To study the development of visual acuity in term-born children with cerebral visual impairment and a history of neonatal hypoxic-ischemic encephalopathy. Methods: We studied 19 term-born children, aged 6 months to 6 years, with moderate to severe neonatal hypoxic-ischemic encephalopathy and behaviors indicative of cerebral visual impairment. Longitudinal measures of grating acuity were obtained using preferential looking (PL) and visual evoked potential (VEP) procedures. Visual acuities at first and last visits were compared. The courses of acuity development in the 9 children who underwent both VEP and PL acuity assessment at 4 or more ages were compared with normal development. Results: All children had measurable PL and VEP acuity, despite poor visual behavior. In nearly all, both PL and VEP acuity were below normal for age. For both PL and VEP measures, acuity at the last visit was, on average, 1 octave better than at the first visit, with a rate of improvement lower than normal. Although parallel courses of PL and VEP development occurred in many, substantial disparities in PL and VEP acuity were observed in others. Conclusions: Modest increases in PL and VEP grating acuity occur during early childhood in many of these patients. The rate of increase is lower than normal.
Purpose-To compare central corneal thickness measurements obtained by Orbscan II, contact ultrasound pachymetry and the non-contact Artemis-2 scanning ultrasound system.
Methods-The central corneal thickness of 40 eyes (20 normal subjects) was measured using first the Orbscan II, followed by contact ultrasound pachymetry, and finally by the Artemis-2. Results were compared statistically using ANOVA, paired T-tests, and Bland-Altman plots.Results-One-way ANOVA showed a significant difference between the three different modes of measuring central corneal thickness (F=32.84, p=0.0001). Artemis-2 and the ultrasound pachymeter measurements were highly correlated (R 2 =0.963, p<0.0001), but with Artemis, on average, measuring central corneal thickness by 11.2±6.6 microns less than the pachymeter. The Artemis-2 and Orbscan II measurements were less well correlated (R 2 =0.851, p<0.001), with Orbscan measurements on average 7.5±15.7 microns thinner than those obtained with the Artemis-2. In addition, the Orbscan showed a trend towards increasing underestimation of corneal thickness for thinner corneas.Conclusions-Ultrasound pachymetry and Artemis-2 measurements of central corneal thickness were highly correlated. The 11-micron mean difference between the pachymeter and Artemis measurements may be attributed to decentration, oblique incidence of the probe to the cornea or possibly the effect of topical anesthetic when using contact pachymetry. While Orbscan values only had an average difference of 7.5 microns from Artemis, they were less correlated than contact ultrasound pachymetry with Artemis values and increasing prone to underestimation of corneal thickness for thinner corneas.
Corneal neovascularization causes deterioration of visual acuity and increases surface irregularities. Various techniques have been employed to help control the progression of corneal neovascularization; bevacizumab is a medication that targets the specific pathway of corneal neovascularization. The Boston Ocular Surface Prosthesis (BOSP) is a large diameter contact lens that aids in maintaining corneal surface integrity and may serve as a delivery system for topical bevacizumab. This paper reviews five patients who were treated with topical bevacizumab in their BOSP. All patients demonstrated improvement in their visual acuity and clinical exam. No adverse reactions were noted.
Purpose: Cenegermin, (OXERVATE) a recently Food and Drug Administration-approved topical formulation of recombinant human nerve growth factor, has been used for the treatment of neurotrophic keratopathy (NK). Corneal deposits have been previously reported as a potential adverse effect; however, the clinical characteristics, visual significance, and treatment options have not been fully described. The purpose of this article is to better characterize corneal deposits occurring during treatment with cenegermin for neurotrophic keratopathy.Methods: This was a retrospective, multicenter consecutive case series.
Results:We identified 5 patients from 3 institutions who developed a white opacity in varying layers of the cornea, consistent with calcium deposition, during treatment with cenegermin. In all cases, the opacity occurred rapidly over the course of a few weeks after initiation of treatment. Histopathologic examination of the cornea from one corneal patient demonstrated extensive calcification of the stroma extending to 90% depth. Before treatment, all patients had stage 2 or 3 NK (Mackie classification). The deposits were visually significant in all patients and did not resolve after cessation of cenegermin. There were no differences in age, sex, etiology of the NK, corneal transplant status, or concurrent medications between the patients who developed a deposit and 15 other patients with stage 2 or 3 NK who did not. One patient was successfully treated with superficial keratectomy with ethylenediaminetetraacetic acid chelation, one patient underwent penetrating keratoplasty, and one patient received a Boston keratoprosthesis.
Conclusions:We report the rapid onset of a corneal opacity after initiation of treatment with cenegermin in patients with stage 2 or 3 NK, consistent with acute calcific band keratopathy. This visually significant adverse finding has not previously been described. We could not identify any risk factors for development. We recommend close monitoring of patients receiving cenegermin therapy because the opacity may be irreversible and may require keratoplasty for visual rehabilitation.
The purpose of this research is to prove a possibility which contributes the globalization of Korean dining and its potential in perceptions from international visitors about images of LOHAS they have. The main study results as follows.There were three subordinate concepts; health, eco-friendly, and substantiality. Second, perceived value noticeably affected the satisfaction of korean restaurant. respectively, the satisfaction of korean restaurant also noticeably affected customer loyalty.This research suggested academic implications of contributable view on foodservice management and tourism study based on the result from Japanese visitors with their Perceived value and domestic restaurant customer loyalty toward Korean dining LOHAS. This study also suggests the implication of the globalization of Korean dining and taking a position as a supporter of the globalization plan from korean dining foundation. Additionally, this study intended to present capable contribution based on the results of study with related proposals of globalization of Korean dining, Korea in-bound tour, and its interagency.
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