Ezekiel Weis - Academia.edu (original) (raw)

Papers by Ezekiel Weis

Ophthalmology, Jun 1, 2006

Canadian journal of ophthalmology, Feb 1, 2019

Objective: To report indications for eye removal, histopathological diagnosis, and surgical trend... more Objective: To report indications for eye removal, histopathological diagnosis, and surgical trends in enucleation versus evisceration over a 23-year period. Design: Retrospective consecutive case series. Participants: All patients undergoing enucleation or evisceration at the Royal Alexandra Hospital in Edmonton, Canada, between January 1994 and December 2016. Methods: Demographic information was recorded and archived hospital charts were accessed and reviewed for clinical diagnosis, histopathological diagnosis, and the type of implant used. Univariate and multivariable logistic regression analysis was performed. The study cohort was divided into 2 time periods by separating the first 10 years of the study period (1994-2004 inclusive) from the rest of the study time period (2005-2016 inclusive). Results: A total of 786 patients with a mean age (± SD) of 52 ± 23 years were included. The most common clinical diagnosis was blind painful eye (56%) followed by intraocular tumour (23%). Corresponding pathological examination of specimens revealed chronic inflammatory change (46%) and intraocular tumour (25%). Eyes with active infection were more likely to be eviscerated (odds ratio: 4.67; p o 0.001) when compared to other diagnostic groups, and all eyes diagnosed with intraocular tumours were enucleated. While most eyes in the study were enucleated, the proportion of eyes eviscerated increased over the study period (p ¼ 0.010) from 8% between 1994-2004 to 14% between 2005-2016. Conclusions: While enucleation was performed more commonly overall, the incidence of evisceration increased throughout the study period. There were no instances of occult intraocular tumour in patients who were eviscerated.

Indian Journal of Ophthalmology, 2012

Springer eBooks, Oct 19, 2021

Digital journal of ophthalmology, Jul 3, 2020

Ophthalmic and Physiological Optics, Jan 9, 2013

Ophthalmology, Sep 1, 2007

To evaluate the ability of Joint Photographic Experts Group (JPEG) compressed, stereoscopic, digi... more To evaluate the ability of Joint Photographic Experts Group (JPEG) compressed, stereoscopic, digital photography to identify clinical levels of diabetic retinopathy, detect clinically significant macular edema (CSME), and make appropriate referral recommendations as compared with Early Treatment Diabetic Retinopathy Study (ETDRS) standard film photography. Design: Prospective, clinic-based, comparative photographic format validation study. Participants: Two hundred four eyes from 102 consecutive, new, diabetic patients with a median duration of diabetes of 12.5 years were enrolled and analyzed. Methods: After pupillary dilation, a trained ophthalmic photographer obtained 2 sets of images: standard ETDRS, stereoscopic 7-field 35-mm film photographs and high-resolution, digital images of the same 7 standard fields (stereoscopic images of fields 1 and 2). Two masked readers graded both sets of images. The 35-mm film photographs were graded by hand using a written template. Digital photographs were compressed, uploaded to a web site, and graded by a web-based, computer-assisted ETDRS algorithm. The ETDRS level of diabetic retinopathy, presence of retinal thickening, and referral recommendation based on these 2 diagnoses were recorded and compared. Main Outcome Measures: The presence of CSME, ETDRS level of diabetic retinopathy, and referral threshold diabetic retinopathy. Results: Film and compressed digital grading levels were compared using a simplified ETDRS categorization scheme. Film and digital gradings were highly correlated with exact agreements for level of diabetic retinopathy, CSME, and referral thresholds Ͼ87% and levels Ͼ0.71. McNemar's testing found no statistically significant difference between compressed digital images and film when comparing referral thresholds (defined as the presence of CSME and/or ETDRS level Ն 61; P ϭ 0.76). Conclusions: A modified ETDRS protocol (stereoscopic images of fields 1 and 2 only) with 16:1 JPEG image compression and computer-assisted ETDRS grading algorithm has excellent reproducibility when compared to standard ETDRS stereoscopic slide-film photography. An internet-based teleophthalmology system can correctly and reliably (ϭ 0.78) identify patients requiring referral for CSME and proliferative diabetic retinopathy (

Investigative Ophthalmology & Visual Science, Apr 17, 2010

DOAJ (DOAJ: Directory of Open Access Journals), 2021

Surgical management of large tumors involving the conjunctival fornix can be challenging, as expo... more Surgical management of large tumors involving the conjunctival fornix can be challenging, as exposure and clear margins may be difficult to achieve. In this case series, we report our initial experience with the open book technique in 4 patients. Through a canthotomy and cantholysis, this surgical approach provides a wide surgical field and facilitates fornix reconstruction post large tumor excision. In our series, one patient had a lateral canthus dehiscence.

Ocular Oncology and Pathology, 2020

• 10-15% of optic disc melanocytomas show subtle enlargement over years. • 1-2% of these are asso... more • 10-15% of optic disc melanocytomas show subtle enlargement over years. • 1-2% of these are associated with malignant transformation. • The incidence for uveal melanocytomas is unknown. Novel Insights • Uveal melanocytomas can grow to very large proportions without histological evidence of malignant transformation. • Uveal melanocytomas can be associated with extrascleral extension after biopsy and rapid growth without histological evidence of malignant transformation.

Investigative Ophthalmology & Visual Science, May 1, 2005

Current Oncology, Feb 1, 2016

PubMed, Jul 21, 2023

Purpose: There is no known optimal treatment for primary periocular orofacial granulomatosis (PPO... more Purpose: There is no known optimal treatment for primary periocular orofacial granulomatosis (PPOFG), a disorder that results in periocular edema. This case series and systematic review identifies management strategies and their reported improvement. Methods: Systematic review and case series. PubMed and MEDLINE databases were searched following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines to identify published cases of PPOFG. Cases were included when edema involved the periocular tissues and when a biopsy was interpreted to be PPOFG. Cases were excluded when edema did not involve the periocular tissues or when the edema was secondary to another process. The electronic medical records of the pathology department were studied to identify cases that were in keeping with PPOFG. The clinical charts were examined to confirm the diagnosis and provide a local case series. Results: There are 38 published cases of PPOFG. An additional 9 cases were identified locally. These cases were combined and analyzed. Most PPOFG has eyelid swelling in isolation, without other facial swelling (36/47; 76.6%). It is most commonly a bilateral disease (30/47; 63.8%). Fissured tongue and facial nerve palsy occur, just as they do in other cases of orofacial granulomatosis. Treatment with surgical debulking or intralesional steroids resulted in high rates of symptomatic improvement of eyelid swelling, but recurrences were common. Conclusions: In light of no curative or highly successful treatment currently available, intralesional steroids and/or surgical debulking are therapies in the treatment of eyelid swelling associated with PPOFG that demonstrate reasonable short- and medium-term results. There is no established therapy that can offer disease remission or long-term symptom improvement.

2022 IEEE 23rd International Conference on Information Reuse and Integration for Data Science (IRI)

Ocular Oncology and Pathology

Introduction: Radiation retinopathy is a dose-dependent complication of the retina following expo... more Introduction: Radiation retinopathy is a dose-dependent complication of the retina following exposure to ionizing radiation. The objective of this prospective case series is to determine the clinical efficacy of intravitreal aflibercept for radiation retinopathy secondary to radiotherapy for uveal melanoma in those that failed intravitreal bevacizumab treatment. Methods: A case series of 30 patients with a mean age of 57 ± 15 years with radiation retinopathy were enrolled. Visual acuity (VA) and central foveal thickness (CFT) responses to therapy were assessed with regression analyses at 1 month, 3 months, and 6 months following the switch to aflibercept. Results: Regression analyses showed a statistically significant reduction in CFT and improvements in VA following the switch to treatment by aflibercept at 1 month, 3 months, and 6 months. The mean CFT improved from 476 μm ± 170 to 386 μm ± 139 and the mean VA improved minimally from 20/115 ± 20/63 to 20/112 ± 20/54 over 6 months. ...

Investigative Ophthalmology & Visual Science, Jun 10, 2020

Brachytherapy, 2021

PURPOSE The aim of this study was to develop an automated dose optimization algorithm, powered by... more PURPOSE The aim of this study was to develop an automated dose optimization algorithm, powered by simulated annealing, for inverse planning of ocular plaque brachytherapy treatments, to improve tumor coverage and critical structure sparing for reduced treatment-related morbidity. METHODS AND MATERIALS A simulated annealing based algorithm was built and evaluated by finding variable seed strengths that maximized dose uniformity across tumor base for model cases of various tumor heights and plaque sizes. This problem assessed its potential to find the minima in the energy function using differential loading. The algorithm was further developed to decrease doses to critical structures while maintaining desired tumor coverage. Doses to the optic disc and fovea were compared to those using uniform seed strengths for various model cases. Finally, 10 retrospective patient cases treated with uniform seed strengths were replanned with the developed algorithm to evaluate effectiveness for clinical application. RESULTS The developed algorithm achieved dose reductions of up to 37.3% and 39.6% to the optic disc and fovea, respectively, compared to those using uniform seed strengths, depending on the tumor and plaque size used for the model cases. Applying the algorithm to 10 clinical scenarios resulted in dose reductions of 14% to the optic disc and fovea relative to clinical treatments performed with uniform seed strengths. CONCLUSIONS The developed automatic dose optimization routine was able to achieve significant dose reductions to the critical structures relative to using uniformly loaded plaques both in the model and in the clinical cases.

Pachydermoperiostosis (PDP), also known as idiopathic or primary hypertrophic osteoarthropathy or... more Pachydermoperiostosis (PDP), also known as idiopathic or primary hypertrophic osteoarthropathy or Touraine-Solente-Gole Syndrome, is a rare genetic disorder affecting skin and bone, consisting of pachydermia and periostosis. Pachydermia is a thickening and furrowing of the skin and face in a manner that resembles the skin of a pachyderm. Periostosis is periosteal new bone formation in the long bones. In this report, a 16-year-old boy presented with bilateral ptosis and floppy eyelids. He was successfully treated with bilateral upper eyelid pentagonal wedge resections. Histopathology of the excised tissue demonstrated mild epidermal acanthosis and marked increased dermal collagen with thickening of individual fibers, consistent with pachydermia, as well as papillary conjunctival inflammation and Meibomian glands hyperplasia with ductal dilatation, consistent with floppy eyelid syndrome. Radiographic imaging did not demonstrate any signs of periostosis, confirming the diagnosis o...