What's new AAPOS 2008 - The Private Eye Clinic

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NEURO-OPHTHALMOLOGY Adverse effects of apraclonidine used in the diagnosis of Horner’s syndrome in infants. Watts T, Satterfield D, Kim MK. J AAPOS 2007; 11: 282-83. The authors present an index case of a five-month-old infant girl along with four additional cases provided through the pediatric ophthalmology listserve. Three of these children had drowsiness and two cases required emergency admission for unresponsiveness. One case had associated bradycardia, hypertension, and decreased oxygen saturations. The authors recommend that apraclonidine be used with caution or not at all in infants under six months of age. If used the patient should be observed for a period of at least two hours after installation of the drops with admission to the pediatric ward if lethargy, bradycardia or reduced respiratory rate develop. Pediatric idiopathic intracranial hypertension Rangwala LM, Liu GT. Surv Ophthalmol 2007; 52: 597-617. This review article summarizes currently knowledge regarding pediatric idiopathic intracranial hypertension. The use of rigorous methodologies and standard definitions in recent studies has demonstrated distinct demographic trends: (1) The incidence of idiopathic intracranial hypertension seems to be increasing among adolescent children, and among older children its clinical picture is similar to that of adult idiopathic intracranial hypertension (female and obese). Within younger age groups there are more boys and nonobese children who may develop idiopathic intracranial hypertension. (2) The pathogenesis of the disease has yet to be elucidated. Idiopathic intracranial hypertension among young children has been associated with several new etiologies, including recombinant growth hormone and all-trans-retinoic acid. (3) More modern neuroimaging techniques such as MRI and MRI-venograms are being used to exclude intracranial processes. (4) Although most cases of pediatric idiopathic intracranial hypertension improve with medical treatment, those who have had visual progression despite medical treatment have undergone optic nerve sheath fenestration and lumboperitoneal shunting. (5) Because idiopathic intracranial hypertension in young children appears to be a different disorder than in adolescents and adults, separate diagnostic criteria for younger children are warranted. The authors propose new criteria for pediatric idiopathic intracranial hypertension in which children should have signs or symptoms consistent with elevated intracranial pressure, be prepubertal, have normal sensorium, can have reversible cranial nerve palsies, and have an opening cerebrospinal fluid pressure greater than 180 mm H 2 O if less than age 8 and papilledema is present, but greater than 250 mm H 2 0 if age 8 or above or less than 8 without papilledema. 74
Neuro-ophthalmological management of optic pathway gliomas Lee AG. Neurosurg Focus 2007 Nov; 23(5):E1-6. Optic pathway gliomas are typically childhood tumors. About 30 of patients with OPGs have NF1. Their growth rates are variable but unpredictable. Dr. Lee recommends treatment on an individual basis. Close clinical neuro-ophthalmic follow-up and serial radiography (preferably MRI) are indicated. Only symptomatic and radiographically progressing OPGs require strong consideration for treatment. Both chemotherapy and radiation treatment can be considered, but chemo in patients
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What’s New and Important in Pedia
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ROP Retinopathy of Prematurity: the
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same diagnosis in 4 of 34 images (1
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PREMATURITY Perinatal care in the t
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STRABISMUS Causes and outcomes for
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METHODS: The medical records of all
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initial positive response to medica
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deviation as an intermittent exodev
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STRABISMUS SURGERY Unilateral reces
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The effect of topical tetracaine ey
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+/-0.08 and 0.34 +/-0.07 mm, for th
Page 23 and 24: THYROID Cigarette smoking and thyro
Page 25 and 26: excluding from the cataract group t
Page 27 and 28: Long-Term Results of Lensectomy in
Page 29 and 30: CATARACT SURGERY Pediatric anterior
Page 31 and 32: Suture-related complications after
Page 33 and 34: included vitrectomy, capsulotomy, c
Page 35 and 36: medication. At the last follow-up,
Page 37 and 38: REFRACTIVE ERROR / REFRACTIVE SURGE
Page 39 and 40: demonstrated a positive effect on t
Page 41 and 42: ANTERIOR SEGMENT Conjunctival Melan
Page 43 and 44: RESULTS: Directly after birth, corn
Page 45 and 46: and photophobia (80%). The children
Page 47 and 48: Validity and reliability of the Chi
Page 49 and 50: outcomes achieved at cessation of t
Page 51 and 52: METHODS: One hundred and thirteen c
Page 53 and 54: Verisyse intraocular lens implantat
Page 55 and 56: GENETICS Marfan syndrome: from mole
Page 57 and 58: Visual outcome of a cohort of child
Page 59 and 60: primarily affect the photoreceptors
Page 61 and 62: single morphogenetic anomaly in dev
Page 63 and 64: Three genome-wide association studi
Page 65 and 66: • Cafe-au-lait macules • Freckl
Page 67 and 68: Laryngeal and tracheal anomalies Po
Page 69 and 70: Treatment of retinoblastoma: Curren
Page 71 and 72: Secondary acute myeloid leukemia af
Page 73: one. Patients treated with radiatio
Page 77 and 78: CONCLUSION: Canalicular involvement
Page 79 and 80: peripheral retinal vasculitis. The
Page 81 and 82: This article describes a 7-month-ol
Page 83 and 84: eference eyes. Photopic flash ERGs
Page 85 and 86: RESULTS: In models that adjusted fo
Page 87 and 88: ORBIT Porous orbital implants, wrap
Page 89 and 90: PLASTICS Conjunctival epithelial ch
Page 91 and 92: The authors conclude that lash ptos
Page 93 and 94: .03). SBP and DBP were significantl
Page 95 and 96: CONGENITAL INFECTION Congenital lym
Page 97 and 98: PEDIATRICS Visual Manifestations of
Page 99 and 100: controversial, ranging from one to
Page 101 and 102: SYSTEMIC Visual function and ocular
Page 103 and 104: Toxocara infection. Toxocara GWC an
Page 105 and 106: congenital cataracts. The retina wa
Page 107 and 108: Childhood blindness: a UK epidemiol
Page 109: safe and efficient procedure to cor
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