Ocular Biometric and Optical Coherence Tomography Parameters in Former Preterm Children: A Cohort Study.

Purpose: To compare biometric and optical coherence tomography parameters as well as refractive status in preterm children aged 4-8 years with or without retinopathy of prematurity (ROP), and evaluate their correlations with age and gender-matched full-term children. Methods: Retrospective comparative cohort study of four groups of children. Children with a history of preterm birth, including ROP who received intravitreal bevacizumab (IVB) treatment, children with a history of ROP that regressed without treatment and those with no history of ROP were compared to age and gender-matched full-term children as a control group. Best corrected visual acuity (BCVA), spherical equivalent of refraction (SE), macular and choroidal thickness, as well as biometric parameters was measured. Results: A total of 120 eyes of 120 children (30 children in each group) were included. There was no significant difference in BCVA, SE, and subjective cylinder between groups (p=0.05, p=0.3, p=0.6, respectively). Axial length was significantly shorter, and the cornea was steeper in both ROP groups than in other groups (p=0.001, p < 0.001, respectively). The central macular thickness was significantly thicker in the treated, regressed ROP and preterm groups than in full-term children (p < 0.001). The gestational age was negatively correlated with macular thickness in both treated and regressed ROP groups (r = -0.517; p=0.003, r = - 0.490; p=0.006, respectively). Conclusions: Children with a history of ROP had a shorter axial length, steeper cornea, and thicker macula that correlated with lower gestational age.

Effect of oral vitamin D supplementation on dry eye disease patients with vitamin D deficiency.

CLINICAL RELEVANCE: Dry eye disease (DED) and vitamin D deficiency are both common clinical entities. Vitamin D has been reported to play a significant role in ocular surface homeostasis. BACKGROUND: This study aimed to determine the therapeutic effect of oral vitamin D supplementation in dry eye disease patients with vitamin D deficiency. METHODS: A randomized, controlled study was completed in 100 patients with dry eye disease and concurrent vitamin D deficiency (< 20 ng/ml). Participants were randomly allocated to 8 weeks of oral vitamin D supplementation with both groups receiving conventional dry eye treatment with artificial tears. Schirmer's, tear break-up time (TBUT) and osmolarity tests were measured before and after eight weeks of treatment. RESULTS: The mean age of participants was 36.8 ± 8.56 years in the treatment group (n: 50) and 34.8 ± 10.13 year in the control group (n: 50). After eight weeks of treatment the mean differences in Schirmer's, TBUT and tear osmolarity were 2.38 ± 1.55 mm, 3.95 ± 1.48 s and -16.9 ± 6.28 mOsm/L, respectively in the treatment group, and 0.7 ± 0.86 mm, 0.92 ± 1.57s and -3.34 ± 2.0 mOsm/L respectively in the control group (p < 0.001 for all parameters). The treatment group demonstrated a more significant improvement than the control group in Schirmer's, TBUT and osmolarity values (p < 0.001). CONCLUSION: Vitamin D supplementation as an adjuvant to routine dry eye treatment improves ocular surface hemostasis parameters, results in better tear stability and a more improved tear osmolarity in patients with vitamin D deficiency.

Peripapillary Retinal Nerve Fiber Layer Thickness Changes in Preterm Children with or without Retinopathy of Prematurity History.

Purpose: To investigate peripapillary retinal nerve fiber layer (pRNFL) thickness changes in preterm children with or without retinopathy of prematurity (ROP) history compared to full-term children. Methods: A retrospective comparative cohort study assessing pRNFL thickness was completed in children aged 4-8 years. Four groups of children were included (n = 30 each group): children with a history of ROP who were treated with intravitreal bevacizumab, children with ROP who received no treatment, and preterm children without ROP compared to age- and gender-matched full-term children. Results: A total of 120 eyes from 120 children were enrolled in this study. Both treated and regressed ROP children showed a significantly thinner pRNFL in the nasal quadrant compared to full-term children (P = 0.017 and P = 0.008, respectively). The pRNFL in the superior quadrant of treated ROP children was thinner than the preterm and control groups (P = 0.015 and P = 0.023, respectively), whereas the inferior quadrant of treated ROP children was thinner than the preterm group alone (P = 0.008). The pRNFL thickness in the temporal quadrant was comparable between groups (P = 0.129). The average spatial distribution profile of pRNFL thickness in treated ROP children was significantly thinner than in the preterm group (P = 0.041). Conclusion: pRNFL thickness is significantly altered in children with a prior history of treated ROP with thinning of the nasal and superior quadrants compared to full-term children.

Visual outcomes of photorefractive keratectomy in non-children with anisometropic amblyopia: One-year Follow-up Outcomes.

OBJECTIVE: To evaluate the safety, efficiency, short term stability, and sensory results of photorefractive keratectomy (PRK) in anisometropic in non-compliant children with correction. METHODS: Twelve eyes of 12 children with an age range: 6-17 years and anisometropic amblyopia who underwent PRK under general anesthesia to correct the dioptric difference between the eyes were included in this study. A complete ophthalmic assessment including refractive status, uncorrected and corrected distance visual acuity (UDVA & CDVA), and binocular vision status using the Worth 4-dot test and stereopsis were performed before and 1, 3, 6, and 12 months after PRK. RESULTS: The mean preoperative CDVA was 0.34 ± 0.24 LogMAR which showed a statistically significant improvement at 12 months (0.20 ± 0.19, p = 0.024) after surgery compared to the preoperative assessment. (p = 0.003) The mean preoperative UDVA was 0.63 ± 0.24 LogMAR that increased to 0.44 ± 0.24, 0.32 ± 0.16, 0.25 ± 0.19, and 0.25 ± 0.19 LogMAR at 1, 3, 6, and 12 months after PRK, respectively. One to three lines improvement in UDVA and CDVA was seen in 10 (83.4%) and 8 eyes (66.7%); while one line UDVA and CDVA loss was seen in one (8.3%) and one (8.3%) eye and unchanged UDVA and CDVA was seen in 1 (8.3%) and 3 eyes (25%), respectively. The mean preoperative stereoacuity was 341.9 ± 245.7 s of arc, which significantly improved to 166.6 ± 87.5 s of arc 12 months after PRK. (p = 0.012). CONCLUSION: PRK was an effective surgical alternative to improve visual acuity and stereopsis in anisometropic children who did not cooperate with conventional methods of amblyopia therapy.

Comparison of binocular game and patching in treating mild to moderate anisometropic amblyopia: a study protocol for a randomized controlled trial.

BACKGROUND: Amblyopia, as a neurodevelopmental preventable visual disorder, affects approximately 1.1 % in Asia. A binocular approach to treating amblyopia has been recently proposed. Whether the binocular playing game treatment is comparable to patching treatment needs further randomized clinical trials. To address this, the present research, designs, develops, and evaluates a new binocular game to treat amblyopia. METHODS: This study has been designed as a non-inferiority, randomized, two parallel-group, controlled trial. Forty-four patients between 4 and 12 years diagnosed with amblyopia will be randomly assigned to the control and intervention groups. In the intervention group, amblyopia treatment is provided with red-green anaglyphic glasses and a red filter placed in front of the amblyopic eye, along with a game to be played for 30 min twice a day. Those in the control group will receive patch therapy according to amblyopia treatment study protocol. The primary outcome is to change visual acuity in the amblyopic eye from the baseline to 3 months after randomization. ETHICS AND DISSEMINATION: The Ethics Committee of Mashhad University of Medical sciences' approval date was February 28, 2018, with a reference code of IR.MUMS.fm.REC.1396.783. Thus far, the recruitment of participants has not been completed and is scheduled to end in September 2021. The results will be disseminated in a peer-reviewed journal. TRIAL REGISTRATION: Iranian Registry of Clinical Trials IRCT20180217038768N1 . Registered on 22 April 2019.

Screening for amblyopia risk factors in pre-verbal children using the Plusoptix photoscreener: a cross-sectional population-based study.

AIMS: To evaluate the accuracy and applicability of Plusoptix photoscreener in screening pre-verbal children at risk of amblyopia. METHODS: In this cross-sectional population-based study 996 children aged 6-36 months were screened with the Plusoptix. The children underwent complete examinations that included a manual cycloplegic retinoscopy, slit lamp examination, cover test, the Hirschberg test and an assessment of fixation pattern. In addition, the prevalence of amblyogenic risk factors was estimated, the Plusopix measurements were compared with cycloplegic retinoscopy, and the referral criteria were modified to improve the accuracy of the device. RESULTS: Amblyogenic hyperopia >+3.50 D, myopia >-3.00 D, astigmatism >1.50 D in the orthogonal meridian or >1.00 D in the oblique meridian, or anisometropia >1.50 D was detected in 4.7%, 0.0%, 12.3% and 0.5% of the samples, respectively. The average difference between retinoscopy and photorefraction for spherical equivalence was -0.16 ± 1.0 D (p<0.05). Testability was 98.1% for the Plusoptix. The Plusoptix vision screener referred 47.8% of these children for sensitivity, specificity, positive predictive value and false-negative rates of 100%, 38.7%, 19% and 100%, respectively. These same measurements with the modified referral criteria (hyperopia ≥ 2.00 D in children under 12 months and astigmatism ≥ 1.25 D) were 93.6%, 51.2%, 21.7% and 98.2%. CONCLUSION: The Plusoptix is a useful objective screening instrument, but still has low specificity for detecting amblyopia risk factors in the paediatric population.