Publications by authors named "Hans Fledelius"

The renewed focus on eye growth in preterm-born children was primarily triggered by Danish cohort studies, including the Copenhagen Project, which focused on children born from 1959-1961. The retinotoxic effects of excessive oxygen on premature neonates had long been clarified and therapeutically adjusted for. Later, ultrasound oculometry and keratometry established that ocular size deficits, linked to development, also occurred in normally developing children, not just frail outliers.

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Background: Scleroderma en coup de sabre (ECDS) and Parry-Romberg idiopathic hemifacial atrophy (IHA) may affect the eyes, oral cavity, teeth and possibly the brain.

Objective: Systematic follow-up study of ECDS/IHA-associated manifestations including ophthalmic and dental status.

Methods: Medical records of ECDS and IHA patients diagnosed in a 40-year period (1975-2015) were reviewed, and patients were re-examined.

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Purpose: A descriptive study on visual fields, as part of a 50-year follow-up of high myopia in an unselected cohort-based Danish sample, now aged 66 years.

Methods: In a Copenhagen 1948 birth cohort (n = 9243), 39 individuals aged 14 years were identified with myopia of at least -6 D, and with regular clinical follow-ups since then. In 2002 (n = 34, age 54 years) and 2008 (n = 32, age 60), the individual ambulatory visual field was outlined by kinetic Goldmann large object perimetry (IV or V,4e).

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Background: To evaluate ophthalmic involvement in a long-term series of patients with en coup de sabre (ECS) close to the eye based on the hypothesis that this is not commonly affected, or simply under-reported.

Methods: An observational study of ophthalmological findings in patients from Copenhagen University Dermatology Clinics. A standard eye examination further included exophthalmometry, axial length and keratometry (IOLMaster), and horizontal eye muscle thickness (B-scan ultrasonography).

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Article Synopsis
  • A long-term study followed a group of individuals with high myopia since they were 14 years old, tracking their visual ability and choroidal thickness into their 60s.
  • Despite potential complications, results showed better visual outcomes than expected based on other clinical studies.
  • The findings indicated a negative correlation between choroidal thickness and eye length, with those experiencing high myopia having significantly thinner choroidal measurements compared to those with lower levels of myopia.
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Background: To investigate whether neonatal hyperglycaemia in the first postnatal week is associated with treatment-demanding retinopathy of prematurity (ROP).

Methods: This is a Danish national, retrospective, case-control study of premature infants (birth period 2003-2006). Three national registers were searched, and data were linked through a unique civil registration number.

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Background/aims: To present a new method to determine dose depth and the distance from the concave side of the plaque to the tumour base in patients with uveal melanoma treated with ruthenium-106 based on ultrasonic mirror image.

Methods: We used the mirror image associated with ultrasound during plaque brachytherapy to determine intraobserver reproducibility and interobserver agreement between two surgeons. 230 eyes with primary uveal melanoma were included in a retrospective analysis to determine the distance from the plaque to the tumour base using ultrasound.

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Purpose: To examine long-term data on optic disc drusen (ODD) from an outpatient hospital series that indicated more cases with advanced visual field constriction than is apparent from other clinical reports. The underlying pathophysiology is discussed, also with regard to enlarged blind spot, which, in view of the small disc at risk, may seem a paradox.

Methods: This is an observational retrospective study on an eye clinic series (n = 49), focusing on visual acuity, kinetic/static perimetry, and longitudinal trends, to include the question of eventual visual incapacity.

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Purpose: One goal of the study was to identify "new" statistically independent risk factors for treatment-demanding retinopathy of prematurity (ROP). Another goal was to evaluate whether any new risk factors could explain the increase in the incidence of treatment-demanding ROP over time in Denmark.

Design: A retrospective, register-based cohort study.

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Purpose: A recent threefold increase in laser treatment for advanced retinopathy of prematurity (ROP) triggered a nationwide preschool ophthalmic and developmental status among extremely preterm survivors. Here, we discuss refraction and visual acuity.

Methods: Survivors (n = 178) from a national birth cohort (February 2004 to March 2006) of gestational age <28 weeks (PT) and 56 full-term (FT) controls attended for evaluation at age 4 years.

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Purpose: Enzyme replacement therapy (ERT) was offered from year 2001 to patients with Fabry disease. The ophthalmic experience was analysed, as part of a general 10-year status.

Methods: A retrospective observational series comprising 39 patients (25 females, 14 males) closely followed by the endocrinologists, and with regular ophthalmic control.

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Raviola and Wiesel's monkey eyelid suture studies of the 1970s laid the cornerstone for the experimental myopia science undertaken since then. The aim has been to clarify the basic humoral and neuronal mechanisms behind induced myopization, its eye tissue transmitters in particular. Besides acquiring new and basic knowledge, the practical object of the research is to reduce the burden of human myopia around the world.

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Purpose: To evaluate whether effects of early foveal motor instability due to infantile nystagmus might compare to those of experimental visual deprivation on refraction in a childhood series.

Methods: This was a retrospective analysis of data from the Danish Register for Blind and Weaksighted Children with infantile nystagmus recorded as prime diagnosis. We perused 90 records of children now aged 10-17 years, some of whom eventually exceeded the register borderline of 0.

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Amyloidogenic transthyretin (ATTR)-related familial amyloidotic polyneuropathy (FAP) is an autosomal-dominant hereditary disease characterised by slowly progressive peripheral sensorimotor and autonomic neuropathy and tissue involvement of the heart, kidneys and central nervous system. Secondary glaucoma has been reported following intraocular surgery, but optic nerve involvement unrelated to glaucoma has not previously been described. We reported a male patient in his late 40s when deceased, who previously had a liver transplant in order to reduce the abnormal protein synthesis underlying his FAP ATTR Val30Met mutation.

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Purpose: To test Sorsby's classical statement of axial eye growth as completed at the age of 13 years, with a view also to differentiating between basic eye growth and juvenile elongation associated with eventual refractive change towards myopia.

Methods: (i) A total of 160 healthy eyes close to emmetropia were included in a cross-sectional set-up (age 4-20 years, 91 males, 69 females), and (ii) 78 longitudinal data sets (67 male and 11 female annual repeat exams over 2-7 years, n=30; age span 4-19 years) were available for evaluating individual axial elongation. The IOL-Master equipment was preferred for conventional ultrasound oculometry due to its extreme repeatability of measuring values, thus making it well fitted for evaluating very small differences.

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After a brief historical oculometry review, the purpose is to bring a longitudinal update on an unselected Danish high myopia series, which was first presented at 1978 SIDUO. The sample was recruited from a Copenhagen school cohort (N=9,423, born 1948) as 14-year-olds with myopia of at least -6 D (n=39) in 1962. Clinical follow-up studies were conducted in 1976, 1986, 1995 and 2002, with A-scan ultrasound oculometry (Kretztechnik 7000, immersion method; and Sonometrics 400, contact method) as a regular part of the schedule.

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Background: A de novo mutation of the ACTA2 gene encoding the smooth muscle cell α-actin has been established in patients with multisystemic smooth muscle dysfunction syndrome associated with patent ductus arteriosus and mydriasis present at birth.

Objective: To describe the structural ocular findings in three Danish children with this new syndrome and evaluate the possible functional consequences for visual development of the poorer imaging condition.

Results: Unresponsive mydriatic pupils with scalloping wisps of persistent pupillary membrane from the iris collarette were an early indicator of this rare genetic disorder in all three cases.

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OBJECTIVES To investigate the importance of cerebral damage and retinopathy of prematurity (ROP) for visual impairment in preschool children born extremely premature and to determine the primary risk factor of the two. METHODS A clinical follow-up study of a Danish national cohort of children born extremely premature (gestational age, <28 weeks). The study sample consisted of 262 extremely preterm children born between February 13, 2004, and March 23, 2006, of whom 178 children (67.

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Purpose: To validate a hypothesis of restricted postnatal ocular growth associated with advanced retinopathy of prematurity (ROP), with a view also to preceding intrauterine growth retardation.

Methods: A clinically uniform sample of 28 preterm neonates was examined under general anesthesia from 1997 to 2002 for threshold retinopathy of prematurity (T-ROP), axial ultrasound oculometry being part of the evaluation (valid data in 53 eyes). Median values for gestational age at delivery (GA) and birth weight (BW) 27 weeks and 855 g, respectively, ranges 24.

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Objectives: To investigate inter-reader agreement on five severity levels of central vascular changes (none, mild, moderate, severe pre-plus disease, plus disease) and aggressive posterior retinopathy of prematurity (ROP), and to see whether an unintended shift in indication for treatment occurred.

Methods: Four international ROP readers participated. Before the grading of the photographs, the readers were informed that a high proportion of advanced ROP cases were included.

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