Most of the peripapillary vessel densities were higher in female subjects. Hypertension and diabetes also affected the vessel densities. Vessel densities in all the regions were significantly higher in scans with higher SSI. These results should be considered when interpreting the vessel densities in retinal diseases and glaucoma.
Middle-income countries such as India are suffering from the third epidemic of retinopathy of prematurity (ROP). Improved survival and lower infant mortality rates have resulted in an increased number of preterm survivors in rural areas that unfortunately lack ROP specialists. We report our experience of a public-private partnership in rural India of an ongoing telemedicine program Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity program KIDROP that provides ROP screening by non-physicians. The analysis of 20,214 imaging sessions of 7106 from 36 rural centers in 77 months of activity are presented. The overall incidence of any stage and treatment requiring ROP was 22.39% and 3.57% respectively. We found a higher incidence of severe ROP in private (7.1%) vs government centers (1.7%). Fifty of the 254 babies (19.69%) who underwent treatment were outside the American screening guidelines cut-off. The report compares other "real-world" tele-ROP programs, summarizes the impact, and provides future strategies for outreach ROP screening in middle-income countries.
Purpose. To evaluate the effectiveness and safety of accelerated corneal collagen cross-linking (ACXL) in patients below 14 years of age with progressive keratoconus. Materials and Methods. Thirty eyes of 18 patients with established progressive keratoconus underwent preoperative and postoperative visual acuity assessment, topography, and specular microscopy prior to ACXL and were followed up for 24 months. Results. Mean age of the patients was 12.7 years with ten males and eight females. There was an improvement in the mean postoperative uncorrected distant visual acuity (from 0.76 ± 0.26 to 0.61 ± 0.25; P = 0.005), mean corrected distant visual acuity (from 0.24 ± 0.19 to 0.12 ± 0.12; P < 0.001), mean spherical refraction (from −3.04 DS ± 3.60 to −2.38 DS ± 3.37; P = 0.28), mean cylinder (from −3.63 DC ± 1.82 to −2.80 DC ± 1.48; P = 0.008), and spherical equivalent (from −4.70 D ± 3.86 to −3.75 D ± 3.49; P = 0.15). Three eyes of two patients with vernal keratoconjunctivitis (VKC) showed progression. There were no intra- or postoperative complications. Conclusion. In pediatric patients ACXL is an effective and safe procedure for the management of keratoconus. Optimal management of VKC is important to arrest the progression of keratoconus.
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