Referral patterns of children with glaucoma and their caretakers in Northern Tanzania.

AIM: To describe the referral patterns of children with primary childhood glaucoma (PCG) or secondary childhood glaucoma (SCG) and their presenting symptoms in Northern Tanzania. METHODS: A retrospective observational study of children 0.48, better eye). Most of the children (60%) and their caretakers presented on their own initiative, while 24% were sent by different general health cadres and 16% by eye care professionals. Buphthalmos was the main symptom mentioned as a trigger for presentation. CONCLUSION: The study shows that most of the children presented late resulting in advanced stages of glaucoma at the time of initiation of treatment. The majority attended the referral eye department on their own initiative with buphthalmos being the most commonly described symptom. Awareness creation among caretakers of children, general health and eye care providers, ideally embedded in general child health promotion activities, is needed to increase and accelerate referrals

Dry Eye Parameters and Lid Geometry in Adults Born Extremely, Very, and Moderately Preterm with and without ROP: Results from the Gutenberg Prematurity Eye Study

Background/Aims: This study aimed to analyze the effects of perinatal history on tear film properties and lid geometry in adults born preterm. Methods: The Gutenberg Prematurity Eye Study (GPES) is a German prospective examination of adults born preterm and term aged 18 to 52 years with Keratograph® 5M and Schirmer test I. Main outcome measures were first non-invasive tear film break-up time (F-NITBUT), bulbar redness (BR), Schirmer test, and nasal palpebral angle measurement. The associations with gestational age (GA), birth weight (BW), and BW percentile, retinopathy of prematurity (ROP), ROP treatment, and other perinatal factors were evaluated using regression analyses. Results: 489 eyes of 255 preterm and 277 eyes of 139 full-term individuals (aged 28.6 +/− 8.8 years, 220 females) were included. Of these, 33 participants (56 eyes) had a history of spontaneously regressed ROP and 9 participants (16 eyes) had a history of ROP treatment. After adjustment for age and sex, lower F-NITBUT (<20 s) was associated with ROP treatment (OR = 4.42; p = 0.025). Lower GA correlated with increased bulbar redness (B = −0.02; p = 0.011) and increased length of wetting in the Schirmer test (B = −0.69; p = 0.003). Furthermore, low GA was associated with narrowing of the nasal palpebral angle (B = 0.22; p = 0.011) adjusted for age and sex, but not when considering ROP in the multivariable model. Conclusion: Our analyses indicate that perinatal history affects ocular surface properties, tear production and lid geometry in adults born term and preterm. This might indicate that affected persons have a predisposition to diseases of the corneal surface such as the dry eye disease

Retinopathy of Prematurity—Targeting Hypoxic and Redox Signaling Pathways

Retinopathy of prematurity (ROP) is a proliferative vascular ailment affecting the retina. It is the main risk factor for visual impairment and blindness in infants and young children worldwide. If left undiagnosed and untreated, it can progress to retinal detachment and severe visual impairment. Geographical variations in ROP epidemiology have emerged over recent decades, attributable to differing levels of care provided to preterm infants across countries and regions. Our understanding of the causes of ROP, screening, diagnosis, treatment, and associated risk factors continues to advance. This review article aims to present the pathophysiological mechanisms of ROP, including its treatment. Specifically, it delves into the latest cutting-edge treatment approaches targeting hypoxia and redox signaling pathways for this condition

Outcomes of surgical interventions for primary childhood glaucoma in Northern Tanzania.

AIM: To evaluate goniotomy, trabeculotomy, transscleral cyclophotocoagulation (TSCPC) and trabeculectomy as initial procedures in children with primary childhood glaucoma from Northern Tanzania. METHODS: A retrospective analysis of consecutive interventions for primary childhood glaucoma from 2000 to 2013 was conducted at the Kilimanjaro Christian Medical Centre. Success was defined as postoperative intraocular pressure (IOP) below 22 mmHg. Success rates, IOP, visual acuity (VA), subsequent interventions and potential risk factors for failure were reported for the respective interventions. RESULTS: The study included 116 eyes of 70 children (age 4.6±5.9 years) with primary childhood glaucoma; 46 (65.7%) children were male. The preoperative IOP was 33.1±10.2 mmHg, the preoperative cup/disc (CD) ratio 0.71±0.3 and the corneal diameter 13.3±1.4 mm. As a primary intervention, 61 (52.6%) eyes underwent goniotomy, 10 (8.6%) eyes trabeculotomy, 12 (10.3%) TSCPC and 33 (28.4%) trabeculectomy. Follow-up data after 12 months were available for 63 (54.3%) eyes. Success rates at 12 months were 38% (goniotomy), 30% (trabeculotomy), 17% (TSCPC) and 64% (trabeculectomy). All interventions achieved a statistically significant IOP reduction at 3, 6 and 12 months, except for trabeculotomy after 6 months and TSCPC at all time points. Postoperative endophthalmitis occurred in one child treated with trabeculectomy. VA in 82% of all eyes was maintained or had improved after 12 months. CONCLUSIONS: Based on the success rates of this retrospective analysis, goniotomy or trabeculotomy for younger and trabeculectomy for older children can be recommended in our setting to reduce IOP. Late presentation in combination with advanced glaucomatous damage as well as erratic postoperative follow-up and treatment were likely factors that compromised overall success rates. More efforts are necessary to detect the blinding disease earlier and improve adherence to follow-up

The association of birth weight (continuous) with visual acuity, refraction and keratometry in separate models in the NHANES 1999–2008.

<p>The association of birth weight (continuous) with visual acuity, refraction and keratometry in separate models in the NHANES 1999–2008.</p

Association of birth weight with corneal power in early adolescence: Results from the National Health and Nutrition Examination Survey (NHANES) 1999–2008

<div><p>Purpose</p><p>To analyze the effect of birth weight on ocular morphology, refraction and visual function in early adolescents aged 12–15 years.</p><p>Material and methods</p><p>We conducted a secondary data analysis using the public use files from the National Health and Nutrition Examination Survey of the period from 1999 to 2008. Study participants aged 12 to 15 years were included with data on birth weight and ophthalmic parameters including presenting distance visual acuity, objective refraction and keratometry. Visual acuity, sphere, astigmatism in power vectors J₀ and J₄₅, corneal power and corneal astigmatism were evaluated for an association with birth weight. Linear and logistic regression with adjustment for age, sex, ethnicity, survey cycle and birth weight as independent variable were calculated.</p><p>Results</p><p>Linear regression analysis revealed an association between corneal power and birth weight (per 100g: beta = -0.04, p<0.001) in the univariate analysis, and in the model adjusted for age, sex, ethnicity and NHANES survey cycle (per 100g: beta = -0.04, p<0.001). A lower birth weight was associated with higher corneal power. We found no evidence for an association of visual acuity, sphere, spherical equivalent, J₀-vector and J₄₅-vector of astigmatism, corneal J₀- or corneal J₄₅-vector with birth weight.</p><p>Conclusion</p><p>Our data demonstrate that low BW is linked to alterations in keratometric power even in early adolescents aged 12–15 years whereas visual acuity and refractive error showed no association.</p></div

Characteristics of NHANES 1999–2008 sample with both birth weight and ophthalmic data available.

<p>Characteristics of NHANES 1999–2008 sample with both birth weight and ophthalmic data available.</p

The association of self-reported birth weight (categorical) with visual acuity, refraction and keratometry in the NHANES 1999–2008.

<p>The association of self-reported birth weight (categorical) with visual acuity, refraction and keratometry in the NHANES 1999–2008.</p