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

{"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}

{"title":"Metastatic alveolar rhabdomyosarcoma to the orbit: a case report and literature review.","authors":"Alex J Yu, Josefina Herrera, Vivek Bhadri, Amandeep Singh, Krishna Tumuluri","doi":"10.1016/j.jcjo.2026.08.017","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.017","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":"148929118","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":"Routine use of OCT and corneal tomography in patients undergoing consultation for cataract surgery.","authors":"Sarah Patterson, Khalifa Ihmouda, Tom Gonder, Moness Masri, Dennis Johnson","doi":"10.1016/j.jcjo.2026.08.018","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.018","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":"148929159","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":"Improved prediction of nasal step defects in glaucoma through wide-field optical coherence tomography.","authors":"Jooyoung Yoon, Hae Min Park, Jong Sub Lee, Soorack Ryu, Sean C Chapman, Derek S Welsbie, Won June Lee","doi":"10.1016/j.jcjo.2026.08.026","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.026","url":null,"abstract":"<p><strong>Objective: </strong>The purpose of this study was to evaluate the clinical utility of 12 × 12 mm wide-field optical coherence tomography (WF-OCT) for assessing structure-function correspondence in glaucoma, specifically analyzing nasal step visual field (VF) defects.</p><p><strong>Methods: </strong>We conducted a retrospective comparative study, classifying participants into 5 groups based on VF defect pattern: healthy controls, nasal step, arcuate scotoma, paracentral scotoma, and preperimetric glaucoma. The structure-function relationship was assessed using the Garway-Heath (G-H) map, the 12 × 9 mm Hood map, and 12 × 12 mm WF-OCT. Predictive accuracy within each VF defect group was categorized as correct, incorrect, or unknown, with a targeted subgroup analysis specifically evaluating diagnostic performance for nasal step defects.</p><p><strong>Results: </strong>When comparing the G-H map, the Hood map, and WF-OCT, no significant differences were observed in the control, arcuate scotoma, paracentral scotoma, and preperimetric glaucoma groups (p > .05 for all comparisons). In contrast, significant differences were found for nasal step defects: the G-H map and WF-OCT correctly identified nasal step defects in 94.4% and 96.3% of cases, respectively, with no significant difference between them (p = 1.000), whereas the Hood map classified 98.1% of nasal step cases as unknown because of insufficient scan coverage (p < .001).</p><p><strong>Conclusions: </strong>While demonstrating comparable sensitivity to the G-H map in nasal step detection, WF-OCT successfully addresses the geographical limitations of the Hood map. By providing direct topographical visualization alongside conventional peripapillary assessments, WF-OCT offers a valuable modality for evaluating peripheral glaucomatous damage.</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":"148929020","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":"Efficacy and safety of bent ab interno needle goniotomy: a systematic review and meta-analysis.","authors":"Faizan Naveed, Yusuf Ahmed, Cody Lo, Wei Sim, Irfan Kherani, Matthew B Schlenker, Jamie Beckman, Arsham Sheybani","doi":"10.1016/j.jcjo.2026.08.024","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.024","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness and safety of bent ab interno needle goniotomy (BANG) for glaucoma through systematic review and meta-analysis. BANG is a device-free trabecular meshwork-excisional, minimally invasive glaucoma surgery that may offer a lower-cost, more accessible alternative to device-based angle surgery, but its efficacy and safety profile have not been comprehensively consolidated.</p><p><strong>Methods: </strong>MEDLINE, Embase, Cochrane CENTRAL, Scopus, and Web of Science were searched until December 14, 2025. Eligible studies included ≥10 eyes undergoing stand-alone or combined phaco-BANG. Two reviewers independently screened and extracted data; risk of bias was assessed using ROBINS-I v2/RoB-2 and certainty using GRADE. Random-effects inverse-variance meta-analyses pooled intra-ocular pressure (IOP) change at 6 and 12 months and anti-glaucoma medication (AGM) reduction at 6 months; hyphema incidence was pooled using proportional meta-analysis. Leave-one-out and subgroup analyses were performed.</p><p><strong>Results: </strong>Fourteen studies met inclusion criteria. Across 10 cohorts (248 eyes), IOP decreased by 4.74 mm Hg (95% CI: 2.13-7.35; I² = 96.2%) at 6 months following BANG-containing procedures (predominantly phaco-BANG). Likewise, across 6 cohorts (140 eyes), 12-month IOP reduction was 4.88 mm Hg (0.44-9.31; I² = 98.0%). Across 6 cohorts (161 eyes), AGM burden decreased by 1.30 medications (0.86-1.74; I² = 85.7%). Across 11 cohorts (261 eyes), pooled hyphema incidence was 0.33 (0.14-0.55; I² = 93.3%). Leave-one-out and design-restricted analyses reduced heterogeneity and attenuated effect sizes, suggesting more conservative estimates of efficacy. Certainty of evidence was low.</p><p><strong>Conclusions: </strong>BANG-containing procedures are associated with modest IOP and medication reductions, with a substantial but typically transient hyphema risk. However, the predominantly phaco-BANG evidence base cannot isolate the independent or clinically meaningful contribution of BANG. Small samples, substantial heterogeneity, limited washout IOP reporting, and low-certainty evidence, support cautious interpretation.</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":"148929085","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":"Optic nerve head swelling and acute glaucoma induced by topiramate.","authors":"Sanam Khataei, Daniel Ovid Black, Andrew Toren","doi":"10.1016/j.jcjo.2026.08.027","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.027","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148917909","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":"Salt-and-pepper rubella retinopathy with associated vitelliform lesion.","authors":"Alessandro Feo, Shahin Faghihi, David Sarraf","doi":"10.1016/j.jcjo.2026.08.022","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.022","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918053","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":"Predicting patient satisfaction with post-small incision lenticule extraction surgery using open-source machine learning software.","authors":"Rebecca M Cairns, Richard N McNeely, Mark C M Dunne, Raquel Gil-Cazorla, Shehzad A Naroo, Jonathan E Moore","doi":"10.1016/j.jcjo.2026.08.004","DOIUrl":"10.1016/j.jcjo.2026.08.004","url":null,"abstract":"<p><strong>Objective: </strong>To predict patient satisfaction 6 months after small-incision lenticule extraction (SMILE) surgery from preoperative clinical data demonstrating the methodological utility of open-source orange data mining software (Orange) feature selection and machine learning (ML) for practice-based evidence.</p><p><strong>Design: </strong>A retrospective study.</p><p><strong>Participants: </strong>Seventy-eight patients who had undergone bilateral uncomplicated SMILE surgery at a private ophthalmology clinic for treatment of their myopic refractive error with complete records available for analysis.</p><p><strong>Methods: </strong>Open-source data mining software Orange was applied to the data. Ten preoperative features (predictors) were investigated. The target (predicted variable) was patient expectations met or exceeded 6 months postoperatively. To simplify downstream clinical interpretation, continuous metrics were discretized using a median-split protocol. Fast correlation-based filter (FCBF) feature selection and Naïve Bayes supervised ML were applied. Optimistic and realistic ML performance were expressed as the area under the receiver operating characteristic (AUC) and Matthews' correlation coefficient (MCC). A nomogram generated log-odds ratios for estimating how each feature influenced the probability of exceeded expectations.</p><p><strong>Main outcome measures: </strong>Primary outcome was ML performance assessed using AUC and MCC.</p><p><strong>Results: </strong>Only 4 clinically relevant features (mean sphere equivalent, sex, quality of vision [QoV] night, corneal staining) were selected using FCBF. Comparable ML performance arose using these 4 features (optimistic: AUC = 0.792, MCC = 0.441; realistic 10-fold cross-validation: AUC = 0.749, MCC = 0.335) or all 10 (optimistic: AUC = 0.778, MCC = 0.447; realistic: AUC = 0.679, MCC = 0.329). Similarity between optimistic and realistic performance indicated sample sufficiency and model stability. The probability of a patient's expectations being exceeded increased by 13.68% for lower magnitude MSE (≥ -3.875 D), 15.15% for males, 10.17% for QoV night scores ≥9, and 8.73% when corneal staining was present, with Orange restricting log-odds measurements to point estimates.</p><p><strong>Conclusions: </strong>Open-source ML software was applied for preoperative prediction of patient satisfaction following SMILE surgery. By using feature selection to ensure feature independence, ML enables clinicians to identify the most relevant preoperative factors, improving surgical counselling and patient expectation management. Reducing redundant clinical tests could optimize preoperative screening, making no-code visual ML decision support tools valuable and accessible in real-world clinical settings.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788649","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":"Steroid-induced macular edema in peripapillary pachychoroid syndrome.","authors":"Anamika Patel, Alessandro Feo, David Sarraf","doi":"10.1016/j.jcjo.2026.08.021","DOIUrl":"https://doi.org/10.1016/j.jcjo.2026.08.021","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148918128","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":"Intermediate outcomes of SIBS microshunt in cases of refractory and nonrefractory glaucoma.","authors":"Edward Tran, Ticiana De Francesco, Anastasiya Vinokurtseva, Matthew B Schlenker, Iqbal Ike K Ahmed","doi":"10.1016/j.jcjo.2026.07.010","DOIUrl":"10.1016/j.jcjo.2026.07.010","url":null,"abstract":"<p><strong>Objective: </strong>To compare the intraocular pressure (IOP)-lowering, adverse event profile, and risk factors for failure of the SIBS (poly[styrene-block-isobutylene-block-styrene]) microshunt implantation in refractory versus nonrefractory glaucoma.</p><p><strong>Design: </strong>A multicentre, retrospective interventional cohort study.</p><p><strong>Participants: </strong>A total of 236 glaucoma eyes were analyzed with an IOP above target or progressing on maximal medical therapy. Refractory glaucoma was defined as a history of prior subconjunctival filtering surgery. One-to-one nearest-neighbor matching yielded 118 refractory eyes (111 patients) and 118 nonrefractory eyes (105 patients).</p><p><strong>Methods: </strong>This study evaluated 1-year outcomes of consecutive eyes undergoing ab externo SIBS microshunt implantation with mitomycin-C (MMC) between July 2015 and August 2020.</p><p><strong>Main outcome measures: </strong>Primary outcome was surgical success, defined as IOP 6-17 mm Hg with ≥20% reduction, classified as complete (without medications) or qualified (with medications). Secondary outcomes included success at IOP thresholds 14 and 21 mm Hg, median IOP, medication burden, risk factors for failure, and postoperative complications, interventions, and reoperations.</p><p><strong>Results: </strong>Complete success was lower in refractory compared with nonrefractory eyes (63.6% vs 77.9%; p = .022). Refractory status (hazard ratio [HR] 1.98; 95% CI: 1.11-3.55) and MMC dose <0.4 mg/mL (HR 2.08; 95% CI 1.21-3.58) were significant risk factors for failure. Serious adverse events were more frequent in refractory eyes (7.6% vs 0.8%; p = .0097), as were reoperations (9.3% vs 1.7%; p = 0.019).</p><p><strong>Conclusions: </strong>In SIBS microshunt implantation, refractory eyes demonstrated lower surgical success and higher rates of serious adverse events and reoperations compared with nonrefractory eyes.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788595","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}