Reduced occipital regional volumes at term predict impaired visual function in early childhood in very low birth weight infants.

Purpose: Premature infants are at increased risk of impaired visual performance related to both cortical and subcortical pathways for oculomotor control. The hypothesis for the current study was that preterm infants with impaired saccades, smooth pursuit, and binocular eye alignment at age 2 years would have smaller occipital brain volumes at term equivalent, as measured by volumetric magnetic resonance (MR) techniques, than would preterm infants without such abnormalities.

Methods: Study participants consisted of 68 infants from a representative regional cohort of 100 preterm infants born between 23 and 33 weeks' gestation.

New Zealand experience of I125 brachytherapy for choroidal melanoma.

Purpose: To examine patient survival, visual function and complications in all patients with choroidal melanoma treated with I125 brachytherapy between 1995 and 2003 at the authors' institution. To compare the results from their institution with those from international series.

Methods: Data were collected on 92 consecutive patients.

Improved clinical management of retinoblastoma through gene testing.

Aims: To investigate the relative benefits of retinoblastoma gene testing over conventional ophthalmological screening methods in a New Zealand setting, and to determine the importance of tumour material in resolving germline status.

Methods: Three cases of gene testing are described to illustrate the clinical advantages over conventional ophthalmological screening. To determine the role of tumour material in resolving germline status, 24 New Zealand families were tested, of which tumour material was available for eight.

Simultaneous choroidal melanoma and rhegmatogenous retinal detachment.

A case is reported of a 30-year-old man who presented with the unusual combination of a unilateral inferonasal choroidal melanoma and an unassociated rhegmatogenous retinal detachment attributable to a large horseshoe tear in the superotemporal quadrant. Over 20 cases of simultaneous occurrence of these two phenomena have now been reported but this patient appears to be the youngest. The reports of this uncommon association are reviewed.

Results of screening low-birth-weight infants for retinopathy of prematurity.

Retinopathy of prematurity (ROP) continues to be an important cause of potentially preventable blindness worldwide. The pattern of visual impairment from ROP in some middle-income countries--high rates affecting larger and more mature infants--resembles that seen in more developed countries two decades ago and has been called a "third epidemic" of the disease. Expert bodies in the United Kingdom and the United States have recently issued new guidelines for screening for ROP that utilize both birth weight and gestational age criteria.

Survival and disability at 7-8 years of age in New Zealand infants less than 28 weeks gestation.

Aims: To determine the survival and disability rates at 7-8 years in infants of less than 28 weeks gestation born in New Zealand in 1986 and admitted to a neonatal unit.

Methods: In 1986, all infants with birthweight less than 1500 g and admitted to neonatal units were enrolled in a prospective audit of retinopathy of prematurity. Surviving infants, including the subset born at less than 28 weeks gestation, have been assessed at a home visit.

Primary choroidal malignant melanoma occurring in a New Zealand Maori.

Purpose/method: A case of a 28-year-old Maori with an aggressive primary choroidal malignant melanoma is presented.

Results/conclusion: Melanoma and particularly intra-ocular melanoma is very rare in pigmented races. This is the first reported case in the Maori.

Prospective study of New Zealand infants with birth weight less than 1500 g and screened for retinopathy of prematurity: visual outcome at age 7-8 years.

Aim: To determine the visual outcome at 7-8 years in very low birth weight (VLBW: birth weight < 1500 g) infants screened for retinopathy of prematurity (ROP).

Methods: In 1986 all 413 VLBW infants admitted to neonatal units in New Zealand were enrolled in a prospective study of acute ROP. Surviving infants were traced and assessed at a home visit.

High iron status in very low birth weight infants is associated with an increased risk of retinopathy of prematurity.

To explore the hypothesis that excessive iron loads may increase the formation of free radicals and the development of retinopathy of prematurity in preterm infants, we carried out a prospective observational study of the association between transfusion volume, iron status, and retinopathy.

Prospective study of New Zealand very low birthweight infants: outcome at 7-8 years.

Objective: To determine the survival and sensorineural outcome at 7-8 years in very low birthweight (VLBW) infants born in New Zealand in 1986.

Methodology: In 1986 all VLBW New Zealand infants admitted to neonatal units were enrolled in a prospective study of acute retinopathy of prematurity. Surviving infants were traced and were assessed at a home visit.

An anatomical study of retinal arteriovenous crossings and their role in the pathogenesis of retinal branch vein occlusions.

To elucidate the anatomical features which predispose artery over vein (AV) crossings to be the preferential sites for retinal branch vein occlusions (RBVO), 11 AV and six vein over artery (VA) crossings in 12 eyes from non-hypertensive donors who were aged 35 to 82 years, were studied by light and electron microscopy. At AV crossings the veins were often observed to abruptly alter direction to pass under the artery. Here focal stratification of the vein basement membrane opposite the point of contact with the artery was seen.

Retinopathy after low-dose retinal irradiation.

A 28-year-old man, after subtotal resection of a Grade I-II frontal lobe astrocytoma, received 5600 cGy of radiotherapy in 200 cGy fractions to residual intracranial tumour. One year later he presented with severe bilateral retinopathy which, in appearance was consistent with retinopathy from irradiation. Total irradiation received by the retina of each eye (< 50 to 1500 cGy) was far less than the dose which commonly produces radiation retinopathy.

Fusidic acid prophylaxis before cataract surgery: patient self-administration.

In a placebo-controlled, randomised, double-blind clinical trial, the authors evaluated the efficacy of patient-administered 1% fusidic acid viscous eye drops in clearing the commonest organisms causing pseudophakic endophthalmitis (Staphylococcus epidermidis and aureus) from the lids and conjunctivae of 79 patients before cataract surgery. The treatment group self-administered fusidic acid viscous eye drops four times daily for seven days before surgery; the placebo group received inert ophthalmic drops. Fellow eyes of both groups remained untreated as a natural control.

Radiation hazards during cobalt 60 plaque therapy for choroidal melanoma.

Prompted by the concerns of the staff and patients, radiation hazards from Cobalt 60 (Co 60) plaque therapy for choroidal melanoma were recently assessed when two patients were concurrently treated at Christchurch Hospital. The risks from radiation to the attending medical staff, nursing personnel from the operating theatre and ward, and the patients' visitors were investigated. The radiation dose for all staff and visitors involved with the two patients was found to be well below the recommended weekly limits set by the International Commission on Radiological Protection.

Retinopathy of prematurity: risk factors in a prospective population-based study.

A prospective study of risk factors for retinopathy of prematurity (ROP) in all very low birthweight (less than 1500 g) infants born in New Zealand in 1986 is reported. Of 413 liveborn infants admitted to neonatal units, 338 (81.2%) survived to be discharged home.

Vitelliform dystrophy: long-term observations on New Zealand pedigrees.

Long-term observations on 29 patients from four pedigrees with vitelliform dystrophy (Best's disease) are described. The majority of patients were examined at yearly intervals and had a mean follow-up of 7.4 years.

An unusual ciliary body tumour: a haemangioblastoma.

A 23-year-old woman who presented with blurred vision in her right eye from increasing astigmatism had a vascular ciliary body tumour. After slow growth was documented over a 15-month period the tumour was excised with an iridocyclectomy. Microscopically the tumour consisted of sheets of large polygonal cells with round nuclei and foamy cytoplasm, separated by numerous capillaries, findings consistent with a diagnosis of a haemangioblastoma.

Serum and neutrophils alter the rate of excretory/secretory antigen release by Toxocara canis infective larvae in vitro.

Infective larvae of Toxocara canis are well suited for studies of nematode antigen expression in vitro. Larvae were labelled with 3H-glucosamine, an approach permitting dual analysis of antigen quantity and composition. Their excretory/secretory (E/S) glycoproteins were efficiently labelled and antigen identity confirmed by immunoprecipitation, SDS-PAGE and fluorography.

Sunglasses: are they necessary in Christchurch?

Concern over potential eye injury from sunlight prompted this study to see if the levels of sunlight in Christchurch posed a particular risk to our population's eyes, whether the populace was aware of any risk and whether effective sunglasses were freely available to the public. While there has been a 4% to 9% increase in UV radiation since 1969 due to global ozone depletion, no firm evidence was found that focal ozone depletion was a particular problem in New Zealand. Christchurch residents were poorly informed about the ocular hazards of sunlight.

Retinopathy of prematurity: screening and optimal use of the ophthalmologist's time.

In recent years it has been standard practice to recommend that indirect ophthalmoscopy be carried out between six and nine weeks of age in very low birthweight infants to screen for the presence of retinopathy of prematurity (ROP). Following this recommendation we examined 85 infants over a two-year period. Acute ROP occurred in 29 (34%), and two (2.