Choroidal neovascularization in 36 eyes of children and adolescents.

PURPOSE: To describe the clinical features and outcomes among eyes with choroidal neovascularization (CNV) in children and adolescents. METHODS: A total of 36 eyes of 27 patients <18 years of age diagnosed with CNV between January 1978 and December 2008 were retrospectively reviewed. CNV was clinically diagnosed in all patients and its presence was confirmed by fundus fluorescein angiography (FFA). A total of 19 eyes underwent treatment. Anatomical outcome was evaluated as regressed/persistent/recurrent CNV. Snellen's values for best corrected visual acuity (BCVA) were converted to logMAR for statistical calculations. RESULTS: Of the 27 patients, 17 (63%) were male. Nine (33.3%) of the 27 patients had bilateral CNV. At presentation, CNV was active in 22 (61.1%) eyes and regressed in 14 (28.9%) eyes. All active CNV cases were 'classic' type, with the majority (80.5%) being subfoveal. The mean greatest linear dimension (GLD) was 3.16 ± 1.94 mm (range, 0.9-10.15). The most common cause (41.7%) was post-inflammatory. The mean duration to regression in treated eyes was 103.53 days (15 eyes). Recurrence was noted in three (8.3%) eyes. The mean duration to first recurrence was 260 days (range, 90-390), and the mean follow-up duration was 779.53 ± 988.00 days. CONCLUSION: CNV remains a cause of significant visual decline in children and adolescents. Male predominance, post-inflammatory etiology, bilateral affection, and subfoveal location are noteworthy, with a high regression rate in response to treatment. Re-treatment is required in a limited number of cases.

Risks and benefits of omega 3 fats for mortality, cardiovascular disease, and cancer: systematic review.

OBJECTIVE: To review systematically the evidence for an effect of long chain and shorter chain omega 3 fatty acids on total mortality, cardiovascular events, and cancer. DATA SOURCES: Electronic databases searched to February 2002; authors contacted and bibliographies of randomised controlled trials (RCTs) checked to locate studies. REVIEW METHODS: Review of RCTs of omega 3 intake for (3) 6 months in adults (with or without risk factors for cardiovascular disease) with data on a relevant outcome. Cohort studies that estimated omega 3 intake and related this to clinical outcome during at least 6 months were also included. Application of inclusion criteria, data extraction, and quality assessments were performed independently in duplicate. RESULTS: Of 15,159 titles and abstracts assessed, 48 RCTs (36,913 participants) and 41 cohort studies were analysed. The trial results were inconsistent. The pooled estimate showed no strong evidence of reduced risk of total mortality (relative risk 0.87, 95% confidence interval 0.73 to 1.03) or combined cardiovascular events (0.95, 0.82 to 1.12) in participants taking additional omega 3 fats. The few studies at low risk of bias were more consistent, but they showed no effect of omega 3 on total mortality (0.98, 0.70 to 1.36) or cardiovascular events (1.09, 0.87 to 1.37). When data from the subgroup of studies of long chain omega 3 fats were analysed separately, total mortality (0.86, 0.70 to 1.04; 138 events) and cardiovascular events (0.93, 0.79 to 1.11) were not clearly reduced. Neither RCTs nor cohort studies suggested increased risk of cancer with a higher intake of omega 3 (trials: 1.07, 0.88 to 1.30; cohort studies: 1.02, 0.87 to 1.19), but clinically important harm could not be excluded. CONCLUSION: Long chain and shorter chain omega 3 fats do not have a clear effect on total mortality, combined cardiovascular events, or cancer.

Primary cutaneous amyloidosis.

Three cases of primary cutaneous amyloidosis are reported. Family history was negative. Systemic involvement was ruled out. Histopathology was confirmed by congored stain. Patients responded to oral colchicine.