Visual Psychophysics and Physiological Optics Development of Refractive Error in Individual Children With Regressed Retinopathy of Prematurity

PURPOSE. We investigated longitudinally the refraction development in children with regressed retinopathy of prematurity (ROP), including those with and those without a history of peripheral retinal laser photocoagulation. METHODS. Longitudinal (0-7 years) cycloplegic refraction data were collected prospectively for two groups of preterm children: severe ROP group included those with regressed ROP following bilateral panretinal laser photocoagulation (n ¼ 37; median gestational age [GA] ¼ 25.2; range, 22.7-27.9 weeks) and mild/no ROP group included those with spontaneously regressed ROP or no ROP (n ¼ 27; median GA ¼ 27.1; range, 23.1-32.0 weeks). Analyses were based on spherical equivalent (SEQ), anisometropia, astigmatism, and age (corrected for gestation). RESULTS. The prevalence, magnitude, and rate of myopic progression all were significantly higher in the severe ROP group than in the mild/no ROP group. Longitudinal SEQ in the severe ROP group were best fit with a bilinear model. Before 1.3 years old, the rate of myopic shift was À4.7 diopters (D)/y; after 1.3 years, the rate slowed to À0.15 D/y. Longitudinal SEQ in the mild/no ROP group was best fit with a linear model, with a rate of À0.004 D/y. Anisometropia in the severe ROP group increased approximately three times faster than in the mild/no ROP group. In the severe ROP group, with-the-rule astigmatism increased significantly with age. CONCLUSIONS. The severe ROP group progressed rapidly toward myopia, particularly during the first 1.3 years; anisometropia and astigmatism also increased with age. The mild/no ROP group showed little change in refraction. Infants treated with laser photocoagulation for severe ROP should be monitored with periodic cycloplegic refractions and provided with early optical correction. Keywords: myopia, refractive error development, retinopathy of prematurity, laser photocoagulation R etinopathy of prematurity (ROP) is one of the leading causes of childhood visual impairment and blindness in the United States. The prevalence of myopia has been reported to vary with severity of ROP, ranging from 0% to 16% for preterm infants with no ROP 1-3 to 21% to 100% for children whose severe ROP was laser-treated. 1-4 The prevalence of myopia in children with severe ROP is astonishingly high, especially in those who received peripheral laser-photocoagulation. 7,8 A longitudinal study of 62 preterm children with mild/no ROP reported that 24% had myopia during early childhood and only 11% had high myopia. 9 This study will focus on comparing longitudinal changes in refractive error of individual preterm children who had severe ROP (treated with laser-photocoagulation) and those with mild/no ROP. To our knowledge, previous studies have not offered a model to predict an individual's development of refractive error because they did not track individual myopic progression. As a result, gaps remain in our understanding of refractive error development in individual children with ROP. Furthermore, it is well-known that there is a high prevalence (6-fold higher tha

Gastrointestinal function in intensive care patients: terminology, definitions and management. Recommendations of the ESICM Working Group on Abdominal Problems

Acute gastrointestinal (GI) dysfunction and failure have been increasingly recognized in critically ill patients. The variety of definitions proposed in the past has led to confusion and difficulty in comparing one study to another. An international working group convened to standardize the definitions for acute GI failure and GI symptoms and to review the therapeutic options

CDKN2B-AS1 Genotype–Glaucoma Feature Correlations in Primary Open-Angle Glaucoma Patients From the United States

PURPOSE: To assess the association between single nucleotide polymorphisms (SNPs) of the gene region containing cyclin dependent kinase inhibitor 2B antisense noncoding RNA (CDKN2B-AS1) and glaucoma features among primary open-angle glaucoma (POAG) patients. DESIGN: Retrospective observational case series. METHODS: We studied associations between ten CDKN2B-AS1 SNPs and glaucoma features among 976 POAG cases from the Glaucoma Genes and Environment (GLAUGEN) study and 1971 cases from the National Eye Institute Glaucoma Human Genetics Collaboration (NEIGHBOR) consortium. For each patient, we chose the feature from the eye with the higher value. We created cohort-specific multivariable models for glaucoma features and then meta-analyzed the results. RESULTS: For nine of the ten protective CDKN2B-AS1 SNPs with minor alleles associated with reduced disease risk (e.g., the G allele at rs2157719), POAG patients carrying these minor alleles had smaller cup-disc ratio (0.05 units smaller per G allele at diagnosis; 95% CI: −0.08, −0.03; p=6.23E-05) despite having higher intraocular pressure (IOP) (0.70 mm Hg higher per G allele at DNA collection; 95% CI: 0.40, 1.00; P=5.45E-06). For the one adverse rs3217992 SNP with minor allele A associated with increased disease risk, POAG patients with A alleles had larger cup-disc ratio (0.05 units larger per A allele at diagnosis; 95% CI: 0.02, 0.07; P=4.74E-04) despite having lower IOP (−0.57 mm Hg per A allele at DNA collection; 95% CI: −0.84, −0.29; P=6.55E-05). CONCLUSION: Alleles of CDKN2B-AS1 SNPs, which influence risk of developing POAG, also modulate optic nerve degeneration among POAG patients, underscoring the role of CDKN2B-AS1 in POAG

Conceptual Readings into the Cold War: Towards Transnational Approaches from the Perspective of Latin American Studies in Eastern and Western Europe

This bibliographical and conceptual essay summarizes recent research in Cold War Studies in Europe and the Americas, especially on smaller states in historiographical studies. Against the background of an increasing connectedness and globalization of research about the Cold War, the authors highlight the importance of the full-scale integration of countries and regions of the 'Global South' into Cold War Studies. Critical readings of the newly available resources reveal the existence of important decentralizing perspectives resulting from Cold War entanglements of the 'Global South' with the 'Global North.' As a result, the idea that these state actors from the former 'periphery' of the Cold War should be considered as passive recipients of superpower politics seems rather troubled. The evidence shows (at least partially) autonomous and active multiple actors