ABSTRACT
PURPOSE: To assess the efficacy of using autofluorescence to identify optic nerve head drusen (ONHD) in children. METHODS: We conducted a cross-sectional, descriptive study of subjects <18 years of age with possible pseudopapilledema due to ONHD. B-scan ultrasonography was considered the gold standard diagnostic technique. All participants underwent an extensive ophthalmic examination that included fundus color photography, autofluorescence analysis, and B-scan echography. ONHD were classified as visible or hidden. Autofluorescence images were analyzed by three observers who were masked to the results of B-scan ultrasonography. RESULTS: A total of 24 children with pseudopapilledema were included. B-scan ultrasonography confirmed ONHD in 32 eyes of 18 patients (9 boys). Mean patient age was 12 years (range, 7-17 years). ONHD was bilateral in 14 patients; unilateral in 4. The majority of the drusen were hidden (26 of 32 eyes). Analysis of autofluorescence patterns identified the drusen in 94% of cases (30 of 32 eyes): visible, 100%; hidden, 92%. Interobserver agreement was high (κ = 0.91, κ = 0.96, κ = 0.89). CONCLUSIONS: In this study cohort, autofluorescence proved a safe, fast, and reliable technique for identifying ONHD in children.
Subject(s)
Eye Diseases, Hereditary/diagnosis , Fluorescein Angiography , Optic Disk Drusen/diagnosis , Optic Nerve Diseases/diagnosis , Optical Imaging/methods , Adolescent , Child , Cohort Studies , Cross-Sectional Studies , Eye Diseases, Hereditary/etiology , Female , Humans , Male , Observer Variation , Optic Disk Drusen/complications , Optic Nerve Diseases/etiologyABSTRACT
AIM: To describe and test a new technique to obtain midstream urine samples in newborns. DESIGN AND METHODS: This was a prospective feasibility and safety study conducted in the neonatal unit of University Infanta Sofía Hospital, Madrid. A new technique based on bladder and lumbar stimulation manoeuvres was tested over a period of 4 months in 80 admitted patients aged less than 30 days. The main variable was the success rate in obtaining a midstream urine sample within 5 min. Secondary variables were time to obtain the sample and complications. RESULTS: This technique was successful in 86.3% of infants. Median time to sample collection was 45 s (IQR 30). No complications other than controlled crying were observed. CONCLUSIONS: A new, quick and safe technique with a high success rate is described, whereby the discomfort and waste of time usually associated with bag collection methods can be avoided.
