Canadian journal of ophthalmology. Journal canadien d'ophtalmologie最新文献

{"title":"Macular fibrosis in neovascular AMD: inter-reader and intermodality variability across four imaging modalities.","authors":"Andrea Coletto, Sonia Serafino, Chiara Olivieri, Valentina Marica, Pasquale Viggiano, Veronica Vallino, Paola Marolo, Enrico Borrelli, Michele Reibaldi","doi":"10.1016/j.jcjo.2025.05.019","DOIUrl":"10.1016/j.jcjo.2025.05.019","url":null,"abstract":"<p><strong>Objective: </strong>To assess inter-reader and intermodality variability in quantifying macular fibrosis in patients with neovascular age-related macular degeneration (AMD) using 4 imaging modalities: color fundus photography (CFP), near-infrared reflectance (NIR), structural optical coherence tomography (OCT), and MultiColor imaging.</p><p><strong>Design: </strong>Prospective, cross-sectional case series.</p><p><strong>Participants: </strong>Thirty eyes of 30 patients with neovascular AMD and macular fibrosis, previously treated with anti-vascular endothelial growth factor therapy.</p><p><strong>Methods: </strong>Imaging was performed using CFP, NIR, structural OCT, and MultiColor modalities. Two masked graders evaluated the size of macular fibrosis using each modality. The study assessed inter-reader agreement using the intraclass correlation coefficient (ICC), coefficient of variation (CV), and 95% coefficient of repeatability. Intermodality variability was analyzed using repeated measures ANOVA and pairwise comparisons.</p><p><strong>Results: </strong>Structural OCT demonstrated the highest inter-reader agreement (ICC = 0.983; CV = 0.04), while NIR exhibited the lowest (ICC = 0.461; CV = 0.26). The median macular fibrosis size was largest on structural OCT (4.87 mm²) and smallest on MultiColor imaging (2.03 mm²). Significant differences were observed between imaging modalities, with fibrosis measurements from different modalities not consistently comparable.</p><p><strong>Conclusions: </strong>Structural OCT is the most reliable modality for quantifying macular fibrosis in neovascular AMD. The observed intermodality variability highlights the need for standardized criteria in fibrosis assessment across imaging techniques, as differences can impact clinical interpretation and management.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293371","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}

{"title":"Polarization-diversity optical coherence tomography analysis of pentosan polysulfate sodium-associated maculopathy.","authors":"Hoyoung Jung, Myeong Jin Ju, Zaid Mammo","doi":"10.1016/j.jcjo.2025.05.020","DOIUrl":"10.1016/j.jcjo.2025.05.020","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257395","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}

{"title":"Changes in retinal flow density during and after pregnancy-an optical coherence tomography angiography study.","authors":"Jens Julian Storp, Caren Schmidt, Kathrin Oelmeier, Ralf Schmitz, Moritz Fabian Danzer, Julian Alexander Zimmermann, Verena Anna Englmaier, Nicole Eter, Viktoria Constanze Brücher","doi":"10.1016/j.jcjo.2025.05.025","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.05.025","url":null,"abstract":"<p><strong>Purpose: </strong>Employing optical coherence tomography angiography (OCTA), recent research has uncovered retinal vascular changes in pregnant women compared to nonpregnant controls. Yet, longitudinal data on retinal OCTA metrics until childbirth are lacking in the current literature, and an understanding of a possible reversibility of these changes remains limited. This prospective study aims to quantify retinal capillary metrics in healthy pregnant women prenatally and postnatally, describing the natural evolution of OCTA metrics during and after pregnancy.</p><p><strong>Methods: </strong>OCTA measurements were performed repeatedly on 52 eyes of 26 healthy, pregnant women, assessing the superficial (SCP), deep (DCP), choriocapillary (CC), and radial peripapillary (RPC) capillary plexus at various intervals during pregnancy and after childbirth. Flow density (FD) within these layers and parameters of the foveal avascular zone (FAZ) were compared throughout pregnancy and in the postpartum period using linear mixed models.</p><p><strong>Results: </strong>52 eyes of 26 pregnant women were included in the study. Although layer-specific variations in FD throughout the prepartum phase were noted, these changes were statistically insignificant for all investigated capillary plexus and the FAZ (p > 0.05). FD of the DCP, CC and RPC capillary plexus was significantly lower after childbirth in comparison to the prepartum phase (p ≤ 0.04).</p><p><strong>Conclusions: </strong>The microvascular structure remains stable throughout healthy pregnancies; however, postpartum changes hint toward late vasculo-structural adaptations after childbirth. OCTA can be used to noninvasively to assess microvascular changes associated with pregnancy.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144367935","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}

{"title":"Metastasis-free survival outcomes of uveal melanoma based on The Cancer Genome Atlas classification in 1585 cases.","authors":"Carol L Shields, Henry Nguyen, Shady Mina, Gabrielle E Kozlowski, Ayra Khan, Madison M Woods, Rolika Bansal, Hidayet Sener, Arupa Ganguly, Sara E Lally, Jerry A Shields","doi":"10.1016/j.jcjo.2025.05.017","DOIUrl":"10.1016/j.jcjo.2025.05.017","url":null,"abstract":"<p><strong>Background: </strong>Genetic testing for uveal melanoma and tumour size is important in prognostication.</p><p><strong>Methods: </strong>A review of 1 585 patients with uveal melanoma who had cytogenetic testing and classification, according to The Cancer Genome Atlas (TCGA), was performed. Kaplan-Meier (KM) metastasis-free survival at 1-, 3-, 5-, and 10-years were explored.</p><p><strong>Results: </strong>The findings revealed TCGA Group A (n = 781; 49%), Group B (n = 215; 14%), Group C (n = 329; 21%), or Group D (n = 260; 16%). The median patient age at diagnosis was 60 years, sex was male in 51%, and race was White in 95%. A comparison (TCGA Group A vs Group B vs Group C vs Group D) revealed a difference in median patient age at tumour diagnosis (59 vs 59 vs 63 vs 65 years; p < 0.01), and initial visual acuity (20/20-20/50: 80% vs 68% vs 69% vs 64%; p < 0.01). The median tumour thickness was 4 mm, and the median diameter was 12 mm. A comparison (TCGA Group A vs Group B vs Group C vs Group D) revealed differences in median tumour thickness (3 vs 5 vs 6 vs 7 mm; p < 0.01), tumour diameter (10 vs 13 vs 13 vs 16 mm; p < 0.01), distance to foveola (3 vs 3 vs 4 vs 5 mm; p < 0.01), and distance to optic disc (3 vs 4 vs 5 vs 4 mm; p < 0.01). The KM metastasis-free survival estimates (TCGA Group A vs Group B vs Group C vs Group D) revealed differences at 1 year, 3 years, 5 years, and 10 years (p < 0.01) for any metastasis and specific survival rates at 5 years (96% vs 86% vs 62% vs 37%; p < 0.01), and 10 years (93% vs 78% vs 50% vs not available; p < 0.01) significantly decreased from Group A to Group D. By multivariate analysis, the hazard ratio for metastasis-free survival revealed differences in Groups B vs A (3.67), Groups C vs B (5.73), and Groups D vs C (3.20) (p < 0.01), as well as differences per tumour thickness (1.06) and diameter (1.13) (p < 0.01).</p><p><strong>Conclusions: </strong>Genetic prognostication for metastatic risk from uveal melanoma using TCGA in this large cohort revealed that increasing TCGA category reduced the rate for metastasis-free survival.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233270","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}

{"title":"Impact of 11 years of glaucoma research funding: Glaucoma Research Society of Canada (2010-2020).","authors":"William J Herspiegel, Melina Moeinkhah, Anastasiya Vinokurtseva, Graham Trope, Cindy M L Hutnik","doi":"10.1016/j.jcjo.2025.05.022","DOIUrl":"10.1016/j.jcjo.2025.05.022","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293370","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}

{"title":"Systematic review and meta-analysis of Densiron-68 anatomic outcomes and complications in the surgical management of retinal detachment.","authors":"Grace S Yin, Alexa Fine, Marko M Popovic, Peter J Kertes, Rajeev H Muni","doi":"10.1016/j.jcjo.2025.05.018","DOIUrl":"10.1016/j.jcjo.2025.05.018","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the anatomical reattachment rates, functional outcomes, and complications associated with Densiron-68 in retinal detachment (RD) surgery.</p><p><strong>Methods: </strong>Following a systematic literature search, primary studies evaluating outcomes associated with Densiron-68 in adult RD surgery between January 2000 and May 2022 were included. Exclusion criteria included secondary studies, non-English language, and those in pediatric populations. The primary endpoints of interest were anatomical reattachment rate, and reported complications associated with Densiron-68.</p><p><strong>Results: </strong>Twenty-eight studies (927 eyes) were included. Mean follow-up time was 41.9 weeks (IQR: 32.4-52.0 weeks). The weighted mean preoperative and postoperative BCVA was 1.38 ± 0.64 logMAR (20/500 Snellen) and 0.86 ± 0.55 logMAR (20/150 Snellen), respectively (p < 0.001). Anatomical reattachment rate after a single surgery was 72.5% overall (n = 672 eyes), with most redetachments occurring while Densiron-68 was in situ (46%; n = 81/255 eyes). Postoperatively, 29 complications were identified. The three most common were raised intraocular pressure (IOP) (n = 251 eyes; 27.1%), intraocular inflammation (n = 182 eyes; 19.6%), and emulsification (n = 160 eyes; 17.3%). Densiron-68 was significantly associated with an increased risk of elevated intraocular pressure postoperatively than traditional silicone oil (RR: 1.83 95% CI: 1.25-2.67; p = 0.001). The overall GRADE certainty of evidence for included studies was determined to be low due to the risk of bias, moderate imprecision in results due to wide confidence intervals, small studies, and few events within comparative studies, and moderate to high heterogeneity impacting consistency of evidence.</p><p><strong>Conclusions: </strong>Densiron-68 is a heavy silicone oil with clinical utility in retinal detachment surgery that has good primary anatomical reattachment rates and overall improvement in BCVA preoperatively to postoperatively. The authors highlight the anatomical and functional outcomes of Densiron-68 and the reported range of complications associated with its use, of which the majority were reversible or treatable with appropriate therapies.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293369","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}

{"title":"Fundus autofluorescence of black sunburst lesion in a sickle cell trait patient.","authors":"Bradley S Gundlach, Samuel Le, David Hsu, David Sarraf","doi":"10.1016/j.jcjo.2025.05.023","DOIUrl":"10.1016/j.jcjo.2025.05.023","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144339921","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}

{"title":"Association between intravitreal anti-vascular endothelial growth factor agents and hypertension: a meta-analysis.","authors":"Michael Balas, Aaditeya Jhaveri, Faran Khalid, Ahmed Abdelaal, Marko M Popovic, Peter J Kertes, Rajeev H Muni","doi":"10.1016/j.jcjo.2025.05.014","DOIUrl":"10.1016/j.jcjo.2025.05.014","url":null,"abstract":"<p><strong>Objective: </strong>To compare the risk of hypertension between intravitreal anti-vascular endothelial growth factor (VEGF) agents and sham injections, and between different anti-VEGF agents.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusion: </strong>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.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207757","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}

{"title":"Spontaneous resolution of idiopathic orbital inflammation following incisional biopsy.","authors":"Nathan Lee-Wing, Guneet Uppal, Janice Safneck","doi":"10.1016/j.jcjo.2025.04.013","DOIUrl":"10.1016/j.jcjo.2025.04.013","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141499","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}

{"title":"Association of changes in optical coherence tomography metrics with changes in refractive error in patients with neovascular age-related macular degeneration in the CATT.","authors":"Matthew R Starr, Eric A Lovett, Rachel Israilevich, Jason Hsu, Peiying Hua, Jiayan Huang, Maureen G Maguire, Daniel F Martin, Gui-Shuang Ying, Ajay E Kuriyan","doi":"10.1016/j.jcjo.2025.05.016","DOIUrl":"10.1016/j.jcjo.2025.05.016","url":null,"abstract":"<p><strong>Objective: </strong>Assess the change in refractive error (RE) in patients receiving anti-vascular endothelial growth factor (VEGF) therapy for exudative age-related macular degeneration.</p><p><strong>Methods: </strong>Post hoc analysis of data from the Comparison of AMD Treatments Trials (CATT). Associations between spherical equivalent (SphE) change and optical coherence tomography (OCT) metrics were evaluated using correlation coefficients (r) and regression analyses stratified by baseline lens status.</p><p><strong>Results: </strong>Analysis included 1 171 patients with OCT fluid in the study eye at baseline. The mean (± SD) of SphE shifted toward myopia in study eyes from 0.62 ± 1.63 diopters (D) at baseline to 0.50 ± 1.61 D at 2 years (p < 0.0001). Phakic study eyes had larger myopic shifts than pseudophakic eyes at 2 years (-0.19 ± 0.97 D vs -0.06 ± 0.90 D; p = 0.03). In phakic study eyes, the RE change was significantly correlated with change in subretinal thickness (Spearman r = 0.21; p < 0.0001), subretinal tissue complex (r = 0.12; p = 0.01), and total thickness (r = 0.36; p < 0.0001). A myopic shift greater than 1.0 D occurred in 74 (7.0%) and 104 (10.2%) study eyes at years 1 and 2, respectively.</p><p><strong>Conclusion: </strong>Among CATT participants, the RE of study eyes shifted toward myopia at 2 years with phakic eyes having larger shifts. OCT metric changes were weakly correlated with changes in RE, suggesting that drying of the macula with anti-VEGF therapy may have a minor impact on RE. Still, 10% of patients may develop a 1 D myopic shift at 2 years, typically in those with more baseline fluid. Patients with neovascular AMD may be able to update their spectacles, even if macular edema is present, as the change in RE is negligible when drying the macula.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198311","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}