BackgroundThe purpose of this study was to evaluate the refraction of eyes treated with diode laser photocoagulation for prethreshold retinopathy of prematurity (ROP) at a mean of 5 years after treatment.Materials and methodsFifty infants with prethreshold ROP treated with diode laser at Hanoi Childrens’ Hospital during the period 2008 to 2009 were reviewed. Refractive error was identified by cycloplegic refraction with Cyclogyl 1%. Myopia was divided into two categories based on magnitude: high myopia (more than −5.00 D) and low myopia (between 0 and −5.00 D). Hypermetropia was subdivided into low hypermetropia (between 0 and +5.00 D) and high hypermetropia (greater than +5.00 D). Astigmatism was classified as high if >2.00 D. Eyes with media opacification that interferes with retinoscopy were excluded. The refractive outcome was correlated with birth weight and gestational age. The anatomical and visual outcomes were recorded.ResultsOne hundred eyes from 50 infants were included in the study. The mean birth weight was 1,426.4 g and the mean gestational age was 29.88 weeks. After 5 years of follow-up, the average spherical equivalent for 100 eyes was −2.87 D. On cycloplegic retinoscopy, high myopia (more than −5.00 D) was seen in 32% of eyes. Twenty (20%) eyes had nonsignificant hypermetropia, and high hypermetropia (more +5.00 D) was seen in only one eye (1%). The prevalence of astigmatism and high astigmatism (more than −2.00 D) was 79% and 49%, respectively. Three infants (6%) had esotropia and two infants (4%) had exotropia. None of the infants had nystagmus.ConclusionThe majority of patients who underwent diode laser therapy for prethreshold ROP had favourable anatomical and visual outcomes. High refractive error is common and may be the cause of visual impairment.

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Purpose: To elucidate the clinical features which predict high-risk histopathological factors for subsequent metastatic disease as well as to report the incidence of these high-risk histopathological factors in a cohort of Asian patients with retinoblastoma. Design: A retrospective and non-randomized sequential cases series. Methods: A retrospective study was done on 334 eyes with retinoblastoma at Vietnam National Institute of Ophthalmology during a 10 year period (January 2004 – December 2013). All pathology specimens and medical records were reviewed and assessed for invasion and clinical signs. Results: Among 334 eyes, 225 (67.4%) had high-risk retinoblastoma and 109 (22.6%) had non-high-risk features on histopathology. The high-risk histopathological features included anterior chamber seeding (48.2%), iris infiltration (14.7%), ciliary body involvement (14.1%), massive choroidal invasion (29.9 %), post-laminar optic nerve invasion (21.2%), invasion of optic nerve transection (9.6 %), combined choroidal and optic nerve invasion (9.6 %), scleral invasion (3.3%), and extra-scleral infiltration (11.4%). The significant clinical features in high-risk group versus non-high-risk group included hyphema (19.6% vs 3.7%, p < 0.001), pseudohypopyon (19.1% vs 6.4%, p = 0.001), iris neovascularization  (25.3% vs 5.5%, p < 0.001), vitreous seeding (72.4% vs 37.6%, p < 0.001), staphyloma (24% vs 4.6%, p < 0.001) and scleritis (20% vs 3.7%, p < 0.001). Conclusions: Clinical signs including hyphema, pseudohypopyon, iris neovascularization, vitreous seeding, staphyloma, and scleritis were significantly associated with high-risk features on histopathology. Globe preserving methods should be used with caution in patients with these signs.

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Previous research identified an increase in formula use as a barrier to exclusive breastfeeding (EBF) in Vietnam. In the context of a process evaluation (PE) of the Alive & Thrive program to promote EBF, 121 in‐depth interviews with rural mothers, fathers, and grandmothers of infants 0‐12 mo formed the basis of a case study analysis (n=48 families). While 79% of mothers had heard about EBF and breastfeeding was universal, EBF prevalence was only 2%. Two‐thirds of infants were formula fed (FF) before 6 months (40% at birth, 12% at 1‐3 mo, and 15% at 4‐6 mo). Stopping and restarting FF was common. Among early starters, families reported a desire to support the mother, “what I could do for her was feed our baby with formula,” often sua non (bovine colostrum formula) sold in the hospital. All 6 cesarean sections FF at birth. Mothers were reluctant to FF but felt they had “no choice” when infants were “crying because of hunger”. For families introducing FF at 1‐3 mo, perception of insufficient milk (PIM) drove use. For the category of 4‐6 mo, introduction of complementary food (CF) was also early due to pressure from grandmothers, or returning to work, or under the perception that infants need to be prepared to accept CF. High awareness of formula advertisements, conflicting advice from health professionals, and a universal perception that insufficient maternal diet led to poor breastmilk supply also influenced FF despite the high cost. Families valued and practiced BF, but require targeted support for BF initiation and PIM, as well as appropriate and timely CF. Grant Funding Source: Alive & Thrive, funded by the Bill & Melinda Gates Foundation and managed by FHI360