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Local and global motion processing in premature children with cerebral visual impairment (CVI)
e30 following PPC. The incidence of PCO and SM formation is similar regardless of IOL type. However, the average time of onset to the development of PCO is slightly longer in the MA60AC group. The recurrence of PCO after Yag capsulotomy is low. Given these results, parents can be better informed regarding the incidence of visual axis opacification depending IOL design that has been placed. 115 Characteristics of retinal hemorrhages in preterm infants screened for retinopathy of prematurity by the Retcam II-A pilot study. Patrick Watts, Raina Goyal, Devina Gogi, Robert Taylor, Hasan Al Madfai Purpose: To report the incidence and characteristics of retinal hemorrhages in preterm infants screened for retinopathy of prematurity by Retcam. Methods:Infants screened consecutively by Retcam over a period of 3 months were included in the study. Retinal hemorrhages observed were graded based on their characteristics. In addition the gestational age, the post conceptional age, the birth weight, the zone and stage of retinopathy, ethnic origin and type of birth were recorded. Results: There were 68 examinations in 36 infants over this period. Dot-like intraretinal hemorrhages scattered in the posterior pole were classified as type 1 were seen in 56% of infants. Superficial retinal haemorrhages commonly seen in newborn infants were classified as type 2 were present in 6% of infants. Type 1 hemorrhages are not easily seen with indirect ophthalmoscope and hence been not reported in the past. There was no statistically significant correlation of the haemorrhages with birth weight (p 5 0.62) gestational age (p 5 0.38) , post-conceptional age (p 5 0.08) or type of birth (p 5 0.33). There was no correlation between hemorrhages and severity of ROP. Conclusions: The presence of type 1 dot retinal hemorrhages has not been previously reported in literature. With increasing use of the retcam to document retinal haemorrhages in infants, it is important to recognise that these haemorrhages are frequently seen compared to retinal hemorrhages described in the newborn. 116 Local and global motion processing in premature children with cerebral visual impairment (CVI). Joel M. Weinstein, Rick O. Gilmore, Sumera Shaikh, Jeremy Fesi, Tashima Lauren, Albert Cheung Introduction: The purpose of this study was to determine the incidence of impaired local and global motion processing in infants with cerebral visual impairment due to either periventricular leukomalacia or hydrocephalus. Methods: Motion processing was evaluated objectively using steady state visual evoked potentials (SSVEP) in 14 children ages 6-14 with relatively mild CVI due to either PVL (12 patients) or hydrocephalus (2 patients). Random dot stimuli moving in either ''Brownian motion'' or synchronous circular motion were used to assess local motion and global motion processing, respectively. Control groups consisted of: (1) 14 age matched visually and neurologically normal subjects and (2) 14 neurologically normal subjects with mild strabismus and/or amblyopia . Results: At the most difficult to detect slower target speeds, global motion processing was impaired in 79% of patients with CVI, 43% of neurologically normal children with mild strabismus/amblyopia, and 14% of normal children. For global motion processing, normal subjects responded more strongly to slower (more difficult to detect) targets, while CVI and strabismus/amblyopia subjects showed the opposite trend, requiring faster targets (easier to detect) to produce an increased VEP response (p \ 0.01) .
Volume 14 Number 1 / February 2010 Conclusions: These findings suggest that children with CVI have impaired higher cortical processing of movement not accounted for by coexisting strabismus/amblyopia or local motion processing defects. SSVEP may be used to objectively detect and quantitate defects of higher cortical function in children with CVI. In addition, our results support a growing body of data demonstrating defects of higher visual cortical processing in patients with strabismus/ amblyopia.
117 A demonstration of the Medisoft strabismus electronic patient record. Stephanie K. West, Suzanne Turner, Catherine Billington, Rob L. Johnston, John D. Ferris Introduction: Medisoft software is already established as a widely used Electronic Patient Record (EPR) in the UK, which has been used to produce and audit the Cataract national dataset. In February 2009 its strabismus module was launched. This is the first fully integrated EPR for oculomotility patients. We would like to illustrate its ease of use by looking at orthoptic, medical and operative data entry. Method: The software was designed by Ophthalmologists and Orthoptists to present data in the British and Irish Orthoptic Society (BIOS) format with dropdown menus and diagrammatic annotations. Theater data entry is designed to input surgical numbers, aims of surgery, and any intraoperative complications. Results We will demonstrate clinical and surgical data entry for the following conditions: intermittent exotropia (true divergence excess) treated with bilateral lateral rectus recessions and hypotropia in thyroid eye disease, treated with bilateral vertical rectus adjustable surgery, including documentation of postoperative adjustment. Discussion: This demonstration illustrates (1) ease of clinical and surgical data entry and the use of prefilled surgical fields; (2) The ability to achieve 100% data capture and to tailor this to specific conditions; (3) automatic production of clinic notes, GP letters, surgical notes and postoperative prescriptions; and (4) the audit facility incorporated in the EPR (see intermittent exotropia audit abstract). Conclusions: This demonstrates the first fully integrated EPR for oculomotility patients.
118 Ophthalmic manifestations of tetrasomy 18p: A series of 25 patients. William A. White, Martha P. Schatz, Jannine D. Cody, Courtney Sebold Background: Tetrasomy 18p is a rare chromosomal anomaly with systemic and ophthalmic manifestations. This condition has been previously associated with strabismus. Methods: Twenty-five subjects were referred to our service for ophthalmologic examination following diagnosis of tetrasomy 18p. All subjects underwent a complete eye exam to screen for ocular pathology. Results: The average age of subjects was 8.2 years. Twelve subjects were male, 13 were female. Nineteen subjects showed evidence of strabismus, with 17 subjects demonstrating esotropia (7 accommodative, 5 infantile, 2 acquired non-accommodative, 2 intermittent, 1 A pattern), one subject displaying an esophoria, and one subject diagnosed with intermittent exotropia. Conclusions: The authors present the first comprehensive description of ophthalmic findings in a large series of patients with tetrasomy 18p. The common coincidence of esotropia with tetrasomy 18p indicates a need to routinely screen these patients for eye movement disorders at the time of diagnosis. The high prevalence of esotropia in our population suggests the possibility that one or more genes on the short arm of chromosome 18 may play a role in the development of esotropic strabismus.
Journal of AAPOS
Volume 14 Number 1 / February 2010 Conclusions: These findings suggest that children with CVI have impaired higher cortical processing of movement not accounted for by coexisting strabismus/amblyopia or local motion processing defects. SSVEP may be used to objectively detect and quantitate defects of higher cortical function in children with CVI. In addition, our results support a growing body of data demonstrating defects of higher visual cortical processing in patients with strabismus/ amblyopia.
117 A demonstration of the Medisoft strabismus electronic patient record. Stephanie K. West, Suzanne Turner, Catherine Billington, Rob L. Johnston, John D. Ferris Introduction: Medisoft software is already established as a widely used Electronic Patient Record (EPR) in the UK, which has been used to produce and audit the Cataract national dataset. In February 2009 its strabismus module was launched. This is the first fully integrated EPR for oculomotility patients. We would like to illustrate its ease of use by looking at orthoptic, medical and operative data entry. Method: The software was designed by Ophthalmologists and Orthoptists to present data in the British and Irish Orthoptic Society (BIOS) format with dropdown menus and diagrammatic annotations. Theater data entry is designed to input surgical numbers, aims of surgery, and any intraoperative complications. Results We will demonstrate clinical and surgical data entry for the following conditions: intermittent exotropia (true divergence excess) treated with bilateral lateral rectus recessions and hypotropia in thyroid eye disease, treated with bilateral vertical rectus adjustable surgery, including documentation of postoperative adjustment. Discussion: This demonstration illustrates (1) ease of clinical and surgical data entry and the use of prefilled surgical fields; (2) The ability to achieve 100% data capture and to tailor this to specific conditions; (3) automatic production of clinic notes, GP letters, surgical notes and postoperative prescriptions; and (4) the audit facility incorporated in the EPR (see intermittent exotropia audit abstract). Conclusions: This demonstrates the first fully integrated EPR for oculomotility patients.
118 Ophthalmic manifestations of tetrasomy 18p: A series of 25 patients. William A. White, Martha P. Schatz, Jannine D. Cody, Courtney Sebold Background: Tetrasomy 18p is a rare chromosomal anomaly with systemic and ophthalmic manifestations. This condition has been previously associated with strabismus. Methods: Twenty-five subjects were referred to our service for ophthalmologic examination following diagnosis of tetrasomy 18p. All subjects underwent a complete eye exam to screen for ocular pathology. Results: The average age of subjects was 8.2 years. Twelve subjects were male, 13 were female. Nineteen subjects showed evidence of strabismus, with 17 subjects demonstrating esotropia (7 accommodative, 5 infantile, 2 acquired non-accommodative, 2 intermittent, 1 A pattern), one subject displaying an esophoria, and one subject diagnosed with intermittent exotropia. Conclusions: The authors present the first comprehensive description of ophthalmic findings in a large series of patients with tetrasomy 18p. The common coincidence of esotropia with tetrasomy 18p indicates a need to routinely screen these patients for eye movement disorders at the time of diagnosis. The high prevalence of esotropia in our population suggests the possibility that one or more genes on the short arm of chromosome 18 may play a role in the development of esotropic strabismus.
Journal of AAPOS