Retinitis pigmentosa (RP) is a heterogeneous group of hereditary diseases characterized by progressive degeneration of retinal photoreceptors leading to progressive visual decline. It is the most common type of inherited retinal dystrophy and has a high burden on both patients and society. This condition causes gradual loss of vision, with its typical manifestations including nyctalopia, concentric visual field loss, and ultimately bilateral central vision loss. It is one of the leading causes of visual disability and blindness in people under 60 years old and affects over 1.5 million people worldwide. There is currently no curative treatment for people with RP, and only a small group of patients with confirmed RPE65 mutations are eligible to receive the only gene therapy on the market: voretigene neparvovec. The current therapeutic armamentarium is limited to retinoids, vitamin A supplements, protection from sunlight, visual aids, and medical and surgical interventions to treat ophthalmic comorbidities, which only aim to slow down the progression of the disease. Considering such a limited therapeutic landscape, there is an urgent need for developing new and individualized therapeutic modalities targeting retinal degeneration. Although the heterogeneity of gene mutations involved in RP makes its target treatment development difficult, recent fundamental studies showed promising progress in elucidation of the photoreceptor degeneration mechanism. The discovery of novel molecule therapeutics that can selectively target specific receptors or specific pathways will serve as a solid foundation for advanced drug development. This article is a review of recent progress in novel treatment of RP focusing on preclinical stage fundamental research on molecular targets, which will serve as a starting point for advanced drug development. We will review the alterations in the molecular pathways involved in the development of RP, mainly those regarding endoplasmic reticulum (ER) stress and apoptotic pathways, maintenance of the redox balance, and genomic stability. We will then discuss the therapeutic approaches under development, such as gene and cell therapy, as well as the recent literature identifying novel potential drug targets for RP.

Background/Objectives: Many Canadians experience challenges navigating the healthcare system during their cancer care. Nurse navigators are uniquely positioned to support patients with their clinical expertise in oncology and patient care, but they have not been widely implemented. This study aimed to examine the impact of nurse navigators and barriers to successful implementation of a nurse navigator program. Methods: MEDLINE, EMBASE, and Web of Science databases were searched for articles examining the role of nurse navigators in cancer care. The data was extracted on study design, patient characteristics, nurse navigators’ responsibilities, outcomes, barriers to success, and recommendations for implementing nurse navigator programs. Content analysis was used to identify common themes. Results: Of 1787 articles identified, 44 articles met the inclusion criteria and underwent data extraction. Nurse navigator responsibilities included patient education, psychosocial support, clinical assessment, care coordination, patient advocacy, and improving workflows. Most studies reported significant benefits from nurse navigator programs, including patient-centered care, satisfaction with the healthcare system, reduced patient distress, healthcare provider support, and enhanced patient monitoring. Barriers included a lack of understanding of the role, overwhelmed nurse navigators, and inefficient healthcare system workflows. Recommendations for future nurse navigator programs include providing personalized support to patients, encouraging integrated healthcare teams, and permanent funding. Conclusions: Nurse navigator programs improve cancer patients’ experiences and the efficiency of cancer care delivery. Implementation necessitates integration into the healthcare team and longitudinal financial and professional support of nurse navigators.

To develop and validate a logMAR Early Treatment Diabetic Retinopathy Study (ETDRS)-style visual acuity chart imprinted with Canadian Aboriginal Syllabics (CAS) optotypes. Prospective, nonrandomized, within-subject analysis. 22 Indigenous patients from the Ullivik residence (Montreal, QC) for Inuit patients who were able to interpret Latin and CAS characteristics. 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). 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). 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.