Comparison of Efficacy of Micropulse and Continuous Wave Cyclophotocoagulation in Patients With Pediatric Glaucoma.

PRCIS: Both micropulse (MP-CPC) and continuous wave (CW-CPC) cyclophotocoagulation exhibited short-term effectiveness in lowering IOP, followed by reversion to near baseline levels 12 months after laser treatment. OBJECTIVE: To determine and compare the effectiveness and safety of MP-CPC and CW-CPC in patients diagnosed with pediatric glaucoma. METHODS: A retrospective cohort study was conducted on a total of 28 patients (81 eyes) diagnosed with pediatric glaucoma either undergoing MP-CPC or CW-CPC. Intraocular pressure (IOP) measurements, number of glaucoma medications, and the onset of complications were collected at baseline, 1-month, 3-month, 6-month, and 12-month intervals. Success rate (SR) was defined as eyes achieving IOP ≤21 mm Hg and ≥5 mm Hg and a 20% reduction in IOP at the last follow-up visit. RESULTS: All patients either undergoing MP-CPC or CW-CPC were matched for age (mean ± SD; 1.76 ± 1.69 vs 1.56 ± 2.49 y). Patients undergoing MP-CPC had significant decreases in IOP from baseline IOP at 1, 3, and 6 months with a 22% SR at 12 months. CW-CPC had a significant decrease in IOP from baseline IOP at all follow-ups, with a 27% SR at 12 months. At the 12-month follow-up, the CW-CPC cohort exhibited a significantly larger overall drop in IOP when compared with the MP-CPC cohort, (7.99 ± 7.95 vs 1.78 ± 6.89, P < 0.05); however, the difference in SR between treatment groups (27% vs 22%) at 12 months was not significant ( P > 0.05). Complications were minimal for both groups. CONCLUSION: Both MP-CPC and CW-CPC exhibited short-term effectiveness in lowering IOP, followed by reversion to near baseline levels 12 months after laser treatment. Both MP-CPC and CW-CPC exhibited similar SR at 12 months, 22% and 27% respectively.

Epidemiological Trends of Ocular Injuries in Infants.

Approximately 21,000 consumer product-related ocular injuries occurred in infants in the United States from 2009 to 2019; toys being the most common (12.9%) consumer product in the 1- to 4-month age cohort, detergents in the 5- to 8-month (21.6%) cohort, and chemicals for the 9- to 12-month (34.0%) age cohort. These results identify an important preventable consumer product-related public health problem in infants. [J Pediatr Ophthalmol Strabismus. 2023;60(4):e41-e44.].

Effectiveness of netarsudil 0.02% in lowering intraocular pressure in patients with secondary glaucoma.

OBJECTIVE: To determine the effectiveness of netarsudil, 0.02% in lowering intraocular pressure (IOP) in patients with secondary forms of glaucoma. METHODS: A total of 77 patients (98 eyes) with either primary open-angle glaucoma (POAG) or secondary glaucoma were reviewed retrospectively over the course of 1 year after starting netarsudil. The secondary glaucoma group was comprised of patients with uveitic, pseudoexfoliative, neovascular, congenital, and other forms of secondary glaucoma. Patient IOP measurements were collected at baseline and at 1-, 3-, 6-, and 12-month intervals. Two sample t tests and 1-way analysis of variance were used to determine differences in IOP reductions following netarsudil treatment. RESULTS: Patients with POAG or secondary glaucomas were matched for age (mean ± SD: 69.1 ± 16.0 years vs. 64.5 ± 21.2 years; p = 0.30). Both the POAG and secondary glaucoma patients exhibited significant decreases in IOP at each time point (1, 3, 6, and 12 months) when compared with baseline (p < 0.05). Both groups showed similar overall decreases in IOP from baseline after 1 year of treatment (6.0 ± 4.5 mm Hg vs. 6.6 ± 8.4 mm Hg; p = 0.70). Forty-sex percent of POAG patients achieved an IOP of <14 mm Hg compared with 17% of secondary glaucoma patients. Among the secondary glaucoma subtypes, netarsudil was found to be most effective for treating uveitic glaucoma, showing a decrease in IOP of 9.5 mm Hg after 12 months (p = 0.02). CONCLUSION: Netarsudil is effective in lowering IOP in patients with certain forms of secondary glaucoma and should be considered for IOP management in those with uveitic glaucoma.

Clinical Report of the Effectiveness of Netasurdil in Patients with Uveitic Glaucoma.

The use of netasurdil 0.02% (Rhopressa) in patients with primary open-angle glaucoma has been shown to be effective in lowering intraocular pressure (IOP). However, the effectiveness of netasurdil in patients with secondary forms of glaucoma has been minimally investigated. Previous reports have suggested its adequacy in lowering IOP in patients with congenital glaucoma. Its effectiveness in treating uveitic glaucoma, on the other hand, has yet to be formally examined. In a small group of patients with uveitic glaucoma, netasurdil has been shown to lower IOP by an average of 10.0mmHg, with over half of patients exhibiting more than a 20% decrease in IOP after 12 months of treatment. No patients developed any serious complications from taking netasurdil, however, conjunctival hyperemia was present in 15% of the patient population. Early success of netasurdil in patients with uveitic glaucoma warrants further investigation to better understand its safety and effectiveness.

Enucleation in pediatric open globe injuries: demographics and risk factors.

PURPOSE: The purpose of this study is to report the demographics and risk factors for undergoing primary enucleation in the setting of acute open globe injury (OGI) in the pediatric population in the USA. METHODS: This retrospective, cross-sectional study of pediatric patients with OGIs in the USA between 2002 and 2014 was conducted utilizing data from the National Inpatient Sample Database. Descriptive statistics, chi-square testing, and univariate and multivariable analyses were performed. RESULTS: In the USA, 8944 cases of pediatric OGI were identified between 2002 and 2014 in the NIS Database, of which 344 underwent primary enucleation. Blacks and Asian/Pacific Islanders made up higher proportions of enucleated cases compared to non-enucleated cases. Older age, male sex, being Black or Asian/Pacific Islander, OGI with an intraocular foreign body, rupture type OGI, and concurrent endophthalmitis were identified as risk factors for undergoing enucleation. There was no significant difference in insurance status among enucleated versus non-enucleated cases. Mean length of hospital stay (in days) was almost 3 times higher in enucleated OGIs. By hospital's geographic location, the Midwest hospitals had a greater proportion of enucleated versus non-enucleated cases compared to other regions. CONCLUSION: Significant demographic differences were identified in OGI patients that underwent primary enucleation versus repair with regard to age, sex, race, the geographic location of hospital admission, mean length of hospital stay, type of ocular injury, and other ocular complications. Most pediatric traumatic enucleations between 2002 and 2014 were reported in teenagers (16-20 age group), in males, and in Blacks.

Epidemiology of Pediatric Open Globe Injury in the United States.

PURPOSE: To use the National Inpatient Sample (NIS) Database to describe trends in demographics, types, and incidence of pediatric open globe injuries in the United States. METHODS: A retrospective, cross-sectional, observational study was conducted of 8,943 acute cases of pediatric open globe injury (age < 21 years) obtained from the NIS Database, between 2002 and 2014. Weighted analysis was performed using IBM SPSS Statistics 25 software (IBM Corporation). Codes from the International Classification of Disease, Ninth Revision, Clinical Modification were used to identify pediatric open globe injury cases. RESULTS: In the United States, 8,943 pediatric cases of acute open globe injuries were identified between 2002 and 2014. Males comprised 78% of the acute pediatric open globe injury cases. Penetrating open globe injuries without intraocular foreign bodies (IOFBs) were the most common type of injury (P < .001). The proportion of injuries that were penetrating open globe injuries decreased with age, whereas the proportion of IOFBs and globe ruptures increased. The proportion of open globe injuries with IOFB in boys was twice as high as in girls. The incidence of open globe injuries by age, race, and gender was highest in the 16 to 20 years age group, in Blacks and Native Americans, and in boys, respectively. CONCLUSIONS: The incidence of open globe injuries in pediatric patients (age < 21 years) was estimated to be 7.93 per 1,000,000 individuals and varied by race, gender, and age. The proportion of different types of open globe injury varied significantly by age, race, and gender. The mean duration of hospital stay for open globe injury management was 2.2 days, and 17.5% of patients lacked medical insurance. [J Pediatr Ophthalmol Strabismus. 2021;58(4):232-239.].