Purpose: To measure and quantify choroidal neovascularization (CNV) lesion size in classic lesions visualized on Spectral Domain-Optical Coherence Tomography (SD-OCT) using automated segmentation analysis and confirm whether further refinement improves the accuracy of disease regression after loading dose Anti-VEGF injections.Methodology: A retrospective study of 10 macular degeneration patients diagnosed with CNV. Blinded observers, trained to detect changes on OCT, delineated boundaries of CNV lesions using SD-OCT (Topcon 2000) with automated software and then modified segmentation manually before and after loading dose Ranbizumab injections. Automated measurements were then compared to manual segmentation values. Statistical analysis was performed, taking into account inter-observer variability.Results: Automatic and manual segmentation measurements are similar in 1) retinal area and fovea center values both pre-and post-injection; and 2) retinal volume post-injection. Retinal volume pre-injection is 1) similar between the two blinded observers; 2) varies between automatic measurements and observers in some patients; and 3) underestimated for all patients in the automatic measurements. Overall, automatic segmentation detects a general reduction in CNV lesion size following loading dose injections.Conclusion: SD-OCT automated segmentation software detects CNV lesions and reports size reduction after the third anti-VEGF injection. SD-OCT automatic segmentation using Topcon segmentation analysis in this small cohort is an accurate diagnostic tool to measure CNV surface area and volume as a biomarker of CNV regression.

Conclusion At a time of increased stress for families of CYP with DDD, and scarce resources to support them, Care Coordinators play a vital role in assisting families to engage with health services, and enabling them to feel supported and empowered. This service reduces the burden on professionals, whilst enhancing relationships with the families.

Results 399 children were assessed from 1 st January 2019 to 31 st December 2020 making a combined total of 4956 children over the 47-year period. For the entire timeline there is a consistent male predominance (figure 1).The previous study showed median age for assessment to be 2-3 years in 1987, this remains unchanged even in 2019-2020 data.Different reasons for referrals were observed over the two data sets of 1999-2004 and 2019-2020 (figure 2(a)). Referrals for 'social interactions' have increased 3 and half fold, an increase from 10.4% in 1999-2004 to 32.6% in 2019-2020. Referrals for behavioural issues have almost doubled (10.1%-18.7%). However, referral for developmental delay/concerns approximately halved over the time.Figure 2b shows recorded assessment diagnosis comparing 1999-2004 with 2019-2020 data. ASD diagnosis predominates -54.5% in 2019-2020. The trend in diagnosis of 'developmental delay' has halved from 1999-2004 to 2019-2020 (figure 2(b)). ConclusionThe previous presumptive South Northamptonshire Autism Follow Up Study (SNAFU) showed between 1974-2014 a clear change in recorded assessment outcomes over this period, with from 2004 the fall of the term 'Developmental delay' and the relentless rise of 'Autism/autistic spectrum disorder' (ASD) (1) . This trend for 2019/2020 has continued in the newly presented data for 2019-2020.Despite the global COVID-19 pandemic, the number of referrals and subsequent diagnosis rates here have not changed much on 2020 data when compared with 2019. It is far too soon to determine for this CDC, the overall impact of COVID-19 for children who will be awaiting assessments.The 47-year long term trend is one of a consistent rise of referrals for and diagnosis of ASD in the CDC. ASD is the dominant cause for referral and diagnosis given. Commissioners of preschool educational services must take into account these rising case numbers to ensure equitably fully funded, preschool diagnosis and service provision for CDCs, Child Development Teams or other local service formulations.

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