Visual Performance of Children with Amblyopia after 6 Weeks of Home-Based Dichoptic Visual Training.

OBJECTIVES: This study was aimed at analyzing the efficacy on the improvement of the visual function of a dichoptic online cloud-based platform for the treatment of amblyopia in anisometropic children. METHODS: A quasi-experimental (pretest-post-test) study was conducted in 23 subjects with ages from 5 to 15 years old with anisometropic amblyopia combined with additional presence (2 subjects) or not (21 subjects) of microtropia. A total of 30 home-based training sessions of 30 min per session with Bynocs® platform were prescribed for 6 weeks. RESULTS: Amblyopic eye logMAR visual acuity (VA) significantly improved from 0.28 ± 0.24 to 0.13 ± 0.20 after the 6-week treatment (p < 0.001). At baseline, 60.9% of participants had VA in amblyopic eye of 0.20 logMAR or worse, whereas this percentage decreased to 21.7% after treatment. Binocular function (BF) significantly improved from 2.82 ± 1.11 to 2.32 ± 0.94 (p < 0.001). Mean compliance was 92%, 87% and 93% at 2, 4 and 6 weeks of treatment, respectively. CONCLUSIONS: In conclusion, home-based dichoptic training with the digital platform evaluated is an effective method to improve amblyopic VA and stereoacuity in children with anisometropic amblyopia combined or not with microtropia.

Clinical Characteristics, Treatment, and Outcome of Trochleitis.

BACKGROUND AND PURPOSE: To study the clinical characteristics, treatment options, and outcome of patients with trochleitis in our population. METHODS: Retrospective review of 59 patients diagnosed with trochleitis in the Ramon y Cajal Hospital Emergency Service between 2003 and 2010. Demographic data and trochleitis features were described. The relationship between outcome and treatment options was analyzed by SPSS. RESULTS: The estimated prevalence rate of trochleitis in our area was 12 per 100,000. The average age of patients was 43±18 years. The majority of cases were women (86%). One case was bilateral. Patients' chief complaints were continuous pain (66%), pain only with ocular movements (25%), or pain only with palpation (8%). Ocular movement limitations were presented in 14%. Diplopia was observed in 12%, and 19% complained of headache. Oral non-steroidal anti-inflammatory drugs (NSAIDs) were the first option for treatment in 85% of cases, associated with oral steroids in 8% of patients. Oral steroids were the first and only option for treatment in 3%. Symptoms completely resolved in 80%, with the worst responses seen in cases with motility disturbances. Peritrochlear triamcinolone acetonide was injected in 14% of cases, achieving a good response in 62%. CONCLUSIONS: The prevalence of trochleitis in our area is low, and this pathology is more frequent in females. Oral NSAIDs are efficient to resolve isolated pain, but the response is partial if diplopia or motility limitations are associated. Some non-responders achieved good results with peritrochlear triamcinolone. Successful management provides a good prognosis for most patients.

Comparison between phaco-deep sclerectomy and phaco-deep sclerectomy reconverted into phaco-trabeculectomy: series of fellow eyes.

BACKGROUND: To evaluate and compare the results and complications after uneventful phaco-deep sclerectomy in one eye with intended phaco-deep sclerectomy converted to phaco-trabeculectomy in the fellow eye. METHODS: In this retrospective study, we analyzed thirty-two eyes of sixteen patients in which bilateral phaco-deep sclerectomy was planned but one eye was converted to phaco-trabeculectomy after perforation of the trabeculo-Descemet's membrane. Visual acuity (VA), slit-lamp examinations, intraocular pressure (IOP), and the number of glaucoma medications were recorded preoperatively and postoperatively at 1 day, 1 week, and 1, 3, 6, 12, 18, and 24 months. The postoperative complications were recorded. Comparisons between the two groups were performed. RESULTS: The IOP was significantly lower in both groups at every postoperative visit. The postoperative IOP and VA levels did not differ significantly between the groups. However, at the last postoperative visit, eyes that underwent uneventful phaco-deep sclerectomy required fewer glaucoma medications than eyes converted to phaco-trabeculectomy (P = 0.04). At 24 months, the group that underwent uneventful phaco-deep sclerectomy had a higher complete success rate (P = 0.01). Immediate postoperative complications such as hyphema, a shallow anterior chamber, or a choroidal detachment occurred more frequently in eyes converted to phaco-trabeculectomy, although the difference did not reach significance. CONCLUSIONS: There were no differences in VA or IOP control between uneventful phaco-deep sclerectomy and phaco-deep sclerectomy converted to phaco-trabeculectomy. However, fewer drugs were needed to successfully control IOP and the rate of complications was lower if phaco-deep sclerectomy was completed uneventfully.

Predictive factors of surgical outcome in oculomotor nerve palsy.

PURPOSE: To investigate the outcomes and predictive factors of surgical treatment of oculomotor nerve palsy. METHODS: Records of patients requiring eye muscle surgery for oculomotor nerve palsy in our institution were retrospectively reviewed. Age, sex, etiology, deviation, completeness of involvement, time between onset and surgery, botulinum toxin treatment, and number of surgical procedures were recorded as potential predictive factors. Muscle function, presence of diplopia, and torticollis were also recorded. The main outcome measure was motor function. Secondary outcome measures were presence of diplopia, torticollis, and limitation of muscle function. RESULTS: Surgery was required in 22 patients, of whom motor success was obtained in 14 (63.6%). Frequency of diplopia and torticollis were significantly reduced by surgery. After multivariate regression analysis, longer time between onset and surgery (p = 0.03) and larger initial deviation (p = 0.05) were significantly associated with poorer postsurgical results in terms of motor function. CONCLUSIONS: Longer time from onset to surgery and larger eye deviation are negative prognostic factors of postsurgical motor success for oculomotor nerve palsy.