What's new AAPOS 2008 - The Private Eye Clinic

METHODS: Thirteen pediatric patients aged one to 15 years with a traumatic macular
hole underwent surgical repair. All patients underwent surgery between February 1997
and March 2005 with autologous plasmin enzyme-assisted vitrectomy. After induction of
posterior vitreous detachment (PVD), vitrectomy with membrane peeling and gas or
silicone oil injection were performed followed by prone positioning for seven days. Main
outcome measures included anatomic closure rate, visual outcome, and ocular
complications.
RESULTS: The macular hole was closed successfully in 12 (92%) of 13 cases. Of the
12 patients for whom vision could be measured, 11 patients (92%) had visual acuity
improvement of 2 or more lines and six patients (50%) achieved vision of 20/50 or
better; all of the patients achieved vision better than 20/200. The visual improvement
was statistically significant (P = .005, Wilcoxon signed-rank test). Surgical complications
included cataract formation in one patient and retinal detachment in one patient.
CONCLUSIONS: Autologous plasmin enzyme may be a helpful adjunct when
performing vitrectomy for traumatic macular holes.
Profile of the retina by optical coherence tomography in the pediatric age group.
Gupta G, Donahue JP, You T.
Am J Ophthalmol. 2007 Aug;144(2):309-10.
PURPOSE: To establish normative values of the retina in the pediatric population using
optical coherence tomography (OCT).
METHODS: Prospective study examining macular thickness and nerve fiber layer
thickness in children with no ocular disease. After clinical examination, patients meeting
the inclusion and exclusion criteria underwent OCT scanning.
RESULTS: Thirty-two eyes were examined for macular thickness and 25 eyes for nerve
fiber layer thickness. Normative values are found in the Table. The average foveal
thickness for children is 221 microns vs 182 microns in adults.
CONCLUSION: This study demonstrates normative values of retinal thickness and
retinal nerve fiber layer (RNFL) thickness in the pediatric age group. Children have
slightly thicker maculas than adults; the RNFL thickness is comparable to adults.
Relationship of axial length and retinal vascular caliber in children.
Cheung N, Tikellis G, Saw SM, Amirul Islam FM, Mitchell P, Wang JJ, Wong TY.
Am J Ophthalmol. 2007 Nov;144(5):658-662. Epub 2007 Sep 17.
PURPOSE: Previous studies in older adults suggest that longer axial length is
associated with narrower arteriolar caliber. In this study, we re-examined this
relationship in a cohort of children, while controlling for the effects of ocular
magnification. DESIGN: Cross-sectional study of 767 children aged 7 to 9 years.
METHODS: Retinal vascular calibers were measured from retinal photographs using a
computer-based program. Ocular magnification was corrected using the Bengtsson
formula. Standardized examination of refraction and ultrasound ocular biometry was
performed for all children.
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