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

{"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}

{"title":"Social media for international surgical skills transfer: using pneumatic retinopexy as a model.","authors":"Jim Shenchu Xie, Angus Fung, Aaron Hao Tan, Aurora Pecaku, Kunihiko Akiyama, Brendan Ka-Lok Tao, Mitul C Mehta, Hemang K Pandya, Francesco Pelligrini, Juan Carlos Hernandez, Mahmoud Alrabiah, Dhawan, Roxane J Hillier, Rajeev H Muni","doi":"10.1016/j.jcjo.2025.02.020","DOIUrl":"https://doi.org/10.1016/j.jcjo.2025.02.020","url":null,"abstract":"<p><strong>Objective: </strong>To assess social media as a potential method of bridging the gap between randomized controlled trial evidence and the implementation of pneumatic retinopexy (PnR).</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Participants: </strong>Vitreoretinal surgeons from a Telegram chat group that was initiated in May 2020 for educating ophthalmologists about PnR.</p><p><strong>Methods: </strong>Between July 25, 2023, and September 25, 2023, longitudinal chat usage was recorded using an automated chatbot, and a subgroup of surgeons was surveyed about the effect of the Telegram group on their PnR practice.</p><p><strong>Results: </strong>Telegram group membership increased from 43 members in May 2020 to 885 members in June 2024, with representation from 64 different countries. A subset of 653 members sent a mean (SD) of 2.6 (28.2) messages and were active 56.4 (195.0) times between July and September 2023. Eighty-one surgeons from 35 different countries completed the survey. Between the year before and year after joining the Telegram group, the proportions of surgeons that treated >25% of RRD cases with PnR (8.6% vs 44.4%; p < .001) and self-reported >80% primary anatomical reattachment rate (27.2% vs 48.1%; p < .001) increased.</p><p><strong>Conclusions: </strong>Social media may be leveraged to support the refinement of surgical techniques such as PnR for physician trainees and practicing surgeons, as well as increase surgical adoption into routine practice, a process that can otherwise take several decades. A randomized implementation trial that compares social media to other dissemination and implementation strategies while incorporating effectiveness and safety outcomes is warranted.</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":"143699628","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, Xavier Chan, Kai Xiong Cheong, Yee Shan Dan, John Y Cheng, Eric W Lai, Huanye Li, Quan V Hoang","doi":"10.1016/j.jcjo.2025.02.002","DOIUrl":"10.1016/j.jcjo.2025.02.002","url":null,"abstract":"<p><strong>Objective: </strong>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.</p><p><strong>Design: </strong>Retrospective observational cohort study.</p><p><strong>Participants: </strong>155 patients from a single vitreoretinal specialist's practice.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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 (p = 0.023).</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-03-03","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, Brad Hall","doi":"10.1016/j.jcjo.2025.01.019","DOIUrl":"10.1016/j.jcjo.2025.01.019","url":null,"abstract":"<p><strong>Objective: </strong>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).</p><p><strong>Methods: </strong>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).</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"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}