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

{"title":"Profound vision loss secondary to malignant intracranial hypertension following a multifocal intracranial hemorrhage in an adult with Alagille Syndrome","authors":"Lindsay Wise , Hanan Safa Fakhruddin , Asim F. Choudhri , Nir Shimony , Stephanie Einhaus , Lauren C. Ditta","doi":"10.1016/j.jcjo.2025.03.017","DOIUrl":"10.1016/j.jcjo.2025.03.017","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":"60 4","pages":"Pages e635-e638"},"PeriodicalIF":3.3,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984739","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":"Ethnic disparities in inherited retinal degenerations.","authors":"Kirk A J Stephenson, Shanil R Dhanji, Olubayo U Kolawole, Cheryl Y Gregory-Evans, Kevin Gregory-Evans","doi":"10.1016/j.jcjo.2025.04.007","DOIUrl":"10.1016/j.jcjo.2025.04.007","url":null,"abstract":"<p><strong>Objective: </strong>Inherited retinal degenerations (IRD) are clinically heterogeneous. There has been little study of the influence of ethnicity on IRD phenotypes. We aim to assess clinical and genetic variability between differing ethnic groups affected by IRD.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Participants: </strong>Patients with genetically resolved IRD (ABCA4, USH2A, RPGR) at a single centre (University of British Columbia).</p><p><strong>Methods: </strong>Clinical and genetic data were contrasted between ethnic groups (Caucasian, East Asian, South Asian, Indigenous, African) and between Caucasians and non-Caucasians.</p><p><strong>Results: </strong>143 patients met the inclusion criteria. Caucasians were over-represented (76%). For ABCA4, East Asians most commonly had bullseye maculopathy, while classic Stargardt disease predominated in other ethnicities; cataract was less prevalent in non-Caucasians (p = 0.001). For USH2A, most non-Caucasians had non-syndromic IRD, while Caucasians were 50% isolated and 50% Usher syndrome. Hyperautofluorescent rings were more common in non-Caucasians (p = 0.027). In RPGR, best-corrected visual acuity was worse for Caucasians (logMAR 0.76 ± 0.69) than non-Caucasians (0.49 ± 0.30; p = 0.047), and myopia was greatest in South Asians (-9.56 ± 0.27 D vs -3.82 ± 4.05 D; p < 0.001). Twenty-one novel genetic variants were identified, and only 3.3% (5/154) of genetic variants were shared between ethnic groups.</p><p><strong>Conclusions: </strong>Clinical and genetic differences are apparent between ethnic groups, even within \"common\" IRD genotypes. Awareness of these different retinal and extra-retinal (e.g., myopia, less favourable VA) features is critical to facilitate diagnostic accuracy and optimal clinical care, including access to novel therapies. Further work to expand the genetic reference databases for non-Caucasian ethnic groups is needed to facilitate equitable access to diagnosis and treatment for IRD.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143967861","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":"Investigating drug-induced optic nerve hypoplasia and septo-optic dysplasia from the FDA adverse events database.","authors":"Ayesh Ali, Jamal O Azhari, Ryan Gise, Omar Solyman, Paul H Phillips, Abdelrahman M Elhusseiny","doi":"10.1016/j.jcjo.2025.05.005","DOIUrl":"10.1016/j.jcjo.2025.05.005","url":null,"abstract":"<p><strong>Objective: </strong>To identify potential teratogenic medication associated with optic nerve hypoplasia (ONH) and/or septo-optic dysplasia (SOD), by screening the Food and Drug Administration Adverse Events Reporting System (FAERS) database.</p><p><strong>Design: </strong>Retrospective pharmacovigilance study using disproportionality signal detection methods.</p><p><strong>Participants: </strong>Adverse event reports submitted to FAERS between Q1 2004 and Q3 2024. Reports were included if ONH or SOD was listed as an adverse event and drug exposure occurred in utero.</p><p><strong>Methods: </strong>A qualitative assessment evaluated patient demographics, and a disproportionality analysis covered pharmacovigilance signal detection and drug-event reporting frequencies. Pharmacovigilance algorithms that were applied to determine the statistical significance of signals included the proportional reporting ratio (PRR), chi-squared with Yates' correction (χ²), reporting odds ratio (ROR), empirical Bayes geometric mean (EBGM), and information component (IC).</p><p><strong>Results: </strong>A total of 103 adverse event reports for ONH and/or SOD were identified. The 75 cases reporting prenatal medication exposure were included. Twenty-three reports were of male patients, 13 reports of female patients, and 39 of unspecified gender. Thirty drugs were implicated as primary suspect drugs. Diazepam was the most reported primary suspect medication (n = 15; 20%) followed by methadone and citalopram (n = 8; 11%). The disproportionality analysis showed a positive signal with one medication: diazepam (n = 15; PRR = 82.24; χ² = 1008.66, ROR 95% CI: 102.55 [56.75-185.33], EBGM [EBGM05]: 48.45 [28.16], IC [IC05]: 4.46 [3.67]).</p><p><strong>Conclusions: </strong>A possible association was found between prenatal diazepam exposure and ONH/SOD. Further investigation is required to confirm this relationship and drug safety profiles.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141419","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":"True muscle transplantation for the management of third nerve palsy.","authors":"Ahmed Awadein, Christina S Farag, Sara Maher","doi":"10.1016/j.jcjo.2025.04.008","DOIUrl":"10.1016/j.jcjo.2025.04.008","url":null,"abstract":"<p><strong>Objective: </strong>To describe and report the results of 2 different techniques for true muscle transplantation for management of exotropia in patients with third nerve palsy.</p><p><strong>Methods: </strong>A retrospective chart review was conducted on patients with third nerve palsy in whom true muscle transplantation was performed. The resected segment of the medial rectus (MR) muscle was used to lengthen the lateral rectus (LR) muscle before recession. The transplantation was performed using either a free graft technique or a modified continuous graft technique. Ductions, versions, and angles of deviation were evaluated before and after surgery.</p><p><strong>Results: </strong>A total of 7 patients were identified (mean age: 32 ± 17 years). Two patients had prior LR recession. The mean preoperative angle of deviation was 53 ± 13 PD, and the mean preoperative limitation of adduction was -4. The free graft and the continuous graft techniques were used in 3 and 4 cases, respectively. The median amount of LR recession was 8 mm, and the amount of MR resection ranged from 6 to 8 mm. The mean follow-up was 6.0 ± 4.2 months. Postoperatively, 5 patients had residual exotropia <10 PD. The remaining 2 cases had residual exotropia 15 PD. The mean postoperative limitation of adduction improved to -2.3 ± 0.5. The postoperative limitation of abduction was -1 or less in 6 patients.</p><p><strong>Conclusions: </strong>True muscle transplantation can be used to correct large exotropia in partially recovered or recurrent third nerve palsy without causing significant limitation of abduction. Undercorrection is associated with smaller amounts of MR resection.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143964333","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":"Short-term effects of tetracycline use in patients with diabetic retinopathy.","authors":"Ahmed M Alshaikhsalama, Amer F Alsoudi, Karen M Wai, Euna Koo, Prithvi Mruthyunjaya, Christina Y Weng, Ehsan Rahimy","doi":"10.1016/j.jcjo.2025.04.009","DOIUrl":"10.1016/j.jcjo.2025.04.009","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the association between tetracycline use and the development of short-term vision threatening complications (VTC) among patients with diabetic retinopathy (DR).</p><p><strong>Methods: </strong>Using a deidentified database, 4 596 patients with severe nonproliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) associated with tetracycline use versus 87,974 patients with NPDR or PDR but no tetracycline use, respectively, were included before propensity score matching (PSM). After PSM, 4 576 patients in each cohort were analyzed. Incidence of developing VTC, including diabetic macular edema (DME), vitreous hemorrhage (VH), tractional retinal detachment (TRD), neovascular glaucoma (NVG), and subsequent need for ocular interventions including intravitreal anti-vascular endothelial growth factor (VEGF) injections, panretinal photocoagulation (PRP), or pars plana vitrectomy (PPV).</p><p><strong>Results: </strong>Patients with DR and repeated tetracycline use had a reduced risk of developing DME (RR: 0.45, 95% CI: 0.28-0.72; p = 0.009) and VH (RR: 0.37, 95% CI: 0.20-0.69; p = 0.001) compared to the tetracycline-naive cohort at 6 months and 1 year. Further, there was a reduced risk of subsequent need for anti-VEGF (RR: 0.25, 95% CI: 0.13-0.47; p = 0.003) and PRP (RR: 0.40, 95% CI: 0.19-0.84; p = 0.012) in the tetracycline cohort compared to the tetracycline-naive group at 6 months and 1 year. There were no significant differences in the development of NVG, TRD, or the requirement for PPV between both cohorts.</p><p><strong>Conclusions: </strong>Repeated tetracycline use was associated with a potentially reduced short-term risk of developing DME, VH, and needing subsequent anti-VEGF or PRP therapy versus tetracycline naive patients.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970558","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 neurotrophic keratopathy on quality of life: a utility analysis.","authors":"Suzan Sargsyan, Sammie E Fung, Tonya S Lee, Kathryn S Park, Brian M Fung, Erik Groessl, Daniel J Ozzello, Bobby S Korn, Don O Kikkawa, Natalie A Afshari, Catherine Y Liu","doi":"10.1016/j.jcjo.2025.04.011","DOIUrl":"10.1016/j.jcjo.2025.04.011","url":null,"abstract":"<p><strong>Objective: </strong>Neurotrophic keratopathy (NK) is a rare degenerative disease leading to impaired corneal sensation and function. In this study, we measured the utility values associated with NK to better understand the impact of this condition on patients.</p><p><strong>Design: </strong>Cross-sectional study.</p><p><strong>Participants: </strong>Twenty-two patients with NK at a university-based outpatient ophthalmology clinic completed a survey.</p><p><strong>Methods: </strong>Patients were asked questions regarding their eye condition, overall health, and completed the Visual Function Questionnaire (VFQ-25). Health utility was calculated using the time trade-off (TTO) and standard gamble (SG) methods with anchor points of perfect eye function (pf) and perfect health (ph).</p><p><strong>Results: </strong>Four different utility values for NK were calculated, ranging from 0.69 to 0.86, depending on the measurement method (TTO or SG) and anchor point (pf or ph). Utility values were not significantly associated with age, gender, comorbidities, visual acuity, or severity of NK disease. Role difficulty and dependence (based on a subset of the VFQ-25) were associated with lower utility.</p><p><strong>Conclusion: </strong>Our study found that NK has a significant impact on quality of life, independent of vision loss. As treatment options for NK are expanding and increasing in efficacy, this study can provide a foundation for future cost-effectiveness analyses on the various treatments for NK.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143954654","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 annular outer retinopathy: initial insights into clinical course variations with multimodal imaging.","authors":"Chunli Chen, Yizhe Cheng, Haiying Zhou, Yongpeng Zhang, Xiaoyan Peng","doi":"10.1016/j.jcjo.2025.05.011","DOIUrl":"10.1016/j.jcjo.2025.05.011","url":null,"abstract":"<p><strong>Objective: </strong>To describe the clinical course and provide initial imaging perspectives in acute annular outer retinopathy (AAOR) by reviewing multimodal imaging (MMI) findings.</p><p><strong>Design: </strong>Observational case series study.</p><p><strong>Participants: </strong>Nine patients (12 eyes) with AAOR.</p><p><strong>Methods: </strong>Review clinical charts and MMI findings.</p><p><strong>Main outcome measures: </strong>Clinical medical records and multimodal imaging features via fundus photographs, optical coherence tomography (OCT), fundus autofluorescence (AF) and OCT angiography (OCTA), as applicable.</p><p><strong>Results: </strong>Twelve eyes of nine patients (18-39 years) were identified. The clinical course was subdivided acutely progressive stage (APS), stationary stage (SS) and atrophic stage (AS) (1-3 weeks, 3 weeks to 3 months and >3 months, respectively). During APS, advancement of peripapillary annular band was noted in all eyes, accompanied by absent ellipsoid zone, increased choroidal thickness (ChT) and thinned outer nuclear layer (ONL) within the affected area. During SS, annular band disappeared on fundus photograph with improved ONL with improved ONL. During AS, affected area became depigmented with scattered pigmentation, exhibiting hyper-AF or mixed AF. Other manifestations included retinal atrophy and decreased ChT. OCTA revealed an enlarged foveal avascular zone in each stage, especially in AS. Seven eyes of 5 patients showed no macular involvement with best corrected visual acuity (BCVA) of 20/20, while 5 eyes of 5 patients showed macular involvement with poorer BCVA of HM-20/400 at the last visit.</p><p><strong>Conclusions: </strong>AAOR mostly occurs in young individuals with unilateral involvement, especially in those with mild to moderate myopia. The observed variations in the clinical course of AAOR, documented through MMI, aid in the prompt recognition and understanding of this rare entity.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144186650","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":"Trends in medico-legal cases against Canadian ophthalmologists: a 10-year retrospective review (2013-2022).","authors":"Derek M Waldner, Gary Garber, Anne Steen, P J Finestone, Richard Liu, Donna Perron, Qian Yang, Anna MacIntyre, Natalie Gagné, Tricia Savoy, Kevin Warrian, Alex Ragan","doi":"10.1016/j.jcjo.2025.05.003","DOIUrl":"10.1016/j.jcjo.2025.05.003","url":null,"abstract":"<p><strong>Objective: </strong>To investigate trends in medico-legal complaints against Canadian ophthalmologists over a ten-year period (2013-2022).</p><p><strong>Methods: </strong>Retrospective review of closed legal, hospital, and regulatory cases involving ophthalmologists was conducted using data from the Canadian Medical Protective Association (CMPA). Cases were systematically coded by nurse analysts using the Canadian Classification of Health Interventions, ICD-10-CA, and a specific schema for contributing factors. Data analyses utilized SAS software (9.4) and Prism GraphPad (9.4.1).</p><p><strong>Results: </strong>A total of 970 closed cases with sufficient data for analysis were identified, including 584 college complaints, 340 legal complaints, and 46 hospital complaints. Complainants were predominantly female (55.4%) and mostly aged 30-64. Of the 1021 ophthalmologists named, 210 faced multiple complaints, with 82% of complaints against those with over ten years of practice. The most common clinical presentations generating complaints were disorders of the lens (37.1%), disorders of the choroid and retina (17.3%), and disorders of refraction (14.9%). The most common complications cited in complaints included visual disturbances (22.0%) and retinal complications (13.8%). Peer expert concerns were noted in 540 cases (55.7%), with common issues being inadequate documentation (31.5%), consent processes (25.9%), and communication (20.6%). Approximately 50.9% of cases had unfavorable outcomes for CMPA members, though the most frequent unfavourable college outcome was \"dismissed with concern\".</p><p><strong>Conclusion: </strong>This review highlights gaps in Canadian ophthalmic care, empowering ophthalmologists to address these concerns. Future work will focus on detailed assessments of cases with peer expert concerns and developing specific recommendations for clinical practice.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149281","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":"Prevalence of ocular manifestations in cutaneous rosacea: Systematic review and meta-analysis.","authors":"Ryan H Kirkpatrick, Kristina Nazzicone, Aleksandar Biorac, Anneke R Froentjes, Sarah M Simpson, Sonja Molin","doi":"10.1016/j.jcjo.2025.04.005","DOIUrl":"10.1016/j.jcjo.2025.04.005","url":null,"abstract":"<p><strong>Objective: </strong>Ocular rosacea (OR) is a rosacea subtype, typically presenting as dry eye, foreign body sensation, and photophobia. Prevalence estimates of OR in cutaneous rosacea (CR) range from 0.03% to 65%. This systematic review and meta-analysis consolidate the prevalence of diagnosed OR within CR and ocular involvement of CR.</p><p><strong>Methods: </strong>Primary research studies reporting the prevalence of OR in adults with CR were eligible for inclusion. Embase, MEDLINE, Web of Science, ProQuest, and Cochrane Central Register of Controlled Trials (CENTRAL) were searched. The Joanna Briggs Institute Critical Appraisal tool for Prevalence Studies and a Peters' regression test assessed risk of bias. Results were analyzed through random intercept logistic regression models using R. Studies reporting diagnosed OR were analyzed separately from those reporting ocular involvement.</p><p><strong>Results: </strong>28 studies were identified, 11 reported on diagnosed OR, and 17 reported on ocular involvement in CR. Prevalence of diagnosed OR (N = 124 093) was 10.3%, whereas the prevalence of ocular involvement in CR (N = 1 747) was 44.3%. In diagnosed OR, publication year significantly contributed to variations in reported OR prevalence, with more recent studies reporting a lower prevalence of diagnosed OR compared to older studies.</p><p><strong>Discussion: </strong>This study highlights the variability in reported prevalences of OR and ocular involvement in CR. This might be explained by a lack of clear guidelines on how to diagnose and refer patients with CR and co-occurring ocular signs and symptoms. Greater clinician awareness and clear referral guidelines are warranted.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076232","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":"ETDRS-style distance visual acuity charts for Indigenous Canadians: development and validation using Canadian Aboriginal syllabics.","authors":"Brendan K Tao, Sidrat Rahman, Dana Toameh, Edsel Ing, Christian El-Hadad","doi":"10.1016/j.jcjo.2025.04.004","DOIUrl":"10.1016/j.jcjo.2025.04.004","url":null,"abstract":"<p><strong>Objective: </strong>To develop and validate a logMAR Early Treatment Diabetic Retinopathy Study (ETDRS)-style visual acuity chart imprinted with Canadian Aboriginal Syllabics (CAS) optotypes.</p><p><strong>Design: </strong>Prospective, nonrandomized, within-subject analysis.</p><p><strong>Participants: </strong>22 Indigenous patients from the Ullivik residence (Montreal, QC) for Inuit patients who were able to interpret Latin and CAS characteristics.</p><p><strong>Methods: </strong>Python and LaTeX scripts were created to generate PDFs of standard ETDRS charts, which could be readily modified for alphabet (CAS or Latin), font, and optotype sizing. We used CAS characters that were preserved across Cree, Ojibwe, and Inuktitut languages. A 60\" television screen (4K resolution) was used to display the eye charts to scale. For each subject, the best-corrected visual acuity (BCVA) of each eye was assessed on each chart (4 measurements per patient).</p><p><strong>Results: </strong>The median difference between visual acuities (logMAR) acquired by the Latin and CAS charts was 0 (Q1: -0.08; Q3: 0). Band-Altman analysis revealed a bias of -0.01 (SD: 0.03), which was near zero (indicating favourable agreement), and one outlier (of 22 patients), whose deviation was attributed to random error. The visual acuity differences between eye charts were not statistically significant (p = 0.1).</p><p><strong>Conclusions: </strong>We developed and validated the first CAS-imprinted ETDRS chart for measuring visual acuity. Given its use of preserved characters across Cree, Ojibwe, and Inuktitut languages, this chart has additional applicability to several Indigenous populations in Canada. Future work should develop near reading cards and other methods of optimizing culturally competent eye care for Indigenous patients.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":3.3,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980384","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}