Preoperative visual acuity and contrast sensitivity in children with small, partial, or non-central cataracts
| Autor: | Christina Cheng Patel, Eileen E. Birch, David R. Stager, Vidhya Subramanian |
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| Rok vydání: | 2013 |
| Předmět: |
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medicine.medical_specialty Visual acuity genetic structures media_common.quotation_subject Visual impairment Visual Acuity Cataract Extraction Nystagmus Article Cataract Cohort Studies Contrast Sensitivity Cataracts Predictive Value of Tests Ophthalmology Outcome Assessment Health Care medicine Pupillary response Humans Contrast (vision) Child Prospective cohort study Strabismus media_common business.industry medicine.disease eye diseases Child Preschool Preoperative Period Pediatrics Perinatology and Child Health Female Guideline Adherence medicine.symptom business |
| Zdroj: | Journal of American Association for Pediatric Ophthalmology and Strabismus. 17:357-362 |
| ISSN: | 1091-8531 |
| DOI: | 10.1016/j.jaapos.2013.03.028 |
| Popis: | Background While there is clear evidence that dense central cataracts >3 mm diameter warrant prompt intervention to prevent deprivation amblyopia, guidelines for management of small, partial and non-central cataracts are not evidence-based. Consensus guidelines advise managing affected infants and preschool children by monitoring for possible progression in size or density and pharmacologic pupillary dilation, if indicated. Extraction is deemed necessary if the cataract progresses sufficiently to obscure the visual axis or if strabismus or nystagmus develops. We evaluated the long-term visual acuity outcome of the consensus guidelines and whether sensory testing during infancy and early childhood may be helpful in guiding treatment. Methods A total of 40 consecutive children diagnosed with small, partial, or non-central cataracts at 1 week to 2.5 years of age were enrolled in a prospective study of forced-choice preferential looking visual acuity and contrast sensitivity development. Long-term visual acuity outcome was assessed by crowded HOTV or ETDRS at 4-11 years. Results Of the 40 children managed by consensus guidelines, 24 (60%) had abnormal visual acuity at 4-11 years of age, including 9 (23%) who had moderate to severe visual impairment (20/80 or worse) in 1 or both eyes. Abnormal visual acuity and contrast sensitivity during development were predictive of abnormal long-term visual acuity outcomes. Conclusions Visual acuity and contrast sensitivity tests were sensitive to the effects of visual deprivation on the developing visual system and may be useful in early identification of children with small, partial, or non-central cataracts who could benefit from cataract extraction. |
| Databáze: | OpenAIRE |
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