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

Biography:

Jasmine H Francis MD is an attending surgeon on the Ophthalmic Oncology Service at Memorial Sloan Kettering Cancer Center, which has one of the highest volume retinoblastoma centers in the world lead by Dr. David H. Abramson MD. She has published more than 40 papers in peer-reviewed journals predominantly on the subject of retinoblastoma. She was voted one of the top 40 under 40 eye doctors by The Ophthalmologist.

Abstract:

Up until a decade ago, there was inadequate treatment for vitroeus seeds in retinobalstoma and most of these eyes came to enucleation. However, with the increased use of both intra-arterial and intra-vitreal chemotherapy, the ocular survival rate for these eye is now greater than 95%. As we salvage more of these eyes, our understanding of vitreous seeds has also improved greatly. Our group has previously proposed a classification system for vitreous seeds, which predicts response to and drug requirements for intra-vitreal melphalan. Furthermore, there are particular tumor, eye and patient characteristics that also correspond with the vitreous seeds classification. We, our recent advancements over the past decade and particularly the last two years, not only has our treatment of vitreous seeds in retinoblastoma greatly improved, but so has our understanding of this disease entity.

Biography:

Dr. Lieberman received her medical training at SUNY Downstate in New York, where she also completed her ophthalmology residency. She then went on to complete a 2 year surgical retina fellowship at Mount Sinai Medical Center, in New York. She is the Director of Medical Retina Services for the Queens Hospital Network, an HHC affiliate. She has published extensively, participated in clinical trials and is involved in the training of ophthalmology residents in the HHC and at Mt. Sinai Medical Center.

Abstract:

Bevacizumab (Avastin®, Genentech, San Francisco, Ca) is a recombinant humanized monoclonal antibody that blocks angiogenesis by inhibiting vascular endothelial growth factor A (VEGF-A). It has been used successfully in the treatment of macular degeneration, diabetic macular edema and proliferative retinopathy and other retinal vascular diseases. It has been shown to be effective and safe in the treatment of specific stages of retinopathy of prematurity (ROP). The purpose of this talk is to compare and contrast intra-vitreal injection of bevacizumab with laser treatment, the current standard of care of care, and discuss the evolving treatment options in this disease. A number of multi center based studies will be discussed, including Early Treatment for Retinopathy of Prematurity (ETROP) and Bevacizumab Eliminates the Angiogenic Threat of Retinopathy of Prematurity [BEAT-ROP], as well as a recent meta analysis on the subject. In addition, our personal experience over a number of years at 2 large centers in New York will be included. Treatment algorithms will be included.

Biography:

Pedro Mattar MD is a Consultant of Pediatric Ophthalmology at Strabismus Division at King Khaled Eye Specialist Hospital in Saudi Arabia. He is a Pediatric Ophthalmology Fellow at University of Colorado, Denver, USA. He completed Ophthalmology course from A.V.A.O, Venezuela and Medicine from Universidad Central de Venezuela. His associations include, American Association of Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Venezuelan Society Ophthalmology, Pan American Association of Ophthalmology, Latin-American Pediatric Ophthalmology Society and Pan American Society of Retinopathy of Prematurity.

Abstract:

Retinopathy of prematurity (ROP) in Venezuela has become the first cause of childhood blindness because of the high incidence of preterm births and poor oxygen control in the neonatal units. Venezuelan screening guidelines are: Infants < or = 1750 grs and < or = 35 weeks of gestation. The first exam should be done on the fourth week of life. Treatment follows the CRYO-ROP and ET-ROP criteria. Diode laser photo-ablation and anti-VEGF intra-vitreal injections are the treatments of choice in ROP. Variation in anesthesia, the risk of neurodevelopmental disorders associated with general anesthesia in small babies and developmental changes in preterm infants in responses to pain has been reported. A total of 103 babies with ROP who received Diode Laser Photocoagulation (93 patients) and intra-vitreal injections of anti-VEGF (10 patients) under topical anesthesia and suction of a pacifier with fructose were evaluate under the Premature Infant Pain Profile (PIPP). In the Laser group 64% presented moderate pain and 36% minimal pain. In the intra-vitreal injection groups all of then presented minimal pain. Topical anesthesia with no sedation and suction of a pacifier with fructose is a safe and effective anesthetic technique for treatment in infants with ROP.

Biography:

Coming soon

Abstract:

Purpose: To study prevalence, pattern and associated comorbidities of ROP in high risk neonates in India. To study efficacy of internationally used online monitoring system called WINROP developed by Sahlgrenska Center for Pediatric Ophthalmology Research; Sweden, in Indian population. Methods: Retrospective analysis of 665 high risk neonates for ROP who were screened at Vanivilas Hospital during study periodbetween 02/01/14 to 25/04/15 was done.Study conductedaccording to guidelines issued by American Academy Of Pediatrics (AAP) 2011 .The inclusion criteria was infants withBW less than 1500 g or GA 30 weeks or less, infants with BWbetween 1500 and 2000 g or GA more than 30 weeks with anunstable clinical course that was considered to place them at high risk for ROP. Same babies were also analyzed by WINROP software. Inthis study, the simplified version of WINROP analysis withpostnatal weight gain alone was used. For analysis, infants were classified into 2 groups: No alarm group: unlikely to develop ROP and infants not satisfying inclusion criteria. Alarm group: at risk for developing ROP Results: Among 611 babies screened by American Academy of Pediatrics guidelines 2011, Non pre threshold ROP developedin 35 babies (58.3%),Type 1 ROP in 22 babies (36.6%)and type 2ROP in 2 babies (3.3%).Single baby developed type 1 ROP in right eye and non Pre-threshold ROP in left eye. Among 60 ROP neonates, Respiratory Distress Syndrome (p-value=0.0001) diagnosed in 35, Anemia of prematurity (p-value=0.001) diagnosed in 13, malnutrition (p-value=0.0001) diagnosed in 16 neonates. Among the 60 ROP neonates, 9 underwent blood transfusion (p-value=0.0001). Pregnancy Induced Hypertension was significant maternal co-morbidity in ROP neonates. Hypoxic Ischemic Encephalopathy, Late Onset Sepsis, Pre-Mature Rupture of Membranes and Birth Asphyxia, Intra Uterine Growth Retardation, Patent Ductus Arteriosus and Hydrocephalus were found insignificant co-morbidities. In WINROP assessment, among 611 babies only 30 received alarm. 26 babies fell in low risk alarm group and 14 babies in high risk alarm group. Among High Risk Alarm group, 3 received alarm on week 30, 8recivedalaram on week 31 and 3 received on week 32. Conclusion: Prevalence of ROP in our study according to AAP guidelines (9.8%) was lower than range reported in other developing countries. Malnutrition, Respiratory Distress, Blood Transfusion and Anemia of Prematurity were significant co-morbidities in Indian ROP neonates. WINROP software could detect only half the ROP babies, hence can only be used as accessory tool but not as alternative for ROP screening in Indian babies.

Biography:

Pavel Pochop has completed his PhD in the year 2012 and in the year 2015 he became Associate Professor at Charles University in Prague. He has published more than 20 papers in reputed journals not only in Czech Republic, but also in other European countries and in United States.

Abstract:

Background: Treatment of retinal capillary hemangioma (RCH) can be complicated. Choice of treatment depends on tumor size, tumor location and any associated findings. Treatment of RCH using infrared laser is a very recent treatment option. Aim: Presentation of RCH treatment results using infrared laser from the Department of Ophthalmology for Children and Adults, 2nd Faculty of Medicine of Charles University and Motol University Hospital (1998-2014). Design: Non-comparative, prospective, interventional case series. Participants: The treatment and follow-up of eight eyes (eleven tumors of different size and localization) in six patients (four children) with RCH. Methods: Infrared diode laser was used at 810 nm and power between 200 and 1100mW with a beam diameter of 2 mm (indirect ophthalmoscope, +28 D or +40 D lens) or 0.5 mm-3 mm (slit-lamp) depending on the diameter of the hemangioma, with 1 minute of exposure time. Results: We achieved complete destruction of the tumor with flat chorioatrophic scar in all cases. Only one tumor regrowth was observed and another treatment in this case was necessary. There was one serious complication, total retinal detachment, causing deterioration in visual acuity. Other complications like haze and bleeding were transient. Final visual acuity ranged from 20/20 to counting fingers at 2 feet. Conclusions: Infrared laser can be considered an acceptable therapeutic option for RCH especially for centrally localized lesions. We believe that the role of this therapy will increase in the future.

Biography:

Huseyin Yetik graduated from Istanbul University Istanbul School of Medicine in 1996 and completed his ophthalmology residency program in 2000 in Istanbul University Cerrahpasa School of Medicine. He became Associate Professorship in 2006 and full professor in 2014 in Cerrahpasa. He worked in several governmental and private hospitals as academician including Goztepe Educational Hospital, Zeynep-Kamil Educational Hospital, Yeditepe University School of Medicine, Memorial Health Group. He worked in Azerbaijan, Albania, Kazakhstan as academican and vitreoretinal consultant. He is still professor in Istanbul University Cerrahpasa School of Medicine and vitreoretinal consultant and chief of ophthalmology department of Surp Pırgic Armenian Foundation Hospital which is the one of main Armenian Foundations in world as well as he is still chief vitreoretinal consultant surgeon of 15 private hospitals in Istanbul, Turkey. He is a member of American Academy of Ophthalmology, American Association of Retina Specialist, European Retina Society (EURETINA) and Turkish Ophthalmology Society.

Abstract:

Retinopathy of prematurity (ROP) is a leading cause of child- hood blindness in developing and developed countries. CRYO-ROP (Cryotherapy for ROP) and ETROP (Early Treatment of ROP) studies demonstrated various successful outcomes after peripheral thermoablation (cryo/laser) of avascular retina. Cryo-ablation was successful in 75 % of the cases in the CRYO-ROP Study. After the cryo era, even with high success rates of up to 98 % depending upon the severity of the disease, laser was not effective, particularly in zone I and aggressive posterior ROP (APROP) cases. Research data demonstrated the role of vascular endothelial growth factor (VEGF) in the pathogenesis of ROP, and anti-VEGF treatments were developed as another therapeutic option. It seems that anti-VEGF treatment is about to become the gold standard in ROP management. Despite an ongoing debate about the possible systemic adverse effects, clinical practice of intravitreal anti-VEGF (bevacizumab) injection demonstrated a better systemic clinical course in all premature babies without any exception besides dramatically successful results for ROP. Those results were able to give some clue about a possible one pathogenic mechanism for all morbidities including intracranial hemorrhage and associated cerebral complications, bronchopulmonary dysplasia (BPD), necrotizing enterocolitis (NEC) and ROP. Details of this possible pathogenesis will be discussed in this lecture.

Biography:

Abstract:

Background: Current techniques used in strabismus surgery are associated with a considerable injury caused to eye tissues. Thus the development of alternative tissue-sparing techniques is very much relevant. Here we present a minimal invasive surgery technique that involves the use of high-frequency radio-wave knife to cut eye tissues. Our study demonstrated that the use of this technique decreases the post-operative edema, hyperemia and scarring processes and reduces patients’ overall rehabilitation time. Introduction: Minimal invasive surgery technique is attracting increasingly more attention in strabismus surgery. An injury caused to ocular muscles is a result of manipulations on connective and covering tissues of the eye. These manipulations lead to post-operative edema and tissue scarring. A complete uncovering of the muscle tissue and its surgical detachment from the sclera cause a vascularization disorder not only in the muscle itself but also in the vascular pools of the corresponding ciliary arteries. Thus, the development of tissue preserving and minimal invasive surgery techniques is very much relevant. We have developed a technique that uses high-frequency radio-wave knife, which allows to preserve the eye’s covering tissues and vessels, significantly reduce the injury caused to muscle during surgery and dose the surgery with maximal accuracy. An increase in precision of strabismus surgery is also achieved by using a mathematical model for esotropia surgery dosage that we have developed. This model was presented by our group at ESA 2011 and AAPOS 2012 and includes 4 anthropometric parameters of patients’ eyes needed for the dosage: strabismus angle, refractive error, axial length and inter-pupillary distance. Methods: A retrospective study was conducted on almost 2500 patients. 1500 patients were treated with conventional surgery method and 1000 patients - with our minimal invasive surgery technique. Two groups were compared by the following criteria: Conjunctival and eyelid edema, hyperemia and post-operative rehabilitation time. We used a high frequency 10 micronradio-wave knife to cut through covering and muscle tissues of the eye. The use of this knife allows making very precise cuts, coagulating the vessels and sterilizing the wound at the same time. Vessel coagulation with radio-wave knife reduces the hemorrhage and reduces the soaking of tissues with blood. The cut is made in such a way that connective tissues covering muscles are preserved, which allows minimizing the scarring process. In our surgeries we use vicryl 7/0 and a silicon protector on a hook for extra tissue preservation. The strengthening of the muscle is achieved by tucking the muscle, without excising it from the eyeball, preserving vessels, nerves and connective tissues of the muscle. The sutures are passed through the muscle and the sclera in such a way that the tuck is equally distributed under the muscle. While conducting a strengthening surgery we also suggest using a fixating suture, which will help sink the tuck beneath the muscle. Results: Our proposed method allows reducing post-operative tissue edema and hyperemia in more than 95% of cases. Also, we reduced the rehabilitation time to up to 7 days in 60% of cases and in 30% of cases patients were able to attend school after 3 days. Discussion: Overall this investigation has demonstrated that a significant reduction in hyperemia and tissue edema post-operatively can be achieved with our minimal invasive surgery technique. Additionally, the rehabilitation time was reduced significantly, while the scarring process was reduced to minimum and the vessels were preserved. Additional steps should be taken to help reduce the post-operative tissue injury and increase surgery precision even further.

Biography:

Sorath Noorani Siddiqui is an Associate Professor of Ophthalmology, a consultant pediatric ophthalmologist and the chief of the department of Pediatric Ophthalmology, Al Shifa Trust Eye Hospital, Rawalpindi, Pakistan Institute of Ophthalmology. She did her fellowship in general ophthalmology from the College of physicians and Surgeons Pakistan. She also earned her second fellowship in Pediatric Ophthalmology from McGill University, Canada. She is the Director of the Pediatric Ophthalmology fellowship program accredited by the College of Physicians and Surgeons Pakistan. She has published more than 28 papers in reputed journals and serves as a Member of the Editorial Board of reputed journals. She received a bronze medal in medical college. She also received a gold medal for the best paper presentation in the Ophthalmology Society of Pakistan meeting in 2014. Ophthalmology Society of Pakistan has awarded her gold medal for her professional achievements. The medal was awarded at the national meeting of the ophthalmology society of Pakistan on 4th December 2015 at Lahore Pakistan.

Abstract:

Retinoblastoma is a global problem affecting many children worldwide. It is the most common intraocular malignancy in children and leads to death if not treated. In high income countries, the goal of treatment is eye and vision preservation while lifesaving is the main goal in low income countries. There are obvious differences in globe survival between developed and developing countries. The most important factor responsible for this difference is the late presentation of the disease/delay in diagnosis in developing countries. At our tertiary eye care center, 217 eyes of 158 children were diagnosed with retinoblastoma in the last four years. Group-A was 0.9%, group-B 16.1%, group-C 4.1%, group-D 9.2% and group E in 70% eyes at first presentation. Globe salvage was not possible in 165 (76.03%) out of 217 eyes due to advanced disease at the time of first presentation. In our set up, reasons for delay in diagnosis are the unavailability of a screening program and health insurance facilities, lack of awareness, refusal for treatment due to greater trust on alternative medicines and spiritual therapies, socioeconomic factors, and the unavailability of treatment facilities close to home and long journeys .In developed countries , besides a good health care system, the modern technique of intra-arterial chemotherapy has resulted in an improved globe survival in children with advanced intraocular involvement. Enucleation is still widely performed in developing countries due to late presentation and the unavailability of intra-arterial chemotherapy. More children could be cured globally by increasing the capacity for the modern technique of intra-arterial chemotherapy in developing countries.

Biography:

Caroline Mvilongo Tsimi has completed 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.

Abstract:

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 centrafican 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.

Biography:

Farzana Afzal is the Lecturer at Faculty of Medicine at AIMST University, Malaysia. She accomplished F.C.P.S (Fellow of College of Physicians and Surgeons, Bangladesh) and M.C.P.S (Member of College of Physicians and Surgeons, Bangladesh) in Ophthalmology as well as she has 4 years professional training on phthalmology. Furthermore, she also passed Basic Science, Theoretical Optics & Refraction and Clinical Science Examination under International Council of Ophthalmology (ICO), London, UK. In addition, She has more than 5 years teaching experiences. It is noted that she completed Basic degree (M.B.B.S) from Bangladesh Medical College under Dhaka University, Bangladesh. She also registered with Bangladesh Medical and Dental Council (BMDC) as Medical Practitioner since November 2008. She joined many international and local conferences/seminars; however, she published 8 research papers at international conference proceedings and reputed journals. Recently, she published two books from LAP, Germany. Her research interests are Cataract, Refraction, UVEA, etc. She is the member of International Council of Ophthalmology (ICO), Ophthalmological Society of Bangladesh (OSB), Malaysian Society of Ophthalmology (MSO), Asia-Pacific Association of Cataract & Refractive Surgeons (APACRS), and so on.

Abstract:

Purpose: This is a comparative study that illustrates the management of childhood cataract and compares the post-operative complication and visual outcome between aphakic and pseudophakic patient group. Materials & Method: It consists of primary and secondary data which was experimented on 250 eyes with cataract of 160 children in Bangladesh within the period of January 2012 to January 2014. In patients up to 8 years, irrigation and aspiration, including primary posterior capsular rhexis with anterior vitrectomy were done. However, after 8 years, I/A were done without PPC and AV. Consequently, all were evaluated and followed up for 1 year. Result: The most common postoperative complication is posterior capsular opacity which was observed in 22 (49%) pseudophakic eye below 1 year and 30 (25%) pseudophakic eye after 1 year of age. The final visual acuity of 82% bilateral and 53% unilateral pseudophakic patient reached 6/60 or better whereas only 50% of bilateral and 32% unilateral aphakic patient’s visual acuity reached to the same level with spectacle or contact lens correction. Conclusion: Primary intraocular lens implantation after childhood cataract surgery definitely results in better visual acuity compared to aphakia. Nevertheless, careful planning and improved technique must be taken to implant IOL especially in younger children because younger eyes are more prone to have serious postoperative complication requiring reoperation. Furthermore, proper postoperative care and regular follow-up are also significant part of childhood cataract management. This paper would unlock further frontiers for prospective researchers in this area and contribute to eradicate the curse of childhood blindness from all over the world.

Biography:

Olga Alvarez-Bulnes has completed her PhD from Universitat Autònoma de Barcelona and a Pediatric Ophthalmology Fellowship at Great Ormond Street Hospital. She is Pediatric Ophthamologist at Fundació Hospital de nens de Barcelona.

Abstract:

Introduction: Gestational diabetes mellitus (GDM) develops in 1-3% of pregnancies. GDM is associated with adverse health outcomes for both mother and newborns. Regarding, children born from a GDM pregnancy, there is association to disturbances of intrauterine growth, congenital anomalies (cardiovascular congenital abnormalities, isolated renal a/dysgenesis, obstructive defects of the urinary tracts, cryptorchidism, shoulder dystocia, esophageal atresia) as well as post-natal neurobehavioral disorders. But after a search through PubMed, we only found one work on how GDM could affect the eyes of these children. Ricci et al., describe changes in the iris vessels and stroma that resolved spontaneously within 2weeks.
Methods: We conducted an observational study among children who attended the outpatients’ ophthalmology clinic in our hospital from January 2011 to December 2015. We divide the study patients into three groups: A (GDM controlled with diet), B (GDM controlled with insulin), C (control, no GDM). We review the notes collecting information on refraction, ophthalmologic pathology and/or congenital ocular malformations.
Results: So far, we have collected date from 217 children (planning to reach about 350 by the end of December). Partial results show similar results in strabismus rate among the three groups. But there seems to be an increase in the rate of ametropia in those children born to a GDM mother, who controlled glycemia with diet and there is an increase in the rate of amblyopia in both diet and insulin treated patients compared to control group.
Conclusion: These results would show a need to refer children born to GDM pregnancies to the ophthalmology department as ametropia and amblyopia can interfere normal acquisition of fine skills as well as academic achievements and can also easily be treated and corrected if detected.

Biography:

Enrique Suarez graduated as Medical Doctor from Universidad de Los Andes. He obtained Internship and Ophthalmology Residency at Military Hospital (Caracas, Venezuela) and Cornea, External Diseases and Anterior Segment Fellowship with Dr. Herbert Kaufman at Louisiana State University (USA). He is the Head of Cornea Division at Military Hospital, Director of Cataract and Refractive Surgery & Clinic Ophthalmology Service at Centro Medico Docente La Trinidad Private Foundation (Caracas, Venezuela) for 20 years. Currently, he is the Senior Academic Consultant at King Khaled Eye Specialists Hospital (Riyadh, Saudi Arabia). He has over 40 publications in his credit and presented 450 lectures in international meetings. He also serves as the Board of Directors of International Ophthalmological Societies and Editorial Board Member of Ophthalmological Journals.

Abstract:

The major concerns in pediatric keratoconus comprise of the accelerated progression of the disease in the pediatric age group and management of co-morbidities such as allergic or vernal kerato-conjuntivitis. In Saudi Arabia, adverse environmental conditions, hereditary factors and consanguinity contribute frequently to visual impairment in pediatric patients due to Corneal Ectasia. The traditional treatment alternatives of visual rehabilitation such as spectacles, contacts lenses and keratoplasty (lamellar or penetrating) are more difficult to achieve in pediatric cases. Corneal collagen crosslinking (CXL) has been successfully utilized for more than a decade in adult patients halting or slowing the progression of the disease and more recently in pediatric keratoconus. It seems quite reasonable to treat not only eyes that demonstrate rapidly progressive keratoconus with corneal collagen crosslinking, but also those pediatric or adolescent eyes without documented progression of keratoconus before the disease potentially worsens. If longer-term follow-up demonstrates continued efficacy and more important, continued safety of this procedure, treating eyes with keratoconus before evidence of definite progression might become the standard of care.

Biography:

Arturo Maldonado-Junyent is a Medical doctor and surgeon, graduated from the National University of Cordoba, Argentina, specialist and master in ophthalmology. He is head of the anterior segment department of the Clinica de Ojos Maldonado Bas in Córdoba, Argentina. He is also Assistant Professor of the Postgraduate specialization in Ophthalmology in the Catholic University of Córdoba and Director of the Postgraduate in Ophthalmology of the Ophthalmology Society of Córdoba, Argentina.

Abstract:

Introduction: This paper analyzes the options of early or late cataract surgery in children with the implantation of different types of intraocular lenses. Development: Because the change of the ocular structure produces very significant variations in the child’s refraction, especially in the first 3 years of life, we analyzed the options of cataract surgery with primary intraocular lens implants. Among the alternatives we used, according to the patient's age, the piggy back lens implant technique, which allows us to later remove one of the lenses when the child has passed the stage of greater refractive changes, is our choice in children under one year of age. Then we can use monofocal lenses in children between one and three years of age, and multifocal lenses in those over three years. In both cases, the lens is implanted in the capsular bag. Conclusion: We believe the primary implantation of the intraocular lens important in order to decrease the degree of amblyopia. Depending on the different lens options, a better forecast can be achieved for refraction in adulthood, with consequent better quality of life.

Biography:

Professor Mohamed Mostafa Kamel Diab has completed his Ph.D. at age of 29 years from Ain Shams University and postdoctoral studies from Ain shams university school of medicine Cairo Egypt. He is professor of ophthalmology Ain shams university Cairo Egypt and consultant ophthalmology Magrabi hospital KSA. He has published 16 international papers in reputed ophthalmology journals.

Abstract:

Purpose: Based on Herring's law of equal innervations to the yoke muscles, this study aims at comparing the anatomical outcome following sound eye surgery versus amblyopic eye surgery for correction of unilateral sensory strabismus in adult patients. Patients & Methods: A prospective study that included 148 adult patients with unilateral sensory strabismus (50 prism Diopters) and amblyopia. Patients were randomly allocated between two groups: Group-A included patients subjected to surgery in the sound eye only, and group B included patients subjected to surgery in amblyopic eye only. Patients were followed-up for at least 6 months to detect the anatomical success rate as well as any residual, consecutive or recurrent strabismus. Results: After a mean follow up period of 7.68±1.93 months in group A, 61 patients (82.4%) had orthotropia, two patients (2.7%) had residual strabismus, 8 patients (10.8%) showed consecutive overcorrection, and three patients (4.1%) had recurrent strabismus. In group B and after a mean follow-up period of 7.24±1.72 months, 49 patients (66.2%) had orthotropia, 3 patients (4.1%) had residual strabismus, 9 patients (12.2%) had consecutive overcorrection, and lastly thirteen patients (17.6%) had recurrent strabismus. The differences between the results of both groups were statistically significant (p<0.05) only in the patients who achieved orthotropia and those with recurrent strabismus. Conclusion: For unilateral sensory strabismus and amblyopia in adults, sound eye surgery could give a higher success rate with a lower chance for recurrence at six months, as compared to amblyopic eye surgery.

Biography:

Pedro Mattar MD is a Consultant of Pediatric Ophthalmology at Strabismus Division at King Khaled Eye Specialist Hospital in Saudi Arabia. He is a Pediatric Ophthalmology Fellow at University of Colorado, Denver, USA. He completed Ophthalmology course from A.V.A.O, Venezuela and Medicine from Universidad Central de Venezuela. His associations include, American Association of Pediatric Ophthalmology and Strabismus, American Society of Cataract and Refractive Surgery, Venezuelan Society Ophthalmology, Pan American Association of Ophthalmology, Latin-American Pediatric Ophthalmology Society and Pan American Society of Retinopathy of Prematurity.

Abstract:

Pediatric cataracts are one of the most important causes of preventable and treatable blindness in children. The eye of the child is not a small adult eye; it is in constant growing, has the risk of amblyopia and has an aggressive inflammation response to any surgical intervention. We present in videos, different tips to avoid and to treat complications during pediatric cataract surgery.

Biography:

Aygun Nabiyeva is a Pediatric Ophthalmologist at Briz-L Eye Clinic in Baku, Azerbaijan. She graduated as Medical Doctor from Azerbaijan Medical University and completed her Internship at National Eye Center (Baku, Azerbaijan). She is a member of Turkish Ophthalmology Society (TOS). She previously presented in National Congresses of TOS and participated in American Academy of Ophthalmology as Rotary Guest.

Abstract:

Congenital cataract is one of the major causes of visual deprivation in pediatric population due to factors like need of early surgery, risk of amblyopia development, demanding surgical skills due to small dimension of infant eye with a small capsular bag, decreased scleral rigidity. Both surgical aphakia and cataract are equally amblyogenic if not corrected in time. Various modalities like spectacle, contact lens, and primary IOL implantation are available for correction of aphasia. Nowadays primary IOL implantation has been widely used with favorable results in children older than two years; however, there are problems such as difficulty in selecting the appropriate dioptric power of the IOL, due to early phase of rapid eye growth in children less than 2 year. Also, current theoretical and regression intraocular lens power prediction formulas are largely based on adult eyes at axial lengths, anterior chamber depth, and keratometric values much different than those seen in infants. The small dimension of infant eye, and increased tissue reactivity leading to excessive postoperative inflammation make IOL implantation technically more difficult in these patients. With the invent of microsurgical techniques, instrumentation and increasing evidence of successful primary intraocular lens implantation in first two years of life, this appears to be new ray of hope in patients with congenital cataract. The aim of the present study was to evaluate outcome of primary IOL implantation in the first 2 years of life.

Biography:

Marcelo C Ventura was graduated from the Medical School of the University of Pernambuco, in Recife, Brazil and completed his Residency training at the Santa Casa de Misericórdiain São Paulo, Brazil. He has completed his Fellowship training in Retina and Cataract Surgery at the University of Puerto Rico. He has also obtained his Master and PhD degrees at the Federal University of São Paulo. He is the Co-Founder and CEO of the Altino Ventura Foundation and Co-Founder and Member of the Board of Directors of the HOPE Hospital, both in Recife, Brazil. He is also the past President of the Latin American Society of Cataract and Refractive Surgeons and of the Brazilian Cataract Society.

Abstract:

Congenital cataract is an important cause of reversible blindness in childhood. Early diagnosis and surgery, adequate refractive error correction, and aggressive amblyopia management improve these patients’ visual prognosis. However, early cataract surgery is associated with greater risk of complications, possibly due to the enhanced inflammatory response and the more reactive vitreous face in children. The use of corticosteroids for modulating postoperative ocular inflammation was established decades ago. Topical and systemic corticosteroid administration results in effective intraocular concentrations. However, they do not maintain long adequate concentrations of the drug in the aqueous humor, which is compensated by frequent doses in the postoperative period. This, in turn, increases the risk of adverse events. Moreover, caregivers do not always adhere to the instructions for administering drugs postoperatively, a scenario favoring complications that may compromise the visual prognosis. In contrast, intraocular injection of corticosteroid delivers an adequate and sustained quantity of the drug to the target tissue. Triamcinolone acetonide is a deposit corticosteroid with low water solubility, which contributes to its prolonged action. It has been increasingly used in ophthalmology as a vitreous dye in children and adults, as well as to modulate intraocular inflammation after phacoemulsification in adults. However, its use is not exempt of risks. Thus, we conducted a series of studies to investigate and compare the use of intracameral triamcinolone at the end of the procedure versus the conventional use of postoperative oral prednisolone for modulating intraocular inflammation in children that undergo congenital cataract surgery younger than 2 years of age.

Biography:

Marcelo C Ventura was graduated from the Medical School of the University of Pernambuco, in Recife, Brazil and completed his Residency training at the Santa Casa de Misericórdiain São Paulo, Brazil. He has completed his Fellowship training in Retina and Cataract Surgery at the University of Puerto Rico. He has also obtained his Master and PhD degrees at the Federal University of São Paulo. He is the Co-Founder and CEO of the Altino Ventura Foundation and Co-Founder and Member of the Board of Directors of the HOPE Hospital, both in Recife, Brazil. He is also the past President of the Latin American Society of Cataract and Refractive Surgeons and of the Brazilian Cataract Society.

Abstract:

Ectopialentis encompasses any displacement or mal-position of the crystalline lens irrespective of the cause or association. Lens subluxation can be congenital, acquired or due to developmental conditions, such as Marfan syndrome. The surgical management of ectopialentis is a challenging situation. The Ventura technique involves inserting an endocapsular tension ring and partly amputating one of the intraocular lens’ (IOL) haptics in order for the IOL’s optic to be centered in the visual axis after lens placement in the bag, without stressing the residual zonules. In the postoperative follow-up, minimal phacoiridodonesis is seen and the lens optic maintains centered in the visual axis. The use of the femtosecond laser associated with the Ventura technique facilitates the confection of the capsulotomy and enables the surgeon to decrease the residual astigmatism by making relaxing incisions.

Biography:

Amrita Verma completed her graduation (MBBS) and post-graduation (MS- ophthalmology) from Himalayan Institute of Medical Sciences, Dehradun, India. She then went on to do her fellowship in vitreo-retina from Dr Nagpal’s retina foundation. Her FICO training is from LMU University, Munich, Germany. She has presented papers in a number of conferences and has international publications to her credit. She is actively involved in ophthalmic social services. She is an accomplished retinal surgeon and is presently a consultant for vitreo-retina services.

Abstract:

The rhegmatogenous retinal detachments in the pediatric age group is uncommon with an annual incidence of 0.38–0.69 per 100,000, making up only 0.5–8% of all retinal detachments. The median ages of presentation reported are 9–13 years of age. The aetiologies encompass trauma, idiopathic, inherited syndromes associated with high myopia and abnormal vitreous, atopic dermatitis, congenital and developmental abnormalities, retinal vascular diseases and intraocular inflammation. A complete ophthalmic evaluation is preferably done under anesthesia. Full systemic workup by a pediatrician is also often required. The surgery for pediatric detachments is challenging. The rate of retinal reattachment with single intervention is considerably low at 50–80%. Visual outcomes are also worse in children with most series showing only 30–40% of patients reaching a final acuity of 20/200–20/400. Patients with congenital and developmental abnormalities have worse anatomical and functional outcomes than patients who had no predisposing factor or high myopia. Other risk factors for poor outcome are macular involvement, the presence of PVR, the presence of giant retinal tear, and inability to determine pre-operative acuity. Multiple surgeries are often required. Especially in younger children the importance of refraction and amblyopia therapy cannot be over emphasized. While visual outcomes are poor compared to the adult population, the high rate of bilateral detachments, as well as, the importance of even low levels of vision in these patients mean that the repair of these detachments pose unique challenges to the surgeon and the family.

Biography:

Mario Audie Sasongko earned his Medical degree in Atma Jaya University in Jakarta and finished his Ophthalmology training in Philippines in 2015. Currently, he is working at International SOS Jakarta while preparing to continue his study. Fueled by the growing need of quality eye care for children, he intends to pursue a fellowship in pediatric Ophthalmology.

Abstract:

Objective: To preform a cost benefit analysis of the retinopathy of prematurity (ROP) screening done in the setting of an urban tertiary hospital in comparison to a hypothetical screening based on the Philippine Retinopathy of Prematurity screening guidelines. Methods: The direct cost of ROP screening and treatment was determined by reviewing data retrospectively from infants admitted in Neonatal Intensive Care Unit (NICU) of the Makati Medical Center (MMC). The indirect cost of severe visual impairment was estimated from currently published Philippine economic data. Progression probabilities were estimated based on MMC census and previously published literature. Results: Retinopathy of prematurity screening was found to be cost beneficial with a benefit cost ratio of 38.58. The net benefit, which is the difference of benefit and cost, is estimated at PHP 583,952 (USD 13,166). Conclusion: Screening for retinopathy of prematurity is cost beneficial despite the wide criterion, high costs incurred, and in the setting of an urban tertiary hospital where financing is largely out-of-pocket.

Biography:

Akanksha Prasad has completed her medical training from B.P. Koirala Institute of Health Sciences and Ophthalmology residency at Icare Hospital (National Board of Examinations, New Delhi). She was selected for the prestigious ARVO Developing Country fellowship in 2015. She is a lifetime member of Association of Research and Vision in Ophthalmology (USA). She is interested in eye research and deeply motivated to improve the quality of life of pediatric population in her region.

Abstract:

PURPOSE: To know acceptance of low vision devices (LVD), taking into account the patient’s adjustment to vision loss. METHODS: In our prospective study, 100 low vision patients including children were assessed at a tertiary eye hospital. The prescription and acceptance of LVD were done for distance and near. RESULTS: Retinal disorders comprised the most common cause affecting 61 patients (61%). Distance vision improved by refractive correction in 48 patients (48%).Out of total 44 patients prescribed LVD for distance, 19 patients (19%) were prescribed handheld telescope. 34 patients (34%) prescribed LVD for near improved to 0.8 M. Another 28 patients (28%) improved to 1 M while 10 patients (10%) improved to 1.6 M. Overall 42 patients (42%) were prescribed Spectacle magnifiers of various powers for near vision. Difference in visual acuity before and after LVD for near was significant (Z=8.658, p=0.00). Overall 72 patients (84.7%) had good acceptance, with low vision device prescribed for near as it improved reading/writing skills.10 patients (11.8%) had moderate acceptance while another 3 patients (3.5%) had poor acceptance. CONCLUSION: It was noted that an accurate refraction can help the patient to improve reading skills for day to day work. We also concluded that even though telescopes are absolute vision enhancers, many patients did not purchase LVD prescribed due to cost factor and cosmesis. Thus, we can conclude that majority of children with low vision had good acceptance of the LVD prescribed as it improved reading and writing skills. Low vision is an important socio-economic burden in this region.

Biography:

Muhammad Irfan Karamat, has completed his MBBS from King Edward medical University. He did FCPS (College Of Physicians and Surgeons Of Pakistan) and MRCS (Royal College Of Edinburgh) in age of 30 years. Currently he is doing fellowship in Vitreo-retina from King Edward Medical University. He has published 1 paper in PJO and presented a case in WOC 2012 in Dubai.

Abstract:

A 12 year old male with marfanoid features (Picture 1) presented in our Out patient clinic with painless decreased vision in both eyes. His past ocular history revealed retinal detachment in left eye 5 years ago for which he under went scleral buckling.There is no history of recent trauma or systemic association. Occular examination showed that best corrected visual acuity was 6/60 and 6/36 in right and left eye respecitvely. Intra Ocular Pressure was 10 and 12mmHg. Patient was having corneal diameters of 15mm and 16mm and axial length of 32.4 and 32.6mm. There was dislocation of nucleus in the vitrous cavity bilaterally. Both pupil were constricted,irregular and they could not be dilated with medication. Anterior chamber was deep and quiet. Iris was atrophic and tremulous (picture 2). Fundal examination through the undilated pupil showed a retinal detachment involving the macula in the right eye and a sclearl band intruding into the globe superonasally with adhesions at the sight of band intrusion (Picture 3,4). B- scan revealed an intact, quite globe with band intrusion superiorly and dropped nucleus in the vitreous cavity in left eye. Patient’s systemic evalution was done to rule out any association. General physical examination showed that patient was tall, and thin with significantelly broad horizantal arm span (Picture 1). Homocystein levels were within normal limits.There was no arotic disection or M.V prolapse on chest X ray and Echocardiography. He underwent right eye scleral buckling along with dropped nucleus removal and pars plana vitrectomy. Laser was applied to the retina at 1st post operative week. We did not plan any surgery for left eye as the eye was quite and chances of globe rupture were very high. Patient was advised a close follow up for both eyes. He developed silicon oil induced raised intra-ocular pressure in right eye which was managed conservatively. After 5 years of follow up, patient again developed retinal detachment in left eye for which he under went vitrectomy with oil without cutting the intruded band.currently,(8 weeks since surgery) his retina is attached.

Biography:

Shu Yi has completed her Master’s degree in Ophthalmology from Chong Qing Medical University, China. She is an attending Doctor of the People’s Hospital of Chong Qing China, who is interested in control of myopia for children. She has published almost 6 papers in international and Chinese journals. She had studied for 3 months in the department of ophthalmology, the affiliated hospital of Rostock university, Germany, in 2015.

Abstract:

Purpose: To evaluate the efficacy of topical atropine 1% in promoting unaided visual acuity, reducing myopia, and slowing the progression of ocular axial elongation in Chinese children with low myopia. Methods: Children with low myopia were randomly assigned to one of two groups, receiving either atropine 1% (treatment group) or placebo eyedrops (control group) once nightly for 1 year. After instillation of 3 drops of cyclopentolate 1%, unaided visual acuity, cycloplegic refraction, and ocular axial length were tested and recorded at baseline (2 weeks after atropine or vehicle eyedrops), 3 months, 6 months, 9 months and 1 year. Results: A total of 132 children 7-12 years of age with a refractive error of spherical equivalent -0.50 D to -2.00 D were included. After 1 year, the mean unaided visual acuity in the treatment group was 0.31±0.16 logMAR; in the control group, 0.66±0.15 logMAR, (P<0.0001). After treatment for 1 year, there was a decrease of 0.32±0.22 D from baseline in the treatment group and an increase of -0.85±0.31 D in the control group (P<0.0001). The axial elongation in the treatment group was -0.03±0.07 mm; in the control group, 0.32±0.15 mm (P<0.0001). Conclusions: In this study cohort, topical atropine1% reduced the degree of low myopia and slowed the progression of ocular axial elongation in children.