study aims to assess morphometric variations in bony nasolacrimal ducts (BNLDs) and sinonasal anatomy in Asian patients with unilateral primary acquired nasolacrimal duct obstruction (PANDO) through computed tomography (CT).</div></div><div><h3>Methods</h3><div>We enrolled 34 patients with unilateral PANDO who underwent endoscopic dacryocystorhinostomy, alongside 34 age- and sex-matched control patients without documented epiphora complaints. We compared BNLD and sinonasal parameters on CT images between the affected and unaffected sides of PANDO patients and the control group.</div></div><div><h3>Results</h3><div>The entrance area of the BNLD was larger on the affected side of unilateral PANDO patients compared to both the unaffected side (<em>p</em> = 0.012) and the control group (<em>p</em> = 0.046). The open angle in the coronal plane was greater on both the affected (<em>p</em> = 0.044) and unaffected side (<em>p</em> = 0.028) than in the control group. Minimal area and distal area in the axial plane showed no differences among the 3 groups. Paranasal parameters did not differ between the study and control groups. More patients in the study group had superiorly located nasal septum deviation than the control group (<em>p</em> = 0.048). A trend suggested that more patients in the study group had anteriorly located nasal septum deviation than the control group (<em>p</em> = 0.056), although not reaching statistical significance.</div></div><div><h3>Conclusion</h3><div>The increased angular tilt in PANDO patients could impede fluid drainage from a fluidics standpoint. The larger BNLD area on the affected side reflects inflammation-induced osteolysis. Additionally, sinonasal variations, particularly nasal septum deviation at the anterior and superior half, have been identified as contributing to a higher risk of PANDO.</div></div><div><h3>Objectif</h3><div>Notre étude a eu recours à la tomographie assistée par ordinateur pour évaluer les variations morphométriques du canal nasolacrymal osseux (CNLO) et de l'anatomie nasosinusienne chez des patients asiatiques présentant une sténose acquise non spécifique du canal lacrymonasal (PANDO, pour <em>primary acquired nasolacrimal duct obstruction</em>) unilatérale.</div></div><div><h3>Méthodes</h3><div>Nous avons recruté 34 patients atteints d'une PANDO unilatérale qui ont subi une dacryocystorhinostomie endoscopique ainsi que 34 sujets témoins sans larmoiement avéré et appariés pour l’âge et le sexe. Nous avons comparé le CNLO et les paramètres nasosinusiens sur les images tomographiques des patients du groupe PANDO (côtés atteints et normaux) et ceux du groupe témoin.</div></div><div><h3>Résultats</h3><div>Chez les patients qui présentaient une PANDO unilatérale, l'entrée du CNLO était plus évasée du côté atteint, comparativement à celle du côté normal (<em>p</em> = 0,012) et à celle des patients du groupe témoin (<em>p</em> = 0,046). L'angle ouvert du plan frontal éta","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e52-e58"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141878444","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jcjo.2024.08.017
Ye Li , Svetlana Cherepanoff , R. Max Conway , Luke B. Hesson , Georgina Long , Nikita Garg , Adrian T. Fung
{"title":"Choroidal melanoma in a patient with multiple endocrine neoplasia type 1","authors":"Ye Li , Svetlana Cherepanoff , R. Max Conway , Luke B. Hesson , Georgina Long , Nikita Garg , Adrian T. Fung","doi":"10.1016/j.jcjo.2024.08.017","DOIUrl":"10.1016/j.jcjo.2024.08.017","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e173-e176"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142280671","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jcjo.2024.05.008
Raziyeh Mahmoudzadeh , Glenn J. Oh , Neil Patel , Samir N. Patel , Thomas Tien , David Xu , Brenton D. Finklea , Omesh P. Gupta , Brandon D. Ayres , M. Ali Khan
<div><h3>Objective</h3><div>To compare clinical outcomes of combined pars plana vitrectomy (PPV) and secondary scleral fixation of an intraocular lens (IOL) using Gore-Tex suture versus flanged intrascleral haptic fixation (FIHF) using double needles.</div></div><div><h3>Design</h3><div>Single-centre retrospective cohort series.</div></div><div><h3>Participants</h3><div>Eyes undergoing PPV with simultaneous scleral fixation of an IOL.</div></div><div><h3>Method</h3><div><span>Eyes that underwent fixation of a Bausch & Lomb Akreos AO60 or enVista MX60E IOL using Gore-Tex suture or a Tecnis ZA9003 or Zeiss CT LUCIA 602 IOL using FIHF were included. The primary outcome was change from baseline visual acuity to postoperative month 3. Secondary outcomes included deviation from refractive target aim and rates of </span>postoperative complications.</div></div><div><h3>Results</h3><div>Seventy-nine eyes of 72 patients were included. Mean (±SD) follow-up was 16 ± 10.5 months (range, 4.5–45.2 months). Fifty-three eyes (67.1%) underwent Gore-Tex suture fixation, and 26 eyes (32.9%) underwent FIHF. Across all eyes, mean visual acuity improved from 1.30 ± 0.74 logMAR (20/399 Snellen equivalent) preoperatively to 0.36 ± 0.36 logMAR (20/45 Snellen equivalent) at 3 months (<em>p</em> < 0.001). No difference in visual acuity at month 3 was noted between the 2 techniques (<em>p</em> = 0.34). Mean deviation from refractive target aim was not significantly different between the Gore-Tex and FIHF groups (+0.14 ± 1.33 D vs –0.16 ± 0.88 D; <em>p</em><span> = 0.45). Reoperation rates were similar between groups (2 of 53 eyes in the Gore-Tex group vs 3 of 26 eyes in the FIHF group; </span><em>p</em> = 0.32).</div></div><div><h3>Conclusion</h3><div>Combined PPV and scleral fixation of IOLs with Gore-Tex suture and FIHF resulted in similar improvements in visual acuity. No significant differences in refractive outcome and postoperative complication profiles were noted.</div></div><div><h3>Objectif</h3><div>Comparer les résultats cliniques de la vitrectomie par la pars plana (VPP) combinée à l'implantation secondaire de lentilles intraoculaires (LIO) grâce à une fixation sclérale à l'aide de sutures en Gore-Tex® ou à une technique de fixation haptique intrasclérale à bride (FHIB) et à deux aiguilles.</div></div><div><h3>Nature</h3><div>Série de cas portant sur une cohorte rétrospective dans un établissement unique.</div></div><div><h3>Participants</h3><div>Yeux devant subir une VPP et une fixation sclérale simultanée de LIO.</div></div><div><h3>Méthode</h3><div>Ont été inclus les yeux qui ont reçu une LIO (Bausch & Lomb Akreos AO60 ou enVista MX60E) fixée à l'aide de sutures en Gore-Tex® ou encore une LIO (Tecnis ZA9003 ou Zeiss CT LUCIA 602) fixée à l'aide d'une technique de FHIB. Le paramètre principal était la variation de l'acuité visuelle entre l'examen initial et l'examen réalisé 3 mois après l'intervention. Parmi les paramètres secondaires, citons la dévia
{"title":"Pars plana vitrectomy and scleral-fixated intraocular lenses: comparison of Gore-Tex suture and flanged intrascleral haptic fixation techniques","authors":"Raziyeh Mahmoudzadeh , Glenn J. Oh , Neil Patel , Samir N. Patel , Thomas Tien , David Xu , Brenton D. Finklea , Omesh P. Gupta , Brandon D. Ayres , M. Ali Khan","doi":"10.1016/j.jcjo.2024.05.008","DOIUrl":"10.1016/j.jcjo.2024.05.008","url":null,"abstract":"<div><h3>Objective</h3><div>To compare clinical outcomes of combined pars plana vitrectomy (PPV) and secondary scleral fixation of an intraocular lens (IOL) using Gore-Tex suture versus flanged intrascleral haptic fixation (FIHF) using double needles.</div></div><div><h3>Design</h3><div>Single-centre retrospective cohort series.</div></div><div><h3>Participants</h3><div>Eyes undergoing PPV with simultaneous scleral fixation of an IOL.</div></div><div><h3>Method</h3><div><span>Eyes that underwent fixation of a Bausch & Lomb Akreos AO60 or enVista MX60E IOL using Gore-Tex suture or a Tecnis ZA9003 or Zeiss CT LUCIA 602 IOL using FIHF were included. The primary outcome was change from baseline visual acuity to postoperative month 3. Secondary outcomes included deviation from refractive target aim and rates of </span>postoperative complications.</div></div><div><h3>Results</h3><div>Seventy-nine eyes of 72 patients were included. Mean (±SD) follow-up was 16 ± 10.5 months (range, 4.5–45.2 months). Fifty-three eyes (67.1%) underwent Gore-Tex suture fixation, and 26 eyes (32.9%) underwent FIHF. Across all eyes, mean visual acuity improved from 1.30 ± 0.74 logMAR (20/399 Snellen equivalent) preoperatively to 0.36 ± 0.36 logMAR (20/45 Snellen equivalent) at 3 months (<em>p</em> < 0.001). No difference in visual acuity at month 3 was noted between the 2 techniques (<em>p</em> = 0.34). Mean deviation from refractive target aim was not significantly different between the Gore-Tex and FIHF groups (+0.14 ± 1.33 D vs –0.16 ± 0.88 D; <em>p</em><span> = 0.45). Reoperation rates were similar between groups (2 of 53 eyes in the Gore-Tex group vs 3 of 26 eyes in the FIHF group; </span><em>p</em> = 0.32).</div></div><div><h3>Conclusion</h3><div>Combined PPV and scleral fixation of IOLs with Gore-Tex suture and FIHF resulted in similar improvements in visual acuity. No significant differences in refractive outcome and postoperative complication profiles were noted.</div></div><div><h3>Objectif</h3><div>Comparer les résultats cliniques de la vitrectomie par la pars plana (VPP) combinée à l'implantation secondaire de lentilles intraoculaires (LIO) grâce à une fixation sclérale à l'aide de sutures en Gore-Tex® ou à une technique de fixation haptique intrasclérale à bride (FHIB) et à deux aiguilles.</div></div><div><h3>Nature</h3><div>Série de cas portant sur une cohorte rétrospective dans un établissement unique.</div></div><div><h3>Participants</h3><div>Yeux devant subir une VPP et une fixation sclérale simultanée de LIO.</div></div><div><h3>Méthode</h3><div>Ont été inclus les yeux qui ont reçu une LIO (Bausch & Lomb Akreos AO60 ou enVista MX60E) fixée à l'aide de sutures en Gore-Tex® ou encore une LIO (Tecnis ZA9003 ou Zeiss CT LUCIA 602) fixée à l'aide d'une technique de FHIB. Le paramètre principal était la variation de l'acuité visuelle entre l'examen initial et l'examen réalisé 3 mois après l'intervention. Parmi les paramètres secondaires, citons la dévia","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e65-e72"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141178840","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jcjo.2024.05.018
Bita Esmaeli , Janet Fan , Hila Goldberg , Tracy Lu , Neil D. Gross , Neal Akhave , Luana Guimaraes Sousa , Renata Ferrarotto
<div><h3>Objective</h3><div>Periocular squamous cell carcinoma (SCC) is relatively rare and presents unique anatomic considerations due to proximity to the eye and risk to ocular structures associated with high-dose radiation therapy or radical surgery. We present our observations in patients with periocular SCC treated with immune checkpoint inhibitor (ICI) therapy in an effort to decrease surgical morbidity or avoid high-dose radiation therapy.</div></div><div><h3>Methods</h3><div>Retrospective review of patients with orbital, conjunctival, or periocular SCC who were treated with ICI either in the neoadjuvant setting prior to surgery or for treatment of perineural spread in the orbit/skull base.</div></div><div><h3>Results</h3><div>Twelve men and 5 women with orbital (n = 6), conjunctival (n = 5), or lacrimal sac/duct (n = 2) SCC, or SCC with perineural spread (n = 4) were treated with ICI (cemiplimab or pembolizumab) either as single drug (n = 9) or combined with chemotherapy (n = 8). Overall, 5 patients achieved complete response, 8 patients achieved partial response, and 4 patients achieved stable disease, using the response evaluation criteria in solid tumors (RECIST) criteria. The objective response rate was 76.5%. In 12 patients ICI was used in the neoadjuvant setting prior to surgery. In 4 patients with perineural spread and unresectable disease, ICI was used to avoid high-dose radiation therapy. One additional patient with conjunctival SCC with nodal metastasis was treated with ICI alone and achieved a dramatic complete response and has thus far managed to avoid surgery altogether.</div></div><div><h3>Conclusions</h3><div>ICI either as single drug or in combination with chemotherapy has a high response rate in patients with periocular SCC. Future prospective trials should aim to correlate molecular data with response.</div></div><div><h3>Objectif</h3><div>Le carcinome épidermoïde périoculaire, cancer relativement rare, est assujetti à des considérations anatomiques uniques en raison de la proximité de l’œil et du risque que posent la radiothérapie fortement dosée ou la chirurgie radicale pour les structures oculaires. La présente étude porte sur l'administration d'un traitement reposant sur un inhibiteur de points de contrôle immunitaire (ICI) dans le carcinome épidermoïde périoculaire afin de réduire la morbidité chirurgicale ou d’éviter la radiothérapie fortement dosée.</div></div><div><h3>Méthodes</h3><div>Il s'agit d'une revue de synthèse rétrospective de patients atteints d'un carcinome épidermoïde orbitaire, conjonctival ou périoculaire qui ont reçu un ICI à titre néoadjuvant avant la chirurgie ou à titre thérapeutique en raison d'une extension périneurale dans l'orbite ou à la base du crâne.</div></div><div><h3>Résultats</h3><div>Ainsi, 12 hommes et 5 femmes qui présentaient un carcinome épidermoïde orbitaire (n = 6), conjonctival (n = 5) ou du sac/canal lacrymal (n = 2) ou encore un carcinome épidermoïde s'accompagnant d'une ext
{"title":"Immune checkpoint inhibitors with or without chemotherapy for orbital, conjunctival, and ocular adnexal squamous cell carcinoma","authors":"Bita Esmaeli , Janet Fan , Hila Goldberg , Tracy Lu , Neil D. Gross , Neal Akhave , Luana Guimaraes Sousa , Renata Ferrarotto","doi":"10.1016/j.jcjo.2024.05.018","DOIUrl":"10.1016/j.jcjo.2024.05.018","url":null,"abstract":"<div><h3>Objective</h3><div>Periocular squamous cell carcinoma (SCC) is relatively rare and presents unique anatomic considerations due to proximity to the eye and risk to ocular structures associated with high-dose radiation therapy or radical surgery. We present our observations in patients with periocular SCC treated with immune checkpoint inhibitor (ICI) therapy in an effort to decrease surgical morbidity or avoid high-dose radiation therapy.</div></div><div><h3>Methods</h3><div>Retrospective review of patients with orbital, conjunctival, or periocular SCC who were treated with ICI either in the neoadjuvant setting prior to surgery or for treatment of perineural spread in the orbit/skull base.</div></div><div><h3>Results</h3><div>Twelve men and 5 women with orbital (n = 6), conjunctival (n = 5), or lacrimal sac/duct (n = 2) SCC, or SCC with perineural spread (n = 4) were treated with ICI (cemiplimab or pembolizumab) either as single drug (n = 9) or combined with chemotherapy (n = 8). Overall, 5 patients achieved complete response, 8 patients achieved partial response, and 4 patients achieved stable disease, using the response evaluation criteria in solid tumors (RECIST) criteria. The objective response rate was 76.5%. In 12 patients ICI was used in the neoadjuvant setting prior to surgery. In 4 patients with perineural spread and unresectable disease, ICI was used to avoid high-dose radiation therapy. One additional patient with conjunctival SCC with nodal metastasis was treated with ICI alone and achieved a dramatic complete response and has thus far managed to avoid surgery altogether.</div></div><div><h3>Conclusions</h3><div>ICI either as single drug or in combination with chemotherapy has a high response rate in patients with periocular SCC. Future prospective trials should aim to correlate molecular data with response.</div></div><div><h3>Objectif</h3><div>Le carcinome épidermoïde périoculaire, cancer relativement rare, est assujetti à des considérations anatomiques uniques en raison de la proximité de l’œil et du risque que posent la radiothérapie fortement dosée ou la chirurgie radicale pour les structures oculaires. La présente étude porte sur l'administration d'un traitement reposant sur un inhibiteur de points de contrôle immunitaire (ICI) dans le carcinome épidermoïde périoculaire afin de réduire la morbidité chirurgicale ou d’éviter la radiothérapie fortement dosée.</div></div><div><h3>Méthodes</h3><div>Il s'agit d'une revue de synthèse rétrospective de patients atteints d'un carcinome épidermoïde orbitaire, conjonctival ou périoculaire qui ont reçu un ICI à titre néoadjuvant avant la chirurgie ou à titre thérapeutique en raison d'une extension périneurale dans l'orbite ou à la base du crâne.</div></div><div><h3>Résultats</h3><div>Ainsi, 12 hommes et 5 femmes qui présentaient un carcinome épidermoïde orbitaire (n = 6), conjonctival (n = 5) ou du sac/canal lacrymal (n = 2) ou encore un carcinome épidermoïde s'accompagnant d'une ext","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e38-e51"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751195","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}
Pub Date : 2025-02-01DOI: 10.1016/j.jcjo.2024.05.007
Sophiana Lindenberg , Muneeswar G. Nittala , Aditya Verma , Malinda E.C. Fitzgerald , Swetha B. Velaga , Robert B. Bhisitkul , SriniVas R. Sadda
<div><h3>Background</h3><div><span>Subretinal hyperreflective material (SHRM) is a significant biomarker for poor visual outcomes in neovascular age-related macular degeneration (nAMD); however, its relationship with fibrosis and atrophy is not well understood. This study aims to evaluate the relationship between SHRM, atrophy, and fibrosis in eyes receiving antivascular </span>endothelial growth factor therapy for nAMD.</div></div><div><h3>Methods</h3><div>Post-hoc analysis of the 65 patients enrolled in the SEVEN-UP study, a multicenter cross-sectional study of patients originally enrolled in the ANCHOR and MARINA trials of ranibizumab<span><span>. Color fundus photographs (CFP) were reviewed and manually segmented to define regions of atrophy and fibrosis. SHRM borders on </span>OCT volume scans were manually delineated, and thickness measurements were computed and compared in corresponding regions of atrophy and fibrosis on the CFPs.</span></div></div><div><h3>Results</h3><div>Of the 65 subjects, 51 eyes showed atrophy and/or fibrosis on CFP and were included in the final analysis. Both atrophy and fibrosis regions exhibited SHRM on OCT. The mean SHRM thickness on OCT was significantly greater in CFP-fibrosis regions (44.19 ± 46.95 μm) compared with CFP-atrophy regions (14.28 ± 13.35 μm; <em>p</em> < 0.001). Additionally, the average maximum height of SHRM in fibrotic regions (268.04 ± 130.05 μm) was significantly thicker than in atrophic regions (121.95 ± 51.17 μm; <em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Although atrophy and fibrosis are thought to be different end-stage outcomes in eyes with nAMD, they both demonstrate SHRM on OCT; the main distinction being thickness. Given these similarities, these regions of nAMD-associated atrophy may be better-termed “<em>atrosis</em><span>” to distinguish these lesions from typical atrophy in the absence of neovascular disease.</span></div></div><div><h3>Contexte</h3><div>Le matériel hyperréflectif sous-rétinien (SHRM, pour <em>subretinal hyperreflective material</em>) est un biomarqueur significatif de résultats visuels médiocres dans la dégénérescence maculaire liée à l’âge néovasculaire (DMLAn); cependant, on connaît mal son lien avec la fibrose et l'atrophie. Notre étude se penchait donc sur l'association entre le SHRM, l'atrophie et la fibrose dans des yeux traités par anti-VEGF (facteur de croissance endothélial vasculaire) en raison d'une DMLAn.</div></div><div><h3>Méthodes</h3><div>Il s'agissait d'une analyse a posteriori de 65 patients admis à l’étude SEVEN-UP (étude transversale multicentrique portant sur les patients admis aux études ANCHOR et MARINA sur le ranibizumab). On a examiné les photographies en couleurs du fond d’œil (PCFO) pour ensuite les segmenter manuellement afin de cerner les zones d'atrophie et de fibrose. Les bordures du SHRM sur les images de volume obtenues à la tomographie par cohérence optique (OCT) ont été délimitées à la main, et les mesur
{"title":"Subretinal hyperreflective material in regions of atrophy and fibrosis in eyes with neovascular age-related macular degeneration","authors":"Sophiana Lindenberg , Muneeswar G. Nittala , Aditya Verma , Malinda E.C. Fitzgerald , Swetha B. Velaga , Robert B. Bhisitkul , SriniVas R. Sadda","doi":"10.1016/j.jcjo.2024.05.007","DOIUrl":"10.1016/j.jcjo.2024.05.007","url":null,"abstract":"<div><h3>Background</h3><div><span>Subretinal hyperreflective material (SHRM) is a significant biomarker for poor visual outcomes in neovascular age-related macular degeneration (nAMD); however, its relationship with fibrosis and atrophy is not well understood. This study aims to evaluate the relationship between SHRM, atrophy, and fibrosis in eyes receiving antivascular </span>endothelial growth factor therapy for nAMD.</div></div><div><h3>Methods</h3><div>Post-hoc analysis of the 65 patients enrolled in the SEVEN-UP study, a multicenter cross-sectional study of patients originally enrolled in the ANCHOR and MARINA trials of ranibizumab<span><span>. Color fundus photographs (CFP) were reviewed and manually segmented to define regions of atrophy and fibrosis. SHRM borders on </span>OCT volume scans were manually delineated, and thickness measurements were computed and compared in corresponding regions of atrophy and fibrosis on the CFPs.</span></div></div><div><h3>Results</h3><div>Of the 65 subjects, 51 eyes showed atrophy and/or fibrosis on CFP and were included in the final analysis. Both atrophy and fibrosis regions exhibited SHRM on OCT. The mean SHRM thickness on OCT was significantly greater in CFP-fibrosis regions (44.19 ± 46.95 μm) compared with CFP-atrophy regions (14.28 ± 13.35 μm; <em>p</em> < 0.001). Additionally, the average maximum height of SHRM in fibrotic regions (268.04 ± 130.05 μm) was significantly thicker than in atrophic regions (121.95 ± 51.17 μm; <em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>Although atrophy and fibrosis are thought to be different end-stage outcomes in eyes with nAMD, they both demonstrate SHRM on OCT; the main distinction being thickness. Given these similarities, these regions of nAMD-associated atrophy may be better-termed “<em>atrosis</em><span>” to distinguish these lesions from typical atrophy in the absence of neovascular disease.</span></div></div><div><h3>Contexte</h3><div>Le matériel hyperréflectif sous-rétinien (SHRM, pour <em>subretinal hyperreflective material</em>) est un biomarqueur significatif de résultats visuels médiocres dans la dégénérescence maculaire liée à l’âge néovasculaire (DMLAn); cependant, on connaît mal son lien avec la fibrose et l'atrophie. Notre étude se penchait donc sur l'association entre le SHRM, l'atrophie et la fibrose dans des yeux traités par anti-VEGF (facteur de croissance endothélial vasculaire) en raison d'une DMLAn.</div></div><div><h3>Méthodes</h3><div>Il s'agissait d'une analyse a posteriori de 65 patients admis à l’étude SEVEN-UP (étude transversale multicentrique portant sur les patients admis aux études ANCHOR et MARINA sur le ranibizumab). On a examiné les photographies en couleurs du fond d’œil (PCFO) pour ensuite les segmenter manuellement afin de cerner les zones d'atrophie et de fibrose. Les bordures du SHRM sur les images de volume obtenues à la tomographie par cohérence optique (OCT) ont été délimitées à la main, et les mesur","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages 26-34"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141178842","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}
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