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

{"title":"Trends in immediate sequential bilateral cataract surgery in Ontario.","authors":"Richard Zhang, Cindy M L Hutnik","doi":"10.1016/j.jcjo.2024.04.009","DOIUrl":"10.1016/j.jcjo.2024.04.009","url":null,"abstract":"<p><strong>Objective: </strong>Because of increased evidence for safety and increased demands, there appears to be a recent adoption and endorsement of immediate sequential bilateral cataract surgery (ISBCS). This study aims to determine whether a paradigm shift has occurred in the delivery of cataract surgery in the province of Ontario and its the extent, if any, and to analyze the current role of ISBCS.</p><p><strong>Design: </strong>Retrospective health records analysis.</p><p><strong>Methods: </strong>We analyzed aggregate Ontario Health Insurance Plan claim counts for cataract surgeries between 2016 and 2022, categorizing cases into unilateral, ISBCS, and delayed sequential bilateral cataract surgery (DSBCS) cases. We examined trends, compared wait times for second surgeries in the DSBCS cohort with wait times for first surgeries, and used previously published cost estimates for ISBCS to estimate annual savings in Ontario.</p><p><strong>Results: </strong>There were 1,122 ISBCS cases in 2016, which increased sixfold during the pandemic (2020-2021) and further increased to 11,876 cases in 2022. Unilateral and DSBCS cases decreased during the pandemic but rebounded in 2022 to 102% and 153% of baseline, respectively. ISBCS increased from 1% to 10%, unilateral cases decreased from 41% to 29% of total cases, and DSBCS increased from 58% to 61%. Median wait for patients' first and second surgeries increased from 65 to 87 days and 28 to 33 days, respectively. Using estimates, ISBCS saved approximately $19 million in 2022.</p><p><strong>Conclusion: </strong>Our study demonstrates a paradigm shift in Ontario in favour of ISBCS. ISBCS also may be a strategy to reduce increasing wait times while saving health care system dollars.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"21-25"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431529","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":"Stereopsis reconstruction in congenital absence of the inferior rectus.","authors":"ZhiYin Lou, Chao Li, MengXia Yuan, Fan Yang","doi":"10.1016/j.jcjo.2024.06.012","DOIUrl":"10.1016/j.jcjo.2024.06.012","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e179-e181"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751197","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":"Switching from intravenous to subcutaneous tocilizumab for uveitis during the COVID-19 pandemic: a case series.","authors":"Nitesh Mohan, Sunil K Srivastava, Kimberly Baynes, Careen Y Lowder, Sumit Sharma","doi":"10.1016/j.jcjo.2024.06.016","DOIUrl":"10.1016/j.jcjo.2024.06.016","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e181-e183"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141896880","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":"Isolated case of noninfectious and nontraumatic panophthalmitis.","authors":"Farnaz Javadian, Niveditha Pattathil, James Farmer, Robert J Campbell","doi":"10.1016/j.jcjo.2024.07.011","DOIUrl":"10.1016/j.jcjo.2024.07.011","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e176-e179"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906043","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":"Impact of COVID-19 on a real-world treat-and-extend regimen with aflibercept for neovascular age-related macular degeneration.","authors":"Keean Nanji, Kevin Kennedy, Matthew Fung, Jim Xie, Amin Hatamnejad, Sunir J Garg, Charles C Wykoff, Varun Chaudhary","doi":"10.1016/j.jcjo.2024.05.027","DOIUrl":"10.1016/j.jcjo.2024.05.027","url":null,"abstract":"<p><strong>Objective: </strong>To assess the effect of the COVID-19 pandemic on injection intervals among patients treated for neovascular age-related macular degeneration.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Patients treated at a single practice using a treat-and-extend regimen with intravitreal aflibercept between December 2018 and April 2021.</p><p><strong>Methods: </strong>The primary outcome was the change in injection intervals. Secondary outcomes included differences in best-recorded visual acuity (BRVA) and central subfield thickness (CST). Associations were evaluated with linear mixed-effects modelling.</p><p><strong>Results: </strong>This study included 1839 injections from 185 eyes (141 patients). The median (interquartile range) injection intervals in the pre-COVID-19 and COVID-19 periods were 60 (42-70) and 70 (49-90) days, respectively. The pandemic was associated with a mean injection interval lengthening of 7.2 days (P < 0.001), a decrease in BRVA of 3.1 Early Treatment Diabetic Retinopathy Study letters (P < 0.001), and a reduction in CST of 14.7 μm (P = 0.003). The presence of exudative intraretinal fluid was associated with a reduction in treatment intervals of 11.1 days (P < 0.001), a reduction in BRVA of 1.9 Early Treatment Diabetic Retinopathy Study letters (P < 0.001), and an increase in CST of 52.4 μm (P < 0.001). The presence of subretinal fluid was associated with a reduction in treatment intervals of 8.5 days (P < 0.001) and an increase in CST of 21.6 μm (P < 0.001).</p><p><strong>Conclusions: </strong>This real-world study estimated that the severe acute respiratory syndrome coronavirus 2 pandemic resulted in an injection extension of 7.2 days with associated decreases in BRVA and CST that are unlikely clinically significant on a population basis. This builds on evidence suggesting that long-term vascular endothelial growth factor suppression can facilitate meaningful interval extensions while maintaining visual acuity.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e92-e99"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141733612","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":"Changes in aqueous and vitreous inflammatory cytokine levels in nonproliferative diabetic retinopathy: systematic review and meta-analysis.","authors":"Ryan H Mason, Samuel A Minaker, Gabriela Lahaie Luna, Priya Bapat, Armin Farahvash, Anubhav Garg, Nishaant Bhambra, Rajeev H Muni","doi":"10.1016/j.jcjo.2024.05.031","DOIUrl":"10.1016/j.jcjo.2024.05.031","url":null,"abstract":"<p><strong>Objective: </strong>Diabetic retinopathy is a complication of diabetes mellitus with the potential for significant patient morbidity. Although changes to intraocular inflammatory cytokines are integral to disease pathogenesis, studies have been inconsistent about which exact cytokines are associated with diabetic retinopathy. We aimed to quantitatively summarize proangiogenic and proinflammatory cytokines in nonproliferative diabetic retinopathy (NPDR), given its frequency among those with diabetes mellitus.</p><p><strong>Methods: </strong>A systematic literature search without year limitation to February 21, 2022, identified 59 studies assessing vitreous or aqueous cytokine levels in NPDR, encompassing 1378 eyes with NPDR and 1288 eyes from nondiabetic controls. Effect sizes were generated as standardized mean differences (SMD) of cytokine concentrations between patients with NPDR and controls.</p><p><strong>Results: </strong>Concentrations (SMD, 95% confidence interval, and p value) of aqueous interleukin-6 (IL-6) (2.58, 1.17-3.99; p = 0.0003), IL-8 (1.56, 0.39-2.74; p = 0.009), IL-17 (13.55, 7.50-19.59; p < 0.001), transforming growth factor beta (TGF-β) (2.44, 1.02-3.85; p = 0.0007) and vascular endothelial growth factor (VEGF) (1.35, 0.76-1.93; p < 0.00001), and vitreous VEGF (1.49, 0.60-2.37; p = 0.001) were significantly higher in patients with NPDR when compared with those of healthy controls.</p><p><strong>Conclusions: </strong>These cytokines may serve as disease markers of the biochemical alterations seen in NPDR and may guide interventions, as we move into an era of more targeted therapeutics.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e100-e116"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141751193","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":"ChatGPT and retinal disease: a cross-sectional study on AI comprehension of clinical guidelines.","authors":"Michael Balas, Efrem D Mandelcorn, Peng Yan, Edsel B Ing, Sean A Crawford, Parnian Arjmand","doi":"10.1016/j.jcjo.2024.06.001","DOIUrl":"10.1016/j.jcjo.2024.06.001","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the performance of an artificial intelligence (AI) large language model, ChatGPT (version 4.0), for common retinal diseases, in accordance with the American Academy of Ophthalmology (AAO) Preferred Practice Pattern (PPP) guidelines.</p><p><strong>Design: </strong>A cross-sectional survey study design was employed to compare the responses made by ChatGPT to established clinical guidelines.</p><p><strong>Participants: </strong>Responses by the AI were reviewed by a panel of three vitreoretinal specialists for evaluation.</p><p><strong>Methods: </strong>To investigate ChatGPT's comprehension of clinical guidelines, we designed 130 questions covering a broad spectrum of topics within 12 AAO PPP domains of retinal disease These questions were crafted to encompass diagnostic criteria, treatment guidelines, and management strategies, including both medical and surgical aspects of retinal care. A panel of 3 retinal specialists independently evaluated responses on a Likert scale from 1 to 5 based on their relevance, accuracy, and adherence to AAO PPP guidelines. Response readability was evaluated using Flesch Readability Ease and Flesch-Kincaid grade level scores.</p><p><strong>Results: </strong>ChatGPT achieved an overall average score of 4.9/5.0, suggesting high alignment with the AAO PPP guidelines. Scores varied across domains, with the lowest in the surgical management of disease. The responses had a low reading ease score and required a college-to-graduate level of comprehension. Identified errors were related to diagnostic criteria, treatment options, and methodological procedures.</p><p><strong>Conclusion: </strong>ChatGPT 4.0 demonstrated significant potential in generating guideline-concordant responses, particularly for common medical retinal diseases. However, its performance slightly decreased in surgical retina, highlighting the ongoing need for clinician input, further model refinement, and improved comprehensibility.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e117-e123"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141888516","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":"Vitreoretinal metastasis from lung adenocarcinoma.","authors":"Thomas M Catapano, Deepthi E Kurian, Tatyana Milman, Jason Hsu, Carol L Shields","doi":"10.1016/j.jcjo.2024.07.020","DOIUrl":"10.1016/j.jcjo.2024.07.020","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e167-e170"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141995406","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":"Illuminated depressor enhanced fundus photography.","authors":"Suma K Thareja, Yasaman Ataei, Aparna Ramasubramanian","doi":"10.1016/j.jcjo.2024.09.001","DOIUrl":"10.1016/j.jcjo.2024.09.001","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"e160"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142375135","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":"Advancing the visibility of outer retinal integrity in neovascular age-related macular degeneration with high-resolution OCT.","authors":"Veronika Prenner, Gregor Sebastian Reiter, Philipp Fuchs, Klaudia Birner, Sophie Frank, Leonard Coulibaly, Markus Gumpinger, Hrvoje Bogunovic, Ursula Schmidt-Erfurth","doi":"10.1016/j.jcjo.2024.05.014","DOIUrl":"10.1016/j.jcjo.2024.05.014","url":null,"abstract":"<p><strong>Objective: </strong>To compare the visibility and accessibility of the outer retina in neovascular age-related macular degeneration (nAMD) between 2 OCT devices.</p><p><strong>Methods: </strong>In this prospective, cross-sectional exploratory study, differences in thickness and loss of individual outer retinal layers in eyes with nAMD and in age-matched healthy eyes between a next-level High-Res OCT device and the conventional SPECTRALIS OCT (both Heidelberg Engineering GmbH, Heidelberg, Germany) were analyzed. Eyes with nAMD and at least 250 nL of retinal fluid, quantified by an approved deep-learning algorithm (Fluid Monitor, RetInSight, Vienna, Austria), fulfilled the inclusion criteria. The outer retinal layers were segmented using automated layer segmentation and were corrected manually. Layer loss and thickness were compared between both devices using a linear mixed-effects model and a paired t test.</p><p><strong>Results: </strong>Nineteen eyes of 17 patients with active nAMD and 17 healthy eyes were included. For nAMD eyes, the thickness of the retinal pigment epithelium (RPE) differed significantly between the devices (25.42 μm [95% CI, 14.24-36.61] and 27.31 μm [95% CI, 16.12-38.50] for high-resolution OCT and conventional OCT, respectively; p = 0.033). Furthermore, a significant difference was found in the mean relative external limiting membrane loss (p = 0.021). However, the thickness of photoreceptors, RPE integrity loss, and photoreceptor integrity loss did not differ significantly between devices in the central 3 mm. In healthy eyes, a significant difference in both RPE and photoreceptor thickness between devices was shown (p < 0.001).</p><p><strong>Conclusion: </strong>Central RPE thickness was significantly thinner on high-resolution OCT compared with conventional OCT images explained by superior optical separation of the RPE and Bruch's membrane.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":"42-49"},"PeriodicalIF":3.3,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141431527","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}