1. Characteristics of a pediatric low vision population in Italy E
Characteristics of a pediatric low vision population in Italy E. Gusson MD, I. Tomaello OD, G. Marchini MD Pediatric Unit-Ophthalmology Department, University of Verona, Italy
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Purpose: :To report SD-OCT findings in acute and chronic retinal artery occlusions (RAO), and to compare these findings with other causes of inner retinal atrophy.
Methods: several cases of central and branch retinal artery occlusion with and without perfused cilio-retinal artery were observed in the acute phase and then followed with SD-OCT until development of atrophic stage. SD- OCT findings in RAOs were than compared with images of other different causes of inner retinal atrophy.
Results: In the acute phase of RAO, SD- OCT discloses thickening and increased reflectivity of the inner retinal layers with shadowing effect on outer structures and sharp demarcation with perfused areas. In the chronic phase, SD-OCT reveals complete inner retinal atrophy and homogeneous intra- retinal structure, while outer nuclear layer and IS-OS/RPE lines remain intact. On the contrary, in advanced glaucoma and optic neuropathy the inner retinal structure although reduced remains clearly detectable.
Conclusions: in acute-CRAO SD-OCT demonstrates swelling of the inner retinal layers with sharp demarcation of the affected area. In the chronic phases homogeneous inner atrophy with absence of identifiable retinal layers and loss of foveal depression (in CRAO) represents a distinctive marker of RAO compared with other causes of inner retinal atrophy, and could be useful in differential diagnosis of chronic cases of visual loss without evident clinical signs.
NO FINANCIAL INTEREST
Early assessment of the causes of childhood visual impairment is crucial
to plan preventive and therapeutic strategies and to minimize the impact of these devastating diseases
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Purpose: to describe the causes of visual impairment (VI) among children attending Pediatric Low Vision Service at the Verona University, Italy. This center is a regional referral site for diagnosis and treatment of Retinopathy of Prematurity.
Methods: a retrospective survey of the clinical records of all children younger than 14 years examined at the Pediatric Low Vision Service of University of Verona between October 2009 and September Data collected included age, race, sex, BCVA measured with Teller cards or Snellen acuity chart , refraction with Retinomax before and after cycloplegia , color test with Ishihara plates, complete eye examination and cause of visual impairment.
Results: the records of 277 children were evaluated. The most common etiology for vision impairment in this population was retinopathy of prematurity (30%) followed by cerebral visual impairment (20%) , retinal degeneration (15%) albinism (7%) and other minor causes (28%). The mean age of children was 7 years (6m-14y), 65% male and 35% female, mean BCVA was 0,12 (lp-0,32 ). Mean SF was – 6D.
Conclusions: being our Center a referral regional site for ROP, this pathology (and not CVI) represents the major cause of VI. A multicenter Italian study would be advisable to better understand the epidemiology of childhood vision impairment in our country: assessment of the causes of childhood VI in fact is crucial to plan preventive and therapeutic strategies to reduce the incidence of this life-long devastating handicap.
GT, 4 YO
Peripheral laser treatment for ROP in zone 2.
Posterior hjaloid contraction.
Later treated with PPV (plasmine)
VA 20/200 stable after treatment
MB, 4 YO
Familiar exudative vitreoretinopathy stage 4
Later treated with scleral buckle and laser
VA 20/60 stable after treatment
FL, 5 YO
X-linked retinoschisis
Later treated with topical dorzolamide
VA 20/60
Bibliography.
Ganesh et al: Impact of low vision rehabilitation on functional vision performance of children with visualimpairment. Ophthalmol J of Oman Sep;6(3):170-4
Solebo AL et al: Epidemiology, aetiology and management of visual impairment in children. Arch Dis Child. 2014 Apr;99(4):375-9.
Mitry D, Bunce C et al: Causes of certifications for severe sight impairment (blind) and sight impairment (partial sight) in children in England and Wales. Br J Ophthalmol Nov;97(11):1431-6
GA. Stevens, RA White et al: global prevalence of vision impairment and blindness: magnitude and temporal trends, Ophthalmol 2013 Dec: 120(12):
AC, 4 YO
ROP stage 4B/5
Later treated with PPV (plasmine)
VA 20/400 stable after treatment
IE, 18M
Norrie disease
Already treated with PPV (later repeated)
VA: light perception
SM, 6 YO
X-linked retinoschisis with retinal detachment
Treated with PPV and silicon oil
VA 20/200
DPG, 18M
Optic disc and retinal coloboma with double OD
Impending retinal detachment at the border of coloboma
Later treated with laser at the border of coloboma
VA 4.8 CY/cm at Teller cards