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

{"title":"Cenegermin treatment for pediatric neurotrophic keratopathy: a systematic review.","authors":"Daiana R Pur, Fady Sedarous, Asim Ali, Rookaya Mather","doi":"10.1016/j.jcjo.2025.06.021","DOIUrl":"10.1016/j.jcjo.2025.06.021","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review evaluates the efficacy and safety of cenegermin in pediatric neurotrophic keratopathy (NK), assessing treatment outcomes, predictors of efficacy, and adverse effects.</p><p><strong>Methods: </strong>Adhering to PRISMA guidelines, we reviewed studies from Embase, MEDLINE, HealthSTAR, and other databases up to July 28, 2024. Studies were included if they involved pediatric patients (≤18 years) treated with cenegermin for NK. Two reviewers independently screened and extracted data, assessing the risk of bias using Joanna Briggs Institute tools.</p><p><strong>Results: </strong>Of the 20 articles reviewed, 8 case reports or series met inclusion criteria, encompassing 21 pediatric cases (33% female), with an average age of 5.87 ± 3.05 years. Etiologies included congenital conditions, radiotherapy, and infections. Cenegermin was administered as a 0.002% drop 6 times daily for 8 weeks. Treatment was typically initiated after the failure of conventional methods. Improvements in corneal transparency were observed in all cases, with visual acuity improved in 4 out of 6 studies reporting this metric. Factors associated with improvement in corneal transparency were the severity of preexisting corneal scarring and ocular surface instability.</p><p><strong>Conclusions: </strong>Cenegermin is a viable treatment option for pediatric NK, showing efficacy in improving corneal transparency and, to a lesser extent, visual acuity. However, its adoption is constrained by limited pediatric data, cost, and potential side effects. Further research is needed to establish long-term safety and effectiveness, and to optimize treatment protocols for this vulnerable population.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682098","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":"A case of cross-reactivity between flaviviruses in a patient with West Nile retinopathy.","authors":"Natalie S Chen, Isaac I Bogoch, Alexander J Kaplan","doi":"10.1016/j.jcjo.2025.06.019","DOIUrl":"10.1016/j.jcjo.2025.06.019","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682097","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":"Flieringa scleral fixation ring-assisted Descemet membrane endothelial keratoplasty in complex eyes.","authors":"Gabriele Gallo Afflitto, Shafi Balal, Francesco Aiello, Vincenzo Maurino","doi":"10.1016/j.jcjo.2025.07.003","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.07.003","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728120","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":"Refractive and visual outcomes of macular edema of prematurity at 9 months, 2 years, and 5 years of age.","authors":"Jolan G Wu, Najma M Adan, Masis Ohan, Leona Ding, Alex T Legocki, Thomas B Gillette, Ayesha Shariff, Laura E Grant, Kristina Tarczy-Hornoch, Michelle T Cabrera","doi":"10.1016/j.jcjo.2025.07.001","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.07.001","url":null,"abstract":"<p><strong>Objective: </strong>Determine visual and refractive outcomes of cystoid macular edema (CME) in preterm infants at risk for retinopathy of prematurity (ROP).</p><p><strong>Design: </strong>Prospective, observational cohort study.</p><p><strong>Participants: </strong>Premature infants eligible for ROP screening from 2 tertiary hospitals.</p><p><strong>Methods: </strong>Participants underwent awake handheld spectral domain optical coherence tomography (SD-OCT) imaging during their ROP exams. A single, masked pediatric ophthalmologist performed eye examinations, including cycloplegic streak retinoscopy, at 9 months, 2 years, and 5 years of age.</p><p><strong>Results: </strong>Among 94 preterm infants (175 eyes), birth weight was 1 018.09 ± 290.16 g and gestational age 28.38 ± 2.87 weeks. Thirty-two infants (34%) developed CME (mean maximum central foveal thickness 300 ± 350 µm) as newborns. No differences were found between those with versus those without CME in high myopia, mild myopia, mild hyperopia, and high hyperopia at 9 months (p = 1.00; n = 65), 2 years (p = 1.00; n = 47), and 5 years (p = 1.00; n = 31). Mean spherical equivalents (1.89 ± 2.19 vs 1.73 ± 1.15, 1.77 ± 1.92 vs 0.99 ± 1.48, and 1.28 ± 0.74 vs 0.41 ± 1.59 at 9 months, 2 years, and 5 years, respectively; p = 0.87-1.00), visual acuity (p = 0.14-1.00), astigmatism (p = 0.71-1.00), and strabismus (p = 1.00) also did not correlate with a history of CME at any time point.</p><p><strong>Conclusions: </strong>We identified no associations between CME in premature newborns screened for ROP and visual acuity or refractive error at 9 months, 2 years, or 5 years of age.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717627","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":"Choroidal features on widefield optical coherence tomography angiography in eyes with circumscribed choroidal hemangioma.","authors":"Judith E Kreminger, Reinhard Told, Stephanie Rokitansky, Adrian Reumueller, Roman Dunavoelgyi, Stefan Sacu","doi":"10.1016/j.jcjo.2025.07.002","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.07.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate choroidal morphologic and vascular findings in eyes with circumscribed choroidal hemangioma (CCH) in a 21 mm × 26 mm widefield (WF) OCT-Angiography (OCTA; VG200D: Intalight Inc., San Jose, CA).</p><p><strong>Methods: </strong>Consecutive patients with CCH were included in this prospective, observational study at the Department of Ophthalmology and Optometry, Medical University of Vienna, Austria. Imaging consisted of ultrasonography, and WF-OCTA. Choroidal vascularity index (CVI) and choroidal thickness (CT) were assessed in study eyes (SE) and fellow eyes (FE) using the software of the device. Measurement of CT and CVI excluded the area of CCH and an equivalent area of FE.</p><p><strong>Results: </strong>Nineteen patients (female: n = 9 (47.4%), mean age: 61 ± 11 years) were included in the study. In ultrasonography, the mean largest basal diameter and thickness were 7.32 ± 2.12 mm and 2.81 ± 0.75 mm, respectively. CT was statistically significantly higher in SE, as compared to FE (294.6 ± 74.2 µm vs 239.9 ± 46.8 µm; paired t test p < 0.001), while CVI was statistically significantly lower in SE, as compared to FE (0.44 ± 0.05 vs 0.45 ± 0.05; paired t test: p = 0.012). Intraretinal or subretinal fluid had no statistically significant influence on CT (with fluid: 303.0 ± 84.3 µm vs without fluid: 285.3 ± 65.0 µm; t test: p = 0.619) and CVI (with fluid: 0.42 ± 0.05 vs without fluid: 0.45 ± 0.03; t test: p = 0.185).</p><p><strong>Conclusions: </strong>Intrasubretinal or subretinal fluid had no impact on CT and CVI of SE. CT is higher and CVI is lower in SE as compared to FE, when excluding the area of CCH in SE and an equivalent area in FE. This suggests that the choroid plays a crucial role in the disease mechanism of CCH.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717625","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":"Clinical characteristics, treatment outcomes and prognostic factors for metastasis in stage 1 choroidal melanoma: a retrospective cohort study in 159 patients.","authors":"Jingting Luo, Jingying Xiu, Zhaoxun Feng, Heng Wang, Yuning Chen, David Maberley, Qiong Yang, Yueming Liu, Yang Li, Wenbin Wei","doi":"10.1016/j.jcjo.2025.06.016","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.06.016","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics, risk factors, and treatment outcomes of stage 1 choroidal melanoma (CM) and to identify prognostic indicators for metastasis.</p><p><strong>Design: </strong>A retrospective cohort study.</p><p><strong>Participants: </strong>Consecutive patients diagnosed with stage 1 CM at Beijing Tongren Hospital.</p><p><strong>Methods: </strong>Tumours were classified according to the American Joint Committee on Cancer Cancer Staging Manual, 8th edition. Clinical, demographic, and treatment data were analyzed, focusing on tumour size, shape, subretinal fluid, and treatment responses. Kaplan-Meier analysis and a nomogram were used to assess metastatic-free survival and identify prognostic factors.</p><p><strong>Results: </strong>This retrospective study analyzed 159 patients with stage I CM to identify metastasis predictors and therapeutic response patterns. With a median follow-up of 78 months, 5.7% (9/159) developed metastases, showing metastasis rates of 0.63%, 3.23%, and 7.89% at 1, 5, and 10 years, respectively. Univariate analysis revealed the largest basal diameter (LBD), subretinal fluid, and irregular tumour shape as potential risk factors for metastasis. A nomogram model integrating LBD, morphology, and subretinal fluid demonstrated superior predictive performance compared to LBD alone (area under the curve = 0.84 vs 0.71). Metastatic cases are more likely to exhibit a \"decrease-then-increase\" treatment response within 24 months. The median metastasis-free interval was 49 months (range: 10-81), and postmetastasis survival averaged 22.6 months.</p><p><strong>Conclusions: </strong>The largest basal diameter, irregular shape, subretinal fluid, and a \"decrease-then-increase\" treatment response pattern are identified as key predictors of metastasis in stage 1 CM. These findings underscore the importance of risk stratification and close monitoring of high-risk patients.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144717626","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":"Prevalence of vernal keratoconjunctivitis in Canada: a cross-sectional survey study.","authors":"Manokamna Agarwal, Ya-Ping Jin, Larissa Gouvea, Kamiar Mireskandari, Asim Ali","doi":"10.1016/j.jcjo.2025.06.005","DOIUrl":"10.1016/j.jcjo.2025.06.005","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the prevalence of vernal keratoconjunctivitis (VKC) in Canada in January 2023.</p><p><strong>Methods: </strong>A total of 1 061 ophthalmologists registered with the Canadian Ophthalmological Society were contacted in January 2023 and offered an online survey on VKC. Eighty (7.5%) responded. The prevalence of VKC in Canada was estimated using 6 distinct hypotheses, each based on different assumptions regarding disease duration and the potential experiences of nonresponding ophthalmologists.</p><p><strong>Results: </strong>On the basis of the 6 different hypotheses, the estimated prevalence (per 10,000) of active VKC in January 2023 ranged between 0.13 (95% confidence interval [CI] 0.12-0.14) to 3.34 (95% CI 3.29-3.40) for the total population of Canada, and 0.61 (95% CI 0.56-0.66) to 16.11 (95% CI 15.84-16.39) for Canadians aged 0-19 years. Building on the most likely hypothesis that the disease duration was 4 years, and assuming on-responding ophthalmologists had seen half of the VKC cases as survey responders, the best estimate of VKC prevalence in Canada was 0.90 (95% CI 0.84-0.96) per 10,000 population and 4.33 (95% CI 4.07-4.61) per 10,000 children and teens. The most common VKC-associated complications were reported to be shield ulcer and steroid-induced ocular hypertension ranging from 0.02 to 0.48 and 0.02 to 0.47 cases per 10,000 inhabitants, respectively, depending on the hypothesis assumed.</p><p><strong>Conclusions: </strong>This national survey reported that the prevalence of VKC per 10,000 population in 2023 ranged from 0.13 to 3.34 for Canadians of all ages and from 0.61 to 16.11 for children and teens. The best estimate was 0.90 per 10,000 population of all ages and 4.33 per 10,000 children and teens.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144574898","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":"Long-term prognosis of repeat Type I Boston keratoprosthesis.","authors":"Wissam B Nassrallah, Emma Youhnovska, Mai Katbe, Andre Pollmann, Fady Sedarous, Rayan Tolba, Dominique Geoffrion, Mona Harissi-Dagher","doi":"10.1016/j.jcjo.2025.06.027","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.06.027","url":null,"abstract":"<p><strong>Objective: </strong>The Boston Type I keratoprosthesis (B-KPro) is a synthetic corneal implant used to restore vision in cases of corneal blindness. While the B-KPro can achieve a visual acuity of better than 20/200, it is associated with a risk of implant failure. In cases of failure, a repeat B-KPro may offer another opportunity for vision restoration. This study aims to evaluate the long-term outcomes of patients undergoing repeat B-KPro after failure of the initial implant.</p><p><strong>Design: </strong>This is a retrospective cohort study.</p><p><strong>Participants: </strong>Eighteen patients who underwent two B-KPro implantations in the same eye, with a mean follow-up period of 8.1 ± 4.6 years.</p><p><strong>Methods: </strong>The primary endpoints were the failure rate of the implant and visual acuity at the last follow-up.</p><p><strong>Results: </strong>The failure rate of the repeat B-KPro (11.11% at 5 years) was significantly lower than that of the first B-KPro (88.89% at 5 years) (p < 0.0001) for the repeat cohort. Visual acuity better than 20/200 was achieved in 30.09% and 24.07% of patients at 3 years and 6 years, respectively, following repeat B-KPro, similar to outcomes observed after the first B-KPro. The incidence of phthisis was higher after the repeat B-KPro, but the rates of hypotony, endophthalmitis, corneal melt, and extrusion were lower compared to the first B-KPro.</p><p><strong>Conclusions: </strong>Repeat B-KPro can provide sustained visual acuity better than 20/200 after failure of the initial implant. Further studies with larger cohorts are needed to better understand the risks and benefits associated with repeat B-KPro.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144688947","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":"Long-term effects of drusenoid pigment epithelial detachment on the retina and the choroid.","authors":"Marlene Hollaus, Magdalena Baratsits, Irene Steiner, Günther Weigert, Maximilian Pawloff, Georgios Mylonas, Ursula Schmidt-Erfurth, Stefan Sacu","doi":"10.1016/j.jcjo.2025.06.010","DOIUrl":"10.1016/j.jcjo.2025.06.010","url":null,"abstract":"<p><strong>Objective: </strong>To analyze the long-term effects of drusenoid pigment epithelial detachment (DPED) on the overlying inner and outer retinal layers and the underlying choroid.</p><p><strong>Methods: </strong>Forty-two eyes from 33 patients with DPED due to intermediate age-related macular degeneration were included in this prospective observational cohort study, which was conducted from December 2017 until July 2023. Patients underwent spectral-domain optical coherence tomography every 6 months. Evaluated parameters included maximum DPED height (=DPED apex) and location of the DPED apex at baseline; furthermore, DPED height, retinal thickness (RT), visibility of retinal layers, presence of hyperreflective foci (HRF), choroidal thickness (CT), and best-corrected visual acuity (BCVA) at baseline and each follow-up visit, as well as development of macular neovascularization or geographic atrophy.</p><p><strong>Results: </strong>DPED height, RT, and CT did not change significantly during the observation period (all p values > 0.05). DPED height and RT correlated significantly regardless of visit (estimate = -0.36, 95% CI = -0.4 to -0.32; p < 0.0001), DPED height, and CT did not (p > 0.05). Outer retina (estimate = -2.19, 95% Cl = -2.74 to -1.63; p < 0.0001), location in the central millimeter (estimate = -0.79, 95% Cl = -1.31 to -0.27; p = 0.004), and the presence of HRF (estimate = -0.65, 95% Cl = -1.05 to -0.24; p = 0.003) were significantly associated with retinal layer visibility regardless of visit, while DPED height was not (p > 0.05). BCVA was not significantly associated with DPED height, RT, CT, or the number of visible outer and inner retinal layers regardless of visit (all p values > 0.05).</p><p><strong>Conclusions: </strong>Our results indicate that increasing DPED height may significantly reduce the thickness of the overlying retina but not of the underlying choroid. Fewer outer retinal layers were visible compared to the inner retina at the DPED apex. Location in the central millimeter of the macula and presence of HRF also reduced the number of visible retinal layers. Impairment of the retinal morphology, which seems to be more pronounced in the outer than the inner retina, need not be accompanied by functional impairment and can recover in case of DPED regression.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607484","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":"Long-term efficacy of accelerated corneal collagen cross-linking for keratoconus.","authors":"Sangeetha Santhakumaran, Wilma M Hopman, Davin Johnson","doi":"10.1016/j.jcjo.2025.06.011","DOIUrl":"10.1016/j.jcjo.2025.06.011","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144590549","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}