Variation in management during and after retinal surgery for retinopathy of prematurity.
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Anesthesia↗
Biomedical subjects
I Casteels
Publications and source records attributed to I Casteels.
Cryotherapy versus laser photocoagulation for threshold retinopathy of prematurity: impact on early postoperative clinical recovery.
In a retrospective study in preterms treated with either cryotherapy (n= 16, 2000-2001) or laser photocoagulation (n= 19, 2002-2005) for threshold retinopathy, a significant decrease in duration of postoperative ventilation, in postoperative administration of analgesics and in time until regain of full enteral feeding was documented in infants who received laser photocoagulation. We therefore conclude that - compared to cryotherapy - laser treatment for threshold retinopathy is associated with a faster clinical postoperative recovery.
Cryotherapy↗
Visual outcome in children with juvenile idiopathic arthritis related uveitis.
PURPOSE: To determine the incidence and characteristics of uveitis in a cohort of patients with juvenile idiopathic arthritis (JIA) as well as the nature of treatment and the risk factors for visual loss. PATIENTS AND METHODS: Retrospective review of 52 patients with JIA, screened for uveitis between 1995 and 2005. The first group, presenting with symptoms of arthritis and uveitis, was diagnosed at screening. The second group presented with symptoms of uveitis, without any rheumatological complaints at the time of diagnosis. During follow-up, reactivation of uveitis and complications were registered and treated when indicated. RESULTS: Seventeen patients had symptoms of uveitis at time of presentation or developed uveitis at follow-up. Ten of this patient group had oligo-arthritis, 16 were antinuclear antibody (ANA) positive, 16 were girls. Three patients presented with ophthalmological symptoms without rheumatological complaints. In this group, complications were more pronounced. Treatment in all patients consisted of topical corticosteroids and dilating drops at different intervals. Visual acuity was good in most patients. CONCLUSION: In this retrospective study, the risk of uveitis was higher in ANA- positive girls with oligoarthritis. To reduce severe disease at presentation, earlier diagnosis of JIA, earlier referral for slit lamp examination and universal screening of vision in childhood are necessary.
Arthritis, Juvenile↗
Bilateral acute retinal necrosis in a 12-year-old girl.
Acute retinal necrosis (ARN) is a severe ocular syndrome consisting of a moderate-to-severe anterior uveitis, vasculitis, and vaso-occlusive retinal necrosis. It can occur in healthy individuals at any age, but reports of this condition in children are rare.
Acyclovir↗
Clinical symptoms and complications of pars planitis in childhood.
UNLABELLED: Pars planitis is the idiopathic form of intermediate uveitis; it most commonly affects persons between 5 and 40 years of age. In childhood, the disease is largely asymptomatic until in a well advanced stage with markedly reduced vision. Lack of early diagnosis and treatment may lead to permanent visual loss and amblyopia. AIM: To report on the clinical symptoms, complications, treatment and visual outcome of pars planitis in childhood. MATERIALS AND METHODS: Ten patients (8 boys and 2 girls) all younger than 16 years were diagnosed with and treated for pars planitis at our clinic between January 1993 and August 2004.
Adolescent↗
Bilateral Coats' disease with unusual presentation--a case report.
Coats' disease is a well-known ocular disorder, characterized by idiopathic retinal telangiectasia, retinal exudation and retinal detachment. We report on a boy who first presented at the age of 2 years with Coats' disease and secondary neovascular glaucoma. The differential diagnosis with retinoblastoma could not be made clinically or with the help of imaging studies, such as ultrasonography or computed tomography scanning (CT-scan). The right eye was consequently enucleated for diagnostic and therapeutical purposes. Histopathologic examination confirmed the diagnosis of Coats' disease. Five years later the same boy consulted again with profound visual loss in his only functional left eye. Fundoscopy revealed lesions typical for Coats' disease. Coats' disease can present in very different ways and bilateral disease is possible, even after several years.
Child, Preschool↗
Surgical treatment outcomes of congenital and juvenile cataracts.
PURPOSE: Evaluation of visual outcome after lens aspiration with or without intraocular lens implantation for isolated congenital and juvenile cataract in children aged 6 years and younger. MATERIAL AND METHODS: Retrospective review of 48 children with isolated congenital and juvenile cataract who were surgically treated between January 1993 and December 2002 and had a minimal follow-up of 12 months. RESULTS: In the group of children with unilateral cataract, 33% (3 out of 9 children) of aphakic children and 45.5% (5 out of 11 children) of pseudophakic children attained a final best corrected visual acuity of 20/200 and 20/60 respectively. In the group of children with bilateral involvement, 35% (6 out of 17 children) of aphakic children have a final best corrected visual acuity of 20/30 and 63.7% (7 out of 11 children) of pseudophakic children have a final best corrected visual acuity of 20/25 or more. CONCLUSION: The results of this study emphasize the need for early surgery and good organisation of postsurgical care in patients with pediatric cataract to optimise visual outcome. Furthermore patients with isolated unilateral congenital cataract surgically treated at an average age of 15 months without primary lens implantation and with variable and low compliance have suboptimal results. The effect of early surgery with primary lens implantation on the long term visual outcome in pediatric cataract needs to be further evaluated.
Anti-Bacterial Agents↗
Dopamine is an indicator but not an independent risk factor for grade 3 retinopathy of prematurity in extreme low birthweight infants.
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Cardiotonic Agents↗
Cryotherapy for threshold retinopathy: perioperative management in a single center.
Perioperative management and complications during and after surgery were reviewed in a population of premature infants who received cryotherapy because of threshold retinopathy by retrospective analysis of medical, anaesthetic, and ophthalmologic files. Infants (n=31) who received cryotherapy between January 1, 1996 and January 1, 2001 and were treated during the neonatal period in the unit were included in the study. Cryotherapy was performed under general anesthesia on the neonatal ward. Neonatal and preoperative characteristics of this cohort point to a vulnerable group of infants with a preoperative weight of 1622 g (1519 to 1862 g), bronchopulmonary dysplasia criteria applying in 29 of 31 patients and methylxanthins prescribed in 26 of 31 patients. No single cryotherapy session had to be interrupted because of systemic complications. Still marked cardiorespiratory instability was documented until 36 hours postoperative in 8 patients. Performing surgical procedures on the neonatal ward is a feasible option. Perioperative management in infants who received cryotherapy is used as an illustration of this approach.
Anesthesia, General↗
A locus for asphyxiating thoracic dystrophy, ATD, maps to chromosome 15q13.
Asphyxiating thoracic dystrophy (ATD), or Jeune syndrome, is a multisystem autosomal recessive disorder associated with a characteristic skeletal dysplasia and variable renal, hepatic, pancreatic, and retinal abnormalities. We have performed a genome wide linkage search using autozygosity mapping in a cohort of four consanguineous families with ATD, three of which originate from Pakistan, and one from southern Italy. In these families, as well as in a fifth consanguineous family from France, we localised a novel ATD locus (ATD) to chromosome 15q13, with a maximum cumulative two point lod score at D15S1031 (Zmax=3.77 at theta=0.00). Five consanguineous families shared a 1.2 cM region of homozygosity between D15S165 and D15S1010. Investigation of a further four European kindreds, with no known parental consanguinity, showed evidence of marker homozygosity across a similar interval. Families with both mild and severe forms of ATD mapped to 15q13, but mutation analysis of two candidate genes, GREMLIN and FORMIN, did not show pathogenic mutations.
Asphyxia↗
Incidence, perinatal risk factors, visual outcome and management of threshold retinopathy.
The incidence of threshold retinopathy, clinical characteristics and risk factors to develop threshold retinopathy are described in a group of preterm infants admitted between 1996 and 2000 in a single tertiary neonatal intensive care unit. A subset of these infants (n = 31) developed threshold retinopathy (ROP). Incidence of threshold ROP in survivors with a birth weight below 1500 g is 6.4%. Pre-, peri- and postnatal characteristics of these infants are described and compared with matched controls of the same gestational age (GA) and admitted in the same unit in an attempt to focus on relevant risk factors of threshold ROP. We also report on visual outcome data in infants who developed threshold retinopathy. Finally, we describe our experience with perioperative management in this cohort.
Belgium↗
Heterochromia of the irides and a motility disorder of the oesophagus: a coincidence or a defect during embryogenesis?
We present an infant with heterochromia of the irides and a motility disorder of the oesophagus. The association between Hirschsprung's disease and heterochromia of the irides has been reported in the past and has been explained by the common origin during embryogenesis of the parasympathetic ganglion cells and the stroma of the iris.
Child, Preschool↗
Ophthalmological findings in a patient with mucolipidosis III (pseudo-hurler polydystrophy). A case report.
Mucolipidosis III (Pseudo-Hurler Polydystrophy) is a rare autosomal recessively inherited Hurler-like disease. The ophthalmological findings in these patients include a triad of mild retinopathy, corneal clouding and hyperopic astigmatism. We present a patient with these ophthalmological characteristics.
Adolescent↗
Cranial imaging in child abuse.
Serious head injury in children less than 2 years old is often the result of child abuse. The role of the different neuroimaging modalities in child abuse is reviewed. Skull X-ray and cranial CT are mandatory. Repeat or serial imaging may be necessary and brain MR imaging may contribute to the diagnostic work-up, particularly in the absence of characteristic CT findings. The radiologist plays an important role in accurately identifying non-accidental cranial trauma. The clinical presentation can be non-specific or misleading. The possibility should be considered of a combined mechanism, i.e., an underlying condition with superimposed trauma. In this context, the radiologist is in the front line to suggest the possibility of child abuse. It is therefore important to know the spectrum of, sometimes subtle, imaging findings one may encounter. Ophthalmological examination is of the greatest importance and is discussed here, because the combination of retinal hemorrhages and subdural hematoma is very suggestive of non-accidental cranial trauma.
Brain Injuries↗
Autosomal dominant microcephaly--lymphoedema-chorioretinal dysplasia syndrome.
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Abnormalities, Multiple↗
Intraocular pressure elevation in a child due to the use of inhalation steroids--a case report.
Inhalation steroid therapy can cause ocular hypertension or open angle glaucoma. The authors describe the case of a young girl who presented with raised intraocular pressure and headaches due to the prolonged administration of nasal and inhalation steroids. The ophthalmologist should monitor the intraocular pressure in patients who use inhalation or nasal steroid therapy on a regular base. The physician or paediatrician should be aware of this complication in children with headaches or diminished visual acuity.
Administration, Inhalation↗
Bilateral cataract and high myopia in a child with trichothiodystrophy: a case report.
Trichothiodystrophy refers to a group of autosomal recessive disorders that have in common brittle sulphur-deficient hair (7). The abnormalities are usually obvious at birth and the clinical expression is variable. Ocular abnormalities are common with bilateral cataract being the most frequent one. We report on a four year old boy with trichothiodystrophy (complementation group TTD-A) who presented to us with strabismus, high myopia and bilateral cataract.
Abnormalities, Multiple↗
Direct caroticocavernous fistula and traumatic dissection of the ipsilateral internal carotid artery: endovascular treatment.
After severe craniocerebral trauma a 14-year-old boy developed progressive exophthalmos with venous congestion and chemosis, due to a direct caroticocavernous fistula. Angiography revealed traumatic occlusion of the ipsilateral internal carotid artery and absence of the inferior petrosal sinus. After failure of an approach via the anterior and posterior communicating arteries, the cavernous sinus was successfully catheterised through the occluded internal carotid artery, and embolisation performed with coils.
Adolescent↗