INPATIENT And also Hospital DIFFERENCES IN PEDIATRIC People WITH LABORATORYCONFIRMED COVID19

PURPOSE To describe the development of a new algorithm for detecting changes in 10-2 visual field (VF) tests using event-based analysis and to test its validity in a second, independent glaucoma cohort. DESIGN Prospective cohort study. METHODS Patients with established open-angle glaucoma from the Macular Assessment and Progression Study (MAPS, development cohort, n=151), and the African Descent and Glaucoma Evaluation Study (ADAGES, validation cohort, n=52) were evaluated. The 10-2 VF results from MAPS were obtained during four test-retest sessions within a four-month period. For the validation analysis, 10-2 VF results from ADAGES performed on at least five visits were used. The event-based pointwise changes on 10-2 tests in the validation cohort were determined using two progression criteria at least three progressing VF locations on two or three consecutive tests ("possible" or "likely" progression). Linear mixed-effects models were used to evaluate VF progression. RESULTS In the validation cohort, the mean (SD) follow-up time was 2.3 (0.7) years. The number of eyes experiencing 10-2 VF progression based on "possible" and "likely" progression was 36 (54.5%) and 11 (16.6%), respectively. Eyes experiencing "possible" progression had MD changes [-0.60 dB/year (95% CI -0.93 to -0.28)] faster than those not meeting this criterion (P less then 0.001), whereas for those with "likely" progression the difference was -0.91 dB/year (95% CI -1.26 to -0.56, P less then 0.001). CONCLUSIONS A new event-based progression algorithm using the 10-2 VF can identify eyes experiencing more rapid MD progression and may be used as a tool to assess progressive macular functional changes in glaucoma. PURPOSE To investigate anterior scleral canal (ASC) area in the eyes with glaucoma using spectral-domain optical coherence tomography (SD-OCT). DESIGN Cross-sectional study. METHODS This study included 206 eyes of 103 patients with glaucoma classified as 66 eyes of 33 patients with unilateral glaucoma and 140 eyes of 70 patients with bilateral glaucoma. Radial scan enhanced depth imaging SD-OCT centered on the optic disc was performed, and parameters that present ASC area such as ASC opening and the largest ASC area were obtained in each eye. The largest ASC area was the largest cross-sectional area of the ASC region identified between the ASC opening and anterior lamina cribrosa insertion. These parameters were compared between eyes with and without glaucoma in unilateral glaucoma, and eyes with worse and better visual field defect (VFD) in bilateral glaucoma. RESULTS In the patients with unilateral glaucoma, ASC opening and largest ASC area were significantly larger in the eyes with glaucoma than in those without glaucoma (both, P less then .001). In bilateral glaucoma, these parameters were significantly larger in the eyes with worse VFD than in those with better VFD (P = .0080 and .0018, respectively). Inter-eye differences of the ASC parameters in the glaucoma patients were significantly greater than that in the normal subjects. CONCLUSIONS Significantly larger ASC area was first observed in the living human eyes with glaucoma compared to the normal eyes. Further longitudinal studies are required to determine if the ASC area is useful in the prevention and treatment of glaucoma. PURPOSE To assess efficacy of intravitreal ranibizumab injections and targeted pan-retinal photocoagulation (TRP) for radiation retinopathy-related macular edema. SD49-7 DESIGN Phase IIb, prospective, randomized clinical trial. SETTING multi-center PATIENTS 40 eyes in 40 treatment-naïve patients with radiation-induced macular edema and a resulting decrease in visual acuity ranging between 20/25 and 20/400 (Snellen-equivalent). INTERVENTION Patients either received intravitreal 0.5mg ranibizumab monthly, monthly ranibizumab with TRP, or 3 monthly ranibizumab (loading doses) followed by as-needed (PRN) injections and TRP. After Week 52, all subjects entered a treat-and-extend protocol for ranibizumab. MAIN OUTCOME MEASURES Mean ETDRS BCVA change from baseline. RESULTS Mean patient age was 57 years (range, 22-80), ETDRS BCVA was 56.7 letters (20/74 Snellen-equivalent), and central macular thickness (CMT) was 423 um (range, 183-826). Thirty-seven patients completed the Month-12 visit (92.5%), at which time the change in mean BCVA was +4.0 letters, -1.9 letters and +0.9 letters in the monthly, monthly plus laser, and PRN plus laser cohorts, respectively. There was a significant difference in mean BCVA at 1 year among all three cohorts (p less then 0.001), as well as between cohorts in pairwise comparisons, with the most significant gains in the monthly group. 82.5% of the patients retained visual acuity of 20/200 or better, and 20.0% improved 10 or more ETDRS letters. CONCLUSIONS Ranibizumab may improve vision and anatomy in patients with radiation retinopathy-related macular edema and prevent vision loss through 48 weeks of therapy. Monthly injections were more effective than as-needed approach, and the addition of TRP yielded no therapeutic benefits. PURPOSE To correlate in vivo confocal microscopy morphological features (IVCM-MF) and Acanthamoeba cyst density (ACD) with final best corrected visual acuity (BCVA) in Acanthamoeba keratitis (AK). DESIGN Retrospective cohort study. METHODS Patient demographics, treatment outcome, and corresponding IVCM-MF performed at the acute stage of infection were analysed. Inclusion criteria were microbiological positive AK cases seen at Moorfields Eye Hospital between February 2013 and October 2017. Statistical significance was assessed by multinomial regression and multiple linear regression analysis. Main outcome measures were final BCVA. RESULTS A total of 157 eyes (157 patients) had AK. Absence of single file of round/ovoid objects was associated with a BCVA of 6/36 to 6/9 (OR 8.13; 95% CI, 1.55-42.56, P = 0.013) and ≥ 6/6 (OR 10.50; 95% CI, 2.12-51.92, P = 0.004) when compared to NPL to 6/60. Absence of rod/spindle objects was associated with a BCVA of ≥ 6/6 (OR 4.55; 95% CI, 1.01-20.45, P = 0.048). Deep stromal/ring infiltrate was associated with single file round/ovoid objects (OR 7.78; 95% CI, 2.69-22.35, P less then 0.001), rod/spindle objects (OR 7.05; 95% CI, 2.11-23.59, P = 0.002), and binary round/ovoid objects (OR 3.45; 95% CI, 1.17-10.14, P = 0.024). There was a positive association between ACD with treatment duration (β = 0.14, P = 0.049), number of IVCM-MF (β = 0.34, P = 0.021) and clusters of round/ovoid objects (β = 0.29, P = 0.002). CONCLUSIONS Specific IVCM-MF correlate with ACD and clinical staging of disease, and are prognostic indicators for a poorer visual outcome.