Anterior segment imaging in pediatric ophthalmology

Mireskandari, Kamiar; Tehrani, Nasrin; VandenHoven, Cynthia; Ali, Asim

doi:10.1016/j.jcrs.2011.09.026

Cited by 25 publications

(34 citation statements)

References 17 publications

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“…Currently, it is common to evaluate pediatric cataracts based on the appearance of the lens at the time of clinical presentation using handheld photographic equipment, 6 or during surgery under general anesthesia using the operating microscope. Although handheld photographic equipment is simple and convenient, it often fails to provide precise assessments and to produce high-quality images of cataract morphology, making it more suitable for preliminary screening than for vital clinical decision making.…”

Section: Introductionmentioning

confidence: 99%

Monitoring and Morphologic Classification of Pediatric Cataract Using Slit-Lamp-Adapted Photography

Long

Lin

Chen

et al. 2017

Trans. Vis. Sci. Tech.

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PurposeTo investigate the feasibility of pediatric cataract monitoring and morphologic classification using slit lamp–adapted anterior segmental photography in a large cohort that included uncooperative children.MethodsPatients registered in the Childhood Cataract Program of the Chinese Ministry of Health were prospectively selected. Eligible patients underwent slit-lamp adapted anterior segmental photography to record and monitor the morphology of their cataractous lenses. A set of assistance techniques for slit lamp–adapted photography was developed to instruct the parents of uncooperative children how to help maintain the child's head position and keep the eyes open after sleep aid administration.ResultsBriefly, slit lamp–adapted photography was completed for all 438 children, including 260 (59.4%) uncooperative children with our assistance techniques. All 746 images of 438 patients successfully confirmed the diagnoses and classifications. Considering the lesion location, pediatric cataract morphologies could be objectively classified into the seven following types: total; nuclear; polar, including two subtypes (anterior and posterior); lamellar; nuclear combined with cortical, including three subtypes (coral-like, dust-like, and blue-dot); cortical; and Y suture. The top three types of unilateral cataracts were polar (55, 42.3%), total (42, 32.3%), and nuclear (23, 17.7%); and the top three types of bilateral cataracts were nuclear (110, 35.8%), total (102, 33.2%), and lamellar (34, 11.1%).ConclusionsSlit lamp–adapted anterior segmental photography is applicable for monitoring and classifying the morphologies of pediatric cataracts and is even safe and feasible for uncooperative children with assistance techniques and sleep aid administration.Translational RelevanceThis study proposes a novel strategy for the preoperative evaluation and evidence-based management of pediatric ophthalmology (Clinical Trials.gov, NCT02748031).

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Section: Introductionmentioning

confidence: 99%

Monitoring and Morphologic Classification of Pediatric Cataract Using Slit-Lamp-Adapted Photography

Long

Lin

Chen

et al. 2017

Trans. Vis. Sci. Tech.

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“…Advances in treatment modalities and imaging equipment1 mean children are increasingly subjected to more testing. Occasionally the child becomes distressed and is unable to cooperate with examinations.…”

Section: Introductionmentioning

confidence: 99%

Utilisation of an outpatient sedation unit in paediatric ophthalmology: safety and effectiveness of chloral hydrate in 1509 sedation episodes

West¹,

Griffiths

Shariff

et al. 2013

Br J Ophthalmol

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“…In addition to being of clinical value, demonstration of pathology can be very helpful with patient and carer education and may improve treatment compliance. 4 AS-OCT provides an invaluable tool for assessment and monitoring of the ocular complications in MPS. This article provides, to our knowledge, the first description of the AS-OCT findings in patients with MPS I, II, and VI.…”

Section: Introductionmentioning

confidence: 99%

Anterior segment OCT imaging in mucopolysaccharidoses type I, II, and VI

Ahmed

Turnbull

Attridge

et al. 2014

Eye

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Purpose To describe the anterior segment optical coherence tomography (AS-OCT) characteristics of patients with ocular manifestations of mucopolysaccharidoses type I (Hurler), II (Hunter), and VI (Maroteaux-Lamy). Methods Prospective, observational study of nine consecutive patients with variants of mucopolysaccharidosis (MPS) attending the Paediatric Ophthalmology service at Manchester Royal Eye Hospital, UK. All patients underwent Visante AS-OCT imaging as part of their ophthalmic assessment. Results Ocular involvement tended to be symmetrical. Angle-to-angle distance was significantly lower in MPS VI than in MPS I (P ¼ 0.04). Anterior chamber depth, angle opening distance, trabecular-iris space area, and scleral spur angle tended to be lower in MPS VI than in MPS I, but did not reach statistical significance. Corneal thickness in the central 0-2 mm zone was greater in MPS VI than in MPS I, approaching but not attaining statistical significance (P ¼ 0.07). The 2-5 and 5-7 mm zones were significantly thicker in MPS VI than MPS I (P ¼ 0.04, P ¼ 0.04). There was no difference in corneal thickness between MPS I and MPS VI in the peripheral 7-10 mm zone (P ¼ 0.57). Measurements of the patient with MPS II resembled the mean values of the MPS I group. Conclusion AS-OCT is valuable in quantifying anterior segment pathology in MPS. It suggests more crowded anterior segments and greater corneal thickness in patients with MPS VI than MPS I. AS-OCT is useful in evaluating the risk and mechanism of glaucoma in MPS patients, and may improve our assessment of the efficacy of systemic treatment.

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Anterior segment imaging in pediatric ophthalmology

Cited by 25 publications

References 17 publications

Monitoring and Morphologic Classification of Pediatric Cataract Using Slit-Lamp-Adapted Photography

Monitoring and Morphologic Classification of Pediatric Cataract Using Slit-Lamp-Adapted Photography

Utilisation of an outpatient sedation unit in paediatric ophthalmology: safety and effectiveness of chloral hydrate in 1509 sedation episodes

Anterior segment OCT imaging in mucopolysaccharidoses type I, II, and VI

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