011: Longitudinal follow-up of hypermetropic children identified during preschool vision screening

Volume 13 Number 1 / February 2009 The incidence and progression of ROP in this subset was compared with age- and weight-matched control group (Group 2, n 5 161) obtained from Vermont Oxford Network ROP database over the same time period. The 2 data sets were cross-referenced to exclude any patient receiving GCSF from the control data. Results: The average BW of patients was 863 g in Group 1 and 847 g in Group 2. The average dose of GCSF received by patients in Group 1 was 11.5 mg (range, 1.2-47 mg). The average age at administration of GCSF was 12 days after birth (range, 0 mg 34 days). Of 50 patients in Group 1, 5 patients (10%) required laser treatment whereas in Group 2 30 patients (18.6 %) required laser treatment. In patients who had received intravenous GCSF the need for laser treatment of ROP was reduced by almost half as compared to the control group. Conclusions: There was a clinically relevant trend in decreased incidence and progression of ROP leading to reduced need for laser treatment in patients who received GCSF as compared to the control group. 010 Residual strabismus in children following resolution of cranial nerve palsies affecting ocular motility. Monica L. Bratton, Mary Ellen Hoehn, Natalie C. Kerr Introduction: Children with cranial nerve palsies (CNP) are at risk for residual strabismus after their motility deficits resolve. Methods: We identified 106 children with CN III, IV, and/or VI palsies who were treated for central nervous system (CNS) malignancies. A retrospective chart review was conducted to determine the presence or absence of residual strabismus after resolution of motility deficits. Results: Forty-eight of 106 children resolved their motility deficits with treatment of their CNS malignancy. One child had a CN III palsy, 6 had CN IV palsies (one was bilateral), 40 patients had CN VI palsies (16 were bilateral), and 1 child had 2 different CNP in the same eye (CN IV and VI). Of the 48 children who resolved their motility deficits, 35 patients had residual strabismus (Group A). Only 13 resolved their strabismus (Group B). Average angle of strabismus before motility deficits resolved was 33.8D in Group A and 20.6D in Group B (not a statistically significant difference). There was no significant difference between Group A and B with regard to age at diagnosis or length of follow-up. Discussion: Our findings indicate that the majority of children with resolved motility deficits from a CNP after treatment for CNS malignancy will be left with residual strabismus, regardless of age at diagnosis, angle of strabismus at presentation, or type of CNP. Conclusions: Children with CNP secondary to CNS malignancy need ophthalmic care after motility deficits resolve because they are likely to have residual strabismus and may require treatment for amblyopia. 011 Longitudinal follow-up of hypermetropic children identified during preschool vision screening. Jeffrey D. Colburn, David G. Morrison, Robert L. Estes, Sean P. Donahue Introduction: Early childhood hypermetropia is an important risk factor for the development of amblyopia or accommodative esotropia. Understanding the natural history with regards to these complications aids in management decisions. Methods: A retrospective observational review of 100 patients referred from a preschool photoscreening program who were determined to have hypermetropia of 13.75D or greater on gold standard examination and were treated and followed by one group of academic pediatric ophthalmologists. The prevalence and incidence of accommodative esotropia and amblyopia were determined.

Journal of AAPOS

e3 Results: At presentation 8% of hyperopes had amblyopia, 19% had accommodative esotropia, and 1 had both. Follow-up data of 69 patients over an average of 39.5 months showed that an additional 16 of 62 (26%) cases of amblyopia and 19 of 53 (36%) cases of accommodative esotropia developed. Of patients initially managed with observation, 38% (6 of 16) developed amblyopia and 25% (4 of 16) developed accommodative esotropia as compared with 19% (10 of 53) and 28% (15 of 53), respectively, for those given full or partial refractive correction. Patients responded well to treatment, with only 2 cases of nonaccommodative strabismus and only one requiring strabismus surgery. Conclusions: The prevalence of amblyopia and strabismus in this case series was greater than expected. However, treatment still resulted in excellent outcomes. The results support the importance of early preschool vision screening and spectacle correction of hypermetropia to reduce the risk of amblyopia. The prognosis of both amblyopia secondary to hypermetropia and accommodative strabismus is excellent when it is identified and treated early and appropriately. 012 Reduced myopia in eyes with severe retinopathy of prematurity (ROP) treated with lower total laser power. Brenda K. Connors, William W. Motley, Michael B. Yang, Hemal Brahmbhatt Introduction: This study compared the degree of myopia that developed in severe ROP eyes treated by different laser photocoagulation techniques. Methods: Two techniques for the treatment of severe ROP warranting surgery were retrospectively compared. Confluent laser spots (CLs) with short spot duration (100 ms; n 5 23) was compared with near confluent laser spots (NCLs) with 1/2 to 1 spot diameter spacing and longer spot duration (200 to 300 ms; n 5 9). Total laser energy used and the interpolated 12-month refractive error (spherical equivalent) for the right eyes of infants in the two groups were compared. Results: For all eyes, there was no statistically significant difference in the total laser power used or the 12-month refractive error between NCL and CL. For anterior severe ROP eyes (mid to anterior zone II), NCL used less total laser energy than CL (0.69  105 vs 1.11 105 mJ, p 5 0.0043) and had less myopia at 12 months (10.89 vs 0.64 D, p 5 0.011). For posterior severe ROP eyes (zone I and posterior zone II), there was no statistically significant difference between NCL and CL groups in the total laser energy applied (2.6 x 105 vs 1.85  105 mJ, p 5 0.35) or the 12-month refractive error ( 2.63 vs 6.14 D, p 5 0.41). There was no difference in structural outcome using either technique. Conclusions: Using less total laser energy for the treatment of anterior severe ROP may decrease the amount of subsequent myopia without loss of efficacy. 013 Spectral domain optical coherence tomography in patients with nystagmus. Tara H. Cronin, Richard W. Hertle, Hiroshi Ishikawa, Joel S. Schuman Purpose: To evaluate the feasibility of spectral domain optical coherence tomography (SD-OCT) macular scanning in nystagmus patients and to introduce this technology as a means of simultaneously studying the afferent and efferent visual system of this unique population. Methods: Prospective analysis of nystagmus patients who underwent complete clinical and electrophysiological evaluation was performed in this single-center, noncomparative study. Three macular three-dimensional cube scans per eye (200  200  1024 samplings