The D-EYE digital ophthalmoscope is a practical device that could be incorporated into medical education and clinical practice. Survey results revealed that most students preferred the D-EYE digital ophthalmoscope due to the recording features and larger image of the fundus. [J Pediatr Ophthalmol Strabismus. 2018;55(3):201-206.].
Purpose
This study aimed to evaluate the visual outcomes of pediatric patients diagnosed with Peters anomaly (PA) in a tertiary eye care center.
Methods
This was a retrospective study undertaken at a single academic center. Clinical records of pediatric patients diagnosed with PA from 2000 to 2017 were reviewed. Parameters recorded included visual acuity (VA), intraocular pressure (IOP), presence of glaucoma, and surgical procedures performed. The impact of PA type on final visual acuity levels was analyzed using generalized estimation equation models.
Results
Twenty-one eyes from 11 patients were analyzed. At the final visit, 9 eyes (42.8%) had a VA ≥20/200, while 12 (57%) had <20/200, ranging from 20/250 to no light perception. Of the study cohort, 15 (71.5%) eyes had type I, while six (28.5%) had type II PA. Glaucoma was present in 20 eyes (95%) at the final visit. One eye had dense central leucoma and microphthalmos where IOP could not be measured accurately. Seventeen eyes (81%) underwent at least one intraocular surgery, while the average number of surgeries per eye was 2.9 ± 2.5 (range=0– 9). The type of PA beta(se)=0.53 (0.41),
p
= 0.20] was not found to be a significant risk factor for worse VA.
Conclusion
Severe visual impairment develops in the majority of patients with PA. The type of anomaly does not appear to be associated with a worse visual function in patients with PA. Glaucoma develops in a high percentage of this patient population, and thus close monitoring of IOP in this patient population is crucial.
Purpose: The D-EYE device, a new fundoscopic smartphone lens, has demonstrated its utility in a clinical setting to detect and document ocular pathology, but has not been tested in the pediatric population. A prospective study was performed to explore the application of D-EYE in pediatric fundus examinations. Methods: Patients ages 3 -18 years old underwent dilated fundus examinations by masked examiners using the video function of the D-EYE, while indirect ophthalmoscopy was performed by apediatric ophthalmologist. The examiners independently analyzed the D-EYE videos for the presence or absence of abnormalities, cup-to-disc (c/d) ratios and optic nerve size and color. The D-EYE video findings were compared to indirect ophthalmoscopy findings. Results: The study included 172 eyes from 87 patients. In comparing D-EYE to indirect ophthalmoscopy for detecting fundus abnormalities, the sensitivity was 0.72, specificity was 0.97, positive predictive value (PPV) was 0.77, negative predictive value (NPV) was 0.97, positive likelihood ratio (LR) was 27.8, and negative LR was 0.29. The agreement rate between the D-EYE video graders for the c/d ratio within a value of 0.1 was 97.0%. Multiple, distinct abnormalities were discovered using the D-EYE device, including nystagmus, optic nerve hypoplasia, optic disc edema, peripapillary atrophy, disc pallor, and optic disc drusen. Conclusion: Fundoscopic imaging using the D-EYE smartphone lens reliably detects the presence of fundus abnormalities and has good reliability in assessing c/d ratios. The video capability is useful in patients with nystagmus or those who are poorly compliant with the examination and allowed for effective teaching by the pediatric ophthalmologist.
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