Low-Intensity Laser Light Projection for Improved Reading Abilities in Low-Vision Patients.

PURPOSE: To evaluate the efficacy of a new laser imaging device that projects images onto functioning macular areas, to improve visual acuity (VA) in low-vision patients with macular diseases. METHODS: An interventional case series of consecutive patients with low vision in their right eyes (RE). RE VA was measured by showing the patients digits of various standard sizes and measuring their best-corrected VA (BCVA). Then, using the I.C.INSIDE device to project the same standard digits onto functioning macular areas. Patient's ability to recognize the digits with the I.C.INSIDE device was correlated with patient's performance using telescopic low-vision aids. The main outcome measure was change in VA with the different visual aids. RESULTS: Eleven patients (6 males and 5 females) with an average age of 75 ± 6.7 years and low vision in their RE due to macular diseases were included in the study. Baseline BCVA was 1.554 ± 0.50 logMAR. Low-vision aids improved mean VA in 10 patients to 0.64 ± 0.40 logMAR (p < .0001), further improvement was noticed in 8 patients to 0.35 ± 0.16 logMAR (p < .0001) using the laser device, but, three patients did not recognize any digit using the laser device. CONCLUSIONS: The I.C.INSIDE device significantly improved baseline VA in low-vision patients with macular diseases, using extra-foveal fixation.

Pain assessment in premature infants treated with intravitreal antiangiogenic therapy for retinopathy of prematurity under topical anesthesia.

PURPOSE: To evaluate the physiological and behavioral pain response in premature infants receiving intravitreal bevacizumab injection (IVB) for retinopathy of prematurity (ROP) under topical anesthesia. METHODS: A prospective interventional non-comparative case series. Premature infants with high-risk prethreshold or threshold ROP received IVB using topical anesthesia with tetracaine eye drops. A Premature Infant Pain Profile was used to assess the pain response during the procedure. RESULTS: Nine premature infants requiring bilateral IVB therapy were included in the study. Mean gestational age was 28.7 ± 1.3 weeks, and birth weight was 1,200 ± 194 grams. The mean total pain score was found to be 8.7 ± 2.4 (range 5-14), indicating generally mild pain during the procedure. Eye squeeze was the most prominent indicator of pain. Most changes occurred at the beginning, with the insertion of the lid speculum and were hardly noted during the rest of the procedure including the injection itself. CONCLUSION: Topical anesthesia with tetracaine is an effective method for the relief of pain associated with intravitreal injections in premature infants with ROP.