Biomedical subjects

S L Fawcett

Publications and source records attributed to S L Fawcett.

6 recordsLinked to original sources

PubMed2004

Vincristine as a treatment for a large haemangioma threatening vital functions.

We report the use of vincristine to treat a large steroid resistant haemangioma of the lower face and neck. At the time of treatment the lesion had shown no signs of involution. The haemangioma was not life threatening but extension within the mouth was associated with bleeding and ulceration, which was impairing feeding and speech development. A significant improvement was seen with vincristine treatment.

Antineoplastic Agents, Phytogenic↗

PubMed2001

A comparison of grating visual acuity, strabismus, and reoperation outcomes among children with aphakia and pseudophakia after unilateral cataract surgery during the first six months of life.

PURPOSE: The method of correcting aphakia after unilateral cataract extraction during infancy is controversial. Some authorities advocate correction with an intraocular lens (IOL) whereas others advocate correction with a contact lens (CL). We compared grating visual acuity, alignment, and reoperative outcomes in age-matched children treated with these 2 modalities at 5 clinical centers. METHODS: Twenty-five infants born in 1997 or 1998 with a dense unilateral congenital cataract who had cataract surgery coupled with (IOL group, n = 12) or without (CL group, n = 13) primary IOL implantation were enrolled in this study. All patients were prescribed half-time occlusion therapy. In July 1999, their grating visual acuities, ocular alignments, and reoperation rates were assessed. RESULTS: The mean grating visual acuity (LogMAR) for the affected eye was 0.70 +/- 0.32 for the IOL group and 0.87 +/- 0.31 for the CL group (P =.19). The mean interocular difference in grating visual acuity was 0.26 +/- 0.30 for the IOL group and 0.50 +/- 0.28 for the CL group (P =.048). The incidence of strabismus (>10 PD) was 75% in the IOL group compared with 92% in the CL group (P =.24). The incidence of reoperations was 83% in the IOL group compared with 23% in the CL group (P =.003). CONCLUSIONS: Our preliminary data suggest that correcting aphakia after unilateral congenital cataract surgery with primary IOL implantation results in an improved visual outcome but a higher rate of complications requiring reoperation. A randomized clinical trial, the Infant Aphakia Treatment Study, is planned to further study the optimal treatment for aphakia following unilateral cataract extraction during infancy.

Aphakia, Postcataract↗

PubMed2001

Stereoacuity and foveal fusion in adults with long-standing surgical monovision.

PURPOSE: Although binocular vision deficits occur in children who have a constant esotropia onset following significant maturation of stereopsis, it is uncertain whether adults are susceptible to changes to binocular vision. We examined binocular vision in adults with longstanding surgical monovision (> or =6 month's duration) to determine whether the binocular visual system remains susceptible to change. METHODS: Participants included 32 adults with longstanding monovision through laser-assisted in situ keratectomy or photorefractive keratectomy and 20 age-matched control subjects. After full binocular correction, binocular function was measured by using the Randot Stereoacuity Test, the Randot Preschool Stereoacuity Test, and the Worth 4-dot test at near and distance. Monovision patients were grouped as having low anisometropia (<1.5 spherical D) or moderate anisometropia (> or =1.5 spherical D). RESULTS: Non-parametric analysis of variance revealed a significant difference between group median stereoacuity (H = 16.062; P <.001). Pairwise multiple comparisons indicated both groups with monovision had significantly worse stereoacuity compared with control subjects (P <.05). Median stereoacuity values were 100 seconds of arc for patients with low anisometropia, 150 seconds of arc for patients with moderate anisometropia, and 40 seconds of arc for control subjects. A larger proportion of patients with moderate anisometropia failed the Worth-4 dot test at distance than control subjects (z = 2.619; P =.009). CONCLUSIONS: Reduced stereoacuity and an absence of foveal fusion in adults with longstanding surgical monovision suggest continued susceptibility of the binocular visual system to anomalous binocular experience.

Adult↗

PubMed2000

Interobserver test-retest reliability of the Randot preschool stereoacuity test.

PURPOSE: Random dot stereoacuity can be quantified to between 40 and 800 seconds of arc in preschool children by using the Randot Preschool Stereoacuity test (Stereo Optical Co, Inc, Chicago, Ill). To incorporate this test into clinic and research settings, the reliability of its stereoacuity scores obtained by separate examiners needs to be evaluated. The purpose of this study was to evaluate its interobserver test-retest reliability. METHODS: Participants included 102 consecutive children with binocular sensory function ranging from fine to no measurable stereopsis. Clinical research participants included children with anomalous binocular vision caused by strabismus, cataracts, anisometropia, and ptosis. In a prospective study, random dot stereoacuity was measured twice under masked testing conditions by 2 examiners within a 1-hour period. RESULTS: Interobserver test-retest reliability of the Randot Preschool Stereoacuity test is high among a population of children with diverse binocular sensory function. The correlation coefficient between individual test scores was highly significant (r = 0.97, P<.001). Mean differences between the 2 scores (0.021 log seconds of arc) were not significantly different from zero (t(99) = 1.33, P>.1). The upper and lower limits of agreement were narrow, reflecting both the large sample size and the small variation between the 2 test scores. Interobserver test-retest reliability of the Randot Preschool Stereoacuity test was nearly constant across levels of functional stereoacuity, patient categorization, and age at the time of the test. CONCLUSIONS: The high agreement between the Randot Preschool Stereoacuity test scores by 2 independent observers supports its use in clinical management and research settings for the quantitative assessment of binocular sensory vision, as well as in multicentered research studies.

Child↗

PubMed2000

Motion VEPs, stereopsis, and bifoveal fusion in children with strabismus.

PURPOSE: The link between nasal-temporal motion asymmetries and anomalous binocular sensory function in infantile esotropia (ET) has led to the idea that visual evoked potential responses to horizontal motion (mVE) is an alternative measure of sensory binocularity to stereopsis. A second hypothesis is that the mVEP response is a marker for bifoveal fusion. The purpose of this study was to directly evaluate these two hypotheses by examining the correspondence between the mVEP response and both stereoacuity and bifoveal fusion in a cohort of strabismic patients with variable binocular sensory function. METHODS: Motion VEPs, random dot stereopsis, and bifoveal fusion were measured in 94 children: 20 with infantile ET, 16 with infantile accommodative ET, 22 with late-onset accommodative ET, 10 with intermittent infantile strabismus, and 26 normal control participants. RESULTS: Patients with infantile ET and infantile accommodative ET had high concordance between mVEP responses and stereoacuity and mVEP responses and bifoveal fusion. Asymmetric mVEP responses were highly concordant with both no measurable stereopsis and an absence of fusional vergence. Patients with late-onset accommodative ET and intermittent infantile strabismus revealed discordance between the mVEP response and stereoacuity and high concordance between the mVEP response and bifoveal fusion. Asymmetric mVEP responses were highly concordant with the absence of bifoveal fusion and the minimum-size prism to elicit fusional vergence. CONCLUSIONS: The qualitative and quantitative relationship between the mVEP response and fusional vergence suggests that the mVEP response is an objective measure of bifoveal fusion. The availability of such a test will facilitate studies of normal development of bifoveal fusion and development of monofixation syndrome in strabismus.

Accommodation, Ocular↗

PubMed1983

Gordon Battelle.

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History, 19th Century↗