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Biomedical subjects

Glen A Gole

Publications and source records attributed to Glen A Gole.

18 recordsLinked to original sources
PubMed2006

The impact of modest prematurity on visual function at age 6 years: findings from a population-based study.

OBJECTIVE: To determine the effects of modest low birth weight and prematurity on visual function of children predominantly aged 6 years. METHODS: Children with a birth weight of 1500 to 2499 g were considered exposed to a modest low birth weight (n = 82) and were compared with children with a birth weight of 2500 g or more (n = 1386). Exposure to modest prematurity, 32 to 36 weeks' gestation (n = 115), was similarly analyzed and compared with birth at term, 37 or more weeks' gestation (n = 1446). Logarithm of the minimum angle of resolution visual acuity was measured in both eyes. Cycloplegic autorefraction (cyclopentolate), cover testing, and dilated fundus examinations were performed. RESULTS: A modest low birth weight increased the risk of amblyopia (relative risk [RR], 5.1; 95% confidence interval [CI], 2.2-12.0), strabismus (RR, 3.7; 95% CI, 1.5-9.1), and anisometropia (RR, 3.7; 95% CI, 1.2-11.1), together with an increased risk of uncorrected visual acuity in the lowest quartile (RR, 1.7; 95% CI, 1.3-2.2). Modest prematurity increased the risk of amblyopia (RR, 4.5; 95% CI, 1.9-10.6), strabismus (RR, 2.6; 95% CI, 1.1-6.0), and uncorrected visual acuity in the lowest quartile (RR, 1.5; 95% CI, 1.1-2.0). CONCLUSION: Modest degrees of low birth weight and prematurity may be associated with increased ophthalmic morbidity at age 6 years.

Amblyopia↗
PubMed2006

Epidemiology of open- and closed-globe trauma presenting to Cairns Base Hospital, Queensland.

PURPOSE: To review the epidemiology of serious ocular trauma presenting to Cairns Base Hospital, from the far north Queensland health districts. METHODS: A retrospective study of cases from January 1995 to November 2002 inclusive. Cases were analysed with respect to demographics, cause and nature of injury, method of transport and time to and type of ophthalmic treatment, and visual outcomes. RESULTS: There were 226 cases identified, including 71 open-globe and 155 closed-globe injuries. The annual rate of injury was 3.7 per 100 000 for open-globe and 11.8 per 100 000 in total. The Aboriginal and Torres Strait Islander population from the far north Queensland districts showed a disproportionate incidence, with 38% of the total number of injuries, despite representing only 12.3% of the population. Assault in the Aboriginal and Torres Strait Islander population resulted in 69.6% of injuries in men and 75.8% of injuries in women. Of all assaults 76.2% were alcohol-related. The majority (71.5%) of injuries in the Caucasian population were due to accidental blunt and sharp trauma. In total, 77.4% of injuries occurred in men, with an average age of 31 years. Of all open and closed injuries in the study, a final visual acuity of 6/12 or better was achieved in 47.8% of eyes and a final visual acuity of 6/60 or less occurred in 17.7% of patients, 20.8% patients were lost to follow up. In total, 14.1% of open injuries required enucleation/evisceration. CONCLUSIONS: The incidence of ocular trauma in far north Queensland is equal to other Australian populations. However, there is a disproportionately high incidence in the Aboriginal and Torres Strait Islander population. Alcohol-related assault is a significant cause of visual loss in the Aboriginal and Torres Strait Islander population. Closed-globe injuries are more common than open globe; however, the latter have poorer visual prognosis. Initial visual acuity of all injuries correlated with final visual acuity.

Adult↗
PubMed2005

Perforated corneal hydrops treated with sulfur hexafluoride (SF6) gas and tissue adhesive.

PURPOSE: To report a case of a perforated acute hydrops in a mentally retarded patient that was successfully managed with intracameral sulfur hexafluoride gas and cyanoacrylate tissue adhesive. METHODS: Interventional case report. RESULTS: A 14-year-old mentally retarded male patient with keratoconus presented with a perforated acute hydrops. A bandage contact lens was applied. However, following a large emesis 2 days later, the aqueous leak worsened with shallowing of the anterior chamber. Under general anesthesia, sulfur hexafluoride was injected to reform the anterior chamber and cyanoacrylate tissue adhesive was applied to the perforated site and covered by a bandage contact lens and temporary tarsorrhaphy. A follow-up examination at 1 month showed a formed anterior chamber with tissue adhesive in situ and no aqueous leak. CONCLUSIONS: The successful use of intracameral sulfur hexafluoride and tissue adhesive in the management of perforated acute hydrops may avoid emergency tectonic penetrating keratoplasty and reduce potential complications in the poorly cooperative patient.

Adolescent↗
PubMed2004

Primary trabeculodysgenesis in association with neonatal Marfan syndrome.

We present the clinical and ophthalmological findings in two infants with neonatal Marfan syndrome (nMFS) and primary trabeculodysgenesis (PT). Fibrillin 1 (FBN1) mutations were confirmed in both cases. Numerous eye anomalies have been recognized in infants with nMFS, but PT has not been reported previously. Our report expands the phenotype of nMFS, and highlights the importance of early and careful ophthalmological assessment of these infants.

Chromatography, High Pressure Liquid↗
PubMed2004

The surgical management of consecutive exotropia.

PURPOSE: To review the results and techniques of surgical treatment of consecutive exotropia. METHODS: We performed a retrospective chart review of all patients who underwent surgery for consecutive exotropia in a pediatric ophthalmology practice between 1992 and 2001. Patients were excluded if follow-up lasted < 6 weeks or if exotropia was caused by other ocular disorders such as previous trauma or congenital cataracts. RESULTS: Fifty-nine patients were identified. The procedure performed in the majority of cases was unilateral lateral rectus recession and medial rectus advancement to the original insertion. Seven patients underwent bilateral lateral rectus recession, and 6 underwent lateral rectus recession combined with medial rectus resection. The mean interval between original surgery and surgery for consecutive exotropia was 14.1 years (range 4 months to 47.5 years). The mean preoperative distance exodeviation was 31.7 prism diopters (PD). Satisfactory alignment (ie, within 10 PD of orthophoria) was achieved in 36 patients (61%) at week 1 and 42 patients (71%) at final follow-up. Mean follow up was 16.0 months. Thirty-nine patients (66%) demonstrated an exodrift after surgery (mean 7.6 PD). CONCLUSION: Consecutive exotropia may occur many years, even decades, after esotropia surgery. Lateral rectus recession with advancement of the previously recessed medial rectus is an effective treatment. An exotropic drift occurs after consecutive exotropia surgery, usually within the first 6 weeks. A suitable ocular alignment immediately after surgery for consecutive exotropia is a small-angle esotropia of 5 to 10 PD.

Adolescent↗
PubMed2004

Diode laser treatment of pre-threshold and threshold retinopathy of prematurity.

PURPOSE: Retinopathy of prematurity (ROP) is a sight-threatening condition of premature infants. This study aimed to investigate the efficacy of diode laser photocoagulation in the treatment of pre-threshold and threshold ROP. METHODS: A retrospective review was conducted of patients who underwent diode laser treatment for ROP by one author (GAG) from 1992 to 2000. During this time, 2137 babies <1500 g birthweight or <32 weeks post-conception age were examined. RESULTS: Seventy-six eyes in 40 infants (20 male, 20 female) were treated for ROP. Treatment was performed on average at 37 weeks post-conception age (range 31-50 weeks, SD = 3.2). The number of burns per eye for the first session of laser ranged between 193 and 1937 (mean 933), with power ranging from 200 to 1000 mW (mean 484). Eighteen (45.0%) of these 40 infants underwent a second session of laser (mean number of burns 683, range 167-1618), which was performed in 29 (38.2%) of the 76 eyes that initially underwent laser treatment. Complete regression was observed in 61 eyes (80.3%), occurring on average at 39 weeks post-conception age (range 35-45, SD = 2.2). Six (7.9%) eyes progressed to stage IVA disease, two (2.6%) to stage IVB and three (3.9%) to stage V ROP. In the latter part of the study as the number of laser burns per eye increased it was found that the number of patients requiring a second session of laser treatment decreased, with no adverse outcomes observed in the last 3 years of the study. At last follow up, the average refractive error in the treated eyes was -0.40 D spherical equivalent (range -12.75 D to +4.25 D, SD = 3.0). The degree of myopia induced showed no significant correlation with the number of laser burns administered. CONCLUSION: Diode laser treatment is able to stop progression of ROP in the majority of cases.

Female↗
PubMed2004

Panoptic versus conventional ophthalmoscope.

BACKGROUND: The 'ease of use' and accuracy in measurement of the vertical optic cup/disc ratio (VCDR) was compared between the conventional direct ophthalmoscope (CO) and Panoptic direct ophthalmoscope (PO) in a group of 'naïve' first year medical students to determine which would be more suitable for non-ophthalmologists. METHODS: In this quasi-randomized method comparison study, eight students received an introductory session on ophthalmoscopy then examined 18 eyes (9 left, 9 right) with each ophthalmoscope in a private practice. The subjects were the eight students themselves plus two other subjects. Each subject (n = 10) had one eye dilated. Students determined a VCDR and a subjective score of 'ease of use' on a scale of 1 (difficult) to 10 (easy). A consultant ophthalmologist (GAG) determined the benchmark VCDR for each eye with each ophthalmoscope. RESULTS: Of 288 eye examinations, there were 111 measurements of VCDR using the CO (47 undilated, 64 dilated), and 140 measurements using the PO (75 undilated, 65 dilated). Differences in the students' estimated VCDR and the benchmark were similar for the CO and PO (P = 0.67). 'Ease of use' was scored in 288 eyes and the median score was higher in the PO overall (CO: median 8, IQR 6-9; PO median 9, IQR 8-10; P < 0.0001), and within each session (P < 0.0001 for each session). CONCLUSIONS: Medical students found the PO much easier to use, with accuracy of rating the VCDR similar to the CO. This comparison would support the wider use of the PO amongst medical students, general practitioners and other primary care providers.

Adolescent↗
PubMed2003

Unilateral leukocoria in off axis flash photographs of normal eyes.

PURPOSE: To describe an optical phenomenon producing leukocoria in off axis flash photographs of children who have a normal ophthalmic examination. DESIGN: Observational case series. METHODS: Description of three otherwise well children who presented to a pediatric ophthalmologist with unilateral leukocoria seen in flash photographs. The children underwent a full ophthalmic examination, including dilated fundus examination. RESULTS: All ophthalmic examinations were normal. The photographs were all found to be approximately 15 degrees off axis with the leukocoria seen in the eyes where the flash illuminated the nasal retina. CONCLUSIONS: Leukocoria can be seen in normal eyes when the child is not fixing directly on the camera. That is due to reflection off the optic nerve head.

Artifacts↗
PubMed2003

Vascular endothelial growth factor-B and retinal vascular development in the mouse.

PURPOSE: Vascular endothelial growth factor-A (VEGF-A) is crucial to retinal vascular growth, both normal and pathological. VEGF-B, recently characterized, is reported to be expressed in retinal tissues, but the importance of VEGF-B to retinal vascular development remained unknown. The aim of this study was to analyse retinal vascular growth in the Vegfb-/- knockout mouse. METHODS: Retinal vascular growth was measured in Vegfb-/- knockout mice raised under normal conditions, and Vegfb-/- knockout mice with an oxygen-induced proliferative retinopathy. Wild type Vegfb+/+ mice served as controls. Vessels were perfused with ink and retinal flatmounts secondarily labelled with FITC-lectin (BS-1, Griffonia simplicifolia). Area and diameter of retinal growth and retinal vascular growth were recorded over days 0-20, and capillary density and mean diameter recorded from day 17 pups. RESULTS: A variety of techniques confirmed that Vegfb+/+ mice expressed VEGF-B and that VEGF-B expression was absent in Vegfb-/- mice. Vegfb-/- mice raised in room air showed no significant differences from Vegfb+/+ controls. No differences were found in oxygen-induced retinopathy between Vegfb-/- and Vegfb+/+ pups in either the extent of the initial oxygen-induced ablation, or in the regrowth of retinal vessels or vitreal (neovascular) sprouts; vitreal sprouts are important markers of the abnormal proliferative response, and are maximally expressed on day 17 in this model of oxygen-induced retinopathy. CONCLUSIONS: These results indicate that a lack of VEGF-B does not significantly affect development of the retinal vasculature under normal conditions, nor does it appear to affect the proliferative retinal responses seen in oxygen-induced retinopathy.

Animals↗
PubMed2003

Comparison of the Retinomax autorefractor with hand-held retinoscopy in 1-year-old infants.

This study aimed to determine the accuracy (and usability) of the Retinomax, a hand-held autorefractor, compared to measurements taken from hand-held retinoscopy (HHR) in a sample of normal 1-year-old children. The study was a method comparison set at four Community Child Health Clinics. Infants (n = 2079) of approximately 1 year of age were identified from birth/immunization records and their caregivers were contacted by mail. A total of 327 infants ranging in age from 46 weeks to 81 weeks (mean 61 weeks) participated in the study. The children underwent a full ophthalmic examination. Under cycloplegia, refraction was measured in each eye by streak retinoscopy (HHR) and then re-measured using the Retinomax autorefractor. Sphere, cylinder, axis of cylinder and spherical equivalent measurements were recorded for HHR and Retinomax instruments, and compared. Across the range of refractive errors measured, there was generally close agreement between the two examination methods, although the Retinomax consistently read around 0.3 D less hyperopic than HHR. Significantly more girls (72 infants, 47.7%), struggled during examination with the Retinomax than boys (52 infants, 29.5%) (P < 0.001). Agreement deteriorated between the two instruments if the patient struggled during the examination (P < 0.001). In general, the Retinomax would appear to be a useful screening instrument in early childhood. However, patient cooperation affects the accuracy of results and is an important consideration in determining whether this screening instrument should be adopted for measuring refractive errors in early infancy.

Female↗
PubMed2003

Three horizontal muscle squint surgery for large angle infantile esotropia.

BACKGROUND: To report the long-term outcome of a series of 49 patients who underwent three horizontal muscle squint surgery for large angle infantile esotropia. METHODS; The patient records were retrospectively reviewed of 49 (24 girls [49%], 25 boys) consecutive patients with infantile esotropia of angle > or =60 Delta, who had undergone three horizontal muscle surgery performed by one surgeon (author GG). Surgery consisted of bilateral medial rectus recession combined with graded unilateral lateral rectus resection. Surgeries were carried out over a 6-year period with a mean follow-up period of 32.9 months (3.7-71.8 months). RESULTS: Using Kaplan-Meier life-table analysis, cumulative surgical success (orthotropia +/-10 Delta) was 93.9% at 1 week, 91.8% at 2 and 6 months, 87.7% at 12 and 18 months, 79.9% at 2 years, 77.1% at 3, 4 and 5 years, and 70.6% at 6 years. The mean preoperative deviation was 68.7 Delta. The mean age at surgery was 12.9 months. The failure rate was independent of preoperative deviation. Prevalence of residual esotropia (>10 Delta) varied from 2.0% at 1 week to 17.0% at 6 years. Similarly the prevalence of consecutive exotropia (>10 Delta) varied from 4.0% at 1 week to 12.4% at 6 years. CONCLUSION; Operating in a graded fashion on three horizontal muscles in children with large angle infantile esotropia has a high success rate, even over long-term follow up. Based on the study's results, amounts of surgery for a given angle of strabismus are proposed.

Child, Preschool↗
PubMed2002

Corticosteroid-induced glaucoma in a child after a scleral reinforcement procedure.

Corticoteroid-induced glaucoma can result from either topical or systemic corticosteroid use. Compared with adults, the corticosteroid response in children is less well known. The case is reported of a child who developed glaucoma after receiving topical corticosteroids following a scleral reinforcement procedure. The raised intraocular pressure was controlled after cessation of the corticosteroids and with the use of antiglaucoma therapy. As many forms of cortico-steroids are widely used, children on corticosteroids should have regular intraocular pressure measurements as part of their management.

Child↗