Objective: Medium and long-term sequelae of intravitreal bevacizumab (IVB) for type 1 retinopathy of prematurity (ROP) are uncertain. Our aim was to describe the fluorescein angiography (FA) findings in patients who received IVB as a primary treatment for type 1 ROP and compare them to findings in patients with spontaneously regressed ROP. Design: Retrospective cohort Participants: Patients with a history of retinopathy of prematurity, who underwent fluorescein angiography between December 1 st , 2013 and July 31 st , 2018. Patients were divided into 2 groups based on whether they had received IVB or had spontaneously regressed. Methods: We reviewed the angiograms in the 2 groups for neovascularization (NV) and other abnormal vascular patterns both in the periphery and the posterior pole. Main Outcome Measures: FA findings including NV, peripheral and macular vascular abnormalities. Results: Forty eyes of 20 infants were included in the IVB group and 16 eyes of 8 infants in the untreated group. Median gestational age was similar in the 2 groups (24.5 & 24.7 weeks respectively; p = 0.44) as was the median birth weight (648.5 & 560.0 g respectively; p=0.26). Median post-menstrual age at the time of FA was 65.1 and 83.9 weeks respectively (p = 0.0002). Review of angiograms demonstrated NV in 30.0% and 37.5% in the IVB and untreated cohorts, respectively (p=0.75). Abnormal vascular patterns in the periphery were similar in both groups
As they grow older, most children with glaucoma must eventually face the transition to self-administering medications. We previously reported factors associated with better or worse medication adherence in children with glaucoma, using an objective, electronic monitor. Utilizing the same data set, the purpose of the current study was to determine whose report (the caregiver’s or the child’s) corresponded better with electronically monitored adherence. Of the 46 participants (22 girls), the mean age of children primarily responsible, and caregiver primarily responsible for medication administration was 15±2 and 10±2 years, respectively. For the children whose caregiver regularly administered the eyedrops, the caregiver’s assessment of drop adherence was associated with measured adherence (P=0.012), but the child’s was not (P=0.476). For the children who self-administered eyedrops, neither the child’s (P=0.218) nor the caregiver’s (P=0.395) assessment was associated with measured percent adherence. This study highlights potential errors when relying on self-reporting of compliance in patients and caregivers with pediatric glaucoma, particularly when the child is responsible for administering their own eyedrops. Frank discussions about the importance of medication adherence and how to improve compliance may help both the child and caregiver better communicate with the treating provider.
Purpose: To investigate the utility of three corneal screening devices in three groups of children. Methods: This was a prospective study of patients with Trisomy 21 (group 1), patients with a first-degree relative with keratoconus (group 2), and control patients (group 3). Informed consent was obtained before testing with the Pentacam (Oculus Optikgeräte GmbH), Orbscan (Orbscan, Inc), and Ocular Response Analyzer (ORA) (Ametek Reichart Technologies). The ability to complete tests, the quality of results, and the corneal parameters obtained for each eye were recorded. A one-way analysis of variance test was used to compare the results between the three groups. Results: Fifty-four patients aged from 7 to 17 years (mean: 11.74 years) were enrolled between July 2014 and July 2016. The number of patients and the percentage of tests completed for groups 1, 2, and 3 were 12 (55%), 21 (87%), and 21 (88%), respectively. The Pentacam values by group were central corneal thickness of 524, 543, and 542 µm ( P = .36); thinnest point of 498, 536, and 534 µm ( P = .03); corneal front mean keratometry of 44.9, 43.2, and 43.2 ( P = .01); and quality score of 1.42, 0.22, and 0.04 ( P < .0001), respectively. Orbscan values by group were central corneal thickness of 493, 551, and 550 µm ( P = .01) and thinnest point of 451, 536, and 538 µm ( P < .0001), respectively. ORA values by group were corneal hysteresis of 10.6, 12.1, and 11.6 ( P = .124); corneal resistance factor of 9.9, 11.8, and 11.6 ( P = .03); and waveform score of 5.6, 7.6, and 7.3 ( P < .0001), respectively. Conclusions: Patients in group 1 completed fewer tests reliably and had thinner corneas and lower corneal resistance factors than patients in groups 2 and 3. Corneal tests used to evaluate adults for keratoconus may not be reliable for the evaluation of certain high-risk pediatric patients. [ J Pediatr Ophthalmol Strabismus . 2022;59(2):94–101.]
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