Validation of a Filipino translation of a vision-related quality of life questionnaire

Objectives@#This study aims to translate the WHO VF-20 questionnaire into Filipino (Tagalog) and validate the translated questionnaire.@*Methods@#Patient information such as age, sex, educational background, and employment was recorded. Preoperative uncorrected and best-corrected visual acuities were also obtained. The VF-20 questionnaire was first translated into Filipino by an independent translator. The Filipino version was then back-translated to English by another translator. The original VF-20 questionnaire and back-translated English version were compared and checked for discrepancies. The Filipino questionnaire was then pretested on 60 participants who met the inclusion and exclusion criteria. Cronbach's alpha coefficient was determined.@*Results@#No major discrepancies in content were noted between the original VF-20 and the back-translated version. Cronbach's alpha coefficient was more than 0.9 for all the 20 items when each item was removed. The translated questionnaire shows high internal consistency (Cronbach's alpha coefficient, 0.9144).@*Conclusion@#The Filipino version of the WHO VF-20 is a valid tool to assess vision-related quality of life in patients with visual impairment due to cataract. The questionnaire can be used as a tool for clinical evaluation, monitoring response to treatment, and future research studies.

Impact of the COVID-19 pandemic on ophthalmology training in the Philippines: A nationwide cross-sectional study among trainees

Objective@#This study was designed to assess the impact of the COVID-19 pandemic on ophthalmology training from the perspective of ophthalmology residents and fellows in the Philippines. @*Methods@#A 55-item online survey on the COVID-19 pandemic’s impact on ophthalmology training was sent to 168 ophthalmologists-in-training from March 15, 2021 to April 19, 2021. Participants from all ophthalmology training programs in the Philippines were selected via random sampling and proportional allocation.@*Results@#A total of 158 ophthalmologists-in-training (138 residents and 20 fellows) completed the survey. The areas of ophthalmology training that were found to be most disrupted during the COVID-19 pandemic were surgical training (95%), clinical activity (94%), and in-person interaction with consultants in the out-patient department (94%) and operating room (85%). In contrast, trainees found an increase in didactic teaching activities (75%) and research activities (39%). Overall, 78% of the trainees felt that the pandemic had a negative impact on their ophthalmology training. The aspects which were most frequently found to be negatively impacted by the pandemic were mental health (70%), followed by technical skills (69%), and clinical skills (61%). No major differences were found on the impact of COVID-19 on training when compared across year levels and across institutions compared by location (National Capital Region vs. non-National Capital Region) and funding type (government vs. private funding). Ninety-nine percent (99%) of institutions shifted most of their didactic teaching activities to online platforms. Surgical video conferences and simulator training or skills labs were thought to be helpful to surgical training by 89% and 81% of the trainees, respectively. Majority of trainees attended to patients via telemedicine averaging 40% of their clinic consults. However, only 16% reported confidence in handling their patients through telemedicine.@*Conclusion@#The COVID-19 pandemic has had an overall negative impact on ophthalmology training in the Philippines. It caused significant disruption in trainees' clinical and surgical activities, and affected their mental health. Despite this, the situation provided an opportunity to boost trainees' theoretical knowledge. Majority are receptive to new technology-based learning tools to preserve the effectiveness of their training. Efforts to re-evaluate current training programs are needed to ensure sustainability and quality of ophthalmology training in the Philippines.

Prevalence and incidence of diabetic retinopathy in women with gestational diabetes and overt diabetes first diagnosed in pregnancy

Objectives@#Due to the lack of evidence linking retinopathy to gestational and overt diabetes, the utility of dilated fundus examination for screening is not established. This study aimed to determine prevalence and progression of retinopathy among newly diagnosed diabetic pregnant women. @*Methodology@#The study was a single-center observational, descriptive study at the outpatient department of a tertiary hospital. Newly diagnosed pregnant women were enrolled based on local criteria, using the 75-gram oral glucose tolerance test, HbA1C level, and random blood sugar test. Dilated fundus photo examination was used to document retinopathy. Fundus photo examination was done every trimester, at delivery and post-partum. Prevalence and incidence of diabetic retinopathy were measured and monitored.@*Results@#Seventy-one women were classified to have gestational diabetes and with no diabetic retinopathy on first consult and remained free of retinopathy during pregnancy and post-partum. In two women diagnosed with ODM, one showed sight-threatening diabetic retinopathy, was asymptomatic and had a visual acuity of 20/20. @*Conclusion@#GDM had no negative impact on retinal pathology and prevalence of diabetic retinopathy was higher among those with ODM. Our results suggest that screening in the GDM population is not advisable, and inconclusive in ODM.

A clinically diagnosed congenital Rubella Syndrome and congenital Cytomegalovirus co-infection

@#This is a case of a four-month-old female infant who presented with clinical manifestations of congenital rubella syndrome (CRS) — bilateral cataracts, poorly-dilating pupils, microcorneas, salt and pepper retinopathies seen after cataract extractions, bilateral sensorineural hearing loss, patent ductus arteriosus, microcephaly, history of blueberry spots and low birth weight, and positive serum IgM and IgG tests for rubella. The patient’s mother also had prenatal rubella infection. However, the patient also presented with additional set of clinical findings not seen in recent patients with CRS and not commonly reported in literature: visual acuities of poor to no dazzle, bilateral choroidal thickening on ocular ultrasound that spontaneously resolved, optic nerve inflammation that became atrophic, vessel tortuosities seen after cataract extractions, bilateral subependymal cysts with lenticulostriate vasculopathy in basal ganglia, basal ganglia hyperintensity suggestive of calcification, and jaundice. These findings plus the overlapping clinical manifestations with CRS and the positive IgM and IgG for cytomegalovirus (CMV) made us consider a congenital CMV co-infection. CRS already causes significant childhood morbidity. Getting co-infected with CMV in utero worsens morbidity and makes management more difficult. This case presented a congenital co-infection of rubella and CMV and discussed the added challenges in their diagnosis and management.

Clinical epidemiology of retinoblastoma at the Philippine General Hospital:1998-2008

Objective@#This study determined the clinical characteristics of retinoblastoma (RB) from 1998 to 2008 and compared the epidemiological and clinical patterns with those of the period from 1967 to 2001.@*Methods@#We reviewed the clinical records of 152 patients with RB from 1998 to 2008 in terms of demographic and ophthalmological data and clinical staging or classification.@*Results@#Sixty-three percent of cases were unilateral and 37% were bilateral. Three (3%) of 95 unilateral cases and 7 (12%) of 57 bilateral cases had family history of RB (p = 0.038). The mean age at onset was 17.8 months for unilateral and 7.4 months for bilateral cases, while the mean age at diagnosis was 26.4 months and 13.7 months respectively. The delay from onset to diagnosis was 69% in unilateral and 56% in bilateral RB groups. Financial cost (71.4%) was the leading reason for delay, followed by misdiagnosis (24.5%), and inaccessibility of medical facility (2.0%). The most common manifestations were leukocoria (77%), extraocular findings of orbital mass (9%), and proptosis (6%). Advanced intraocular stage was seen in 63 – 71.6% among those with unilateral and 56 – 60% in those with bilateral tumor.@*Conclusion@#The onset of disease had not changed over the years, but patients in general were brought earlier for consultation. Most cases presented in the advanced stage. Decreasing the occurrence of extraocular RB through early consultation and treatment can improve patient survival.

Correlation of visual acuity and optical coherence tomography in patients with decreased visual acuity after surgery for retinal detachment

Objective@#This study determined the incidence of macular abnormalities detected by optical coherence tomography (OCT) among patients who have undergone retinal-detachment surgery and investigated the association between pre- and postoperative vision, macular thickness, duration of detachment, and type of surgery done with respect to OCT findings.@*Methods@#This is a noncomparative, nonconsecutive prospective case series of 41 eyes with unsatisfactory vision after scleral buckling, vitrectomy, or pneumatic retinopexy. OCT of the macula were taken and pre- and postoperative visual acuity (VA), time until retinal repair, time until OCT, and type of surgery were analyzed.@*Results@#The mean postoperative VA was 20/130. There was a positive linear relationship between pre- and postoperative VA. The average macular thickness was 254 ± 60 µ, and a strong positive correlation with postoperative logMAR VA was observed. Nineteen (49%) eyes exhibited pockets of subretinal fluid (SRF), 6 had foveal thinning, 5 had macular hole, and 1 each had foveal cyst, cystoid macular edema, and epiretinal membrane. Six patients had worse vision after surgery, 2 of whom had SRF on OCT, 2 foveal thinning, 1 mild macular thickening, and 1 normal image.@*Conclusion@#OCT images of various macular abnormalities may explain post-detachmentsurgery visual complaints. There was a positive correlation between pre- and postoperative VA, and an inverse correlation between macular thickness and postoperative VA.