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

{"title":"Clinical and MRI outcomes of teprotumumab in Japanese thyroid eye disease.","authors":"Muhammad Abumanhal, Mizuki Tagami, Taichi Higashida, Gen Kinari, Yasuhiro Takahashi","doi":"10.1016/j.jcjo.2026.08.002","DOIUrl":"10.1016/j.jcjo.2026.08.002","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate and compare the clinical and magnetic resonance imaging (MRI)-based radiologic outcomes of teprotumumab treatment between patients with active thyroid eye disease (TED) with and without dysthyroid optic neuropathy (DON).</p><p><strong>Design: </strong>Retrospective multicentre study.</p><p><strong>Participants: </strong>Patients with active moderate-to-severe or sight-threatening TED who completed teprotumumab treatment and a 3-month follow-up after treatment completion.</p><p><strong>Methods: </strong>Patients were classified according to the presence or absence of DON. Clinical evaluation included clinical activity score, visual acuity, Hertel exophthalmometric values, and thyroid-stimulating antibody activity. MRI-based quantitative analyses included measurements of extraocular muscle (EOM) volume on T1-weighted images and signal intensity ratio on short tau inversion recovery MRI.</p><p><strong>Results: </strong>Thirty-one patients were included, comprising 24 patients without DON and 7 patients with DON. After teprotumumab treatment, significant improvements or reductions were observed in visual acuity, clinical activity score, Hertel exophthalmometric values, thyroid-stimulating antibody activity, EOM volume, and signal intensity ratio in all rectus muscles (all P < 0.05). Follow-up MRI showed complete resolution of high-signal inflammatory lesions in all patients. Patients with DON demonstrated significantly greater EOM volume reduction compared with patients without DON (P < 0.050). Adverse events occurred in 77.4% of patients, most commonly otologic symptoms and muscle cramps, although no patient required permanent treatment discontinuation.</p><p><strong>Conclusions: </strong>Teprotumumab demonstrated significant clinical and radiologic efficacy in patients with active TED, including those with DON. MRI revealed marked reductions in orbital inflammation and EOM enlargement after treatment, supporting the value of MRI as an objective tool for assessing disease activity and treatment response.</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":"148812031","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":"Best vitelliform macular dystrophy masquerading as pachyvitelliform maculopathy in an elderly patient.","authors":"Thanaporn Kritfuangfoo, Akanksha Pandit, Alessandro Feo, Shahin Faghihi, David Sarraf","doi":"10.1016/j.jcjo.2026.08.008","DOIUrl":"10.1016/j.jcjo.2026.08.008","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788581","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":"Medial canthoplasty for pediatric exposure keratopathy.","authors":"Muhannad A Alnahdi, Georges Nassrallah, Asim Ali","doi":"10.1016/j.jcjo.2026.08.007","DOIUrl":"10.1016/j.jcjo.2026.08.007","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788552","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":"Extraocular muscle and orbital fat changes in treatment of thyroid eye disease with monoclonal antibodies: a systematic review and meta-analysis.","authors":"Alexander W C Kos, Angelica Hanna, Chris Zajner, Lulu L C D Bursztyn","doi":"10.1016/j.jcjo.2026.07.011","DOIUrl":"10.1016/j.jcjo.2026.07.011","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate radiological changes in extraocular muscle (EOM) and orbital fat sizes in thyroid eye disease (TED) patients after receiving monoclonal antibody therapy.</p><p><strong>Methods: </strong>The protocol was registered on PROSPERO (CRD420251129246). The electronic databases Embase (OVID), Medline, and PubMed were searched from inception to August 18, 2025, using keywords related to TED, EOMs, and monoclonal antibodies. Eligible studies reported baseline and follow-up imaging outcomes in monoclonal antibody-treated TED patients. Two reviewers independently conducted screening, data extraction, and RoB2 (or the revised Cochrane risk-of-bias tool for randomized trials) or ROBINS-I (or Risk of Bias in Non-randomized Studies-of Interventions) risk of bias assessment. Data were pooled using random-effects models to estimate mean differences in EOM and orbital fat volumes.</p><p><strong>Results: </strong>Fourteen studies were identified-3 randomized controlled trials, 4 retrospective cohort studies, and 7 prospective cohort studies-comprising 566 orbits from 304 TED patients. Pooled analysis revealed a total EOM volume mean difference of -1377 mm³ (95% CI: -2012 to -743; I² = 90.8%; p < .001), representing a 26.7% ± 7.0% reduction with treatment, and an orbital fat volume mean difference of -1732 mm³ (95% CI: -3002 to -461; I² = 82.8%; p < 0.001), representing a 16.2% ± 6.3% volume reduction with treatment. Cohen's-D effect sizes for individual EOM changes were superior rectus -0.67 (95% CI: -1.00 to -0.33; p < 0.01), inferior rectus -1.07 (95% CI: -1.89 to -0.25; p = 0.01), medial rectus -0.75 (95% CI: -1.12 to -0.37; p < 0.01), and lateral rectus -0.86 (95% CI: -1.53 to -0.18; p = 0.01).</p><p><strong>Discussion: </strong>Monoclonal antibody therapy is associated with significant EOM and orbital fat volume reductions in TED. Despite nonrandomization and heterogeneity limitations, these findings suggest that biologics improve clinical activity and remodel orbital soft tissues, supporting their role in disease modification.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788571","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":"Is extensive macular atrophy with pseudodrusen a variant of age-related macular degeneration? Insights from the first multiethnic, multicentre US cohort.","authors":"Alessandro Feo, Alberto Quarta, Prithvi Ramtohul, Livia Faes, Giulia Corradetti, Diogo Cabral, Samantha D Butterfield, Paolo Forte, Tal Eshkoly-Lior, Marko M Popovic, Mario R Romano, Touka Banaee, Anita Agarwal, K Bailey Freund, SriniVas R Sadda, David Sarraf","doi":"10.1016/j.jcjo.2026.07.008","DOIUrl":"10.1016/j.jcjo.2026.07.008","url":null,"abstract":"<p><strong>Objective: </strong>To characterize the long-term clinical and multimodal imaging (MMI) features of extensive macular atrophy with pseudodrusen (EMAP) in a US cohort.</p><p><strong>Design: </strong>Multicentre retrospective case series.</p><p><strong>Participants: </strong>Patients diagnosed with EMAP between 2015 and 2025.</p><p><strong>Methods: </strong>Clinical records and MMI-including colour fundus photography, fundus autofluorescence, OCT, and OCT angiography-were reviewed at baseline and last follow-up.</p><p><strong>Results: </strong>Fifteen patients (30 eyes) were included, with longitudinal MMI analysis available in 11 patients (22 eyes). Median age at referral was 72 years (range, 40-76 years), and median baseline visual acuity was 0.3 logMAR (20/40). All eyes demonstrated diffuse pseudodrusen-like deposits and retinal pigment epithelium-Bruch membrane separation consistent with basal laminar deposits. Four eyes (13.3%) showed no macular atrophy at baseline, suggesting an early disease stage (stage 0). Peripheral retinal degeneration was identified in approximately 50% of eyes, and macular neovascularization developed in 23% including 2 eyes (6.7%) with type 3 macular neovascularization. Median visual acuity declined to 0.54 logMAR (20/70) at final follow-up (P < 0.001), and 27% met criteria for U.S. legal blindness. Disease progression was observed in 59% after a median follow-up of 40 months (range, 4-114 months).</p><p><strong>Conclusions: </strong>EMAP may represent a high-risk variant of age-related macular degeneration characterized by rapid progression to geographic atrophy. Critical diagnostic features include pseudodrusen-like deposits and basal laminar deposits, whereas a vertical pattern of atrophy represents the typical outcome. Atrophy may be absent in early disease stages. Genetic validation and consideration for inclusion in future atrophic AMD interventional trials are warranted.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148721075","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":"Preoperative Management and Cataract Surgery Outcomes in oGVHD.","authors":"Krishna Sinha, Andrea A Lopez-Ruiz, Skye A Buckner-Petty, David A Leske, Nandita Khera, Joanne F Shen","doi":"10.1016/j.jcjo.2026.07.012","DOIUrl":"10.1016/j.jcjo.2026.07.012","url":null,"abstract":"<p><strong>Objective: </strong>To describe common preoperative treatments and visual outcomes after cataract surgery in patients with definite ocular graft-versus-host disease (oGVHD), as defined by the International Chronic Ocular Graft-Versus-Host-Disease (ICCGVHD) consensus group criteria.</p><p><strong>Design: </strong>Retrospective study.</p><p><strong>Participants: </strong>Fifty eyes of 33 patients who had definite oGVHD, as defined by the ICCGVHD criteria, and underwent cataract extraction at Mayo Clinic were included.</p><p><strong>Methods: </strong>Various preoperative interventions and best-corrected visual acuity (BCVA) preoperatively, 1 month postoperatively, and at final ophthalmology follow-up were recorded. Postoperative corneal complications were also identified.</p><p><strong>Results: </strong>Fifty eyes across 33 patients (42% female) were included, with a mean age at cataract surgery of 57 ± 9 years. Common preoperative treatments used for patients included punctal occlusion via plugs or cautery (44 eyes, 88%), artificial tears (35 eyes, 70%), autologous serum tears (22 eyes, 44%); topical nonsteroidal anti-inflammatory drugs were used postoperatively in 7 eyes (14%). BCVA significantly improved from a preoperative mean of Snellen 20/61 (0.487 ± 0.429) to 20/26 at 1 month postoperatively (0.109 ± 0.184, P < 0.001) and remained stable at 20/29 at final ophthalmology follow-up (0.163 ± 0.381, P < 0.001). Postoperative corneal complications developed in 2 eyes (4%), including 1 corneal ulcer and 1 corneal abrasion, both of which resolved within 1 month with appropriate treatment.</p><p><strong>Conclusion: </strong>The ICCGVHD criteria demonstrate potential for comprehensively evaluating oGVHD before cataract surgery. In addition, patients with definite oGVHD according to these criteria are treated with a variety of interventions preoperatively and are able to achieve favorable postoperative visual outcomes with a low incidence of postoperative corneal complications.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788667","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":"Retinal metastasis of breast cancer: case report and literature review.","authors":"Akli Aouane, Samuel Farag, Andrew Farag, Ananda Kalevar","doi":"10.1016/j.jcjo.2026.07.009","DOIUrl":"10.1016/j.jcjo.2026.07.009","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788676","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":"Polarization-diversity optical coherence tomography features of optic disc melanocytomas: a case series.","authors":"Jiwon Hwang, Hoyoung Jung, Myeong Jin Ju, Katherine Paton, Zaid Mammo","doi":"10.1016/j.jcjo.2026.07.013","DOIUrl":"10.1016/j.jcjo.2026.07.013","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788682","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":"Applications of artificial intelligence in rural ophthalmology: a scoping review.","authors":"Thomas Scott Armstrong, Abdullahi Mohamed, Ojas Srivastava, Matthew T S Tennant","doi":"10.1016/j.jcjo.2026.08.005","DOIUrl":"10.1016/j.jcjo.2026.08.005","url":null,"abstract":"<p><strong>Objective: </strong>Artificial intelligence (AI) is increasingly utilized for screening within ophthalmology, yet its application in rural communities remains poorly understood. This scoping review mapped modalities, feasibility, and barriers to implementation of AI in rural ophthalmology.</p><p><strong>Design: </strong>A scoping review (adhering to PRISMA-ScR guidelines).</p><p><strong>Methods: </strong>A comprehensive literature search was conducted in August 2025. Eligible articles were original studies detailing clinical applications of AI in ophthalmology within a rural setting.</p><p><strong>Results: </strong>Eleven (78.6%) focused on diabetic retinopathy (DR), 2 (14.3%) focused on glaucoma, and 1 (7.1%) on multiple retinal lesions. AI modalities included cloud-based platforms and offline models. Sensitivities ranged from 81% to 100% with specificities of 84%-100% for DR screening, and 91% and 93%, respectively, in glaucoma detection. Multilesion screening demonstrated an area under the curve of 0.918. Patient acceptance ranged from 94% to 98.6%. Economic models supported the cost-effectiveness of AI in DR screening but not in glaucoma screening. Barriers included unreliable connectivity, lack of trained ophthalmic personnel, equipment fragility, and poor image quality.</p><p><strong>Conclusions: </strong>AI is a valuable ophthalmological tool in the rural setting and could benefit geographically dispersed nations like Canada by amplifying disease screening and increasing accessibility of care. Use of this technology in rural locations can be complemented by longitudinal studies and technological innovation.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788621","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":"Infraorbital fog light sign: bilateral infraorbital nerve thickening and enhancement in IgG4-related ophthalmic disease.","authors":"Kamaljeet Singh, Shivaprakash Basavanthaiah Hiremath, Santanu Chakraborty","doi":"10.1016/j.jcjo.2026.06.014","DOIUrl":"10.1016/j.jcjo.2026.06.014","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469290","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}