Aim: To compare the visual acuity (VA), spherical equivalent refractive error, motility, and anatomical outcomes in children with treated regressed threshold stage3 retinopathy of prematurity (ROP) and those with spon...Aim: To compare the visual acuity (VA), spherical equivalent refractive error, motility, and anatomical outcomes in children with treated regressed threshold stage3 retinopathy of prematurity (ROP) and those with spontaneously regressed subthreshold stage3 ROP. Method: 6 month and 3 year data collected from infants examined between 1989 and 1999 with regressed stage3 ROP, with or without treatment were retrospectively reviewed. Results: 85 infants were included in this study. 40 eyes received cryotherapy, 81 eyes laser photocoagulation, and 34 eyes had spontaneously regressed subthreshold stage3 ROP. Grating acuity score ≥ 2 cycles/degree (c/d) at 6 months was predictive of optotype acuity ≥ 6/9 in 69% of eyes and a score < 2 c/d at 6 months was predictive of acuity < 6/9 in 88% of eyes. Eyes with subthreshold stage3 ROP were twice as likely to haveVA of 6/9 or better at 36 months than the treated eyes. The mean spherical equivalent refractive error at 36 months was-6.5 dioptres (D) (-21.5D to + 1.38D) in cryotherapy treated eyes,-2.4D (-13D to + 4D) in the laser group, and-0.22D (-9D to + 2.25D) in the subthreshold group. Eyes within the treated groups were more myopic than the eyes within the spontaneously regressed group (P=0.005). At 36 months, 42 out of the 85 infants (that is, 49% ) had strabismus (44% in the cryotherapy group, 26% in the laser group, and 25% in the subthreshold group). There was a statistically significant association between the presence of strabismus and anisometropia (P=0.016) and strabismus and intraventricular haemorrhage (IVH) (P=0.005). There was a statistically significant difference in the incidence of strabismus between mild and moderate and severe grade IVH (P=0.01). Eight out of 40 eyes in the cryotherapy group and six out of the 81 eyes in the laser group developed macular ectopia. None of the eyes in the spontaneously regressed group had macular dragging. Conclusions: In this study, the grating acuity at 6 months was a good predictor of the 3 year optotype acuity in all groups. Eyes with spontaneously regressed subthreshold stage3 ROP were associated with better vision at 3 years of age and a lesser degree of myopia compared to the treated groups. Strabismus developed predominantly in the treated groups and was frequently associated with neurological damage and/or anisometropia. The spontaneously regressed subthreshold stage3 group had a better anatomical outcome compared to the groups in which the retinopathy regressed following treatment.展开更多
Aims: To introduce new terminology and validate its reliability for the analys is of optical coherence tomography (OCT) scans, compare clinical detection of cy stoid macular oedema (CMO)and subretinal fluid (SRF) with...Aims: To introduce new terminology and validate its reliability for the analys is of optical coherence tomography (OCT) scans, compare clinical detection of cy stoid macular oedema (CMO)and subretinal fluid (SRF) with OCT findings, and to s tudy the effect of photodynamic therapy (PDT) on the foveal morphology. Methods: Patients with subfoveal, predominantly classic choroidal neovascularisation (CN V) secondary to age related macular degeneration (AMD) undergoing PDT were evalu ated with refraction protocol best corrected logMAR visual acuity (VA), slit lam p biomicroscopy, stereoscopic fluorescein angiography (FFA), and OCT. New termin ologies introduced to interpret the OCT scans were: neuroretinal foveal thicknes s (NFT), bilaminar foveal thickness (BFT), outer high reflectivity band thicknes s (OHRBT), intraretinal fluid (IRF), subretinal fluid (oSRF), and vitreomacular hyaloid attachment (VMHA). Results: Fifty six eyes of 53 patients were studied. VA was better in eyes with a thinner outer high reflectivity band (OHRBT) (p=0.0 2) and BFT (p=0.05). BFT was less in eyes that had undergone a greater number of PDT treatments (p=0.04). There was poor agreement between OCT and clinical exam ination in the detection of CMO and subretinal fluid (κ.=0.289 and κ.=0.165 re spectively). To validate the interpretation and measurements on OCT, two groups of 20 scans were analysed by two independent observers. There was good agreement between the observers in the detection of IRF,oSRF, and VMHA (p< 0.001). Measur ements of NFTand BFThad a high reproducibility, and of OHRBT reproducibility was low. Conclusions: New terminology has been introduced and tested. OCT appears t o be superior to clinical examination and FFAin the detection of CMO. In this st udy, better vision was associated with a thinner OHRBT and/or the absence of SRF giving insight into the biological effect of PDT.展开更多
文摘Aim: To compare the visual acuity (VA), spherical equivalent refractive error, motility, and anatomical outcomes in children with treated regressed threshold stage3 retinopathy of prematurity (ROP) and those with spontaneously regressed subthreshold stage3 ROP. Method: 6 month and 3 year data collected from infants examined between 1989 and 1999 with regressed stage3 ROP, with or without treatment were retrospectively reviewed. Results: 85 infants were included in this study. 40 eyes received cryotherapy, 81 eyes laser photocoagulation, and 34 eyes had spontaneously regressed subthreshold stage3 ROP. Grating acuity score ≥ 2 cycles/degree (c/d) at 6 months was predictive of optotype acuity ≥ 6/9 in 69% of eyes and a score < 2 c/d at 6 months was predictive of acuity < 6/9 in 88% of eyes. Eyes with subthreshold stage3 ROP were twice as likely to haveVA of 6/9 or better at 36 months than the treated eyes. The mean spherical equivalent refractive error at 36 months was-6.5 dioptres (D) (-21.5D to + 1.38D) in cryotherapy treated eyes,-2.4D (-13D to + 4D) in the laser group, and-0.22D (-9D to + 2.25D) in the subthreshold group. Eyes within the treated groups were more myopic than the eyes within the spontaneously regressed group (P=0.005). At 36 months, 42 out of the 85 infants (that is, 49% ) had strabismus (44% in the cryotherapy group, 26% in the laser group, and 25% in the subthreshold group). There was a statistically significant association between the presence of strabismus and anisometropia (P=0.016) and strabismus and intraventricular haemorrhage (IVH) (P=0.005). There was a statistically significant difference in the incidence of strabismus between mild and moderate and severe grade IVH (P=0.01). Eight out of 40 eyes in the cryotherapy group and six out of the 81 eyes in the laser group developed macular ectopia. None of the eyes in the spontaneously regressed group had macular dragging. Conclusions: In this study, the grating acuity at 6 months was a good predictor of the 3 year optotype acuity in all groups. Eyes with spontaneously regressed subthreshold stage3 ROP were associated with better vision at 3 years of age and a lesser degree of myopia compared to the treated groups. Strabismus developed predominantly in the treated groups and was frequently associated with neurological damage and/or anisometropia. The spontaneously regressed subthreshold stage3 group had a better anatomical outcome compared to the groups in which the retinopathy regressed following treatment.
文摘Aims: To introduce new terminology and validate its reliability for the analys is of optical coherence tomography (OCT) scans, compare clinical detection of cy stoid macular oedema (CMO)and subretinal fluid (SRF) with OCT findings, and to s tudy the effect of photodynamic therapy (PDT) on the foveal morphology. Methods: Patients with subfoveal, predominantly classic choroidal neovascularisation (CN V) secondary to age related macular degeneration (AMD) undergoing PDT were evalu ated with refraction protocol best corrected logMAR visual acuity (VA), slit lam p biomicroscopy, stereoscopic fluorescein angiography (FFA), and OCT. New termin ologies introduced to interpret the OCT scans were: neuroretinal foveal thicknes s (NFT), bilaminar foveal thickness (BFT), outer high reflectivity band thicknes s (OHRBT), intraretinal fluid (IRF), subretinal fluid (oSRF), and vitreomacular hyaloid attachment (VMHA). Results: Fifty six eyes of 53 patients were studied. VA was better in eyes with a thinner outer high reflectivity band (OHRBT) (p=0.0 2) and BFT (p=0.05). BFT was less in eyes that had undergone a greater number of PDT treatments (p=0.04). There was poor agreement between OCT and clinical exam ination in the detection of CMO and subretinal fluid (κ.=0.289 and κ.=0.165 re spectively). To validate the interpretation and measurements on OCT, two groups of 20 scans were analysed by two independent observers. There was good agreement between the observers in the detection of IRF,oSRF, and VMHA (p< 0.001). Measur ements of NFTand BFThad a high reproducibility, and of OHRBT reproducibility was low. Conclusions: New terminology has been introduced and tested. OCT appears t o be superior to clinical examination and FFAin the detection of CMO. In this st udy, better vision was associated with a thinner OHRBT and/or the absence of SRF giving insight into the biological effect of PDT.
