Search

Michael T Kryshtalskyj,1 Matthew J Novello,2 Monali S Malvankar-Mehta,3,4 Marcelo T Nicolela,5 Cindy ML Hutnik3,6 1Department of Surgery (Section of Ophthalmology), University of Calgary, Calgary, Alberta, Canada; 2Department of Physiology and Pharmacology, Western University, London, Ontario, Canada; 3Department of Ophthalmology, Western University, London, Ontario, Canada; 4Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; 5Department of Ophthalmology and Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada; 6Department of Pathology, Western University, London, Ontario, CanadaCorrespondence: Michael T KryshtalskyjDepartment of Surgery (Section of Ophthalmology), University of Calgary, Eye Clinic, Rockyview General Hospital, Main (Fourth) Floor, Fisher Building, 7007 14th Street SW, Calgary, T2V1P9, Alberta, CanadaTel +1-(647)-938-4450Email michael.kryshtalskyj@ucalgary.caObjective: To outline the current impact of Canadian ophthalmology and vision science research as measured by novel research metrics.Design: Cross-sectional survey.Participants: All Canadian ophthalmologists (n = 687) and vision scientists (n = 119) with an online bibliometric profile and academic appointment at a major ophthalmology training centre were included.Methods: Faculty lists of Canada’s 15 major academic ophthalmology departments were obtained. Faculty names, appointments, sex, and educational background were recorded. Elsevier’s Scopus database was used to calculate H-index, m-quotient, and total citations for each faculty member. Details around grant funding were obtained through the Canadian Institutes of Health Research (CIHR) Funding Decisions Database.Results: Average H-indices were 7.42 ± 7.98 for ophthalmologists and 23.78 ± 15.25 for vision scientists. Higher academic appointment was correlated with higher h-indices and m-quotients (p < 0.0001 for both). Most academic departments had significantly more males than females (avg. 71% male, 29% female); however, more equal ratios were seen in faculties in Quebec. No significant differences in research impact were identified between male and female ophthalmologists when controlled for academic appointment and career stage (p > 0.05). In clinical ophthalmology research, the top three departments with the highest average H-indices were Western University, the University of Toronto, and Dalhousie University. The University of British Columbia, Université de Montréal, and McGill University received the most funding from the CIHR in the last 10 years.Conclusion: This study highlights the current scope of ophthalmology and vision science research in Canada. Important trends were identified in research productivity across academic rank, sex, and clinical subspecialty.Keywords: bibliometrics, h-index, m-quotient, scholarly impact, research, ophthalmology

Background: The purpose of the study is to compare visual acuity, complications and outer retinal integrity following subretinal fluid (SRF) drainage from the peripheral retinal breaks (PRBs) versus posterior retinotomy (PR) versus perfluorocarbon liquid (PFCL) for macula-off rhegmatogenous retinal detachments (RRDs) at 2 years post-surgery., Methods: Retrospective analysis of 300 consecutive patients with primary RRD undergoing 23-gauge pars plana vitrectomy with SRF drainage through (1) PRB (n=100), (2) PR (n=100) or (3) with PFCL (n=100). Primary outcomes were visual acuity (best-corrected visual acuity (BCVA)) and complications (cystoid macular oedema (CMO) and epiretinal membrane (ERM)). Secondary outcomes were discontinuity of the external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IDZ) at 2 years post-surgery., Results: Mean (±SD) logMAR BCVA at 24 months was better in the PRB compared with PR and PFCL, with PFCL having the worst BCVA (PRB 0.5±0.6; PR 0.7±0.5; PFCL 0.9±0.7, p=0.001). CMO was higher with PFCL (PRB 29.7%; PR 30.2%; PFCL 45.9%, p=0.0015) and ERM formation was higher in PR (PRB 62.6%; PR 93.0%; PFCL 68.9%, p=0.002). There were no differences in ELM or EZ discontinuity. However, IDZ discontinuity was higher in PFCL (PRB 34%; PR 27%; PFCL 46%, p=0.002) at 2 years., Conclusions: Visual acuity was worse and discontinuity of the IDZ and CMO was greater in eyes with PFCL-assisted drainage compared with PRB or PR. Drainage technique may impact long-term visual acuity and photoreceptor integrity., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. No commercial re-use. See rights and permissions. Published by BMJ.)

Purpose: To characterize optical coherence tomography features in patients with idiopathic intermediate, posterior, or panuveitis., Methods: This is a retrospective case series of all consecutive cases of idiopathic intermediate, posterior, or panuveitis at four tertiary care centres between 2010 and 2021., Results: A total of 94 eyes (55 patients) were followed for an average duration of 29.8 (SD 21) months. The median central macular thickness was 284 µ m at baseline and 267 µ m at last follow-up. At baseline and last follow-up, respectively, 24% and 20% of uveitic eyes had intraretinal fluid, 12% and 1% subretinal fluid, and 43% and 54% epiretinal membrane. In addition, ellipsoid zone abnormalities on en-face were noted in 34% and 19% of cases at baseline and last follow-up, respectively. The baseline median visual acuity was significantly lower among cases with ellipsoid zone en-face slab abnormalities compared with those without (0.2 logarithm of minimum angle of resolution [interquartile range: 0-0.6] vs. 0.1 logarithm of minimum angle of resolution [interquartile range: 0-0.3], P = 0.0051)., Conclusion: With initiation of treatment, the central macular thickness, intraretinal fluid, subretinal fluid, and ellipsoid zone en-face abnormalities improved over time, whereas the number of cases with epiretinal membrane increased among eyes with idiopathic intermediate, posterior, and panuveitis. Presence of ellipsoid zone en-face abnormalities at presentation may be associated with worse visual acuity.

Purpose: To compare visual acuity and photoreceptor integrity following pars plana vitrectomy with drainage from the peripheral retinal break(s) (PRB), posterior retinotomy (PR), or perfluorocarbon liquid (PFCL) for macula-off rhegmatogenous retinal detachment., Design: Retrospective consecutive interventional comparative clinical study., Methods: 300 consecutive patients (300 eyes) with primary macula-off rhegmatogenous retinal detachment underwent 23-gauge pars plana vitrectomy with subretinal fluid drainage through PRB (n = 100), PR (n = 100), or with PFCL (n = 100). Visual acuity and spectral-domain optical coherence tomography were performed preoperatively and at 3, 6, and 12 months postoperatively. Primary outcomes were visual acuity and discontinuity of the external limiting membrane, ellipsoid zone, interdigitation zone, and retinal pigment epithelium at 1 year., Results: Baseline characteristics were similar. Single-operation reattachment rates were as follows: PRB 86%, PR 85%, and PFCL 83% (P = .9). Mean (±SD) logMAR visual acuity at 1 year was greater with PRB and PR compared with PFCL (PRB 0.6 ± 0.5, PR 0.7 ± 0.6, PFCL 0.9 ± 0.6, P = .002). There was an association between drainage technique and discontinuity of the external limiting membrane (PRB 26%, PR 24%, PFCL 44%, P = .001), ellipsoid zone (PRB 29%, PR 31%, PFCL 49%, P < .001), and interdigitation zone (PRB 43%, PR 39%, PFCL 56%, P = .004). There was an association between drainage technique and risk of cystoid macular edema (PRB 28%, PR 39%, PFCL 46%, P = .003) and epiretinal membrane (PRB 64%, PR 90%, PFCL 61%, P < .001)., Conclusions: PFCL-assisted drainage is associated with worse visual acuity and greater risk of outer retinal band discontinuity and cystoid macular edema compared with PRB or PR. PR had a greater risk of epiretinal membrane compared with PRB and PFCL. PRB had the best outcomes overall. Drainage technique may impact long-term anatomic and functional outcomes., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Design: Systematic review., Objective: To conduct a systematic review to (1) summarize various classification systems used to describe cervical ossification of the posterior longitudinal ligament (OPLL) and (2) evaluate the diagnostic accuracy of various imaging modalities and the reliability of these classification systems., Methods: A search was performed to identify studies that used a classification system to categorize patients with OPLL. Furthermore, studies were included if they reported the diagnostic accuracy of various imaging modalities or the reliability of a classification system., Results: A total of 167 studies were deemed relevant. Five classification systems were developed based on X-ray: the 9-classification system (0.60%); continuous, segmental, mixed, localized or focal, circumscribed and others (92.81%); hook, staple, bridge, and total types (2.40%); distribution of OPLL (2.40%); and K-line classification (4.19%). Six methods were based on computed tomography scans: free-type, contiguous-type, and broken sign (0.60%); hill-, plateau-, square-, mushroom-, irregular-, or round-shaped (5.99%); rectangular, oval, triangular, or pedunculate (1.20%); centralized or laterally deviated (1.80%); plank-, spindle-, or rod-shaped (0.60%); and rule of nine (0.60%). Classification systems based on 3-dimensional computed tomography were bridging and nonbridging (1.20%) and flat, irregular, and localized (0.60%). A single classification system was based on magnetic resonance imaging: triangular, teardrop, or boomerang. Finally, a variation of methods was used to classify OPLL associated with the dura mater (4.19%)., Conclusions: The most common method of classification was that proposed by the Japanese Ministry of Health, Labour and Welfare. Other important methods include K-line (+/-), signs of dural ossification, and patterns of distribution., Competing Interests: Declaration of Conflicting Interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Summary: We report the serendipitous discovery of a map drawn by an army surgeon during the First World War. The map, entitled “Loos 36° NW3,’”was drawn by 24-year-old Captain Alexander Edward MacDonald in fall 1917 and was found in his old surgery textbook. MacDonald’s map depicts the positions of Canadian frontlines and medical units after the Battle of Hill 70. During the battle, Dr. MacDonald tended to the wounded in an aid post that he constructed in a ruined coal mine near the Front. MacDonald would go on to serve with distinction in the Battle of Passchendaele and Canada’s Hundred Days, and he received the Military Cross for gallantry. He maintained a passionate interest in cartography throughout his life and eventually became an authority among map collectors. Artifacts such as MacDonald’s map remind us of the realities of war and the sacrifices of our surgeon predecessors., Competing Interests: None declared.

This systematic review aims to summarize important clinical predictors of outcomes in patients undergoing surgery for the treatment of degenerative cervical myelopathy. Based on the results of this article, patients with a longer duration of symptoms and more severe myelopathy are likely to have worse surgical outcomes. With respect to age, several studies have indicated that elderly patients are less likely to translate neurologic recovery into functional improvements. However, many other studies have failed to identify a significant association between age and outcomes. Finally, smoking status and presence of comorbidities may be important predictors of outcomes., (Copyright © 2017 Elsevier Inc. All rights reserved.)