Retinal detachment following retinopathy of prematurity in France: Screening and treatment pathways.

AIM: Preterm children are highly vulnerable to sensorial impairments through Retinopathy Of Prematurity (ROP). The objective was to determine whether some cases of ROP requiring surgery could be secondary to deficiencies in care pathways. METHODS: Descriptive study of neonatal characteristics and the screening/treatment pathways of children treated for stage ≥4A ROP from 2009 to 2020 in a referral unit in France. RESULTS: Twenty-five preterm children (44 eyes) were included: median gestational age was 25 weeks, and median birthweight was 700 grams. Eighty-four per cent had received at least one fundus examination, 50% of which were completed on time. At the time of retinal detachment diagnosis, only 36% of the children had received laser or anti-vascular endothelial growth factor (VEGF) intra-vitreal injection. ROP stage was only reported in 8%, and the zone or type was reported in 16% of the files. CONCLUSION: The risk of blindness and the effectiveness of laser or anti-VEGF treatment highlight the need to enhance screening and treatment practices in France.

Hidden in the Eyes-Recurrence of Systemic Hemopathies Reportedly "In Remission": Six Cases and Review of Literature.

Background and Objectives: Secondary ocular localizations of hematological malignancies are blinding conditions with a poor prognosis, and often result in a delay in the diagnosis. Materials and Methods: We describe a series of rare cases of ocular involvement in six patients with hematological malignancies, reportedly in remission, who presented secondary ocular localizations, challenging to diagnose. Two patients had an acute lymphoblastic leukemia (ALL) and developed either a posterior scleritis or a pseudo-panuveitis with ciliary process infiltration. One patient had iris plasmacytoma and developed an anterior uveitis as a secondary presentation. Two patients had a current systemic diffuse large B-cell lymphoma (DLBCL) and were referred either for intermediate uveitis or for papilledema and vitritis with secondary retinitis. Finally, one patient with an acute myeloid leukemia (AML) presented a conjunctival localization of a myeloid sarcoma. We herein summarize the current knowledge of ophthalmologic manifestations of extramedullary hematopathies. Results: Inflammatory signs were associated with symptomatic infiltrative lesions well displayed in either the iris, the retina, the choroid, or the cavernous sinus, from the admission of the patients in the ophthalmological department. These findings suggest that patients with ALL, AML, systemic DLBCL, and myeloma can present with ophthalmic involvement, even after having been reported as in remission following an effective systemic treatment and/or allograft. Conclusions: Early detection of hidden recurrence in the eyes may permit effective treatment. Furthermore, oncologists and ophthalmologists should be aware of those rare ocular malignant locations when monitoring patient's progression after initial treatment, and close ophthalmologic examinations should be recommended when detecting patient's ocular symptoms after treatment.

Stromal Keratitis After Varicella in Children.

PURPOSE: We describe here a case series of patients with stromal keratitis of chronic course, a potential manifestation after chickenpox in children. METHODS: This is a retrospective review of 8 eyes (7 children) with stromal keratitis after varicella seen in our referral cornea center. All patients received a systemic antiviral treatment with oral acyclovir and topical steroid eye drops. Topical cyclosporine eye drops were associated with steroids in case of steroid dependence or steroid-related side effects. Both antiinflammatory treatments were slowly tapered over time. RESULTS: Median age at diagnosis was 3 years and 4 months. Stromal keratitis was unilateral in 6 children (85.7%) and consisted of superficial nummular keratitis in 4 cases and deep stromal diffuse keratitis in 3 cases. During the median follow-up of 31 months (range, 13-59 months), 6 children had 1 to 6 episodes of relapse. The median duration of topical steroid eye drop was 26 months (range, 2-59 months). Topical cyclosporine eye drops were used with steroids in 3 patients (42.9%). Three patients stopped topical steroids after 2, 5, and 8 months, without recurrence. Four patients were still undergoing treatment after a median of 43 months (range, 26-59 months). All patients regained a best-corrected visual acuity of 20/20 at the end of the follow-up. CONCLUSIONS: Stromal keratitis after varicella is an entity with a potential chronic course lasting 3 months or more. Steroid dependence and relapses during tapering are 2 major challenges for the management.