7^th Global Pediatric Ophthalmology Congress March 07-08, 2022 Barcelona, Spain

Biography:

Khalid Shuail Alotaibi has graduated from Dammam University, Saudi Arabia in 2014 and is now currently working as Ophthalmology Resident R4 in Saudi Ophthalmology Program.

Abstract:

Background: Botulinum toxin is known to have a powerful chemo denervation effect, and it is a well-established alternative to incisional surgery for strabismus. This study aims to investigate the efficacy of dose increments of Botulinum Toxin A (BTA) for the treatment of specific ranges of angle deviation.

Methods: This was a prospective study that included patients presenting with esotropia to Dhahran Eye Specialist Hospital between 2016 and 2020, who were managed by a single surgeon. Botulinum toxin was given in different dosages (2.5, 5, 7.5, 10 international units (IU)) according to the size of deviation (11–19, 20–29, 30–39, and ≥40 prism diopters (PD)), respectively. A successful outcome was defined as deviation ≤10 PD in the last visit (a minimum of 6 months) following a single injection.

Results: A total of 56 patients with esotropia were included. The mean pre-treatment angle of deviation was 38.6 ± 2.5 PD. BTA injections in a dose of 2.5 IU for the 11–19 PD angle of deviation showed the highest rate of successful outcomes (75%). According to the type of esotropia, partially accommodative esotropia showed the best response to the use of dose increments (59%). The incidence of ptosis post-BTA injection was the least (37.5%) with the smallest dose (2.5 IU).

Conclusion: BTA usage in dose increments is safe, efficient, and might be more cost effective with less incidence of BTA associated complications. Different esotropia diagnoses have different clinical responses. However, larger studies are necessary to better predict the outcome of using dose increments.

Biography:

Mordechai Goldenfeld, MD, is a glaucoma specialist at the Sam Rothenberg Glaucoma Center, Goldschleger Eye Institute, Sheba Medical Center. He received his MD degree from Tel Aviv University and specialized in the treatment of glaucoma at North-western University, Chicago. Goldenfeld served as chairman of the Israeli Glaucoma Society from 2002-2004. He devotes his professional life to treat glaucoma patients, delay the progression of the disease and educate his patients how to cope with the demanding treatment. Awards or Testimonials: 1991 Fight for Sight, The National Society for the Prevention of Blindness - Postgraduate - Fellowship research award: Optic disc analysis using digitized photography and flicker analysis.

Abstract:

Purpose: Direct Selective Laser Trabeculoplasty (DSLT) is a rapid, non-contact automated procedure performed directly through the limbus without gonioscopy. In this first non- randomized clinical trial to assess its safety and ability to reduce Intraocular Pressure (IOP).

Methods: Fifteen patients (15 eyes: 10 with open-angle glaucoma (OAG), 4 with ocular hypertension, and one with pseudoexfoliation glaucoma), naïve or after medication washout, with an IOP ≥22 mmHg, underwent DSLT by irradiation with 100 or 120 sequential non-contact 532 nm, Q- switched laser shots (0.8−1.4 mJ) automatically applied during 1.5 or 2.3 seconds on the limbus, guided by image analysis and eye tracking. Results were assessed at 1 and 3 hours, 1 day, 1 week, and 1, 3, and 6 months.

Results: The mean ± standard deviation baseline IOP (mmHg) in all eyes was 26.7±2.3. At 1, 3, and 6 months, this value was significantly reduced to 21.7±4.2 (by 18.1%), to 20.8±2.5 (by

21.4%), and to 21.5±4.1 (by 18.8%) respectively. In 6 patients treated with 1.4 mJ/shot, the mean IOP at 6 months decreased from 26.7±3.2 to 19.3±2.0 (27.1%, P=0.03). There was a significant reduction in hypotensive medications (from 1.6±1.0 to 0.4±0.7, P=0.03). No serious adverse events occurred.

Conclusions: Automated DSLT appears to be an effective and safe non-contact, rapid modality for reducing IOP in patients with OAG. Higher energy usage led to better results.

Recent Publications

1. Mordechai Goldenfeld, Michael Belkin, Masha Dobkin-Bekman, Zachary Sacks, Sharon Blum Meirovitch, Noa Geffen, Ari Leshno, Alon Skaat. Automated Direct Selective Laser Trabeculoplasty: First Prospective Clinical Trial. Translational Vision Science & Technology March 2021,Vol.10,5.
2. Zachary S. Sacks, Masha Dobkin-Bekman, Noa Geffen, Mordechai Goldenfeld, and Michael Belkin. Non-contact direct selective laser trabeculoplasty: light propagation analysis. Biomedical Optics Express Vol. 11, Issue 6, pp. 2889-2904 (2020).
3. Noa Geffen, Shay Ofir, Avner Belkin, Fani Segev, Yaniv Barkana, Audrey Kaplan Messas, Ehud I Assia, Michael Belkin. Trasscleral selective laser trabeculoplasty without a gonioscopy lens. Journal of Glaucoma: March 2017 - Volume 26 - Issue 3 - p 201-207.
4. G.Gazzard et al. Selective laser trabeculoplasty versus eye drops for first-line treatment of ocular hypertension and glaucoma (Light): A multicentre randomised controlled trial. The Lancet VO 393, ISSUE 10180, P1505-1516, APRIL 13, 2019.
5. Yujia Zhou & Ahmad A. Aref. A Review of Selective Laser Trabeculoplasty: Recent Findings and Current Perspectives. Ophthalmology and Therapy volume 6, pages 19–32 (2017).

Biography:

Wojciech Hautz graduated from Medical Academy in Lublin, Poland in 1988 and he has done his specialization in ophthalmology (consultant), Warsaw and training in ocular oncology in St. Bartholomev’s Hospital London in 1995 (6 months). He also did his training in European Vitreo Retinal Society School – Bremen, Germany during 2006-1994. At present he is working in Ophthalmology Department - Children’s Memorial Health Institute, Warsaw, from 2012. He is Head of The Ophthalmology Department general pediatric ophthalmology, consulting complicated cases from all over the country, he also deals with ophthalmic surgery – cataracts, glaucoma, strabismus, retinopathy of prematurity, intraocular tumors, retinal detachment, laser treatments conducting training for ophthalmologists from all over the country in pediatric ophthalmology, especially in retinopathy of prematurity and intraocular tumors. He is an author or co-author of about 118 papers published in Polish (97) and foreign (21) Ophthalmic Journals.

Abstract:

Coats’ disease is a rare, idiopatic illness caused by a presence of teleangiectatic – abnormal retinal vessels. Untreated may lead to retinal detachment, cataract and secondary glaucoma or even atrophy of the eye.

Aim of the Study: To determinate the most common diagnostic problems and evaluation of clinical response to the treatment of Coats’ disease in children.

Material and Methods: The examined group constituted 68 patients (70 eyes). All patients were Caucasian, the vast majority of them were boys (83, 8%) in 2, 9% disease was bilateral. Examinations allowing recognizing disease were indirect ophthalmoscopy and USG. The choice of treatment method depended on a clinical condition: Extensity and location of abnormal vessels. Cryotherapy, transpupillary laser hyperthermia and anty-VEGF injections were used. A mean time of observation was 41 months.

Results: The mean age, at which the patients were diagnosed, was 80 months. A hearing impairment was additionally noted in 4 patients (5, 9%). The most commonly observed first symptoms was decreased vision (42, 6%), squint (32, 4%) and leucocoria (14,7%).  The most common improper diagnosis confirmed by local doctors was retinoblastoma. The biggest diagnostic problems were with patients with stage 3B (Shields’ classification)–complete retinal detachment. As a result of the conducted treatment the improvement of visual acuity was achieved in 39, 2% of eyes, stabilisation in 33, 3% and deterioration in 27, 5% of eyes. A statistically significant relationship was found between a baseline disease characteristics and a final anatomical effect and between the expanse of abnormal vessels area and a final anatomical effects. The best results were achieved in patients with early stages of the disease (1 and 2 Shields’ classification) and with a smaller expanse of abnormal vessels area (1-2 clock hours).