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

{"title":"Vacuolated lymphocytes: a diagnostic biomarker for CLN3-related Batten disease","authors":"Miguel Cruz-Pimentel , Deepika C. Parameswarappa , Giwon Ryu , Regan Klatt , Ajoy Vincent","doi":"10.1016/j.jcjo.2025.02.021","DOIUrl":"10.1016/j.jcjo.2025.02.021","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Pages e652-e654"},"PeriodicalIF":3.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143691227","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":"Correlation of point-wise retinal sensitivity with localized features of diabetic macular edema using deep learning.","authors":"Heiko Stino, Klaudia Birner, Irene Steiner, Laetitia Hinterhuber, Markus Gumpinger, Simon Schürer-Waldheim, Hrvoje Bogunovic, Ursula Schmidt-Erfurth, Gregor S Reiter, Andreas Pollreisz","doi":"10.1016/j.jcjo.2025.02.013","DOIUrl":"10.1016/j.jcjo.2025.02.013","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between localized features of diabetic macular edema (DME) and point-wise retinal sensitivity (RS) assessed with microperimetry (MP) using deep learning (DL)-based automated quantification on optical coherence tomography (OCT) scans.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Participants: </strong>Twenty eyes of 20 subjects with clinically significant DME were included in this study.</p><p><strong>Methods: </strong>Patients with DME visible on OCT scans (Spectralis Heidelberg Retina Angiograph [HRA]+OCT) completed 2 MP examinations using a custom 45 stimuli grid on MAIA (CenterVue). MP stimuli were coregistered with the corresponding OCT location using image registration algorithms. DL-based algorithms were used to quantify intraretinal fluid (IRF) and ellipsoid zone (EZ) thickness. Hard exudates (HEs) were quantified semiautomatically. Multivariable mixed-effect models were calculated to investigate the association between DME-specific OCT features and point-wise RS. As EZ thickness values below HEs were excluded, the models included either EZ thickness or HEs.</p><p><strong>Results: </strong>A total of 1800 MP stimuli from 20 eyes of 20 patients were analyzed. Stimuli with IRF (n = 568) showed significantly decreased RS compared to areas without (estimate [95% CI]: -1.11 dB [-1.69, -0.52]; p = 0.0002). IRF volume was significantly negatively (-0.45 dB/nL [-0.71; -0.18]; p = 0.001) and EZ thickness positively (0.14 dB/µm [0.1; 0.19]; p < 0.0001) associated with localized point-wise RS. In the multivariable mixed model, including HE volume instead of EZ thickness, a negative impact on RS was observed (-0.43/0.1 nL [-0.81; -0.05]; p = 0.027).</p><p><strong>Conclusions: </strong>DME-specific features, as analyzed on OCT, have a significant impact on point-wise RS. IRF and HE volume showed a negative and EZ thickness, a positive association with localized RS.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143639558","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":"An amelanotic conjunctival lesion in a 40-year-old man","authors":"Rachel M. Malsch,&nbsp;Sanjay V. Patel,&nbsp;Jorge A. Trejo-Lopez,&nbsp;Lauren A. Dalvin","doi":"10.1016/j.jcjo.2025.02.008","DOIUrl":"10.1016/j.jcjo.2025.02.008","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Page e620"},"PeriodicalIF":3.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669107","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":"Longitudinal clinical characteristics of patients with neurofibromatosis type 1.","authors":"Lorenz Wassermann, Sandra Rezar-Dreindl, Gregor S Reiter, Thomas Neumayer, Ursula Schmidt-Erfurth, Eva Stifter","doi":"10.1016/j.jcjo.2025.02.014","DOIUrl":"10.1016/j.jcjo.2025.02.014","url":null,"abstract":"<p><strong>Purpose: </strong>This study reports on longitudinal clinical characteristics of patients with neurofibromatosis type 1 (NF1) treated at the Department of Ophthalmology of the Medical University of Vienna.</p><p><strong>Methods: </strong>This retrospective study included children with a genetically proven diagnosis of NF1. Clinical characteristics and outcomes, including best-corrected visual acuity (BCVA), refractive error, ocular motility, specific ophthalmological findings (e.g., Lisch nodules), and the presence of cutaneous café au lait stains were evaluated. Optical coherence tomography (OCT) and magnetic resonance imaging (MRI) were obtained to evaluate optic nerve abnormalities and early detection of optic glioma.</p><p><strong>Results: </strong>One hundred and sixty-eight eyes of 85 children were included. The mean follow-up of the patients was 8 ± 3.7 years (range: 2-19 years) and mean age at baseline was 3.1 ± 2.6 years. Mean (±SD) BCVA was 0.19 (±0.20) logMAR at baseline. 16.5% of patients showed the presence of optic nerve abnormalities, 18.8% had therapy, 32.9% of the patients had cafe au lait stains, and 37.1% had Lisch nodules in the eye examination. Worse BCVA at baseline was associated with the presence of severe optic nerve abnormalities (mean 0.21 ± 0.14 logMAR; p < 0.01), compared to patients without optic nerve abnormalities (mean 0.14 ± 0.14 logMAR). Additionally, BCVA at baseline was dependent on the visual test (from mean 0.04 ± 0.19 logMAR to mean 0.3 ± 0.16 logMAR; p < 0.01). There was also a significant difference in BCVA change to follow-up in patients who received therapy compared to patients who did not (p = 0.033). The age showed no significant influence on the BCVA at baseline (p = 0.92).</p><p><strong>Conclusions: </strong>Optic nerve glioma poses a significant threat to vision in NF1 patients, necessitating biannual follow-up until age 6, including MRI, fundoscopy, and OCT imaging.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604018","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":"Physician reimbursement for strabismus surgery across provinces and territories in Canada.","authors":"Kaylin O'Hara, Nicole Costanzo, Vishaal Bhambhwani","doi":"10.1016/j.jcjo.2025.02.005","DOIUrl":"10.1016/j.jcjo.2025.02.005","url":null,"abstract":"<p><strong>Objective: </strong>Inadequate financial reimbursements in pediatric ophthalmology and strabismus (POS) are held responsible for the declining interest of ophthalmology graduates, leading to serious workforce concerns. The purpose of this study is to review physician reimbursements for strabismus surgery across provinces and territories in Canada.</p><p><strong>Methods: </strong>The manuals for physician remuneration for provinces/territories in Canada were reviewed in 2023 and 2024; strabismus surgery and routine cataract surgery billing codes with their respective compensation were extracted. The data were analyzed using appropriate statistical tests.</p><p><strong>Results: </strong>Physician reimbursement for 1-muscle strabismus surgery varied from $369 (Ontario and Newfoundland and Labrador) to $835 (Yukon) before April 2023 and from $369 (Newfoundland and Labrador) to $891 (Yukon) after April 2023. For 5-muscle surgery, the values were $502 (Prince Edward Island) to $1723 (Manitoba) before, and $512 (Prince Edward Island) to $2626 (Ontario) after April 2023 [ANOVA test statistically significant, p < 0.0001 for both]. Two out of 12 (17%) provinces/territories do not pay for adjustable sutures, 4/12 (33%) for reoperations, 7/12 (58%) for more complex strabismus procedures, at present. Before April 2023, mean reimbursement for 1-muscle strabismus surgery was $529 ± 149.7, and for cataract surgery, it was $489 ± 168.7; p = 0.5453. After April 2023, the values were $551 ± 151.4 and $496.4 ± 176.7, respectively; p = 0.4251. Four out of 12 (33%) and 3/12 (25%) provinces/territories paid more for cataract compared to 1-muscle strabismus surgery before and after April 2023, respectively.</p><p><strong>Conclusions: </strong>There is high variability in payments for the same strabismus procedures across provinces/territories in Canada. Physician reimbursement issues may lead to POS workforce concerns and limit access to care.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143584737","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":"F. Y. EYE","authors":"","doi":"10.1016/j.jcjo.2025.02.006","DOIUrl":"10.1016/j.jcjo.2025.02.006","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 2","pages":"Page 128"},"PeriodicalIF":3.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143636949","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":"Resident Perspectives 60–2","authors":"","doi":"10.1016/j.jcjo.2025.02.007","DOIUrl":"10.1016/j.jcjo.2025.02.007","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 2","pages":"Pages e303-e306"},"PeriodicalIF":3.3,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143637800","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":"Sensitivity of ophthalmologists, residents, and optometrists in identifying peripheral retinal tears on ultra-widefield imaging","authors":"Jesse J. Jung ,&nbsp;Xavier Chan ,&nbsp;Kai Xiong Cheong ,&nbsp;Yee Shan Dan ,&nbsp;John Y. Cheng ,&nbsp;Eric W. Lai ,&nbsp;Huanye Li ,&nbsp;Quan V. Hoang","doi":"10.1016/j.jcjo.2025.02.002","DOIUrl":"10.1016/j.jcjo.2025.02.002","url":null,"abstract":"<div><h3>Objective</h3><div>To compare the sensitivity of 3 groups of masked graders with varying levels of ophthalmic training to identify peripheral retinal breaks utilizing ultra-widefield orthogonal, directed peripheral steering, and auto-montaged images.</div></div><div><h3>Design</h3><div>Retrospective observational cohort study.</div></div><div><h3>Participants</h3><div>155 patients from a single vitreoretinal specialist's practice.</div></div><div><h3>Methods</h3><div>221 eyes with pretreatment orthogonal, directed-peripheral steering, and auto-montage that underwent laser retinopexy for retinal tears between 2015 and 2021 were divided into 2 groups: treatment-naïve and control. Combined sensitivity and specificity of identifying all retinal breaks on orthogonal, directed-peripheral steering, and auto-montaged imaging were calculated compared with the gold standard of mydriatic, scleral depression examination. Linear probability modeling was performed to calculate the required surface area from auto-montage images to identify breaks that were missed initially on orthogonal images.</div></div><div><h3>Results</h3><div>For orthogonal images, combined sensitivity was highest for ophthalmologists (67.53%), residents (62.34%), and then optometrists (55.84%). The sensitivity increased for orthogonal/steering (ophthalmologists [85.71%], residents [77.92%], and optometrists [67.53%]) and auto-montage (ophthalmologists [85.51%], residents (80.28%), and optometrists [75.00%]). To ensure identification of all tears with auto-montage that was initially missed on grading the orthogonal image, for every 10% increase in montage surface area, there was a 4.8 percentage point (%p) increase in the likelihood of detecting a retinal tear on montage image grading (<em>p</em> = 0.023).</div></div><div><h3>Conclusions</h3><div>Masked graders had moderate sensitivity in identifying retinal breaks with ultra-widefield images. Even with directed-peripheral steering and auto-montage, optometrists had the lowest sensitivity compared to ophthalmology residents and general ophthalmologists and required increased surface area to identify all retinal breaks.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Pages 222-229"},"PeriodicalIF":3.3,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143490887","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":"Visual outcomes of an extended depth of focus intraocular lens in patients with high ocular axial length","authors":"James Wiens ,&nbsp;Brad Hall","doi":"10.1016/j.jcjo.2025.01.019","DOIUrl":"10.1016/j.jcjo.2025.01.019","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the visual outcomes and quality of vision in patients receiving a nondiffractive extended depth of focus (EDOF) intraocular lens (IOL), when implanted in eyes with high ocular axial length (≥24.5 mm).</div></div><div><h3>Methods</h3><div>This was a prospective, single-arm, single-surgeon study. Subjects were bilaterally implanted with the Vivity EDOF IOL (toric and nontoric). At 3 months postoperatively, assessments included binocular and monocular visual acuities at distance (6 m), intermediate (66 cm), and near (40 cm), manifest refraction, and administration of a visual disturbance questionnaire (QUVID) and a satisfaction questionnaire (IOLSAT).</div></div><div><h3>Results</h3><div>At 3 months postoperatively, 100% (20/20), 100% (20/20), and 65% (13/20) of subjects had binocular visual acuity 20/32 or better at distance, intermediate, and near, respectively. Similar visual acuities were obtained with distance correction. At 3 months postoperatively, 93% of eyes (37/40) had manifest refraction spherical equivalent 0.5 D or less. Patient reported spectacle independence was 95% (19/20), 90% (18/20), and 40% (8/20) at distance, intermediate, and near, respectively. Patient-reported satisfaction with their corrected vision was 95% (19/20). In addition, 70% (14/20), 65% (13/20), and 70% (14/20) of subjects reported never or rarely experiencing starburst, halo, and glare, respectively.</div></div><div><h3>Conclusions</h3><div>The results of this study suggest that the Vivity nontoric and toric IOLs can provide excellent distance and intermediate vision and functional near vision in eyes with high ocular axial length. Good spectacle independence can also be achieved at distance and intermediate, with high reported patient satisfaction and low reported visual disturbances.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Pages e536-e540"},"PeriodicalIF":3.3,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439945","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":"Visual outcomes, quality of vision, and patient satisfaction of a trifocal intraocular lens","authors":"Marius A. Scheepers ,&nbsp;Nina M. Pasin ,&nbsp;Brad Hall","doi":"10.1016/j.jcjo.2025.01.018","DOIUrl":"10.1016/j.jcjo.2025.01.018","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate visual outcomes, patient satisfaction, and quality of vision after bilateral Clareon PanOptix implantation.</div></div><div><h3>Methods</h3><div>This was a prospective, observational, single-arm, single-surgeon, single-site study of the clinical outcomes following implantation of the Clareon PanOptix (toric and nontoric). A total of 28 subjects (56 eyes) completed the study. At 3 months postoperatively, assessments included binocular uncorrected and distance-corrected visual acuity at distance (UDVA, CDVA), intermediate (UIVA, DCIVA; 60 cm), and near (UNVA, DCNVA; 40 cm), refraction, and patient-reported outcomes on a satisfaction questionnaire (IOLSAT) and a visual disturbance questionnaire (QUVID).</div></div><div><h3>Results</h3><div>Mean postoperative binocular CDVA, DCIVA, and DCNVA were −0.02 ± 0.09, 0.03 ± 0.11, 0.04 ± 0.07 logMAR, respectively. In addition, mean binocular UDVA, UIVA, and UNVA were 0.00 ± 0.09, 0.06 ± 0.11, 0.03 ± 0.06 logMAR, respectively. Mean postoperative manifest refraction spherical equivalent (MRSE) was 0.01 ± 0.23 D and 96% of eyes had MRSE of 0.5 D or less. The percentage of subjects reporting spectacle independence at distance, intermediate, and near was 100%, 100%, and 89%, respectively. Moreover, 89% of subjects rated their satisfaction as “Satisfied” or “Very Satisfied.” Additionally, 0%, 8%, and 7% of subjects were “bothered quite a bit” or “bothered very much” by starbursts, halos, and glare, respectively.</div></div><div><h3>Conclusions</h3><div>Patients in this study who were implanted with the Clareon PanOptix intraocular lens had excellent refractive and visual outcomes and reported good spectacle independence at distance, intermediate, and near, high overall satisfaction, and low visual disturbances.</div></div>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Pages e530-e535"},"PeriodicalIF":3.3,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143439874","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}