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Scott DA, Wang MT, Danesh-Meyer HV, Hull S. Optic atrophy in prematurity: pathophysiology and clinical features. Clin Exp Optom 2024; 107:245-254. [PMID: 37867148 DOI: 10.1080/08164622.2023.2256734] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/05/2023] [Indexed: 10/24/2023] Open
Abstract
Optic atrophy is an important cause of visual impairment in children, and the aetiological profile has changed over time. Technological advancements led by neuroimaging of the visual pathway and imaging of the optic nerve with optical coherence tomography have accelerated the understanding of this condition. In the new millennium, an increasing prevalence of prematurity as a cause of optic atrophy in children has been highlighted. This new shift has been linked with increasing rates of premature births and improved neonatal survival of preterm infants. The available literature is limited to hospital and registry-based cohorts with modest sample sizes, methodological heterogeneity and selection bias limitations. Larger studies that are better designed are required to better understand the contribution of prematurity to the disease burden. In addition to considering other life-threatening aetiologies, screening for premature birth should be covered as part of a comprehensive history when evaluating a child with paediatric optic atrophy.
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Affiliation(s)
- Daniel Ar Scott
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | - Michael Tm Wang
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
| | | | - Sarah Hull
- Department of Ophthalmology, University of Auckland, Auckland, New Zealand
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2
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Astasheva IB, Guseva MR, Atamuradov R, Smirnov DN, Marenkov VV, Kyun YA, Baranova AR. [Morphological features of an optic nerve in premature infants according to the optical coherence tomography data]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:92-101. [PMID: 38884435 DOI: 10.17116/jnevro202412405192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To assess the morphological state of the visual analyzer in premature infants in long-term. MATERIAL AND METHODS We examined 40 premature children (74 eyes) aged 10.3±2.92 years (gestational age (GA) 25-34 weeks, birth weight (BW) 690-2700 g). Twenty mature children (40 eyes), aged 10.8±3.05 years, were examined as a control group. The children underwent standard ophthalmologic examination, optical coherence tomography (OCT) and recording of visual evoked potentials (VEP). RESULTS The thickness of retinal nerve fiber layer (RNFL) is less in preterm infants than in term infants, regardless of retinopathy of prematurity (ROP) and refraction (p<0.05). Thickness loss has an inverse proportion with the degree of hypoxic-ischemic encephalopathy (HIE) and intraventricular hemorrhage (IVH) (p<0.05). Retinal thickness in fovea is significantly greater in preterm infants and has a direct proportionality with the degree of IVH and the number of days on artificial lung ventilation (p<0.05). Moderate organic changes were detected in conduction pathways in 43.08% of premature infants according to VEP data. CONCLUSION The use of OCT and recording of VEP may improve the quality of comprehensive neuro-ophthalmologic diagnosis in preterm infants. The thickness loss of RNFL can be expected in premature infants with HIE and IVH.
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Affiliation(s)
- I B Astasheva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - M R Guseva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - R Atamuradov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - D N Smirnov
- Yudin City Clinical Hospital, Moscow, Russia
| | | | - Yu A Kyun
- Morozov Children's City Clinical Hospital, Moscow, Russia
| | - A R Baranova
- Pirogov Russian National Research Medical University, Moscow, Russia
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3
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Phuljhele S, Saluja G, Dhiman R, Saxena R. Current perspective: Cerebral visual impairment-The impending doom. Indian J Ophthalmol 2023; 71:3277-3279. [PMID: 37787221 PMCID: PMC10683684 DOI: 10.4103/ijo.ijo_2446_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 10/04/2023] Open
Abstract
Cerebral visual impairment (CVI) has emerged as an important cause of morbidity in young children. CVI children often have a large number of visual symptoms along with motor abnormalities. It is the need of the hour to build an integrated approach towards their management. This article aimed to provide a comprehensive view of the manifestations, evaluation, and management of children with CVI.
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Affiliation(s)
- Swati Phuljhele
- Strabismus, Pediatric Ophthalmology and Neuro-Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India
| | - Gunjan Saluja
- Strabismus, Pediatric Ophthalmology and Neuro-Ophthalmology Services, Bhatia Netralaya, Bhilai, Chhattisgarh, India
| | - Rebika Dhiman
- Strabismus, Pediatric Ophthalmology and Neuro-Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India
| | - Rohit Saxena
- Strabismus, Pediatric Ophthalmology and Neuro-Ophthalmology Services, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All Institute of Medical Sciences, New Delhi, India
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4
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Wenner Y, Kunze K, Lazaridis A, Brauer V, Besgen V, Davidova P, Sekundo W, Maier RF. The impact of perinatal brain injury on retinal nerve fiber layer thickness and optic nerve head parameters of premature children. Graefes Arch Clin Exp Ophthalmol 2023; 261:2701-2707. [PMID: 37119306 PMCID: PMC10432335 DOI: 10.1007/s00417-023-06069-2] [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: 10/14/2022] [Revised: 03/14/2023] [Accepted: 04/11/2023] [Indexed: 05/01/2023] Open
Abstract
PURPOSE This study aims to evaluate the impact of birth weight (BW), gestational age (GA), retinopathy of prematurity (ROP), and perinatal brain injury (PBI) on optic nerve head (ONH) parameters and nerve fiber layer thickness (RNFLT) in preterm children. METHODS ONH parameters and RNFLT were examined prospectively in 5-15-year-old preterm and full-term children with RTVue-100 OCT (Optovue, USA). The parameters of the two groups were compared and possible influences of BW, GA, ROP, and PBI analyzed in preterm children. RESULTS In total, 51 full-term and 55 preterm children were included. The mean age was 9.98 ± 3.4 years in full-term and 10.0 ± 2.5 years in preterm children. The mean GA in preterm children was 29.6 ± 3.8 weeks with a BW of 1523 ± 732 g. RNFLT was significantly lower in preterm than in full-term children in all but temporal quadrants. Cup area, volume, cup/disc area ratio, and horizontal cup/disc ratio (CDR) were significantly larger and rim area significantly thinner in preterm children. GA was positively correlated with superior, nasal, and overall RNFLT and negatively correlated with cup area, volume, and horizontal CDR. ROP stage correlated negatively with superior and nasal RNFLT. PBI was the only significant predicting factor for RNFL thinning in all but temporal quadrant in multiple regression analysis. Preterm children with PBI had a significantly larger optic cup (CDR 0.70 ± 0.33 vs. 0.37 ± 0.27) and thinner optic rim. CONCLUSION PBI correlated strongest with RNFL thinning, a thinner optic rim, and a larger optic cup in preterm children and should be evaluated in each patient to prevent incorrect diagnosis like glaucoma.
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Affiliation(s)
- Yaroslava Wenner
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany.
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany.
| | - Kira Kunze
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Apostolos Lazaridis
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Vanessa Brauer
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Volker Besgen
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Petra Davidova
- Department of Ophthalmology, Goethe-University, Theodor-Stern-Kai 7, 60590, Frankfurt Am Main, Germany
| | - Walter Sekundo
- Department of Ophthalmology, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
| | - Rolf F Maier
- Department of Paediatrics, Philipps-University, Universitätsklinikum Giessen and Marburg GmbH, Marburg Campus, Marburg, Germany
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5
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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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6
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Fenner BJ, Li H, Gan ATL, Song YS, Tham YC, Jonas JB, Wang YX, Cheng CY, Wong TY, Teo KYC, Tan ACS, Fan Q, Cheung CMG. Genetic Variability of Complement Factor H Has Ethnicity-Specific Associations With Choroidal Thickness. Invest Ophthalmol Vis Sci 2023; 64:10. [PMID: 36749597 PMCID: PMC9919691 DOI: 10.1167/iovs.64.2.10] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Purpose To identify genetic alleles associated with differences in choroidal thickness (CT) in a population-based multiethnic Asian cohort. Methods A population-based multiethnic Asian cohort without retinal pathology was subjected to spectral-domain OCT (SD-OCT) and genotyping of risk alleles in CFH, VIPR2, ARMS2, and CETP. Subfoveal choroidal thickness (SFCT) values were assessed from SD-OCT, and associations with the risk alleles were determined for each cohort. Results A total of 1045 healthy Asian individuals (550 Chinese, 147 Indians, 348 Malays) were prospectively enrolled in the study. Several CFH alleles (rs800292, rs1061170, and rs1329428) were associated with increased SFCT in Indians (+18.7 to +31.7 µm; P = 0.001-0.038) and marginally associated with decreased SFCT in Malays (-12.7 to -20.6 µm; P = 0.014-0.022). Haplotype analysis of CFH revealed variable associations with SFCT among races, with the H6 haplotype being associated with a 29.08-µm reduction in SFCT in the Chinese cohort (P = 0.02) but a 35.2-µm increase in SFCT in the Indian cohort (P < 0.001). Finally, subfield analysis of the Chinese cohort identified associations between the CFH risk allele rs1061170 and reduced CT in the nasal and superior sectors (-20.2 to -25.8 µm; P = 0.003-0.027). Conclusions CFH variants are variably associated with CT among Asian ethnic groups. This has broad implications for the pathogenesis of common diseases such as age-related macular degeneration and central serous choroidopathy, the pathogenesis of which is associated with CT.
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Affiliation(s)
- Beau J Fenner
- Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore
| | | | | | - Young Seok Song
- Singapore Eye Research Institute, Singapore.,Department of Ophthalmology, Asahikawa Medical University, Asahikawa, Hokkaido, Japan
| | - Yih Chung Tham
- Singapore Eye Research Institute, Singapore.,Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Jost B Jonas
- Institute of Molecular and Clinical Ophthalmology, Basel, Switzerland
| | - Ya Xing Wang
- Beijing Institute of Ophthalmology, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Ching Yu Cheng
- Singapore Eye Research Institute, Singapore.,Centre for Innovation & Precision Eye Health, Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore
| | - Tien Yin Wong
- School of Medicine, Tsinghua University, Beijing, China
| | - Kelvin Y C Teo
- Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore
| | - Anna C S Tan
- Singapore National Eye Centre, Singapore.,Singapore Eye Research Institute, Singapore
| | - Qiao Fan
- Singapore Eye Research Institute, Singapore.,Center for Quantitative Medicine, Duke-NUS Graduate Medical School, Singapore
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Kocaaga A, Yimenicioglu S, Gürsoy HH. Novel NR2F1 variant identified by whole-exome sequencing in a patient with Bosch-Boonstra-Schaaf optic atrophy syndrome. Indian J Ophthalmol 2022; 70:2762-2764. [PMID: 35791240 PMCID: PMC9426133 DOI: 10.4103/ijo.ijo_1061_22] [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] [Indexed: 11/25/2022] Open
Abstract
Bosch–Boonstra–Schaaf optic atrophy syndrome (BBSOAS) is an extremely rare autosomal dominant disorder characterized by intellectual disability, developmental delay, seizures, hypotonia, hearing loss, and optic nerve atrophy. This syndrome is caused by loss-of-function variants in the nuclear receptor subfamily 2 group F member 1 (NR2F1) gene. To date, approximately 80 patients have been reported with BBSOAS. Here, we describe a 3-year-old infant with delayed development, intellectual disability, strabismus, nystagmus, and optic atrophy with well-characterized features associated with BBSOAS. Whole-exome sequencing revealed a novel heterozygous missense mutation (NM_005654.6:c.437G>A, p.Cys146Tyr) in the NR2F1 gene. This missense variant is predicted to be deleterious by the protein prediction tools (SIFT, PolyPhen-2, and MutationTaster). To the best of our knowledge, this is the first patient with BBSOAS reported from Turkey.
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Affiliation(s)
- Ayca Kocaaga
- Department of Medical Genetics, Eskişehir City Hospital, Eskişehir, Turkey
| | - Sevgi Yimenicioglu
- Department of Pediatric Neurology, Eskişehir City Hospital, Eskişehir, Turkey
| | - Haluk Hüseyin Gürsoy
- Department of Ophtalmology, Eskisehir Osmangazi University Hospital, Eskişehir, Turkey
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8
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Astasheva IB, Guseva MR, Atamuradov R, Marenkov VV, Kyun YA. [Modern possibilities of diagnosing lesions of the visual analyzer in perinatal lesions of the central nervous system in full-term and premature infants]. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:7-15. [PMID: 36537625 DOI: 10.17116/jnevro20221221217] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The article provides an overview of current neuro-ophthalmological diagnostic capabilities in patients with perinatal lesions. The main attention is paid to the diagnosis of patients with periventricular leukomalacia and peri- and intraventricular hemorrhages. The most relevant methods of neuro-ophthalmological diagnosis in hypoxic-ischemic CNS lesions are covered. The functions and peculiarities of blood supply of the germinal matrix are described. The importance of the use of optical coherence tomography and visual evoked potential recording in full-term and premature infants with visual pathway and/or visual cortex lesions in brain lesions is discussed. The conclusion emphasizes the need for an interdisciplinary approach in the examination of children with perinatal CNS lesions.
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Affiliation(s)
- I B Astasheva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - M R Guseva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - R Atamuradov
- Pirogov Russian National Research Medical University, Moscow, Russia
| | | | - Yu A Kyun
- Morozov Children's City Clinical Hospital, Moscow, Russia
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9
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Waisberg E, Micieli JA. Neuro-Ophthalmological Optic Nerve Cupping: An Overview. Eye Brain 2021; 13:255-268. [PMID: 34934377 PMCID: PMC8684388 DOI: 10.2147/eb.s272343] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/02/2021] [Indexed: 11/23/2022] Open
Abstract
Optic nerve cupping or enlargement of the cup-to-disc ratio is widely recognized as a feature of glaucoma, however it may also occur in non-glaucomatous optic neuropathies. The most well-recognized non-glaucomatous optic neuropathies that cause cupping include compressive optic neuropathies, arteritic anterior ischemic optic neuropathies, hereditary optic neuropathies, and optic neuritis. Cupping is thought to consist of two main components: prelaminar and laminar thinning. The former is a shallow form of cupping and related to loss of retinal ganglion cells, whereas the latter involves damage to the lamina cribrosa and peripapillary scleral connective tissue. Differentiating glaucomatous and non-glaucomatous optic nerve cupping remains challenging even for experienced observers. Classically, the optic nerve in non-glaucomatous causes has pallor of the neuroretinal rim, but the optic nerve should not be examined in isolation. The patient’s medical history, history of presenting illness, visual function (visual acuity, color vision and visual field testing) and ocular examination also need to be considered. Ancillary testing such as optical coherence tomography of the retinal nerve fiber layer and ganglion cell layer-inner plexiform layer may also be helpful in localizing the disease. In this review, we review the non-glaucomatous causes of cupping and provide an approach to evaluating a patient that presents with an enlarged cup-to-disc ratio.
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Affiliation(s)
- Ethan Waisberg
- UCD School of Medicine, University College Dublin, Belfield, Dublin, 4, Ireland
| | - Jonathan A Micieli
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.,Kensington Vision and Research Centre, Toronto, Ontario, Canada
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10
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Ortueta‐Olartecoechea A, Torres‐Peña JL, Muñoz‐Gallego A, Torres‐Valdivieso MJ, Vázquez‐Román S, De la Cruz J, Tejada‐Palacios P. Retinal ganglion cell complex thickness at school-age, prematurity and neonatal stressors. Acta Ophthalmol 2021; 100:e1253-e1263. [PMID: 34873863 DOI: 10.1111/aos.15073] [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: 11/27/2020] [Revised: 11/10/2021] [Accepted: 11/19/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE To investigate the association between the ganglion cell complex (GCC) thickness at early school-age and prematurity and other neonatal factors. METHODS Cross-sectional study. The sample included very preterm children with gestational age (GA) below 32 weeks or birthweight below 1500 g enrolled in a follow-up program (n = 101) and a comparison group of term-born children (n = 49). Ganglion cell complex (GCC) thickness was measured at 4-8 years using high-quality optical coherence tomography (OCT) images. Data on neonatal and postnatal features were extracted from clinical records; analyses included mixed linear models. RESULTS Ganglion cell layer (GCL) and retinal nerve fiber layer (mRNFL) were thicker in term than in preterm born children (2.9 μm and 2.4 μm respectively, p < 0.001). Within the preterm group, lower GA was associated with a decrease in total GCL (0.7 μm per week, p < 0.001). Being small for GA was associated with further thinning in both layers (1.4 and 2.8 µm). Postnatal corticosteroids therapy and severe brain lesion were associated with thinning in the total GCL of 6 µm (p < 0.001) and 4.1 µm (p = 0.002), respectively, and shock was associated with thinning in total mRNFL of 6 µm (p < 0.001). CONCLUSIONS Lower GA or birthweight are associated with thinning of GCC layers. When performing an OCT examination at school-age and a decrease in GCC thickness is observed, it may be relevant to ask about a history of prematurity, and further enquire about neonatal shock, postnatal corticosteroids therapy or severe brain lesion that are related to additional decrease in GCC thickness.
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Affiliation(s)
| | - Jose L. Torres‐Peña
- Madrid University Hospital “12 de Octubre”, Department of Ophthalmology Madrid Spain
| | - Alicia Muñoz‐Gallego
- Madrid University Hospital “12 de Octubre”, Department of Ophthalmology Madrid Spain
| | | | - Sara Vázquez‐Román
- Madrid University Hospital “12 de Octubre”, Department of Neonatology Madrid Spain
| | - Javier De la Cruz
- Madrid University Hospital “12 de Octubre”, Research Institute (imas12) Madrid Spain
- Mother and Child Health, and Development Research Network SAMIDISCIII Madrid Spain
| | - Pilar Tejada‐Palacios
- Madrid University Hospital “12 de Octubre”, Department of Ophthalmology Madrid Spain
- Madrid University Hospital “12 de Octubre”, Research Institute (imas12) Madrid Spain
- Madrid University Complutense Madrid Spain
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11
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Khurana R, Shyamsundar K, Taank P, Singh A. Periventricular leukomalacia: an ophthalmic perspective. Med J Armed Forces India 2021; 77:147-153. [PMID: 33867629 DOI: 10.1016/j.mjafi.2020.05.013] [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: 06/23/2019] [Accepted: 05/18/2020] [Indexed: 10/23/2022] Open
Abstract
Periventricular leukomalacia (PVL) is a common magnetic resonance imaging (MRI) finding in cases of hypoxic ischemic encephalopathy. PVL, in MRI, is identified by the increased signal intensity of periventricular white matter on T2-weighted sequences which is more conspicuous in the posterior cortex. It occurs because of perinatal damage to the cerebral cortex. This insult is in the form of hypoxia, metabolic insults, prematurity, seizures, or infection. Periventricular area is most prone to damage owing to its immaturity and vascular supply. PVL is proven to affect vision in children. Depending on the area and cause of affection, PVL is associated with variable ophthalmic manifestations. It is known that visual function is closely linked to the overall neurodevelopment of a child. A multidisciplinary approach is required to promote the growth and development of these children, and in the midst of multiple disabilities, visual function should not be overlooked. A comprehensive knowledge of the ophthalmological presentation in the developing world can aid us in an early and accurate diagnosis and in intervention for better therapeutic recovery and rehabilitation of these children.
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Affiliation(s)
- Rolli Khurana
- Assistant Professor & Graded Specialist (Ophthalmology), Military Hospital Ahmedabad, C/O 56 APO, India
| | | | - Priya Taank
- Associate Professor & Classified Specialist (Ophthalmology), Command Hospital (Southern Command), Pune, India
| | - Ankita Singh
- Resident, Department of Ophthalmology, Armed Forces Medical College, Pune, India
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12
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Senthil S, Nakka M, Sachdeva V, Goyal S, Sahoo N, Choudhari N. Glaucoma Mimickers: A major review of causes, diagnostic evaluation, and recommendations. Semin Ophthalmol 2021; 36:692-712. [PMID: 33689583 DOI: 10.1080/08820538.2021.1897855] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Background: Glaucoma is characterized by chronic progressive optic neuropathy with corresponding visual field changes, with or without raised intraocular pressure (IOP). When diagnosing glaucoma or monitoring its progression, the examiner has to rely on the appearance of the optic disc, characteristic retinal nerve fiber layer defects, and corresponding visual field defects. However, similar changes and symptoms may be observed in several other disorders of the optic nerve and retina that may mimic glaucoma, often leading to misdiagnosis. Methods and result: The consequences of misdiagnosis not only result in improper treatment that may impact vision but also would negatively affect the overall health, psychological well-being of the patient, and may have considerable economic implications.Conclusion: The current review describes various conditions that mimic glaucoma and the features that help differentiate these conditions from glaucoma.
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Affiliation(s)
- Sirisha Senthil
- VST Glaucoma Center, L V Prasad Eye Institute, Hyderabad, India
| | - Mamata Nakka
- VST Glaucoma Center, L V Prasad Eye Institute, Hyderabad, India
| | - Virender Sachdeva
- Nimmagada Prasad Children's Eye Care Centre, GMRV Campus, L V Prasad Eye Institute, Visakhapatnam, India
| | - Shaveta Goyal
- VST Glaucoma Center, L V Prasad Eye Institute, Hyderabad, India
| | - Nibedita Sahoo
- MTC Campus, L V Prasad Eye Institute, Bhubaneswar, India
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13
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Ozen Tunay Z, Ustunyurt Z, Idil A. Causes of severe visual impairment in infants and methods of management. Eye (Lond) 2020; 35:1191-1197. [PMID: 32678353 DOI: 10.1038/s41433-020-1101-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES To examine the causes of severe visual impairment (SVI) in infants below the age of 2 years and to review management methods. METHODS The data of 2657 patients followed between January 2014 and July 2019 were reviewed, and 148 (5.6%) infants who had SVI were enrolled. Data including age, gender, affected anatomical site, diagnosis, presence of any non-ophthalmological deficiencies, and methods of management were reviewed. The diagnoses were investigated in the categories of avoidable and unavoidable basis. The methods of management were analysed from the perspective of low vision habilitation. RESULTS The mean age at first eye examination was 6.61 ± 5.25 months, and 84 (56.7%) infants were male. Of the 148 infants, 69 (46.6%) were premature. Cerebral visual impairment (CVI) was the most common diagnosis in both preterm (39.1%) and term (11.4%) infants. Delayed visual maturation, optic nerve pathologies, oculocutaneous albinism, and congenital cataract were the other frequent causes. The rate of multiple disabilities was 30% in the whole group and 94% in infants with CVI. Most of the babies had a normal-appearing globe (43.3%). Retina was affected in 23.7% of the infants. Avoidable causes were identified in 79.7% of the infants. The used methods of management were optic interventions, visual stimulation therapy, medical and/or surgical treatment. CONCLUSIONS CVI was found the most common cause of SVI in both preterm and term-born infants, and the higher rate of multiple disabilities in these infants was remarkable. Optic interventions and visual stimulation therapy were the most common methods of management.
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Affiliation(s)
- Zuhal Ozen Tunay
- University of Health Sciences, Zekai Tahir Burak Education and Research Hospital, Department of Ophthalmology, Ankara, Turkey.
| | - Zeynep Ustunyurt
- University of Health Sciences, Zekai Tahir Burak Education and Research Hospital, Department of Developmental Pediatrics, Ankara, Turkey
| | - Aysun Idil
- Ankara University Faculty of Medicine, Department of Ophthalmology, Low Vision Rehabilitation and Research Center, Ankara, Turkey
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14
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Jin HD, Demmler-Harrison GJ, Miller J, Edmond JC, Coats DK, Paysse EA, Bhatt AR, Yen KG, Klingen JT, Steinkuller P. Cortical Visual Impairment in Congenital Cytomegalovirus Infection. J Pediatr Ophthalmol Strabismus 2019; 56:194-202. [PMID: 31116869 DOI: 10.3928/01913913-20190311-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 02/14/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To describe the presentation, evolution, and long-term outcome of cortical visual impairment (CVI) in patients with symptomatic congenital cytomegalovirus (CMV) infection, and to identify risk factors for the development of CVI in patients with symptomatic congenital CMV. METHODS Retrospective subanalysis of a long-term prospective cohort study with data gathered from 1982 to 2013. RESULTS Eleven of 77 (14.3%) patients with symptomatic CMV, 0 of 109 with asymptomatic CMV, and 51 control patients had CVI. Overall, patients with symptomatic CMV had worse vision than patients with asymptomatic CMV, who in turn had worse vision than control patients. Microcephaly, intracranial calcification, dilatation of ventricles, encephalomalacia, seizure at birth, optic atrophy, chorioretinitis/retinal scars, strabismus, and neonatal onset of sensorineural hearing loss were risk factors associated with CVI. CONCLUSIONS CVI may result from symptomatic congenital CMV infection. The relationship of CVI and its risk factors in patients with CMV suggests the potential to predict the development of CVI through predictive modeling in future research. Early screening of CVI in children born with symptomatic congenital CMV can facilitate educational, social, and developmental interventions. [J Pediatr Ophthalmol Strabismus. 2019;56(3):194-202.].
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Pinto F, Fernandes E, Virella D, Abrantes A, Neto M. Born Preterm: A Public Health Issue. PORTUGUESE JOURNAL OF PUBLIC HEALTH 2019. [DOI: 10.1159/000497249] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
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Kumar V, Kumawat D, Kumar P. Swept source optical coherence tomography analysis of choroidal thickness in macular telangiectasia type 2: a case-control study. Graefes Arch Clin Exp Ophthalmol 2018; 257:567-573. [DOI: 10.1007/s00417-018-04215-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2018] [Revised: 11/24/2018] [Accepted: 12/06/2018] [Indexed: 10/27/2022] Open
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Ganesh S, Khurana R, Wallang B, Sharma S. Ophthalmic Manifestations in Children with Periventricular Leukomalacia. Indian J Pediatr 2018; 85:572. [PMID: 29511949 DOI: 10.1007/s12098-018-2643-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2018] [Accepted: 02/13/2018] [Indexed: 10/17/2022]
Affiliation(s)
- Suma Ganesh
- Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, 5027, Kedar Nath Road, Daryaganj, New Delhi, 110002, India.
| | - Rolli Khurana
- Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, 5027, Kedar Nath Road, Daryaganj, New Delhi, 110002, India
| | - Batriti Wallang
- Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, 5027, Kedar Nath Road, Daryaganj, New Delhi, 110002, India
| | - Sonia Sharma
- Pediatric Ophthalmology and Strabismology Services, Dr. Shroff's Charity Eye Hospital, 5027, Kedar Nath Road, Daryaganj, New Delhi, 110002, India
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Maitreya A, Rawat D, Pandey S. A pilot study regarding basic knowledge of "cortical visual impairment in children" among ophthalmologists. Indian J Ophthalmol 2018; 66:279-284. [PMID: 29380776 PMCID: PMC5819113 DOI: 10.4103/ijo.ijo_425_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Purpose: A pilot study was done to evaluate knowledge regarding “cortical visual impairment (CVI) in children” among ophthalmologists. Methods: This study was conducted during the annual conference of a zonal ophthalmological society. All ophthalmologists who attended the conference were requested to participate in this study. Those who agreed were given a validated questionnaire to assess knowledge regarding CVI. Cronbach's alpha of the questionnaire was 0.6. Participants were asked to respond to multiple choice questions by choosing the single best option. The responses obtained were then evaluated. Results: The total number of registered delegates in the conference was 448. A total of 103 ophthalmologists showed interest to participate in the study with a response rate of 22.9%. Only 89/103 interested delegates were included in the study as remaining were unaware of CVI. No participant gave correct answers to all questions. Although more than 80% of them knew the most common association (87%) and site of pathology (84%), only 52% were sure about clinical features and even lesser respondents (39%) knew that magnetic resonance imaging is the correct investigation of choice. The majority responded correctly that these children need eye examination (89%) and can be managed by rehabilitation through multidisciplinary approach (82%), but only 58% could recognize differential diagnoses and had a correct idea regarding the prognosis of CVI. There was no correlation between the number of patients diagnosed per month by the respondent with knowledge of the disease. Conclusion: In this pilot study, ophthalmologists were found to have limited knowledge regarding clinical features, investigation, differential diagnosis, and visual prognosis of CVI in children. There is a need to improve awareness regarding CVI among ophthalmologists.
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Affiliation(s)
- Amit Maitreya
- Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Darshika Rawat
- Department of Ophthalmology, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
| | - Shubham Pandey
- Department of Bio-statistics, Himalayan Institute of Medical Sciences, Swami Rama Himalayan University, Dehradun, Uttarakhand, India
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Kang S, Shaikh AG. Acquired pendular nystagmus. J Neurol Sci 2017; 375:8-17. [PMID: 28320194 DOI: 10.1016/j.jns.2017.01.033] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 12/18/2016] [Accepted: 01/09/2017] [Indexed: 11/16/2022]
Abstract
Acquired pendular nystagmus is comprised of quasi-sinusoidal oscillations of the eyes significantly affecting gaze holding and clarity of vision. The most common causes of acquired pendular nystagmus include demyelinating disorders such as multiple sclerosis and the syndrome of ocular palatal tremor. However, several other deficits, such as pharmacological intoxication, metabolic and genetic disorders, and granulomatous disorders can lead to syndromes mimicking acquired pendular nystagmus. Study of the kinematic features of acquired pendular nystagmus has suggested a putative pathophysiology of an otherwise mysterious neurological disorder. Here we review clinical features of neurological deficits that co-occur with acquired pendular nystagmus. Subsequent discussion of the pathophysiology of individual forms of pendular nystagmus speculates on mechanisms of the underlying disease while providing insights into pharmacotherapy of nystagmus.
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Affiliation(s)
- Sarah Kang
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA; Daroff-DelOsso Ocular Motility Laboratory, Neurology Service, Louis Stoke VA Medical Center, Cleveland, OH, USA
| | - Aasef G Shaikh
- Department of Neurology, Case Western Reserve University, Cleveland, OH, USA; Daroff-DelOsso Ocular Motility Laboratory, Neurology Service, Louis Stoke VA Medical Center, Cleveland, OH, USA.
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Ghate D, Vedanarayanan V, Kamour A, Corbett JJ, Kedar S. Optic nerve morphology as marker for disease severity in cerebral palsy of perinatal origin. J Neurol Sci 2016; 368:25-31. [DOI: 10.1016/j.jns.2016.06.029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2016] [Revised: 06/07/2016] [Accepted: 06/12/2016] [Indexed: 11/29/2022]
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Author's Reply. Indian J Ophthalmol 2015; 63:360. [PMID: 26244174 PMCID: PMC4463571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Al-Mendalawi M. Etiology and clinical profile of childhood optic nerve atrophy at a tertiary eye care center in South India. Indian J Ophthalmol 2015; 63:359-60. [PMID: 26044485 PMCID: PMC4463570 DOI: 10.4103/0301-4738.158102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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