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Goyal S, Singh R, Singh JR, Vanita V. Novel and known variants in GJA3 and LIM2 in congenital cataract families from North India. BMC Genomics 2024; 25:31. [PMID: 38178039 PMCID: PMC10765620 DOI: 10.1186/s12864-023-09880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 12/07/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND To identify the underlying genetic defects in autosomal dominant (ADCC) and autosomal recessive (ARCC) congenital cataract families from North India. METHODS Detailed family histories were collected, pedigrees drawn followed by slit-lamp examination and lens photography. Mutation screening was performed using Sanger sequencing in the known candidate genes for crystallins, connexins, and membrane proteins. The pathogenicity of identified variants was assessed bioinformatically. RESULTS In two ADCC families (CC-281 and CC-3015) with posterior lenticonus cataract, a novel change c.263C > T (p.P88L) in GJA3 in CC-281 family and a previously reported substitution c.388C > T (p.R130C) in LIM2 in CC-3015 family was observed. In an ARCC family (CC-3005) having central pulverulent cataract, a novel frameshift deletion (c.764delT;p.L255R46fs) in GJA3 was detected. The observed variants segregated completely with phenotypes in the affected members and were neither present in unaffected family members nor in the ethnically matched 150 controls (tested for two novel variants), hence excluding these as polymorphisms. CONCLUSIONS Present study identified two novel mutations i.e., c.263C > T;p.P88L and c.764delT;p.L255R46fs in GJA3 in an ADCC and an ARCC family having posterior lenticonus and central pulverulent cataract, respectively. In another ADCC family with posterior lenticonus cataract, a previously reported mutation c.388C > T;p.R130C in LIM2 was observed. R130 may be a mutation hotspot as previously ADCC families from different ethnicities (UK/Czechia, China, Spain, Japan) also harbored the same substitution, however, with different phenotypes i.e., nuclear pulverulent, membranous, nuclear, lamellar, and sutural/lamellar. Findings in present study thus expand the mutation spectrum and phenotypic heterogeneity linked with GJA3 and LIM2.
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Affiliation(s)
- Shiwali Goyal
- Department of Human Genetics, Guru Nanak Dev University (GNDU), Amritsar, 143005, Punjab, India
| | - Ravijit Singh
- Dr. Daljit, Singh Eye Hospital, Amritsar, 143001, Punjab, India
| | - Jai Rup Singh
- Department of Human Genetics, Guru Nanak Dev University (GNDU), Amritsar, 143005, Punjab, India
| | - Vanita Vanita
- Department of Human Genetics, Guru Nanak Dev University (GNDU), Amritsar, 143005, Punjab, India.
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Al-Damri A, Alotaibi HM. Congenital Cataracts in Preterm Infants: A Review. Cureus 2023; 15:e40378. [PMID: 37456485 PMCID: PMC10344420 DOI: 10.7759/cureus.40378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2023] [Indexed: 07/18/2023] Open
Abstract
A congenital cataract is one of the most treatable causes of visual impairment during infancy. Preterm infants who are born alive before 37 weeks of pregnancy need special care, including proper age documentation, preoperative assessment, and monitoring postoperatively for at least 24 hours. Management of cataracts in preterm infants is critical as regards the timing of cataract surgery and the challenges associated with cataract surgery and posterior segment management for retinopathy of prematurity (ROP). This narrative review aims to provide comprehensive insight and up-to-date clinical research findings regarding the pathophysiology and management of congenital cataracts in preterm infants.
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Kim SJ, Slinger K, Lambert SR, Koo E, Shue A, Roberts TL. Strabismus and Nystagmus in Patients With Pediatric Cataracts: Study Using Insurance Claims Data. Am J Ophthalmol 2023; 248:87-95. [PMID: 36410473 PMCID: PMC11088441 DOI: 10.1016/j.ajo.2022.11.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/19/2022]
Abstract
PURPOSE To describe the characteristics and prevalence of strabismus and nystagmus in children diagnosed with cataracts using a national insurance claims database. DESIGN Population-based retrospective cohort study. METHODS Patients aged <13 years diagnosed with cataracts (traumatic cataracts excluded) and enrolled continuously in their health care program for ≥5 years after their first cataract diagnosis were identified in a retrospective review of 66 million charts in Optum's de-identified Clinformatics Data Mart Database between 2003 and 2015. Patients were categorized based on age of their first diagnosed cataract, and if cataract surgery was performed. Clinical and demographic factors associated with the occurrence of strabismus and nystagmus were evaluated. RESULTS Of 1636 children diagnosed with cataract, 434 (26.5%) and 109 (6.7%) were diagnosed with strabismus and nystagmus, respectively. Both strabismus and nystagmus were more common in those who underwent cataract surgery (P < .001) and in patients diagnosed with cataract at ≤12 months of age (P < .001). Survival analysis demonstrated that strabismus and nystagmus may be diagnosed 8 years after the initial cataract diagnosis. Cox proportional hazard regression analyses revealed strabismus was associated with cataract surgery, nystagmus, and the diagnosis with cataract at ≤12 months and cataract surgery at >12 months. CONCLUSIONS As strabismus and nystagmus occur more frequently in children diagnosed with cataracts necessitating cataract surgery, regular long-term follow-up is crucial for these children to monitor for the development of strabismus and nystagmus.
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Affiliation(s)
- Su-Jin Kim
- Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine & Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital (S.-J.K.), Yangsan, Korea
| | - Kristin Slinger
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University (K.S., S.R.L., E.K., A.S., T.L.R.), Palo Alto, California, USA
| | - Scott R Lambert
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University (K.S., S.R.L., E.K., A.S., T.L.R.), Palo Alto, California, USA
| | - Euna Koo
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University (K.S., S.R.L., E.K., A.S., T.L.R.), Palo Alto, California, USA
| | - Ann Shue
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University (K.S., S.R.L., E.K., A.S., T.L.R.), Palo Alto, California, USA
| | - Tawna L Roberts
- Spencer Center for Vision Research, Byers Eye Institute at Stanford University (K.S., S.R.L., E.K., A.S., T.L.R.), Palo Alto, California, USA.
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Kaplan AT, Yalçın SÖ, Oral AY. Primary versus secondary intraocular lens implantation following removal of congenital/de al of congenital/developmental catar elopmental cataracts: outcomes after acts: outcomes after at least 4 years. Turk J Med Sci 2023; 53:77-87. [PMID: 36945931 PMCID: PMC10388037 DOI: 10.55730/1300-0144.5560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 02/11/2023] [Indexed: 02/26/2023] Open
Abstract
BACKGROUND The aim of this study is to evaluate the long-term outcomes of primary and secondary intraocular lens (IOL) implantation following removal of congenital/developmental cataracts. METHODS One hundred and forty-four patients aged under 16 years who were followed up between 2003 and 2021 were analyzed retrospectively. The long-term results of children who underwent surgery before 2 years of age for congenital or developmental cataracts and underwent secondary IOL implantation after 2 years of age and those who underwent cataract surgery with primary IOL implantation after 2 years of age were compared. Patients with traumatic, secondary cataracts and cataracts due to ocular anomalies were not included in the study. RESULTS We evaluated 64 patients (mean age 9.5 ± 4.5 years) with secondary IOL implantation and 80 patients (mean age 12.8 ± 4.1 years) with primary IOL implantation in the study. Distance and near best-corrected visual acuities were significantly better in the primary IOL group than the secondary IOL group (p < 0.001). Incidence of strabismus after primary IOL surgery was significantly lower and presence of binocular vision was more often than the secondary IOL group (p = 0.002). There was no significant difference between the two groups in terms of refraction and myopic shift (p = 0.242, p = 0.172, respectively). Mean refractive changes were significant in unilateral cases of secondary IOL group and primary IOL group (p = 0.013, p = 0.049, respectively) and myopic shift was also greater in both groups of unilateral cases than the fellow eyes (p = 0.023, p = 0.012, respectively). DISCUSSION Visual outcomes and binocular vision were better, and the incidence of strabismus was also much less in the primary IOL group.
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Affiliation(s)
- Ayşin Tuba Kaplan
- Department of Ophthalmology, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Sciences, İstanbul,Turkey
| | - Sibel Öskan Yalçın
- Department of Ophthalmology, Kartal Dr. Lütfi Kırdar City Hospital, University of Health Sciences, İstanbul,Turkey
| | - Ayşe Yeşim Oral
- Department of Ophthalmology, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, Turkey
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Choe S, Ha A, Choi S, Baek SU, Kim JS, Jeoung JW, Park KH, Kim YK. Nationwide Incidence of Infantile Cataract Surgery and Risk of Secondary Glaucoma in a Population-based Birth Cohort. Am J Ophthalmol 2023; 246:130-140. [PMID: 36328202 DOI: 10.1016/j.ajo.2022.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/05/2022] [Accepted: 10/18/2022] [Indexed: 11/05/2022]
Abstract
PURPOSE To determine the nationwide birth cohort incidence of infantile cataract (IC) surgery and the risk of secondary glaucoma in a Korean population. DESIGN A population-based, retrospective cohort study. METHODS We accessed the Korean National Health Claims database to identify patients with IC who were diagnosed before 1 year of age and who underwent IC surgery among all Koreans born between 2008 and 2018 (n = 9,593,003). We estimated IC surgery incidence in a birth cohort. The incidence rates of post-IC surgery glaucoma were estimated per 100 person-years, based on the Poisson distribution. The risk factors for post-IC surgery glaucoma, including ophthalmic and systemic comorbidities, were analyzed by multivariable logistic regression analysis. RESULTS During the 11-year study period, 692 patients underwent IC surgery. The annual birth cohort incidence of IC surgery in the general population ranged from 5.10 to 9.29 cases per 100,000 individuals. Among patients who had been followed up for longer than 1 year (n = 650), 92 (14.2%) developed glaucoma, and its incidence rate was 2.29 (95% confidence interval, 1.86-2.80) per 100 person-years. The mean time from IC surgery to glaucoma development was 4.7 ± 3.5 years. No factors were identified as being associated with post-IC surgery glaucoma risk other than primary or secondary intraocular lens implantation, which reduces the risk (all P < .05). In patients without primary intraocular lens implantation, the risk of glaucoma increased steeply during the first 2 years after IC surgery. CONCLUSION This study identified the birth cohort incidence of IC surgery and secondary glaucoma risk in individuals of East Asian ethnicity. These estimates may help to better understand the epidemiologic features and clinical courses of patients with IC.
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Affiliation(s)
- Sooyeon Choe
- From the Department of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University College of Medicine, Seoul; Departments of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University Hospital, Seoul
| | - Ahnul Ha
- Departments of Ophthalmology at Jeju National University Hospital and Jeju National University College of Medicine (A.H.).
| | - Seulggie Choi
- Internal Medicine (S. Choi), Seoul National University Hospital, Seoul
| | - Sung Uk Baek
- Jeju-si; Departments of Ophthalmology at Hallym University College of Medicine, Chuncheon; Hallym University Sacred Heart Hospital (S.U.B.), Anyang
| | - Jin-Soo Kim
- Department of Ophthalmology (J-S.K.), Chungnam National University Sejong Hospital, Sejong
| | - Jin Wook Jeoung
- From the Department of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University College of Medicine, Seoul; Departments of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University Hospital, Seoul
| | - Ki Ho Park
- From the Department of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University College of Medicine, Seoul; Departments of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University Hospital, Seoul
| | - Young Kook Kim
- From the Department of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University College of Medicine, Seoul; Departments of Ophthalmology (S.Choe, J.W.J., K.H.P., Y.K.K.), Seoul National University Hospital, Seoul; Department of Pediatric Ophthalmology (Y.K.K.), Seoul National University Children's Hospital, Seoul; EyeLight Data Science Laboratory (Y.K.K.), Seoul, Korea.
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Muacevic A, Adler JR. The Prevalence of Cataract in Children. Cureus 2022; 14:e30135. [PMID: 36381901 PMCID: PMC9645413 DOI: 10.7759/cureus.30135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 10/10/2022] [Indexed: 11/24/2022] Open
Abstract
Cataract is the leading cause of childhood blindness in developing countries. Early detection and treatment of childhood cataracts can reduce the burden of blindness in the nation. Often the etiology of pediatric cataract is idiopathic; however, genetics play a role in the development of congenital cataract. According to epidemiologists, one-fourth of cases of congenital cataracts are hereditary. Gene responsible for the development of cataract is identified using gene mapping, which helps to prevent future blindness in the family. Cataracts can also present with systemic disease, microphthalmia, microcornea, and aniridia. The presentation of cataracts varies in individuals, some are symptomatic while others are asymptomatic. Parents after noticing strabismus and leukocoria bring their children to an ophthalmologist. Early diagnosis can restore visual function in cases of congenital cataract. In young babies, the type of cataract is determined using slit-lamp examination and examination under anesthesia in OR. Most cases of pediatric cataracts are accidental findings during routine checkups. On direct ophthalmoscopy, red reflex is not appreciated in cases of cataracts. Advancing technology changes the ophthalmologist's approach to pediatric cataract surgery, improving postoperative refractory function. In children, minor incision surgery was preferred to heal early. An appropriate choice of intraocular lens (IOL) should be made for implantation in a child's eye to avoid postimplanted complications. Inflammation and amblyopia affect the outcome of treatment. Complications of cataract surgery include posterior capsule opacification, glaucoma, inflammation, and uveitis.
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A Novel Mutation in the FYCO1 Gene Causing Congenital Cataract: Case Study of a Chinese Family. DISEASE MARKERS 2022; 2022:5838104. [PMID: 36061348 PMCID: PMC9439885 DOI: 10.1155/2022/5838104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/14/2022] [Indexed: 11/17/2022]
Abstract
Congenital cataract is the most important global cause of visual impairment in children. Autosomal dominant and autosomal recessive inheritance account for the majority of the hereditary nonsyndromic congenital cataract. The function of FYCO1 gene is to guide the transport of the microtubule-directed vesicles. Mutations in the FYCO1 gene may cause cataracts. We reported a novel nonsense mutation in FYCO1 (c.1411C > T, P. R471 ∗), which could cause nonsyndrome autosomal recessive congenital cataract. We underwent an ophthalmology examination of all participants and collected blood samples from all participants and extracted genomic DNAs. By whole exome sequencing, we found that this family carried an unreported mutation in the FYCO1 gene: c.1411C > T, P. R471 ∗. Sanger sequencing was performed to verify the mutation. We used ITASSER and PYMOL to predict and compare the structure and function of the mutated proteins. Using SIFT software and referring to the relevant guidelines of ACMG, the mutation was determined to be pathogenic. The models suggested that the nonsense mutation p.R471∗ resulted in a profound disruption of the FYCO1 protein structure. This report expands the locus information of the FYCO1 mutations.
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Agarwal P, Maan V, Sutar S, Chauhan L. Suture Selection for Incision Closure in Pediatric Cataract Surgery: A Dilemma for Pediatric Ophthalmologists. J Pediatr Ophthalmol Strabismus 2022; 59:243-247. [PMID: 35076313 DOI: 10.3928/01913913-20211111-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To measure and compare suture-related complications in children undergoing cataract surgery with a surgical incision closure performed by either a 10-0 nylon suture followed by suture removal within 1 to 2 weeks after surgery or a 10-0 polyglactin suture left in situ. METHODS This was a prospective, non-randomized cohort study. All children with bilateral cataracts who underwent cataract surgery with a surgical incision closure by non-absorbable 10-0 nylon sutures followed by suture removal within 1 to 2 weeks after surgery in their first eye and incision closure by absorbable 10-0 polyglactin sutures left in situ after their second eye surgery. The frequency of suture-related complications (vascularization near to suture, loosening of suture, mucus accumulation, early rupture, and infective keratitis) was noted for 10-0 nylon and 10-0 polyglactin sutures. RESULTS Eighty-two eyes of 41 children were enrolled in the study. All children were observed until 3 months after surgery. Of the 10-0 nylon sutures, 2 (4.9%) were loose and 2 (4.9%) had underlying corneal edema. The remaining sutures (n = 37, 90.2%) were removed within 1 to 2 weeks after surgery. Of the 10-0 polyglactin sutures, 5 (12.2%) were loose, 2 (4.9%) were vascularized, and 3 (7.3%) had mucus infiltration. These sutures (n = 10, 24.3%) were removed 2 to 5 weeks after the second eye surgery. The remaining polyglactin sutures (n = 31, 75.6%) were left in situ. CONCLUSIONS A higher frequency of suture-related complications was observed with the 10-0 polyglactin sutures than the 10-0 nylon sutures. The authors recommend using 10-0 nylon sutures with suture removal within 1 to 2 weeks after surgery over using 10-0 polyglactin sutures for incision closure in pediatric cataract surgeries. [J Pediatr Ophthalmol Strabismus. 2022;59(4):243-247.].
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Jabbarpour N, Saei H, Jabbarpoor Bonyadi MH, Bonyadi M. Identification of novel cis-mutations in the GJA8 gene in a 3-generation Iranian family with autosomal dominant congenital nuclear cataract. Ophthalmic Genet 2022; 43:609-614. [PMID: 35726576 DOI: 10.1080/13816810.2022.2089363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Cataract is mainly due to the presence of high molecular weight protein, which disrupts the normal function of the lens. Pathogenic variants in Gap Junction protein alpha-8 (GJA8) have been associated with autosomal dominant congenital nuclear cataract. In general, mutations in those genes that have important functions in lens development lead to congenital cataract. METHODS We conducted whole-exome sequencing (WES) in a four-year-old male patient referred to the genetic center for genetic analysis. He had developed cataract at an early age. DNAs were extracted from the blood samples of all family members and subjected to PCR-Sanger sequencing to confirm the WES results. RESULTS WES analysis on the proband revealed two mutations in the GJA8 gene (c.G12C, c.G58A). His mother, alongside several other members of the third-generation family, had developed cataract. Sanger sequencing of the interested regions showed that these two mutations were co-segregated in all affected members. However, none of the healthy individuals carried these mutations confirming that these two mutations are located in the same allele (complex allele). Bioinformatics analysis of the mutated GJA8 RNA and protein structure confirmed the pathogenicity of the cis-mutations. CONCLUSIONS Genetic segregation analysis in a three-generation family and also bioinformatics analysis showed that the complex-allele containing c.G12C+c.G58A mutations in the GJA8 gene is a pathogenic variant that causes autosomal-dominant congenital nuclear cataract.
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Affiliation(s)
- Neda Jabbarpour
- Animal Biology Department, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
| | - Hassan Saei
- Laboratoire des Maladies Rénales Héréditaires, Institut Imagine, Université de Paris-Cité, Paris, France
| | | | - Mortaza Bonyadi
- Center of Excellence for Biodiversity, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran
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Visual Function in Children With Posterior Lens Opacities Before and After Surgery. Am J Ophthalmol 2022; 241:160-167. [PMID: 35513026 DOI: 10.1016/j.ajo.2022.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2021] [Revised: 04/16/2022] [Accepted: 04/20/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the visual function before and after cataract surgery in children with congenital posterior lens opacities as well as the factors associated with a good visual outcome. DESIGN Perspective case-series study. METHODS Pediatric patients with posterior lens opacities who underwent cataract surgery were recruited in this study. The cataract type, location, area of opacities, and strabismus were examined perioperatively. Moreover, visual acuity, modulation transfer function (MTF), ocular aberrations, and stereopsis were measured before and after cataract surgery. RESULTS Sixty-nine eyes of 63 patients were studied. The mean age of patients at surgery was 6.5 ± 2.9 years. Visual function including corrected distance visual acuity (CDVA), MTF cutoff frequency, and ocular aberrations were significantly affected in eyes with posterior lens opacities. Postoperatively, CDVA was significantly improved from 0.81 ± 0.53 logMAR to 0.40 ± 0.40 logarithm of the minimum angle of resolution (logMAR) (P < .001). Thirty-nine patients (56.5%) achieved a final VA of 20/40 or better. Moreover, MTF cutoff values were significantly improved, and total ocular aberrations were decreased after cataract removal (both P < .001). The stereopsis was also improved postoperatively (P < .001). The multivariate analysis of the risk factors for postoperative CDVA showed that worse preoperative CDVA, larger size of lens opacities, and mean keratometry were the risk factors (all P < .05). CONCLUSIONS Visual function can be significantly decreased in children with posterior lens opacities, and surgery was effective in improving visual function. Patients with a CDVA of 0.52 logMAR or better, a size of lens opacity <6.5 mm2 and smaller mean keratometry had a greater CDVA postoperatively.
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Sand MK, Cholidis S, Kristianslund O, Drolsum L. Primary intraocular lens implantation in infants with unilateral congenital cataract operated before 12 weeks of age. Acta Ophthalmol 2022; 100:526-533. [PMID: 35411695 DOI: 10.1111/aos.15155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of this study was to report visual outcome and safety after cataract surgery with primary intraocular lens implantation before 12 weeks of age. METHODS Infants with visually significant unilateral congenital cataract having primary IOL implantation in the capsular bag before 12 weeks of age in 2007-2016 were enrolled for a prospective study examination in 2017. The medical records were also reviewed. RESULTS In total, 23 patients with a median age at cataract surgery of 32 days (range, 12-75 days) were included. Seventeen (74%) eyes had persistent foetal vasculature (PFV). After a median follow-up of 6.3 years (range, 1.4-10.9 years), the corrected distance visual acuity was 0.8 logMAR (range, 3.0-0.1 logMAR). All, except one eye, required surgery for visual axis opacification (VAO), with a median of two (range 0-5) additional surgical procedures. Four (17%) eyes developed secondary glaucoma. CONCLUSION Cataract surgery with primary IOL implantation before 12 weeks of age resulted in a high number of VAO operations, and the visual outcome varied considerably, showing the range in outcome for this challenging patient group. Co-existent PFV in these young patients was common. The incidence of secondary glaucoma was similar to other studies, despite the young age at surgery, high percentage of PFV and number of surgical procedures for VAO.
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Affiliation(s)
- Mari Kathrine Sand
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Symira Cholidis
- Department of Ophthalmology Oslo University Hospital Oslo Norway
| | - Olav Kristianslund
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
| | - Liv Drolsum
- Department of Ophthalmology Oslo University Hospital Oslo Norway
- Institute of Clinical Medicine University of Oslo Oslo Norway
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Incidence and risk factors of glaucoma after surgery for congenital cataract diagnosed under one year of age: Protocol for Korean Nationwide Epidemiological Study for Childhood Glaucoma (KoNEC). PLoS One 2022; 17:e0264020. [PMID: 35176075 PMCID: PMC8853525 DOI: 10.1371/journal.pone.0264020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 02/01/2022] [Indexed: 11/19/2022] Open
Abstract
Introduction Congenital cataract (CC) can cause childhood visual impairment, even after CC surgery, due to subsequent occurrence of glaucoma. The post-CC-surgery glaucoma study results vary, due largely to the lack of a sufficient number of population-based cohort studies. This study herein proposed aims to assess the incidence and risk factors of post-CC-surgery glaucoma in a nationwide cohort. The clinico-demographic factors associated with outcomes of post-CC-surgery glaucoma will be investigated as well. Materials and methods This population-based, nested case-control study is planned as part of the Korean Nationwide Epidemiological Study for Childhood Glaucoma (KoNEC). Data for a nationwide retrospective cohort representative of the years 2008 to 2018 will be extracted from the National Institutes of Health database, which includes demographic information, diagnoses and medical visits as well as procedures, records of prescriptions, and comorbidities. Among the patients whose first CC diagnosis was made before age 1, only those who underwent surgery for CC will be included in the study. The rate of occurrence of post-CC-surgery glaucoma will be determined based on a Poisson distribution. Also, for cumulative incidence plotting, the Kaplan-Meier method will be used. To identify risk factors for occurrence and poor outcomes of post-CC-surgery glaucoma, we will perform a multivariable regression analysis of matched samples. The detailed patterns of post-CC-surgery glaucoma management will be studied as well. OSF registration number DOI 10.17605/OSF.IO/AWTEC.
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Khokhar S, Surve A, Verma S, Azad S, Chandra P, Dhull C, Vohra R. Cataract in retinopathy of prematurity - A review. Indian J Ophthalmol 2022; 70:369-377. [PMID: 35086199 PMCID: PMC9023920 DOI: 10.4103/ijo.ijo_125_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Preterm babies with retinopathy of prematurity (ROP) can become blind if they do not receive appropriate timely intervention. The presence of cataract in these individuals in addition to visual deprivation amblyopia, also delays proper screening, adequate treatment, and makes follow-up assessment difficult. Anatomical differences in these infants and amblyopia management, especially in unilateral cataract, are other important concerns, and hence, management of these cases with cataract and ROP is challenging. In this review, studies where ROP cases were associated with cataract, were evaluated with a focus on preterm individuals less than 6 months age. Preterm babies are at increased risk of developing cataract because of systemic factors. In addition, those with ROP may have cataract associated with retinal detachment or treatment received. The type of cataract, risk factors, and pathophysiology associated with each cause varies. This review highlights these different aspects of cataract in ROP including causes, pathophysiology, types of cataracts, and management. The management of these cases is critical in terms of the timing of cataract surgery and the challenges associated with surgery and posterior segment management for ROP. Anatomical differences, preoperative retina status, pupillary dilatation, neovascularization of iris in aggressive posterior ROP, fundus examination, amblyopia, and follow-up are various important aspects in the management of the same. The preoperative workup, intraoperative challenges, postoperative care, and rehabilitation in these individuals are discussed.
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Affiliation(s)
- Sudarshan Khokhar
- Cataract and Refractive Service; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Abhidnya Surve
- Cataract and Refractive Service; Vitreoretinal, Uvea and ROP Service; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Saurabh Verma
- Cataract and Refractive Service; Vitreoretinal, Uvea and ROP Service; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Shorya Azad
- Vitreoretinal, Uvea and ROP Service; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Parijat Chandra
- Vitreoretinal, Uvea and ROP Service; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Chirakshi Dhull
- Cataract and Refractive Service; Vitreoretinal, Uvea and ROP Service; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - Rajpal Vohra
- Vitreoretinal, Uvea and ROP Service; Dr. Rajendra Prasad Center for Ophthalmic Sciences, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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14
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Bartlett S, Hassan A, Ibrahim N, Isiyaku S, Muhammad N, Ngom B, Nwosu C. OUP accepted manuscript. Int Health 2022; 14:i64-i67. [PMID: 35385869 PMCID: PMC8986353 DOI: 10.1093/inthealth/ihab079] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 09/30/2021] [Accepted: 11/09/2021] [Indexed: 11/18/2022] Open
Abstract
Cataract is a leading cause of blindness in children worldwide. Blindness can be treated with effective surgery, but in low-resource settings this treatment can be difficult to access. In addition, positive outcomes of the surgery are heavily dependent on comprehensive postoperative care. To date in Nigeria and many other low-resource countries, robust electronic data-management systems that help facility teams to manage their patient data, especially when it comes to tracking children for follow-up visits after surgery, have either yet to be put into place or are in place but have yet to be refined to respond to the specific needs of eye care programs. Sightsavers has worked with multiple state ministries in Nigeria to set up and test a system that responds to those needs.
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Affiliation(s)
| | - Amina Hassan
- National Eye Centre, Kaduna, Off Nnamdi Azikiwe By-Pass Mando, Kaduna 800266, Nigeria
| | | | - Sunday Isiyaku
- Sightsavers, No 1 Golf Course Road, Kaduna 800241, Nigeria
| | - Nasiru Muhammad
- Usmanu Danfodiyo University Teaching Hospital, Garba Nadama Road, Sokoto 840103, Nigeria
| | - Babacar Ngom
- Sightsavers, VDN Cit. Teylium lot Numero 36, Dakar 16810, Senegal
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15
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Davis TA, Edmunds M, Liao SM. Extinguishing the TORCH Differential: Evaluation of a Neonate with Blueberry Muffin Rash. Neoreviews 2021; 22:e540-e543. [PMID: 34341161 DOI: 10.1542/neo.22-8-e540] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Trevor A Davis
- Department of Pediatrics, St Louis Children's Hospital/Washington University School of Medicine
| | - Miranda Edmunds
- Department of Pediatrics, St Louis Children's Hospital/Washington University School of Medicine
| | - Steve M Liao
- Department of Pediatrics, St Louis Children's Hospital/Washington University School of Medicine
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16
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Barashkov NA, Konovalov FA, Borisova TV, Teryutin FM, Solovyev AV, Pshennikova VG, Sapojnikova NV, Vychuzhina LS, Romanov GP, Gotovtsev NN, Morozov IV, Bondar AA, Platonov FA, Burtseva TE, Khusnutdinova EK, Posukh OL, Fedorova SA. Autosomal recessive cataract (CTRCT18) in the Yakut population isolate of Eastern Siberia: a novel founder variant in the FYCO1 gene. Eur J Hum Genet 2021; 29:965-976. [PMID: 33767456 PMCID: PMC8187664 DOI: 10.1038/s41431-021-00833-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 12/19/2020] [Accepted: 02/10/2021] [Indexed: 11/09/2022] Open
Abstract
Congenital autosomal recessive cataract with unknown genetic etiology is one of the most common Mendelian diseases among the Turkic-speaking Yakut population (Eastern Siberia, Russia). To identify the genetic cause of congenital cataract spread in this population, we performed whole-exome sequencing (Illumina NextSeq 500) in one Yakut family with three affected siblings whose parents had preserved vision. We have revealed the novel homozygous c.1621C>T transition leading to premature stop codon p.(Gln541*) in exon 8 of the FYCO1 gene (NM_024513.4). Subsequent screening of c.1621C>T p.(Gln541*) revealed this variant in a homozygous state in 25 out of 29 Yakut families with congenital cataract (86%). Among 424 healthy individuals from seven populations of Eastern Siberia (Russians, Yakuts, Evenks, Evens, Dolgans, Chukchi, and Yukaghirs), the highest carrier frequency of c.1621C>T p.(Gln541*) was found in the Yakut population (7.9%). DNA samples of 25 homozygous for c.1621C>T p.(Gln541*) patients with congenital cataract and 114 unaffected unrelated individuals without this variant were used for a haplotype analysis based on the genotyping of six STR markers (D3S3512, D3S3685, D3S3582, D3S3561, D3S1289, and D3S3698). The structure of the identified haplotypes indicates a common origin for all of the studied mutant chromosomes bearing c.1621C>T p.(Gln541*). The age of the с.1621C>T p.(Gln541*) founder haplotype was estimated to be approximately 260 ± 65 years (10 generations). These findings characterize Eastern Siberia as the region of the world with the most extensive accumulation of the unique variant c.1621C>T p.(Gln541*) in the FYCO1 gene as a result of the founder effect.
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Affiliation(s)
- Nikolay A Barashkov
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation.
- Laboratory of Molecular Biology, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation.
| | | | - Tuyara V Borisova
- Laboratory of Molecular Biology, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Fedor M Teryutin
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
| | - Aisen V Solovyev
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
- Laboratory of Molecular Biology, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Vera G Pshennikova
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
| | - Nadejda V Sapojnikova
- Department of Ophthalmology, Republican Hospital #1 - National Centre of Medicine, Yakutsk, Russian Federation
| | - Lyubov S Vychuzhina
- Department of Ophthalmology, Republican Hospital #1 - National Centre of Medicine, Yakutsk, Russian Federation
| | - Georgii P Romanov
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
- Laboratory of Molecular Biology, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Nyurgun N Gotovtsev
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
| | - Igor V Morozov
- SB RAS Genomics Core Facility, Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
- Novosibirsk State University, Novosibirsk, Russian Federation
| | - Alexander A Bondar
- SB RAS Genomics Core Facility, Institute of Chemical Biology and Fundamental Medicine, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Fedor A Platonov
- Medical Institute, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
| | - Tatiana E Burtseva
- Medical Institute, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
- Laboratory of the Children Health Monitoring and Medical-environmental Research, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
| | - Elza K Khusnutdinova
- Laboratory of Molecular Biology, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
- Laboratory of Human Molecular Genetics, Institute of Biochemistry and Genetics, Ufa Federal Research Center of Russian Academy of Sciences, Ufa, Russian Federation
- Department of Genetics and Fundamental Medicine, Bashkir State University, Ufa, Russian Federation
| | - Olga L Posukh
- Novosibirsk State University, Novosibirsk, Russian Federation
- Federal Research Center Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Novosibirsk, Russian Federation
| | - Sardana A Fedorova
- Laboratory of Molecular Genetics, Yakut Science Centre of Complex Medical Problems, Yakutsk, Russian Federation
- Laboratory of Molecular Biology, M.K. Ammosov North-Eastern Federal University, Yakutsk, Russian Federation
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Singh VM, Badakere A, Patil-Chhablani P, Kekunnaya R. Profile of congenital cataract in the first year of life from a tertiary care center in South India - A modern series. Indian J Ophthalmol 2021; 69:932-936. [PMID: 33727462 PMCID: PMC8012959 DOI: 10.4103/ijo.ijo_1558_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Purpose: To report the etiology, clinical presentation, and morphology of congenital cataract in a tertiary care center. Methods: It is a prospective cohort study conducted at L V Prasad Eye Institute, Hyderabad. All children with congenital cataract ≤ 12 months of age that required surgical intervention between August 2015 and July 2016 were included in the study. 109 such patients were subjected to meticulous history taking, pedigree charting, ocular, and systemic examination, B-scan, TORCH testing, clinical photographs, pediatrician consult and blood tests, which included serum calcium, serum phosphorous and urine for reducing sugars. Results: The mean age of presentation was 4.1 months (±2.6 months) and both the genders were equally affected (P = 0.49). Eighty-five patients (77.9%) presented with bilateral cataracts while 24 patients had a unilateral presentation (22.1%). The common morphological presentation was either a total or a nuclear cataract, both variants noticed in 47 patients (43.1%). TORCH infections were responsible for a maximum (37 patients, 33.4%) number of cases followed by familial (20 patients, 18%) and developmental anomalies (11 patients, 10.1%) while the total number of idiopathic cases were 24% (27 patients). Eighteen patients (16.5%) had congenital heart defects and the majority (16 patients, 88.9%) of these had positive TORCH titres. Conclusion: Familial cataract and those possibly due to TORCH are still the predominant cause of congenital cataract in this series-highlighting the role of vaccination and preventive measures.
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Affiliation(s)
| | - Akshay Badakere
- Pediatric Ophthalmology and Strabismus Services, LVPEI, Hyderabad, India
| | | | - Ramesh Kekunnaya
- Pediatric Ophthalmology and Strabismus Services, LVPEI, Hyderabad, India
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18
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Taylan Şekeroğlu H, Utine GE. Congenital Cataract and Its Genetics: The Era of Next-Generation Sequencing. Turk J Ophthalmol 2021; 51:107-113. [PMID: 33951899 PMCID: PMC8109038 DOI: 10.4274/tjo.galenos.2020.08377] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Congenital cataract is a challenging ophthalmological disorder which can cause severe visual loss. It can be diagnosed at birth or during the first year of life. Early diagnosis and treatment are crucial for the visual prognosis. It can be associated with various ocular and systemic abnormalities. Determining whether congenital cataract is isolated or associated with other pathology is an indispensable step for the prediction of potential vision as well as early diagnosis and treatment of conditions that can cause morbidity or mortality. Many genes have been identified in the molecular etiology of congenital cataract. Most mutations have been reported in the crystallin genes. Determination of the genetic cause may not only enable individualized genetic counseling but also help to identify concomitant ocular and/or systemic disorders depending on the characteristics of the genetic test used. Recently, next-generation sequencing in particular has become an evolving technology for determining the molecular etiology of congenital cataract and furthering our knowledge of the disease.
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Affiliation(s)
| | - Gülen Eda Utine
- Hacettepe University Faculty of Medicine, Department of Pediatrics, Department of Pediatric Genetics, Ankara, Turkey
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20
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Pon JAMC, Bevin TH, Herbison P, Taylor BJ, Sanderson G. A novel instrument for assessing the retinal red reflex for non‐ophthalmic health professionals. Clin Exp Optom 2021; 88:160-4. [PMID: 15926879 DOI: 10.1111/j.1444-0938.2005.tb06689.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2004] [Revised: 03/08/2005] [Accepted: 04/13/2005] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The direct ophthalmoscope is the standard instrument for assessing retinal red reflexes when screening for cataract, however, it is expensive and often not available to non-ophthalmic health professionals. The pen torch ophthalmoscope is a new economic alternative for this purpose. This study aimed to determine its accuracy in assessing retinal red reflexes and to compare it to the direct ophthalmoscope. It is anticipated that this instrument will be useful in detecting both congenital and adult type cataracts. METHODS Eighteen health professionals evaluated the retinal red reflexes of 68 subjects at the Dunedin Hospital Eye Clinic with both the direct ophthalmoscope and the pen torch ophthalmoscope. Three groups of seven, six and five observers assessed both eyes of 24, 21 and 23 subjects, respectively, resulting in 1,574 examinations. RESULTS Compared to the direct ophthalmoscope, the pen torch ophthalmoscope exhibited lower sensitivity (68 per cent versus 75 per cent), but higher specificity (72 per cent versus 63 per cent) and lower over-referral (false positive) rates by nine per cent. The positive predictive value in respect to identifying for cataract was better for the pen torch ophthalmoscope (71 per cent) than for the direct ophthalmoscope (66 per cent), while the negative predictive value was slightly worse (70 per cent and 73 per cent, respectively). When compared to the direct ophthalmoscope, 15/18 observers felt the pen torch ophthalmoscope was accurate enough, one felt it was just as good and two did not respond. CONCLUSIONS This pilot study demonstrates that the pen torch ophthalmoscope is comparable to the direct ophthalmoscope in detecting abnormal retinal red reflexes in adults with cataracts. At six per cent of the cost of a direct ophthalmoscope, it may appeal to non-ophthalmic health professionals in developed and developing countries. It may also increase the frequency of screening for cataract in children and adults. Further development and study of this pen torch ophthalmoscope prototype is warranted.
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Affiliation(s)
- Jo-Anne M C Pon
- Ophthalmology Section, Medical and Surgical Sciences Department, University of Otago Dunedin School of Medicine, Dunedin, New Zealand
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21
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Lytvynchuk LM, Thiele MV, Schmidt W, Lorenz B. Precision of bag-in-the-lens intraocular lens power calculation in different age groups of pediatric cataract patients: Report of the Giessen Pediatric Cataract Study Group. J Cataract Refract Surg 2020; 45:1372-1379. [PMID: 31564311 DOI: 10.1016/j.jcrs.2019.05.032] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 05/23/2019] [Accepted: 05/26/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE To evaluate the precision of bag-in-the-lens intraocular lens (BIL IOL) power calculation in different age groups of pediatric cataract patients. SETTINGS Department of Ophthalmology, Justus-Liebig-University Giessen, University Hospital Giessen and Marburg GmbH, Campus Giessen, Giessen, Germany. DESIGN Retrospective nonrandomized consecutive case series. METHODS Pediatric patients diagnosed with cataract and operated with BIL IOL implantation were divided into 4 age groups: Group 1 (0 to 3 months), Group 2 (>3 months, <12 months), Group 3 (12 to 36 months), and Group 4 (>36 months to 17 years). BIL IOL power was calculated with the SRK/T formula. The prediction error (PE) was defined as the absolute difference between the preoperative selected target and postoperative achieved refraction. The impact of age at the time of surgery, axial length (AL), keratometry, and corneal astigmatism on PE was analyzed. RESULTS The study comprised 87 eyes of 56 pediatric patients. The mean and median PEs for the entire group were 1.79 diopters (D) and 1.23 D, respectively. The mean PE in each age group was: 3.43 D in Group 1, 2.14 D in Group 2, 1.60 D in Group 3, and 1.33 D in Group 4. The mean PE in eyes with ALs shorter than 20 mm was 2.67 D, and 1.44 D in eyes with an AL of 20 mm or longer. The mean PE in eyes with corneal radii less than 7.3 mm was 2.45 D, and 1.66 D in eyes with corneal radii of 7.3 mm or more. In the age and AL subgroups, the PE differences were statistically significant (P < .05). CONCLUSIONS The PE was larger in the youngest study group, and it decreased gradually with age and in eyes with ALs shorter than 20 mm. The PE has to be considered during BIL IOL power calculation in children.
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Affiliation(s)
- Lyubomyr M Lytvynchuk
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Maximilian V Thiele
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Werner Schmidt
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany
| | - Birgit Lorenz
- Department of Ophthalmology, Justus-Liebig-University Giessen, Eye Clinic, University Hospital Giessen and Marburg GmbH, Giessen, Germany.
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22
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Zeng LF, Tang ZD, Gu J, Wang CQ, Zhang HL. Incidence of congenital heart diseases in Chinese children with non-syndromic congenital blepharoptosis: a prospective observational study of 1053 patients. World J Pediatr 2020; 16:411-415. [PMID: 31267383 DOI: 10.1007/s12519-019-00282-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/18/2019] [Indexed: 10/26/2022]
Abstract
BACKGROUND Congenital blepharoptosis (CBP) may be part of a large spectrum of birth defects presenting with other ocular or systemic conditions. Therefore, the aim of the study was to investigate the incidence of congenital heart diseases (CHD) in CBP children not associated with specific syndromes. METHODS A total of 1053 Chinese children diagnosed with non-syndromic CBP were consecutively enrolled and their cardiac structure was evaluated by echocardiography. RESULTS Forty children were identified with CHD. Twenty-four children had one type of structural malformation (simple CHD). Sixteen children had two or more types of structural malformation (complex CHD). CHD and complex CHD were more prevalent in patients with severe or bilateral ptosis. Multivariate analysis revealed that presence of severe ptosis and bilateral ptosis was independently associated with CHD occurrence. CONCLUSIONS We found an increased frequency of CHD in CBP children, suggesting a clinical need for routine echocardiography evaluation in CBP, especially in children with severe or bilateral ptosis.
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Affiliation(s)
- Le-Feng Zeng
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Zheng-De Tang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Jun Gu
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Chang-Qian Wang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China
| | - Hui-Li Zhang
- Department of Cardiology, Shanghai Ninth People's Hospital, Shanghai Jiaotong University School of Medicine, 639 Zhizaoju Road, Shanghai, 200011, China.
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23
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Liu S, Hu C, Luo Y, Yao K. Genome-wide DNA methylation profiles may reveal new possible epigenetic pathogenesis of sporadic congenital cataract. Epigenomics 2020; 12:771-788. [PMID: 32516005 DOI: 10.2217/epi-2019-0254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Aim: To investigate the possible epigenetic pathogenesis of sporadic congenital cataract. Materials & methods: We conducted whole genome bisulfite sequencing on peripheral blood from sporadic binocular or monocular congenital cataract patients and cataract-free participants. Results: We found massive differentially methylated regions within the whole genomes between any two groups. Meanwhile, we identified five genes (ACTN4, ACTG1, TUBA1A, TUBA1C, TUBB4B) for the binocular and control groups and TUBA1A for the monocular and control groups as the core differentially methylated region-related genes. The proteins encoded by these core genes are involved in building cytoskeleton and intercellular junctions. Conclusion: Changes in the methylation levels of core genes may disturb the function of cytoskeleton and intercellular junctions, eventually leading to sporadic congenital cataract.
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Affiliation(s)
- Siyu Liu
- Eye Center of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310031, PR China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, Zhejiang Province 310031, PR China
| | - Chenyang Hu
- Eye Center of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310031, PR China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, Zhejiang Province 310031, PR China
| | - Yueqiu Luo
- Eye Center of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310031, PR China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, Zhejiang Province 310031, PR China
| | - Ke Yao
- Eye Center of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310031, PR China.,Zhejiang Provincial Key Lab of Ophthalmology, Hangzhou, Zhejiang Province 310031, PR China
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24
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Lin D, Chen J, Lin Z, Li X, Zhang K, Wu X, Liu Z, Huang J, Li J, Zhu Y, Chen C, Zhao L, Xiang Y, Guo C, Wang L, Liu Y, Chen W, Lin H. A practical model for the identification of congenital cataracts using machine learning. EBioMedicine 2020; 51:102621. [PMID: 31901869 PMCID: PMC6948173 DOI: 10.1016/j.ebiom.2019.102621] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 12/18/2019] [Accepted: 12/19/2019] [Indexed: 12/29/2022] Open
Abstract
Background Approximately 1 in 33 newborns is affected by congenital anomalies worldwide. We aimed to develop a practical model for identifying infants with a high risk of congenital cataracts (CCs), which is the leading cause of avoidable childhood blindness. Methods This case-control study was performed in the Zhongshan Ophthalmic Center and involved 2005 subjects, including 1274 children with CCs and 731 healthy controls. The CC identification models were established based on birth conditions, family medical history, and family environmental factors using the random forest (RF) and adaptive boosting methods (trained by 1129 CC cases and 609 healthy controls), which were tested by internal 4-fold cross-validation and external validation (145 CC cases and 122 healthy controls). The models were also tested using 4 datasets with gradually reduced proportions of CC patients (bilateral cases) to validate their performance in an approximate simulation of a clinical environment with a relatively low disease prevalence. Findings The CC identification models showed high discrimination in both the 4-fold cross validation (area under the curve (AUC)=0.91 [95% confidence interval: 0.88–0.94] in bilateral cases; 0.82 [0.77–0.89] in unilateral cases) and external validation (AUC=0.93±0.05 in bilateral cases; 0.86±0.01 in unilateral cases), and achieved stable performance in the clinical tests (AUC=0.94–0.96 in the four subgroups by RF). Furthermore, family history of CC, low parental education level, and comorbidity were identified as the top three most relevant factors to both bilateral and unilateral CC diagnosis. Interpretation Our CC identification models can accurately discriminate CC patients from healthy children and have the potential to serve as a complementary screening procedure, especially in undeveloped and remote areas.
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Affiliation(s)
- Duoru Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Xiaoyan Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Kai Zhang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China; School of Computer Science and Technology, Xidian University, Xi'an, Shanxi 710071, People's Republic of China
| | - Xiaohang Wu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Jialing Huang
- School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510060, People's Republic of China
| | - Jing Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Yi Zhu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China; Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Chuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China; Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Lanqin Zhao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Yifan Xiang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Chong Guo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Liming Wang
- School of Computer Science and Technology, Xidian University, Xi'an, Shanxi 710071, People's Republic of China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China.
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Jinsui Road #7, Guangzhou, Guangdong 510060, People's Republic of China.
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Li S, Zhang J, Cao Y, You Y, Zhao X. Novel mutations identified in Chinese families with autosomal dominant congenital cataracts by targeted next-generation sequencing. BMC MEDICAL GENETICS 2019; 20:196. [PMID: 31842807 PMCID: PMC6915918 DOI: 10.1186/s12881-019-0933-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 12/01/2019] [Indexed: 11/18/2022]
Abstract
Background Congenital cataract is a clinically and genetically heterogeneous visual impairment. The aim of this study was to identify causative mutations in five unrelated Chinese families diagnosed with congenital cataracts. Methods Detailed family history and clinical data were collected, and ophthalmological examinations were performed using slit-lamp photography. Genomic DNA was extracted from peripheral blood of all available members. Thirty-eight genes associated with cataract were captured and sequenced in 5 typical nonsyndromic congenital cataract probands by targeted next-generation sequencing (NGS), and the results were confirmed by Sanger sequencing. Bioinformatics analysis was performed to predict the functional effect of mutant genes. Results Results from the DNA sequencing revealed five potential causative mutations: c.154 T > C(p.F52 L) in GJA8 of Family 1, c.1152_1153insG(p.S385Efs*83) in GJA3 of Family 2, c.1804 G > C(p.G602R) in BFSP1 of Family 3, c.1532C > T(p.T511 M) in EPHA2 of Family 4 and c.356G > A(p.R119H) in HSF4 of Family 5. These mutations co-segregated with all affected individuals in the families and were not found in unaffected family members nor in 50 controls. Bioinformatics analysis from several prediction tools supported the possible pathogenicity of these mutations. Conclusions In this study, we identified five novel mutations (c.154 T > C in GJA8, c.1152_1153insG in GJA3, c.1804G > C in BFSP1, c.1532C > T in EPHA2, c.356G > A in HSF4) in five Chinese families with hereditary cataracts, respectively. NGS can be used as an effective tool for molecular diagnosis of genetically heterogeneous disorders such as congenital cataract, and the results can provide more effective clinical diagnosis and genetic counseling for the five families.
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Affiliation(s)
- Shan Li
- Department of Medical Genetics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences - School of Basic Medicine Peking Union Medical College, 5 Dong Dan San Tiao, Dongcheng District, Beijing, 100005, People's Republic of China
| | - Jianfei Zhang
- The No.4 hospital (eye hospital) of Zhangjiakou, Zhangjiakou, 075000, People's Republic of China
| | - Yixuan Cao
- Department of Medical Genetics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences - School of Basic Medicine Peking Union Medical College, 5 Dong Dan San Tiao, Dongcheng District, Beijing, 100005, People's Republic of China
| | - Yi You
- Department of Medical Genetics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences - School of Basic Medicine Peking Union Medical College, 5 Dong Dan San Tiao, Dongcheng District, Beijing, 100005, People's Republic of China
| | - Xiuli Zhao
- Department of Medical Genetics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences - School of Basic Medicine Peking Union Medical College, 5 Dong Dan San Tiao, Dongcheng District, Beijing, 100005, People's Republic of China.
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Shahid E, Shaikh A, Aziz S, Rehman A. Frequency of Ocular Diseases in Infants at a Tertiary Care Hospital. KOREAN JOURNAL OF OPHTHALMOLOGY 2019; 33:287-293. [PMID: 31179661 PMCID: PMC6557792 DOI: 10.3341/kjo.2017.0142] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 04/10/2018] [Accepted: 04/19/2018] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine the frequency of ocular diseases in infants visiting the ophthalmology department of a tertiary care hospital. Methods This was a cross-sectional descriptive study conducted in the department of ophthalmology, Abbasi Shaheed Hospital, from January 2015 to May 2016. The study included 377 infants ranging in age from 1 day to less than 1 year who were, selected by a nonprobability consecutive sampling technique. A detailed history was taken, and a complete ocular examination was performed. Descriptive statistics were used to calculate the mean and standard deviation for age. Frequencies were calculated for ocular diseases along with the percentages. Outcome variables included various congenital and acquired diseases such as conjunctivitis, congenital cataract, glaucoma, nasolacrimal duct blockage, squint, trauma, and fundus abnormalities. Results The mean age of infants was 5.0 ± 3.7 months. There were 196 (52%) males and 181 (48%) females. The sample included 330 (87.5%) full term infants. Acquired ocular diseases occurred in 230 (61%) infants; and congenital diseases, in 147 (39%). The most common ocular disease was conjunctivitis, which occurred in 173 (46%) infants, followed by congenital blocked nasolacrimal duct, which occurred in 57 (15 %) infants. Conjunctivitis was more common among neonates than infants. Conclusions Acquired ocular diseases were more common than congenital ocular diseases. The most common ocular pathology was conjunctivitis, followed by congenital nasolacrimal duct obstruction, in infants. Conjunctivitis was more common in neonates than infants.
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Affiliation(s)
- Erum Shahid
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan.
| | - Arshad Shaikh
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
| | - Sina Aziz
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
| | - Atya Rehman
- Department of Ophthalmology, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Karachi, Pakistan
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Wernecke L, Keckeis S, Reichhart N, Strauß O, Salchow DJ. Epithelial-Mesenchymal Transdifferentiation in Pediatric Lens Epithelial Cells. Invest Ophthalmol Vis Sci 2019; 59:5785-5794. [PMID: 30521667 DOI: 10.1167/iovs.18-23789] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Posterior capsule opacification (PCO) is a complication after cataract surgery, particularly in children. Epithelial-mesenchymal transition (EMT) of lens epithelial cells, mediated by transforming growth factor beta (TGFβ), contributes to PCO. However, its pathogenesis in children is poorly understood. We correlated cell growth in culture with patient characteristics, studied gene expression of pediatric lens epithelial cells (pLEC), and examined the effects of TGFβ-2 on these cells in vitro. Methods Clinical characteristics of children with cataracts correlated with growth behavior of pLEC in vitro. mRNA expression of epithelial (αB-crystallin, connexin-43) and mesenchymal (αV-integrin, α-smooth muscle actin, collagen-Iα2, fibronectin-1) markers was quantified in pLEC and in cell line HLE-B3 in the presence and absence of TGFβ-2. Results Fifty-four anterior lens capsules from 40 children aged 1 to 180 months were obtained. Cell outgrowth occurred in 44% of the capsules from patients ≤ 12 months and in 33% of capsules from children aged 13 to 60 months, but in only 6% of capsules from children over 60 months. TGFβ-2 significantly upregulated expression of αB-crystallin (HLE-B3), αV-integrin (HLE-B3), collagen-Iα2, and fibronectin-1 (in pLEC and HLE-B3 cells). Conclusions Patient characteristics correlated with growth behavior of pLEC in vitro, paralleling a higher clinical incidence of PCO in younger children. Gene expression profiles of pLEC and HLE-B3 suggest that upregulation of αV-integrin, collagen-Iα2, and fibronectin-1 are involved in EMT.
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Affiliation(s)
- Laura Wernecke
- Experimental Ophthalmology, Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Susanne Keckeis
- Experimental Ophthalmology, Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Nadine Reichhart
- Experimental Ophthalmology, Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Olaf Strauß
- Experimental Ophthalmology, Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Daniel J Salchow
- Department of Ophthalmology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
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Seven E, Tekin S, Batur M, Artuç T, Yaşar T. Evaluation of changes in axial length after congenital cataract surgery. J Cataract Refract Surg 2019; 45:470-474. [PMID: 30661967 DOI: 10.1016/j.jcrs.2018.11.012] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 08/14/2018] [Accepted: 11/18/2018] [Indexed: 12/30/2022]
Abstract
PURPOSE To investigate the relationship between lens status and axial length (AL) in patients operated for unilateral and bilateral congenital cataract. SETTING Yüzüncü Yıl University, Ophthalmology Clinic, Van, Turkey. DESIGN Retrospective study. METHODS Records of patients who underwent surgery for unilateral or bilateral congenital cataract were analyzed. The patients were separated into three groups: bilateral aphakic, bilateral pseudophakic, and unilateral. The unilateral group was subdivided into the operated cataract eyes (unilateral aphakic and unilateral pseudophakic) and unoperated fellow phakic eyes. The patients' age at surgery, follow-up time, preoperative and postoperative AL measurements, change in AL, and monthly growth rate were evaluated. RESULTS The bilateral aphakic group included 40 eyes of 20 patients, the bilateral pseudophakic group included 103 eyes of 54 patients, and the unilateral group included 40 eyes of 20 patients. The mean age at time of surgery in these groups was 8.17 months ± 10.65 (SD), 42.47 ± 43.81 months, and 42.47 ± 43.81 months, respectively. There were no significant differences in preoperative AL, postoperative AL, change in AL, or monthly growth rate between the aphakic and fellow phakic eyes in the unilateral group (P > .05). There were also no significant differences between unilateral pseudophakic eyes and fellow phakic eyes in the unilateral group with respect to preoperative AL or change in AL, but there were significant differences in final AL and monthly growth rate (P < .05). CONCLUSIONS Various factors can affect axial elongation. The monthly growth rate was lower in pseudophakic eyes compared with phakic eyes. Experimental studies are required to understand the mechanism underlying this effect.
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Affiliation(s)
- Erbil Seven
- Department of Ophthalmology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey.
| | - Serek Tekin
- Department of Ophthalmology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey
| | - Muhammed Batur
- Department of Ophthalmology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey
| | - Tuncay Artuç
- Department of Ophthalmology, Faculty of Medicine, Yüzüncü Yıl University, Van, Turkey
| | - Tekin Yaşar
- Department of Ophthalmology, Beyoglu Eye and Research Hospital, Istanbul, Turkey
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Matalia J, Panmand P, Ghalla P. Comparative analysis of non-absorbable 10-0 nylon sutures with absorbable 10-0 Vicryl sutures in pediatric cataract surgery. Indian J Ophthalmol 2018; 66:661-664. [PMID: 29676310 PMCID: PMC5939158 DOI: 10.4103/ijo.ijo_654_17] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose: The purpose of the study is to compare the efficiency as well as the rate and type of suture-related complications between 10-0 monofilament nylon (Aurolab Nylon Sutures, double arm, Aurolab) and 10-0 polyglactin 910 sutures (Vicryl, single arm, Aurolab) for pediatric cataract surgery. Methods: It is a prospective, comparative study performed in children who underwent surgery for congenital or developmental cataract from March 2013 to February 2016. Patients underwent suturing with either nylon or Vicryl in unilateral cases, but in most bilateral surgeries, one eye received Vicryl sutures while the other eye received nylon. The sutures were compared for their complications and the need for suture removal. Results: Forty-one children (72 eyes) were included in the study, of which 31 children (62 eyes) underwent bilateral surgery while 10 (10 eyes) underwent unilateral surgery. Sixty-four nylon sutures were placed in 32 children (34 eyes), of which 22 (34.4%) were removed due to suture-related complications, whereas 14 (19.7%) (P = 0.03) of the 71 Vicryl sutures placed in 32 children (38 eyes) needed suture removal at an average of 2.9 weeks with the earliest at 6 days postoperatively. The odds of Vicryl suture being removed was 0.42 times with respect to nylon. The most common reason encountered for suture removal in both the materials was sutures becoming loose (16.3%), followed by vascularization (14.1%), infiltration (1.5%), and opacification (4.4%). Conclusion: Absorbable suture such as 10-0 Vicryl is preferred over nonabsorbable suture 10-0 nylon for suturing incisions in pediatric cataract surgery, to avoid subjecting the child to repeated anesthesia.
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Affiliation(s)
- Jyoti Matalia
- Department of Paediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Pratibha Panmand
- Department of Paediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Pooja Ghalla
- Department of Paediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
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Affiliation(s)
- Arlene V. Drack
- Department of Ophthalmology, Emory Eye Center, Atlanta, Georgia
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31
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Seaber JH, Buckley EG. Functional Outcome of Monocular and Binocular Congenital Cataract Part I: Visual Acuity. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/0065955x.1997.11982110] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Cicik ME, Doğan C, Bölükbaşı S, Cinhüseyinoğlu MN, Arslan OŞ. Comparison of Two Intraocular Lens Implantation Techniques in Pediatric Cataract Surgery in Terms of Postoperative Complications. Balkan Med J 2018; 35:186-190. [PMID: 29553467 PMCID: PMC5863258 DOI: 10.4274/balkanmedj.2017.1504] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background: Pediatric cataract surgery differs substantially from adult cataract surgery. Numerous studies have focused on reducing the development of postoperative complications. Aims: To compare two intraocular lens implantation techniques used in pediatric cataract surgery in terms of postoperative complications. Study Design: Case-control study. Methods: Patients who underwent pediatric cataract surgery and intraocular lens implantation between 2008 and 2016 were evaluated in this retrospective study. Patients aged 3-15 years with unilateral or bilateral cataract and without corneal pathology were included in the study. The patients were categorized into the following two groups: those who underwent posterior capsulorhexis and anterior vitrectomy using in-the-bag intraocular lens implantation (group 1) and those who underwent posterior capsulorhexis and intraocular lens implantation with the optic fixed behind the posterior capsulorhexis (group 2). Rates of postoperative visual axis opacification and complications (glaucoma, posterior synechiae, uveitic reaction, and intraocular lens decentration) were evaluated in these groups. The implanted intraocular lenses were either monoblock (AcrySof SN60AT intraocular lens), triple-piece (AcrySof MA60BM intraocular lens) foldable hydrophobic acrylic lenses, or multifocal lenses (AcrySof IQ ReSTOR). Results: This retrospective study included 52 eyes of 37 patients. Group 1 comprised 26 eyes of 20 patients and group 2 comprised 26 eyes of 17 patients. During the follow-up, visual axis opacification was observed in two patients in group 1 but no patients in group 2. Regarding postoperative complications, there was no uveitic reaction, posterior synechiae, or intraocular lens decentration in either group. There was no significant difference between the groups in terms of the postoperative complications (p>0.05). Conclusion: There was no significant difference between in-the-bag intraocular lens implantation after posterior capsulorhexis and intraocular lens optic capture through posterior capsulorhexis in terms of the complications.
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Affiliation(s)
- Mustafa Erdoğan Cicik
- Department of Ophthalmology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Cezmi Doğan
- Department of Ophthalmology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey
| | - Selim Bölükbaşı
- Clinic of Ophthalmology, İstanbul Okmeydanı Training and Research Hospital, İstanbul, Turkey
| | | | - Osman Şevki Arslan
- Department of Ophthalmology, İstanbul University, Cerrahpaşa School of Medicine, İstanbul, Turkey
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Ching YH, Yeh JI, Fan WL, Chen KC, Yeh MC, Woon PY, Lee YC. A CRYBB2 mutation in a Taiwanese family with autosomal dominant cataract. J Formos Med Assoc 2018; 118:57-63. [PMID: 29395391 DOI: 10.1016/j.jfma.2018.01.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2017] [Revised: 12/24/2017] [Accepted: 01/05/2018] [Indexed: 10/18/2022] Open
Abstract
BACKGROUND/PURPOSE To identify the underlying genetic cause of a Taiwanese family with autosomal dominant cerulean cataract. METHODS A three-generation cerulean cataract family with 13 affected and 13 normal was identified. Whole exome sequencing, whole genome single nucleotide polymorphism genotyping and haplotype analysis, and fine mapping using polymorphic short tandem repeat markers were used to identify the causative gene mutation. RESULTS Whole genome single nucleotide polymorphism genotyping and haplotype analysis mapped the candidate disease loci to chromosome 18 and chromosome 22. Polymorphic short tandem repeat markers further narrowed down the disease interval to chromosome 22 between markers D22S1174 and D22S1163. Whole exome sequencing was performed on selected individuals. Polymorphisms detected were filtered based on their genomic positions, allele frequency (<1%), and segregation within the pedigree. Affected individuals were found to be heterozygous carrying a C to T mutation on exon 6 of the CRYBB2 gene (with SNP ID: rs74315489). The mutation was predicted to produce a premature stop mutation Q155X. The mutation is co-segregation across the pedigree and the disease "T" allele was not detected in healthy members of the family and in additional 50 normal controls (100 chromosomes). Phylogenic protein alignment was also performed for the CRYBB2 gene across 68 species ranging from fishes, Sauropsida, Placentalia, carnivores, rodents, and primates with total 56 orthologous genes. The Q155 residue is 100% conserved across the evolutionary tree, indicating its crucial function. CONCLUSION Here we identify the first Taiwanese cerulean cataract family carrying a CRYBB2_Q155X mutation.
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Affiliation(s)
- Yung-Hao Ching
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan
| | - Jih-I Yeh
- Department of Family Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Wen-Lang Fan
- Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Ko-Chen Chen
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Man-Chieh Yeh
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Peng Yeong Woon
- Department of Molecular Biology and Human Genetics, Tzu Chi University, Hualien, Taiwan
| | - Yuan-Chieh Lee
- Department of Ophthalmology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan; Department of Ophthalmology and Visual Science, Tzu Chi University, Hualien, Taiwan.
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Matalia J, Shirke S, Shetty KB, Matalia H. Surgical Outcome of Congenital Cataract in Eyes With Microcornea. J Pediatr Ophthalmol Strabismus 2018; 55:30-36. [PMID: 28991349 DOI: 10.3928/01913913-20170703-13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2017] [Accepted: 05/26/2017] [Indexed: 11/20/2022]
Abstract
PURPOSE To report the intraoperative and postoperative outcomes of congenital cataract surgery in eyes with microcornea. METHODS In this retrospective, interventional, comparative case series, the authors reviewed 47 eyes of 26 children with microcornea and congenital cataract (21 bilateral and 5 unilateral) who underwent lens aspiration with primary posterior capsulectomy and anterior vitrectomy between 2008 and 2014 with a minimum follow-up period of 6 months. Demographic profiles and systemic and ocular features were documented. Intraoperative and postoperative complications were studied separately for bilateral and unilateral cases. Patients were also divided into two groups on the basis of their ages at surgery (early surgery group: 3 months or younger; late surgery group: older than 3 months) and postoperative complications were compared. Visual outcome was analyzed in those with a follow-up period of more than 1 year. RESULTS Early surgery was performed in 24 eyes of 13 patients (11 bilateral and 2 unilateral) and late surgery in 23 eyes of 13 patients (10 bilateral and 3 unilateral). Intraoperatively, all eyes had poor pupillary dilatation and 6 (12.8%) eyes needed iris hooks. Postoperatively, the most common early complication was transient corneal edema observed in 22 (46.8%) eyes (13 and 8 eyes in the early and late surgery groups, respectively). Late complications included visual axis opacification in 6 (12.76%) eyes (3 in each group), and secondary glaucoma in 5 (10.64%) eyes (2 and 3 eyes in the early and late surgery groups, respectively). Vision was normal for age in 18 (60%) of the bilateral cases with a follow-up period of more than 1 year. CONCLUSIONS Early surgical intervention for congenital cataract in eyes with microcornea can result in favorable outcomes with an acceptable rate of postoperative complications. [J Pediatr Ophthalmol Strabismus. 2018;55(1):30-36.].
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Townsend WM. Disease and Surgery of the Equine Lens. Vet Clin North Am Equine Pract 2017; 33:483-497. [PMID: 29103558 DOI: 10.1016/j.cveq.2017.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Examination of the lens is critical, particularly when evaluating horses with visual impairment or performing prepurchase examinations. To adequately evaluate the lens, the pupil must be pharmacologically dilated. A cataract is any lens opacity. The size, density, and position of a cataract determine the impact on vision. Cataracts may be congenital or inherited or occur secondary to trauma or equine recurrent uveitis. Surgical removal is the only treatment option for vision impairing cataracts, but careful selection of surgical candidates is critical for successful outcomes.
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Affiliation(s)
- Wendy M Townsend
- Department of Veterinary Clinical Sciences, Purdue University, 625 Harrison Street, West Lafayette, IN 47907-2026, USA.
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Long E, Lin Z, Chen J, Liu Z, Cao Q, Lin H, Chen W, Liu Y. Monitoring and Morphologic Classification of Pediatric Cataract Using Slit-Lamp-Adapted Photography. Transl Vis Sci Technol 2017; 6:2. [PMID: 29134133 PMCID: PMC5678553 DOI: 10.1167/tvst.6.6.2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/30/2017] [Indexed: 12/02/2022] Open
Abstract
Purpose To investigate the feasibility of pediatric cataract monitoring and morphologic classification using slit lamp–adapted anterior segmental photography in a large cohort that included uncooperative children. Methods Patients registered in the Childhood Cataract Program of the Chinese Ministry of Health were prospectively selected. Eligible patients underwent slit-lamp adapted anterior segmental photography to record and monitor the morphology of their cataractous lenses. A set of assistance techniques for slit lamp–adapted photography was developed to instruct the parents of uncooperative children how to help maintain the child's head position and keep the eyes open after sleep aid administration. Results Briefly, slit lamp–adapted photography was completed for all 438 children, including 260 (59.4%) uncooperative children with our assistance techniques. All 746 images of 438 patients successfully confirmed the diagnoses and classifications. Considering the lesion location, pediatric cataract morphologies could be objectively classified into the seven following types: total; nuclear; polar, including two subtypes (anterior and posterior); lamellar; nuclear combined with cortical, including three subtypes (coral-like, dust-like, and blue-dot); cortical; and Y suture. The top three types of unilateral cataracts were polar (55, 42.3%), total (42, 32.3%), and nuclear (23, 17.7%); and the top three types of bilateral cataracts were nuclear (110, 35.8%), total (102, 33.2%), and lamellar (34, 11.1%). Conclusions Slit lamp–adapted anterior segmental photography is applicable for monitoring and classifying the morphologies of pediatric cataracts and is even safe and feasible for uncooperative children with assistance techniques and sleep aid administration. Translational Relevance This study proposes a novel strategy for the preoperative evaluation and evidence-based management of pediatric ophthalmology (Clinical Trials.gov, NCT02748031).
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Affiliation(s)
- Erping Long
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Zhuoling Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Jingjing Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Zhenzhen Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Qianzhong Cao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Haotian Lin
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Weirong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
| | - Yizhi Liu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, 510060, China
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Segregation of a novel p.(Ser270Tyr) MAF mutation and p.(Tyr56∗) CRYGD variant in a family with dominantly inherited congenital cataracts. Mol Biol Rep 2017; 44:435-440. [DOI: 10.1007/s11033-017-4121-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 08/19/2017] [Indexed: 12/17/2022]
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Characterization of a variant of gap junction protein α8 identified in a family with hereditary cataract. PLoS One 2017; 12:e0183438. [PMID: 28827829 PMCID: PMC5565107 DOI: 10.1371/journal.pone.0183438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 08/03/2017] [Indexed: 11/25/2022] Open
Abstract
Purpose Congenital cataracts occur in isolation in about 70% of cases or are associated with other abnormalities such as anterior segment dysgenesis and microphthalmia. We identified a three-generation family in the University of California San Francisco glaucoma clinic comprising three individuals with congenital cataracts and aphakic glaucoma, one of whom also had microphthalmia. The purpose of this study was to identify a possible causative mutation in this family and to investigate its pathogenesis. Methods We performed exome sequencing and identified a putative mutation in gap junction protein α8 (GJA8). We used PCR and DNA sequencing of GJA8 in affected and unaffected members of the pedigree to test segregation of the variant with the phenotype. We tested cellular distribution and function of the variant protein by immunofluorescence and intercellular transfer of Neurobiotin in transiently transfected HeLa cells. Results Exome sequencing revealed a variant in GJA8 (c.658A>G) encoding connexin50 (Cx50) that resulted in a missense change (p.N220D) in transmembrane domain 4. The variant was present in all three affected family members, but was also present in the proband's grandfather who was reported to be unaffected. The mutant protein localized to the plasma membrane and supported intercellular Neurobiotin transfer in HeLa cells. Conclusions We identified a variant in transmembrane domain 4 of Cx50 in a family with autosomal dominant congenital cataracts. This variant has been previously identified in other cataract cohorts, but it is also present in unaffected individuals. Our study demonstrates that the mutant protein localized to the plasma membrane and formed functional intercellular channels. These data suggest that GJA8 c.658A>G is most likely a benign rare variant.
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Khatib N, Tsumi E, Baidousi A, Nussinovitch H, Bilenko N, Lifshitz T, Levy J. Infantile cataract: comparison of two surgical approaches. Can J Ophthalmol 2017; 52:527-532. [PMID: 28985816 DOI: 10.1016/j.jcjo.2017.02.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/18/2017] [Accepted: 02/24/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To compare the results of 2 cataract extraction techniques with primary intraocular lens (IOL) implantation in children. DESIGN Retrospective comparative case series study. METHODS This study included children with congenital or developmental cataract. In all cases, anterior capsulorhexis, lens aspiration, posterior continuous curvilinear capsulorhexis, and primary IOL implantation were performed. We compared 2 surgical approaches. In the first approach, after IOL implantation in the bag, posterior optic capture (OC) was performed without anterior vitrectomy (OC technique); in the second approach, anterior vitrectomy was performed without OC of the IOL (AV technique). Patient demographic data as well as ethnic origin, child's age at cataract diagnosis, child's age at surgery, axial length, IOL power in diopters, visual acuity, visual axis opacification, and complications were assessed. RESULTS One hundred twenty-three eyes were included for surgical approach outcomes comparison; 21 eyes underwent the OC surgical approach and 102 the AV surgical approach. The mean patient age at surgery was 57.3 ± 47.1 months. The mean follow-up was 63.13 months (range 12-202 months). Epithelial lens reproliferation was the major adverse event in our series, affecting 21.1% of patients' eyes; the mean time to epithelial lens reproliferation development was 90 ± 9.70 months. There was no statistically significant difference between the two groups in best spectacle-corrected visual acuity or epithelial lens reproliferation incidence. CONCLUSIONS In our case series we did not find any difference between surgical techniques.
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Affiliation(s)
- Nur Khatib
- Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
| | - Erez Tsumi
- Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Amjad Baidousi
- Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hanan Nussinovitch
- Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Natalya Bilenko
- Public Health Department, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Tova Lifshitz
- Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Jaime Levy
- Department of Ophthalmology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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Visual outcomes of dense pediatric cataract surgery in eastern China. PLoS One 2017; 12:e0180166. [PMID: 28671961 PMCID: PMC5495382 DOI: 10.1371/journal.pone.0180166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2016] [Accepted: 06/10/2017] [Indexed: 11/19/2022] Open
Abstract
Purpose To evaluate the visual outcomes of dense pediatric cataract surgery in eastern China. Methods Medical records of children who underwent surgery for dense unilateral or bilateral pediatric cataract in Shandong Provincial Hospital between January 2007 and December 2012 were collected. Patients who cooperated with optical correction and aggressive patching of the sound eye and who had a minimum postoperative follow-up of more than 2 years were included. Risk factors for poor visual outcomes were analyzed. Results Of the 105 eligible patients (181 eyes), 76 had bilateral cataract, and 29 unilateral. With a mean follow up of 46.77 mo (range 24.0~96.0 mo), the final best corrected visual acuity (BCVA) of 158 eyes were recorded, and 4.43% (7/158) achieved 0.1 logarithm of the minimum angle of resolution (logMAR) or better; 15.19% (24/158) obtained a BCVA between 0.1 logMAR and 0.3 logMAR; 18.99%, (30/158) between 0.3 logMAR and 0.5 logMAR; 46.84% (74/158), between 0.5 logMAR and 1 logMAR; 14.55%, worse than 1 logMAR. The mean BCVA of the patients who underwent lensectomy before 3 months of age was significantly better than that of patients who underwent lensectomy between 3 and 12 months (p = 0.001). In the same lensectomy age groups, the final BCVA of the children in the bilateral and unilateral groups did not differ significantly (P>0.05). Lensectomy after 3 months of age, postoperative complications, strabismus and nystagmus were shown to be risk factors for poor visual outcomes. Conclusions Lensectomy before 3 months of age, IOL implantation, proper managing of postoperative complications, early optical correction and aggressive postoperative patching of the sound eye would increase the final BCVA for patients with dense pediatric cataract.
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Zhu X, Du Y, He W, Sun T, Zhang Y, Chang R, Zhang K, Lu Y. Clinical Features of Congenital and Developmental Cataract in East China: A Five-year Retrospective Review. Sci Rep 2017; 7:4254. [PMID: 28652574 PMCID: PMC5484708 DOI: 10.1038/s41598-017-04332-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Accepted: 05/12/2017] [Indexed: 12/19/2022] Open
Abstract
Congenital/developmental cataract is a significant cause of blindness in children worldwide. Full knowledge of clinical features is essential for early diagnosis and proper treatment to prevent irreversible visual impairment. We conducted a retrospective chart review on 520 congenital/developmental cataract cases based on a five-year clinical data from Eye and ENT Hospital of Fudan University, Shanghai, China. Clinical features including age at the surgery, chief complaints, interval between initial identification of cataract-related manifestations and surgery, etc. were summarized. 56.3% of children were bilateral. The age at surgery ranged from 0.25 to 17.4 years, only 9.2% receiving surgery below 1 year. Interval between initial identification of manifestations and surgery ranged from 2 days to 17 years. Concomitant congenital abnormalities were present in 67 patients, with persistent hyperplastic primary vitreous and congenital heart disease as the most frequent ocular and systemic disorders. Strabismus and nystagmus were seen in 20.6% and 11.9% of patients. In bilateral cataract patients with strabismus, axial lengths of esotropia-affected eyes were statistically shorter than exotropia-affected eyes. These findings provide information on characteristics of congenital/developmental cataract in China and may assist in achievement of comprehensive treating strategies in these cases.
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Affiliation(s)
- Xiangjia Zhu
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China.,Eye Institute of Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yu Du
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China.,Eye Institute of Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Wenwen He
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China.,Eye Institute of Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Ting Sun
- Department of Biostatistics, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, 130 Dong'an Road, 200032, Shanghai, China
| | - Yinglei Zhang
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China.,Eye Institute of Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Ruiqi Chang
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China.,Eye Institute of Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Keke Zhang
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China.,Eye Institute of Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China.,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai, 200031, China
| | - Yi Lu
- Department of Ophthalmology, Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,Key Laboratory of Myopia, Ministry of Health, 83 Fenyang Road, Shanghai, 200031, China. .,Eye Institute of Eye and Ear, Nose, and Throat Hospital of Fudan University, 83 Fenyang Road, Shanghai, 200031, China. .,Key Laboratory of Visual Impairment and Restoration of Shanghai, Fudan University, 83 Fenyang Road, Shanghai, 200031, China.
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Chen J, Wang Q, Cabrera PE, Zhong Z, Sun W, Jiao X, Chen Y, Govindarajan G, Naeem MA, Khan SN, Ali MH, Assir MZ, Rahman FU, Qazi ZA, Riazuddin S, Akram J, Riazuddin SA, Hejtmancik JF. Molecular Genetic Analysis of Pakistani Families With Autosomal Recessive Congenital Cataracts by Homozygosity Screening. Invest Ophthalmol Vis Sci 2017; 58:2207-2217. [PMID: 28418495 PMCID: PMC5397132 DOI: 10.1167/iovs.17-21469] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To identify the genetic origins of autosomal recessive congenital cataracts (arCC) in the Pakistani population. Methods Based on the hypothesis that most arCC patients in consanguineous families in the Punjab areas of Pakistan should be homozygous for causative mutations, affected individuals were screened for homozygosity of nearby highly informative microsatellite markers and then screened for pathogenic mutations by DNA sequencing. A total of 83 unmapped consanguineous families were screened for mutations in 33 known candidate genes. Results Patients in 32 arCC families were homozygous for markers near at least 1 of the 33 known CC genes. Sequencing the included genes revealed homozygous cosegregating sequence changes in 10 families, 2 of which had the same variation. These included five missense, one nonsense, two frame shift, and one splice site mutations, eight of which were novel, in EPHA2, FOXE3, FYCO1, TDRD7, MIP, GALK1, and CRYBA4. Conclusions The above results confirm the usefulness of homozygosity mapping for identifying genetic defects underlying autosomal recessive disorders in consanguineous families. In our ongoing study of arCC in Pakistan, including 83 arCC families that underwent homozygosity mapping, 3 mapped using genome-wide linkage analysis in unpublished data, and 30 previously reported families, mutations were detected in approximately 37.1% (43/116) of all families studied, suggesting that additional genes might be responsible in the remaining families. The most commonly mutated gene was FYCO1 (14%), followed by CRYBB3 (5.2%), GALK1 (3.5%), and EPHA2 (2.6%). This provides the first comprehensive description of the genetic architecture of arCC in the Pakistani population.
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Affiliation(s)
- Jianjun Chen
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States 2Department of Ophthalmology, Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China
| | - Qiwei Wang
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States 3State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Patricia E Cabrera
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Zilin Zhong
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States 2Department of Ophthalmology, Shanghai Tenth People's Hospital, and Tongji Eye Institute, Tongji University School of Medicine, Shanghai, China
| | - Wenmin Sun
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States 3State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiaodong Jiao
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Yabin Chen
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Gowthaman Govindarajan
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
| | - Muhammad Asif Naeem
- National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | - Shaheen N Khan
- National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan
| | | | | | - Fawad Ur Rahman
- Layton Rahmatulla Benevolent Trust Hospital, Lahore, Pakistan
| | | | - Sheikh Riazuddin
- National Centre of Excellence in Molecular Biology, University of the Punjab, Lahore, Pakistan 5Allama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan 7National Centre for Genetic Diseases, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Javed Akram
- Allama Iqbal Medical College, University of Health Sciences, Lahore, Pakistan 7National Centre for Genetic Diseases, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - S Amer Riazuddin
- The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States 9McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - J Fielding Hejtmancik
- Ophthalmic Genetics and Visual Function Branch, National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
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Tsai TH, Tsai CY, Huang JY, Hu FR. Outcomes of pediatric cataract surgery with triamcinolone-assisted vitrectomy. J Formos Med Assoc 2017; 116:940-945. [PMID: 28254265 DOI: 10.1016/j.jfma.2017.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 01/12/2017] [Accepted: 01/17/2017] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND/PURPOSE To evaluate outcomes in pediatric patients undergoing lensectomy, posterior capsulotomy, and triamcinolone-assisted vitrectomy for congenital cataract. METHODS This retrospective study included 34 patients younger than 72 months who underwent lensectomy, posterior capsulotomy, and triamcinolone-assisted vitrectomy with or without intraocular lens (IOL) implantation for cataract at the National Taiwan University Hospital from July 2006 to December 2012. RESULTS Fifty-one eyes from 34 patients with cataract (unilateral in 17 patients, bilateral in 17 patients) were included. The mean age at surgery was 26.74 months (range: 2-72 months). The mean postoperative follow-up was 27.8 months (range: 6-72 months). Primary IOL implantation was performed in 25 eyes, 21 of which had the IOL implanted in the capsular bag. Fifty eyes had a central round pupil. The median logarithm of the minimum angle of resolution visual acuity was 0.3 in patients with unilateral cataract and 0.1 in those with bilateral cataract. Three eyes (5.9%) developed visual axis opacification (VAO) and required further surgery. Univariate analysis using Fisher's exact test indicated that surgery in the first 12 months of life was significantly associated with development of VAO (p=0.047). The incidence of postoperative VAO was approximately 15.8% in this age group. CONCLUSION Triamcinolone-assisted vitrectomy can be used in pediatric cataract surgery without serious long-term adverse effects. While the incidence of VAO is low, it appears unavoidable in approximately one-sixth of patients who undergo surgery before 12 months of age.
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Affiliation(s)
- Tzu-Hsun Tsai
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, Republic of China
| | - Chia-Ying Tsai
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China
| | - Jehn-Yu Huang
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China
| | - Fung-Rong Hu
- Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Department of Ophthalmology, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China.
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Vasavada AR, Vasavada V. Current Status of IOL implantation in pediatric eyes: an update. Expert Rev Med Devices 2017; 14:1-9. [PMID: 28042714 DOI: 10.1080/17434440.2016.1271706] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 12/09/2016] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Pediatric cataracts are a huge problem worldwide, and with improving techniques and technology, the surgical treatment and postoperative visual rehabilitation are improving. Despite intraocular lenses(IOLs) being the standard of care for adult cataract surgery, this issue is still somewhat controversial, particularly in young children and infants due to lack of unequivocal evidence. This review therefore summarises the findings from recent studies on the aspect of IOL implantation in pediatric eyes. Areas covered: An extensive literature search was undertaken for published articles on congenital/developmental pediatric cataracts, and IOL implantation, where literature pertinent to traumatic and subluxated cataracts was not included in the review. Pubmed was used for literature search, and keywords entered were : pediatric, cataract surgery, intraocular lens, persistent fetal vasculature, outcomes, complications, visual performance with intraocular lenses. Expert commentary: Recent literature supports IOL implantation in most cases of congenital / developmental pediatric cataracts, and it seems like the way forward. However, the jury is still out on IOL implantation in infants, particularly in bilateral cataracts. Thus, surgeons must be extremely cautious in planning primary IOL implantation in infant eyes, and if they do perform IOL implantation, rigorous followup is mandatory.
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Affiliation(s)
- Abhay R Vasavada
- a Iladevi Cataract & IOL Research Centre, Raghudeep Eye Hospital , Ahmedabad , India
| | - Vaishali Vasavada
- a Iladevi Cataract & IOL Research Centre, Raghudeep Eye Hospital , Ahmedabad , India
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Cagini C, Tosi G, Stracci F, Rinaldi VE, Verrotti A. Red reflex examination in neonates: evaluation of 3 years of screening. Int Ophthalmol 2016; 37:1199-1204. [PMID: 27822637 DOI: 10.1007/s10792-016-0393-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 11/01/2016] [Indexed: 12/17/2022]
Abstract
PURPOSE Red reflex is a test that can detect potentially life-threatening ocular abnormalities. In 2012, a red reflex screening campaign was started in Umbria, central Italy. In this study, we report the results of the first 3 years (2012-2014) of screening. METHODS Red reflex screening was carried out in the 11 regional birth centres. On the first level, the test was performed on all newborns within the third day of life. A pathologic test was an indication for referral to the nearest Ophthalmology Hospital Department (II level). Patients were referred to the Perugia University Ophthalmology Hospital Department if an ulterior evaluation or if treatment was necessary (III level). RESULTS Between 1 January 2012 and 31 December 2014, 22,884 children were born in Umbria and of these, 22,272 (97.3%) were tested with the red reflex. Four hundred and sixty-one (4.83%) neonates resulted having a positive or equivocal test and were sent to II level. Three of these cases (0.01%) were affected by an important eye disease, in particular two patients (0.009%) presented congenital cataract and one patient (0.005%) presented retinoblastoma. CONCLUSION Our results are consistent with the previous findings, although reports on red reflex screening are sporadic in the literature. Despite the high number of false positives, the red reflex test has proven to be a useful, easy to perform and low cost test for the early detection of congenital low vision diseases, and our data confirm that it must become part of normal neonatal assessments.
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Affiliation(s)
- Carlo Cagini
- Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy.
| | - Gianluigi Tosi
- Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
| | - Fabrizio Stracci
- Public Health Section, Department of Experimental Medicine, Ospedale S. Maria della Misericordia, University of Perugia, Perugia, Italy
| | - Victoria Elisa Rinaldi
- Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
| | - Alberto Verrotti
- Division of Ophthalmology, Department of Surgical and Biomedical Sciences, Ospedale S. Maria della Misericordia, University of Perugia, S. Andrea delle Fratte, 06156, Perugia, Italy
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Giles K, Christelle D, Yannick B, Fricke OH, Wiedemann P. Cataract surgery with intraocular lens implantation in children aged 5-15 in local anaesthesia: visual outcomes and complications. Pan Afr Med J 2016; 24:200. [PMID: 27795795 PMCID: PMC5072871 DOI: 10.11604/pamj.2016.24.200.9771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 06/26/2016] [Indexed: 11/11/2022] Open
Abstract
The aim of this study was to report feasibility, the visual outcomes and complications of pediatric cataract surgery with primary intraocular lens implantation in children aged 5 to15 years in local anesthesia. This retrospective interventional case series included 62 eyes from 50 children who underwent pediatrc cataract surgery with primary intraocular lens implantation at the Mana eye Clinic Nkongsamba between 2006 and 2015 Main outcome measures were: best-corrected post operative visual acuity, and intraoperative and postoperative complications. Mean age at surgery was 10.18 ± 3.21 years. Mean follow up length was 15.75 ± 3.36 weeks. Etiology included: 10 congenital cataracs (16.12%). 35 developmental cataracts (56.45%) and 17 traumatic cataracts (27.41%). The mean preoperative BCVA was logMAR 1.19 ± 0.33. (range 0.6-2.3). After cycloplegia refraction 2 weeks after surgery, the mean postoperative BCVA was log MAR 0.58 ± 0.88 ( range 0.5-1.8). The mean implanted IOL power was 22.01 ±3.16 D. IOL was succefuly implanted in 54 eyes (87.07%). Eight eyes (9.67%) were left aphakic. Increase in BCVA of 4 logMAR lines and above was recorded in 27 patients (43.55%). Intraoperative complications included: 4 posterior capsule holes with vitrous lost, 3 lenses subluxation and 1 case of iris dialyse. Late postoperative complications included: posterior capsular opacity which occurred in 16 patients, 3 posterior synechia, 2 retinal detachment. Peribulbar anaesthesia can be considered as a viable option in selected patients presenting developmental cataract undergoing cataract surgery in developing countries. Effort should be made to improve the early identification of congenital cataract and its early surgical intervention and prompt optical rehabilitation to prevent amblyopia.
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Affiliation(s)
- Kagmeni Giles
- University Teaching Hospital Yaoundé (UTHY), Cameroon; University of Yaoundé I, Faculty of Medicine and Biomedical Sciences, Cameroon
| | | | - Bilong Yannick
- University of Yaoundé I, Faculty of Medicine and Biomedical Sciences, Cameroon
| | - Otto Herrmann Fricke
- Department of Ophthalmology and Department of Clinical and Experimental Medicine, Linkoping University, Sweden
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Sachdeva V, Katukuri S, Ali M, Kekunnaya R. Second intraocular surgery after primary pediatric cataract surgery: indications and outcomes during long-term follow-up at a tertiary eye care center. Eye (Lond) 2016; 30:1260-5. [PMID: 27472208 DOI: 10.1038/eye.2016.170] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 07/01/2016] [Indexed: 11/10/2022] Open
Abstract
PurposeAlthough pediatric cataract surgery has become standardized and safe, further surgical interventions are not uncommon. The purpose of this study was to analyze the incidence of complications in children who required an intraocular intervention.MethodsA retrospective review of medical records of children (<7 years) with cataract who underwent cataract surgery with or without primary posterior chamber intraocular lens (IOL) placement between January 2006 and December 2014 was carried out. Data were collected regarding visual axis opacification (VAO), glaucoma, IOL decentration, intraocular infections, and other indications that required a second intraocular surgery.ResultsOut of 814 (570 pseudophakic and 244 aphakic) eyes of 620 operated children, 45 eyes of 40 children (5.5%, 45/814) needed a second surgery. The most common indication being VAO (2.9%, 24/814), followed by glaucoma (0.73%, 6/814). Incidence of complications was higher in children <1 year (VAO 6.1%, 19/308 and glaucoma 6%, 6/308). Among all children, repeat interventions and VAO were slightly less frequent in pseudophakics (4.91%, 28/570) vs aphakics (6.91%, 17/244) (P=0.31). As VAO was more common in pseudophakic eyes in infants, glaucoma was equally common in both groups. Best-corrected visual acuity improved from 1.6±0.56 LogMAR preoperatively to 0.80±0.50 LogMAR postoperatively.ConclusionsOur study suggests that overall incidence of second intraocular surgery is low after primary pediatric cataract surgery. VAO remains the most common indication followed by secondary glaucoma. Incidence of complications is higher in children <1 year of age at initial surgery.
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Affiliation(s)
- V Sachdeva
- Nimmagada Prasad Children's Eye Care Centre, LV Prasad Eye Institute, GMRV Campus, Visakhapatnam, India
| | - S Katukuri
- Jasti V Ramanamma Children's Eye Care Centre, LV Prasad Eye Institute, KAR Campus, Hyderabad, India
| | - MdH Ali
- Centre for Clinical Epidemiology and Biostatistics, LV Prasad Eye Institute, KAR Campus, Hyderabad, India
| | - R Kekunnaya
- Jasti V Ramanamma Children's Eye Care Centre, LV Prasad Eye Institute, KAR Campus, Hyderabad, India
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Prevalence and epidemiological characteristics of congenital cataract: a systematic review and meta-analysis. Sci Rep 2016; 6:28564. [PMID: 27334676 PMCID: PMC4917826 DOI: 10.1038/srep28564] [Citation(s) in RCA: 103] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 06/03/2016] [Indexed: 11/19/2022] Open
Abstract
Congenital cataract (CC) is the primary cause of treatable childhood blindness worldwide. The establishment of reliable, epidemiological estimates is an essential first step towards management strategies. We undertook an initial systematic review and meta-analysis to estimate the prevalence and other epidemiological characteristics of CC. PubMed, Medline, Web of Science, Embase, and Cochrane Library were searched before January 2015. A meta-analysis with random-effects model based on a proportions approach was performed to determine the population-based prevalence of CC and to describe the data regarding the laterality, morphology, associated comorbidities and etiology. Heterogeneity was analyzed using the meta-regression method, and subgroup analyses were performed. 27 studies were selected from 2,610 references. The pooled prevalence estimate was 4.24 per 10,000 people, making it a rare disease based on WHO standards. Subgroup analyses revealed the highest CC prevalence in Asia, and an increasing prevalence trend through 2000. Other epidemiological characteristics showed CC tended to be bilateral, isolated, hereditary and in total/nuclear morphology. Huge heterogeneity was identified across most estimates (I2 > 75%). Most of the variations could be explained by sample size, research period and age at diagnosis. The findings provide suggestions for etiology of CC, improvements in screening techniques and development of public health strategies.
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Magli A, Carelli R, Forte R, Chiariello Vecchio E, Esposito F, Torre A. Congenital and Developmental Cataracts: Focus on Strabismus Outcomes at Long-Term Follow-Up. Semin Ophthalmol 2016; 32:358-362. [PMID: 27077682 DOI: 10.3109/08820538.2015.1095305] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the incidence of strabismus in congenital and developmental cataract surgery in patients with a follow-up longer than five years. METHODS All patients with congenital and developmental cataracts observed from 1996 to 2013 with a follow-up longer than five years were retrospectively included. RESULTS We included 117 patients (58 females and 59 males, mean age 0.62±0.3 years, 160 eyes) with congenital cataracts and 73 patients (32 females and 41 males, mean age 6.63±0.7 years, 121 eyes) with developmental cataracts. Before cataract surgery, strabismus was present in 88 patients with congenital cataracts (75.2%) and in 30 patients with developmental cataracts (41.1%) (p=0.01). After a follow-up of 9.26±1.3 years (range, 5-14 years), a significantly greater incidence of strabismus was observed after surgery only in patients with unilateral congenital cataracts who underwent cataract removal and primary IOL implantation (p=0.02). Distance BCVA and near BCVA were better after surgery for developmental cataracts (p<0.05). Presence of binocular vision was more frequent after surgery for developmental cataracts (p=0.001). CONCLUSION Incidence of strabismus and postsurgical onset of strabismus at long-term follow-up was greater in patients with congenital cataracts.
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Affiliation(s)
- Adriano Magli
- a Pediatric Eye Department , University of Salerno , Salerno , Italy.,b Gi.Ma Eye Center , Naples , Italy
| | - Roberta Carelli
- a Pediatric Eye Department , University of Salerno , Salerno , Italy
| | - Raimondo Forte
- c Eye Department , University of Salerno , Salerno , Italy
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Raina UK, Bhambhwani V, Gupta A, Bhushan G, Seth A, Ghosh B. Comparison of Transcorneal and Pars Plana Routes in Pediatric Cataract Surgery in Infants Using a 25-Gauge Vitrectomy System. J Pediatr Ophthalmol Strabismus 2016; 53:105-12. [PMID: 27018883 DOI: 10.3928/01913913-20160208-01] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Accepted: 12/22/2015] [Indexed: 11/20/2022]
Abstract
PURPOSE To demonstrate and compare the performance of the 25-gauge transconjunctival sutureless vitrectomy system via anterior (transcorneal) and posterior (pars plana) routes in congenital cataracts in infants. METHODS In this prospective interventional study, 12 pediatric patients younger than 1 year with bilateral congenital cataract were included to undergo cataract surgery with posterior vitreorhexis and limited anterior vitrectomy using a 25-gauge vitrectomy system. One eye of each patient was operated on by the anterior (transcorneal) route and the other by the posterior (pars plana) route. All eyes were left aphakic. Intraoperative and postoperative (12 months after surgery) results were compared between the two routes, including visual axis opacification and astigmatism. All eyes were rehabilitated with contact lenses or spectacles. RESULTS The 25-gauge vitrectomy system allowed excellent intraoperative control in both groups. Postoperatively, there was minimal conjunctival congestion, corneal edema, and inflammatory reaction. No intra-operative or postoperative complications were noted in any eye. All eyes had a clear visual axis 12 months after surgery. Mean spherical equivalent was 15.50 ± 2.28 diopters (D) and mean astigmatism was 0.25 ± 0.45 D in the transcorneal group, whereas in the pars plana group it was 15.46 ± 2.45 D and 0.16 ± 0.39 D, respectively, at 12 months, the difference being statistically insignificant (P > .05). CONCLUSIONS The 25-gauge vitrectomy system allows sutureless surgery with excellent intraoperative control and minimal postoperative inflammation and astigmatism with clear visual axis by both the transcorneal and pars plana routes.
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