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Mhango PP, Zungu TL, Nkume HI, Musopole A, Mdala SY. The outcomes of paediatric cataract surgery with intraocular lens insertion in sub-Saharan Africa: a systematic review. Syst Rev 2024; 13:204. [PMID: 39095869 PMCID: PMC11295353 DOI: 10.1186/s13643-024-02607-z] [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] [Received: 07/13/2023] [Accepted: 07/09/2024] [Indexed: 08/04/2024] Open
Abstract
IMPORTANCE Cataract is one of the leading causes of childhood blindness in Africa. The management of this condition requires timely surgical extraction of the cataractous lens with immediate optical correction and long-term follow-up to monitor visual improvement and manage complications that may arise. This review provides an opportunity to benchmark outcomes and to shed light on the reasons for those outcomes. OBJECTIVES To review the published literature and report on the outcomes of paediatric cataract surgery with intraocular lens insertion in sub-Saharan Africa. DATA SOURCE The EMBASE, PubMed, Scopus, and Web of Science were searched for relevant articles. STUDY SELECTION We included all published primary studies from sub-Saharan Africa on cataract surgery outcomes in children aged 0-16 years with primary intraocular lens implantation conducted between 1990 and 2020. Eligible studies were those published in English or for which an English translation was available. In addition, reviewers screened the reference lists of all studies included in the full-text review for eligible studies. During the review, studies fitting the inclusion criteria above except for having been conducted in middle and high-income countries were tagged and placed in a comparison arm. DATA EXTRACTION AND SYNTHESIS Study eligibility was determined by two independent reviewers, and data extraction was conducted by one reviewer with entries checked for accuracy by another reviewer. Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines for data synthesis were followed. The Joanna Briggs Institute (JBI) critical appraisal checklist was used for quality appraisal of the studies. The statistical software R was used in the analysis, and data were pooled using a random-effects model. Forest plots were generated using the R package 'metafor'. MAIN OUTCOMES AND MEASURES The primary outcome was visual acuity (VA) after cataract surgery and the proportions of eyes that achieved good, borderline, or poor visual outcome according to the World Health Organisation (WHO) categorisation of post-operative visual acuity. The secondary outcome measures reported included lag time to surgery, rates of follow-up, and rate of complications. RESULTS Eight out of 4763 studies were eligible for inclusion in this review, and seven were included in the quantitative analysis. There was a male preponderance in the study population, and the mean age at the time of cataract surgery ranged from 3.4 to 8.4 years. Visual outcomes were available for short-term visual outcomes (1 to 6 months) as the studies had a significant loss to follow-up. The pooled proportion of eyes that achieved a good visual acuity (i.e. equal to or greater than 6/18) in the short-term period was 31% (CI, 20-42). The comparative studies from middle and high-income countries reported proportions ranging from 41 to 91%, with higher thresholds for good visual acuity of 6/12 and 6/15. CONCLUSION AND RELEVANCE This review reports that there is a lower proportion of eyes with good outcomes after undergoing paediatric cataract surgery in sub-Saharan Africa than in middle- and high-income countries. Furthermore, this review states that there is a high proportion of patients lost to follow-up and suboptimal refractive correction and amblyopia treatment after paediatric cataract surgery.
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Affiliation(s)
- Priscilla Princess Mhango
- Ophthalmology Unit, Department of Surgery, Kamuzu University of Health Sciences (Formerly University of Malawi College of Medicine), P. Bag 360, Blantyre, Malawi.
| | - Thokozani Linda Zungu
- Ophthalmology Unit, Department of Surgery, Kamuzu University of Health Sciences (Formerly University of Malawi College of Medicine), P. Bag 360, Blantyre, Malawi
| | | | - Alinune Musopole
- Department of Biomedical Sciences, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - Shaffi Yusuf Mdala
- Ophthalmology Unit, Department of Surgery, Kamuzu University of Health Sciences (Formerly University of Malawi College of Medicine), P. Bag 360, Blantyre, Malawi
- Queen Elizabeth Central Hospital, Blantyre, Malawi
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Mandal S, Singhal D, Saluja G, Nagpal R, Tripathy K, Tripathi M, Sharma N, Maharana PK. Management of ectopia lentis in children. Saudi J Ophthalmol 2024; 38:226-234. [PMID: 39465025 PMCID: PMC11503969 DOI: 10.4103/sjopt.sjopt_172_23] [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: 08/01/2023] [Revised: 08/28/2023] [Accepted: 09/17/2023] [Indexed: 10/29/2024] Open
Abstract
The medical management of ectopia lentis involves refractive correction as well as co-management of any associated systemic disease. Surgical management remains a challenge, as inherent defects in the lens capsule make implantation of an intraocular lens (IOL) difficult. Multiple visual rehabilitative measures are available such as aphakic contact lenses or spectacles, capsular bag fixation with implantation of in-the-bag IOL, iris-fixated, and scleral-fixated IOL. It depends on the surgeon's expertise and discretion whether the capsular bag needs to be preserved or compromised.
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Affiliation(s)
- Sohini Mandal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | | | - Gunjan Saluja
- Bhatia Advanced Eye Care Centre, Strabismus, Oculoplasty, and Neuro-Ophthalmology Services, Bhatia Advanced Eye Care Centre, Bhilai, Chhattisgarh, India
| | - Ritu Nagpal
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Koushik Tripathy
- Department of Retina, Uvea and Cataract, ASG Eye Hospital, Kolkata, West Bengal, India
| | - Manasi Tripathi
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Namrata Sharma
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Prafulla K. Maharana
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Khokhar S, Chandel L, Rani D, Rathod A, Nathiya V, Pujari A. Visual axis opacification after pediatric cataract surgery - An analysis of morphology and etiology. Indian J Ophthalmol 2024; 72:S623-S627. [PMID: 38454840 PMCID: PMC11338403 DOI: 10.4103/ijo.ijo_2339_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: 08/25/2023] [Revised: 12/15/2023] [Accepted: 12/17/2023] [Indexed: 03/09/2024] Open
Abstract
PURPOSE To investigate the morphological types and delineate the clinical and surgical variables associated with VAO in children undergoing pediatric cataract surgery. METHODS We included 33 eyes of 28 children who developed clinically significant visual axis opacification (VAO) after congenital or developmental cataract surgery. All eyes underwent a comprehensive examination under anesthesia followed by a membranectomy to clear the visual axis. We classified VAO into three subgroups: fibrotic, proliferative, and combined morphologies. We reviewed and analyzed the retrospective data and the findings during membranectomy to identify the etiological variables associated with various morphologies of VAO. RESULTS The median age at primary surgery was 7 (2-96) months. The median interval from primary surgery to the first documentation of VAO was 6 (1-22) months. Younger children developed VAO sooner than older children. VAO was fibrotic in 11 eyes (33%), proliferative in 18 eyes (54.5%), and combined in four eyes (12.12%). Most children with fibrotic VAO belonged to economically disadvantaged sections of society ( P = 0.04). CONCLUSION Lower age at primary surgery was the predominant risk factor for the development of VAO. Besides primary posterior capsulotomy and adequate anterior vitrectomy, a strict adherence to anti- inflammatory measures and follow up in necessary to prevent the occurrence of VAO. A close follow-up facilitates early detection and management, which can prevent the onset of visually impairing amblyopia.
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Affiliation(s)
- Sudarshan Khokhar
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Lekha Chandel
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Deeksha Rani
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Aishwarya Rathod
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Venkatesh Nathiya
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Amar Pujari
- Department of Ophthalmology, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Yu X, Zhao Y, Yang Z, Chen X, Kang G. Genetic research on Nance-Horan syndrome caused by a novel mutation in the NHS gene. Gene 2024; 906:148223. [PMID: 38286268 DOI: 10.1016/j.gene.2024.148223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 01/21/2024] [Accepted: 01/26/2024] [Indexed: 01/31/2024]
Affiliation(s)
- Xuelin Yu
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
| | - Yueyue Zhao
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
| | - Zhenghua Yang
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
| | - Xing Chen
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
| | - Gangjing Kang
- Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, China.
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Kemmanu V, Khanum A, Madhavrao B, Raghunandan N, Muthu S, Venkatesh R, Shetty BK. Outcome of pediatric cataract surgery including color vision, stereopsis, and cognition in a tertiary eye care center in India. Oman J Ophthalmol 2024; 17:237-244. [PMID: 39132104 PMCID: PMC11309545 DOI: 10.4103/ojo.ojo_225_22] [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: 07/31/2022] [Revised: 04/07/2024] [Accepted: 05/15/2024] [Indexed: 08/13/2024] Open
Abstract
BACKGROUND Pediatric cataract is an important cause of avoidable childhood blindness in India. Although there are studies on clinical features and visual acuity outcomes of pediatric cataract surgery, there are no studies that look into aspects of color vision, stereopsis, and cognitive functions in children with cataracts. Studying these parameters pre- and postsurgery will help us assess the overall components of visual function that are critical for the child's development. With this in mind, we aimed to study the clinical features, outcome of treatment, color vision, stereopsis, and cognitive functions in children with cataracts. MATERIALS AND METHODS Design: Hospital-based prospective descriptive study. Data of 68 children (0 < 18 years) were collected, on the clinical features, visual acuity, color vision, stereopsis, and social and intelligence quotient before and after surgery. Data analysis was performed using Graph Pad Prism software version 9.4.0 (673). RESULTS Ninety eyes of 68 children (36-bilateral/32-unilateral) were operated. A total of 46 children were available at 6 months' follow-up (28 bilateral cataracts (46 eyes) and 18 unilateral cataracts). Nineteen (67.8%) of the bilateral, had a best corrected visual acuity of 6/6-6/18 in the better eye and nine (50%) of the unilateral had a visual acuity of 6/18-6/6 in the operated eye. Preoperatively, 61.5% of the children had a stereopsis of 100-600 arc-secs. Post-operatively, 84.4% of the children had a stereopsis in the range <50-600 arc-secs. All children had color vision deficiency. Preoperatively, 62% of the children had strong and moderate deficiency, whereas postoperatively, 66.6% had mild deficiency. We found negative correlation (r = -0.503) between social quotient and percentage of visual impairment indicating that when visual impairment increases social quotient decreases. The mean IQ preoperatively was 94.36 ± 2.98 and postoperatively 101.38 ± 2.77, with 95% confidence interval P value was statistically significant (P = 0.0001). This shows better and faster performance postoperatively. CONCLUSION Majority of the children had improved visual acuity after surgery. This outcome can be extrapolated to the overall improvement in stereopsis, color vision, and higher cognitive functions.
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Affiliation(s)
- Vasudha Kemmanu
- Department of Pediatric Ophthalmology and Strabismus Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Aayesha Khanum
- Department of Vitreo-retinal Services Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Bhanumathi Madhavrao
- Department of Pediatric Ophthalmology and Strabismus Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Nithya Raghunandan
- Department of Pediatric Ophthalmology and Strabismus Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Sumitha Muthu
- Department of Pediatric Ophthalmology and Strabismus Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Ramesh Venkatesh
- Department of Vitreo-retinal Services Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Bhujanga K. Shetty
- Department of Cataract Services Narayana Nethralaya, Bengaluru, Karnataka, India
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Guarnera A, Valente P, Pasquini L, Moltoni G, Randisi F, Carducci C, Carboni A, Lucignani G, Napolitano A, Romanzo A, Longo D, Gandolfo C, Rossi-Espagnet MC. Congenital Malformations of the Eye: A Pictorial Review and Clinico-Radiological Correlations. J Ophthalmol 2024; 2024:5993083. [PMID: 38322500 PMCID: PMC10846927 DOI: 10.1155/2024/5993083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 06/23/2023] [Accepted: 11/10/2023] [Indexed: 02/08/2024] Open
Abstract
Congenital malformations of the eye represent a wide and heterogeneous spectrum of abnormalities that may be part of a complex syndrome or be isolated. Ocular malformation severity depends on the timing of the causative event during eye formation, ranging from the complete absence of the eye if injury occurs during the first weeks of gestation, to subtle abnormalities if the cause occurs later on. Knowledge of ocular malformations is crucial to performing a tailored imaging protocol and correctly reporting imaging findings. Together with the ophthalmologic evaluation, imaging may help frame ocular malformations and identify underlying genetic conditions. The purpose of this pictorial review is to describe the imaging features of the main ocular malformations and the related ophthalmologic findings in order to provide a clinico-radiological overview of these abnormalities to the clinical radiologist. Sight is a crucial sense for children to explore the world and relate with their parents from birth. Vision impairment or even blindness secondary to ocular malformations deeply affects children's growth and quality of life.
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Affiliation(s)
- Alessia Guarnera
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
- Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital, La Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy
| | - Paola Valente
- Ophthalmology Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Luca Pasquini
- Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital, La Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy
- Neuroradiology Service, Department of Radiology, Memorial Sloan Kettering Cancer Center, New York 10065, NY, USA
| | - Giulia Moltoni
- Neuroradiology Unit, NESMOS Department, Sant'Andrea Hospital, La Sapienza University, Via di Grottarossa 1035-1039, Rome 00189, Italy
| | - Francesco Randisi
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Chiara Carducci
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Alessia Carboni
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Giulia Lucignani
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Antonio Napolitano
- Medical Physics Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Antonino Romanzo
- Ophthalmology Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Daniela Longo
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Carlo Gandolfo
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
| | - Maria Camilla Rossi-Espagnet
- Neuroradiology Unit, Imaging Department, Bambino Gesù Children's Hospital, IRCCS, Piazza S. Onofrio 4, Rome 00165, Italy
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Sun Q, Li J, Ma J, Zheng Y, Ju R, Li X, Ren X, Huang L, Chen R, Tan X, Luo L. JAM-C Is Important for Lens Epithelial Cell Proliferation and Lens Fiber Maturation in Murine Lens Development. Invest Ophthalmol Vis Sci 2023; 64:15. [PMID: 38095908 PMCID: PMC10723223 DOI: 10.1167/iovs.64.15.15] [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: 09/03/2023] [Accepted: 11/16/2023] [Indexed: 12/17/2023] Open
Abstract
Purpose The underlying mechanism of congenital cataracts caused by deficiency or mutation of junctional adhesion molecule C (JAM-C) gene remains unclear. Our study aims to elucidate the abnormal developmental process in Jamc-/- lenses and reveal the genes related to lens development that JAM-C may regulate. Methods Jamc knockout (Jamc-/-) mouse embryos and pups were generated for in vivo studies. Four key developmental stages from embryonic day (E) 12.5 to postnatal day (P) 0.5 were selected for the following experiments. Hematoxylin and eosin staining was used for histological analysis. The 5-bromo-2'-deoxyuridine (BrdU) incorporation assay and TUNEL staining were performed to label lens epithelial cell (LEC) proliferation and apoptosis, respectively. Immunofluorescence and Western blot were used to analyze the markers of lens epithelium, cell cycle exit, and lens fiber differentiation. Results JAM-C was expressed throughout the process of lens development. Deletion of Jamc resulted in decreased lens size and disorganized lens fibers, which arose from E16.5 and aggravated gradually. The LECs of Jamc-/- lenses showed decreased quantity and proliferation, accompanied with reduction of key transcription factor, FOXE3. The fibers in Jamc-/- lenses were disorganized. Moreover, Jamc-deficient lens fibers showed significantly altered distribution patterns of Cx46 and Cx50. The marker of fiber homeostasis, γ-crystallin, was also decreased in the inner cortex and core fibers of Jamc-/- lenses. Conclusions Deletion of JAM-C exhibits malfunction of LEC proliferation and fiber maturation during murine lens development, which may be related to the downregulation of FOXE3 expression and abnormal localization patterns of Cx46 and Cx50.
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Affiliation(s)
- Qihang Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Jiani Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Jingyu Ma
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Yuxing Zheng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Rong Ju
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xuri Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xiangrong Ren
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Lijuan Huang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Rongyuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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Ullah MI, Rehman Z, Dad R, Alsrhani A, Shakil M, Ghanem HB, Alameen AAM, Elsadek MF, Eltayeb LB, Ullah S, Atif M. Identification and Functional Characterization of Mutation in FYCO1 in Families with Congenital Cataract. Life (Basel) 2023; 13:1788. [PMID: 37629644 PMCID: PMC10456301 DOI: 10.3390/life13081788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/10/2023] [Accepted: 08/18/2023] [Indexed: 08/27/2023] Open
Abstract
Congenital cataract (CC) causes a third of the cases of treatable childhood blindness worldwide. CC is a disorder of the crystalline lens which is established as clinically divergent and has complex heterogeneity. This study aimed to determine the genetic basis of CC. Whole blood was obtained from four consanguineous families with CC. Genomic DNA was extracted from the blood, and the combination of targeted and Sanger sequencing was used to identify the causative gene. The mutations detected were analyzed in silico for structural and protein-protein interactions to predict their impact on protein activities. The sequencing found a known FYCO1 mutation (c.2206C>T; p.Gln736Term) in autosomal recessive mode in families with CC. Co-segregation analysis showed affected individuals as homozygous and carriers as heterozygous for the mutation and the unaffected as wild-type. Bioinformatics tools uncovered the loss of the Znf domain and structural compactness of the mutant protein. In conclusion, a previously reported nonsense mutation was identified in four consanguineous families with CC. Structural analysis predicted the protein as disordered and coordinated with other structural proteins. The autophagy process was found to be significant for the development of the lens and maintenance of its transparency. The identification of these markers expands the scientific knowledge of CC; the future goal should be to understand the mechanism of disease severity. Ascertaining the genetic etiology of CC in a family member facilitates establishing a molecular diagnosis, unlocks the prospect of prenatal diagnosis in pregnancies, and guides the successive generations by genetic counseling.
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Affiliation(s)
- Muhammad Ikram Ullah
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (A.A.); (H.B.G.); (A.A.M.A.); (M.A.)
| | - Zaira Rehman
- Department of Pathology, Indus Hospital & Health Network, Karachi 75190, Pakistan;
| | - Rubina Dad
- Structure Biology Research Centre, Human Technopole, 20157 Milan, Italy
| | - Abdullah Alsrhani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (A.A.); (H.B.G.); (A.A.M.A.); (M.A.)
| | - Muhammad Shakil
- Department of Biochemistry, King Edward Medical University, Lahore 54600, Pakistan;
- Department of Biochemistry, University of Health Sciences, Lahore 54600, Pakistan
| | - Heba Bassiony Ghanem
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (A.A.); (H.B.G.); (A.A.M.A.); (M.A.)
| | - Ayman Ali Mohammed Alameen
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (A.A.); (H.B.G.); (A.A.M.A.); (M.A.)
| | - Mohamed Farouk Elsadek
- Department of Community Health Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11433, Saudi Arabia;
| | - Lienda Bashier Eltayeb
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdul-Aziz University, Al-Kharj, Riyadh 11942, Saudi Arabia;
| | - Sajjad Ullah
- University Institute of Medical Laboratory Technology, Faculty of Allied Health Sciences, The University of Lahore, Lahore 54600, Pakistan;
| | - Muhammad Atif
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia; (A.A.); (H.B.G.); (A.A.M.A.); (M.A.)
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Al-Bakri M, Skovgaard AM, Bach-Holm D, Larsen DA, Siersma V, Kessel L. School performances in children with cataract: results from a population-based cohort study. BMJ Open 2023; 13:e072984. [PMID: 37532485 PMCID: PMC10401207 DOI: 10.1136/bmjopen-2023-072984] [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] [Indexed: 08/04/2023] Open
Abstract
OBJECTIVES Childhood cataract is a chronic condition that may interfere with the child's learning capacities. We aimed to investigate whether childhood cataract influences academic development by comparing school performance in reading and mathematics in children with cataract to a matched control group. DESIGN Nationwide registry-based cohort study. SETTINGS Two surgical centres that perform all treatments for childhood cataract in Denmark. PARTICIPANTS Children born between 2000 and 2009 diagnosed with cataract before 10 years of age (n=275) and an age-matched and sex-matched control group (n=2473). MAIN OUTCOME MEASURES School performance was assessed as test scores in national tests performed at regular intervals from grade 2 to grade 8 in reading and mathematics. Analyses were corrected for birth origin, child somatic and mental disorder and parental socioeconomic status and mental disorders. RESULTS Of 275 children, 85 (30.9%) were operated for bilateral cataract, 79 (28.7%) unilateral cataract and 111 (40,4%) were not operated. We found that children with cataract have lower participation rate in the tests (62.5%) compared with the control cohort (77.2%) (p value=0.0001). After adjusting the pooled analyses for birth origin, somatic and mental disease in the child and parental socioeconomic status and mental disorders, we found that the children with cataract scored significantly lower in mathematics compared with those without cataract (mean difference=-4.78, 95% CI: -8.18 to -1.38, p value=0.006), whereas no difference was found regarding scores in reading (p=0.576). The lower score in mathematics was driven by children who had been operated for bilateral cataract (p-value=0.004). CONCLUSION Children with cataract without somatic or neurodevelopmental comorbidities or psychosocial adversities seem to do well in school, whereas children operated for bilateral cataract have higher frequencies of difficulties in mathematical tasks.
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Affiliation(s)
- Moug Al-Bakri
- Department of Ophthalmology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Anne Mette Skovgaard
- National Institute of Public Health, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
| | - Daniella Bach-Holm
- Department of Ophthalmology, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | | | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
| | - Line Kessel
- Department of Ophthalmology, Rigshospitalet Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Rodríguez-Solana P, Arruti N, Nieves-Moreno M, Mena R, Rodríguez-Jiménez C, Guerrero-Carretero M, Acal JC, Blasco J, Peralta JM, Del Pozo Á, Montaño VEF, Dios-Blázquez LD, Fernández-Alcalde C, González-Atienza C, Sánchez-Cazorla E, Gómez-Cano MDLÁ, Delgado-Mora L, Noval S, Vallespín E. Whole Exome Sequencing of 20 Spanish Families: Candidate Genes for Non-Syndromic Pediatric Cataracts. Int J Mol Sci 2023; 24:11429. [PMID: 37511188 PMCID: PMC10380485 DOI: 10.3390/ijms241411429] [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: 05/25/2023] [Revised: 06/23/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
Non-syndromic pediatric cataracts are defined as opacification of the crystalline lens that occurs during the first years of life without affecting other organs. Given that this disease is one of the most frequent causes of reversible blindness in childhood, the main objective of this study was to propose new responsible gene candidates that would allow a more targeted genetic approach and expand our genetic knowledge about the disease. We present a whole exome sequencing (WES) study of 20 Spanish families with non-syndromic pediatric cataracts and a previous negative result on an ophthalmology next-generation sequencing panel. After ophthalmological evaluation and collection of peripheral blood samples from these families, WES was performed. We were able to reach a genetic diagnosis in 10% of the families analyzed and found genes that could cause pediatric cataracts in 35% of the cohort. Of the variants found, 18.2% were classified as pathogenic, 9% as likely pathogenic, and 72.8% as variants of uncertain significance. However, we did not find conclusive results in 55% of the families studied, which suggests further studies are needed. The results of this WES study allow us to propose LONP1, ACACA, TRPM1, CLIC5, HSPE1, ODF1, PIKFYVE, and CHMP4A as potential candidates to further investigate for their role in pediatric cataracts, and AQP5 and locus 2q37 as causal genes.
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Affiliation(s)
- Patricia Rodríguez-Solana
- Molecular Ophthalmology Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.G.-A.); (E.S.-C.)
| | - Natalia Arruti
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), La Paz University Hospital, 28046 Madrid, Spain
| | - María Nieves-Moreno
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), La Paz University Hospital, 28046 Madrid, Spain
| | - Rocío Mena
- Molecular Ophthalmology Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.G.-A.); (E.S.-C.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (Á.D.P.); (M.d.L.Á.G.-C.); (L.D.-M.)
| | - Carmen Rodríguez-Jiménez
- Molecular Ophthalmology Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.G.-A.); (E.S.-C.)
| | - Marta Guerrero-Carretero
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
| | - Juan Carlos Acal
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
| | - Joana Blasco
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
| | - Jesús M. Peralta
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
| | - Ángela Del Pozo
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (Á.D.P.); (M.d.L.Á.G.-C.); (L.D.-M.)
- Clinical Bioinformatics Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, CIBERER, La Paz University Hospital, 28046 Madrid, Spain;
| | - Victoria E. F. Montaño
- Molecular Ophthalmology Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.G.-A.); (E.S.-C.)
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (Á.D.P.); (M.d.L.Á.G.-C.); (L.D.-M.)
| | - Lucía De Dios-Blázquez
- Clinical Bioinformatics Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, CIBERER, La Paz University Hospital, 28046 Madrid, Spain;
| | - Celia Fernández-Alcalde
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
| | - Carmen González-Atienza
- Molecular Ophthalmology Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.G.-A.); (E.S.-C.)
| | - Eloísa Sánchez-Cazorla
- Molecular Ophthalmology Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.G.-A.); (E.S.-C.)
| | - María de Los Ángeles Gómez-Cano
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (Á.D.P.); (M.d.L.Á.G.-C.); (L.D.-M.)
- Clinical Genetics Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, CIBERER, La Paz University Hospital, 28046 Madrid, Spain
| | - Luna Delgado-Mora
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (Á.D.P.); (M.d.L.Á.G.-C.); (L.D.-M.)
- Clinical Genetics Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, CIBERER, La Paz University Hospital, 28046 Madrid, Spain
| | - Susana Noval
- Department of Pediatric Ophthalmology, IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (N.A.); (M.N.-M.); (M.G.-C.); (J.C.A.); (J.B.); (J.M.P.); (C.F.-A.); (S.N.)
- European Reference Network on Eye Diseases (ERN-EYE), La Paz University Hospital, 28046 Madrid, Spain
| | - Elena Vallespín
- Molecular Ophthalmology Section, Institute of Medical and Molecular Genetics (INGEMM), IdiPaz, La Paz University Hospital, 28046 Madrid, Spain; (P.R.-S.); (R.M.); (C.R.-J.); (V.E.F.M.); (C.G.-A.); (E.S.-C.)
- European Reference Network on Eye Diseases (ERN-EYE), La Paz University Hospital, 28046 Madrid, Spain
- Biomedical Research Center in the Rare Diseases Network (CIBERER), Carlos II Health Institute (ISCIII), 28029 Madrid, Spain; (Á.D.P.); (M.d.L.Á.G.-C.); (L.D.-M.)
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11
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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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Theophanous CN, Wolfgeher DJ, Farooq AV, Hilkert Rodriguez S. Biomarkers of Pediatric Cataracts: A Proteomics Analysis of Aqueous Fluid. Int J Mol Sci 2023; 24:ijms24109040. [PMID: 37240389 DOI: 10.3390/ijms24109040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Revised: 05/13/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Cataracts are among the most common causes of childhood vision loss worldwide. This study seeks to identify differentially expressed proteins in the aqueous humor of pediatric cataract patients. Samples of aqueous humor were collected from pediatric and adult cataract patients and subjected to mass spectrometry-based proteomic analysis. Samples of pediatric cataracts were grouped by subtype and compared to adult samples. Differentially expressed proteins in each subtype were identified. Gene ontology analysis was performed using WikiPaths for each cataract subtype. Seven pediatric patients and ten adult patients were included in the study. Of the pediatric samples, all seven (100%) were male, three (43%) had traumatic cataracts, two (29%) had congenital cataracts, and two (29%) had posterior polar cataracts. Of the adult patients, seven (70%) were female and seven (70%) had predominantly nuclear sclerotic cataracts. A total of 128 proteins were upregulated in the pediatric samples, and 127 proteins were upregulated in the adult samples, with 75 proteins shared by both groups. Gene ontology analysis identified inflammatory and oxidative stress pathways as upregulated in pediatric cataracts. Inflammatory and oxidative stress mechanisms may be involved in pediatric cataract formation and warrant further investigation.
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Affiliation(s)
- Christos N Theophanous
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Donald J Wolfgeher
- Department of Molecular Genetics and Cell Biology, University of Chicago, Chicago, IL 60637, USA
| | - Asim V Farooq
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA
| | - Sarah Hilkert Rodriguez
- Department of Ophthalmology and Visual Science, University of Chicago Medical Center, Chicago, IL 60637, USA
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Shanbagh S, Matalia J, Kannan R, Shetty R, Panmand P, Muthu SO, Chaurasia SS, Deshpande V, Bhattacharya SS, Gopalakrishnan AV, Ghosh A. Distinct gene expression profiles underlie morphological and etiological differences in pediatric cataracts. Indian J Ophthalmol 2023; 71:2143-2151. [PMID: 37203095 PMCID: PMC10391435 DOI: 10.4103/ijo.ijo_3269_22] [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: 05/20/2023] Open
Abstract
Purpose Pediatric cataract is a major cause of preventable childhood blindness worldwide. Although genetic mutations or infections have been described in patients, the mechanistic basis of human cataract development remains poorly understood. Therefore, gene expression of structural, developmental, profibrotic, and transcription factors in phenotypically and etiologically distinct forms of pediatric cataracts were evaluated. Methods This cross-sectional study included 89 pediatric cataract subjects subtyped into 1) prenatal infectious (cytomegalovirus, rubella, and combined cytomegalovirus with rubella infection), 2) prenatal non-infectious, 3) posterior capsular anomalies, 4) postnatal, 5) traumatic, and 6) secondary, and compared to clear, non-cataractous material of eyes with the subluxated lenses. Expression of lens structure-related genes (Aqp-0, HspA4/Hsp70, CrygC), transcription factors (Tdrd7, FoxE3, Maf, Pitx 3) and profibrotic genes (Tgfβ, Bmp7, αSmA, vimentin) in surgically extracted cataract lens material were studied and correlated clinically. Results In cataract material, the lens-related gene expression profiles were uniquely associated with phenotype/etiology of different cataracts. Postnatal cataracts showed a significantly altered FoxE3 expression. Low levels of Tdrd7 expression correlated with posterior subcapsular opacity, whereas CrygC correlated significantly with anterior capsular ruptures. The expression of Aqp0 and Maf was elevated in infectious cataracts, particularly in CMV infections, compared to other cataract subtypes. Tgfβ showed significantly low expression in various cataract subtypes, whereas vimentin had elevated gene expression in infectious and prenatal cataracts. Conclusion A significant association between lens gene expression patterns in phenotypically and etiologically distinct subtypes of pediatric cataracts suggests regulatory mechanisms in cataractogenesis. The data reveal that cataract formation and presentation is a consequence of altered expression of a complex network of genes.
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Affiliation(s)
- Shaika Shanbagh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, Karnataka; Department of Integrative Biology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Jyoti Matalia
- Department of Paediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Ramaraj Kannan
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, Karnataka, India
| | - Rohit Shetty
- Cornea and Refractive Services, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Pratibha Panmand
- Department of Paediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Sumitha O Muthu
- Department of Paediatric Ophthalmology and Strabismus, Narayana Nethralaya, Bengaluru, Karnataka, India
| | - Shyam S Chaurasia
- Department of Ophthalmology and Visual Sciences, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Vrushali Deshpande
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, Karnataka, India
| | - Shomi S Bhattacharya
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, Karnataka, India; Institute of Ophthalmology, University College London, London, UK
| | - Abilash V Gopalakrishnan
- Department of Integrative Biology, School of Bio Sciences and Technology, Vellore Institute of Technology, Vellore, Tamil Nadu, India
| | - Arkasubhra Ghosh
- GROW Research Laboratory, Narayana Nethralaya Foundation, Bengaluru, Karnataka, India
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14
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Luoma-Overstreet GN, Kumar V, Lam K, Brown DD, Couser NL. The epidemiology of strabismus and cataracts within a pediatric population in Saint Vincent and the Grenadines: an analysis of 201 consecutive cases. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2023; 14:11-18. [PMID: 37214589 PMCID: PMC10195391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 03/28/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE Childhood cataracts and strabismus are among the most common causes of visual impairment in children worldwide, and prompt diagnosis and correction can significantly reduce disease burden. In certain regions, including the Eastern Caribbean, access to adequate treatment can be limited and epidemiological data scarce. This study aims to analyze the epidemiological data of pediatric strabismus and cataract cases in St. Vincent and the Grenadines. METHODS The setting of the study is a clinical practice including 201 patients between the age of 0 to 19 who received care with World Pediatric Project (WPP). Factors analyzed include patient age, sex, and type of cataract or strabismus. The findings were compared to publicly available demographic information. RESULTS The cases were divided into cataract (n=51), strabismus (n=134), and both strabismus and cataract (n=16). Mean ages (years) were 5.96, 5.54, and 4.50, respectively. The most frequent type of cataract and strabismus were congenital (n=25) and esotropia (n=95), respectively. The highest annual cumulative incidence was 31 and 49 cases per 100,000 people for cataracts and strabismus, respectively. CONCLUSION This study provides regional epidemiological data on pediatric strabismus and cataracts. Further studies can expand the patient population by increasing collaboration with local providers. Ultimately, these findings can offer a basis for which additional epidemiological studies can be performed and help guide public health efforts to prevent visual impairment in St. Vincent and the Grenadines.
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Affiliation(s)
| | - Virang Kumar
- Virginia Commonwealth University School of MedicineRichmond, VA, USA
| | - Kevin Lam
- Virginia Commonwealth University School of MedicineRichmond, VA, USA
| | - Donna D Brown
- World Pediatric ProjectRichmond, VA, USA
- Virginia Eye InstituteRichmond, VA, USA
| | - Natario L Couser
- Department of Ophthalmology, Virginia Commonwealth University School of MedicineRichmond, VA, USA
- Department of Pediatrics, Virginia Commonwealth University School of Medicine, Children’s Hospital of Richmond at VCURichmond, VA, USA
- Department of Human and Molecular Genetics, Virginia Commonwealth University School of MedicineRichmond, VA, USA
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15
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Akgun A, Dogan Y. All aspects of galactosemia: a single center experience. J Pediatr Endocrinol Metab 2023; 36:29-35. [PMID: 36399011 DOI: 10.1515/jpem-2022-0308] [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: 06/18/2022] [Accepted: 11/04/2022] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Classic galactosemia is a galactose metabolism disorder due to galactose-1-phosphate uridyltransferase deficiency. In this study we report the clinical features of a cohort of children with classic galactosemia. METHODS A retrospective evaluation was made of the files of 42 cases followed up for a diagnosis of classic galactosemia between January 2000 and December 2021. The data were collected of clinical, laboratory and genetic characteristics. RESULTS The cases comprised of 25 (59.5%) girls and 17 (40.5%) boys with a median age of 15 days (range, 1 day to 9 years) at diagnosis. In addition, thirty-six cases (92.3%) could be diagnosed before they were 4 months old by hospitalization with various clinical findings, primarily liver dysfunction. The most common complaints on presentation were jaundice (78.4%) and vomiting (27%) and the most frequently seen genetic pathogenic variant was c.563A>G (p.Gln188Arg) (92.4%). CONCLUSIONS It can be emphasized that there is a need for a neonatal screening program for classic galactosemia to be able to increase the possibility of early diagnosis and to be able to start treatment before the development of a severe clinical picture.
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Affiliation(s)
- Abdurrahman Akgun
- Department of Pediatrics, Division of Metabolism, Firat University School of Medicine, Elazig, Turkiye
| | - Yasar Dogan
- Department of Pediatrics, Division of Gastroenterology, Firat University School of Medicine, Elazig, Turkey
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16
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Irfani I, Wahyu T, Oktarima P, Caesarya S, Sari M, Karfiati F. Accuracy of the SRK/T Formula in Pediatric Cataract Surgery. CLINICAL OPTOMETRY 2023; 15:1-8. [PMID: 36628129 PMCID: PMC9826636 DOI: 10.2147/opto.s390994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 12/22/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE Determining IOL power is an important step in achieving the desired postoperative refractive target, but this determination remains challenging, as currently the used formulas were developed using IOL power calculations derived from adults. PATIENTS AND METHODS This is a retrospective analytical study with the period of June 2018 to May 2019. All of the data were taken from medical records in referral tertiary eye hospital in Indonesia. All type of cataracts underwent uncomplicated surgeries and in-the-bag IOL implantation were included in this study, while aphakia, secondary IOL implantation, primary sulcus implantation, and history of ocular disorders were excluded. The data were analyzed using Wilcoxon sign-rank, paired t, and Kruskal-Wallis tests. RESULTS Sixty-seven patients (106 eyes) were found to meet the inclusion criteria, average age was 7.35 ± 4.61 years (1.00 to 17.00 years). Average targeted refraction was 1.69 ± 2.06 D (-0.38-+6.99 D), and spherical equivalent (actual postoperative refraction) was -0.90 ± 1.45 D (-4.38 to +2.75 D). There was statistically significant difference between preoperative targeted refraction and actual postoperative refraction (p < 0.001). Mean absolute prediction error (APE) in general was 1.34 ± 1.18 D, 1.22 ± 0.88 D (in short eyes), 1.52 ± 1.37 D (in moderate eyes), and 0.69 ± 0.52 D (in long eyes) (p = 0.202). Mean APE in age group <7 years old was 1.27 ± 1.18 D and ≥7 years-old was 1.42 ± 1.19 D (p = 0.429). CONCLUSION SRK/T formula is fairly accurate in calculating IOL power in pediatric cataract surgery. Mean APE in this study was within the range of accurate mean APE in pediatric patients despite differentiated axial length and age.
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Affiliation(s)
- Irawati Irfani
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Tri Wahyu
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
| | - Primawita Oktarima
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Sesy Caesarya
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Maya Sari
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
| | - Feti Karfiati
- Department of Ophthalmology, Faculty of Medicine Universitas Padjadjaran, Bandung, West Java, Indonesia
- Pediatric Ophthalmology & Strabismus Division, Cicendo National Eye Hospital, Bandung, West Java, Indonesia
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17
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Systemic and ocular associations in pediatric patients undergoing cataract surgery. Graefes Arch Clin Exp Ophthalmol 2023; 261:241-246. [PMID: 35969326 DOI: 10.1007/s00417-022-05802-7] [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: 05/03/2022] [Revised: 07/23/2022] [Accepted: 08/04/2022] [Indexed: 01/04/2023] Open
Abstract
PURPOSE Evaluation for systemic diagnosis is an important part of pediatric cataract management. While there are reports on associated systemic and ocular associations in children with infantile cataracts, reports specifying associations in large cohorts of children undergoing cataract surgery are lacking. METHODS Retrospective chart review of consecutive patients undergoing cataract surgery at a pediatric tertiary referral center during 30-year period was performed. Associated systemic and ocular associations were recorded. The etiologies were analyzed depending on laterality, age, and gender. RESULTS Seven-hundred twenty-seven patients (1135 eyes) were included for analysis: 408 (56%) with bilateral and 319 (44%) with unilateral cataract. An identifiable cause for cataract was identified in 66% (270/408) bilateral and 55% (176/319) unilateral cataract patients. Hereditary cataract accounted for 22% of bilateral cataracts. An underlying syndrome or genetic diagnosis was found in 24% bilateral (97/408, 86 genetic/syndromic, 11 metabolic) but only in 2% of unilateral cases (5/319). Cataracts were the result of treatment for cancer, or other systemic conditions requiring steroids, in 60/408 bilateral (15%) and 15/319 (5%) unilateral cataract patients. In contrast, unilateral cataracts had higher ocular associations (49%, 156/319) than bilateral cataracts (6%, 23/408) primarily ocular trauma (20%, 64/319) and persistent fetal vasculature (20%, 62/319). CONCLUSION Clinicians should be aware of potential systemic and ocular associations among children with visually significant cataracts. Those with no family history of juvenile cataract should be evaluated for systemic associations, and referral to genetics may be warranted in select cases.
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18
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Pediatric cataract surgery: considerations and updates in diagnosis and management. Curr Opin Ophthalmol 2023; 34:58-63. [PMID: 36413417 DOI: 10.1097/icu.0000000000000918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
PURPOSE OF REVIEW The purpose of this review is to provide an overview of updates in the diagnosis and management of pediatric cataracts, with an emphasis on recent discoveries in the last two years. RECENT FINDINGS Pediatric cataracts remain an infrequent but significant disease with vision threatening consequences. Although much of the management has not changed historically, more recent updates, particularly borrowed from adult cataract management, have influenced the field of cataract management in children. Even these studies emphasize that pediatric cataracts are a distinct clinical entity from adult-onset cataracts, and further research is needed to optimize the diagnosis and management of cataracts in childhood. SUMMARY This is an overview of the recent advancements in the diagnosis of management of pediatric cataracts, with advancements that originate from the adult cataract surgery field in addition to studies that challenge classical surgical techniques to make cataract surgery safer and to promote amblyopia therapy.
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Zheng Y, Li L, Wang L, Zhang C. Prenatal ultrasound findings of X-linked congenital cataracts: case report and description of a novel variant. Am J Transl Res 2022; 14:9066-9071. [PMID: 36628231 PMCID: PMC9827286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/06/2022] [Indexed: 01/12/2023]
Abstract
Congenital cataracts, an important cause of permanent visual loss in children, are predominantly caused by hereditary factors. Genetic variants reportedly cause approximately 50% of congenital cataracts. The literature mainly describes cases of autosomal dominant inheritance diagnosed after birth, and minimal information is available concerning the prenatal diagnosis of X-linked congenital cataracts. Prenatal ultrasound is the primary method for diagnosis of congenital cataracts, whereas the diagnostic value of prenatal genetic testing remains controversial; however, such testing is reportedly essential for determination of disease etiology. Here, we describe a 33-year-old multigravida woman with a singleton pregnancy who was referred to our center at 24 weeks for routine prenatal examination; ultrasound imaging revealed bilateral cataracts in the male fetus. Genetic testing revealed a pathogenic variant in exon 11 of the OCRL inositol polyphosphate-5-phosphatase (OCRL) gene in the fetal sample, with the potential to cause the X-linked recessive genetic disease Dent disease 2 (Online Mendelian Inheritance in Man [OMIM]: 300555) or the X-linked recessive genetic disorder Lowe's syndrome (OMIM: 309000). We provide a comprehensive family history and our findings in a gross examination of the stillborn fetus. So, ultrasound imaging provides important information that can guide the diagnosis of congenital cataracts. When congenital cataracts are detected by prenatal ultrasound, a detailed family history should be obtained. We recommend genetic testing of the fetus and the family members to determine the etiology.
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Lam M, Suh D. Screening, Diagnosis, and Treatment of Pediatric Ocular Diseases. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121939. [PMID: 36553382 PMCID: PMC9777216 DOI: 10.3390/children9121939] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 11/28/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022]
Abstract
Vision is an important aspect of a child's quality of life and intellectual, social, and emotional development. Disruptions to vision during infancy and early childhood can cause lifelong vision impairment or blindness. However, early identification and treatment of eye disease can prevent loss of sight and its consequent long-term effects. Therefore, screening guidelines exist to guide physicians in detecting the most common threats to sight in the different stages of infancy and childhood. This review describes common causes of pediatric vision impairment, the recommended screening guidelines for diagnosing them, and current treatment modalities.
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Affiliation(s)
- Matthew Lam
- Creighton University School of Medicine Phoenix Regional Campus, Phoenix, AZ 85012, USA
| | - Donny Suh
- Gavin Herbert Eye Institute, University of California Irvine, Irvine, CA 92697, USA
- Correspondence:
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21
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Accuracy of newer generation intraocular lens power calculation formulas in pediatric cataract patients. Graefes Arch Clin Exp Ophthalmol 2022; 261:1019-1027. [PMID: 36385570 DOI: 10.1007/s00417-022-05896-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 09/23/2022] [Accepted: 11/01/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE To evaluate the accuracy of newer generation intraocular lens (IOL) power calculation formulas (EVO 2.0 and Kane) with established formulas (Barrett Universal II, Haigis and SRK/T) in pediatric cataract patients. METHODS Retrospective study. We enrolled 110 eyes (110 patients) in Eye Hospital of Wenzhou Medical University. All patients underwent uneventful cataract surgery and implanted with posterior chamber IOL in the bag. We calculate the mean prediction errors (PE) and percentage within 1 diopter (D) at 1 month to assess the accuracy, and percentage > 2D was defined as prediction accident. Then, we performed subgroup analysis according to age and axial length (AL). RESULTS The mean age and AL were 37.45 ± 23.28 months and 21.16 ± 1.29 mm. The mean PE for all patients was as follows: Barrett (- 0.30), EVO (0.18), Haigis (- 0.74), Kane (- 0.36), and SRK/T (0.58), p < 0.001. In addition, EVO and SRK/T formulas were relatively accurate in patients younger than 24 months and with AL ≤ 21 mm, while EVO got lower prediction accident rate than SRK/T (3/41 vs 8/41, 4/52 vs 5/52). Moreover, Barrett, EVO, and Kane formulas achieved better accuracy and lower prediction accident rate in patients older than 24 months and with AL > 21 mm (both > 51/69 and 43/58, and < 3/69 and 3/58). CONCLUSIONS In patients older than 24 months and with AL > 21 mm, Barrett, EVO, and Kane formulas were relatively accurate, while in patients younger than 24 months and with AL ≤ 21 mm, EVO was more accurate, followed by SRK/T formula.
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Kaur S, Keshari S, Sukhija J. Delay in pediatric cataract surgery. Indian J Ophthalmol 2022; 70:3726-3727. [PMID: 36190085 PMCID: PMC9789809 DOI: 10.4103/ijo.ijo_1592_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Savleen Kaur
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Correspondence to: Dr. Savleen Kaur, Advanced Eye Centre (Department of Ophthalmology), Post Graduate Institute of Medical Education and Research, Chandigarh, India. E-mail:
| | - Shreya Keshari
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jaspreet Sukhija
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Asif MI, Raj N, Kalra N, Yadav MA, Bafna RK, Sinha R. Premium intraocular lenses in children. Eur J Ophthalmol 2022:11206721221126301. [PMID: 36124376 DOI: 10.1177/11206721221126301] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Multifocal and toric intraocular lenses (IOLs) or the so-called premium IOLs are currently widely used in adult patients as a one-step refractive solution following cataract surgery. However, the decision to implant a premium IOL in a pediatric patient involves multiple factors affecting the child's visual development and is associated with several dilemmas and surgical challenges. The purpose of this review is to summarize these factors and analyse the influence of each of them on the visual outcomes following premium IOL implantation. A review of literature was conducted using the relevant keywords from various databases until 31st January 2022. All pertinent studies with multifocal or toric IOL implantation in children were reviewed, and relevant articles were studied in detail for age, IOL power calculation, visual outcomes (refractive outcomes, contrast sensitivity and stereopsis) and complications such as dysphotic phenomena and others. A total of 17 relevant studies (10 case series/interventional studies and 7 case reports) on the subject were included. All studies showed a favourable refractive outcome; however, the data available was significantly less. Studies with earlier models of multifocal IOLs showed a higher incidence of IOL decentration and posterior capsule opacification; however, more recent studies with newer IOL models showed much better safety profiles. Toric IOLs showed promising results in all the studies evaluated. Premium IOLs have shown promising results in the pediatric age group. However, their long-term outcomes specifically concerning refractive shift, capsular contraction and role in the management of amblyopia needs to be explored further.
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Affiliation(s)
- Mohamed Ibrahime Asif
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Nimmy Raj
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Nidhi Kalra
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Mrinalini Anand Yadav
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Rahul Kumar Bafna
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sinha
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, 28730All India Institute of Medical Sciences, New Delhi, India
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Li J, Tan X, Sun Q, Li X, Chen R, Luo L. Deficiency of Jamc Leads to Congenital Nuclear Cataract and Activates the Unfolded Protein Response in Mouse Lenses. Invest Ophthalmol Vis Sci 2022; 63:1. [PMID: 36048019 PMCID: PMC9440611 DOI: 10.1167/iovs.63.10.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The malfunction of junctional adhesion molecule C (JAM-C) has been reported to induce congenital cataract in humans and mice; however, specific characters and the mechanism of this cataract are still unclear. This study aimed to characterize abnormal lens development in Jamc knockout mice and clarify the underlying mechanism. Methods Jamc knockout mice backcrossed onto the C57BL/6 genetic background were used for this research. Slit-lamp and darkfield images showed the cataract phenotype of Jamc−/− mice. Hematoxylin and eosin staining was performed to visualize the morphological and histological features. RNA sequencing was applied to detect differentially expressed genes. Quantitative RT-PCR, western blot, and immunofluorescence were used to determine the level of unfolded protein response (UPR)-related genes. TUNEL staining was utilized to label cell death. Results Jamc knockout mice exhibited nuclear cataract with abnormal lens morphology and defective degradation of nuclei and organelles in lens fiber cells. Compared with wild-type control mice, the expression level of BiP, CHOP, TRIB3, and CHAC1, genes involved in endoplasmic reticulum stress and the UPR, were highly upregulated in Jamc−/− lenses, suggesting that abnormal lens development was accompanied by UPR activation. Moreover, increased cell death was also found in Jamc−/− lenses. Conclusions Congenital nuclear cataract caused by Jamc deficiency is accompanied by defective degradation of nuclei and organelles in lens fiber cells, lens structure disorder, and UPR activation, suggesting that JAM-C is required for maintaining normal lens development and that UPR activation is involved in cataract formation in Jamc-deficient lenses.
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Affiliation(s)
- Jiani Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xuhua Tan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Qihang Sun
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Xuri Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Rongyuan Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
| | - Lixia Luo
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangzhou, China
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Khokhar S, Gupta Y, Rani D, Rathod A, Moharana S. North India Childhood Cataract Study - The real scenario and causes of surgical delay of pediatric cataract. Indian J Ophthalmol 2022; 70:2421-2425. [PMID: 35791123 PMCID: PMC9426101 DOI: 10.4103/ijo.ijo_293_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: 11/30/2022] Open
Abstract
Purpose: The study sought to describe the clinical presentation pattern of pediatric cataracts and factors leading to delay in surgery at a tertiary care center in North India. Methods: A cross-sectional, interview-based study was conducted from January 2020 to October 2020, that included pediatric patients <12 years, with unilateral or bilateral congenital or developmental cataract. A pre-validated questionnaire was used to record data. The parameters recorded were age at first symptoms, age at diagnosis of cataract, age at surgery, laterality of cataract, first symptom, first family member noticing the abnormality, the morphology of cataract, association of perinatal complications, family history, systemic diseases, and cause (s) of delay in surgery. Results: A total of 89 patients were included. The mean age of subjects was 4.75(±3.51) years. A white pupil was the most common symptom (64.04%) and appeared in infancy in 30.3% of cases. Parents first detected the problem in 60.67%, and the pediatrician was the first medical contact in 11.23% of cases. The median (IQR) delay period between diagnosis of cataract and cataract surgery was 4 (3–6) months, the major causes were long GA waiting (30.33%), and delay due to systemic ill health (14.61%). Conclusion: Parental education on cataract detection is recommended to help in the timely detection and hence, improved outcomes of pediatric cataract surgery. Pediatricians, consulted for any systemic illness, have the role of the second most important contact in the detection of pediatric cataract.
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Affiliation(s)
- Sudarshan Khokhar
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Yogita Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Deeksha Rani
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Aishwarya Rathod
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sikshya Moharana
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Wang M, Li D, Fan Z, Zhang J, Zhou J, Huang Y. Accuracy of Intraocular Lens Power Calculation Formulas in Patients With Multifocal Intraocular Lens Implantation With Optic Capture in Berger Space for Pediatric Cataract. J Pediatr Ophthalmol Strabismus 2022; 60:139-146. [PMID: 35611823 DOI: 10.3928/01913913-20220428-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the accuracy of intraocular lens (IOL) calculation formulas in pediatric patients with multifocal IOL implantation with optic capture in Berger space. METHODS This prospective observational study enrolled 68 children (101 eyes), aged 3 to 14 years, who received multifocal IOL (Tecnis ZMB00; Abbott Medical Optics) implantation with optic capture in Berger space from June 2019 to June 2020 in Qingdao Eye Hospital. Ocular biometry was performed using the IOLMaster 700 (Carl Zeiss Meditec). The IOL power and intended postoperative refraction were calculated using the Hoffer Q, Barrett Universal II, Holladay, Holladay2, SRK/T, Haigis, and SRKII formulas. The refractive state of patients, prediction error, and absolute prediction error were evaluated. RESULTS The mean absolute error of the formulas was significantly different (0.49 diopters [D], Hoffer Q; 0.52 D, Barrett Universal II; 0.47 D, Holladay; 0.54 D, Holladay2; 0.52 D, SRK/T; 0.67 D, Haigis; 0.99 D, SRKII; P < .001). However, the Hoffer Q, Barrett Universal II, Holladay, Holladay2, and SRK/T formulas had a similar accuracy in predicting refractive error within ±0.50 D (62.4%, 59.4%, 62.4%, 62.4%, and 58.4%). There was a trend toward a greater prediction error in eyes with a shorter axial length (≤ 22 mm) or a steeper cornea (> 43.50 D), for which the Hoffer Q and Holladay2 formulas were more accurate. When the axial length was greater than 22 mm or the corneal curvature was 43.50 D or less, the Holladay, Hoffer Q, and Barrett Universal II formulas were more accurate. CONCLUSIONS For patients with pediatric cataract treated with multifocal IOL implantation with optic capture in Berger space, the Hoffer Q, Barrett Universal II, Holladay, Holladay2, and SRK/T formulas performed better than the other formulas. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].
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Trifanenkova IG, Tereshchenko AV, Isaev SV. Femtosecond laser-assisted anterior capsulotomy in children undergoing cataract surgery: a large case series. BMJ Open Ophthalmol 2022; 7:bmjophth-2021-000945. [PMID: 36161832 PMCID: PMC9121473 DOI: 10.1136/bmjophth-2021-000945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 05/05/2022] [Indexed: 11/20/2022] Open
Abstract
Objective To evaluate safety and postoperative visual outcomes of low-energy femtosecond laser-assisted (FLA) anterior capsulotomy in paediatric cataract surgery. Methods and analysis We report a retrospective single-centre consecutive case series of 51 eyes of 33 paediatric cataract patients with a mean age of 3.22 years (range: 2 months to 13 years) who underwent cataract surgery with FLA anterior capsulotomy, using FEMTO LDV Z8 femtosecond laser (Ziemer Ophthalmic Systems). Anterior laser capsulotomy, phacoaspiration and intraocular lens implantation were performed in all eyes. Both intraoperative and long-term postoperative complications, along with long-term monocular corrected distance visual acuity (CDVA), were assessed during average follow-up period of 32.96 months (range: 13–69 months). Results In 48 out of 51 eyes, a well-sized and well-located anterior capsulotomy was achieved without intraoperative complications. Anterior capsule tears occurred in three eyes; however, they did not extend posteriorly and the intraocular lens were placed in the bags without any further complications. Posterior capsular opacification developed in 45.10% of eyes (23 out of 51) and was subsequently treated with neodymium:yttrium-aluminum-garnet (Nd:YAG) laser capsulotomy. Mean CDVA at final follow-up was 20/40 (range: 20/63 to 20/32) in unilateral cases younger than 12 months, 20/40 (range: 20/1000 to 20/25) in unilateral cases older than 12 months, 20/66 (range: 20/400 to 20/32) in bilateral cases younger than 12 months and 20/40 (range: 20/200 to 20/20) in bilateral cases older than 12 months. Conclusions Paediatric cataract surgery with low-energy FLA anterior capsulotomy is a procedure with long-term safety, resulting in significant improvement in CDVA.
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Affiliation(s)
- Irina G Trifanenkova
- Kaluga Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Kaluga, Russian Federation
| | - Aleksandr V Tereshchenko
- Kaluga Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Kaluga, Russian Federation
| | - Sergey V Isaev
- Kaluga Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Kaluga, Russian Federation
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Tariq MA, Uddin QS, Ahmed B, Sheikh S, Ali U, Mohiuddin A. Prevalence of Pediatric Cataract in Asia: A Systematic Review and Meta-Analysis. J Curr Ophthalmol 2022; 34:148-159. [PMID: 36147271 PMCID: PMC9487007 DOI: 10.4103/joco.joco_339_21] [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: 11/27/2021] [Revised: 02/06/2022] [Accepted: 02/09/2022] [Indexed: 01/09/2023] Open
Abstract
Purpose To conduct a systematic review and meta-analysis for estimating the prevalence of pediatric cataracts across Asia. Methods A detailed literature search of PubMed, Embase, Web of Science, Cochrane Library, and Google Scholar databases, from 1990 to July 2021, was performed to include all studies reporting the prevalence of cataracts among children. Two researchers performed the literature search and screening of articles independently, and a third researcher critically reviewed the overall search and screening process to ensure the consistency. The JBI Critical Appraisal Checklist for studies reporting prevalence data was used to assess the methodological quality of the included studies. Results Of the 496 identified articles, 35 studies with a sample size of 1,168,814 from 12 Asian countries were included in this analysis. The estimated pooled prevalence of pediatric cataracts in Asian children is 3.78 (95% confidence interval: 2.54-5.26)/10,000 individuals with high heterogeneity (I[2] = 89.5%). The pooled prevalence by each country per 10,000 was 0.60 in Indonesia, 0.92 in Bangladesh, 1.47 in Iran, 2.01 in Bhutan, 3.45 in Laos, 3.68 in China, 4.27 in Thailand, 4.47 in India, 5.33 in Malaysia, 5.42 in Nepal, 9.34 in Vietnam, and 10.86 in Cambodia. Conclusions This study utilizes existing literature to identify the prevalence of cataracts in Asian children. Moreover, it highlights the need for more epidemiological studies with large sample sizes from other countries in Asia to accurately estimate the burden of disease.
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Affiliation(s)
- Muhammad Ali Tariq
- Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan
| | | | - Bilal Ahmed
- Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan
| | - Shehryar Sheikh
- Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan
| | - Uzair Ali
- Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan
| | - Ashar Mohiuddin
- Department of Ophthalmology, Dow University Hospital, Dow International Medical College, Karachi, Pakistan
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Al-Bakri M, Skovgaard AM, Bach-Holm D, Larsen DA, Siersma V, Kessel L. Increased Incidence of Mental Disorders in Children with Cataract: Findings from a Population-based Study. Am J Ophthalmol 2022; 236:204-211. [PMID: 34648774 DOI: 10.1016/j.ajo.2021.09.034] [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: 06/26/2021] [Revised: 09/23/2021] [Accepted: 09/23/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE To examine the incidence of mental disorders in children with cataract compared with children without cataract. DESIGN Nationwide cohort study based on entries in comprehensive national databases. METHODS The incidence of mental disorders in children born between 2000 and 2017 diagnosed with cataract before 10 years of age (n = 485) was compared with sex- and age-matched controls (n = 4358). Analyses were corrected to somatic disease in the child and parental socioeconomic status and psychiatric morbidity. The study was conducted as 2 university hospitals in Denmark managing children 6 years of age our younger with cataract. RESULTS The incidence of mental disorders was nearly doubled in children with cataract compared with controls (odds ratio [OR], 1.83; 95% CI, 1.28-3.63). The risk of anxiety disorders was quadrupled (OR, 4.10; 95% CI, 1.90-8.84) and the risk of developmental delay was doubled (OR, 2.66; 95% CI, 1.45-4.90). The risk of mental disorders was significantly higher in children diagnosed with cataract in the first 3 years of life compared with controls (OR, 2.36; 95% CI, 1.53-3.64), whereas those diagnosed with cataract later in childhood did not have an increased risk (OR, 1.24; 95% CI, 0.66-2.30). CONCLUSIONS The risk of mental disorders, in particular anxiety and neurodevelopmental delay, is markedly increased in children with cataract and even more so in those diagnosed within the first 3 years of life. Psychiatric screening instruments may be integrated in the management of these children.
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Affiliation(s)
- Moug Al-Bakri
- From the Department of Ophthalmology, Rigshospitalet (M.A.-L., D.B.-HH, L.K.).
| | | | - Daniella Bach-Holm
- From the Department of Ophthalmology, Rigshospitalet (M.A.-L., D.B.-HH, L.K.); Department of Clinical Medicine, University of Copenhagen, Copenhagen
| | | | - Volkert Siersma
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen (V.S.), Copenhagen, Denmark
| | - Line Kessel
- From the Department of Ophthalmology, Rigshospitalet (M.A.-L., D.B.-HH, L.K.); Department of Clinical Medicine, University of Copenhagen, Copenhagen
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Chattannavar G, Badakere A, Mohamed A, Kekunnaya R. Visual outcomes and complications in infantile cataract surgery: a real - world scenario. BMJ Open Ophthalmol 2022; 7:e000744. [PMID: 35342821 PMCID: PMC8905877 DOI: 10.1136/bmjophth-2021-000744] [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: 02/13/2021] [Accepted: 02/04/2022] [Indexed: 11/11/2022] Open
Abstract
Objective To evaluate visual outcomes and complications of infantile cataract surgery through a 1-year follow-up period in a real world scenario. Methods and analysis Prospective observational study evaluating infants with cataract undergoing surgery. Results We analysed 173 eyes of 97 infants (76 bilateral); median age 18.7 weeks, (IQR: 11–33.9 weeks). Toxoplasmosis, rubella, cytomegalovirus and herpes infection was the most common aetiology in both unilateral 10 (47.6%) and bilateral 43 (55.1%) cases, followed by familial and syndromic cases. Fifty-four eyes (29.5%) received primary intraocular lens (IOL) implantation. Seventy-five infants (76%) were less than 6 months of age. At 1-year follow-up, mean log MAR best-corrected visual acuity was 1.00±0.08 and 1.21±0.03 in unilateral and bilateral cases respectively (p=0.012), which was not statistically significant. At 1-year follow-up, pseudophakic(1.09±0.05) eyes had a better mean log MAR visual acuity comparing aphakes(1.24±0.04) clinically but was not statistically significant after the application of Bonferroni correction (p=0.012). The mean myopic shift of −2.9 D±0.39 and −4.53 D±0.55 over 1 year was noted in aphakes and pseudophakes, respectively (p=0.016). Visual axis opacification and glaucoma were the most common complications noted in pseudophakes and aphakes, respectively. Conclusion Primary IOL implantation in selected cases of infantile cataract is a feasible option, particularly in cases when optimal aftercare and refractive rehabilitation of aphakia are not possible.
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Affiliation(s)
- Goura Chattannavar
- Strabimsus, Pediatric and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye care, Child Sight Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Akshay Badakere
- Strabimsus, Pediatric and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye care, Child Sight Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Ashik Mohamed
- Ophthalmic Biophysics, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Ramesh Kekunnaya
- Strabimsus, Pediatric and Neuro-ophthalmology, Jasti V Ramanamma Children's Eye care, Child Sight Institute, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Kavitha V, Heralgi MM, Aafreen S. Analysis of postoperative visual and surgical outcome following surgery for absorbed cataract in pediatric age group and the intraoperative difficulties. Indian J Ophthalmol 2022; 70:788-793. [PMID: 35225515 PMCID: PMC9114569 DOI: 10.4103/ijo.ijo_1091_21] [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: 11/05/2022] Open
Abstract
PURPOSE To analyze the postoperative visual and surgical outcomes following surgery for pediatric-absorbed cataracts and intraoperative difficulties. METHODS This prospective longitudinal study included 43 eyes (30 children) with absorbed cataracts aged between 6 months and 18 years (either sex). All children underwent best-corrected visual acuity (BCVA), anterior and posterior segment evaluation, rubella titer estimation, intraocular lens (IOL) power calculation, superior small incision cataract surgery with or without posterior capsulotomy/anterior vitrectomy/IOL implantation under general anesthesia, visual rehabilitation, and were followed up for 1 year. RESULTS The mean age was 7.89 ± 4.84 years. Preoperative BCVA distance: 39 eyes had either perception of light (PL) or counting finger close to face (CFCF); near BCVA: all eyes had either PL or N36. Postoperative (12 months) distant BCVA: a majority of the eyes (27) had 6/60-1/60, 11 eyes had 6/18-6/36; near: N18 in 19 eyes, N6 in 7 eyes. Anterior continuous curvilinear capsulorrhexis (ACCC) was possible in eight eyes. Cortical aspiration was difficult in 16 eyes (peripheral calcified ring). A majority (32 eyes) underwent in the sulcus implantation (in-the-bag: eight eyes); two eyes: no IOL, one eye: secondary IOL. Eleven eyes had early postoperative inflammation. At 12 months, one eye underwent membranectomy for visual axis opacification and 38 eyes had well-centered IOLs. CONCLUSION Surgery in absorbed cataracts is challenging because of the anatomic disorganization of the absorbed lens. By adopting appropriate surgical methods and good visual rehabilitation, one can achieve satisfactory surgical and visual outcomes, highlighting the need for surgical intervention.
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Affiliation(s)
- V Kavitha
- Department of Paediatric Ophthalmology, Sankara Eye Hospital, Shimoga, Karnataka, India
| | - Mallikarjun M Heralgi
- Department of Paediatric Ophthalmology, Sankara Eye Hospital, Shimoga, Karnataka, India
| | - Saba Aafreen
- Department of Paediatric Ophthalmology, Sankara Eye Hospital, Shimoga, Karnataka, India
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Khokhar SK, Bhayana AA, Banerjee M. Outcomes and complications of immediate versus delayed sequential bilateral cataract surgery in children. J AAPOS 2022; 26:49. [PMID: 34748902 DOI: 10.1016/j.jaapos.2020.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/09/2020] [Accepted: 10/13/2020] [Indexed: 11/18/2022]
Affiliation(s)
| | - Amber Amar Bhayana
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
| | - Mousumi Banerjee
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, AIIMS, New Delhi, India
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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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Mei S, Wu Y, Wang Y, Cui Y, Zhang M, Zhang T, Huang X, Yu S, Yu T, Zhao J. Disruption of PIKFYVE causes congenital cataract in human and zebrafish. eLife 2022; 11:71256. [PMID: 35023829 PMCID: PMC8758139 DOI: 10.7554/elife.71256] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 01/03/2022] [Indexed: 12/14/2022] Open
Abstract
Congenital cataract, an ocular disease predominantly occurring within the first decade of life, is one of the leading causes of blindness in children. However, the molecular mechanisms underlying the pathogenesis of congenital cataract remain incompletely defined. Through whole-exome sequencing of a Chinese family with congenital cataract, we identified a potential pathological variant (p.G1943E) in PIKFYVE, which is located in the PIP kinase domain of the PIKFYVE protein. We demonstrated that heterozygous/homozygous disruption of PIKFYVE kinase domain, instead of overexpression of PIKFYVEG1943E in zebrafish mimicked the cataract defect in human patients, suggesting that haploinsufficiency, rather than dominant-negative inhibition of PIKFYVE activity caused the disease. Phenotypical analysis of pikfyve zebrafish mutants revealed that loss of Pikfyve caused aberrant vacuolation (accumulation of Rab7+Lc3+ amphisomes) in lens cells, which was significantly alleviated by treatment with the V-ATPase inhibitor bafilomycin A1 (Baf-A1). Collectively, we identified PIKFYVE as a novel causative gene for congenital cataract and pinpointed the potential application of Baf-A1 for the treatment of congenital cataract caused by PIKFYVE deficiency.
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Affiliation(s)
- Shaoyi Mei
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, China
| | - Yi Wu
- Shenzhen Key Laboratory for Neuronal Structural Biology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Yan Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Yubo Cui
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The first Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Miao Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, China
| | - Tong Zhang
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, China
| | - Xiaosheng Huang
- Shenzhen Eye Institute, Shenzhen Eye Hospital Affiliated to Jinan University, Shenzhen, China
| | - Sejie Yu
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The first Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Tao Yu
- Shenzhen Key Laboratory for Neuronal Structural Biology, Biomedical Research Institute, Shenzhen Peking University-The Hong Kong University of Science and Technology Medical Center, Shenzhen, China
| | - Jun Zhao
- Department of Ophthalmology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The first Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
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Congenital Cataract Surgery: A Retrospective Analysis of 62 Patients in a Developing Country. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2021:6431276. [PMID: 34976112 PMCID: PMC8718274 DOI: 10.1155/2021/6431276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 11/01/2021] [Accepted: 11/11/2021] [Indexed: 11/17/2022]
Abstract
Purpose This study was aimed at describing our experience in congenital cataract surgery in a developing Country. Methods A retrospective study was conducted in Amman, Jordan. The patients who were diagnosed with congenital cataract and underwent the surgery were included in the study. It was decided to use an intraocular lens if the corneal diameter was more than 10 millimeters. Results The findings revealed that around 13 of the patients did not have any visual axis opacification, indicating that they were aphakic. Visual axis opacification was seen in 8 out of the total sample of participants. Eleven patients with obvious opacification of the visual axis were found to be pseudophakic after at least two procedures and were thus cleared. It was necessary to do a second surgery to rectify the visual axis opacification induced by pseudophakia, which was putting the patient's ability to recuperate at danger. Three of them (or 12 percent) exhibited visual axis opacification, which is a rare occurrence. The intraocular lenses used in the remaining 24 patients were constructed of hydrophilic plastic. Conclusion Patients are less prone to have visual axis opacification while implanted by hydrophobic intraocular lenses is something they should consider.
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Ramesh P, Ramesh S, Ray P, Ebenezar A, Ramesh M, Rajasekaran R. Rare coevality of bilateral mixed morphology of developmental blue dot cataract with lamellar cataract. TNOA JOURNAL OF OPHTHALMIC SCIENCE AND RESEARCH 2022. [DOI: 10.4103/tjosr.tjosr_186_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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Yulia DE, Pambudy IM, Amanda L. Review of Corticosteroid Use in Pediatric Cataract Surgery. Open Ophthalmol J 2021. [DOI: 10.2174/1874364102115010251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Introduction:
Following pediatric cataract surgery, an intense inflammatory response is related to various complications, including posterior capsule opacification (PCO), which is a visually threatening incidence that can lead to visual axis opacification (VAO). Although corticosteroids are essentially effective in reducing inflammation, potential ocular side effects are a remaining concern.
Objective:
This study aimed to review the efficacy and safety of corticosteroid drugs and their administration routes in pediatric patients who underwent cataract surgery
Methods:
A literature search was conducted from four electronic databases using keywords selected a priori. Identified articles were sorted according to the type of corticosteroid used, route of administration, and outcome measures, including inflammatory response and ocular side effects.
Results:
Five studies were included with one case series, one retrospective case-control, and three clinical trials. The total number of subjects was 311 patients, with an age range of six weeks to 15 years old. Four studies analyzed the use of triamcinolone acetonide intracamerally, which was superior to topical steroids. Most of the studies reported a decrease in inflammatory parameters. The outcome of PCO and VAO varied between studies. Nearly all the studies observed elevated intraocular pressure (IOP) as an ocular side effect.
Conclusion:
Various corticosteroids and different delivery routes can be used to ameliorate inflammation in pediatric cataract surgery. However, there is promising evidence suggesting intracameral steroids as substantially beneficial in reducing inflammatory parameters. Due to the limited number of studies reviewed, no firm conclusion regarding the superior steroid preparation or route of administration can be inferred. This review highlights the need for further studies.
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Bhattacharjee H, Buragohain S, Javeri H, Deshmukh S. Optical biometry and influence of media opacity due to cataract on development of axial length in NorthEast Indian paediatric patients- A prospective study. BMC Ophthalmol 2021; 21:374. [PMID: 34686183 PMCID: PMC8539773 DOI: 10.1186/s12886-021-02138-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 09/28/2021] [Indexed: 11/10/2022] Open
Abstract
AIM To study the influence of media opacity due to cataract on the development of axial length in paediatric patients from North-East India, using optical biometry. METHOD This is a prospective, observational study, including consecutive patients attending the paediatric ophthalmology clinic, over a period of 1 year. Patients with other ocular and systemic diseases, unfit for optical biometry measurements due to dense cataract, nystagmus and strabismus were excluded and rest divided into three groups after proper age matching - 1. Group A (Bilateral cataract) 2. Group B (Unilateral cataract) 3. Group C (Bilateral normal). The axial length of the various groups was analysed using independent sample test (for bilateral cataract group) and paired t-test (for unilateral cataract group). Linear regression analysis between age and axial length was done. RESULTS A total of 177 patients were included.80 cases in Group A (bilateral cataract), 18 cases in Group B (unilateral cataract) and 79 in Group C (bilateral normal) The mean age of the patients in all the groups was 8.88 ± 3.51 years (range: 1-17 years). The bivariate analysis and simple linear regression revealed a statistically significant correlation between age and AL in case of cataractous eyes. (Pearson's coefficient: 0.341, p < 0.001). The mean AL was significantly longer (p = 0.013) in the cataractous eyes (mean = 23.38 ± 2.08 mm) of Group A(bilateral cataract) in the 7-12 years age group as compared to the bilaterally normal eyes (mean AL = 22.57 ± 0.70 mm) of patients in the same age group in Group C. The mean AL of cataractous eyes in group B (unilateral cataract) (mean = 22.46 ± 1.73 mm) as compared to the fellow normal eyes, (mean = 21.87 ± 0.97 mm) was not statistically significant. CONCLUSION Cataractous eyes have an abnormal axial length development. The influence of media opacity due to cataract on development of axial length in paediatric eyes in the North-East Indian population is variable, in line with global data on the same. Although there is some influence of media opacity, the exact nature is not clearly understood and may have a crucial interaction with genetic and other environmental factors. Genetic testing integrated with biometric analysis is recommended for further understanding of the ocular growth and development.
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Affiliation(s)
- Harsha Bhattacharjee
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India
| | - Suklengmung Buragohain
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India
| | - Henal Javeri
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India.
| | - Saurabh Deshmukh
- Sri Sankaradeva Nethralaya, 96 Basistha Road, Saurabh Nagar, Beltola Tiniali, Guwahati, Assam, 781028, India
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Majhi D, Sachdeva V, Warkad VU, Kekunnaya R, Natarajan D, Karan S, Garg B. Tribal Odisha Eye Disease Study (TOES). Report # 8. Childhood cataract surgery and determinants of visual outcome in tribal districts. Indian J Ophthalmol 2021; 69:2072-2077. [PMID: 34304181 PMCID: PMC8482927 DOI: 10.4103/ijo.ijo_3332_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose The purpose of this study is to describe the demographic profile, clinical features, visual outcomes, and follow-up patterns after successful cataract surgery in children from the tribal community in Odisha, India. Methods We retrospectively reviewed records of tribal children aged 4 months-16 years, who underwent public health financed cataract surgery at our institute from January 1, 2015, to December 31, 2019. Collected data included demographic profile, clinical features, outcomes, and follow-up. Univariate and multivariate linear regression identified factors affecting the visual outcome at a 6-week follow-up. Results During this period, a total of 352 children [536 eyes; mean age: 9.11 ± 4.4 years, 219 boys (62%)] underwent cataract surgery. The most common etiology and presenting complaints were idiopathic congenital cataract and decreased vision, respectively. In 304 children (86%), presenting best-corrected visual acuity (BCVA) was <20/200 (1.0 LogMAR), 113 (32%) had associated strabismus, and 57 (16%) had associated nystagmus. The public health agency did not sponsor postoperative follow-up, and only 195 (56%) and 61 (17.3%) children completed a 6-week and a 3-month follow-up, respectively. Median BCVA at 6-week and 3-month review was 20/125 (0.8, interquartile range [IQR], 0.2-2 LogMAR) and 20/60 (0.5, IQR, 0.25-1.35 LogMAR), respectively. Conclusion This study showed that children from the tribal community presented late with poor presenting VA and had suboptimal visual outcomes with inconsistent follow-ups. Greater advocacy, delivery of care closer to the place of residence, and financial support for follow-up care could improve early detection, regular evaluation, and outcomes.
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Affiliation(s)
- Debasmita Majhi
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Child Sight Institute, Miriam Hyman Children's Eye Care Centre Mithu Tulsi Chanrai Campus, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Virender Sachdeva
- Department of Pediatric Ophthalmology, Strabismus, and Neuro-ophthalmology Child Sight Institute, Nimmagada Prasad Children's Eye Care Centre, L V Prasad Eye Institute, GMRV Campus, Visakhapatnam, Andhra Pradesh, India
| | - Vivekanand Uttamrao Warkad
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Child Sight Institute, Miriam Hyman Children's Eye Care Centre Mithu Tulsi Chanrai Campus, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Ramesh Kekunnaya
- Department of Pediatric Ophthalmology, Child Sight Institute and Jasti V Ramanamama Children's Eye Care Centre, L. V. Prasad Eye Institute, KAR Campus, Hyderabad, Telangana, India
| | - Divya Natarajan
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Child Sight Institute, Miriam Hyman Children's Eye Care Centre Mithu Tulsi Chanrai Campus, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Sanjib Karan
- Department of Pediatric Ophthalmology, Strabismus and Neuro-Ophthalmology, Child Sight Institute, Miriam Hyman Children's Eye Care Centre Mithu Tulsi Chanrai Campus, L. V. Prasad Eye Institute, Bhubaneswar, Odisha, India
| | - Bhawna Garg
- Department of Statistic and Ethical Committee Member of Holy Family Hospital, New Delhi, India
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Troncoso M, Balut F, Witting S, Rubilar C, Carrera J, Cartes F, Herrera L. Hypomyelination and Congenital Cataract: Identification of a Novel likely pathogenic c.414+1G>A in FAM126A gene Variant. Clin Case Rep 2021; 9:e04171. [PMID: 34026180 PMCID: PMC8133089 DOI: 10.1002/ccr3.4171] [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] [Revised: 02/28/2021] [Accepted: 03/27/2021] [Indexed: 11/08/2022] Open
Abstract
It is key to expand the differential diagnosis and consider possible genetic etiologies on a patient with congenital cataracts associated with clinical features, such as leukodystrophy or polyneuropathy.
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Affiliation(s)
- Mónica Troncoso
- Hospital Clinico San Borja ArriaranPediatric Neurology. Pediatric DepartmentCentral CampusFacultad de MedicinaUniversidad de ChileSantiagoChile
| | - Fernanda Balut
- Hospital Clinico San Borja ArriaranPediatric Neurology. Pediatric DepartmentCentral CampusFacultad de MedicinaUniversidad de ChileSantiagoChile
| | - Scarlet Witting
- Hospital Clinico San Borja ArriaranPediatric Neurology. Pediatric DepartmentCentral CampusFacultad de MedicinaUniversidad de ChileSantiagoChile
| | - Carla Rubilar
- Hospital Clinico San Borja ArriaranPediatric Neurology. Pediatric DepartmentCentral CampusFacultad de MedicinaUniversidad de ChileSantiagoChile
| | | | - Fabiola Cartes
- Human Genetics ProgramInstitute of Biomedical SciencesFacultad de MedicinaUniversidad de ChileSantiagoChile
| | - Luisa Herrera
- Human Genetics ProgramInstitute of Biomedical SciencesFacultad de MedicinaUniversidad de ChileSantiagoChile
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Khamraeva LS, Narzullaeva DU. [Risk factors and prognosis of the development of pseudophakic myopia in children]. Vestn Oftalmol 2021; 137:90-94. [PMID: 33881268 DOI: 10.17116/oftalma202113702190] [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: 11/17/2022]
Abstract
Recent studies indicate the prevalence of myopic refraction in children with pseudophakia, which significantly reduces the functional results of treatment and may be an indication for replacing the intraocular lens (IOL). Therefore, studies conducted to achieve the target refraction in children with pseudophakia are relevant. PURPOSE To determine the risk factors for the prognosis of myopic refraction in children after extraction of congenital cataract and IOL implantation. MATERIAL AND METHODS The study presents the results of refraction examination in 69 (110 eyes) children aged 1 to 12 years 36 months after extraction of congenital cataract with implantation of soft IOL. RESULTS The obtained data of anamnesis, results of ophthalmological, echobiometric, clinical and laboratory studies were subjected to statistical processing assessing the significance of differences in outcomes depending on the impact of possible risk factors for the development of pseudophakic myopia; a regression logistic model and a ROC-curve were constructed. CONCLUSION According to the authors, reliable risk factors for the development of pseudophakic myopia in children can be such indicators as axial eye length at the time of IOL implantation exceeding the age norm by more than 0.2 mm; the child from the first pregnancy; the AL/CR ratio of ≥3.0; myopia on the paired eye; strabismus of more than 4 prism diopters; hereditary load; tension of eye's fibrous capsule: pressure of ≤180 mm Hg at the time of IOL implantation. The presented reliable factors, as well as a combination of less significant signs (the child being outside for less than 1 hour per day, intermarriage of the patient's parents, near-sight visual loads of more than 3 hours per day, the blood Ca level of less than 1.8 mmol/L) can be used for prognosis of the development of pseudophakic myopia and to help make adjustments in the management tactics for patients to achieve target refraction.
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Affiliation(s)
- L S Khamraeva
- Tashkent Pediatric Medical Institute - Ministry of Healthcare, Tashkent, Uzbekistan
| | - D U Narzullaeva
- Tashkent Pediatric Medical Institute - Ministry of Healthcare, Tashkent, Uzbekistan
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Lo Giudice G, Angelini E, Bini S, Candian T, Crudeli C, Galan A. Outcome of cataract surgery in children affected by malignancies other than retinoblastoma with eye-lens radiation exposure. Eur J Ophthalmol 2021; 32:11206721211009445. [PMID: 33843295 DOI: 10.1177/11206721211009445] [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: 11/16/2022]
Abstract
PURPOSE To describe, retrospectively, the visual outcome, feasibility, and safety of cataract surgery in a pediatric population affected by iatrogenic cataract, secondary to systemic oncological treatment for malignancies other than retinoblastoma. METHODS Young patients, affected by radiation-induced cataract, who were referred to the San Paolo Ophthalmic Center in Padova between 2010 and 2017, were included in the study. All patients had previously received radiotherapy and/or chemotherapy treatment for malignancies, between 2004 and 2013. All medical records of infants who underwent cataract surgery were accurately reviewed. RESULTS Eighteen eyes out of 11 patients included in the study underwent cataract surgery. The mean age at surgery was 9.7 ± 3.6 years. The interval between tumor diagnosis and cataract development was around 3 years. Mean follow-up after surgery was 15.4 ± 6.3 months. All eyes underwent posterior chamber intraocular lens implantation, posterior capsulotomy, and anterior vitrectomy in one time surgery. No intraoperative complications were shown. Post-operatively, only one eye received laser capsulotomy due to posterior capsule opacification. At the end of follow up, best-corrected visual acuity was 20/20 (LogMAR 0) in all eyes and significantly improved (p < 0.01) compared to baseline. CONCLUSIONS Iatrogenic-cataract surgery in pediatric oncological patients is a safe and effective way to improve visual acuity. Posterior capsulotomy and anterior vitrectomy at the time of surgery reduce the rate of posterior lens opacification and guarantee an excellent visual acuity in these patients.
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Affiliation(s)
- Giuseppe Lo Giudice
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Edoardo Angelini
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Silvia Bini
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Tommaso Candian
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Clorinda Crudeli
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
| | - Alessandro Galan
- San Paolo Ophthalmic Center, San Antonio Hospital - University Hospital, Padova, Italy
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Sen P, Chandra K, Jain E, Sen A, Kumar A, Mohan A, Shah C. Audit of 1000 consecutive cases of sutureless cataract surgery in children above two years of age. Indian J Ophthalmol 2021; 68:460-465. [PMID: 32057003 PMCID: PMC7043184 DOI: 10.4103/ijo.ijo_1138_19] [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: 11/04/2022] Open
Abstract
Purpose To study the safety of sutureless cataract surgery and risk factors for wound leak of clear corneal incision in children affected with congenital or developmental cataract. Methods It is a retrospective, noncomparative interventional case study involving children in the age group of 2 to 16 years, who underwent cataract surgery with intraocular lens implantation with the minimum follow up of 1 month. Results Out of 1000 eyes studied, lens matter aspiration with intraocular lens implantation with or without primary posterior capsulorhexis and anterior vitrectomy was done in 609 and 391 eyes, respectively. Incisions of 943 eyes did not require sutures while sutures were applied for wound leak in 57 eyes on the table and in 5 eyes on postoperative day 1. Risk of wound leak for suture application was found to be greater in patients; having age less than 5 years (P < 0.0001), surgeries performed by junior surgeons (P < 0.0003), wound problems (P < 0.0001), intraocular lens (IOL) related factors (P < 0.0001), use of iris hooks (P < 0.0001), and anterior capsulorhexis extension (P < 0.0001). On the first postoperative day, anterior chamber reaction (P < 0.0001) and fibrinous membrane (P = 0.0007) were significantly more in the sutured group. Incidence of postoperative complications was 0.98 per sutured eyes (59 complications in 60 eyes). One patient developed endophthalmitis after suture removal. Conclusion Sutureless clear corneal incision in pediatric patients undergoing cataract surgery can achieve stable wound. However, after hydro closure, every wound should be checked for water tightness and the leaky wound should be sutured.
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Affiliation(s)
- Pradhnya Sen
- Children Eye Care Center, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Kriti Chandra
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Elesh Jain
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Alok Sen
- Department of Retina and Uvea, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Amit Kumar
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Amit Mohan
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | - Chintan Shah
- Pediatric Ophthalmology and Strabismus, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
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Ugalahi MO, Olusanya BA, Aremu OO, Baiyeroju AM. Outcome of surgery for traumatic cataract in children in a child eye health tertiary facility, Ibadan, Nigeria. Ther Adv Ophthalmol 2021; 13:25158414211005308. [PMID: 35187399 PMCID: PMC8855383 DOI: 10.1177/25158414211005308] [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: 11/17/2020] [Accepted: 03/04/2021] [Indexed: 11/16/2022] Open
Abstract
Objective: The objective of this study was to describe the outcome of surgery for traumatic cataract and associated factors in children aged 16 years and below operated in a tertiary facility. Methods: This was a retrospective review of records of children who had surgery for traumatic cataract between August 2015 and August 2019. Information on biodata, preoperative visual acuity, surgical methods, complications, and postoperative visual acuity were retrieved. Data were analyzed using IBM SPSS Statistics 20.0. Results: Traumatic cataract accounted for 87 (14.7%) of 593 eyes operated for childhood cataract during the period. Of these, a total of 79 records were available for review. There were 56 (70.9%) males with a mean age of 10.11 (±3.39) years. All injuries were unilateral; closed globe injuries accounted for 70 (88.8%) of the cataracts and the left eye was affected in 42 (53.2%) patients. Fifty-two (67.09%) eyes had other ocular injuries apart from cataracts. The morphology of the cataract was membranous in 44 (55.7%) eyes, and 76 (96.2%) eyes had cataract surgery with intraocular lens (IOL) implantation; 39 (51.3%) of these IOLs were implanted within the capsular bag. The preoperative best corrected visual acuity was worse than 6/18 in all 79 (100%) eyes and improved to 6/18 or better in 32 (40.5%) eyes at 3 months postoperatively. Conclusion: Traumatic cataract accounted for less than a quarter of all childhood cataracts in our center. Majority of the eyes had successful IOLs implantation during surgery, and the best corrected visual acuity improved in a moderate proportion of these patients.
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Affiliation(s)
- Mary Ogbenyi Ugalahi
- Department of Ophthalmology, College of Medicine and University College Hospital, University of Ibadan, Ibadan, Nigeria
| | - Bolutife Ayokunnu Olusanya
- Department of Ophthalmology, College of Medicine and University College Hospital, University of Ibadan, Ibadan 200212, Oyo State, Nigeria
| | | | - Aderonke Mojisola Baiyeroju
- Department of Ophthalmology, College of Medicine and University College Hospital, University of Ibadan, Ibadan, Nigeria
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45
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Gogate PM, Sil AK. Comments on: Causes of delayed presentation of pediatric cataract: A questionnaire-based prospective study at a tertiary eye care centre in central rural India. Indian J Ophthalmol 2021; 69:173-174. [PMID: 33323619 PMCID: PMC7926169 DOI: 10.4103/ijo.ijo_845_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Affiliation(s)
- Parikshit M Gogate
- Community Eye Care Foundation, Dr. Gogate's Eye Clinic, Pimpri, Pune, Maharashtra, India
- Department of Ophthalmology, D.Y. Patil Medical College, Pimpri, Pune, Maharashtra, India
| | - Asim K Sil
- Vivekananda Mission Ashram Netra Niramay Niketan, West Bengal, India
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46
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Khurana S, Gupta PC, Ram J. Starry sky cataract in a teenage girl. Indian J Ophthalmol 2020; 68:2527. [PMID: 33120672 PMCID: PMC7774129 DOI: 10.4103/ijo.ijo_905_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Surbhi Khurana
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Parul Chawla Gupta
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jagat Ram
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Bhat R, Al-Samarraie M, Nada A, Leiva-Salinas C, Whitehead M, Mahdi E. Spotlight on the pediatric eye: a pictorial review of orbital anatomy and congenital orbital pathologies. Neuroradiol J 2020; 34:21-32. [PMID: 32865127 DOI: 10.1177/1971400920949232] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Orbital lesions in the pediatric population vary from adults in terms of their presentation, unique pathology, and imaging characteristics. The prompt and accurate diagnosis of these lesions is imperative to prevent serious consequences in terms of visual impairment and disfigurement. Along with dedicated ophthalmologic examination, imaging is instrumental in characterizing these lesions, both for accurate diagnosis and subsequent management. In our pictorial essay, we provide a basic review of orbital embryology, anatomy, and congenital orbital pathologies, with emphasis on radiological findings.
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Affiliation(s)
- Roopa Bhat
- Department of Radiology, University of Missouri Health Care, USA
| | | | - Ayman Nada
- Department of Radiology, University of Missouri Health Care, USA
| | | | - Matthew Whitehead
- Diagnostic Imaging and Radiology, Children's National Health Systems, USA.,George Washington University Hospital, USA
| | - Eman Mahdi
- Department of Radiology, University of Missouri Health Care, USA
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48
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Zhang YT, Du LQ, Liu M, Zhu J. Spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury: a case report. BMC Ophthalmol 2020; 20:285. [PMID: 32660455 PMCID: PMC7359477 DOI: 10.1186/s12886-020-01555-1] [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] [Received: 04/30/2020] [Accepted: 07/06/2020] [Indexed: 11/20/2022] Open
Abstract
Background We report a case of spontaneous resolution of a traumatic cataract in a patient with an open-globe ocular injury. This case highlights the importance of conservative management in these types of cases, as excellent visual outcome is possible without invasive surgical intervention. Case presentation A 13-year-old boy presented with a corneal laceration in the left eye caused by a neuter pen. He underwent emergency repair of the corneal laceration under general anesthesia, and at 3 days post-op, a dense posterior cortical cataract was observed. Based on the patient’s age and normal visual development, in addition to preserving accommodative potential, the patient received conservative management and follow-up. Interestingly, the cataract spontaneously resolved over the following 9 months and the corrected distance visual acuity in the injured eye was restored from finger counting at 50 cm, to 20/25 + 3. Conclusions To optimize treatment in pediatric traumatic cataract, several critical factors such as age, visual development and the preservation of accommodative potential, need to be comprehensively considered. Conservative management with lens preservation is important to consider in young, traumatic cataract patients where invasive surgical intervention may not be required.
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Affiliation(s)
- Yu-Ting Zhang
- Department of Ophthalmology, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan, Shandong, 250012, PR China
| | - Li-Qun Du
- Department of Ophthalmology, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan, Shandong, 250012, PR China
| | - Mei Liu
- Department of Ophthalmology, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan, Shandong, 250012, PR China
| | - Jing Zhu
- Department of Ophthalmology, Qilu Hospital of Shandong University, 107#, Wenhua Xi Road, Jinan, Shandong, 250012, PR China.
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49
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Kochgaway L, Jain S, Mandal M, Roy R, Bhargava S, Singh M. Commentary: Causes of delayed presentation of pediatric cataract: A questionnaire.based prospective study at a tertiary eye care center in central rural India. Indian J Ophthalmol 2020; 68:607-610. [PMID: 32174579 PMCID: PMC7210859 DOI: 10.4103/ijo.ijo_2156_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
| | - Sneha Jain
- B B Eye Foundation, Kolkata, West Bengal, India
| | | | - Rupak Roy
- B B Eye Foundation, Kolkata, West Bengal, India
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50
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Ting DSJ, Foo VH, Yang LWY, Sia JT, Ang M, Lin H, Chodosh J, Mehta JS, Ting DSW. Artificial intelligence for anterior segment diseases: Emerging applications in ophthalmology. Br J Ophthalmol 2020; 105:158-168. [PMID: 32532762 DOI: 10.1136/bjophthalmol-2019-315651] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Revised: 02/21/2020] [Accepted: 03/24/2020] [Indexed: 12/12/2022]
Abstract
With the advancement of computational power, refinement of learning algorithms and architectures, and availability of big data, artificial intelligence (AI) technology, particularly with machine learning and deep learning, is paving the way for 'intelligent' healthcare systems. AI-related research in ophthalmology previously focused on the screening and diagnosis of posterior segment diseases, particularly diabetic retinopathy, age-related macular degeneration and glaucoma. There is now emerging evidence demonstrating the application of AI to the diagnosis and management of a variety of anterior segment conditions. In this review, we provide an overview of AI applications to the anterior segment addressing keratoconus, infectious keratitis, refractive surgery, corneal transplant, adult and paediatric cataracts, angle-closure glaucoma and iris tumour, and highlight important clinical considerations for adoption of AI technologies, potential integration with telemedicine and future directions.
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Affiliation(s)
- Darren Shu Jeng Ting
- Academic Ophthalmology, University of Nottingham, Nottingham, UK.,Department of Ophthalmology, Queen's Medical Centre, Nottingham, UK.,Singapore Eye Research Institute, Singapore
| | | | | | - Josh Tjunrong Sia
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore
| | - Marcus Ang
- Singapore Eye Research Institute, Singapore.,Cornea And Ext Disease, Singapore National Eye Centre, Singapore
| | - Haotian Lin
- Sun Yat-Sen University Zhongshan Ophthalmic Center, Guangzhou, China
| | - James Chodosh
- Ophthalmology, Massachusetts Eye and Ear Infirmary Howe Laboratory Harvard Medical School, Boston, Massachusetts, USA
| | - Jodhbir S Mehta
- Singapore Eye Research Institute, Singapore.,Cornea And Ext Disease, Singapore National Eye Centre, Singapore
| | - Daniel Shu Wei Ting
- Singapore Eye Research Institute, Singapore .,Vitreo-retinal Department, Singapore National Eye Center, Singapore
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