Purpose: To evaluate the neurodevelopmental and ocular developmental outcomes in premature children who have undergone intravitreal bevacizumab injection (IVB) for treatment of type 1 retinopathy of prematurity (ROP).Design: Prospective case-control study.Participants: We enrolled 3 groups of premature patients: premature children who had no history of ROP (group 0), premature children with history of ROP without treatment (group 1), and premature children with ROP who had received a single IVB (0.625 mg; group 2).Methods: Ocular developmental assessment, including cycloplegic refractometry, axial length, Cardiff acuity, and neurodevelopmental assessment via the Bayley Scales of Infant and Toddler Development, Third Edition (Bayley III), were performed at 1 to 3 years of age and were compared between groups.Main Outcome Measures: Ocular developmental outcomes and Bayley III scores.Results: A total of 148 patients (85 boys and 63 girls) were included. The mean age at assessment was 1.49AE0.59 years. Group 0 patients demonstrated significantly higher gestational age (GA), birth weight, and Apgar scores compared with group 1 and 2 patients. There were no significant differences between groups 1 and 2 in demographics or systemic risk factors except for lower GA in group 2. The cylindrical power was significantly larger in groups 1 and 2 compared with group 0. The spherical equivalent was significantly more myopic and the Cardiff acuity was significantly poorer in group 2 than in group 0. There were no significant differences between groups 1 and 2 in refractive status, axial length, or Cardiff acuity. Neurodevelopmental assessment using Bayley III showed no significant difference among the 3 groups in any aspect after adjusting for GA and other systemic risk factors. The risks for poor neurodevelopmental outcomes also were not significantly different.Conclusions: At the mean age of 1.5 years, children with prior history of IVB (group 2) showed similar refractive and visual outcomes and similar neurodevelopmental outcomes compared with premature patients with ROP without requirement of treatment (group 1), although there is a possibility that a small but clinically significant difference may not have been detected in the current study.
Background/objectives To investigate the correlation between obstructive sleep apnea (OSA) severity and the structural and functional progression in patients with glaucoma. Subjects/methods This retrospective comparative cohort study included subjects from the polysomnography database in Chang Gung Memorial Hospital between June 1, 2009, and June 1, 2017, by identifying patients who had received diagnoses of primary open-angle glaucoma (POAG), normal-tension glaucoma (NTG), or glaucoma suspect. Patients with follow-up time of <3 years and/or <3 consecutive reliable optical coherence tomography (OCT) or visual field (VF) tests were excluded. Progression of overall peripapillary retinal nerve fiber layer (RNFL) thickness on OCT scans and VF mean deviation (MD) or VF index (VFI) were determined through linear regression trend analysis. Results Thirty-two patients were included. There was a trend to higher percentage of progression on RNFL thickness and VF in higher OSAS severity. After stratifying patients to no OSA/mild OSA (group 1) and moderate/severe OSA (group 2), group 2 exhibited a significantly higher percentage of RNFL thickness progression than did group 1 (64.7% vs 26.7%, P = 0.042). Multivariate Cox regression analysis showed that severe OSA had an 8.448-fold higher risk of RNFL thickness progression after age, sex, diabetes mellitus, hypertension, hyperlipidemia, and body mass index adjustment (95% confidence interval, 1.464-48.752, P = 0.017). Conclusions Severe OSA is significantly correlated with a higher risk of structural deterioration in patients with glaucoma.
PURPOSE:The aim of this study is to evaluate the effectiveness and predictability of photorefractive keratectomy (PRK) for correcting residual refractive error following cataract surgery with premium intraocular lens (IOL) implantation.METHODS:We conducted a retrospective review of the medical records of patients who received PRK for correcting residual hyperopia, myopia, and/or astigmatism due to unsatisfied uncorrected distance visual acuity (UDVA) after cataract extraction with implantation of aspheric, diffractive multifocal, or toric IOL from September 2011 to December 2017. Pre-cataract surgery, pre- and post-PRK data including UDVA, best-corrected distance visual acuity, and refractive status were analyzed.RESULTS:A total of 18 consecutive eyes in 17 patients were included in this study. The UDVA after PRK improved 1 line or more in 10 eyes, remained unchanged in five eyes, and decreased in three eyes. The overall improvement in the logarithm of minimal angle of resolution (logMAR) UDVA after PRK was significant (P < 0.05). While dividing patients into subgroups based on IOL type, significant improvement in logMAR UDVA was found in patients with aspheric IOL or diffractive multifocal IOL implantation (P < 0.05). No significant improvement of UDVA was found in patients with toric IOL implantation. All eyes achieved ± 1.00 D of the attempted spherical correction, demonstrating good predictability of PRK.CONCLUSIONS:PRK was a safe and effective procedure to correct residual refractive error following cataract extraction with premium IOL implantation. Although satisfactory for all patients, the outcome is better and more predictable in patients with aspheric and diffractive multifocal IOL implantation and is less satisfactory and unpredictable in patients with toric IOL implantation.
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