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Juvenile idiopathic arthritis (JIA) is the most common cause of chronic arthritis in children. It is a group of heterogeneous disorders that have chronic arthritis as a common feature. It has a worldwide distribution and many studies have shown that subtype frequencies in JIA seem to be showing geographical distribution. The aim of this study was to define subtype frequencies, demographic features, and the rates of macrophage activation syndrome, uveitis and remission in Turkish JIA patients. The files of all JIA patients (378 cases) that were being followed in Pediatric Rheumatology Clinic of our institution, between May 2010 and February 2016 were reviewed. Two hundred and sixty-five patients were included into the study. Gender, JIA subtype, age at diagnosis, age at the initial symptoms, JIA medications, uveitis presence, JIA status at the time of enrollment were recorded from the files. There were 87 enthesitis related arthritis, 87 oligoarthritis (81 persistent, 6 extended), 36 rheumatoid factor (RF) negative polyarthritis, 35 systemic arthritis, 10 RF-positive polyarthritis, 5 psoriatic arthritis and 5 undifferentiated arthritis cases. Mean age at diagnosis was 9.9 ± 4.9 years and male/female ratio was 1.05. Uveitis was found in 4.5% of the cases. Biologics were used in 26% of the patients. At the time of enrollment, 69% of the patients were under remission while 31% of them were active. Systemic arthritis and persistent oligoarthritis cases were the groups that most commonly achieved remission, while patients with polyarticular involvement, namely RF positive polyarthritis, RF negative polyarthritis and extended oligoarthritis patients were the groups with high number of active patients. In conclusion, JIA is a heterogeneous group of disorder, and differences in subtype frequencies from country to country make it even more heterogeneous disease. Patients with polyarticular involvement may need early and aggressive treatment to control the disease activity.

Purpose: To compare the efficacy of intravitreal aflibercept and laser photocoagulation in the treatment of retinopathy of prematurity (ROP). Methods: The files of patients who were diagnosed as having type 1 ROP or aggressive posterior ROP (APROP) and treated with laser photocoagulation and 1 mg/0.025 mL of intravitreal aflibercept were retrospectively analyzed. The patients' birth weight, gestational age, detection week of the disease, zone, stage, presence of plus disease and rubeosis, regression of ROP, re-treatments administered during the follow-up, and spherical equivalent values obtained at the corrected sixth month were recorded. Results: The study included 27 eyes of 15 patients who underwent laser photocoagulation and 24 eyes of 12 patients who received intravitreal aflibercept. Retinal vascularization was in zone II in all eyes in the laser photocoagulation group and zone 1 in 22 eyes (91.7%) in the intravitreal aflibercept group ( P < .05). In the laser photocoagulation group, 25 eyes (92.6%) had stage 3 ROP and 2 eyes (7.4%) had stage 2 ROP. In the intravitreal aflibercept group, 14 eyes (58.3%) had stage 3 ROP and 10 eyes (41.7%) had APROP ( P < .05). Treatment was established at a postmenstrual age of 37.6 ± 2.5 weeks in the laser photocoagulation group and 34.2 ± 2.4 weeks in the intravitreal aflibercept group ( P < .05). The regression rates after treatment were 92.6% and 100%, respectively ( P > .05). In the intravitreal aflibercept group, laser photocoagulation was performed on 10 eyes (41.6%) during follow-up visits. Spherical equivalents were measured as +1.10 ± 2.30 and +1.50 ± 2.41 diopters, respectively ( P < .05) at the corrected sixth month. Conclusions: Intravitreal aflibercept is an effective treatment for ROP. However, it requires more additional treatments than laser photocoagulation during the follow-up visits. [ J Pediatr Ophthalmol Strabismus . 2020;57(1):54–60.]

Background Hematological parameters have been investigated as being indicative of increased inflammatory response in morbidity of very preterm infants. This study aims to determine whether the hematologic parameters and ratios of preterms can be an indicative risk factor for the development of retinopathy of prematurity (ROP). Materials-Methods This retrospective cohort study examined newborns born before 32 weeks. Twenty-three patients treated with the diagnosis of ROP were included in the patient group. The control group included 23 patients who did not have ROP (no-ROP). Medical records of eligible preterm infants were retrospectively reviewed. Hemogram samples obtained from all patients during the first 24 h of life and samples of their mothers obtained before delivery were evaluated. The hemogram parameters of white blood cell (WBC) count, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, lymphocyte/monocyte ratio, and platelet mass index were calculated. Results No difference was observed between the groups in terms of demographic data. In terms of hematological parameters, maternal WBC counts of ROP patients were significantly higher than those of no-ROP patients and WBC counts of ROP patients were significantly lower than those of no-ROP patients. Conclusions This study found that high WBC counts in mothers before delivery and/or low WBC counts in preterms during the first postnatal day were higher in developed ROP. These results could lead to the development of prospective studies to assess the real prognostic value of WBC in ROP.

Clozapine may induce dry eye syndrome and thus may lead to morphological alterations in corneal parameters through its anticholinergic and antidopaminergic activities. Because of these corneal alterations, one should be aware of evaluating patients having diseases like glaucoma or preoperative selection of corneal refractive surgery candidates.

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<b><i>Purpose:</i></b> It is aimed to evaluate vascular outgrowth rate (VOR) of retinal vessels and retinal vascular development border (RVDB) after intravitreal injections of aflibercept or bevacizumab (IVA or IVB) monotherapy, which have been used to treat retinopathy of prematurity. <b><i>Methods:</i></b> In this study, patients were followed by two sequential fluorescein angiography (FA) examinations (Ret-Cam III Imaging System Clarity Medical Systems, Pleasanton, CA, USA) after anti-VEGF monotherapy. RVDB was determined by the ratio between DB (the distance from the center of the disk to the RVDB) and DM (the distance from the center of the disk to the center of the macula). On the other hand, VOR was calculated by the following novel formula: VOR = (DB/DM on the second FA) – (DB/DM on the first FA)/time between two FA examinations. <b><i>Results:</i></b> Fifty-one eyes of 27 infants who received aflibercept were included as group 1; 38 eyes of 19 patients who received bevacizumab were included in group 2. There were no significant differences between these groups in terms of demographic variables, percentages of disease at zone 1 and posterior zone 2 (<i>p</i> = 0.260), as well as stage 2+ and stage 3+ disease (<i>p</i> = 1.0) at the time of anti-VEGF injections. VORs, which had been measured in between two sequential follow-up FAs, were estimated to be significantly higher in group 1, both in nasal (<i>p</i> = 0.042) and temporal sides (<i>p</i> = 0.033). However, DB/DM ratios were significantly higher in group 2 in the first FA (<i>p</i> = 0.001 at nasal and temporal sides) and the second FA examinations (<i>p</i> = 0.007 and <i>p</i> = 0.004 at nasal and temporal sides, respectively). <b><i>Conclusion:</i></b> VOR was found to be significantly higher in patients who were treated with IVA monotherapy. Paradoxically, RVDB was farther in patients receiving IVB monotherapy despite a slower VOR in these patients.