AIM:To study eyes with extraocular dissemination(EORB),with the following aims:first to establish the mean lag period and to understand various reasons for delayed presentation,second to study their imaging profiles a...AIM:To study eyes with extraocular dissemination(EORB),with the following aims:first to establish the mean lag period and to understand various reasons for delayed presentation,second to study their imaging profiles and third to analyze histopathological features of eyes enucleated after neoadjuvant chemotherapy.·METHODS:Prospective study of clinical and imaging features of EORBs(stage Ⅲ and Ⅳ International Retinoblastoma Staging System) presenting to a tertiary eye care centre.Histopathological features of eyes enucleated after receiving neoadjuvant chemotherapy were analyzed.A pictorial illustration of the varied imaging profile of EORB was also presented.·RESULTS:Over a period of one year,97 eyes were diagnosed with retinoblastoma;32 children(36 eyes)(37.1%) had EORB.Mean age 3.6±1.9 years,71.9% males,71.9% unilateral,3.1% with positive family history and40.6% with metastasis.On imaging,there was extrascleral involvement in 22.2%,involvement of orbital part of optic nerve in 33.3%,involvement of central nervous system in 27.8% and orbital wall involvement in2.9% eyes.On histopathological analysis of eyesenucleated after neoadjuvant chemotherapy,25.0% had no residual viable tumour tissue and rest all tumours were poorly differentiated.·CONCLUSION:There are very few human malignancies where definitive treatment is started without any confirmed histopathological diagnosis and imaging plays an important role in diagnosis and appropriate staging of the disease.Chemotherapy has a variable effect on EORB,75.0% of eyes with EORB had residual viable tumour tissue when enucleated after receiving neoadjuvant chemotherapy.展开更多
Dear Editor,We read with great interest article titled"Anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia"by Chen et al[1].The authors have analysed subjects with pre...Dear Editor,We read with great interest article titled"Anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia"by Chen et al[1].The authors have analysed subjects with previously untreated anisometropic amblyopia and found a significant correlation between high degree of anisometropia and deep amblyopia,worse contrast sensitivity,fusion and stereopsis functions.We commend the authors in addressing a very important problem and agree with the authors in the notation that children with anisometropia are usually detected later owing to lack of noticeable physical abnormalities.展开更多
Purpose: Use of appropriate cycloplegic agent is an essential area of management in children with strabismus and refractive error. This study was designed to audit our own department’s understanding and practice with...Purpose: Use of appropriate cycloplegic agent is an essential area of management in children with strabismus and refractive error. This study was designed to audit our own department’s understanding and practice with respect to cycloplegia. Methods: Children in age group of 0 - 12 years with refractive errors and strabismus were evaluated with respect to four parameters: adherence to cycloplegic refraction (group-I), choice of cycloplegic agent (group-II), dosage of cycloplegia (group-III) and duration of cycloplegia (group-IV). Following the initial audit, the hospital audit committee evaluated the results;thereafter concerned staff was educated and aidememoires of the dilatation protocol were introduced;a second audit cycle was carried out after 3 months. Results: First and second audit cycle included 334 children (mean age 6.2 ± 2.2 years) and 436 children (mean age 7.25 ± 2.9 years) respectively. A statistically significant improvement was found in all four parameters in the second audit cycle: adherence to dilation protocol (82.3% in first cycle to 94.3% in second cycle;p = 0.001), choice of cycloplegic agent (77% in the first cycle to 94.8% in the second cycle;p = 0.001), dosage of cycloplegic agent (84% in the first cycle to 96.3% in the second cycle;p = 0.001) and duration of cycloplegic agents (65% in the first cycle to 97.5% in the second cycle;p = 0.001 for CTC and 71.8% in the first cycle to 98% in the second cycle;p = 0.001 for Tropicamide). Conclusions: A complete audit cycle demonstrated a statistically significant improvement in all four parameters related to cycloplegic refraction in children. Regular auditing coupled with targeted interventions aimed to maintain the “best practice guidelines” for determination of refractive errors in children could prove effective in improving standards of clinical practice.展开更多
文摘AIM:To study eyes with extraocular dissemination(EORB),with the following aims:first to establish the mean lag period and to understand various reasons for delayed presentation,second to study their imaging profiles and third to analyze histopathological features of eyes enucleated after neoadjuvant chemotherapy.·METHODS:Prospective study of clinical and imaging features of EORBs(stage Ⅲ and Ⅳ International Retinoblastoma Staging System) presenting to a tertiary eye care centre.Histopathological features of eyes enucleated after receiving neoadjuvant chemotherapy were analyzed.A pictorial illustration of the varied imaging profile of EORB was also presented.·RESULTS:Over a period of one year,97 eyes were diagnosed with retinoblastoma;32 children(36 eyes)(37.1%) had EORB.Mean age 3.6±1.9 years,71.9% males,71.9% unilateral,3.1% with positive family history and40.6% with metastasis.On imaging,there was extrascleral involvement in 22.2%,involvement of orbital part of optic nerve in 33.3%,involvement of central nervous system in 27.8% and orbital wall involvement in2.9% eyes.On histopathological analysis of eyesenucleated after neoadjuvant chemotherapy,25.0% had no residual viable tumour tissue and rest all tumours were poorly differentiated.·CONCLUSION:There are very few human malignancies where definitive treatment is started without any confirmed histopathological diagnosis and imaging plays an important role in diagnosis and appropriate staging of the disease.Chemotherapy has a variable effect on EORB,75.0% of eyes with EORB had residual viable tumour tissue when enucleated after receiving neoadjuvant chemotherapy.
文摘Dear Editor,We read with great interest article titled"Anisometropia magnitude and visual deficits in previously untreated anisometropic amblyopia"by Chen et al[1].The authors have analysed subjects with previously untreated anisometropic amblyopia and found a significant correlation between high degree of anisometropia and deep amblyopia,worse contrast sensitivity,fusion and stereopsis functions.We commend the authors in addressing a very important problem and agree with the authors in the notation that children with anisometropia are usually detected later owing to lack of noticeable physical abnormalities.
文摘Purpose: Use of appropriate cycloplegic agent is an essential area of management in children with strabismus and refractive error. This study was designed to audit our own department’s understanding and practice with respect to cycloplegia. Methods: Children in age group of 0 - 12 years with refractive errors and strabismus were evaluated with respect to four parameters: adherence to cycloplegic refraction (group-I), choice of cycloplegic agent (group-II), dosage of cycloplegia (group-III) and duration of cycloplegia (group-IV). Following the initial audit, the hospital audit committee evaluated the results;thereafter concerned staff was educated and aidememoires of the dilatation protocol were introduced;a second audit cycle was carried out after 3 months. Results: First and second audit cycle included 334 children (mean age 6.2 ± 2.2 years) and 436 children (mean age 7.25 ± 2.9 years) respectively. A statistically significant improvement was found in all four parameters in the second audit cycle: adherence to dilation protocol (82.3% in first cycle to 94.3% in second cycle;p = 0.001), choice of cycloplegic agent (77% in the first cycle to 94.8% in the second cycle;p = 0.001), dosage of cycloplegic agent (84% in the first cycle to 96.3% in the second cycle;p = 0.001) and duration of cycloplegic agents (65% in the first cycle to 97.5% in the second cycle;p = 0.001 for CTC and 71.8% in the first cycle to 98% in the second cycle;p = 0.001 for Tropicamide). Conclusions: A complete audit cycle demonstrated a statistically significant improvement in all four parameters related to cycloplegic refraction in children. Regular auditing coupled with targeted interventions aimed to maintain the “best practice guidelines” for determination of refractive errors in children could prove effective in improving standards of clinical practice.
