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

{"title":"Recurrent herpes simplex virus keratitis associated with recombinant zoster vaccination.","authors":"Francesca Giovannetti, Sonia N Yeung, Marco Marenco, Alessandro Lambiase, Alfonso Iovieno","doi":"10.1016/j.jcjo.2026.08.028","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.028","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944208","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":"Age, sex, and hormone therapy are associated with open-angle glaucoma: a case-only analysis in U.S. veterans.","authors":"Yanhua Wang, Xiangqin Cui, Annette Giangiacomo, Andrew J Feola","doi":"10.1016/j.jcjo.2026.08.023","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.023","url":null,"abstract":"<p><strong>Objective: </strong>Open-angle glaucoma (OAG) is a leading cause of blindness, yet the understanding of sex and age on disease diagnosis remains incomplete. In females, the role of age and hormone therapy (HT) in modulating OAG diagnosis is also uncertain. This study evaluated potential sex- and age-related differences in OAG diagnosis.</p><p><strong>Design: </strong>Retrospective cohort study, using the nationwide Veterans Affairs database, of longitudinally followed U.S. veterans with OAG.</p><p><strong>Participants: </strong>Males and females with a previous negative OAG screening and a current OAG diagnosis were included.</p><p><strong>Methods: </strong>Propensity-score matching was performed for age, body mass index, diabetes, and hypertension between females not taking HT and males (n = 5102 pairs). Patients were stratified by baseline age cohorts (<45, 45-55, >55 years). OAG diagnoses were estimated using Kaplan-Meier analyses, and Cox proportional hazards regression evaluated covariates including age, sex, body mass index, hypertension, diabetes, myopia, diabetic retinopathy, and cataracts. Then, matched females not taking HT to females taking HT (n = 2655 pairs) were analysed. Outcome measures were median time to OAG diagnosis and significance of covariates influencing age of diagnosis across sex and age groups.</p><p><strong>Results: </strong>Females developed OAG earlier than males in younger cohorts (<45, 45-55 years), whereas sex differences diminished after 55 years of age. HT use was associated with delayed diagnosis in females, with the greatest effect in those <45 years. Diabetes, hypertension, myopia, and cataracts were linked to earlier OAG diagnosis similarly in both sexes.</p><p><strong>Conclusions: </strong>Females experience earlier OAG diagnosis than males, but this difference narrows with age. HT was associated with later diagnosis, particularly in younger women, highlighting potential sex-specific influences in OAG.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148944244","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":"Predictors of loss to follow-up in neovascular age-related macular degeneration.","authors":"Ryan S Huang, Sumana C Naidu, Andrew Mihalache, Jim S Xie, Marko M Popovic, Peter J Kertes, David Sarraf, SriniVas R Sadda, Rajeev H Muni, Radha P Kohly","doi":"10.1016/j.jcjo.2026.08.006","DOIUrl":"10.1016/j.jcjo.2026.08.006","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the demographic, clinical, and treatment-related risk factors associated with being lost to follow-up (LTFU) among patients with neovascular age-related macular degeneration (nAMD) receiving antivascular endothelial growth factor (anti-VEGF) intravitreal injections (IVIs).</p><p><strong>Methods: </strong>We conducted a multicentre retrospective cohort study of patients with nAMD treated with anti-VEGF IVIs in Toronto, Ontario, from January 2012 to December 2021. LTFU was defined as the absence of an ophthalmic visit within 1 year of the last retinal specialist appointment. Univariable and multivariable logistic regression analyses were conducted to examine associations between demographic, clinical, and treatment-related factors and becoming LTFU.</p><p><strong>Results: </strong>Among 2556 patients with nAMD, 527 (21%) were LTFU over a mean follow-up of 65.5 ± 15.2 months. In multivariable analysis, male sex (OR = 1.40; p < .001), greater travel distance (>200 km; OR = 2.51; p < .001), and multiple systemic comorbidities (≥3; OR = 1.39; p = .01) were associated with higher odds of LTFU. Compared with White patients, Black (OR = 2.07; p < .001) and Hispanic patients (OR = 1.70; p < .001) had increased odds of LTFU. In contrast, age ≥90 years (OR = 0.53; p < .001), worse baseline visual acuity (>20/200; OR = 0.72; p = .03), pseudophakia (OR = 0.80; p = .04), bilateral disease (OR = 0.72; p = .01), and higher first-year anti-VEGF injection burden (OR = 0.55; p < .001) were associated with lower odds of LTFU.</p><p><strong>Conclusions: </strong>Male sex, Black or Hispanic race/ethnicity, multiple systemic comorbidities, and greater travel distance were associated with increased odds of becoming LTFU, while older age, worse baseline visual acuity, pseudophakia, bilateral disease, and higher IVI burden were protective factors. These findings can inform the development of targeted retention strategies for high-risk patients.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825019","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":"Spontaneous expulsive suprachoroidal hemorrhage: a case series, taxonomy, and systematic review.","authors":"Joshua Bierbrier, Lauren Breslin, David Plemel","doi":"10.1016/j.jcjo.2026.08.016","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.016","url":null,"abstract":"<p><strong>Purpose: </strong>Spontaneous expulsive suprachoroidal hemorrhage (SESCH) is a rare ophthalmic emergency characterized by rupture of the globe with extrusion of intraocular contents without a temporally related inciting ocular trauma or surgery. We present 2 new cases and conduct a systematic review to elucidate the risk factors, pathophysiology, and management.</p><p><strong>Methods: </strong>A systematic search of PubMed, Embase, and Scopus was conducted in July 2025 by 2 independent reviewers. Cases were included if they described SESCH in human patients without inciting ocular surgery or trauma. Two new cases were presented. Cases were categorized using an epidemiologic-pathophysiologic taxonomy, including typical, infantile, lesion-related, and systemic-induced SESCH. Study quality was assessed with the Joanna Briggs Institute checklist.</p><p><strong>Results: </strong>Forty-three published cases and 2 new patients (n = 45) were analyzed. Typical SESCH was the most common (n = 36). Typical SESCH is most frequently associated with glaucoma (24/29, 82.8%) and corneal pathology (6/14, 42.9%). Six patients were receiving systemic anticoagulation, and over three-quarters (17/22, 77.3%) had hypertension. Systemic-induced SESCH (n = 4) was linked to coagulopathies. Lesion-related SESCH (n = 2) involved ocular tumours. Infantile SESCH (n = 3) was associated with prematurity, congenital anomalies, or ocular dysgenesis. No patient perceived light following SESCH. Surgical management most involved evisceration (46.7%) or enucleation (37.8%). Pathophysiological mechanisms remain in debate.</p><p><strong>Conclusions: </strong>SESCH is a rare and devastating ocular condition with poor visual outcomes. Glaucoma, corneal pathology, and systemic vascular disease appear to be risk factors; interpretation is limited by the rarity of SESCH. The pathophysiology likely varies by context. Management is context dependent but generally involves removal of the diseased globe.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929180","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":"Orbital socket reconstruction using free muscle flaps and dermis fat graft in cases of eyelid- and conjunctiva-sparing exenterations.","authors":"Claire Ufongene, Kevin Heinze, Sasha Hubschman, Chad Purnell, Lee Alkureishi, Pete Setabutr, Ann Q Tran","doi":"10.1016/j.jcjo.2026.08.015","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.015","url":null,"abstract":"<p><p>We present a novel technique in 3 patients utilizing free musculocutaneous or adipocutaneous flap with or without an overlying dermis fat graft (DFG) for reconstruction of eyelid- and conjunctiva-sparing exenterations. Indications for exenteration included recurrent grade 2 spheno-orbital meningioma in a blind painful eye, a recurrent malignant solitary fibrous tumour, and a chronic nasocutaneous fistula in an anophthalmic socket that had previously undergone radiation and surgical resection for sinonasal orbital lymphoma. Adductor magnus (n = 1) and radial forearm (n = 2) were used for muscle-free flap harvest sites. Two months postoperatively, both DFGs had conjunctivalization of dermis faces, and the patients maintained a traditional ocular prosthesis. In one case, the flap's native dermis face was preserved without the need for a DFG; however, there was socket contraction at postoperative month 21. In eyelid- and conjunctiva-sparing exenteration, reconstruction can be considered with a muscle-free flap and overlying DFG.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929168","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":"Vision programs for Canadian communities facing care barriers: a systematic review.","authors":"Shayaan Kaleem, Dream Tuitt-Barnes, Umar Rahman, Sameen Kaleem, Carmen Balian, Manokaraananthan Chandrakumar, Myrna Lichter","doi":"10.1016/j.jcjo.2026.08.003","DOIUrl":"10.1016/j.jcjo.2026.08.003","url":null,"abstract":"<p><strong>Objective: </strong>To systematically review Canadian programs designed to improve access to eye care for communities facing barriers to care and to summarise access outcomes, clinical yield, and implementation features.</p><p><strong>Methods: </strong>MEDLINE, Embase, and the Cumulative Index of Nursing and Allied Health were searched through July 30, 2025. Supplementary French-language searches in the 3 databases, as well as French- and English-language searches in Google Scholar, were conducted through June 14, 2026. Two reviewers independently screened records, extracted data, assessed risk of bias, and evaluated certainty of evidence.</p><p><strong>Results: </strong>Seventeen studies were included. Seven studies focused on Indigenous or First Nations communities, 5 on people experiencing homelessness or marginal housing, and 5 on low-income, immigrant, refugee, or school-based populations. Teleophthalmology, teleretinal, and mobile diabetes screening models were the most common program type (8/17, 47.1%), followed by shelter-based or outreach eye examination programs (5/17, 29.4%), primary care, newcomer, refugee, or policy-based access models (3/17, 17.6%), and school-based screening (1/17, 5.9%). Programs frequently identified unmet need, including high rates of uncorrected refractive error, vision impairment, diabetic retinopathy, glaucoma or glaucoma-suspect status, and referral need. However, referral completion, repeat screening, treatment receipt, and patient-reported outcomes were inconsistently reported.</p><p><strong>Conclusions: </strong>Canadian community-based, shelter-based, school-based, mobile, and teleophthalmology programs can reach populations that experience barriers to eye care. The evidence supports the importance of co-location, culturally safe partnerships, low-barrier referral pathways, and spectacle or treatment navigation, but certainty remains limited by observational designs, heterogeneity, and incomplete downstream outcome reporting.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148825098","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":"CorrespondenceA technique for periocular administration of rabies immunoglobulin.","authors":"Michael T Kryshtalskyj, Arturo Balaguer, Kenneth E Morgenstern, Cat N Burkat, Evan H Black, Carson D Schell, Karim G Punja","doi":"10.1016/j.jcjo.2026.08.014","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.014","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929011","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":"Epidemiologic trends and outcomes of primary vitreoretinal lymphoma in the U.S., 2000-2021.","authors":"Itika Garg, Kavin Sugumar, Wei Fang, David M Hinkle","doi":"10.1016/j.jcjo.2026.08.019","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.019","url":null,"abstract":"<p><strong>Purpose: </strong>Primary vitreoretinal lymphoma (PVRL) is a rare and aggressive tumour. Most existing evidence comes from low-powered, historical cohorts. In addition, its incidence is usually indirectly estimated from primary central nervous system lymphoma and is limited to pre-2010 cohorts. Herein, we analyse recent trends in the incidence, sociodemographic characteristics, and survival outcomes of PVRL using U.S. national databases.</p><p><strong>Methods: </strong>Patients diagnosed with PVRL between 2000 and 2021 were identified using the 2 national population databases, National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology and End Results Research (SEER) Plus. Incidence, sociodemographic characteristics, and survival outcomes were calculated. Predictors for survival were analysed using restricted mean survival time analysis.</p><p><strong>Results: </strong>NPCR and SEER Plus had a total of 267 and 76 patients, respectively. The age-adjusted incidence was 0.004 cases per 100 000. Using the SEER database, we found there was a significant increase in the age-adjusted incidence rates between 2000 and 2021, with an annual percentage change of 5.10. In addition, there was a significant increase in patients aged older than 75 years over time. Patients were more commonly White, non-Hispanic, and 70-74 years of age. Black race was associated with worse survival (P = 0.0001). Type of treatment was not associated with survival (P > 0.05).</p><p><strong>Conclusions: </strong>PVRL is underrepresented in national cancer databases, possibly as the result of misdiagnosis or coding errors. However, its incidence continues to increase in the U.S., with a significantly older population of patients diagnosed in 2021 compared with 2000. Significant racial disparities exist in the survival of PVRL.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929046","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":"Acute corneal hydrops treated with autologous stromal blood injection: in vivo confocal microscopy findings.","authors":"Ítalo Pena de Oliveira, Tais Hitomi Wakamatsu, Lucas Baldiserra Tochetto, Flavio Eduardo Hirai, Luiz Guilherme Ito da Cruz, José Álvaro Pereira Gomes","doi":"10.1016/j.jcjo.2026.08.025","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.025","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate microstructural changes in the cornea of patients with acute corneal hydrops who underwent autologous blood injection using in vivo confocal microscopy (IVCM).</p><p><strong>Methods: </strong>This prospective study included consecutive patients presenting with acute hydrops, who were treated with autologous blood injection. Patients were evaluated using slit-lamp biomicroscopy and IVCM at baseline, and 30 and 90 days after injection.</p><p><strong>Results: </strong>Nineteen patients (12 males and 7 females) aged 10-52 years (mean: 21.9 ± 10.7 years) were included. The overall IVCM features were comparable to those previously described for acute corneal hydrops without surgical intervention. Hyper-reflective cells, presumed to be inflammatory cells, were observed during follow-up; however, no consistent structural abnormalities suggestive of treatment-related toxicity were identified during the study period.</p><p><strong>Conclusions: </strong>This study provides prospective serial IVCM characterization of eyes treated with intrastromal autologous blood for acute corneal hydrops. Within the limitations of a small cohort and short-term follow-up, no structural abnormalities suggestive of treatment-related toxicity were observed during the 90-day follow-up. Because this was a small, uncontrolled study, further comparative investigations are required to better define the clinical impact, benefits, and risks of this approach.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929063","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":"Binocular disturbances following glaucoma drainage device surgery.","authors":"Ahmad F Alzein, Hashem Abu Serhan, Qais A Dihan, Paul H Phillips, Ta C Chang, Abdelrahman M Elhusseiny","doi":"10.1016/j.jcjo.2026.08.020","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.020","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the risk of developing strabismus and/or diplopia following glaucoma drainage device implantation in patients with glaucoma.</p><p><strong>Design: </strong>A retrospective clinical cohort study.</p><p><strong>Methods: </strong>We utilized deidentified electronic medical records, identifying adults (aged ≥18 years) diagnosed with glaucoma. Two cohorts were compared: patients who underwent glaucoma drainage device (GDD) implantation and those who did not. Propensity score matching (PSM) (1:1) was applied to control for demographic, systemic, and ocular comorbidities. The primary outcomes were new diagnoses of strabismus or diplopia at 1- and 5-year follow-ups. Multivariable Cox proportional hazard models estimated adjusted hazard ratios (aHRs) and CIs.</p><p><strong>Results: </strong>Prior to PSM, 10,192 patients underwent GDD implantation, and 139,045 did not. After matching, each cohort included 9614 patients. At 1 and 5 years, strabismus was more frequent in the GDD group (1.4% vs 0.52%, and 2.54% vs 1.16%), and diplopia (2.03% vs 0.49%, and 3.01% vs 1.26%; all p < .001). Cox proportional hazards model showed an increased hazard of strabismus (aHR: 1.65 [95% CI: 1.42-1.92] at 1 year; 1.61 [1.43-1.81] at 5 years) and diplopia (aHR: 2.08 [1.81-2.38] at 1 year; 1.61 [1.44-1.80] at 5 years) in the GDD group. The likelihood of strabismus surgery did not differ significantly between groups at 1 year (aHR: 0.99 [95% CI: 0.56-1.70]; p = .98) but was significantly increased at 5 years (aHR: 1.47 [95% CI: 1.05-2.06]; p = 0.024).</p><p><strong>Conclusions: </strong>GDD implantation in glaucoma patients was associated with a significantly increased risk of developing strabismus and diplopia.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148929043","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}