Alcohol and recall: state-dependent effects in man

Male vollunteers performed four memory tasks either while sober or lunder effects of alcohol. Twenty-four hours later they were tested under the same or different conditions. In tasks measuiring recall and interference, learning transfer was better when the subject was intoxicated during both sessions than when he was intoxicated only during the learning session. In a task measuring recognition, transfer was not significantly affected by changing state. Thus, alcohol appears to produce "dissociated" or state-dependent effects in man, but not all forms of memory are equally sensitive to the phenomenon.

Amblyopia: the normal eye is not normal

When acuity was used to evaluate amblyopia in children, the amblyopic eye had decreased acuity and the nonamblyopic eye had normal acuity. However when Contrast Sensitivity Functions (CSFs) were used to evaluate amblyopia, losses in the CSF were discovered in both the amblyopic and the nonamblyopic eyes. During the course of occlusion therapy, the amblyopic eye improved in acuity and CSF and the nonamblyopic eye improved in CSF. The results suggest that the nonamblyopic eye is not normal and that the CSF provides additional information to acuity about amblyopia in children.

Pseudotumor cerebri in children receiving recombinant human growth hormone

PURPOSE

This article represents the first report in the ophthalmology literature of an association between pseudotumor cerebri (PTC) and recombinant human growth hormone (rhGH).

DESIGN

Noncomparative case series.

PARTICIPANTS

Three children receiving rhGH for short stature with Turner syndrome, Jeune syndrome, or Down syndrome.

METHODS

Children underwent full ocular examination. After papilledema was identified, patients underwent lumbar puncture and imaging with either magnetic resonance imaging or computerized tomography. Treatment was under the guidance of the primary physician or neurosurgeon. The rhGH was discontinued in all children.

MAIN OUTCOME MEASURES

Visual acuity and evaluation of the optic nerve for resolution of papilledema were followed at each examination.

RESULTS

In all three cases, papilledema resolved with the cessation of rhGH, and treatment with acetazolamide or prednisone. Visual acuity was unchanged in case 1, decreased by two to three lines in case 2, and was inconsistent in case 3. One child (case 2) required a ventriculoperitoneal shunt for persistent elevation of intracranial pressure.

CONCLUSION

There appears to be a causal relationship between the initiation of rhGH with the development of PTC. Children should have a complete ophthalmic evaluation if they report headache or visual disturbances. Baseline examination with routine follow-up should be instituted when children cannot adequately communicate.

Strabismus in premature infants in the first year of life. Cryotherapy for Retinopathy of Prematurity Cooperative Group

OBJECTIVES

To present the 3- and 12-month strabismus data from 3030 premature infants with birth weights less than 1251 g enrolled in the Multicenter Trial of Cryotherapy for Retinopathy of Prematurity.

DESIGN

Data from the 3- and 12-month examinations conducted at 23 regional study centers were tabulated for all infants. The main outcome measure, ocular motility, was compared with baseline demographic variables and retinopathy of prematurity severity for the worse eye. Findings at 3 months were compared with the incidence of strabismus at 12 months.

RESULTS

At 3 months, 200 (6.6%) of the 3030 infants were strabismic. In the 2449 infants examined at both time points, 289 (11.8%) were found to have strabismus at 12 months. Retinopathy of prematurity was significant for strabismus at both 3 and 12 months (P<.001). The presence of strabismus at 3 months was found to be a highly significant predictor of strabismus at 12 months. Anisometropia, abnormal fixation, and unfavorable retinal structure also were significant predictors of strabismus at 1 year. The total prevalence of strabismus in the first year of life was 14.7%.

CONCLUSION

The presence of acute-phase retinopathy of prematurity places the premature infant at increased risk for strabismus.

Primary-position hypotropia after anterior transposition of the inferior oblique

Three patients with fourth cranial nerve palsy underwent a recession of the ipsilateral inferior oblique muscle. In all three cases, the inferior oblique muscle was anteriorly displaced to the temporal border of the inferior rectus muscle. In the immediate postoperative period, all three patients developed a hypotropia and diplopia in the primary position with limitation of upgaze. The hypotropia remained stable and required retrodisplacement of the inferior oblique muscle in order to eliminate the diplopia. We emphasize the power of the anterior transposition of the inferior oblique muscle and caution its use as a unilateral procedure in patients with central fusion.

Levodopa/carbidopa treatment for amblyopia in older children

The purpose of the present study is to determine how long visual function improves during levodopa/carbidopa with part-time occlusion treatment in older amblyopic children. A 7-week open clinical trial of levodopa (0.55 mg/kg, three times daily) with 25% carbidopa combined with part-time occlusion (3 hours/day), was undertaken in 15 older (mean age, 8.87 years) amblyopic children. Visual acuity, fusion, and stereo acuity were measured at baseline, at weeks 1, 3, 5, and 7 during treatment, and 6 weeks following the end of all treatment. Health status was assessed by physical examination, questionnaire, and standard laboratory tests (CHEM 20, complete blood cell count [CBC], and differential). The results revealed that visual acuity in the amblyopic eye improved for 5 weeks, from 20/170 at baseline to 20/107, then stabilized for the last 2 weeks. Visual acuity also improved in the dominant eye by 0.6 lines, from 20/19 to 20/16. At the 6-week follow up, visual acuity in the amblyopic eye remained at 20/107 (paired t = 4.78, df = 14, P < .001), a 37% improvement. Thirty-three percent of the subjects demonstrated improved fusion from baseline to the 7-week trial that was maintained at follow up (chi 2 = 3.97, P < .05). Stereo acuity did not significantly change. Physical exam (blood pressure, body temperature, respiration, heart rate) and standard laboratory tests remained normal and side effects were minimal.(ABSTRACT TRUNCATED AT 250 WORDS)

Longitudinal study of levodopa/carbidopa for childhood amblyopia

To determine the tolerability and efficacy of levodopa/carbidopa combined with occlusion therapy for childhood amblyopia, a double-masked placebo-controlled randomized longitudinal study was performed on 10 amblyopic children between 6 and 14 years of age. Subjects received, on average, 20/5 mg levodopa/carbidopa or 20 mg of placebo three times per day combined with part-time occlusion over a 3-week period. Visual function was assessed by Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity charts and by contrast sensitivity. Tolerability was assessed by questionnaire, SMAC (standard laboratory tests; consists of a chem 20 and complete blood count [CBC]) analysis, and physical examination. Compliance with occlusion and capsule consumption were assessed by questionnaire and by capsule count, respectively. At the end of the dosing regimen, the levodopa/carbidopa group significantly improved in visual acuity by 2.7 lines and in mean contrast sensitivity by 72% in the amblyopic eye. The placebo group improved in visual acuity by 1.6 lines in the amblyopic eye. Tolerability and occlusion compliance were similar between groups; however, capsule ingestion compliance was significantly lower in the levodopa/carbidopa group. One month after the termination of treatment, the levodopa/carbidopa group maintained a significant 1.2-line improvement in visual acuity and 74% improvement in contrast sensitivity in the amblyopic eye. The placebo group did not maintain an improvement in visual acuity between the eyes. It is concluded that levodopa/carbidopa, at an average of 0.48/0.12 mg/kg, is well tolerated and, when combined with part-time occlusion, is efficacious in improving visual function in amblyopic children.

Occlusion and levodopa-carbidopa treatment for childhood amblyopia

PURPOSE

The purpose of the current study was to compare the effects of levodopa-carbidopa with and without part-time occlusion on visual function in older amblyopic children.

METHODS

Thirteen older amblyopic children were randomly assigned to receive or not receive part-time occlusion (3 h/day) combined with 7 weeks of oral dosing with levodopa-carbidopa (1.02 mg/0.25 mg/kg body weight three times daily). Visual acuity, contrast sensitivity, and fusion were measured at baseline; 1, 3, 5, and 7 weeks during the treatment regimen; and 4 weeks after termination of all treatment. At these same times health status was assessed with standard laboratory blood tests, physical examination, and subjective questionnaire.

RESULTS

From baseline to the follow-up test trial, both groups improved in visual acuity in the amblyopic eyes (occlusion group 20/116 to 20/76, P < .001; no occlusion group 20/90 to 20/73, P < .01) and dominant eyes (occlusion group 20/18 to 20/15, P > .05; no occlusion group 20/20 to 20/16, P < .01). The occlusion group exhibited a significant decrease in the difference in acuity between the dominant and amblyopic eyes of 1.3 lines (P < .02), whereas the no occlusion group revealed no significant effect. A comparison between groups revealed a significantly greater improvement in visual acuity in the amblyopic eye in the occlusion group compared with the no occlusion group (P = .01). In contrast, there was no significant difference between groups in terms of the change in visual acuity in the dominant eye (P = .15). Mean log contrast sensitivity in the amblyopic eye significantly improved in the occlusion group and did not significantly change in the no occlusion group. Fusion changed similarly in both groups. The improvements in visual function were maintained 4 weeks after the termination of all treatment. Adverse side effects were minimal in both groups.

CONCLUSION

The combination of levodopa-carbidopa and occlusion improves visual function more than levodopa-carbidopa alone in older amblyopic children.

Levodopa and childhood amblyopia

A pilot study was undertaken to address the tolerance and efficacy of levodopa/carbidopa treatment for amblyopia in older amblyopic children who failed to respond to conventional occlusion therapy. Five amblyopic children, between the ages of 7 and 12 years, and two normal adults were given between 100 mg/25 mg and 400 mg/100 mg of levodopa/carbidopa, respectively, depending on body weight. A symptoms questionnaire was completed, with temperature, respiration, heart rate, and blood pressure taken periodically to assess tolerance. Blood samples were taken, via a heparin well, to assess the pharmacokinetics of levodopa, dopamine, noradrenaline, and DOPAC. Snellen visual acuity, contrast sensitivity, stereo acuity, and pattern VERs were measured periodically to assess efficacy. The results revealed a high prevalence of side effects including emesis and nausea (four of seven subjects). Pharmacokinetics revealed that maximum serum levels of levodopa occurred 30 minutes to 1 hour after drug ingestion and decreased by 50% after 2 to 4 hours. One hour after drug ingestion, Snellen visual acuity temporarily improved from an average of 20/159 to 20/83 in the amblyopic eyes. Contrast sensitivity and pattern VERs (10-minute checks) temporarily improved in both dominant and amblyopic eyes, whereas visual function remained stable in normal eyes. The improvements in visual function started to decrease 5 hours after drug ingestion. The results are discussed in the context of developing a therapeutic trial of levodopa/carbidopa for childhood amblyopia.

Prevalence and course of strabismus through age 6 years in participants of the Early Treatment for Retinopathy of Prematurity randomized trial

PURPOSE

To present strabismus data for children who participated in the Early Treatment for Retinopathy of Prematurity (ETROP) randomized trial.

METHODS

The prevalence of strabismus, categorized as present or absent, was tabulated for all children with history of high-risk prethreshold retinopathy of prematurity (ROP) who participated in the ETROP randomized trial and were examined at 9 months to 6 years of age. Relationships among strabismus and demographic measures, eye characteristics, and neurodevelopmental factors were analyzed.

RESULTS

Among the 342 children evaluated at 6 years, the prevalence of strabismus was 42.2%. Even with favorable acuity scores in both eyes, the prevalence of strabismus was 25.4%, and with favorable structural outcomes in both eyes the prevalence of strabismus was 34.2%. Of children categorized as visually impaired as the result of either ocular or cerebral causes, 80% were strabismic at the 6-year examination. Of 103 study participants who were strabismic at 9 months, 77 (74.8%) remained so at 6 years. Most strabismus was constant at both the 9-month (62.7%) and the 6-year examination (72.3%). After multiple logistic regression analysis, risk factors for strabismus were abnormal fixation behavior in one or both eyes (P < 0.001), history of amblyopia (P < 0.003), unfavorable structural outcome in one or both eyes (P = 0.025), and history of anisometropia (P = 0.04). Strabismus surgery was performed for 53 children. By 6 years, the cumulative prevalence of strabismus was 59.4%.

CONCLUSIONS

Most children with a history of high-risk prethreshold ROP develop strabismus at some time during the first 6 years of life.

Anterior tendon displacement of the inferior oblique for DVD

The effect of grading the anteriorization of the posterior portion of the inferior oblique muscle tendon fibers, relative to the insertion of the inferior rectus, was assessed for patients with dissociated vertical deviation (DVD). The placement of these fibers was varied dependent on the degree of preoperative DVD. The results from the graded group were compared to a group of patients with DVD that always received the same amount of anteriorization regardless of the degree of preoperative DVD. The results showed that, in general, anteriorization of the inferior obligue muscle tendon fibers to the level of insertion of the inferior rectus was an effective treatment for DVD. In addition, grading the anteriorization of the posterior portion of the inferior oblique muscle tendon fibers significantly decreased residual postoperative deviation.

Surgical treatment of the upshoot and downshoot in Duanes' retraction syndrome

The upshoot and downshoot that occurs when the eye is rotated into the adducted position in Duanes' retraction syndrome is believed to be related to a taut or leash effect from the lateral rectus muscle. When the eye is adducted, the lateral rectus muscle is believed to "slip" over the globe, producing this abnormal movement. Five patients with Duanes' retraction syndrome demonstrated this finding and underwent a splitting of the lateral rectus into a Y configuration. All five patients demonstrated a marked decrease in the up- or downshoot after surgery.

Retinopathy of prematurity outcome in infants with prethreshold retinopathy of prematurity and oxygen saturation >94% in room air: the high oxygen percentage in retinopathy of prematurity study

OBJECTIVES

To determine the rate of progression from prethreshold to threshold retinopathy of prematurity (ROP) in infants excluded from Supplemental Therapeutic Oxygen for Prethreshold Retinopathy of Prematurity (STOP-ROP) because their median arterial oxygen saturation by pulse oximetry (SpO2) values were >94% in room air at the time of prethreshold diagnosis and to compare them with infants who were enrolled in STOP-ROP and had median SpO2 < or =94% in room air.

METHODS

Fifteen of the 30 centers that participated in STOP-ROP elected to participate in the High Oxygen Percentage in Retinopathy of Prematurity study (HOPE-ROP) from January 1996 to March 1999. Infants were followed prospectively from the time prethreshold ROP was diagnosed until ROP either progressed to threshold in at least 1 study eye (adverse outcome) or resolved (favorable outcome).

RESULTS

A total of 136 HOPE-ROP infants were compared with 229 STOP-ROP infants enrolled during the same time period from the same 15 hospitals. HOPE-ROP infants were of greater gestational age at birth (26.2 +/- 1.8 vs 25.2 +/- 1.4 weeks) and greater postmenstrual age at the time of prethreshold ROP diagnosis (36.7 +/- 2.5 vs 35.4 +/- 2.5 weeks). HOPE-ROP infants progressed to threshold ROP 25% of the time compared with 46% of STOP-ROP infants. After gestational age, race, postmenstrual age at prethreshold diagnosis, zone 1 disease, and plus disease at prethreshold diagnosis were controlled for, logistic regression analysis showed that HOPE-ROP infants progressed from prethreshold to threshold ROP less often than STOP-ROP infants (odds ratio: 0.607; 95% confidence interval: 0.359-1.026).

CONCLUSIONS

The mechanisms that result in better ROP outcome for HOPE-ROP versus STOP-ROP are not fully understood. It seems that an infant's SpO2 value at the time of prethreshold diagnosis is a prognostic indicator for which infants may progress to severe ROP. When other known prognostic indicators are factored in, the SpO2 is of borderline significance.

Specific cognitive impairment in sons of early onset alcoholics

Cognitive and behavioral functioning in school-aged sons of early onset alcoholics, late onset alcoholics, normal social drinking fathers, and depressed fathers were compared on a battery of neuropsychological measures. Sons of early onset alcoholics performed more poorly than offspring of the normal fathers on tests measuring attention and verbal intellectual capacity, but were not significantly different from sons of late onset alcoholic fathers. Sons of normal and late onset alcoholics were not distinguishable from each other.

The contrast sensitivity function and childhood amblyopia

We measured contrast sensitivity function and visual acuity in both eyes of strabismic and anisometropic amblyopic patients. There was a linear relationship between contrast sensitivity function and visual acuity in the amblyopic eye. As visual acuity decreased, the contrast sensitivity function decreased along the contrast sensitivity axis, and peak sensitivity shifted to lower spatial frequencies. After patching therapy, when visual acuity reached 20/20 in each eye, suggesting that the amblyopia was cured, there continued to be statistically significant difference in the contrast sensitivity functions between the eyes. The contrast sensitivity function from the previously amblyopic eye was depressed compared to the nonamblyopic eye. A comparison between patients with strabismic and anisometropic amblyopia showed that, when matched for visual acuity, the contrast sensitivity functions were similar for both the nonamblyopic and amblyopic eyes. However, a large difference was found between the amblyopic and nonamblyopic eyes of each group.

Changes in Course of Retinopathy of Prematurity from 1986 to 2013: Comparison of Three Studies in the United States

PURPOSE

To compare infant and retinopathy of prematurity (ROP) characteristics from 3 clinical studies conducted over a 27-year period in the United States.

DESIGN

Secondary analysis of results of 3 clinical studies.

PARTICIPANTS

Infants with birth weight (BW) <1251 g.

METHODS

Analysis of data from the Cryotherapy for Retinopathy of Prematurity (CRYO-ROP) and Early Treatment for Retinopathy of Prematurity (ETROP) trials and the primary data from the Telemedicine Approaches for the Evaluation of Acute-Phase Retinopathy of Prematurity (e-ROP) study.

MAIN OUTCOME MEASURES

Infant characteristics and onset, severity, and time course of ROP.

RESULTS

Across the 3 studies, mean (standard deviation) BW and mean gestational age (GA) decreased over time from CRYO-ROP (954 g [185 g], 27.9 weeks [2.2 weeks]) to ETROP (907 g [205 g], 27.4 weeks [2.2 weeks]) to e-ROP (864 g [212 g], 27.0 weeks [2.2 weeks]), with an increase in the percentage of infants enrolled weighing <750 g (15.8% CRYO, 24.9% ETROP, 33.4% e-ROP; P<0.0001). The percentage of infants who developed ROP varied only minimally (65.8% CRYO, 68.0% ETROP, 63.7% e-ROP; P = 0.003). Moderately severe ROP (defined as prethreshold or referral warranted) varied (17.8% CRYO, 12.3% ETROP, 19.4% e-ROP; P<0.0001), whereas the time of onset of any ROP did not vary (34.3 weeks CRYO, 34.1 weeks ETROP, 34.8 weeks e-ROP).

CONCLUSIONS

The BW and GA of infants enrolled in ROP studies in the United States have decreased over the past 27 years, whereas ROP prevalence and onset of disease are stable.

Cycloplegic refraction in esotropic children. Cyclopentolate versus atropine

Retinoscopy was performed on a population of predominantly white esotropic children younger than 5.5 years with cyclopentolate 1% and atropine 1.0%. Atropine 1.0% revealed +0.34 diopters more hyperopia than cyclopentolate 1.0%, when the mean differences between the two drugs were examined. Mean difference analysis would probably indicate that atropine retinoscopy was unnecessary. However, 22% of the children had +1.0 diopters or more of hyperopia uncovered by atropine. This significant subpopulation suggests that in young patients with esotropia, an atropine refraction is essential to uncover the maximum amount of hyperopia. Almost all of this subgroup with +1.00 or greater hyperopia had an initial cyclopentolate retinoscopy of +2.00 diopters or more. Therefore, retinoscopy using atropine cycloplegia becomes even more important in this population. There was a trend for the greater differences to be in children older than age 2 years. However, these values were not statistically significant.

CSF interocular interactions in childhood ambylopia

Contrast sensitivity functions (CSF's) were measured in the amblyopic and dominant eyes of 17 strabismic and 28 anisometropic children and in 19 similar age normal controls. A three-alternative forced-choice procedure was used to measure CSF's with the VCTS 6500. The results revealed reduced contrast sensitivity (CS) in both the amblyopic and dominant eyes of strabismic and anisometropic amblyopes compared to normal controls. Statistically significant intereye correlations of CS at each spatial frequency were found in all groups and in the presence of deep amblyopia, suggesting continued interocular interactions and binocularity. A separate longitudinal study of 7 of the amblyopes showed that, during the course of occlusion therapy, both the amblyopic and the dominant eyes improved in CSF. The results suggest that the amblyopic eye may influence CS in the dominant eye through interocular interactions. This process may serve to minimize CSF differences between the eyes and maximize binocular vision.

The basement membrane of the persisting maternal blood vessels in the placenta of Callithrix jacchus

Formation and morphology of the thickened basement membrane-like layer around the persisting maternal vessels of the Callithrix jacchus placenta were investigated from day 45 until term (day 142) using light, electron and immunofluorescence microscopy. Thickening occurs with the establishment of contacts between the vessels and the syncytiotrophoblast (day 48). Final thickness is reached at about day 100. The course of the vessels shows wide gaps where the maternal blood flows freely into the intertrabecular spaces. As revealed by electron microscopy, the extracellular sheath around the maternal vessels consists of an inner subendothelial basement membrane (3-6 microns) and an outer fibril-containing layer (2-4 microns). Cell debris is seen between the two layers and in the basement membrane. Plaques of granular and fine-filamentous material are incorporated into the fibril-containing layer. The synthesis of the basement membrane material is localized in the endothelial cells. Immunofluorescence microscopy reveals collagen types IV and V, laminin and heparan sulfate proteoglycan (BM-1) in the sheath around the persisting vessels. Fibronectin occurs only in certain areas or in the form of dots. Collagen types I and III are not seen in the region of the vascular wall. It can, therefore, be assumed that the subendothelial layer represents a genuine basement membrane; the fibrils consist of collagen type V and the plaques contain fibronectin. The existence of the thick perivascular sheath is attributed to the persistence and stability of the maternal vessels.

Assessing Mood with Affect-Sensitive Tasks

It is hypothesized that when an individual experiences a change in mood there are concomitant changes in performance at cognitive and psychomotor tasks. The present study attempts to identify tasks which are mood-sensitive. The nature of affect-sensitive tasks will yield information about how mood influences behavior. Further, to the extent that relationships between mood and affect-sensitive tasks are found, clients may be motivated to change their mood by a knowledge of expectable improvements in performance. Ten tasks and a mood-adjective checklist were administered to 106 subjects. Four of the tasks showed statistically significant relationships with self-reported mood. Results were promising for further investigations of affect-sensitive tasks.

Effects of Myo-inositol on Type 1 Retinopathy of Prematurity Among Preterm Infants <28 Weeks' Gestational Age: A Randomized Clinical Trial

IMPORTANCE

Previous studies of myo-inositol in preterm infants with respiratory distress found reduced severity of retinopathy of prematurity (ROP) and less frequent ROP, death, and intraventricular hemorrhage. However, no large trials have tested its efficacy or safety.

OBJECTIVE

To test the adverse events and efficacy of myo-inositol to reduce type 1 ROP among infants younger than 28 weeks' gestational age.

DESIGN, SETTING, AND PARTICIPANTS

Randomized clinical trial included 638 infants younger than 28 weeks' gestational age enrolled from 18 neonatal intensive care centers throughout the United States from April 17, 2014, to September 4, 2015; final date of follow-up was February 12, 2016. The planned enrollment of 1760 participants would permit detection of an absolute reduction in death or type 1 ROP of 7% with 90% power. The trial was terminated early due to a statistically significantly higher mortality rate in the myo-inositol group.

INTERVENTIONS

A 40-mg/kg dose of myo-inositol was given every 12 hours (initially intravenously, then enterally when feeding; n = 317) or placebo (n = 321) for up to 10 weeks.

MAIN OUTCOMES AND MEASURES

Type 1 ROP or death before determination of ROP outcome was designated as unfavorable. The designated favorable outcome was survival without type 1 ROP.

RESULTS

Among 638 infants (mean, 26 weeks' gestational age; 50% male), 632 (99%) received the trial drug or placebo and 589 (92%) had a study outcome. Death or type 1 ROP occurred more often in the myo-inositol group vs the placebo group (29% vs 21%, respectively; adjusted risk difference, 7% [95% CI, 0%-13%]; adjusted relative risk, 1.41 [95% CI, 1.08-1.83], P = .01). All-cause death before 55 weeks' postmenstrual age occurred in 18% of the myo-inositol group and in 11% of the placebo group (adjusted risk difference, 6% [95% CI, 0%-11%]; adjusted relative risk, 1.66 [95% CI, 1.14-2.43], P = .007). The most common serious adverse events up to 7 days of receiving the ending dose were necrotizing enterocolitis (6% for myo-inositol vs 4% for placebo), poor perfusion or hypotension (7% vs 4%, respectively), intraventricular hemorrhage (10% vs 9%), systemic infection (16% vs 11%), and respiratory distress (15% vs 13%).

CONCLUSIONS AND RELEVANCE

Among premature infants younger than 28 weeks' gestational age, treatment with myo-inositol for up to 10 weeks did not reduce the risk of type 1 ROP or death vs placebo. These findings do not support the use of myo-inositol among premature infants; however, the early termination of the trial limits definitive conclusions.

Pilomatricoma in a pediatric hospital

Of 150 cases of pilomatricoma in Columbus (Ohio) Children's Hospital, nearly 45% were discovered before the age of 5 years and 80% were present by 10 years of age. Lesions involved the periorbital region in 17% of the cases; the upper lid and brow were involved most frequently. These lesions were frequently misdiagnosed: only two of the periorbital cases were correctly diagnosed prior to excisional biopsy.

Treatment of corneal opacification in mucolipidosis IV with conjunctival transplantation

Mucolipidosis IV is a rare, inherited metabolic storage disease producing progressive psychomotor retardation and congenital corneal clouding. Histopathologic studies have shown that the corneal epithelium is strikingly involved with intracytoplasmic vacuolated storage material with relative noninvolvement of the corneal stroma and endothelium. Additionally, it has been noted that epithelial removal results in corneal clarity. We treated a 28-month-old patient with mucolipidosis IV with conjunctival transplantation with donor conjunctiva from an unaffected sibling. Improved corneal clarity resulted and has persisted with a follow-up of one year.