Current trends among pediatric ophthalmologists to decrease myopia progression—an international perspective

Purpose To explore what the current worldwide preferred practice patterns of pediatric ophthalmologists are to decrease myopia progression among their patients. Methods A questionnaire was sent to all members of supranational and national pediatric ophthalmology and strabismus societies. Results The questionnaire was fully completed by most respondents 90.10% (847 of 940 responses). Fifty-seven percent (457) routinely treat to decrease myopia progression. The most common parameter to initiate treatment was a myopic increase of 1 diopter/year or more (74.8%, 246). Seventy percent (345) prescribed eye drops. Atropine 0.01% was the most popular (63.4%, 277) followed by atropine 1% (10.9%, 48) and atropine 0.5% (8.9%, 39). Eighty-six percent (394) of the respondents advised to spend more time outdoors, to reduce the amount of time viewing screens (60.2%, 277), and cutback the use of smart phones (63.9%, 294). Conclusions Most pediatric ophthalmologists treat to decrease myopia. They employ a wide variety of means to decrease myopia progression. Atropine 0.01% is the most popular and safe modality used similarly to recent reports. However, there is no consensus when treatment should be initiated. Further prospective studies are needed to elucidate the best timing to start treatment and the applicability of recent studies in the Asian population to other ethnic groups. This will improve the ability to update pediatric ophthalmologist with evidenced-based treatment options to counter the myopia epidemic

Practice patterns to decrease myopia progression differ among paediatric ophthalmologists around the world

Introduction Myopia is a worldwide epidemic. Plethora of treatments are offered to decrease myopia progression. In this study, we compared between different geographical areas worldwide the practice patterns used by paediatric ophthalmologists to decrease the progression of myopia. Methods Global responses to a questionnaire were analysed (n=794) for demographic variations. Pharmacological, optical and behavioural categories were defined as effective or ineffective based on the current scientific peer reviewed literature. Results Treatment rates varied significantly between geographical regions (mean 57%, range 39%–89%, p<0.001). Nearly all participants who treat myopia used at least one form of effective treatment, regardless of location (98%, p=0.16). Among those prescribing pharmacological treatments, European physicians offered the lowest rate of effective treatment compared with other regions (85% vs mean 97%). Rates of effective optical treatment varied significantly between locations (p<0.001), from 16% (Central-South America) to 56% (Far East). Most treating respondents advocated behavioural modifications (92%), between 87% (North America) and 100% (Central Asia). Nearly all respondents used combinations of treatment modalities (95%)—mostly pharmacological, optical and behavioural combination. However, combination rates varied significantly between regions (p<0.001). Discussion The utility of treatment to decrease myopia progression differs significantly across the world both in type, combination and efficacy. Conclusion Paediatric ophthalmologists involvement and proficiency in myopia progression treatment varies around the world. This may entail promoting continuous medical education and other incentives to increase the number and proficiency of paediatric ophthalmologist to have a more effective impact to control the myopia epidemic in children

Rotation of retinal vascular arcades and comparison with disc-fovea angle in the assessment of cycloposition

Background/aims: To assess the agreement between disc-fovea angle (DFA) and the retinal vascular arcades rotation to measure cycloposition. Device repeatability and reproducibility between observers were also evaluated. Methods: Cycloplegic retinography was taken in 321 eyes of 165 normal patients and repeated in 18 eyes at least 24 h later. Two independent observers used software to determine DFA, vein-related angle (VRA) and artery-related angle (ARA) in every retinography. Mean value of related angle (MRA) (mean value of VRA and ARA) was calculated. Results: Camera repeatability was good (Intra-class Correlation Coefficient, ICC 0.89). In Bland-Altman analysis, mean VRA, ARA and MRA were 4° to 5° different from DFA (p0.05). Conclusions: The rotation of retinal vascular arcades using a first-order approximation technique is no substitute to DFA when assessing torsion in fundus photographs. Of the methods tested, MRA correlated most closely, but DFA remains the gold standard for cycloposition. The rotation of vascular arcades provides a qualitative assessment, particularly in uncertain macular location

Integración de alumnos Erasmus, durante su estancia semestral en el extranjero, en el curso de Oftalmología. Elaboración de material didáctico para seminarios‐practicas y tutorización "on‐line" a través de e‐mail, Whatsapp y Hangouts

Depto. de Inmunología, Oftalmología y ORLFac. de MedicinaFALSEsubmitte