Diverse Research Teams and Underrepresented Groups in Clinical Studies.

Importance: Several ophthalmic diseases disproportionately affect racial and ethnic minority patients, yet most clinical trials struggle to enroll cohorts that are demographically representative of disease burden; some barriers to recruitment include time and transportation, language and cultural differences, and fear and mistrust of research due to historical abuses. Incorporating diversity within the research team has been proposed as a method to increase trust and improve engagement among potential study participants.

Objective: To examine how demographic factors of potential research participants and personnel may be associated with patient consent rates to participate in prospective ophthalmic clinical studies.

Modifiable Risk Factors and Preventative Strategies for Severe Retinopathy of Prematurity.

Severe ROP is characterized by the development of retinal fibrovascular proliferation that may progress to retinal detachment. The purpose of this report is to review five of the most common and well-studied perinatal and neonatal modifiable risk factors for the development of severe ROP. Hyperoxemia, hypoxia, and associated prolonged respiratory support are linked to the development of severe ROP.

The Scholarly Impact of Student Authorship in Ophthalmology.

 The H-index (H ), an author-level metric of scholarly impact, is predictive of future scientific achievement. We sought to analyze the scholarly impact of student authorship on the H of corresponding authors (CAs) within a major academic journal in the specialty of ophthalmology.  We compared the H of all unique CAs for manuscripts published in (Journal of the American Academy of Ophthalmology) in 2008, 2012, and 2016.

Long-term strabismus outcomes after unilateral infantile cataract surgery in the Infant Aphakia Treatment Study.

Purpose: To characterize long-term strabismus outcomes in children in the Infant Aphakia Treatment Study (IATS).

Methods: This study was a secondary data analysis of long-term ocular alignment characteristics of children aged 10.5 years who had previously been enrolled in a randomized clinical trial evaluating aphakic management after unilateral cataract surgery between 1 and 6 months of age.

Unilateral Familial Exudative Vitreoretinopathy: Clinical Profile and Pathology.

We report a case of a newborn with unilateral retinal detachment that could not be repaired. At examination under anesthesia, the retina was markedly abnormal and a presumptive diagnosis of retinal dysplasia was made. Several years later, the eye was enucleated because it was blind and painful.

Rate of ocular trauma in children operated on for unilateral cataract in infancy-data from the Infant Aphakia Treatment Study.

To determine whether the fellow eye of children who have undergone unilateral cataract extraction in the first year of life are at increased risk of injury and vision loss, the 10.5-year data on 109 of 114 children enrolled in the Infant Aphakia Treatment Study were examined. Based on this limited data, it was estimated that the fellow eye is at greater risk of injury than the operated eye.

Development of refractive error in children treated for retinopathy of prematurity with anti-vascular endothelial growth factor (anti-VEGF) agents: A meta-analysis and systematic review.

Objective: To investigate refractive error development in preterm children with severe retinopathy of prematurity (ROP) treated with anti-vascular endothelial growth factor (anti-VEGF) agents and laser photocoagulation.

Methods: Selection criteria were comparative studies that compared the refractive errors in children, birthweights ≤1500 grams and gestational ages ≤30 weeks, and treatments for Type I ROP with intravitreal bevacizumab (IVB) versus laser photocoagulation. Studies were identified using PubMed, Google Scholar, and published reviews.

Don't Miss This! Red Flags in the Pediatric Eye Examination: Introduction and Essential Concepts.

Although the pediatric eye examination can be made more challenging by inattention, poor cooperation, sleep, or just the wiggles, these should never be justification for an inadequate assessment of the child. In fact, a challenging patient should make the examiner ever more careful to get a good history and to look carefully for potential red flags that should be examined in greater detail. Missing a history of diplopia, or not noticing an abnormal pupil, or blurred disc margins, to name a few, may delay the diagnosis and treatment of potentially life-threatening entities.

Don't Miss This! Red Flags in the Pediatric Eye Exam: Pupils.

The pupillary exam in the pediatric population is a vital part of any clinician's workup. In the right clinical setting, pupillary abnormalities such as anisocoria, light-near dissociation, an afferent pupillary defect, and paradoxic pupillary constriction in the dark can be red flags that trigger further examination and workup. Through both careful physical examination and detailed history-taking and observation, potentially vision- and life-threatening conditions can be detected.

Improvement of Eye Alignment in Adult Strabismic Monkeys by Sustained IGF-1 Treatment.

Purpose: The goal of this study was to determine if continuous application of insulin-like growth factor-1 (IGF-1) could improve eye alignment of adult strabismic nonhuman primates and to assess possible mechanisms of effect.

Methods: A continuous release pellet of IGF-1 was placed on one medial rectus muscle in two adult nonhuman primates (M1, M2) rendered exotropic by the alternating monocular occlusion method during the first months of life. Eye alignment and eye movements were recorded for 3 months, after which M1 was euthanized, and the lateral and medial rectus muscles were removed for morphometric analysis of fiber size, nerve, and neuromuscular density.

Strabismus surgery outcomes in the Infant Aphakia Treatment Study (IATS) at age 5 years.

Purpose: To report strabismus surgery frequency and outcomes after monocular infantile cataract surgery with or without IOL implantation.

Methods: The Infant Aphakia Treatment Study (IATS) is a randomized, multicenter clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with a unilateral congenital cataract. This report is a secondary outcome analysis of ocular motor data from IATS patients who underwent strabismus surgery prior to age 5 years.

Tonic pupil after botulinum toxin-A injection for treatment of esotropia in children.

A total of 27 children with esotropia (mean age, 3.9 years; range, 9 months to 13.8 years) were enrolled in a 9-month observational study following botulinum toxin A (BTX-A) injection of one (n = 7) or both (n = 20) medial rectus muscles.

Sensorimotor outcomes by age 5 years after monocular cataract surgery in the Infant Aphakia Treatment Study (IATS).

Purpose: To evaluate sensorimotor outcomes among children in the Infant Aphakia Treatment Study (IATS).

Methods: Secondary outcome analysis was performed in this randomized, multicenter, clinical trial comparing treatment of unilateral aphakia with a primary intraocular lens (IOL) or contact lens (CL) correction. The alignment characteristics and sensory status of children through age 5 years were evaluated.

One-year strabismus outcomes in the Infant Aphakia Treatment Study.

Objective: To evaluate the characteristics of strabismus in infants who underwent cataract surgery with and without intraocular lens (IOL) implantation.

Design: Secondary outcome analysis in a prospective, randomized clinical trial.

Participants: The Infant Aphakia Treatment Study is a randomized, multicenter (n = 12), clinical trial comparing treatment of aphakia with a primary IOL or contact lens in 114 infants with a unilateral congenital cataract.

Incidence of cataract development by 6 months' corrected age in the Early Treatment for Retinopathy of Prematurity study.

Purpose: To report the incidence of cataract development by 6 months' corrected age in preterm children who participated in the Early Treatment for Retinopathy of Prematurity study.

Methods: Infants who developed prethreshold retinopathy of prematurity (ROP) in one or both eyes and were determined by the RM-ROP2 model to have a high risk of poor structural outcome without treatment were randomized to receive early treatment (ET), defined as laser photocoagulation at high-risk prethreshold ROP, or to be conventionally managed (CM), receiving treatment only if threshold ROP developed. Data on eyes developing a cataract by 6 months' corrected age were analyzed.

Diplopia after glaucoma surgery.

The occurrence of strabismus and symptomatic diplopia following glaucoma surgery is becoming more common as the use of implanted setons increases. Understanding the factors contributing to the diplopia is critical to the development of treatment strategies to alleviate the patient's symptoms.

Effects of sequential injections of hepatocyte growth factor and insulin-like growth factor-I on adult rabbit extraocular muscle.

Purpose: To determine whether hepatocyte growth factor (HGF) and insulin-like growth factor-I (IGF-I) have synergistic effects in promoting extraocular muscle fiber growth and force generation.

Methods: A superior rectus muscle of adult rabbits was treated with either a single injection of HGF or sequential injections of HGF followed 1 week later by IGF-I. One week after HGF alone and 1 week after the IGF-I injection, the superior rectus muscles from treated and control orbits were examined for alterations in force generation as well as changes in myofiber size.

Improving preterm ophthalmologic care in the era of accountable care organizations.

OBJECTIVES To understand retinopathy of prematurity (ROP) follow-up care for preterm very low-birth-weight infants (VLBW; <1500 g) in the context of the chronic care model and identify opportunities for improvement under accountable care organizations. METHODS We conducted focus groups and interviews with parents (N = 47) of VLBW infants and interviews with neonatal intensive care unit and ophthalmologic providers (N = 28) at 6 sites in Massachusetts and South Carolina. Themes are reported according to consolidated criteria for reporting qualitative research guidelines.

Effects of the sustained release of IGF-1 on extraocular muscle of the infant non-human primate: adaptations at the effector organ level.

Purpose: The authors have demonstrated that prolonged exposure of adult rabbit extraocular muscle (EOM) to insulin-like growth factor-1 (IGF-1) results in significantly increased cross-sectional area and muscle force generation lasting over 3 months. Here the authors assess the effects on EOM of sustained IGF-1 treatment on normal binocular infant Macaca mulatta.

Methods: Sustained-release IGF-1 pellets were implanted bilaterally in each medial rectus (MR) muscle of two normal infant non-human primates.