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

{"title":"Systematic review and meta-analysis of Densiron-68 anatomic outcomes and complications in the surgical management of retinal detachment.","authors":"Grace S Yin, Alexa Fine, Marko M Popovic, Peter J Kertes, Rajeev H Muni","doi":"10.1016/j.jcjo.2025.05.018","DOIUrl":"10.1016/j.jcjo.2025.05.018","url":null,"abstract":"<p><strong>Objective: </strong>To summarize the anatomical reattachment rates, functional outcomes, and complications associated with Densiron-68 in retinal detachment (RD) surgery.</p><p><strong>Methods: </strong>Following a systematic literature search, primary studies evaluating outcomes associated with Densiron-68 in adult RD surgery between January 2000 and May 2022 were included. Exclusion criteria included secondary studies, non-English language, and those in pediatric populations. The primary endpoints of interest were anatomical reattachment rate, and reported complications associated with Densiron-68.</p><p><strong>Results: </strong>Twenty-eight studies (927 eyes) were included. Mean follow-up time was 41.9 weeks (IQR: 32.4-52.0 weeks). The weighted mean preoperative and postoperative BCVA was 1.38 ± 0.64 logMAR (20/500 Snellen) and 0.86 ± 0.55 logMAR (20/150 Snellen), respectively (p < 0.001). Anatomical reattachment rate after a single surgery was 72.5% overall (n = 672 eyes), with most redetachments occurring while Densiron-68 was in situ (46%; n = 81/255 eyes). Postoperatively, 29 complications were identified. The three most common were raised intraocular pressure (IOP) (n = 251 eyes; 27.1%), intraocular inflammation (n = 182 eyes; 19.6%), and emulsification (n = 160 eyes; 17.3%). Densiron-68 was significantly associated with an increased risk of elevated intraocular pressure postoperatively than traditional silicone oil (RR: 1.83 95% CI: 1.25-2.67; p = 0.001). The overall GRADE certainty of evidence for included studies was determined to be low due to the risk of bias, moderate imprecision in results due to wide confidence intervals, small studies, and few events within comparative studies, and moderate to high heterogeneity impacting consistency of evidence.</p><p><strong>Conclusions: </strong>Densiron-68 is a heavy silicone oil with clinical utility in retinal detachment surgery that has good primary anatomical reattachment rates and overall improvement in BCVA preoperatively to postoperatively. The authors highlight the anatomical and functional outcomes of Densiron-68 and the reported range of complications associated with its use, of which the majority were reversible or treatable with appropriate therapies.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293369","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":"Association between intravitreal anti-vascular endothelial growth factor agents and hypertension: a meta-analysis.","authors":"Michael Balas, Aaditeya Jhaveri, Faran Khalid, Ahmed Abdelaal, Marko M Popovic, Peter J Kertes, Rajeev H Muni","doi":"10.1016/j.jcjo.2025.05.014","DOIUrl":"10.1016/j.jcjo.2025.05.014","url":null,"abstract":"<p><strong>Objective: </strong>To compare the risk of hypertension between intravitreal anti-vascular endothelial growth factor (VEGF) agents and sham injections, and between different anti-VEGF agents.</p><p><strong>Methods: </strong>A systematic search was performed on OVID MEDLINE, EMBASE, and the Cochrane Controlled Register of Trials from January 2005 to August 2023. Inclusion criteria included published randomized clinical trials (RCTs) reporting on cases of hypertension as an adverse event for standard dose intravitreal anti-VEGF agents. Using random-effects modeling, risk ratios (RR) and 95% confidence intervals (CI) were used to estimate the frequency of hypertension between patients who received anti-VEGF agents versus sham injections.</p><p><strong>Results: </strong>Twenty RCTs with 11 196 patients were included. There were 189/2873 (6.6%) new cases of hypertension in the ranibizumab 0.5-mg group, 61/1448 (4.2%) in the bevacizumab 1.25-mg group, 287/3450 (8.3%) in the aflibercept 2-mg group, 32/412 (7.8%) in the brolucizumab 6-mg group, 99/2063 (4.8%) in the faricimab 6-mg group, and 73/950 (7.7%) new cases of hypertension in patients receiving sham injections. There was no significant difference in the risk of developing hypertension between any of the included anti-VEGF agents. Compared to sham injection, ranibizumab (RR = 1.02, 95% CI: [0.74 to 1.40]; p = 0.92) and aflibercept (RR = 0.77, 95% CI: [0.54 to 1.11]; p = 0.17) did not significantly increase the risk of developing hypertension.</p><p><strong>Conclusion: </strong>This meta-analysis found no significant difference in hypertension risk between different intravitreal anti-VEGF agents or sham injection. These results reinforce the notion that these agents have similar and safe side effect profiles, and that the choice of agent should not be based on the risk of hypertension.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207757","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 resolution of idiopathic orbital inflammation following incisional biopsy","authors":"Nathan Lee-Wing ,&nbsp;Guneet Uppal ,&nbsp;Janice Safneck","doi":"10.1016/j.jcjo.2025.04.013","DOIUrl":"10.1016/j.jcjo.2025.04.013","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Pages e644-e646"},"PeriodicalIF":3.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141499","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":"Association of changes in optical coherence tomography metrics with changes in refractive error in patients with neovascular age-related macular degeneration in the CATT.","authors":"Matthew R Starr, Eric A Lovett, Rachel Israilevich, Jason Hsu, Peiying Hua, Jiayan Huang, Maureen G Maguire, Daniel F Martin, Gui-Shuang Ying, Ajay E Kuriyan","doi":"10.1016/j.jcjo.2025.05.016","DOIUrl":"10.1016/j.jcjo.2025.05.016","url":null,"abstract":"<p><strong>Objective: </strong>Assess the change in refractive error (RE) in patients receiving anti-vascular endothelial growth factor (VEGF) therapy for exudative age-related macular degeneration.</p><p><strong>Methods: </strong>Post hoc analysis of data from the Comparison of AMD Treatments Trials (CATT). Associations between spherical equivalent (SphE) change and optical coherence tomography (OCT) metrics were evaluated using correlation coefficients (r) and regression analyses stratified by baseline lens status.</p><p><strong>Results: </strong>Analysis included 1 171 patients with OCT fluid in the study eye at baseline. The mean (± SD) of SphE shifted toward myopia in study eyes from 0.62 ± 1.63 diopters (D) at baseline to 0.50 ± 1.61 D at 2 years (p < 0.0001). Phakic study eyes had larger myopic shifts than pseudophakic eyes at 2 years (-0.19 ± 0.97 D vs -0.06 ± 0.90 D; p = 0.03). In phakic study eyes, the RE change was significantly correlated with change in subretinal thickness (Spearman r = 0.21; p < 0.0001), subretinal tissue complex (r = 0.12; p = 0.01), and total thickness (r = 0.36; p < 0.0001). A myopic shift greater than 1.0 D occurred in 74 (7.0%) and 104 (10.2%) study eyes at years 1 and 2, respectively.</p><p><strong>Conclusion: </strong>Among CATT participants, the RE of study eyes shifted toward myopia at 2 years with phakic eyes having larger shifts. OCT metric changes were weakly correlated with changes in RE, suggesting that drying of the macula with anti-VEGF therapy may have a minor impact on RE. Still, 10% of patients may develop a 1 D myopic shift at 2 years, typically in those with more baseline fluid. Patients with neovascular AMD may be able to update their spectacles, even if macular edema is present, as the change in RE is negligible when drying the macula.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198311","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":"Benchmarking test-retest variability in microperimetry for intermediate age-related macular degeneration using MP-3 and MAIA.","authors":"Jakob Schweighofer, Klaudia Birner, Hamza Mohamed, Johannes Schrittwieser, Hrvoje Bogunovic, Gregor S Reiter, Ursula Schmidt-Erfurth","doi":"10.1016/j.jcjo.2025.05.002","DOIUrl":"10.1016/j.jcjo.2025.05.002","url":null,"abstract":"<p><strong>Objective: </strong>Microperimetry (MP) has emerged as a clinical functional endpoint in nonexudative age-related macular degeneration (AMD). In this study, we aim to provide reference values for test-retest outcomes on two MP devices in intermediate AMD (iAMD).</p><p><strong>Design: </strong>Prospective, cross-sectional study.</p><p><strong>Participants: </strong>3 600 stimuli from 20 eyes in 20 subjects.</p><p><strong>Methods: </strong>Patients diagnosed with iAMD underwent consecutive testing on MP-3 (NIKED, Gamagori, Japan) and MAIA (CenterVue Icare, Padova, Italy). The obtained point-wise sensitivity (PWS) measurements were superimposed with optical coherence tomography (OCT) (Spectralis, Heildelberg Engineering) acquired. Hyperreflective foci (HRF), drusen volume, ellipsoid zone (EZ)-thickness and outer nuclear layer (ONL)-thickness were quantified with deep-learning algorithms. Subretinal drusenoid deposits (SDD) were manually annotated. We assessed test-retest repeatability at the location of these biomarkers using Bland-Altmann coefficients of repeatability. Furthermore, interdevice correlation, fixation stabilities, and examination durations were evaluated.</p><p><strong>Results: </strong>Comparable overall point-wise retest variances were detected for MP-3 (±4.54 dB) and MAIA (±5.24 dB). SDDs led to significantly worse repeatability in the MAIA device (p = 0.03). Drusen, HRF, EZ-thickness, and ONL thickness had no significant impact on test-retest variance. A good intradevice correlation (MP-3: 0.869 [0.851 - 0.886] MAIA 0.848 [0.827 - 0.867]), and a good mean interdevice correlation (0.841 [0.819 - 0.861]) was observed.</p><p><strong>Conclusions: </strong>Intradevice and interdevice repeatability for MP examinations with MP-3 and MAIA in patients with iAMD can be considered as good. Biomarkers except for SDD show no significant impact in repeatability in both devices. This supports MP as a reliable functional endpoint in clinical trials in iAMD.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198312","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 unique genotype-phenotype relationship between a novel BEST1 mutation and a case of severe autosomal recessive bestrophinopathy.","authors":"Matthaeus Ware, Marko Popovic, Brian Ballios","doi":"10.1016/j.jcjo.2025.05.015","DOIUrl":"10.1016/j.jcjo.2025.05.015","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144207756","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":"Temporal trends and risk factors for retinopathy of prematurity: insights from a population-based study (1995-2021).","authors":"Rachel Shemesh, Brian Reichman, Tzipora Strauss, Inna Zaslavsky-Paltiel, Liat Lerner-Geva, Tamara Wygnanski-Jaffe","doi":"10.1016/j.jcjo.2025.04.016","DOIUrl":"10.1016/j.jcjo.2025.04.016","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this population-based study was to evaluate the temporal trends in the incidence of retinopathy of prematurity (ROP) and the demographic and clinical factors associated with ROP.</p><p><strong>Methods: </strong>In this population-based observational cohort study data from the Israel national very low birthweight infant database were used. Following exclusions, the final study population comprised 16,257 infants born at 23-29 weeks. The independent effect of variables associated with ROP was assessed using multivariable logistic regression. P values for trend were determined by applying the Cochran-Armitage Trend Test.</p><p><strong>Results: </strong>The rates of ROP decreased from 32.9% in the years 1995-2000 to 16.0% in 2017-2021 (p < 0.0001). In comparison to the reference epoch (1995-2000), the adjusted odds ratio (OR) [95% confidence interval] for ROP, were significantly lower in 2001-2006 (OR 0.68 [0.59-0.77]), in 2007-2011 (OR 0.36 [0.31-0.42]), in 2012-2016 (OR 0.31 [0.26-0.36]), and in 2017-2021 (OR 0.32 [0.27-0.39]). Sepsis (OR 1.67 [1.52-1.83]), surgically treated necrotizing enterocolitis (NEC) (OR 1.86 [1.49-2.32]) and surgically treated patent ductus arteriosus (PDA) (OR 1.88 [1.56-2.27]) were associated with ROP. Among the infants with sepsis, surgically treated PDA or surgically treated NEC, the rates of ROP increased in the 2017-2021 epoch.</p><p><strong>Conclusions: </strong>The odds for ROP decreased by over two-thirds throughout the period 1995-2021, although the decline was attenuated in the recent decade. In view of the independent association found between surgically treated PDA or NEC and ROP, and the increasing rates of ROP in these infants, further studies may elucidate whether earlier ROP screening and possibly earlier therapeutic interventions may be appropriate for these infants.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144126832","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":"Bilateral optic nerve compression from suprasellar breast cancer metastasis","authors":"Karanvir Gill,&nbsp;Colten Wendel,&nbsp;Briar Sexton","doi":"10.1016/j.jcjo.2025.04.006","DOIUrl":"10.1016/j.jcjo.2025.04.006","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Pages e638-e642"},"PeriodicalIF":3.3,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977281","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":"Comparing the rate of cataract surgery complications between a hospital and an independent health facility.","authors":"Joshua Bierbrier, Stephanie Baxter, Davin Johnson","doi":"10.1016/j.jcjo.2025.04.002","DOIUrl":"10.1016/j.jcjo.2025.04.002","url":null,"abstract":"<p><strong>Objective: </strong>To compare the perioperative complication rates of cataract surgeries performed at a hospital and an independent health facility (IHF) in Ontario following governmental funding changes affecting for-profit private clinics.</p><p><strong>Design: </strong>Retrospective chart review.</p><p><strong>Participants: </strong>All patients receiving publicly funded elective cataract surgery in Kingston, Ontario, between January 1, 2023, and December 31, 2023.</p><p><strong>Methods: </strong>Electronic medical records were assessed for 3 cataract surgery complications: posterior capsular rupture (PCR), retinal tear/detachment, and endophthalmitis. Age, eye, lens type (spheric, aspheric, premium), intraoperative complication, and postoperative complications were recorded for each chart. Differences between clinical settings were evaluated using Fisher's Exact and χ² tests (p < 0.05).</p><p><strong>Results: </strong>A total of 3190 (hospital: 1741; IHF: 1449) charts were reviewed. The hospital had a significantly higher rate of PCRs (1.44% vs 0.21%; p < 0.01). Retinal tears/detachments occurred in 5 hospital cases (0.29%) and none at the IHF, while 2 endophthalmitis cases were reported at the IHF (0.14%) and none at the hospital (both p > 0.05). Lens use patterns significantly differed, with more premium and aspheric lenses used at the IHF and more spheric lenses at the hospital.</p><p><strong>Conclusions: </strong>Complication rates at both sites were similar and within expected ranges. Differences in PCR rates may be explained by a tendency to perform more complicated surgeries at the hospital. The findings suggest that cataract surgery at both clinical settings is safe.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977686","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":"Disparities in screening, diagnosis, treatment, and outcomes for diabetic retinopathy among people with lived experience of homelessness in Canada.","authors":"Ruchi Sharan, Kathryn Wiens, Li Bai, Paul E Ronksley, Gillian L Booth, Stephen W Hwang, Peter C Austin, Eldon Spackman, Anna Ells, Michael Fielden, David J T Campbell","doi":"10.1016/j.jcjo.2025.05.004","DOIUrl":"10.1016/j.jcjo.2025.05.004","url":null,"abstract":"<p><strong>Objective: </strong>To estimate the rates of screening, diagnosis, treatment, and outcomes related to diabetic retinopathy among persons with diabetes who have experienced homelessness compared with a matched cohort of nonhomeless controls.</p><p><strong>Methods: </strong>A propensity score-matched cohort study was conducted using administrative health data from Ontario. Eligible persons required a diagnosis of diabetes and at least 1 hospital encounter between April 2006 and March 2019. Homeless status was determined using a validated algorithm that identified whether individuals were homeless at the time of any acute care encounter during the study period. Each person who experienced homelessness was matched to a nonhomeless control based on sociodemographic and clinical characteristics. Rate ratios (RR) and differences in proportions were calculated for screening, diagnosis, and treatment of diabetic retinopathy, as well as for the outcome of vision loss using generalized linear models with a negative binomial distribution and robust standard errors.</p><p><strong>Results: </strong>1,069,493 people met the inclusion criteria, of which, 6 944 had a history of homelessness. A suitable nonhomeless match was found for 5 712 individuals. The rate of diabetic retinopathy screening was lower in those with a history of homelessness when compared to controls (RR = 0.75; 95% CI: 0.72-0.78), while the rate of having billing codes representing diabetic retinopathy was higher (RR = 1.42; 95% CI: 1.02-1.97). There was no significant difference in rates of treatment or vision loss.</p><p><strong>Conclusions: </strong>The disparities in rates of screening and diagnosis of diabetic retinopathy in those with lived experience of homelessness presents an area for targeted interventions to improve health outcomes in this population.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141417","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}