Nicole J. Topilow , Rafaella Cleto Penteado , Michelle Ting , Eman Al-Sharif , George A. Villatoro , Jin Sook Yoon , Catherine Y. Liu , Bobby S. Korn , Don O. Kikkawa
{"title":"Orbital decompression following treatment with teprotumumab for thyroid eye disease","authors":"Nicole J. Topilow , Rafaella Cleto Penteado , Michelle Ting , Eman Al-Sharif , George A. Villatoro , Jin Sook Yoon , Catherine Y. Liu , Bobby S. Korn , Don O. Kikkawa","doi":"10.1016/j.jcjo.2024.06.003","DOIUrl":"10.1016/j.jcjo.2024.06.003","url":null,"abstract":"<div><h3>Objective</h3><div>To quantify the observed decrease in orbital decompressions being performed at one tertiary care institution and to determine the rate and predictive factors of orbital decompression surgery following treatment with teprotumumab for thyroid eye disease.</div></div><div><h3>Methods</h3><div>Epic's SlicerDicer program was used to analyze recent trends in the overall number of thyroid eye disease (TED) patients evaluated in the oculoplastic surgery department, as well as usage trends of CPT codes 67445 (lateral orbitotomy with bone removal for decompression) and 67414 (orbitotomy with removal of bone for decompression). A retrospective chart review of active moderate-to-severe TED patients treated with teprotumumab was performed at a single tertiary care center. The main outcome measure was whether or not patients underwent bony orbital decompression surgery following treatment with teprotumumab. The SlicerDicer search demonstrated stable usage of CPT codes 67445 and 67414 from 2016 to 2019, followed by a significant decrease from 2020 to 2023, over a background of increasing numbers of TED patients evaluated in clinic. Following teprotumumab therapy, 25% of patients and 18% of orbits underwent bony decompression. Surgically decompressed patients had higher pre- and post-teprotumumab exophthalmometry measurements compared with patients who did not undergo bony decompression. Average time to decompression following conclusion or cessation of teprotumumab therapy was 12.6 months.</div></div><div><h3>Conclusion</h3><div>While the number of TED patients treated at one tertiary care center has risen over recent years, the number of orbital decompression surgeries has declined. Orbital decompression, however, is still needed in select patients after treatment with teprotumumab.</div></div><div><h3>Objectif</h3><div>Quantifier la baisse observée du nombre de décompressions orbitaires réalisées dans un établissement de soins tertiaires, calculer le taux de ce type de chirurgie après l'administration de téprotumumab dans le traitement de l'ophtalmopathie thyroïdienne (OT) et faire ressortir les facteurs de prédiction à cet égard.</div></div><div><h3>Méthodes</h3><div>Le programme SlicerDicer d'Epic a servi à analyser les tendances récentes quant au nombre global de patients présentant une OT qui ont été évalués au service de chirurgie oculoplastique de même que les tendances en matière d'utilisation des codes d'identification 67445 (orbitotomie latérale comprenant une résection osseuse afin de réaliser une décompression) et 67414 (orbitotomie comprenant une résection osseuse afin de réaliser une décompression) selon la <em>Current Procedural Terminology</em> (CPT). Un examen rétrospectif des dossiers médicaux de patients présentant une OT évolutive modérée à grave et qui ont reçu le téprotumumab a eu lieu dans un établissement de soins tertiaires unique. Le principal paramètre de mesure reposait sur la réalisation – ou non – d'une","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e59-e64"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141765542","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Emma Iverson , Mahadeo Sukhai , Matthew P. Quinn , Marie-Josée Aubin , Ellen E. Freeman
{"title":"Visual impairment, employment status, and reduction in income: the Canadian Longitudinal Study on Aging","authors":"Emma Iverson , Mahadeo Sukhai , Matthew P. Quinn , Marie-Josée Aubin , Ellen E. Freeman","doi":"10.1016/j.jcjo.2024.04.006","DOIUrl":"10.1016/j.jcjo.2024.04.006","url":null,"abstract":"<div><h3>Objective</h3><div>To examine the employment status of those with and without visual impairment and eye disease and to examine the association between visual impairment and eye disease and a reduction in income over a 3-year period.</div></div><div><h3>Design</h3><div>Population-based prospective cohort study.</div></div><div><h3>Participants</h3><div>A total of 12,174 nonretired participants aged 45–64 years old in the Canadian Longitudinal Study on Aging.</div></div><div><h3>Methods</h3><div>Visual impairment was defined if binocular presenting or pinhole-corrected monocular visual acuity in the better eye was worse than 20/40 at baseline. Self-reported diagnoses of age-related macular degeneration (AMD) and glaucoma were collected. Employment status (employed, not employed due to sickness or disability, or unemployed) was based on questions on labour force participation. Income reduction was defined as household income <$50,000 per year at follow-up when household income was ≥$50,000 at baseline. Multinomial and logistic regressions were used to adjust for demographic and health variables.</div></div><div><h3>Results</h3><div>Visual impairment using binocular presenting visual acuity (odds ratio [OR] = 2.09; 95% CI, 1.21–3.62) and pinhole-corrected visual acuity (OR = 2.99; 95% CI, 1.54–5.83) were associated with a higher odds of not being employed due to sickness or disability after adjustment. AMD (OR = 1.82; 95% CI, 1.11–3.01) and glaucoma (OR = 2.05; 95% CI, 1.28–3.28) at baseline were both associated with reductions in income over a 3-year period after adjustment.</div></div><div><h3>Conclusion</h3><div>Individuals with visual impairment experienced lower employment, and those with AMD or glaucoma were more likely to have their incomes decline over 3 years. Policies to improve workplace participation by those with vision loss are needed.</div></div><div><h3>Objectif</h3><div>Examiner la situation de l'emploi en fonction de la déficience visuelle et des pathologies oculaires et analyser le lien entre la présence d'une déficience visuelle et d'une pathologie oculaire, d'une part, et une baisse des revenus sur une période de 3 ans, d'autre part.</div></div><div><h3>Nature</h3><div>Étude de cohorte populationnelle prospective.</div></div><div><h3>Participants</h3><div>Un total de 12 174 participants à l’Étude longitudinale canadienne sur le vieillissement âgés de 45 à 64 ans qui n’étaient pas à la retraite.</div></div><div><h3>Méthodes</h3><div>La déficience visuelle se définissait comme suit : acuité visuelle binoculaire au moment de l'examen ou acuité visuelle monoculaire corrigée au trou sténopéique du meilleur œil inférieure à 20/40 au départ. On a également consigné les diagnostics spontanément signalés de dégénérescence maculaire liée à l’âge (DMLA) et de glaucome. La situation de l'emploi (avec emploi, sans emploi en raison d'une maladie ou d'un handicap ou sans emploi) a été déterminée à partir de questions sur la présence","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e16-e22"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141135540","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tina Felfeli , Michael Balas , Felicia Tai , Arshia Eshtiaghi , Jess Rhee , Alexander J. Kaplan , Panos G. Christakis , Efrem D. Mandelcorn , Nupura K. Bakshi , Laurence A. Rubin , Larissa A. Derzko-Dzulynsky
{"title":"Long-term outcomes of noninfectious uveitis treated with systemic immunomodulatory therapy: a retrospective case series","authors":"Tina Felfeli , Michael Balas , Felicia Tai , Arshia Eshtiaghi , Jess Rhee , Alexander J. Kaplan , Panos G. Christakis , Efrem D. Mandelcorn , Nupura K. Bakshi , Laurence A. Rubin , Larissa A. Derzko-Dzulynsky","doi":"10.1016/j.jcjo.2024.05.005","DOIUrl":"10.1016/j.jcjo.2024.05.005","url":null,"abstract":"<div><h3>Objective</h3><div>To study the clinical characteristics and long-term outcomes of patients with noninfectious uveitis (NIU) who are treated with systemic immunomodulatory therapy (IMT).</div></div><div><h3>Design</h3><div>Retrospective case series.</div></div><div><h3>Participants</h3><div>All consecutive cases of adults with NIU under the care of 5 uveitis subspecialty tertiary care clinics between 2010 to 2021 were included.</div></div><div><h3>Methods</h3><div>Patient outcomes were assessed at initial presentation and at the latest available follow-up.</div></div><div><h3>Results</h3><div>A total of 418 NIU patients receiving IMT therapy with a median age of 46.0 years and 59.3% female were identified. Each patient required an average of 1.4 agents until achieving an optimal response. Following initial treatment with prednisone, patients were most commonly initiated on methotrexate. The top 3 treatments with the highest proportion of optimal treatment response when taken alone or in combination with other agents were infliximab (79.3%), cyclosporine (75%), and adalimumab (70%). The strongest predictors for requiring a greater number of IMTs trialed were younger age, panuveitis, and a chronic or recurrent disease course. Multivariable linear regression analysis suggested that baseline visual acuity at diagnosis was the only significant predictor of final visual acuity (<em>p</em> < 0.001).</div></div><div><h3>Conclusions</h3><div>NIU patients on IMT are often trialed on multiple therapeutic agents before achieving an optimal treatment response. Visual acuity at diagnosis is a predictor of final visual outcomes, whereas chronic or recurrent disease course, younger age, and panuveitis are predictors of requiring multiagent treatment regimens.</div></div><div><h3>Objectif</h3><div>Étudier les caractéristiques cliniques et les résultats à long terme des patients présentant une uvéite non infectieuse (UNI) qui reçoivent un immunomodulateur (IM) par voie générale.</div></div><div><h3>Nature</h3><div>Série de cas rétrospectifs.</div></div><div><h3>Participants</h3><div>Ont été inclus tous les adultes consécutifs qui présentaient une UNI et qui étaient traités dans 5 cliniques de soins tertiaires spécialisées dans l'uvéite entre 2010 et 2021.</div></div><div><h3>Méthodes</h3><div>Les résultats ont été évalués lors de l'examen initial et au moment du dernier suivi figurant au dossier.</div></div><div><h3>Résultats</h3><div>Au total, 418 patients (âge médian : 46,0 ans; 59,3 % de sexe féminin) atteints d'UNI ont reçu un IM. Chaque patient a dû recevoir en moyenne 1,4 médicament différent avant d'obtenir une réponse optimale. Après l'administration initiale de prednisone, les patients ont le plus souvent reçu le méthotrexate. Les 3 médicaments qui ont donné la proportion la plus élevée de réponse optimale ont été administrés seuls ou en association avec d'autres médicaments; il s'agissait de l'infliximab (79,3 %), de la cyclosporine (75 %) et","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 1","pages":"Pages e133-e143"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141407841","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}
Sami H Uwaydat, Muhammad Z Chauhan, Pedro S Tetelbom
{"title":"Anatomic and visual outcomes of pars plana vitrectomy in patients with incomplete closure of Zone 3 scleral lacerations.","authors":"Sami H Uwaydat, Muhammad Z Chauhan, Pedro S Tetelbom","doi":"10.1016/j.jcjo.2025.01.010","DOIUrl":"10.1016/j.jcjo.2025.01.010","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051671","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}
Oded Rock, Tiran Golani, Sari David, Mor Vered, Rasha Mosleh, Sharon Armarnik, Tamara Wygnanski-Jaffe
{"title":"Improvement of stereopsis following strabismus surgery in adults: a retrospective analysis.","authors":"Oded Rock, Tiran Golani, Sari David, Mor Vered, Rasha Mosleh, Sharon Armarnik, Tamara Wygnanski-Jaffe","doi":"10.1016/j.jcjo.2024.12.007","DOIUrl":"10.1016/j.jcjo.2024.12.007","url":null,"abstract":"<p><strong>Objective: </strong>Adults who undergo strabismus surgery, in addition to cosmesis, could benefit from improved stereopsis. This improvement is associated with the performance of motor skill tasks in young adults; they reduce the risk of tripping or falling during everyday locomotion and improve reading efficiency. This study aimed to assess stereopsis level after strabismus surgery in adults who underwent strabismus surgery for any reason.</p><p><strong>Methods: </strong>Retrospective observational study of adult patients who underwent strabismus surgery at our institution between 2010 and 2022.</p><p><strong>Results: </strong>One hundred and thirty-two patients were included. Postoperatively, 48% had a stereo acuity better than 100 seconds of arc, and only 21.5% had no stereopsis. The most significant factor influencing improved stereopsis after surgery was the angle of strabismus postoperatively (p = 0.018). There was a statistically significant correlation between fusion at a distance and the stereo acuity (p = 0.0337). There was no statistically significant correlation between the stereo acuity level and the strabismus angle of deviation, the strabismus direction (vertical, horizontal, or combined), or the type (esotropia or exotropia) before or after the surgery. Although not statistically significant (p = 0.6579), the underlying cause categories were correlated with the stereo level. Patients with neurological causes demonstrated higher levels of stereopsis, followed by TED, whereas patients with childhood strabismus have the lowest probability of regaining stereopsis after surgery.</p><p><strong>Conclusions: </strong>Although long-standing strabismus reduces the potential for binocularity, surgery may be beneficial and improve stereopsis regardless of the cause of strabismus.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000604","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}
Raphael Lechtenboehmer, Matthias M Mauschitz, Frank G Holz, Robert P Finger, Maximilian W M Wintergerst
{"title":"A case of VEXAS syndrome with therapy refractive macular involvement.","authors":"Raphael Lechtenboehmer, Matthias M Mauschitz, Frank G Holz, Robert P Finger, Maximilian W M Wintergerst","doi":"10.1016/j.jcjo.2025.01.002","DOIUrl":"10.1016/j.jcjo.2025.01.002","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142982875","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}
Deepika C Parameswarappa, Kirk A J Stephenson, Mark Seamone, Cynthia X Qian, Rajeev H Muni, Peter J Kertes, Ajoy Vincent, Elise Héon
{"title":"\"Blindness\" is not a contraindication for voretigene neparvovec-rzyl treatment: a review of 9 cases.","authors":"Deepika C Parameswarappa, Kirk A J Stephenson, Mark Seamone, Cynthia X Qian, Rajeev H Muni, Peter J Kertes, Ajoy Vincent, Elise Héon","doi":"10.1016/j.jcjo.2024.12.013","DOIUrl":"10.1016/j.jcjo.2024.12.013","url":null,"abstract":"<p><strong>Objective: </strong>Biallelic RPE65 pathogenic variants may cause Leber congenital amaurosis (LCA). Voretigene neparvovec-rzyl (VN, Luxturna) is the only approved subretinal gene therapy that demonstrated benefit and safety. The eligibility criteria are vague and variable between centres. This is the first comprehensive outcome report of RPE65-LCA patients with World Health Organization blindness criteria vision treated with VN.</p><p><strong>Design: </strong>Multicentre retrospective case series.</p><p><strong>Participants: </strong>Patients meeting the treatment criteria for VN who had best-corrected visual acuity (BCVA) <20/400 or visual field (VF)III4e isopter <10°.</p><p><strong>Methods: </strong>Patients were followed for a mean of 11.1 ± 4.7 months. Age, sex, BCVA, central retinal thickness (CRT), retinal atrophy, VF, full-field stimulus testing (FST), and subjective impressions were assessed.</p><p><strong>Results: </strong>Nine patients met the inclusion criteria (mean: BCVA 1.89 LogMAR, range: 1.4 - 2.7 LogMAR, mean age: 28.7-years-old, range: 17-59 years). Though VF area did not improve, FST improved in patients with better baseline FST (-8.83 dB vs -0.56 dB; p = 0.010), and better VFV4e (7245 vs 341<sup>o2</sup>; p < 0.001) and III4e (596.1 vs 24.8<sup>o2</sup>; p = 0.011) area. VA improved in younger (20 vs 32 years; p = 0.011) patients with thinner CRT<sup>1mm</sup> (155 vs 193 µm; p = 0.038). VFV4e loss occurred in older (38 vs 19 years; p = 0.001) patients with worse baseline V4e area (1728 vs 8159<sup>o2</sup>; p < 0.001). Subjective improvement in dim light navigation skills occurred in younger patients (20.3 vs 45.3 years; p < 0.001).</p><p><strong>Conclusions: </strong>Blindness is not a contraindication to VN treatment for RPE65-LCA. Superior results correlated with greater baseline FST but not with CRT<sup>1mm</sup>, provided that measurable outer retinal structures persist.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142944911","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}