Retinopathy of Prematurity among Syrian Refugees: Incidence and Severity.

PURPOSE: The aim of this study is to compare the incidence and severity of retinopathy of prematurity (ROP) in premature newborns of Syrian refugees and those of Turkish origin. METHODS: This retrospective, the single-center study included 1545 premature infants assigned to two groups based on maternal origin. Group 1 comprised 1366 premature infants of Turkish origin, and Group II comprised 179 premature infants born to Syrian refugees. All the premature infants were screened for ROP by the same ophthalmologist who is experienced in the screening and treatment of ROP. All data including gestational age (GA), birth weight (BW), the presence of ROP, and severe ROP collected from 2014 to 2017 were recorded for each group. The outcomes were compared between the two groups. RESULTS: The mean GA at birth was 30.6 ± 2 weeks and was significantly lower in Group II (P = 0.03). The overall incidence of ROP was similar in both groups. The incidence of severe ROP in Group II was nearly seven times higher than in Group I (1.5% and 10%, respectively). The incidence of severe ROP seen in Group II evaluated according to different ranges of GA and BW was higher than in Group I. CONCLUSION: The higher incidence of severe ROP in the premature newborns of Syrian refugees could play an important role in identifying ongoing health problems of refugees.

Assessment of orbital blood flow velocities in retinopathy of prematurity.

The purpose of this study is to evaluate whether the presence of any stage retinopathy of prematurity (ROP) alters central retinal artery (CRA) and ophthalmic artery (OA) blood flow parameters in premature infants. The patients were divided into two groups according to the development of ROP; those who have ROP were defined as group I, those without ROP were defined as group II. Ninety eyes of 45 patients in group I and 40 eyes of 20 patients in group II were investigated. The blood flows in the CRA and OA were measured using ultrasound color doppler imaging (CDI) that allows to evaluate the peak systolic velocity (PSV), end diastolic velocity (EDV), and resistivity index (RI). The results were compared between two groups of subjects. There were no significant differences in the PSV, EDV, and RI of CRA between two groups (P = 0.09, P = 0.20 and P = 0.63, respectively). The mean PSV value of OA in group I was found to be significantly higher than the one in group II (P < 0.05), but there were no significant differences in the mean EDV and RI values of OA between two groups (P = 0.40, P = 0.17 respectively). The subgroup analysis revealed that the ocular blood dynamics were not found to be significant between eyes with stage I ROP and eyes with stage II ROP (P > 0.05), whereas the difference in the mean PSV values of OA were found to be significant among the eyes with stage 1 ROP, eyes with stage 2 ROP, and eyes without ROP (P = 0.03). This study demonstrated significant alterations in systolic flow velocities in the OA predicted by CDI in infants with ROP.

Necrotizing Retinitis Secondary to Congenital Cytomegalovirus Infection Associated with Severe Combined Immunodeficiency.

A 20-day-old male infant who was born at 39 weeks of gestation was admitted to neonatal intensive care unit due to severe respiratory insufficiency. In retinal examination, peripheric retinal white-black color areas that correspond to necrotizing retinitis, moderate vitritis, macular and optic nerve head involvement, vascular leakage, and sheathing indicating perivasculitis were revealed. Despite the fact that CMV specific IgM was undetectable, CMV DNA with high viral load was found in his blood sample by means of real-time polymerase chain reaction assay. Serologic examination (IgM) for rubella, toxoplasma, herpes simplex type 2, and human immunodeficiency virus (anti-HIV) was negative. During the further evaluation for systemic immune dysfunction, decreased immunoglobulin and lymphocyte levels that confirm the diagnosis of severe combined immunodeficiency have been reached. Although given systemic intravenous ganciclovir and antibiotics treatment, the patient died at the 4th month of life due to respiratory insufficiency.

Effect on anterior chamber bevacizumab injection combined with seton implantation in treatment of rubeosis iridis in neovascular glaucoma.

OBJECTIVE: To evaluate the effect of anti-VEGF (bevacizumab) injection to the posterior chamber (BIPC) behind the iris combined with seton implantation in treatment of neovascular glaucoma (NVG). METHODS: Twenty-eight eyes with NVG who underwent BIPC, prospectively evaluated. Anterior segment photographs were taken for grading of neovascularization on anterior segment in pretreatment period and at each follow-up. Grading and regression of rubeosis iridis was classified according to Teich and Walsh grading system and glaucoma filtration surgery with drainage device was performed following BIPC. RESULTS: The mean pre-BIPC IOP was 39.71 ± 7.09 mmHg, post-BIPC IOP in the 1st, 2nd day, 1st week, 1st, 3rd, 6th month were 19.7 ± 8.9 mmHg, 13.5 ± 6.7 mmHg, 9.9 ± 3.4 mmHg, 13.07 ± 5.3 mmHg, 16.6 ± 5.03 mmHg, 18.5 ± 3.8 mmHg, respectively. Twenty seven eyes underwent seton implantation surgery. No one had anterior segment bleeding during surgery. The pre-BIPC grades were Grade 4: 67.58%, Grade 3: 28.57%, Grade 2: 3.57%, no one had Grade 1or Grade 0, while post BIPC grade were at the 1st week Grade 1: 64.28%, Grade 0: 35.71%, no one had Grade 2 or more, at 1st month Grade 2: 3.57%, Grade 1: 39.28%, Grade 0: 57.14%, at 3rd month Grade 2: 17.85% Grade 1: 28.57%, Grade 0: 53.57%, no one had Grade 3 or more both in first and the third month, at 6th month Grade 3: 7.14%, Grade 2: 28.57%, Grade 1: 42.85%, Grade 0: 21.42%. and no one had Grade 4. CONCLUSION: Significant reduction of NV was observed during the first week. Minimal increasement was seen in third month, significant regression effect persisted for 6 months. BIPC inhibited the peroperative risk of anterior segment bleeding, increased the surgical comfort and prevented the failure of filtration procedure by inhibiting reproliferation.

Surgical repair of scrolled descemet's membrane detachment with intracameral injection of 1.8% sodium hyaluronate.

We report the case of a 76-year-old woman with scrolled Descemet's membrane detachment (DMD) that was successfully treated by an intracameral injection of 1.8% sodium hyaluronate. During phacoemulsification cataract surgery, an undulating DMD involving the central cornea was observed and air tamponade into the anterior chamber was performed. The patient underwent surgical repair 2 weeks after the unsuccessful intracameral air injection. To increase the tamponade pressure and surface tension on the scrolled flap, viscoelastic material was injected into the air-filled anterior chamber. Corneal edema started subsiding clinically after the injection of sodium hyaluronate. Descemetopexy with sodium hyaluronate can successfully repair scrolled DMD and injection of viscoelastic material into the air-filled anterior chamber facilitates unfolding of the scrolled flap of DMD.