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

{"title":"Barriers and challenges to accessing and utilizing low vision services among people with visual impairment in Canada: a systematic review.","authors":"Salem Abu Al-Burak, Amrit Das, Khaldon F Abbas, Thomas Sheidow, Monali S Malvankar-Mehta","doi":"10.1016/j.jcjo.2026.07.005","DOIUrl":"10.1016/j.jcjo.2026.07.005","url":null,"abstract":"<p><strong>Objective: </strong>Visual impairment affects ∼2.18 million Canadians and is associated with reduced quality of life and substantial economic burden. Although low-vision services (LVS) improve independence and functioning, utilization remains low. This systematic review examines barriers to accessing and utilizing LVS in Canada.</p><p><strong>Methods: </strong>A systematic search of MEDLINE, EMBASE, Cochrane Library, CINAHL, grey literature sources, and Google Scholar was conducted from inception to June 15, 2025, and registered with PROSPERO: (CRD420251082000). English-language studies examining barriers to accessing or utilizing LVS in Canada were included. Screening and data extraction were performed independently by multiple reviewers following PRISMA guidelines. Thematic analysis categorized barriers into systemic/structural, personal, and societal domains. Study quality was assessed using the Mixed-Methods Appraisal Tool (MMAT).</p><p><strong>Results: </strong>Of 730 records identified, 25 studies met inclusion criteria. Systemic barriers included limited-service availability, inconsistent provincial funding, high out-of-pocket costs, geographic maldistribution, and provider-related gaps in referral knowledge and training. Personal barriers included lack of awareness of LVS, financial insecurity, lower educational attainment, comorbid health conditions, and psychosocial resistance, such as stigma or denial. Societal barriers included negative attitudes toward disability, limited family support, cultural and linguistic challenges, and inaccessible public infrastructure. Study quality was moderate to high, with 60% rated 4 stars or higher on MMAT.</p><p><strong>Discussion: </strong>Access to LVS in Canada is limited by intersecting structural, personal, and societal factors. Coordinated reforms in provider education, public awareness, funding policy, and inclusive design are needed to improve equitable access and reduce underutilization of low-vision rehabilitation services.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648311","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":"ABCC6-associated retinopathy presenting with a pattern dystrophy phenotype.","authors":"Ashley Benchluch, Austin Pereira, Brian G Ballios","doi":"10.1016/j.jcjo.2026.06.020","DOIUrl":"10.1016/j.jcjo.2026.06.020","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148454740","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":"RPE microrips within pigment epithelial detachments colocalize with focal leakage in acute central serous chorioretinopathy.","authors":"Mostafa Mafi, Elodie Bousquet, Alessandro Feo, Andrea Coletto, Mohamed El Barkani, Pradeep Prasad, Marko M Popovic, Mark Breazzano, Michael Javaheri, David Sarraf","doi":"10.1016/j.jcjo.2026.07.007","DOIUrl":"10.1016/j.jcjo.2026.07.007","url":null,"abstract":"<p><strong>Objective: </strong>To determine the prevalence of retinal pigment epithelium (RPE) microrips within serous pigment epithelial detachments (PEDs) in first-episode acute central serous chorioretinopathy (CSCR) and to assess their spatial relationship with focal angiographic leakage using multimodal imaging.</p><p><strong>Design: </strong>Retrospective observational case series.</p><p><strong>Participants: </strong>Thirty-nine eyes of 39 patients with acute CSCR (symptom duration <3 months).</p><p><strong>Methods: </strong>All eyes underwent spectral-domain OCT, fluorescein angiography, and indocyanine green angiography (ICGA). Imaging biomarkers at leakage sites included PEDs, RPE microrips, outer retinal erosion and outer retinal pinching, pachyvessels, midphase ICGA hyperfluorescent plaques, and subfoveal choroidal thickness. Clinical outcomes included best-corrected visual acuity, subretinal fluid (SRF) resolution, recurrence, and progression to chronic disease.</p><p><strong>Results: </strong>Mean age was 44.5 ± 10.0 years, and 61.5% of patients were male. PEDs colocalized with the focal leakage site in all eyes, whereas RPE microrips colocalized with the site of focal angiographic leakage in 66.7% of eyes, with good interobserver agreement (κ = 0.79) observed. Outer retinal erosion and outer retinal pinching were observed in 38.5% and 12.8% of eyes, respectively. Midphase ICGA hyperfluorescent plaques were observed in 56.4% and pachyvessels in 46.2% of cases. Mean best-corrected visual acuity improved from 0.24 ± 0.25 (20/34 Snellen) to 0.10 ± 0.17 logMAR (20/25 Snellen) at final follow-up, with complete SRF resolution in 68.4%. Baseline subfoveal choroidal thickness correlated with SRF height (P = 0.018), but no baseline imaging biomarkers predicted final visual or anatomical outcomes.</p><p><strong>Conclusions: </strong>RPE microrips within serous PEDs frequently are observed and precisely colocalize with focal leakage in acute CSCR, supporting a mechanical model of focal RPE dehiscence driven by increased choroidal pressure. These findings provide insight into CSCR pathophysiology and may inform therapeutic strategies.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148700719","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":"Lens-assisted needling post minimally invasive bleb surgery.","authors":"Ravina Anand, Ritesh Gupta, Harmanjit Singh","doi":"10.1016/j.jcjo.2026.07.003","DOIUrl":"10.1016/j.jcjo.2026.07.003","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648263","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":"Bisphosphonates and glaucoma: a pharmacovigilance signal detection analysis using the FAERS database.","authors":"Yan Zhang, Yi Hong Huang, Yan Ling Xiao, Xin Xing Zhu, Mao Sheng Guo","doi":"10.1016/j.jcjo.2026.06.019","DOIUrl":"10.1016/j.jcjo.2026.06.019","url":null,"abstract":"<p><strong>Objective: </strong>To detect and characterize disproportionality signals between individual bisphosphonates and glaucoma subtypes using the U.S. Food and Drug Administration Adverse Event Reporting System (FAERS).</p><p><strong>Design: </strong>A retrospective pharmacovigilance disproportionality analysis.</p><p><strong>Participants: </strong>Participant data were drawn from adverse event reports from the FAERS database (Q1 2004-Q1 2025).</p><p><strong>Methods: </strong>Disproportionality analysis was conducted using the reporting odds ratio (ROR), proportional reporting ratio (PRR), and Bayesian confidence propagation neural network (BCPNN). Adverse events were coded using Medical Dictionary for Regulatory Activities (version 27.1). A significant signal required ≥3 cases and meeting thresholds (ROR 95% CI lower limit >1, PRR ≥2 with χ² ≥4, or BCPNN IC025 >0).</p><p><strong>Results: </strong>Among 539 reports, significant disproportionality signals were identified for alendronic acid (ROR = 2.42; 95% CI: 2.18-2.70) and pamidronic acid (ROR = 2.23; 95% CI: 1.69-2.93) at the group level. Subtype-level signals included alendronic acid with open-angle glaucoma (ROR = 5.67) and normal-tension glaucoma (ROR = 4.60); pamidronic acid with open-angle glaucoma (ROR = 8.62); and risedronic acid with angle-closure glaucoma (ROR = 2.93). Median time-to-onset varied from 10 days (risedronic acid) to 1579 days (pamidronic acid).</p><p><strong>Conclusions: </strong>This pharmacovigilance analysis identifies distinct disproportionality signals linking specific bisphosphonates to different glaucoma subtypes, with heterogeneous time-to-onset patterns. The findings highlight potential safety signals warranting further clinical and mechanistic investigation.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583644","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 case of bupivacaine-induced cardiotoxicity during a blepharoplasty.","authors":"Bruce B Becker, Kendall Goodyear","doi":"10.1016/j.jcjo.2026.06.013","DOIUrl":"10.1016/j.jcjo.2026.06.013","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148583590","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":"Eyelid melanoma in situ treated with intralesional IL-2 injection therapy: case report and literature review.","authors":"Mohamed Nashnoush, Mariam Abdelghaffar, Carman Giacomantonio, Ahsen Hussain","doi":"10.1016/j.jcjo.2026.07.004","DOIUrl":"10.1016/j.jcjo.2026.07.004","url":null,"abstract":"","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648290","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":"Systematic review and meta-analysis of the readability of large language models for patient education on ophthalmological conditions.","authors":"Kyran Sachdeva, Emaan Chaudry, Fahad R Butt, George Wright, Alaina Dhawan, Adil Bhatti","doi":"10.1016/j.jcjo.2026.07.006","DOIUrl":"10.1016/j.jcjo.2026.07.006","url":null,"abstract":"<p><strong>Objective: </strong>Ophthalmological patient education materials (PEMs) are written at a reading level of grades 10.4-12.6, higher than the recommended 8th-grade level. This study quantitatively assesses the readability of large language model (LLM)-generated chatbot responses to patient queries, de novo PEM creation, and simplification of existing PEMs.</p><p><strong>Methods: </strong>This systematic review and meta-analysis article was registered in PROSPERO (CRD420251123401). We searched Ovid MEDLINE, Embase, CINAHL, Web of Science, and Scopus (August 11, 2025). The primary outcome was readability, measured by the Flesch-Kincaid Grade Level (FKGL). Random-effects meta-analysis compared ChatGPT-generated PEM readability with existing control PEMs (i.e., clinician- or organization-authored websites, brochures, and clinical guidelines). A binomial test evaluated the proportion of studies achieving an 8th-grade reading level. Joanna Briggs Institute and Grading of Recommendations Assessment, Development, and Evaluation tools assessed risk of bias and quality.</p><p><strong>Results: </strong>Of 1660 studies screened, 57 were included, with 11 contributing to the meta-analysis. Pooled FKGL scores were 9.82 (95% CI: 7.93-11.70) for ChatGPT PEMs and 9.54 (95% CI: 8.68-10.40) for control PEMs. There was no significant difference in FKGL readability between ChatGPT and control PEMs (mean difference = 0.21; 95% CI: -1.52 to 1.94; p = 0.81; I² = 97.08%). Seventeen studies (29.82%) included LLM(s) at or below 8th-grade reading level. Grade-level prompting significantly improved LLM-generated PEM readability. Risk of bias was low to moderate. Reasons for downgrading were inconsistency and imprecision.</p><p><strong>Conclusions: </strong>In the context of high heterogeneity and low certainty, it appears that LLMs do not produce ophthalmology PEMs that are more readable than existing materials.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148668527","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":"Ophthalmic needs of Indigenous adults experiencing homelessness and marginal housing: a serial cross-sectional analysis.","authors":"Shayaan Kaleem, Winnie Yu, Michael Balas, Shiva Acharya, Saige McMahon, Nicky Bomberry, Victoria Wylson-Sher, Myrna Lichter","doi":"10.1016/j.jcjo.2026.07.002","DOIUrl":"10.1016/j.jcjo.2026.07.002","url":null,"abstract":"<p><strong>Objective: </strong>To describe the frequency and causes of visual impairment (VI) among Indigenous adults experiencing homelessness or marginal housing in Toronto and Hamilton, Ontario.</p><p><strong>Design: </strong>Serial cross-sectional study.</p><p><strong>Participants: </strong>Indigenous adults 18 years or older attending 5 ocular screening clinics at Indigenous-led shelters (September 2021 to October 2023) who had not received an eye examination in the previous 12 months and were not currently seeing an ophthalmologist.</p><p><strong>Methods: </strong>We collected sociodemographic data and medical history and performed presenting and pinhole visual acuity, intraocular pressure measurement, autorefraction, and anterior and posterior examination. VI was defined using the North American threshold (better-eye visual acuity <20/50). World Health Organization VI categories also were recorded. We report categorical variables as counts and percentages and continuous variables as means and SDs.</p><p><strong>Results: </strong>Ninety-seven participants were included. VI was present in 30.9% (n = 30) of participants on the basis of presenting acuity and 9.3% (n = 9) after pinhole. By World Health Organization categories, 25.8% (n = 25) had moderate impairment or blindness at presentation and 6.2% (n = 6) after pinhole. Most participants were dissatisfied with their vision (75.3%, n = 73), and 48.5% (n = 47) currently owned glasses, despite 73.2% (n = 71) having previously owned a pair. Cost was the most commonly reported barrier to eye care (30.9%, n = 30). The mean time since last eye examination was 6.3 years (SD 6.5 years).</p><p><strong>Conclusions: </strong>Indigenous adults experiencing homelessness or marginal housing had a high burden of correctable VI and long intervals without care. Refractive services with on-site dispensing and facilitated follow-up may reduce vision loss in this population.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148653209","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":"Clinical and sociodemographic characteristics of limited and persistent uveitis cases: a population-based study.","authors":"Tina Felfeli, Luis Palma, Laura Rosella, Sherif El-Defrawy, Thomas Albini, Efrem D Mandelcorn, Jessica Widdifield","doi":"10.1016/j.jcjo.2026.06.023","DOIUrl":"10.1016/j.jcjo.2026.06.023","url":null,"abstract":"<p><strong>Objective: </strong>To compare the clinical and sociodemographic characteristics of limited and persistent uveitis cases and temporal trends in incidence in Ontario.</p><p><strong>Methods: </strong>A retrospective population-based study using Ontario health administrative data identifying individuals with limited or persistent uveitis. The analysis described demographics, comorbidities, aggregated diagnosis groups (ADGs), resource utilization, income quintiles, and systemic therapy use. Annual age/sex-standardized, and age-specific incidence rates of limited and persistent uveitis were determined.</p><p><strong>Results: </strong>Between 2000 and 2023, 289 031 limited and 41 482 persistent uveitis cases were identified, with mean index ages of 56.8 (SD 21.0) and 58.3 (SD 20.3) years, respectively. A higher proportion of children and youth were identified with limited duration uveitis. Sex distribution was similar between groups, and 89%-91% of cases resided in urban areas. Persistent uveitis cases had significantly more moderate to high ADGs (86.0%) compared with limited cases (16.2%), with hypertension being the most prevalent comorbidity in both limited (43.8%) and persistent (46.4%) uveitis cases. Persistent cases also had substantially higher resource utilization than limited uveitis cases. Incidence rates were higher for limited uveitis overall and among older age groups. Annual age-specific incidence declined in older age groups but increased over time for children with limited duration uveitis.</p><p><strong>Conclusions: </strong>This study highlights significant age-related trends in uveitis incidence, including an increase in pediatric cases and a high incidence of uveitis among the elderly. Age-specific health care strategies and resource planning are essential for adapting interventions and ensuring timely access to care.</p>","PeriodicalId":9606,"journal":{"name":"Canadian journal of ophthalmology. Journal canadien d'ophtalmologie","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497199","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}