Heart rate variability changes and its association with the development of severe retinopathy of prematurity.

PURPOSE: To evaluate differences in autonomic nervous system (ANS) activity associated with the development of retinopathy of prematurity. METHODS: Heart rate variability (HRV) as an indicator of ANS activity was calculated in two groups of premature infants: (1) a treatment group of infants who developed type 1 ROP and underwent treatment and (2) a control group of infants who did not develop ROP more severe than stage 1 and who were matched to the treatment group in terms of age, weight, and similar risk factors, including similar frequency of intraventricular hemorrhage, bronchopulmonary dysplasia, and sepsis. HRV was analyzed during the first 5 days of life, within 5 days of initial ROP examination, and within 5 days of ROP treatment for the treatment group or, for controls, on the day of last electrocardiogram data prior to discharge. Calculations were performed for the high frequency, low frequency, and low frequency-high frequency values of the HRV components for all infants. RESULTS: Between the initial ophthalmologic evaluation and the final evaluation, there was a tendency for reduction in both the low- and high-frequency components of the HRV indices in the treatment group, whereas there was a tendency for an increase in both components of the HRV indices in the control group. The difference in the rate of change of the high frequency between groups was statistically significant (P = 0.021). CONCLUSIONS: Disruption in ANS activity may play an important role in the development and severity of ROP.

The long-term outcomes in children who are not compliant with spectacle treatment for accommodative esotropia.

PURPOSE: To evaluate the long-term motor and sensory outcomes of children who have refractive accommodative esotropia and are noncompliant with spectacle wear. METHODS: The medical records of patients diagnosed with pure refractive accommodative esotropia between 1999 and 2004 were retrospectively reviewed. All patients had hyperopia of at least 3 D and at least 1 year's follow-up. Patients were classified according to degree of compliance with spectacle wear as good, fair, and poor. The main outcome measures were sensory and motor outcomes. RESULTS: A total of 92 patients were included. The mean follow-up period was 61.4 months (range, 12-200 months). Compared to patients with good compliance, those with fair compliance had a significantly higher risk for poor sensory outcome (odds ratio [OR] = 4.56; 95% CI 2.1 - 24.7; P = 0.0003) and poor motor outcome (OR = 4.1; 95% CI, 1.44 -11.75; P = 0.0065). Patients with poor compliance likewise had a higher risk for poor sensory outcome (OR = 12.3; 95% CI, 1.29-96.79; P = 0.0061) and poor motor outcome (OR = 11.7; 95% CI, 2.38-74.19; P = 0.0006). CONCLUSIONS: Fair and poor compliance with spectacle use greatly increases the risk of poor sensory and motor outcomes in children with pure refractive accommodative esotropia.