Ocular Features and Autism Spectrum Disorder: A 10-Year Retrospective Review.

We reviewed the medical records of our pediatric ophthalmology and strabismus clinic of our hospitals for the period 1 January, 2009 to 31 December, 2018, to identify children with autism spectrum disorder (ASD). We found that refractive errors (62%) and strabismus (63%) were the most common ocular manifestations in children with ASD. With timely management, amblyopia and strabismus could have favorable outcome. As amblyopia was significantly associated with intellectual disability (P=0.02), early ophthalmic monitoring via multidisciplinary approach is warranted.

Combined Phacoendoscopic Cyclophotocoagulation versus Combined Phacotrabeculectomy in the Management of Coexisting Cataract and Glaucoma: A Comparative Study.

PURPOSE: To compare the surgical outcome of combined phacoemulsification and endoscopic cyclophotocoagulation (phacoECP) versus combined phacoemulsification and mitomycin C-augmented trabeculectomy (phacoTbx) in patients with coexisting glaucoma and visually significant cataract. METHODS: A retrospective review of 89 eyes of 89 patients who received phacoECP (N=49) and phacoTbx (N=40) was carried out at a tertiary eye center in Hong Kong. The minimum follow-up period was 6 months. Criterion of success was reduction of IOP at least 30% or absolute IOP of 15 mmHg or below without (complete success) or with (qualified success) antiglaucomatous medication. RESULTS: PhacoTbx had more reduction of antiglaucomatous medication (4 vs 1, P < 0.001). At postoperative year one, there was more IOP reduction for phacoTbx than phacoECP (8 mmHg vs 3 mmHg, P=0.012). The one-year complete success rate was also higher for phacoTbx (46.2% vs 8.2%, P < 0.001), while qualified success was comparable between the 2 groups (74.4% vs 73.5%, P=0.925). Operation time was shorter for phacoECP (37 vs 73 minutes, P < 0.001). The number of postoperative follow-up visits was less (6 vs 11.5, P < 0.001) for phacoECP. Additional surgical procedures were more common in phacoTbx (55% vs 0%, P < 0.001). There was no postoperative cystoid macula edema, hypotony, or endophthalmitis reported in both groups. CONCLUSIONS: PhacoECP is significantly less effective than phacoTbx in reduction of both IOP and number of antiglaucomatous medications for patients with medically uncontrolled glaucoma and cataract. Its complete success rate is also significantly lower than that of phacoTbx. With its comparable qualified success, shorter operation time, less number of postoperative visits, and secondary surgical intervention, phacoECP may still have a role in very selected cases.

Optic disc measurements in myopia with optical coherence tomography and confocal scanning laser ophthalmoscopy.

PURPOSE: To evaluate the relationships between optic disc measurements, obtained by an optical coherence tomograph and a confocal scanning laser ophthalmoscope, and myopia. METHODS: One hundred thirty-three eyes from 133 healthy subjects with mean spherical equivalent -6.0 +/- 4.2 D (range, -13.13 to +3.25 D) were analyzed. Optic disc measurements including disc area, rim area, cup area, cup-to-disc area, and vertical and horizontal ratios were obtained with an optical coherence tomograph (StratusOCT; Carl Zeiss Meditec Inc., Dublin, CA) and a confocal scanning laser ophthalmoscope (Heidelberg Retina Tomograph, HRT 3; Heidelberg Engineering, GmbH, Dossenheim, Germany). The modified axial length method derived from prior published work was used to correct the OCT measurements for ocular magnification. Bland-Altman plots were used to evaluate the agreement for each optic disc parameter. Associations between optic disc area and axial length/spherical equivalent were evaluated by linear regression analysis. RESULTS: Disc area increased with the axial length/negative spherical equivalent in the HRT and the corrected OCT measurements although opposite directions of associations were found when the OCT measurements were not corrected for magnification. The difference of the corrected OCT and HRT disc area (corrected OCT disc area minus HRT disc area) was correlated with the axial length (r = 0.195, P = 0.025). When the ametropia was limited to -8.0 to +4.0 D, the correlations became insignificant in the HRT. Using the corrected OCT measurements, disc area, rim area, and cup area, cup-to-disc area, and cup-to-disc horizontal and vertical ratios were significantly larger than those measured by the HRT, with a span of 95% limits of agreement at 1.99, 1.33, and 1.86 mm(2) for the areas, 0.34, 0.53, and 0.58 for the ratios, respectively. CONCLUSIONS: While optic disc area generally increased with the axial length and myopic refraction, the HRT measurements demonstrated that optic disc size was largely independent of axial length and refractive error between -8 and +4 D. OCT may overestimate optic disc size in myopic eyes and results in poor agreement between the two instruments.