Global Pediatric Ophthalmology Congress June 06-07, 2016 London, UK

Caroline Mvilongo Tsimi has completed her MD degree from Yaounde Faculty of Medicine and Biomedical Sciences. She is an Ophthalmologist at Yaounde Central Hospital and has published some papers in reputed journals.

Introduction: Retinoblastoma is an embryonal tumor of neuroectodermal origin, highly malignant affecting the young child and the infant. It is bilateral in 40% of cases. We report 2 clinical cases of bilateral retinoblastoma with extra-retinal diffusion which is a poor prognosis factor. Case 1: DW, 20 months brought in our ophthalmology service in 2009 with a tumor of the left eye since one month with a past history of leucocoria since birth. At the ophthalmology exam, he was classified at stage V of Reese- Ellsworth for the contro-lateral right eye and orbital extension of the left eye. He has been enucleated for the left eye and received 3 doses of chemotherapy. The patient was lost of view 2 months after the surgery. Case 2: H O, 3 years central African refugee referred in our ophthalmology service on June 2015 for the care of a tumor of the right eye since 3 months. She had a leucocoria in the right eye since one year; with past history of 1st degree consanguinity. The ophthalmology exam showed a great tumor with necrosis and inflammation of the right eye. At the left eye, sub-retinal mass with retinal detachment stage-V of Reese- Ellsworth, she has received neoadjuvant chemotherapy and exenteration of the right eye. She died few hours after the surgery. These 2 cases have been seen late in an appropriate ophthalmology unit. The prognosis was poor because of the extra retinal diffusion of the tumor.

Seong-Joon Kim has completed his PhD from Seoul National University. He is a Professor in Department of Ophthalmology, Seoul National University College of Medicine with specialization in Strabismology and Neuro-Ophthalmology. He has published more than 80 papers in reputed journals and has been serving as an Editorial Board Member of Korean Journal of Ophthalmology.

Amblyopia is the most common cause of visual impairment in children and most of current treatments are monocular patching or penalization. Recent studies report that abnormal binocular interactions play a key role in amblyopia. The mechanism of dichoptic presentation is presenting the strong stimulus to the amblyopic eye and another weak stimulus to the normal fellow eye. The device which directly targets the binocular function using dichoptic presentation is developed. The developed device and software program separate the 3D images and control the visual inputs into the both eyes using head-mounted display. It increases the contrast, size and intensity of the 3D target to the amblyopic eye and decreases those to the normal fellow eye. This separation of 3D images is expected to improve the monocular visual acuity of the amblyopic eye with the reduction of suppression and strengthen the binocular fusion including stereopsis. The newly developed binocular therapy using head-mounted display is hand-held and convenient. Further investigation is needed to prove the effectiveness in improvement of both monocular and binocular vision in children and adults with amblyopia.

Morreale Bubella Raffaella is a Specialist in Ophthalmology and has obtained PhD in Neuroscience and disorders of comportment. She has published more than 36 papers in reputed journals and a book “L'occhio nella patologia endocrina”.

Chromosome 16 abnormalities cause a wide spectrum of disorders associated with a variety of outcomes. Full trisomy 16 is the most frequent autosomal cause of miscarriages due to associated malformations. While complete trisomy 16 can be considered to be lethal in early pregnancy, mosaic trisomy 16 have been reported. Partial trisomy 16 for the entire long arm is rare-Partial trisomy 16q is regarded as a clinically recognizable entity presenting with intrauterine growth restrinction, dysmorphic features, central nervous system malformations, generalized hypotonia, absence of suck, severe psychomotor retardation and intellectual disability, congenital heart defects, ambiguous genitalia, vertebral and anorectal anomalies. Several ocular abnormalities have been described in partial trisomy 16q patients, such as bilateral anterior segment dysgenesis with iris hypoplasia, Rieger’s anomaly, congenital glaucoma and megalocornea. In this paper we report our experience following a female patient with partial trisomy 16q. Her clinical features appeared similar to those reported in the literature (low birth weight, microcephaly, congenital heart defect, pre and postnatal growth and mental retardation, seizures, mild dysmorphic features, liver and central nervous system anomalies). However, she also developed a bilateral optic nerve head drusen, confirmed by OCT that has never been described in literature.

Mohamed Mostafa Kamel Diab has completed his PhD from Ain Shams University and Postdoctoral studies from Ain Shams University School of Medicine, Cairo, Egypt. He is a Professor of Ophthalmology, Ain Shams University, Cairo, Egypt and Consultant Ophthalmology Magrabi Hospital, KSA. He has published 16 international papers in reputed ophthalmology journals.

Purpose: To report the short-term anatomic response of intravitreal bevacizumab (Avastin) and peripheral cryotherapy for the treatment of posterior retinopathy of prematurity (ROP) with vitreous hemorrhage in a small series of patients. Patients & Methods: This was a retrospective study that included 19 eyes of 14 premature babies with posterior ROP and vitreous hemorrhage where conventional laser treatment could not be applied. Patients received an intravitreal injection of bevacizumab (Avastin) together with peripheral retinal cryotherapy. Results: Vascularization began to regress within a few days after the injection, but vitreous hemorrhage absorbed more slowly. Repeat intravitreal injections of bevacizumab were administered in eight eyes within 1 month from the first injection. There were varying development of tractional retinal detachments in two of the eyes, but the ROP component quieted in all cases. Conclusion: Off-label use of intravitreal bevacizumab with peripheral retinal cryotherapy appears to be useful as a treatment for posterior ROP when laser treatment is precluded. It improves dilatation, regressing and quiescent the disease and improves visibility.

Mohamed Mostafa Kamel Diab has completed his PhD from Ain Shams University and Postdoctoral studies from Ain Shams University School of Medicine, Cairo, Egypt. He is a Professor of Ophthalmology, Ain Shams University, Cairo, Egypt and Consultant Ophthalmology Magrabi Hospital, KSA. He has published 16 international papers in reputed ophthalmology journals.

Introduction: Vertical rectus transposition (VRT) is useful in Duane syndrome and abducens palsy. However, many clinicians avoid transpositions due to the risk of induced vertical deviations and over-corrections. Objective: Posterior fixation sutures enhance the effect of VRT, but preclude the use of adjustable sutures. An adjustable augmented VRT with or without ciliary vessel-sparing is described. Methods: Partial or full tendon VRT augmented by resection of the transposed muscles. Ciliary vessels were preserved by either splitting the transposed muscle or by dragging the transposed muscle without disrupting the muscle insertion. Results: Six patients with abducens palsy and one with eso-Duane syndrome were included. Mean follow up was 2.2±2.2 months. Resection of 3-5 mm was performed in all patients. Pre-operative central gaze esotropia of 32.6±12.6 PD (range, 18-50) decreased to 8.7±7.4 PD (range, 0-18) at the final visit (p=0.002). Two patients required post-operative adjustment with recession of one of the transposed muscles due to an induced vertical deviation with overcorrection. At the final visit, one patient had a vertical deviation & lt; 4 PD and none had overcorrection or anterior segment ischemia. Conclusion: Augmentation of VRT by resection of the transposed muscles can be performed with adjustable sutures and vessel-sparing technique. This allows for postoperative control of overcorrection and induced vertical deviation as well as less risk of anterior ischemia.

Introduction: Architecture of the extraocular muscles and pulleys revealed two distinct muscle layers seen on the transverse histopathological cross section. The peripheral layer is closest to the orbital wall and is called the orbital layer (OL). The inner layer is closest to the globe and is called the global layer (GL). Objective: To compare ocular motility after sole extraocular muscle disinsertion and after both extraocular muscle with extensive orbital connective tissue disinsertion during surgery under peribulbar sensorimotor differential blocking anesthesia by 0.25% lidocaine or 0.2% Ropivacaine and to correlate that with surgical outcome. Methods: 210 Eyes subject to various strabismus surgeries. The patients were divided at first into two groups. Group 1 was exposed to 0.2% Ropivacaine and Group-II was blocked by0.25% lidocaine. Patients were further sub divided into two sub groups; Group A 105 eyes included muscles subject only to sole scleral disinsertion of extraocular muscle. Group B 105 eyes included muscles subject to scleral disinsertion in addition to complete extensive dissection and cutting of the surrounding orbital connective tissue and intermuscular membranes. We estimated ocular motility and active force generation test in both group. Results: Patients receiving anesthesia using Ropivacaine had shown better blockage than those who received lidocain, as limitations of eye movement were more with lidocain than with ropivacain. Ocular motility in group A of 82 (78.09%) of all muscles was normal while for 21 (20%) muscles eye movement was reduced after disinsertion but only two rectus muscles 2 (1.91%) showing complete loss ocular motility. Ocular motility and force generation muscle strength in group B were markedly decreased 17 (16.19%) up to lost 88 (83.81%) and statistically significantly in comparable to group A. Postoperative residual and recurrent strabismus was higher and statistically significant in Group A. Conclusion: Complete disinsertion of the fibromuscular orbital connective tissues surrounding the extraocular muscle during surgery is recommended and may prevent the unexpected under correction following strabismus surgery.