scholarly journals Ocular and Cerebral Causes and A New Scoring System to Evaluate Visual Function in Young Children with Visual Impairment

2021 ◽  
Author(s):  
Pinar Bingol Kiziltunc ◽  
Esra Şahlı ◽  
Ömer Bektaş ◽  
Özben Akıncı Göktaş ◽  
Merve Feyza Yüksel ◽  
...  
Keyword(s):  
Visual Impairment ◽  
Visual Function ◽  
Scoring System ◽  
Low Vision ◽  
Oculocutaneous Albinism ◽  
Function Score ◽  
Factors Affecting ◽  
Structural Disorders ◽  
Different Populations

Abstract Purpose: Childhood blindness is important cause contributing to the burden of blindness. It is necessary to identify the most frequently observed diseases in different populations. We aimed to demonstrate clinical features of low vision children and to evaluate the factors affecting visual function by a new visual function scoring system. Methods: 249 children between the age of 6 months and 3 years were included. Visual function was scored from 0 to 15 according to; response to threat, light, object, presence of fixation, duration of fixation, following of light and object in horizontal, vertical, oblique, and circular gazes, optokinetic nystagmus. Patients were classified according to neurological diagnosis and cranial magnetic resonance imaging. Correlation between visual function score and ocular and neurologic findings were evaluated. Results: While 136 patients (54.6%) had cerebral visual impairment (CVI), 89 (35.7%) had ocular pathology, 24 patients (9.6%) had combined pathology. The most common ocular and cerebral pathologies were oculocutaneous albinism (23.9%) and hypoxic ischemic encephalopathy (HIE) (27.5%), respectively. Patients with CVI had lower visual function than ocular pathologies. Neurological structural disorders and HIE had worse visual function. Widespread involvement of brain had lower visual function score. Seizure negatively affected visual function.Conclusions: Cerebral causes were found in approximately half of infants and children with low vision who were referred to our center for visual habilitation. The visual function scoring system we developed in this study will provide an opportunity to be objective in the follow-up of babies and in evaluating the effectiveness of visual habilitation programs.

scholarly journals Disability and visual outcomes following suspected abusive head trauma in children under 2 years

2020 ◽  
pp. archdischild-2019-318638
Author(s):  
Juliana Wright ◽  
Sally Painter ◽  
Sheethal Sujayeendra Kodagali ◽  
Nicholas R Jones ◽  
Andrea Roalfe ◽  
...  
Keyword(s):  
Visual Impairment ◽  
Hospital Discharge ◽  
Head Trauma ◽  
Visual Function ◽  
Case Series ◽  
Abusive Head Trauma ◽  
Retinal Haemorrhage ◽  
Visual Outcomes ◽  
Outcome Score

AimTo report disability and visual outcomes following suspected abusive head trauma (AHT) in children under 2 years.MethodsWe present a retrospective case series (1995–2017) of children with suspected AHT aged ≤24 months. King’s Outcome Score of Childhood Head Injury (KOSCHI) was used to assess disability outcomes at hospital discharge and at follow-up. The study used a retinal haemorrhage score (RHS) to record findings at presentation and a visual outcome score at follow-up.ResultsWe included 44 children (median age 16 weeks). At presentation, 98% had a subdural haemorrhage and 93% had a retinal haemorrhage. At discharge, 61% had moderate-to-severe disability, and 34% a good recovery. A higher RHS was observed in those with more disability (r=−0.54, p=0.0002). At follow-up, 14% had a worse KOSCHI score (p=0.055). 35% children had visual impairment, including 9% with no functional vision. Those with poorer visual function had a higher RHS (r=0.53, p=0.003). 28% attended mainstream school without support; 50% were in foster care or had been adopted, 32% lived with birth mother and 18% with extended family.ConclusionIt is known that injuries from suspected AHT result in high levels of morbidity; our cohort showed significant rates of disability and visual impairment. Those with higher disability at discharge and poorer visual function showed more significant retinal changes. The extent of disability was not always apparent at hospital discharge, impacting on provision of prognostic information and targeted follow-up.

scholarly journals RARE-62. VISUAL FUNCTION IN CHILDREN WITH CRANIOPHARYNGIOMA AT DIAGNOSIS: A SYSTEMATIC REVIEW

2020 ◽  
Vol 22 (Supplement_3) ◽  
pp. iii455-iii456
Author(s):  
Myrthe Nuijts ◽  
Nienke Veldhuis ◽  
Inge Stegeman ◽  
Hanneke van Santen ◽  
Giorgio Porro ◽  
...  
Keyword(s):  
Visual Impairment ◽  
Visual Function ◽  
Meta Analysis ◽  
Treatment Strategies ◽  
Visual Field Defects ◽  
Ophthalmological Examination ◽  
Suprasellar Region

Abstract Childhood craniopharyngioma is a rare and slow growing brain tumour, often located in the sellar and suprasellar region. It commonly manifests with visual impairment, increased intracranial pressure and hypothalamic and/or pituitary deficiencies. Visual impairment in childhood adversely affects a child’s daily functioning and quality of life. We systematically reviewed the literature to provide an extensive overview of the visual function in children with craniopharyngioma at diagnosis in order to estimate the diversity, magnitude and relevance of the problem of visual impairment. Of the 543 potentially relevant articles, 84 studies met our inclusion criteria. Visual impairment at diagnosis was reported in 1041 of 2071 children (50.3%), decreased visual acuity was reported in 546 of 1321 children (41.3%) and visual field defects were reported in 426 of 1111 children (38.3%). Other ophthalmological findings described were fundoscopic (32.5%) and orthoptic abnormalities (12.5%). Variations in ophthalmological testing methods and ophthalmological definitions precluded a meta-analysis. The results of this review confirm the importance of ophthalmological examination in children with craniopharyngioma at diagnosis in order to detect visual impairment and provide adequate support. Future studies should focus on long-term visual follow-up of childhood craniopharyngioma in response to different treatment strategies to provide insight in risks and ways to prevent further loss of vision.

scholarly journals Relationship of socioeconomic factors with vision-related quality of life on severe low vision and blind population in Indonesia

2015 ◽  
Vol 24 (4) ◽  
pp. 245-51
Author(s):  
Habsyiyah Habsyiyah ◽  
Yeni D. Lestari ◽  
Iwan Ariawan ◽  
Tjahjono D. Gondhowiardjo
Keyword(s):  
Quality Of Life ◽  
Socioeconomic Status ◽  
Visual Impairment ◽  
Socioeconomic Factors ◽  
Visual Function ◽  
Educational Level ◽  
Low Vision ◽  
Income Level ◽  
Related Quality

Background: Socioeconomic factors are known to be associated with visual impairment. Being someone who is visually impaired could affect his quality of life. The aim of this study is to evaluate the quality of life (QOL) in severe low vision and blind population in Indonesia in relation to their socioeconomic status. Methods: A cross sectional population-based study was performed in 5 provinces, in Indonesia. Respondents of validation study on blindness data of national basic health survey 2013 (RISKESDAS 2013), who were above 18 years old with severe low vision (BCVA≥3/60 to 6/60) and blind (BCVA<3/60), were included in this study. Questionnaires for socioeconomic status and a questionnaire from the national eye institute visual function questionnaire 25 (NEI VFQ 25) for visual function were administered. Total  scores of NEI-VFQ25 were compared based on severity of visual impairment, educational level, occupation, literacy adequacy, income level, and residency. Data analysis was using independent T-test or Mann-Whitney test, and Chi square test.Results: A total of 134 subjects were enrolled in this study, most of them are  women (68.2%), aged >64 years old (64.9%) with low education (65.7%), illiterate (52.2%), low income (71.6%), non working (63.4%) and living in urban areas (58.2%). The blind population has lower VFQ scores than severe low vision (p=0.001). Different status of educational level, literacy adequacy, income level and residency did not show significant difference in VFQ scores, but those who have an occupation had better VFQ scores than those who do not (p=0.041).Conclusion: Visual related quality of life (VRQOL) of severe low vision and blind population was associated significantly with occupational status. Because of culture and characteristics of Indonesian people, VRQOL of severe low vision and blind population in Indonesia was not affected by educational level, literacy, income level, and residency.

scholarly journals Visual impairment in children with a brain tumor: a prospective nationwide multicenter study using standard visual testing and optical coherence tomography (CCISS study)

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
M. A. Nuijts ◽  
M. H. Degeling ◽  
I. Stegeman ◽  
A. Y. N. Schouten-van Meeteren ◽  
S. M. Imhof
Keyword(s):  
Optical Coherence Tomography ◽  
Visual Acuity ◽  
Brain Tumor ◽  
Visual Field ◽  
Visual Impairment ◽  
Visual Function ◽  
Field Testing ◽  
Optical Coherence ◽  
Visual Field Testing

Abstract Background Children with a brain tumor have a high risk of impaired vision. Up to now, visual acuity measurement, visual field testing and orthoptic testing are the most informative diagnostic investigations for the assessment of visual function. Evaluating vision in children can be challenging given the challenges in cooperation, concentration and age-dependent shifts in visual tests. Since visual loss due to a brain tumor can be progressive and irreversible, we must aim to detect visual impairment as early as possible. Several studies have shown that optical coherence tomography facilitates discovery of nerve fiber damage caused by optic nerve glioma. Consequently, early detection of potential ocular damage will effect treatment decisions and will provide timely referral to visual rehabilitation centers. Methods/design The CCISS study is a prospective, observational, multicenter cohort study in The Netherlands. Patients aged 0–18 years with a newly diagnosed brain tumor are invited for inclusion in this study. Follow-up visits are planned at 6, 12, 18 and 24 months. Primary endpoints are visual acuity, visual field and optical coherence tomography parameters (retinal nerve fiber layer thickness and ganglion cell layer – inner plexiform layer thickness). Secondary endpoints include the course of visual function (measured by visual acuity, visual field and optical coherence tomography at different follow-up visits), course of the disease and types of treatment. Discussion The CCISS study will heighten the awareness of visual impairment in different types of brain tumors in children. This study will show whether optical coherence tomography leads to earlier detection of visual impairment compared to standard ophthalmological testing (i.e. visual acuity, visual field testing) in children with a brain tumor. Furthermore, the systematic approach of ophthalmological follow-up in this study will give us insight in the longitudinal relation between the course of visual function, course of the disease and types of treatment in children with a brain tumor. Trial registration The CCISS study is prospectively registered in the Netherlands Trial Register (NTR) since April 2019. Identifier: NL7697.

Factors Affecting the Use and Consequences of Management Accounting Practices in A Transitional Economy: The Case of Vietnam

2016 ◽  
pp. 54-73 ◽  
Author(s):  
Anh Doan Ngoc Phi
Keyword(s):  
Significant Influence ◽  
Quantitative Data ◽  
Structural Equation ◽  
Qualitative Data ◽  
Management Accounting ◽  
Transitional Economy ◽  
Equation Modeling ◽  
Enterprise Performance ◽  
Factors Affecting

This study seeks to help fill an important gap in the literature by investigating factors that have facilitated the use of management accounting practices (MAPs) in Vietnam - a transitional economy. Data were collected from 220 medium-to-large enterprises. Follow-up interviews were conducted with 20 accounting heads/vice heads to obtain further information and clarification. The quantitative data collected was analyzed using both descriptive and inferential statistics (including t-tests and structural equation modeling), while the qualitative data was used to shed further light on the various relationships described by the quantitative analysis. This paper reveals that both decentralization and competition have a positive, significant influence on the use of new MAPs except for the old ones. Consequently, the use of MAPs has a positive, significant influence on enterprise performance.

STRUCTURAL AND DYNAMIC FEATURES OF EAR-LY DISABILITY DUE TO MENTAL DISEASES

2020 ◽  
pp. 62-67
Author(s):  
Shmakova O.P.
Keyword(s):  
People With Disabilities ◽  
Child And Adolescent Psychiatry ◽  
Child Psychiatrist ◽  
Childhood And Adolescence ◽  
Disabled Children ◽  
Dynamic Features ◽  
Factors Affecting ◽  
Number Of Children ◽  
Number Of Patients

Prevention of disability is one of the most significant tasks of child and adolescent psychiatry. Obtaining data on the dynamics of the number of people with disabilities and the factors affecting this indicator seems to be one of the relevant aspects. Aim: to trace the dynamics of the number of children with disabili-ties and to assess the change in the structure of early disability over the past decades. Materials and Meth-ods. A comparative analysis of two cohorts of patients was carried out: 1st - patients born in 1990-1992. (1203 patients (men - 914, 76%; women - 289, 24%)) who applied to the district neuropsychiatric dispensa-ry for outpatient care in childhood and adolescence; II - children and adolescents born in 2005 - 2018 (602 patients (male - 410, 68%; female - 192, 32%), ob-served at the time of the study by a child psychiatrist in the neuropsychiatric dispensary. Research methods: clinical and psychopathological; follow-up; statisti-cal. Results. Comparison of the number and nosologi-cal distribution of disabled children in two cohorts showed that over the 15th year there has been a shift towards an increase in the proportion of disabled children among patients observed by child and ado-lescent psychiatrists. The increase in the number of children with disabilities was due to those suffering from childhood autism and other disorders of general development. There were no statistically significant differences in the number of people with disabilities who received benefits before the age of 7, as well as differences in gender ratios among disabled people in the two cohorts. Conclusion. Early disability is a mul-tifactorial phenomenon, prevalence, dynamics, the structure of which depends not only on clinical, but also on socio-administrative realities. Children with autism require increased attention, since there has been a multiple increase in the number of patients with this diagnosis.

Scoring System for the Diagnosis of COVID-19

2020 ◽  
Vol 13 (1) ◽  
pp. 413-414 ◽  
Author(s):  
Mohamed Farouk Allam
Keyword(s):  
Scoring System ◽  
Clinical Symptoms ◽  
False Negative ◽  
Nasopharyngeal Swab ◽  
Rt Pcr ◽  
Pcr Assay ◽  
Negative Results ◽  
False Negative Results ◽  
Symptoms And Signs

Due to the international spread of COVID-19, the difficulty of collecting nasopharyngeal swab specimen from all suspected patients, the costs of RT-PCR and CT, and the false negative results of RT-PCR assay in 41% of COVID-19 patients, a scoring system is needed to classify the suspected patients in order to determine the need for follow-up, home isolation, quarantine or the conduction of further investigations. A scoring system is proposed as a diagnostic tool for suspected patients. It includes Epidemiological Evidence of Exposure, Clinical Symptoms and Signs, and Investigations (if available). This scoring system is simple, could be calculated in a few minutes, and incorporates the main possible data/findings of any patient.

scholarly journals Ibuprofen-Induced Aseptic Meningitis in a Male Adolescent with Intracranial Hypertension and Visual Impairment: A Case Report

2021 ◽  
Vol 13 (1) ◽  
pp. 233-238
Author(s):  
Seyed Mohammad Mousavi Mirzaei ◽  
Zahra Ahmadi
Keyword(s):  
Visual Impairment ◽  
Intracranial Hypertension ◽  
Aseptic Meningitis ◽  
Rare Complication ◽  
Clinical Signs ◽  
Male Adolescent ◽  
Drug Induced ◽  
Blurred Vision ◽  
Inflammatory Drugs

Drug-induced aseptic meningitis (DIAM) is a rare complication of certain drugs, most commonly reported with ibuprofen use. The present study reports on a male adolescent with intracranial hypertension and visual impairment accompanied by DIAM. We present a 16-year-old male patient who after ibuprofen consumption displayed headache, fever, photophobia, and blurred vision following heavy exercises. Examination of cerebrospinal fluid showed a mononuclear pleocytosis and an increase in protein concentration. Other examinations had normal results. The development of common clinical signs following ibuprofen use reflected DIAM. The patient’s vision was found to improve with supportive care and stopping of the drug during follow-up. Given the widespread use of nonsteroidal anti-inflammatory drugs and the fact that these drugs are the most common cause of DIAM, the probability of occurrence of this event should be always kept in mind, and screening for autoimmune diseases in these patients is of great importance.

Coronary endarterectomy in coronary artery disease: Factors affecting graft patency and survival

2021 ◽  
pp. 021849232110068
Author(s):  
Simon CY Chow ◽  
Jacky YK Ho ◽  
Micky WT Kwok ◽  
Takuya Fujikawa ◽  
Kevin Lim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Graft Patency ◽  
Complete Revascularization ◽  
Coronary Endarterectomy ◽  
Factors Affecting ◽  
Early Results ◽  
Cerebrovascular Events ◽  
Obtuse Marginal ◽  
One Year

Background Coronary endarterectomy aims to improve completeness of revascularization in patients with occluded coronary vessels. The benefits of coronary endarterectomy remain uncertain. The aim of this study was to evaluate short-term surgical outcomes and factors affecting graft patency post-coronary endarterectomy. Methods Between 2009 and 2019, 81 consecutive patients who had coronary endarterectomy done were evaluated for their perioperative and early results. A total of 36 patients with follow-up coronary studies were included in patency analysis. Mortality rates, major adverse cardiac and cerebrovascular events, and graft patency were outcomes of interest. Survival and risk factor analysis were performed with Kaplan–Meier and logistic regression analysis. Results The average age of the cohort was 61.9 ± 9.29 years. Complete revascularization rate was 95.4% post-coronary endarterectomy. The 30-day and 1-year mortality was 2.5 and 6.2%, respectively. One-year major adverse cardiac and cerebrovascular events rate was 11.1%. Periprocedural myocardial infarction rate was 7.4%. Three patients required repeat revascularization within a mean follow-up duration of 49.6 ± 36.5 months. Overall graft patency was 89.2% at 20.2 months and graft patency post-coronary endarterectomy was 85.4%. Arterial grafts showed 100% patency. Vein grafts to endarterectomized obtuse marginal branch had patency rates of 33.3%. Multiple endarterectomies were associated with worse one-year major adverse cardiac and cerebrovascular events (OR: 28.6 ± 1.16; P = 0.003). Conclusions Coronary endarterectomy facilitates completeness of revascularization and does not increase early mortality. Graft patency post-coronary endarterectomy on obtuse marginal artery was suboptimal. Judicious use of coronary endarterectomy should be practiced to balance the need of completeness of revascularization against the risk of myocardial infarction.

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