Microcornea and Thickened Lens in Angle Closure following Nonsurgical Treatment of Retinopathy of Prematurity

Purpose. To characterize the clinical features in young patients with angle closure and to determine the characteristics associated with acquired anterior segment abnormality following retinopathy of prematurity (ROP) treatment. Methods. We performed two retrospective case-control series. In the first series, we identified consecutive young angle closure patients without prior surgeries, with and without a history of ROP treatment; in the second series we identified consecutive patients who underwent ROP treatment, without and without anterior segment changes. Results. In the first series, 25 eyes of 14 consecutive angle closure patients were included: 19 eyes (11 patients, 78.6%) had a history of treated ROP, while 6 eyes (3 patients) belonged to full-term patients. The treated ROP eyes had significantly shallower anterior chambers (1.77 ± 0.17 mm vs 2.72 ± 0.18 mm, P<0.0001) and thicker lenses (5.20 ± 0.54 mm vs 3.98 ± 0.20 mm, P=0.0002) compared to the full-term controls. In the second series, 79 eyes of 40 patients were included, with median gestational age of 24.6 weeks. Acquired iridocorneal adhesion was noted in the eight eyes (10.1%) at a mean age of 4.7 years and was associated with prior zone 1 and plus disease (P=0.0013), a history of initial intravitreal bevacizumab treatment (IVB, P=0.0477) and a history of requiring additional IVB after initial treatment (P=0.0337). Conclusions. Many young angle closure patients may have a history of treated ROP and may present with the triad of increased lens thickness, microcornea, and angle closure.

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Etiologies and clinical characteristics of young patients with angle-closure glaucoma: a 15-year single-center retrospective study

Graefe s Archive for Clinical and Experimental Ophthalmology ◽

10.1007/s00417-021-05172-6 ◽

2021 ◽

Author(s):

Feng Gao ◽

Jiajian Wang ◽

Junyi Chen ◽

Xiaolei Wang ◽

Yuhong Chen ◽

...

Keyword(s):

Clinical Characteristics ◽

Anterior Segment ◽

Young Patients ◽

Case Series ◽

Neovascular Glaucoma ◽

Angle Closure Glaucoma ◽

Angle Closure ◽

Primary Angle Closure Glaucoma ◽

Uncommon Presentation ◽

Underlying Causes

Abstract Purpose To investigate the etiologies and the clinical characteristics of angle-closure glaucoma (ACG) patients younger than 40 years old in Chinese. Methods Inpatients with diagnosis of ACG and diagnosed age younger than or equal to 40 years old, who were admitted in Eye, Ear, Nose, and Throat Hospital Fudan University from 2002 to 2017, were included in this retrospective non-comparative case series. The underlying causes and clinical features for all the patients were analyzed by comprehensive review of medical charts. Results A total of 298 patients (463 eyes) met the criteria, including 153 females (51.3%) and 145 males (48.7%); the mean age was 25.6 ± 13.0 years. Primary angle-closure glaucoma (PACG), uveitis, and anterior segment dysgenesis (ASD) were the top three etiologies in our patients, which accounted for 32.6%, 20.3%, and 15.1% of the total patients respectively. PACG mainly occurs after 30 years of age and ASD is the top reason of ACG in patients younger than 20 years old. Other known etiologies include iridocorneal endothelial syndrome, neovascular glaucoma, nanophthalmos, retinitis pigmentosa, spherophakia, bestrophinopathy, persistent fetal vasculature, iridociliary cysts, congenital retinoschisis, Marfan’s syndrome, retinopathy of prematurity, familial exudative vitreoretinopathy, congenital retinal folds, Coat’s disease, and neurofibromatosis. Conclusions We described the uncommon presentation of ACG in Chinese young patients. Although unusual, most of the etiologies could be identified. Therefore, more careful and comprehensive examinations are needed for early detection and timely treatment for young ACG patients.

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Comparison of Outcomes Between Combined Sparing Laser Photocoagulation and Intravitreal Bevacizumab Treatment Versus Conventional Laser Photocoagulation in Aggressive Posterior Retinopathy of Prematurity

Journal of Pediatric Ophthalmology & Strabismus ◽

10.3928/01913913-20210316-01 ◽

2021 ◽

pp. 1-6

Author(s):

Mantapond Ittarat

Keyword(s):

Retinopathy Of Prematurity ◽

Laser Photocoagulation ◽

Intravitreal Bevacizumab ◽

Bevacizumab Treatment ◽

Conventional Laser

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Does Intravitreal Bevacizumab Injection for Retinopathy of Prematurity Treatment Arrest Anterior Segment Development?

JOJ Ophthalmology ◽

10.19080/jojo.2016.01.555559 ◽

2016 ◽

Vol 1 (2) ◽

Cited By ~ 1

Author(s):

Joobin Khadamy

Keyword(s):

Retinopathy Of Prematurity ◽

Anterior Segment ◽

Intravitreal Bevacizumab ◽

Intravitreal Bevacizumab Injection ◽

Bevacizumab Injection

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Intravitreal Bevacizumab as an Adjunct Treatment for Neovascular Glaucoma

European Journal of Ophthalmology ◽

10.1177/112067210901900414 ◽

2009 ◽

Vol 19 (4) ◽

pp. 607-612 ◽

Cited By ~ 8

Author(s):

Murat Hasanreisoglu ◽

Dov Weinberger ◽

Karin Mimouni ◽

Moshe Luski ◽

Dan Bourla ◽

...

Keyword(s):

Visual Acuity ◽

Intraocular Pressure ◽

Anterior Segment ◽

Intravitreal Bevacizumab ◽

Neovascular Glaucoma ◽

Additional Treatment ◽

Adjunct Treatment ◽

Delayed Treatment ◽

Bevacizumab Treatment ◽

Before And After

Purpose To assess the effect of adjunctive intravitreal bevacizumab treatment on neovascular glaucoma (NVG). Methods The medical records of all consecutive patients with NVG treated with intravitreal bevacizumab at our center from May 2006 to February 2008 were reviewed. The data collected included background features, findings on full ophthalmologic examination (including visual acuity, gonioscopy, and intraocular pressure), glaucoma medications prescribed, and additional procedures for glaucoma performed before and after bevacizumab injection. The interval between the diagnosis of NVG and intravitreal bevacizumab treatment was calculated. Results Eighteen patients (6 male, 12 female; mean age 63±13.2 years) met the study criteria. Causes of NVG were proliferative diabetic retinopathy (n=14), central retinal vein occlusion (n=2), occlusive vasculitis (n=1), and panuveitis (n=1). The mean duration of follow-up was 52 (±12) weeks. Mean intraocular pressure decreased from 32.3 (±4.99) to 18 (±6.1) mmHg (p<0.0001) and mean number of glaucoma medications decreased from 3.16 (±1.2) to 2.55 (±1.46) (p=0.1938). An interval of less than 6 months between the start of bevacizumab treatment and diagnosis was associated with better final visual acuity than delayed treatment (0.82±0.4 logMAR vs 1.88±1.1 logMAR, p=0.002) and a better regression of iris neovascularization (22% vs 89%; p=0.015). Conclusions Intravitreal bevacizumab is beneficial for the treatment of anterior segment neovascularization and NVG when used as an adjunct, making the administration of additional treatment for the underlying cause possible. Bevacizumab should be instituted promptly after diagnosis, before irreversible anatomic and functional damage occurs.

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Fluorescein Angiography of Persistent Incomplete Vascularization of the Retina After Bevacizumab Therapy in Retinopathy of Prematurity

Journal of VitreoRetinal Diseases ◽

10.1177/2474126419850980 ◽

2019 ◽

Vol 3 (5) ◽

pp. 304-308 ◽

Cited By ~ 1

Author(s):

Xihui Lin ◽

Sagar B. Patel ◽

Alice Y. Zhang ◽

Daniel A. Brill ◽

Kim H. Le ◽

...

Keyword(s):

Fluorescein Angiography ◽

Gestational Age ◽

Retinopathy Of Prematurity ◽

Case Series ◽

Intravitreal Bevacizumab ◽

Peripheral Retina ◽

Medical Systems ◽

Retrospective Case ◽

Type 1 Rop

Purpose: This study evaluates the vascular development of premature infants at 50 weeks postconception after treatment with intravitreal bevacizumab for type 1 retinopathy of prematurity (ROP). Methods: A retrospective case series was conducted on type 1 ROP neonates with a high risk of general anesthesia complications. Patients were treated with bevacizumab between February 2013 and February 2016. At 50 weeks’ gestational age, all patients were imaged with RetCam (Clarity Medical Systems, Inc) fundus photographs and widefield fluorescein angiography (FA). Results: There were 4 boys and 7 girls with an average gestational age of 24.8 weeks and weight of 734.3 grams at birth. The estimated gestational age at injection was 37.1 weeks. Examination under anesthesia with FA was performed at a mean of 61 weeks posttreatment. Nineteen of 20 eyes (95%) of 11 infants had incomplete vascularization and peripheral nonperfusion on imaging. FA showed new vessels with increased tortuosity, microvascular abnormalities, and leakage past the original ridge. These 19 patients were treated with confluent ablative photocoagulation to the peripheral nonperfused retina. Patients were followed for a mean of 73.3 weeks after birth. None required incisional surgery. Conclusions: Patients with type 1 ROP treated with bevacizumab may have delayed vascularization of the peripheral retina and even late recurrence of active disease. Clinicians should regularly monitor patients after bevacizumab for potential neovascular complications.

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Angiographic Review of Choroidal Involution in Eyes with Retinopathy of Prematurity Treated with Bevacizumab

Ophthalmic Research ◽

10.1159/000512620 ◽

2020 ◽

Author(s):

Yasmin Islam ◽

Lorick Andersen ◽

Swati Agarwal-Sinha

Keyword(s):

Retinopathy Of Prematurity ◽

Late Phase ◽

Critical Role ◽

Intravitreal Bevacizumab ◽

Retinal Function ◽

Peripheral Retina ◽

Phase Imaging ◽

History Of ◽

Choroidal Vasculature

Purpose: Retinopathy of prematurity (ROP) is considered a disease of the inner retina; however, there is increasing evidence that demonstrates choroidal vasculature loss in ROP, leading to degeneration of outer retinal function and visual deterioration. Central choroidal thinning is noted in children with history of ROP using optical coherence tomography (OCT) imaging. This study characterizes the presence and persistence of choroidal loss angiographically in eyes of infants treated with intravitreal bevacizumab (IVB) for stage 3 ROP. Methods: Retrospectively reviewed the fluorescein angiography (FA) images of 62 eyes of 31 infants treated with IVB monotherapy. The eyes with good quality early-, mid-, and late-phase imaging were included in this study. The presence of choroidal hypofluoresence involving the central and or peripheral retina were noted. In infants with multiple FAs, serial FAs were analyzed for persistence of choroidal hypofluorescence. Results: The mean age and birth weight of infants was 24.4 weeks PMA and 683 grams, respectively. All infants received IVB monotherapy. 24 of 62 angiography images of sufficient quality reviewed showed the presence of choroidal hypofluorescence involving central and peripheral lobular loss in the early phase and its persistence into mid and late phases. 12 eyes demonstrated persistent choroidal loss on sequential FA until three years chronological age. Conclusions: The study demonstrates the presence of choroidal vascular loss angiographically both central and peripheral fundus in infants with ROP. It highlights the critical role of choroidal involution in outer retinal function that could affect visual outcomes.

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Intravitreal Bevacizumab to Treat Retinopathy of Prematurity in 865 Eyes: a Study to Determine Predictors of Primary Treatment Failure and Recurrence

10.21203/rs.3.rs-876613/v1 ◽

2021 ◽

Author(s):

Kaveh Fadakar ◽

Mohammadreza Mehrabi Bahar ◽

Hamid Riazi-Esfahani ◽

Afsaneh Azarkish ◽

Afsar Dastjani Farahani ◽

...

Keyword(s):

Risk Factors ◽

Birth Weight ◽

Treatment Failure ◽

Retinopathy Of Prematurity ◽

Intravitreal Bevacizumab ◽

Primary Treatment ◽

Anti Vegf ◽

History Of ◽

Mean Time

Abstract Purpose: This study aimed To evaluate the rate and risk factors for primary failure and recurrence after intravitreal anti-VEGF injection in retinopathy of prematurity (ROP).Methods: This retrospective study was performed on 865 eyes from 441 patients with retinopathy of prematurity receiving intravitreal Bevacizumab from 2012 to 2019. Medical records of patients were evaluated.Results: Mean gestational age (GA) and birth weight of patients were 28±2 weeks and 1121±312 g, respectively. Thirty-five eyes (4.04%) had a primary failure, including 18 eyes from 187 eyes in zone 1 (9.6%) and 17 eyes from 678 eyes in zone 2 (2.5%). The mean time of retreatment was 16.64±13.68 days in eyes without regression ROP. The remaining 830 eyes (95.95%) were included in recurrence analysis. The recurrence occurred in 33 eyes (3.97 %) of them in 20 patients, with the meantime of 77.52 days after the first treatment (IVB). Presence of plus disease, history of oxygen therapy or phototherapy, and GA less than 32 were associated with significantly increased prevalence of treatment failure. The risk factor predicting recurrence are lower birth weight, zone 1 pretreatment, history of intubation, anemia, and sepsis.Conclusion: Intravitreal anti-VEGF is a successful treatment for ROP with a low rate of primary failure and recurrence. Attention to risk factors accompanied by special care to patterns of treatment failure and recurrence helps to achieve early detection of treatment failure and vigilant follow up for recurrence.

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Keratoconus in a 4-year-old Girl with a Strong Family History of Keratoconus

US Ophthalmic Review ◽

10.17925/usor.2018.11.1.56 ◽

2018 ◽

Vol 11 (1) ◽

pp. 56 ◽

Cited By ~ 1

Author(s):

Mohammad M Shehadeh ◽

Mohammad T Akkawi ◽

Ammar A Aghbar ◽

◽

...

Keyword(s):

Risk Factors ◽

Family History ◽

Positive Family History ◽

Young Patients ◽

Safe Procedure ◽

Strong Family History ◽

Early Screening ◽

Retrospective Case ◽

History Of ◽

Local Risk

Purpose: To present the diagnosis and management of the youngest-described keratoconus patient, despite the absence of any systemic or local risk factors except the presence of a strongly positive family history of keratoconus. Methods: A retrospective case report. Results: A 4-year-old female child with free past medical and ocular histories, and a strongly positive family history of keratoconus, presented with deterioration in her vision in the previous 6 months as observed by the family. Objective/subjective refraction showed high astigmatism. Corneal tomography using the Scheimpflug camera Pentacam® HR confirmed the diagnosis of keratoconus in both eyes. Conventional corneal collagen crosslinking (CXL) procedure was performed shortly with a stabilization effect observed over a 1-year follow up period. Conclusion: Keratoconus onset may occur in early childhood, especially in patients with strong family history of the disease even in the absence of systemic or ocular risk factors. So, early screening before the age of 4 years should be done for all children of a family history of keratoconus. Crosslinking may be an effective and safe procedure for very young patients diagnosed with keratoconus.

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