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

{"title":"Medial canthoplasty for pediatric exposure keratopathy.","authors":"Muhannad A Alnahdi, Georges Nassrallah, Asim Ali","doi":"10.1016/j.jcjo.2026.08.007","DOIUrl":"10.1016/j.jcjo.2026.08.007","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788552","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":"Patient-reported outcome measures in cataract surgery: a systematic review and meta-analysis of visual function and quality of life.","authors":"Leon Zhong, Maximilian Wu, Emma Anwar, Brian Yu, Amit X Garg, Cindy M L Hutnik, Monali Malvankar","doi":"10.1016/j.jcjo.2026.07.001","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.07.001","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the improvement in vision-related quality of life, as measured by validated patient-reported outcome measures (PROMs) (NEI-VFQ-14, NEI-VFQ-25) after cataract surgery, and to explore sources of variability in outcomes.</p><p><strong>Methods: </strong>MEDLINE, EMBASE, and CINAHL were searched, with supplementary grey‑literature screening, for primary studies reporting preoperative and postoperative PROM scores following cataract surgery. Eligible instruments were the Visual Function Index (NEI-VFQ-14), National Eye Institute Visual Function Questionnaire (NEI‑VFQ‑25/‑14), Catquest‑9SF, and related tools. Two reviewers independently performed study selection, data extraction, and risk‑of‑bias assessment using design‑specific CLARITY/U.S. National Institutes of Health frameworks. Random-effects meta-analyses pooled mean change scores for NEI-VFQ-14 and NEI-VFQ-25. Heterogeneity (τ², I²), 95% prediction intervals, small-study effects (Egger's test), and trim-and-fill were assessed. Risk of bias used design-specific CLARITY/NIH tools.</p><p><strong>Results: </strong>From 3473 records, 122 studies met inclusion criteria. Forty‑seven were prospective cohorts, 9 were randomized controlled trials, and 38 were case series; 52% were judged at moderate risk of bias. Fifty-six NEI-VFQ-14 cohorts (k = 56) and 33 NEI-VFQ-25 cohorts (k = 33) were pooled. Mean improvements were +21.8 points (95% CI: 17.4-26.3; I² = 99.9%; PI: -11.3 to 54.9) for NEI-VFQ-14 and +19.3 points (95% CI: 17.0-21.6; I² = 99.4%; PI: 6.5-32.1) for NEI-VFQ-25. For NEI-VFQ-25, Egger's test suggested small-study effects (p = .002); trim-and-fill imputed 3 studies, yielding +18.2 (95% CI: 16.0-20.4).</p><p><strong>Conclusions: </strong>Cataract extraction consistently enhances patient‑perceived visual function and quality of life. Unfortunately, high heterogeneity limits precision and suggests that gains in PROM score may vary by patient and procedural factors, and small-study effects may overestimate the true benefit recorded by NEI-VFQ-25. Routine integration of validated PROMs into cataract pathways will better capture outcomes that matter to patients, given that the very high heterogeneity, standardized reporting, and longer follow‑up are priorities.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148879005","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":"Posterior capsule rupture during cataract surgery: analysis of visual outcomes and associated risk factors.","authors":"Wenjun Song, Jeremy Y W Hu, Jarryl H J Tsai, Chua Chun Hau, Bryan C H Ang, David Law","doi":"10.1016/j.jcjo.2026.08.011","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.011","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate visual outcomes and identify risk factors for poor visual prognosis and dropped nucleus following posterior capsule rupture (PCR) during cataract surgery over a 5-year period in an Asian tertiary institution.</p><p><strong>Design: </strong>A retrospective chart review.</p><p><strong>Participants: </strong>All eyes that were complicated by PCR during cataract surgery at Tan Tock Seng Hospital, Singapore, between January 2016 and December 2020.</p><p><strong>Methods: </strong>Medical records were reviewed for demographics, preoperative, intraoperative, and postoperative data. The primary outcome measures were best-corrected visual acuity (BCVA) ≥20/40 at 3 months (short-term visual outcome) and at final follow-up (long-term visual outcome). Logistic regression identified independent predictors of poor visual outcomes and intraoperative dropped nucleus.</p><p><strong>Results: </strong>Among 31,663 phacoemulsification cataract surgeries performed during the study period, 234 (0.74%) were complicated by PCR. Of 211 eyes with PCR analyzed for vision, 191 (90.5%) achieved BCVA ≥20/40 at 3 months, and 174 (83.3%) maintained this at final follow-up (median 35 months). Predictors of poor final vision included increasing age (odds ratio [OR]: 1.05; 95% confidence interval [CI]: 1.00-1.10; p = .042), postoperative complications (OR: 8.17; 95% CI: 3.34-20.56; p < .001), and non-in-the-bag lens status (OR: 3.89; 95% CI: 1.56-9.69; p = 0.003). Dropped nucleus was associated with early PCR (OR: 8.37; 95% CI: 2.39-32.61; p = 0.001) and vitreous loss (OR: 20.66; 95% CI: 3.95-386.89; p = 0.004).</p><p><strong>Conclusions: </strong>Despite PCR, most patients achieved favourable long-term visual outcomes. Poor long-term visual prognosis was associated with older age, postoperative complications, and non-in-the-bag lens status. Early PCR and vitreous loss were key predictors of dropped nucleus.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873107","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":"Retrocorneal pigmented membrane simulating iris melanoma.","authors":"Antonio Bechara Ghobril, Salaam Botros, Carol L Shields","doi":"10.1016/j.jcjo.2026.08.001","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.001","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873105","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":"Re: Isolated mydriasis from ipsilateral internal carotid artery aneurysm.","authors":"Jonathan A Micieli, Edward Margolin","doi":"10.1016/j.jcjo.2026.08.010","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.010","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873053","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":"Extraocular muscle and orbital fat changes in treatment of thyroid eye disease with monoclonal antibodies: a systematic review and meta-analysis.","authors":"Alexander W C Kos, Angelica Hanna, Chris Zajner, Lulu L C D Bursztyn","doi":"10.1016/j.jcjo.2026.07.011","DOIUrl":"10.1016/j.jcjo.2026.07.011","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate radiological changes in extraocular muscle (EOM) and orbital fat sizes in thyroid eye disease (TED) patients after receiving monoclonal antibody therapy.</p><p><strong>Methods: </strong>The protocol was registered on PROSPERO (CRD420251129246). The electronic databases Embase (OVID), Medline, and PubMed were searched from inception to August 18, 2025, using keywords related to TED, EOMs, and monoclonal antibodies. Eligible studies reported baseline and follow-up imaging outcomes in monoclonal antibody-treated TED patients. Two reviewers independently conducted screening, data extraction, and RoB2 (or the revised Cochrane risk-of-bias tool for randomized trials) or ROBINS-I (or Risk of Bias in Non-randomized Studies-of Interventions) risk of bias assessment. Data were pooled using random-effects models to estimate mean differences in EOM and orbital fat volumes.</p><p><strong>Results: </strong>Fourteen studies were identified-3 randomized controlled trials, 4 retrospective cohort studies, and 7 prospective cohort studies-comprising 566 orbits from 304 TED patients. Pooled analysis revealed a total EOM volume mean difference of -1377 mm³ (95% CI: -2012 to -743; I² = 90.8%; p < .001), representing a 26.7% ± 7.0% reduction with treatment, and an orbital fat volume mean difference of -1732 mm³ (95% CI: -3002 to -461; I² = 82.8%; p < 0.001), representing a 16.2% ± 6.3% volume reduction with treatment. Cohen's-D effect sizes for individual EOM changes were superior rectus -0.67 (95% CI: -1.00 to -0.33; p < 0.01), inferior rectus -1.07 (95% CI: -1.89 to -0.25; p = 0.01), medial rectus -0.75 (95% CI: -1.12 to -0.37; p < 0.01), and lateral rectus -0.86 (95% CI: -1.53 to -0.18; p = 0.01).</p><p><strong>Discussion: </strong>Monoclonal antibody therapy is associated with significant EOM and orbital fat volume reductions in TED. Despite nonrandomization and heterogeneity limitations, these findings suggest that biologics improve clinical activity and remodel orbital soft tissues, supporting their role in disease modification.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788571","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":"Is extensive macular atrophy with pseudodrusen a variant of age-related macular degeneration? Insights from the first multiethnic, multicentre US cohort.","authors":"Alessandro Feo, Alberto Quarta, Prithvi Ramtohul, Livia Faes, Giulia Corradetti, Diogo Cabral, Samantha D Butterfield, Paolo Forte, Tal Eshkoly-Lior, Marko M Popovic, Mario R Romano, Touka Banaee, Anita Agarwal, K Bailey Freund, SriniVas R Sadda, David Sarraf","doi":"10.1016/j.jcjo.2026.07.008","DOIUrl":"10.1016/j.jcjo.2026.07.008","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the long-term clinical and multimodal imaging (MMI) features of extensive macular atrophy with pseudodrusen (EMAP) in a US cohort.</p><p><strong>Design: </strong>Multicentre retrospective case series.</p><p><strong>Participants: </strong>Patients diagnosed with EMAP between 2015 and 2025.</p><p><strong>Methods: </strong>Clinical records and MMI-including colour fundus photography, fundus autofluorescence, OCT, and OCT angiography-were reviewed at baseline and last follow-up.</p><p><strong>Results: </strong>Fifteen patients (30 eyes) were included, with longitudinal MMI analysis available in 11 patients (22 eyes). Median age at referral was 72 years (range, 40-76 years), and median baseline visual acuity was 0.3 logMAR (20/40). All eyes demonstrated diffuse pseudodrusen-like deposits and retinal pigment epithelium-Bruch membrane separation consistent with basal laminar deposits. Four eyes (13.3%) showed no macular atrophy at baseline, suggesting an early disease stage (stage 0). Peripheral retinal degeneration was identified in approximately 50% of eyes, and macular neovascularization developed in 23% including 2 eyes (6.7%) with type 3 macular neovascularization. Median visual acuity declined to 0.54 logMAR (20/70) at final follow-up (P < 0.001), and 27% met criteria for U.S. legal blindness. Disease progression was observed in 59% after a median follow-up of 40 months (range, 4-114 months).</p><p><strong>Conclusions: </strong>EMAP may represent a high-risk variant of age-related macular degeneration characterized by rapid progression to geographic atrophy. Critical diagnostic features include pseudodrusen-like deposits and basal laminar deposits, whereas a vertical pattern of atrophy represents the typical outcome. Atrophy may be absent in early disease stages. Genetic validation and consideration for inclusion in future atrophic AMD interventional trials are warranted.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721075","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":"Preoperative Management and Cataract Surgery Outcomes in oGVHD.","authors":"Krishna Sinha, Andrea A Lopez-Ruiz, Skye A Buckner-Petty, David A Leske, Nandita Khera, Joanne F Shen","doi":"10.1016/j.jcjo.2026.07.012","DOIUrl":"10.1016/j.jcjo.2026.07.012","url":null,"abstract":"<p><strong>Objective: </strong>To describe common preoperative treatments and visual outcomes after cataract surgery in patients with definite ocular graft-versus-host disease (oGVHD), as defined by the International Chronic Ocular Graft-Versus-Host-Disease (ICCGVHD) consensus group criteria.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Participants: </strong>Fifty eyes of 33 patients who had definite oGVHD, as defined by the ICCGVHD criteria, and underwent cataract extraction at Mayo Clinic were included.</p><p><strong>Methods: </strong>Various preoperative interventions and best-corrected visual acuity (BCVA) preoperatively, 1 month postoperatively, and at final ophthalmology follow-up were recorded. Postoperative corneal complications were also identified.</p><p><strong>Results: </strong>Fifty eyes across 33 patients (42% female) were included, with a mean age at cataract surgery of 57 ± 9 years. Common preoperative treatments used for patients included punctal occlusion via plugs or cautery (44 eyes, 88%), artificial tears (35 eyes, 70%), autologous serum tears (22 eyes, 44%); topical nonsteroidal anti-inflammatory drugs were used postoperatively in 7 eyes (14%). BCVA significantly improved from a preoperative mean of Snellen 20/61 (0.487 ± 0.429) to 20/26 at 1 month postoperatively (0.109 ± 0.184, P < 0.001) and remained stable at 20/29 at final ophthalmology follow-up (0.163 ± 0.381, P < 0.001). Postoperative corneal complications developed in 2 eyes (4%), including 1 corneal ulcer and 1 corneal abrasion, both of which resolved within 1 month with appropriate treatment.</p><p><strong>Conclusion: </strong>The ICCGVHD criteria demonstrate potential for comprehensively evaluating oGVHD before cataract surgery. In addition, patients with definite oGVHD according to these criteria are treated with a variety of interventions preoperatively and are able to achieve favorable postoperative visual outcomes with a low incidence of postoperative corneal complications.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788667","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":"Retinal metastasis of breast cancer: case report and literature review.","authors":"Akli Aouane, Samuel Farag, Andrew Farag, Ananda Kalevar","doi":"10.1016/j.jcjo.2026.07.009","DOIUrl":"10.1016/j.jcjo.2026.07.009","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788676","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 features of optic disc melanocytomas: a case series.","authors":"Jiwon Hwang, Hoyoung Jung, Myeong Jin Ju, Katherine Paton, Zaid Mammo","doi":"10.1016/j.jcjo.2026.07.013","DOIUrl":"10.1016/j.jcjo.2026.07.013","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788682","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}