Pediatric glaucoma suspects: characteristics and outcomes.

Purpose: To determine the characteristics of children diagnosed with glaucoma suspect (GS) status, their clinical outcomes, and risk factors for progression to a diagnosis of glaucoma.

Methods: This was a retrospective sequential cohort study of children <18 years diagnosed as GS between 2013 and 2019, based on clinical (C-GS) and CGRN (CGRN-GS) criteria. Children with penetrating ocular trauma, steroid-response, treated ocular hypertension, and glaucoma at presentation were excluded.

Simultaneous Versus Sequential Ptosis and Strabismus Surgery in Children.

Purpose: The authors sought to compare the clinical outcomes of simultaneous versus sequential ptosis and strabismus surgery in children.

Methods: Retrospective, single-center cohort study of children requiring both ptosis and strabismus surgery on the same eye. Simultaneous surgeries were performed during a single anesthetic event; sequential surgeries were performed at least 7 weeks apart.

Timely implementation of a retinopathy of prematurity telemedicine system.

Purpose: To examine the feasibility of a retinopathy of prematurity (ROP) telemedicine evaluation system of providing timely feedback to a neonatal intensive care unit (NICU) with at-risk premature infants.

Methods: This was a prospective observational study of premature infants with birth weights of <1251 g in five NICUs in the United States. Infants scheduled for clinically indicated ROP evaluations underwent indirect ophthalmoscopic examinations and digital imaging on the same day.

Cobalamin C Deficiency Shows a Rapidly Progressing Maculopathy With Severe Photoreceptor and Ganglion Cell Loss.

Purpose: To describe in detail the retinal structure and function of a group of patients with cobalamin C (cblC) disease.

Methods: Patients (n = 11, age 4 months to 15 years) with cblC disease (9/11, early onset) diagnosed by newborn screening underwent complete ophthalmic examinations, fundus photography, near-infrared reflectance imaging, and spectral-domain optical coherence tomography (SD-OCT). Electroretinograms (ERGs) were performed in a subset of patients.

Uveitis Reactivation in Children Treated With Tumor Necrosis Factor Alpha Inhibitors.

Purpose: To evaluate reactivation of pediatric uveitis during/following treatment with tumor necrosis factor alpha inhibition (anti-TNFα).

Design: Retrospective cohort study.

Methods: We assessed the incidence of uveitis reactivation in children ≤18 years who had achieved uveitis quiescence under anti-TNFα.

Interactive retinal vessel extraction by integrating vessel tracing and graph search.

Despite recent advances, automatic blood vessel extraction from low quality retina images remains difficult. We propose an interactive approach that enables a user to efficiently obtain near perfect vessel segmentation with a few mouse clicks. Given two seed points, the approach seeks an optimal path between them by minimizing a cost function.

Retinal Structure in Cobalamin C Disease: Mechanistic and Therapeutic Implications.

Purpose: To describe the retinal structure in a patient with cobalamin C (cblC) disease.

Methods: A 13-year-old male patient diagnosed with cblC disease during a perinatal metabolic screening prompted by jaundice and hypotony underwent ophthalmic examinations, electroretinography (ERG) and spectral domain optical coherence tomography (SD-OCT).

Results: The patient carried a homozygous (c.

Response of pediatric uveitis to tumor necrosis factor-α inhibitors.

Objective: To evaluate the outcome of tumor necrosis factor-α inhibition (anti-TNF) for pediatric uveitis.

Methods: We retrospectively assessed children (age ≤ 18 yrs) with noninfectious uveitis receiving anti-TNF at 5 uveitis centers and 1 pediatric rheumatology center. Incident treatment success was defined as minimal or no uveitis activity at ≥ 2 consecutive ophthalmological examinations ≥ 28 days apart while taking no oral and ≤ 2 eyedrops/day of corticosteroids.

The rate of change in retinal vessel width and tortuosity in eyes at risk for retinopathy of prematurity.

Purpose: To describe the rate of change in retinal vessel width and tortuosity in eyes that develop treatment-requiring, or type 1, retinopathy of prematurity (ROP) versus eyes that do not develop type 1 ROP.

Methods: Posterior poles of eyes of 41 infants at risk for ROP were imaged longitudinally with a 30° fundus camera. Retinal vessel width and tortuosity were measured with computer-assisted image analysis.

Visual acuity outcomes in pediatric glaucomas.

Purpose: To evaluate and compare the visual acuity prognosis in the various pediatric glaucoma subtypes and to determine risk factors for vision loss.

Methods: The medical records of pediatric glaucoma patients from 2000 to 2010 at Children's Hospital of Philadelphia were retrospectively reviewed. Visual acuities, surgeries, glaucoma subtype, and etiology of vision impairment were recorded.

Retinal vessel changes after laser treatment for retinopathy of prematurity.

Background: The clinical response to retinopathy of prematurity (ROP) treatment is currently assessed subjectively. This study aims to quantify treatment response objectively by assessing changes in digital images of posterior pole retinal vessel width and tortuosity.

Methods: Images of 30 right eyes with type 1 ROP obtained at up to three time points were analyzed: before treatment (T = 0) and 1 (T = 1) and/or 2 weeks (T = 2) after treatment.

Comparison of expert graders to computer-assisted image analysis of the retina in retinopathy of prematurity.

Aims: To determine correlation of width and tortuosity between expert graders and computer-assisted image analysis of the retina in narrow-field images of eyes with retinopathy of prematurity.

Methods: 11 digital images were selected based on severity of retinopathy of prematurity (ROP). Narrow field images were analysed for width and tortuosity of vessels using computer-aided image analysis of the retina (CAIAR), an image analysis software, and by four ROP experts.

Risk stratification of preplus retinopathy of prematurity by semiautomated analysis of digital images.

Objective: To determine whether quantitative analysis of retinal vessel width and tortuosity from digital images discriminates which eyes with preplus retinopathy of prematurity (ROP) progress to treatment severity.

Methods: Posterior pole images of eyes at first clinical diagnosis of preplus ROP were obtained using a 30 degrees-field, noncontact fundus camera. Width and tortuosity of retinal vessels were analyzed from digital images using computer-assisted image analysis software.

Simultaneous bilateral intraocular surgery in children.

Background: Simultaneous bilateral intraocular surgery (SBIS), defined as sequential bilateral intraocular surgery completed in one visit to the operating room, is a controversial topic. The reluctance of ophthalmologists to perform SBIS has been mainly attributable to concerns about bilateral catastrophic complications (endophthalmitis, expulsive hemorrhage, or retinal detachment). Herein we report our experience with SBIS in children and review the literature.

Image analysis of posterior pole vessels identifies type 1 retinopathy of prematurity.

Identification of type 1 retinopathy of prematurity (ROP) relies heavily on the presence of characteristics of plus disease, especially tortuosity. However, a relatively infrequent subset of eyes with type 1 ROP, eyes with zone 1, stage 3 ROP without plus disease, is included in treatment indications. We examined if posterior pole vessel width is associated with type 1 ROP in a subset of eyes with zone 1, stage 3 ROP without plus disease and whether vessel width differentiates type 1 from non-type 1 ROP.

Semiautomated digital image analysis of posterior pole vessels in retinopathy of prematurity.

Plus disease is a major indicator for treatment in retinopathy of prematurity (ROP), and computer-assisted image analysis of vessel caliber and tortuosity in the posterior pole may indicate disease progression and severity. We sought to determine whether semiautomated digital analysis of posterior pole vessels using narrow field images with varying severity of ROP correlated with vessel width and tortuosity.

The rate of retinal vessel dilation in severe retinopathy of prematurity requiring treatment.

Purpose: To assess whether the rate of change of retinal vessel diameter can help identify infants at the highest risk for severe retinopathy of prematurity (ROP).

Design: Thirty-five infants at risk for ROP were included in this prospective, longitudinal study.

Methods: Images were obtained using the NIDEK NM200D noncontact camera (NIDEK Inc, Aichi, Japan) at the time of ROP examinations in the intensive care unit.

Computerized analysis of retinal vessel width and tortuosity in premature infants.

Purpose: To determine, with novel software, the feasibility of measuring the tortuosity and width of retinal veins and arteries from digital retinal images of infants at risk of retinopathy of prematurity (ROP).

Methods: The Computer-Aided Image Analysis of the Retina (CAIAR) program was developed to enable semiautomatic detection of retinal vasculature and measurement of vessel tortuosity and width from digital images. CAIAR was tested for accuracy and reproducibility of tortuosity and width measurements by using computer-generated vessel-like lines of known frequency, amplitude, and width.

Telemedicine screening for retinopathy of prematurity in developing countries using digital retinal images: a feasibility project.

Purpose: To determine the feasibility in a middle-level human development country of onsite training, image collection, Internet transfer, and remote grading of digital retinal images from babies screened for retinopathy of prematurity (ROP).

Methods: Two experienced nurses in a neonatal nursery in Lima, Peru, were trained to take posterior pole (30 degrees ) digital retinal images. Nurses obtained posterior pole retinal images from babies undergoing routine ROP screening and selected images for uploading via Internet for remote evaluation by five masked ROP experts.

Progression to severe retinopathy predicted by retinal vessel diameter between 31 and 34 weeks of postconception age.

Objective: To assess the predictive value of early retinal vascular diameter measurements for the development of severe retinopathy of prematurity (ROP) in high-risk preterm infants.

Methods: Digital fundus images were taken of 78 eyes at risk for ROP with a noncontact camera during fundoscopic examination when infants were 31 to 34 weeks of postconception age. Vessel diameters were measured for the major superior and inferior temporal arteries and veins with the use of VesselMap software.

A comparison of hang-back with conventional recession surgery for exotropia.

Background: The hang-back loop suspension surgical technique for rectus muscle recession offers potential advantages over the conventional rectus muscle recession, including better exposure at the site of scleral sutures, shorter procedure duration, and lower risk of scleral perforation. Previous reports suggest that the hang-back technique for lateral rectus recession for exotropia results in poorer surgical success and may require a different surgical dosage.

Methods: We compared strabismus in a nonrandomized series of 55 children with exotropia treated with conventional surgery or hang-back surgery.