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

{"title":"Outer nuclear layer thickness as a biomarker for photoreceptor function in pachychoroid spectrum disorders.","authors":"Su Min Jo, Kyung Tae Kim, Eoi Jong Seo","doi":"10.1016/j.jcjo.2025.02.009","DOIUrl":"10.1016/j.jcjo.2025.02.009","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether the outer nuclear layer (ONL) could serve as a quantitative biomarker for photoreceptor function in pachychoroid pigment epitheliopathy (PPE) and pachychoroid neovasculopathy (PNV). Additionally, to assess the impact of pachychoroid features, the presence of neovascularization, and a history of exudation on photoreceptor function.</p><p><strong>Methods: </strong>One hundred and one eyes with pachychoroid features and thirty-four normal control eyes were retrospectively analyzed. The study groups were categorized into PNV and PPE subgroups based on the presence of neovascularization detected on optical coherence tomography angiography. PNV eyes were further stratified based on a history of exudation. The average thicknesses of individual retinal layers and choroidal thickness were measured, along with best-corrected visual acuity (BCVA). The relationship between BCVA and each retinal/choroidal layer thickness was analyzed.</p><p><strong>Results: </strong>ONL thickness differed significantly among the 3 groups, with the thinnest in the PNV group and the thickest in the control group (p = 0.001), revealing a linear correlation to BCVA. The PPE group exhibited thicker ONL and better BCVA than the PNV group without a history of exudation (p < 0.001 and p = 0.015, respectively). In PNV eyes, those with a history of exudation had thinner ONL and worse BCVA compared to those without such a history (p = 0.003 and 0.008, respectively).</p><p><strong>Conclusions: </strong>ONL thickness serves as a quantitative biomarker of photoreceptor function in PNV and PPE. Photoreceptor function declines in eyes with pachychoroid features, the presence of neovascularization, and a history of exudation. The development of neovascularization or exudation in PNV or PPE should be treated promptly to salvage photoreceptors.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143633623","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":"Disproportionality analysis of BRAF and MEK inhibitors demonstrate risk of retinal detachment: an analysis of the FDA Adverse Event Reporting System.","authors":"Connor Frey, Mahyar Etminan","doi":"10.1016/j.jcjo.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.03.003","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742547","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":"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":" ","pages":""},"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":"Idiopathic granulomatous orbital inflammation: A case series and literature review.","authors":"Sonia Huang, Valerie Juniat, Jessica Y Tong, Craig James, Nigel Morlet, Saul Rajak, Roy Tan Da Duan, Peerooz Saeed, Ilse Mombaerts, Dinesh Selva","doi":"10.1016/j.jcjo.2025.02.023","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.02.023","url":null,"abstract":"<p><strong>Purpose: </strong>Idiopathic granulomatous orbital inflammation is an uncommon histological finding that remains poorly defined due to its overlap with specific causes of granulomatous orbital inflammation, such as orbital sarcoidosis. We aim to identify clinico-radiological features that may differentiate it from other aetiologies of granulomatous inflammation.</p><p><strong>Methods: </strong>Retrospective case series involving 12 patients and review of the literature.</p><p><strong>Results: </strong>Eight patients (66.7%) were female. The mean age at presentation was 57.8 ± 9.1 years of age. Eleven cases were unilateral (91.7%). The most common presenting symptoms and signs were palpable mass (n = 10; 83.3%), lid swelling (n = 9; 75%) decreased extraocular movements (n = 4; 33.3%), and proptosis (n = 4; 33.3%). One patient (8.3%) had signs consistent with optic neuropathy on presentation. The lacrimal glands were involved in 6 (50%) cases. For initial management, 2 patients (16.7%) underwent observation only, 8 patients (66.7%) were managed with immunosuppressive drugs, and 2 patients (16.7%) were managed with surgical excision or debulking. Four patients (33.3%) required additional management with either methotrexate or intralesional triamcinolone. Patients were followed up for a mean of 68.4 months. At last follow-up, 7 patients (63.6%) had complete resolution, and 5 (41.7%) had stable disease without further progression.</p><p><strong>Conclusion: </strong>We present a case series of idiopathic granulomatous orbital inflammation. We found that those with idiopathic disease often had unilateral presentations and appeared to present at a later age than those with orbital sarcoidosis in the literature. Although the differentiation between orbital sarcoidosis and idiopathic disease remains difficult, the features described in this series contribute to a greater understanding of the latter condition.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742548","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":"Analysis of diplopia referrals in a tertiary neuro-ophthalmology center.","authors":"Mariam Issa, Milena Cioana, Marko M Popovic, Laura Donaldson, Jonathan Micieli, Edward Margolin","doi":"10.1016/j.jcjo.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.03.001","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the potential for morbidity and mortality in patients referred to neuro-ophthalmology service for evaluation of diplopia.</p><p><strong>Methods: </strong>A retrospective chart review of all patients seen by two neuro-ophthalmologists in a tertiary neuro-ophthalmology practice between December 2, 2021, and May 21, 2022, was performed. All patients who were referred for diplopia were included. The primary outcome was to describe the potential for vision loss, progression of symptoms, or systemic morbidity or mortality without a neuro-ophthalmic consult.</p><p><strong>Results: </strong>One hundred ninety-six patients were referred for diplopia. The mean age at presentation was 61.3 ± 17.0 years, and 48.5% were women. The most common final diagnosis reached following neuro-ophthalmology consultation were cranial nerve palsies (38.3%, 75/196), convergence insufficiency and decompensated phoria (22.4%, 44/196), non-neuro-ophthalmic causes (19.9%, 39/196), thyroid eye disease (4.5%, 9/196), myasthenia gravis (3.5%, 7/196), and multiple sclerosis (6/196, 3.1%). On the basis of final diagnosis, 15.3% of patients referred to neuro-ophthalmology service for diplopia had the potential for morbidity or mortality. Specifically, 1% (2/196) were at risk for visual loss due severe papilledema in the context of untreated idiopathic intracranial hypertension, and 3.0% (6/196) had the potential for systemic morbidity or mortality due to their final diagnosis (brain aneurysms in 2/196, pituitary apoplexy in 1/196, anaplastic glioma in 1/196, and other malignancy in 2/196). In addition, 11.2% (22/196) had the potential for progression of symptoms and systemic morbidity due to thyroid eye disease (9/196), myasthenia gravis (7/196), and multiple sclerosis (6/196). Of the patients who had a prereferral neuroimaging study, 30.1% required additional neuroimaging after neuro-ophthalmic consultation.</p><p><strong>Conclusions: </strong>Overall, 15.3% (30/196) of patients with diplopia had potential for morbidity and mortality without neuro-ophthalmic consultation. This study emphasizes the importance of urgent neuro-ophthalmologic referral for patients with diplopia to allow for appropriate evaluation and investigations to reduce potential morbidity and mortality.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708654","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":"Ozanimod-associated macular edema.","authors":"Thomas M W Buckley, Mayuresh Naik, Samantha R De Silva","doi":"10.1016/j.jcjo.2025.02.022","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.02.022","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708656","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, Sanjay V Patel, Jorge A Trejo-Lopez, 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":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-21","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":"Relative exophthalmos in facial nerve palsy.","authors":"Nishita T Sheth, Irene T Lee, Sandra S Stinnett, Julie Woodward, Richard C Allen, Christopher R Dermarkarian","doi":"10.1016/j.jcjo.2025.02.017","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.02.017","url":null,"abstract":"<p><strong>Objective: </strong>While ocular manifestations of facial nerve palsy, such as lagophthalmos are well known, there is limited knowledge on whether CN 7 palsy impacts globe positioning and its implications on symptoms and management. We hypothesize that CN 7 palsy is associated with ipsilateral exophthalmos.</p><p><strong>Methods: </strong>A retrospective analysis of 500 patients diagnosed with facial nerve disorders, identified by ICD codes G51.0-G51.9, was conducted at a tertiary health care facility from January to November 2023. Patients were included if they had a diagnosis of unilateral facial nerve (CN 7) palsy and available computed tomography (CT) imaging after diagnosis. Patients under 18 years, those with bilateral CN 7 palsy, or with CT images of poor resolution were excluded. Axial position of the globe was measured on CT scans using 2 methods, both previously shown to correlate with Hertel exophthalmometry.</p><p><strong>Results: </strong>Of the 500 charts reviewed, 55 patients met inclusion criteria. 55% (n = 30) of patients were male, and 58% (n = 32) had right-sided CN 7 palsy. The predominant etiology was acute Bell's palsy 76% (n = 42). CT measurements revealed a statistically significant relative exophthalmos on the side affected by CN 7 palsy, measuring an average of 0.89 mm (Method 1) and 0.92 mm (Method 2) (both methods p < .001).</p><p><strong>Conclusions: </strong>Our study is the first to highlight changes in ocular globe position in CN 7 palsies. The observed exophthalmos highlights the importance of assessing globe position in ophthalmologic management of the disorder.</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":"143699624","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}