Canadian journal of ophthalmology. Journal canadien d'ophtalmologie最新文献_第7页

Artificial intelligence in the classification and segmentation of fundus images with choroidal nevi 人工智能在脉络膜痣眼底图像分类和分割中的应用。

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.2024.07.009

R. Trafford Crump , Emad Mohammed , Mehregan Biglarbeiki , Mohammadmahdi Eshragh , Esmaeil Shakeri , Gunnar Joakim Siljedal , Behrouz Far , Ezekiel Weis

Objective

The purpose of this study is to summarize the results from 3 experimental studies into the use of artificial intelligence to classify and segment colour fundus images with choroidal nevi.

Study Design

This study is based on a secondary analysis of colour fundus images taken of patients receiving usual clinical care from the Alberta Ocular Brachytherapy Program.

Methods

High-resolution colour fundus images were labeled by experienced ocular oncologists. In experimental study 1, four pre-trained models (ResNet 50, VGG-19, VGG-16, and AlexNet) were evaluated for their ability to classify images based on the presence of choroidal nevi. In experimental study 2, the performance of 3 patch-based models to classify images based on the presence of choroidal nevi were compared. In experimental study 3, four convolutional neural network models were developed to segment the images. In experimental studies 1 and 2, performance was measured using accuracy, precision, recall, F1 score, and AUC. In experimental study 3, IoU and Dice measures were used to evaluate performance.

Results

A total of 591 labelled colour fundus images were used for analysis. In experimental study 1, VGG-16 showed the best accuracy, AUC, and recall, but lower precision in classifying images. In experimental study 2, the patched approached enhanced with artifact and contrast outperformed the others in classifying images. In experimental study 3, a voting-based Ensemble model excelled in segmenting the part of images with nevi.

Conclusions

It is feasible to train AI models to identify choroidal nevi in colour fundus images.

研究目的本研究旨在总结利用人工智能对带有脉络膜痣的彩色眼底图像进行分类和分割的 3 项实验研究的结果：方法：由经验丰富的眼部肿瘤专家对高分辨率彩色眼底图像进行标注。在实验研究 1 中，评估了四个预训练模型（ResNet 50、VGG-19、VGG-16 和 AlexNet）根据脉络膜痣的存在对图像进行分类的能力。在实验研究 2 中，比较了 3 个基于补丁的模型根据脉络膜痣的存在对图像进行分类的性能。在实验研究 3 中，开发了 4 个卷积神经网络模型来分割图像。在实验研究 1 和 2 中，使用准确率、精确度、召回率、F1 分数和 AUC 来衡量性能。在实验研究 3 中，使用 IoU 和 Dice 度量来评估性能：共有 591 张标注了颜色的眼底图像被用于分析。在实验研究 1 中，VGG-16 显示出最佳的准确率、AUC 和召回率，但图像分类精度较低。在实验研究 2 中，用人工痕迹和对比度增强的修补方法在图像分类方面优于其他方法。在实验研究 3 中，基于投票的集合模型在分割有痣的图像部分方面表现出色：训练人工智能模型来识别彩色眼底图像中的脉络膜痣是可行的。

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引用次数: 0

Impact of 11 years of glaucoma research funding: Glaucoma Research Society of Canada (2010–2020) 11年青光眼研究经费的影响：加拿大青光眼研究协会（2010-2020）。

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.2025.05.022

William J. Herspiegel , Melina Moeinkhah , Anastasiya Vinokurtseva , Graham Trope , Cindy M.L. Hutnik

Objective

The Glaucoma Research Society of Canada (GRSC) is Canada’s only nonprofit organization dedicated to funding peer-reviewed glaucoma research. This study evaluates the impact of GRSC-funded projects using established research productivity metrics.

Design

Retrospective study.

Methods

GRSC-funded grants from 2010 to 2020 were analyzed, including project details and funding amounts. Research productivity was assessed by (1) the number of peer-reviewed publications and (2) the number of conference presentations at major North American meetings. Publications were identified via PubMed searches of grant recipients, ensuring alignment with GRSC-funded topics. Conference presentations were determined by reviewing accepted abstracts from 5 key ophthalmology meetings: the Canadian Ophthalmological Society, American Society of Cataract and Refractive Surgery, American Academy of Ophthalmology, American Glaucoma Society, and Association for Research in Vision and Ophthalmology. Research output was analyzed in relation to funding costs.

Results

Of 135 grants totaling $2,220,822, 84 (62%) led to at least one publication (92 total), while 67 (50%) resulted in conference presentations (85 total). The average research output per grant was 1.3, with costs of $12,547 per research output and $24,139 per publication. Research costs increased over time, with a slight decrease in 2019.

Conclusions

GRSC-funded research consistently generates peer-reviewed knowledge, with over half of projects producing publications or presentations. Despite rising research costs, the high success rate in knowledge dissemination underscores GRSC’s critical role in sustaining and advancing glaucoma research in Canada.

目的：加拿大青光眼研究协会（GRSC）是加拿大唯一致力于资助同行评议青光眼研究的非营利组织。本研究使用已建立的研究生产力指标评估grsc资助项目的影响。研究设计：回顾性研究。方法：对2010 - 2020年grsc资助项目进行分析，包括项目明细和资助金额。研究生产力是通过(1)同行评议的出版物数量和(2)在北美主要会议上的会议发言数量来评估的。通过PubMed对资助接受者的搜索确定出版物，确保与grsc资助的主题保持一致。会议报告是通过审查5个主要眼科会议的接受摘要来确定的：加拿大眼科学会、美国白内障和屈光手术学会、美国眼科学会、美国青光眼学会和视觉和眼科研究协会。研究产出与资金成本的关系进行了分析。结果：在135项资助中，总计2,220,822美元，84项（62%）导致至少一篇论文发表（总共92篇），67项（50%）导致会议报告（总共85篇）。每笔赠款的平均研究产出为1.3，每项研究产出费用为12 547美元，每本出版物费用为24 139美元。研究成本随着时间的推移而增加，2019年略有下降。结论：grsc资助的研究始终产生同行评审的知识，超过一半的项目产生出版物或演示文稿。尽管研究成本不断上升，但知识传播的高成功率强调了GRSC在维持和推进加拿大青光眼研究方面的关键作用。

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引用次数: 0

Prevalence of ocular manifestations in cutaneous rosacea: systematic review and meta-analysis 皮肤酒渣鼻眼部表现的患病率：一项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.2025.04.005

Ryan H. Kirkpatrick , Kristina Nazzicone , Aleksandar Biorac , Anneke R. Froentjes , Sarah M. Simpson , Sonja Molin

Objective

Ocular rosacea (OR) is a rosacea subtype, typically presenting as dry eye, foreign body sensation, and photophobia. Prevalence estimates of OR in cutaneous rosacea (CR) range from 0.03% to 65%. This systematic review and meta-analysis consolidate the prevalence of diagnosed OR within CR and ocular involvement of CR.

Methods

Primary research studies reporting the prevalence of OR in adults with CR were eligible for inclusion. Embase, MEDLINE, Web of Science, ProQuest, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. The Joanna Briggs Institute Critical Appraisal tool for Prevalence Studies and a Peters’ regression test assessed risk of bias. Results were analyzed through random intercept logistic regression models using R. Studies reporting diagnosed OR were analyzed separately from those reporting ocular involvement.

Results

28 studies were identified, 11 reported on diagnosed OR, and 17 reported on ocular involvement in CR. Prevalence of diagnosed OR (N = 124 093) was 10.3%, whereas the prevalence of ocular involvement in CR (N = 1 747) was 44.3%. In diagnosed OR, publication year significantly contributed to variations in reported OR prevalence, with more recent studies reporting a lower prevalence of diagnosed OR compared to older studies.

Discussion

This study highlights the variability in reported prevalences of OR and ocular involvement in CR. This might be explained by a lack of clear guidelines on how to diagnose and refer patients with CR and co-occurring ocular signs and symptoms. Greater clinician awareness and clear referral guidelines are warranted.

目的：眼酒渣鼻（OR）是一种酒渣鼻亚型，典型表现为干眼、异物感和畏光。OR在皮肤酒渣鼻（CR）中的患病率估计在0.03%到65%之间。本系统综述和荟萃分析巩固了CR中诊断的OR的患病率和CR的眼部受累。方法：报告成人CR中OR患病率的初步研究符合纳入条件。检索了Embase、MEDLINE、Web of Science、ProQuest和Cochrane Central Register of Controlled Trials （Central）。乔安娜布里格斯研究所流行病学研究关键评估工具和彼得斯回归测试评估了偏倚风险。结果通过随机截距logistic回归模型进行分析。报告诊断为OR的研究与报告眼部受累的研究分开分析。结果：共纳入28项研究，其中11项报告了诊断为OR， 17项报告了CR的眼部受累。诊断为OR的患病率（N = 124,093）为10.3%，而CR的眼部受累患病率（N = 1 747）为44.3%。在诊断性OR中，发表年份对报告的OR患病率差异有显著影响，与较早的研究相比，最近的研究报告诊断性OR的患病率较低。讨论：本研究强调了报道的CR中OR患病率和眼部受累的差异，这可能是由于缺乏关于如何诊断和转诊CR患者并同时出现眼部体征和症状的明确指南。提高临床医生的认识和明确的转诊指南是必要的。

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引用次数: 0

An atypical case of thyroid-related orbitopathy presenting as bilateral infiltrative mass lesions 一个不典型的甲状腺相关眼病病例，表现为双侧浸润性肿块病变。

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.2025.08.013

Nishanth S. Iyengar, Edward Xie, Casey Bunge, Tahmeena Ahmed, Nariman S. Boyle

引用次数: 0

Visual Abstract 视觉文摘

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.2025.11.007

引用次数: 0

ETDRS-style distance visual acuity charts for Indigenous Canadians: development and validation using Canadian Aboriginal syllabics 加拿大原住民etdrs风格的距离视力表：使用加拿大原住民音节的发展与验证。

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.2025.04.004

Brendan K. Tao , Sidrat Rahman , Dana Toameh , Edsel Ing , Christian El-Hadad

Objective

To develop and validate a logMAR Early Treatment Diabetic Retinopathy Study (ETDRS)-style visual acuity chart imprinted with Canadian Aboriginal Syllabics (CAS) optotypes.

Design

Prospective, nonrandomized, within-subject analysis.

Participants

22 Indigenous patients from the Ullivik residence (Montreal, QC) for Inuit patients who were able to interpret Latin and CAS characteristics.

Methods

Python and LaTeX scripts were created to generate PDFs of standard ETDRS charts, which could be readily modified for alphabet (CAS or Latin), font, and optotype sizing. We used CAS characters that were preserved across Cree, Ojibwe, and Inuktitut languages. A 60" television screen (4K resolution) was used to display the eye charts to scale. For each subject, the best-corrected visual acuity (BCVA) of each eye was assessed on each chart (4 measurements per patient).

Results

The median difference between visual acuities (logMAR) acquired by the Latin and CAS charts was 0 (Q1: –0.08; Q3: 0). Band–Altman analysis revealed a bias of −0.01 (SD: 0.03), which was near zero (indicating favourable agreement), and one outlier (of 22 patients), whose deviation was attributed to random error. The visual acuity differences between eye charts were not statistically significant (p = 0.1).

Conclusions

We developed and validated the first CAS-imprinted ETDRS chart for measuring visual acuity. Given its use of preserved characters across Cree, Ojibwe, and Inuktitut languages, this chart has additional applicability to several Indigenous populations in Canada. Future work should develop near reading cards and other methods of optimizing culturally competent eye care for Indigenous patients.

目的：开发并验证一种带有加拿大原住民音节（CAS）视力表的logMAR早期治疗糖尿病视网膜病变研究（ETDRS）式视力表。设计：前瞻性、非随机、受试者内分析。参与者：来自Ullivik住所（蒙特利尔，QC）的22名土著患者，其中因纽特人能够解释拉丁语和CAS特征。方法：编写Python和LaTeX脚本，生成标准ETDRS图表的pdf格式，该格式可以方便地修改字母（CAS或Latin）、字体和视字大小。我们使用了保存在克里语、奥吉布语和因纽特语中的CAS字符。使用60英寸的电视屏幕（4K分辨率）按比例显示视力表。每位受试者在每张图表上评估每只眼睛的最佳矫正视力（BCVA）（每位患者4次测量）。结果：拉丁图和CAS图获得的视力（logMAR）中位数差值为0 (Q1: -0.08；问题3:0)。Band-Altman分析显示偏差为-0.01 (SD: 0.03)，接近于零（表明有利的一致性），并且有一个异常值（22例患者），其偏差归因于随机误差。两组视力表视力差异无统计学意义（p = 0.1）。结论：我们开发并验证了第一个用于测量视力的cas印迹ETDRS表。考虑到它使用了克里语、奥吉布语和因纽特语中保留的字符，这个图表对加拿大的几个土著人口有额外的适用性。未来的工作应该开发近阅读卡和其他方法，以优化土著患者的文化主管眼保健。

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引用次数: 0

Cost analysis of immediate versus delayed bilateral cataract surgery in seniors in community-based ambulatory surgical centers in a post-COVID-19 era 后covid -19时代社区门诊中心老年人即刻与延迟双侧白内障手术的成本分析

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.2025.04.010

Francesca Lee , Zaynab Somani , Eric S. Tam , Hannah H Chiu , Lili Tong , Steve Arshinoff , Sohel Somani

Objective

To evaluate the cost-savings of immediately sequential bilateral cataract surgery versus delayed sequential bilateral cataract surgery among seniors at a Canadian community-based ambulatory surgical center in the post-COVID-19 era.

Design

Prospective chart review.

Participants

Seniors aged 60 and older undergoing cataract extraction surgery at a community-based ambulatory surgical center in Ontario.

Methods

Direct and indirect cost metrics were collected from 202 patients who underwent either delayed sequential bilateral cataract surgery (DSBCS) or immediately sequential bilateral cataract surgery (ISBCS) at 1 of 2 community-based ambulatory surgical center (ASCs) between January 2022 and January 2023. Direct cost measures included preoperative, intraoperative, and postoperative surgical expenses. Preoperative measures included diagnostic and consultation fees. Intraoperative metrics consisted of medical and nonmedical labor, anesthesia fees, and consumables (including amortized cost of equipment and sterilization). Postoperative surgical costs included the first postoperative follow-up visit and a postoperative visit at week 1 (POW1). Indirect costs were measured by the cost of travel and additional postoperative visits (any visits other than required for the first postoperative visit and POW1). Additional economic factors included total time spent travelling and total duration of travel.

Results

The average costs were reduced by $375.22 CAD when performing ISBCS (p < 0.001), totaling to $1260.33 versus DSCBS’s total cost of $1635.55. Specifically, direct surgical costs were $1487.95 for DSBCS and $1176.93 for ISBCS (p < 0.001), whereas indirect costs were $147.60 for DSBCS versus $83.40 for ISBCS (p < 0.001).

Conclusions

The average costs of cataract extraction among senior patients in ambulatory surgical centers were significantly lower for ISBCS compared to DSBCS.

目的：评估后covid -19时代加拿大社区门诊中心老年人立即顺序双侧白内障手术与延迟顺序双侧白内障手术的成本节约。设计：前瞻性图表回顾。参与者：在安大略省社区流动外科中心接受白内障摘除手术的60岁及以上老年人。方法：收集2022年1月至2023年1月期间在2个社区流动手术中心（ASCs）中的1个接受延迟顺序双侧白内障手术（DSBCS）或立即顺序双侧白内障手术（ISBCS）的202例患者的直接和间接成本指标。直接成本措施包括术前、术中和术后手术费用。术前措施包括诊断费和咨询费。术中指标包括医疗和非医疗人工、麻醉费用和消耗品（包括设备和灭菌的摊销成本）。术后手术费用包括术后第一次随访和术后第1周随访（POW1）。间接成本是通过差旅费和术后额外访问（除术后第一次访问和POW1所需的任何访问）的成本来衡量的。其他经济因素包括总旅行时间和总旅行时间。结果：执行ISBCS时，平均成本降低了375.22加元（p < 0.001），总计为1260.33美元，而DSCBS的总成本为1635.55美元。具体来说，DSBCS的直接手术费用为1487.95美元，ISBCS为1176.93美元（p < 0.001），而DSBCS的间接费用为147.60美元，ISBCS为83.40美元（p < 0.001）。结论：在门诊手术中心进行ISBCS的老年患者白内障摘出的平均费用明显低于DSBCS。

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引用次数: 0

Association between intravitreal anti-vascular endothelial growth factor agents and hypertension: a meta-analysis 玻璃体内抗血管内皮生长因子与高血压之间的关系：一项荟萃分析。

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.2025.05.014

Michael Balas , Aaditeya Jhaveri , Faran Khalid , Ahmed Abdelaal , Marko M. Popovic , Peter J. Kertes , Rajeev H. Muni

Objective

To compare the risk of hypertension between intravitreal anti-vascular endothelial growth factor (VEGF) agents and sham injections, and between different anti-VEGF agents.

Methods

A systematic search was performed on OVID MEDLINE, EMBASE, and the Cochrane Controlled Register of Trials from January 2005 to August 2023. Inclusion criteria included published randomized clinical trials (RCTs) reporting on cases of hypertension as an adverse event for standard dose intravitreal anti-VEGF agents. Using random-effects modeling, risk ratios (RR) and 95% confidence intervals (CI) were used to estimate the frequency of hypertension between patients who received anti-VEGF agents versus sham injections.

Results

Twenty RCTs with 11 196 patients were included. There were 189/2873 (6.6%) new cases of hypertension in the ranibizumab 0.5-mg group, 61/1448 (4.2%) in the bevacizumab 1.25-mg group, 287/3450 (8.3%) in the aflibercept 2-mg group, 32/412 (7.8%) in the brolucizumab 6-mg group, 99/2063 (4.8%) in the faricimab 6-mg group, and 73/950 (7.7%) new cases of hypertension in patients receiving sham injections. There was no significant difference in the risk of developing hypertension between any of the included anti-VEGF agents. Compared to sham injection, ranibizumab (RR = 1.02, 95% CI: [0.74 to 1.40]; p = 0.92) and aflibercept (RR = 0.77, 95% CI: [0.54 to 1.11]; p = 0.17) did not significantly increase the risk of developing hypertension.

Conclusion

This meta-analysis found no significant difference in hypertension risk between different intravitreal anti-VEGF agents or sham injection. These results reinforce the notion that these agents have similar and safe side effect profiles, and that the choice of agent should not be based on the risk of hypertension.

目的：比较玻璃体内注射抗血管内皮生长因子（VEGF）与假注射抗血管内皮生长因子（VEGF）以及不同抗VEGF药物之间的高血压风险。方法：系统检索2005年1月至2023年8月的OVID MEDLINE、EMBASE和Cochrane Controlled Register of Trials。纳入标准包括已发表的随机临床试验（rct），这些试验报告了标准剂量玻璃体内抗vegf药物的不良事件高血压病例。使用随机效应模型，使用风险比（RR）和95%置信区间（CI）来估计接受抗vegf药物和假注射的患者之间高血压的频率。结果：纳入20项随机对照试验，共11196例患者。雷尼单抗0.5 mg组高血压新发病例数为181 /2873例（6.6%），贝伐单抗1.25 mg组为61/1448例（4.2%），阿非利西普2 mg组为287/3450例（8.3%），博鲁单抗6 mg组为32/412例（7.8%），法利西单抗6 mg组为99/2063例（4.8%），假注射患者高血压新发病例数为73/950例（7.7%）。在任何抗vegf药物之间，发生高血压的风险没有显著差异。与假注射相比，雷尼单抗(RR = 1.02,95% CI: [0.74 ~ 1.40]；p = 0.92)和afliberept (RR = 0.77,95% CI: [0.54 ~ 1.11]；P = 0.17)没有显著增加患高血压的风险。结论：本荟萃分析发现，不同玻璃体内抗vegf药物或假注射之间高血压风险无显著差异。这些结果强化了这些药物具有相似且安全的副作用概况的概念，并且药物的选择不应基于高血压的风险。

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引用次数: 0

Temporal trends and risk factors for retinopathy of prematurity: insights from a population-based study (1995–2021) 早产儿视网膜病变的时间趋势和危险因素：一项基于人群的研究（1995-2021）

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.2025.04.016

Rachel Shemesh , Brian Reichman , Tzipora Strauss , Inna Zaslavsky-Paltiel , Liat Lerner-Geva , Tamara Wygnanski-Jaffe , Israel Neonatal Network

Objective

The aim of this population-based study was to evaluate the temporal trends in the incidence of retinopathy of prematurity (ROP) and the demographic and clinical factors associated with ROP.

Methods

In this population-based observational cohort study data from the Israel national very low birthweight infant database were used. Following exclusions, the final study population comprised 16,257 infants born at 23–29 weeks. The independent effect of variables associated with ROP was assessed using multivariable logistic regression. P values for trend were determined by applying the Cochran-Armitage Trend Test.

Results

The rates of ROP decreased from 32.9% in the years 1995–2000 to 16.0% in 2017–2021 (p < 0.0001). In comparison to the reference epoch (1995–2000), the adjusted odds ratio (OR) [95% confidence interval] for ROP, were significantly lower in 2001–2006 (OR 0.68 [0.59–0.77]), in 2007–2011 (OR 0.36 [0.31–0.42]), in 2012–2016 (OR 0.31 [0.26–0.36]), and in 2017–2021 (OR 0.32 [0.27–0.39]). Sepsis (OR 1.67 [1.52–1.83]), surgically treated necrotizing enterocolitis (NEC) (OR 1.86 [1.49–2.32]) and surgically treated patent ductus arteriosus (PDA) (OR 1.88 [1.56–2.27]) were associated with ROP. Among the infants with sepsis, surgically treated PDA or surgically treated NEC, the rates of ROP increased in the 2017–2021 epoch.

Conclusions

The odds for ROP decreased by over two-thirds throughout the period 1995–2021, although the decline was attenuated in the recent decade. In view of the independent association found between surgically treated PDA or NEC and ROP, and the increasing rates of ROP in these infants, further studies may elucidate whether earlier ROP screening and possibly earlier therapeutic interventions may be appropriate for these infants.

目的：这项基于人群的研究旨在评估早产儿视网膜病变（ROP）发病率的时间趋势以及与ROP相关的人口统计学和临床因素。方法：在这项以人群为基础的观察队列研究中，数据来自以色列国家极低出生体重婴儿数据库。排除后，最终的研究人群包括16257名在23-29周出生的婴儿。使用多变量逻辑回归评估与ROP相关的变量的独立效应。趋势P值采用Cochran-Armitage趋势检验。结果：ROP由1995-2000年的32.9%下降到2017-2021年的16.0% （p < 0.0001）。与参考时期（1995-2000年）相比，2001-2006年（OR 0.68[0.59-0.77]）、2007-2011年（OR 0.36[0.31-0.42]）、2012-2016年（OR 0.31[0.26-0.36]）和2017-2021年（OR 0.32 [0.27-0.39]） ROP的校正优势比（OR）[95%置信区间]显著降低。脓毒症（OR 1.67[1.52-1.83]）、手术治疗的坏死性小肠结肠炎（NEC）（OR 1.86[1.49-2.32]）和手术治疗的动脉导管未闭（PDA）（OR 1.88[1.56-2.27]）与ROP相关。在脓毒症、手术治疗PDA或手术治疗NEC的婴儿中，2017-2021时期ROP发生率增加。结论：在1995年至2021年期间，ROP的几率下降了三分之二以上，尽管近十年来下降幅度有所减弱。鉴于手术治疗的PDA或NEC与ROP之间的独立关联，以及这些婴儿ROP发生率的增加，进一步的研究可能会阐明早期ROP筛查和早期治疗干预是否适合这些婴儿。

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引用次数: 0

Disparities in screening, diagnosis, treatment, and outcomes for diabetic retinopathy among people with lived experience of homelessness in Canada 在加拿大有过无家可归经历的人群中，糖尿病视网膜病变的筛查、诊断、治疗和结果的差异：一项匹配的纵向队列研究结果

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.2025.05.004

Ruchi Sharan , Kathryn Wiens , Li Bai , Paul E. Ronksley , Gillian L. Booth , Stephen W. Hwang , Peter C. Austin , Eldon Spackman , Anna Ells , Michael Fielden , David J.T. Campbell

Objective

To estimate the rates of screening, diagnosis, treatment, and outcomes related to diabetic retinopathy among persons with diabetes who have experienced homelessness compared with a matched cohort of nonhomeless controls.

Methods

A propensity score-matched cohort study was conducted using administrative health data from Ontario. Eligible persons required a diagnosis of diabetes and at least 1 hospital encounter between April 2006 and March 2019. Homeless status was determined using a validated algorithm that identified whether individuals were homeless at the time of any acute care encounter during the study period. Each person who experienced homelessness was matched to a nonhomeless control based on sociodemographic and clinical characteristics. Rate ratios (RR) and differences in proportions were calculated for screening, diagnosis, and treatment of diabetic retinopathy, as well as for the outcome of vision loss using generalized linear models with a negative binomial distribution and robust standard errors.

Results

1,069,493 people met the inclusion criteria, of which, 6 944 had a history of homelessness. A suitable nonhomeless match was found for 5 712 individuals. The rate of diabetic retinopathy screening was lower in those with a history of homelessness when compared to controls (RR = 0.75; 95% CI: 0.72–0.78), while the rate of having billing codes representing diabetic retinopathy was higher (RR = 1.42; 95% CI: 1.02–1.97). There was no significant difference in rates of treatment or vision loss.

Conclusions

The disparities in rates of screening and diagnosis of diabetic retinopathy in those with lived experience of homelessness presents an area for targeted interventions to improve health outcomes in this population.

目的：评估无家可归的糖尿病患者与非无家可归对照者的糖尿病视网膜病变筛查、诊断、治疗和预后的比率。方法：使用安大略省行政卫生数据进行倾向评分匹配队列研究。符合条件的人需要在2006年4月至2019年3月期间诊断为糖尿病并至少住院一次。无家可归的状态是用一种经过验证的算法确定的，该算法确定了在研究期间的任何紧急护理遇到时个人是否无家可归。根据社会人口学和临床特征，每个经历过无家可归的人都与非无家可归的对照组相匹配。使用具有负二项分布和稳健标准误差的广义线性模型，计算糖尿病视网膜病变的筛查、诊断和治疗的比率比（RR）和比例差异，以及视力丧失的结果。结果：1,069,493人符合纳入标准，其中6,944人有无家可归史。为5712个人找到了合适的非无家可归者配对。与对照组相比，有无家可归史的糖尿病视网膜病变筛查率较低(RR = 0.75；95% CI: 0.72-0.78)，而拥有代表糖尿病视网膜病变的账单代码的比率更高(RR = 1.42；95% ci: 1.02-1.97)。在治疗率和视力丧失方面没有显著差异。结论：在有过无家可归经历的人群中，糖尿病视网膜病变筛查和诊断率的差异为有针对性的干预措施提供了一个领域，以改善这一人群的健康结果。

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