Ocular Manifestations In Children Research Articles

Optical Coherence Tomography Angiography of Macular Microangiopathy in Children With Sickle Cell Disease.

In this study, we identified the presence of sickle cell maculopathy and determined correlations between hemolysis indicators and systemic and ocular manifestations in children with sickle cell disease (SCD). Thirty-three patients with SCD 5 to 18 years of age underwent optical coherence tomography angiography (OCTA) as part of a thorough eye examination. The hematological indices and clinical data (hemoglobin, fetal hemoglobin, mean corpuscular volume, and frequency of sickle cell-associated complications and therapy) were collected. The SCD group contained 33 patients (66 eyes), and the control group contained 36 healthy participants (72 eyes). The SCD group had significantly thinner parafoveal thickness ( P =0.041) and significantly smaller parafoveal volume ( P =0.041) than the controls. The SCD group had lower deep capillary plexus density than the controls ( P =0.029). The SCD group had significantly smaller flow areas than the controls ( P <0.001). The foveal avascular zone (FAZ) perimeter, foveal density, and FAZ area in the entire retina did not differ significantly between the groups ( P >0.05). The platelet level was negatively correlated with parafoveal and perifoveal thickness and density. OCTA detected early macular microvascular changes in children and adolescents with asymptomatic SCD.

Ocular Manifestations in Children with Special Needs Presenting in a Tertiary Eye Hospital of Central Nepal

Background Children with special needs are at a substantially higher risk of visual impairment (VI) (10.5% compared with 0.16%) but also of ocular disorders of all types, including refractive errors and strabismus. VI and other potentially correctable ocular disorders are frequently unidentified in children with complex needs. Although assessment may be more challenging, identifying these potential additional barriers to learning and development may be critical.MethodsDetailed ophthalmic examination was carried out in all children with special needs presenting to the Pediatric OPD of Bharatpur Eye Hospital over 6 months (January to June 2023). Ophthalmic examination included case history, presenting distance visual acuity, cycloplegic refraction, binocular vision examination, anterior and posterior segment evaluation.ResultsOut of the total of 55 participants, mean age was 9.74 ± 5.07 years, majority were male 32 (58.18%). Quantitative visual acuity could be assessed only in 19 (34.55%) children, using picture chart 9 (16.36%) and Snellen chart 10 (18.18%). Strabismus 21 (38.18%) and refractive error 14 (25.45%) were the commonest visual disorders in our study children.Conclusions With patience, suitably adapted methods, visual assessment is feasible in the majority of children with special needs. It is hoped that the formulation of proper vision care guidelines at a national level may help in early detection and management of visual disorders in this special population and enhance their quality of life.

Ocular manifestations of juvenile lupus erythematosus: An 2023 update

Aims/Purpose: Juvenile Systemic Lupus Erythematosus (jSLE) is a chronic multisystem inflammatory disease that manifests before the age of 16 years, following a remitting ‐ relapsing course. The range of clinical presentations of juvenile Systemic Lupus Erythematosus (jSLE) in children is multifaceted. Ocular manifestations are uncommon for children with jSLE but can have a significant effect on their vision if not diagnosed early. Any part of the visual pathway can be affected by jSLE. The aim of this report is to systematically review the ocular manifestations of jSLE.Methods: A systematic review according to Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) 2020 Guidelines was conducted searching MEDLINE and Scopus, including reference lists with appropriate terms for jSLE ocular manifestations. Epidemiological studies, preferably cross‐sectional studies, that describe the prevalence of ocular manifestations in children with a diagnosis or upon diagnosis of jSLE were assessed.Results: Our search yielded 131 results, screened by two independent reviewers. 33 studies were finally included in the review after preliminary assessment. Keratoconjunctivitis sicca, dry eye syndrome, retinopathy and optic neuritis are among the conditions that have been reported. Ocular manifestations in jSLE may be the result of three different mechanisms: the disease itself, infections related to immunosuppression and side effects of drug therapy. Retinal involvement is one of the most important manifestations, implying high possibility of visual loss. It is usually caused by immune complexes and autoantibodies deposition to the retinal vessels or hypertension resulting from kidney disease.Conclusions: Ocular manifestations can occur early in the course of jSLE, sometimes even before other systemic symptoms and can serve as markers of disease activity. Diagnosing ocular manifestations in children with jSLE is important for early intervention, monitoring disease activity, preventing vision loss and providing comprehensive care. By addressing ocular manifestations alongside systemic lupus management, healthcare providers can optimize outcomes and improve the overall well‐being of children with jSLE.

A Study of Ocular Manifestations in Children with Developmental Delay

Background and Objective: The study was conducted to determine the occurrence and types of ophthalmologic abnormalities in children with developmental delay. Methods: children with developmental delay between age group of 6 months to 16 years visiting Himalayan hospital were studied for presence and types of ocular manifestations over a period of 1year. Results: Among 54 children, ocular manifestation was noted in 48 (88.89%) children. Among various ocular manifestations refractive error was commonest seen in 29 out of 54(53.70%) cases of which hypermetropia was most common. Second most common manifestations was esotropia 11 out of 54 (20.37%) followed by exotropia 7 out of (12.96%). In 12 out of 54 (22.22%) subjects temporal disc pallor was present. Conclusion: In developmentally delayed children, visual handicap plays an important role in overall morbidity. early assessment and correction of visual problems will provide such children greater chances of achieving their true potential and will prevent unnecessary visual impairment

Ophthalmologic and neuro-ophthalmologic findings in children with Down syndrome.

Down syndrome, also known as Trisomy 21, is a genetic disorder associated with mild-to-moderate intellectual disability, delays in growth, and characteristic facial features. A wide range of ocular complications are seen in children with Down syndrome, including strabismus, nystagmus, refractive errors, congenital cataracts, the presence of keratoconus, and decreased visual acuity. Early ophthalmic examination is needed for early diagnosis and treatment in patients. This narrative review examines ocular manifestations in children with Down syndrome and the importance of prompt ophthalmic interventions for treatment.

Congenital ocular manifestations in children born to mothers who had COVID-19 coronavirus infection during pregnancy. Clinical cases

Preliminary data show that the incidence of eye damage in COVID-19 reaches 32%, with a diverse range of clinical manifestations. Both the anterior segment of the eye (conjunctivitis, keratoconjunctivitis) and the posterior segment (retinal vascular thrombosis, neuritis, neuroretinitis) can be affected. The infection in children is diagnosed much less frequently than in adults, so ophthalmic manifestations have hardly ever been studied.Purpose: to present cases of congenital eye lesions in children born to mothers who had COVID-19 during pregnancy.Material. We present 4 clinical cases of ocular manifestations in newborns born to such mothers.Results. 4 variants of congenital ocular manifestations are reported. Clinical manifestations are listed, and treatment tactics for such patients is proposed.Conclusion. In order to timely diagnose, and choose the optimal treatment tactics of such conditions, thorough collection of case history and the ophthalmologists’ awareness of ocular symptoms of COVID-19 manifestations is essential.

Ocular manifestations of children with atopic dermatitis in Saudi Arabia.

To examine the incidence of ocular abnormalities in children with atopic dermatitis (AD) in Saudi Arabia and its association with the severity of AD. This is a cross-sectional study on 50 children with AD who were between 5 and 16 years of age. The severity of AD was evaluated using the SCORing Atopic Dermatitis (SCORAD) index. All the children underwent slit lamp exams, visual acuity assessment, intraocular pressure measurement, and corneal topography. The children were considered to have an ophthalmic abnormality if one or more of the following signs were present: glaucoma, keratoconus suspicion, in addition to lid, conjunctival, corneal, lenticular, or retinal abnormalities. Based on the SCORAD severity index, 14% of children had mild AD (7/50), 38% had moderate AD (19/50), and nearly half had severe AD. More than half the children exhibited facial involvement, and half had peri-orbital signs. The mean SCORAD index was 35.75. The mean age was 10.48±3.6y, and the cohort showed a slight male predominance (54% males). Both eyes of the 50 children in the cohort were studied. Based on the ocular examinations, 92% of the patients showed ocular abnormalities: lid abnormalities (27/50) followed by keratitis (22/50). Four patients had moderate risk for keratoconus in one eye and eight patients were suspected to have keratoconus. However, SCORAD severity index was not associated with age, sex, or the number or presence of ophthalmic abnormalities. This is the first study in Saudi Arabia to evaluate the prevalence of ocular manifestations in children with AD. The results indicate that the majority of children with AD have ocular abnormalities that mainly include lid abnormalities. Based on these findings, larger scale studies are needed to affirm whether regular screening for ophthalmic abnormalities would be beneficial for children with AD in terms of early intervention and prevention of sight-threatening complications.

Assessment of Ocular Manifestations in Children with Nephrotic Syndrome during steroid Treatment

Assessment of Ocular Manifestations in Children with Nephrotic Syndrome during steroid Treatment

Ocular Manifestations in Children with COVID-19: Systematic Review and Meta-Analysis

Ocular Manifestations in Children with COVID-19: Systematic Review and Meta-Analysis

Acute and sub-acute ocular manifestations in pediatric patients with COVID-19: A systematic review.

The coronavirus disease 2019 (COVID-19) pandemic has been the most challenging health problem in the last 2 years. Post-COVID-19 multisystem inflammatory syndrome of children (MIS-C) is a severe post-COVID-19 complication in pediatric patients. Ocular manifestations may be the first presentation of MIS-C, wherein prompt treatment may improve outcomes. In this systematic review, we aimed to summarize the acute and sub-acute ocular manifestations in pediatric patients with laboratory-confirmed COVID-19. We included all online primary studies, with no language restriction and published between January 1, 2019 and November 18, 2020, reporting any acute or sub-acute ocular manifestations in children with laboratory-confirmed COVID-19. PubMed/MEDLINE was searched using the following MeSH and Emtree terms: "eye," "ophthalmologic," "ocular," "vision," "conjunctivitis," "severe acute respiratory syndrome coronavirus 2," "SARS-CoV-2," "corona," "2019-nCoV," "COVID19," and "COVID." The eligibility and quality of the selected records were assessed by two independent reviewers as per the Cochrane Handbook for Systematic Review. A total of 1,192 records were identified electronically. Seven papers were extracted from the reference lists of the eligible records. Thirty-six papers met the inclusion criteria and were categorized into two subgroups according to acute or sub-acute presentation of ocular manifestations. Among 463 pediatric patients with COVID-19, 72 (15.5%) had acute ocular manifestations. There was one patient with central retinal vein occlusion and another with photophobia and diplopia associated with meningoencephalitis. Among 895 pediatric patients with post-COVID-19 MIS-C, 469 (52.4%) had ocular manifestations, which only included non-purulent conjunctivitis. Ocular manifestations have been reported in less than one-fifth of pediatric patients with acute COVID-19. Furthermore, conjunctivitis was the only ocular manifestation reported in half of the patients with MIS-C, and it may be missed easily due to its non-purulent nature. During the COVID-19 pandemic, pediatricians and health workers must remain vigilant for early detection of signs of this potentially fatal post-COVID-19 inflammatory syndrome.

Clinical manifestations of congenital rubella syndrome at the Korle-Bu Teaching Hospital, Ghana

Background: Congenital rubella syndrome (CRS) is a variable constellation of birth defects related to intrauterine rubella infection which may result in visual, hearing, intellectual and cardiac impairments. Objective: The objective of this study is to describe the clinical manifestations in patients presenting with CRS at the Korle Bu Teaching Hospital using the World Health Organization criteria. Methods: A retrospective analysis of the medical charts of 16 children under 16 years old who presented with CRS at the Lions International Eye and the National Cardiothoracic Centres of the Korle Bu Teaching Hospital from 2012 to 2015, was done. Ocular, cardiac and other systemic clinical and laboratory findings were documented for each patient using predesigned forms. Results: Sixteen cases of CRS were recorded over the period (2012-2015) comprising 9 males and 7 females. The median (interquartile range) age at diagnosis was 4.0 months (2.0-7.0 months), age range at diagnosis was 1.0-24.0 months. The main ocular manifestations were; cataract 10 (62.5 %), microcornea 10 (62.5 %), microphthalmia 9 (56.3 %), nystagmus 7 (43.8 %) and strabismus 4 (25.0 %). The main cardiac defects included patent ductus arteriosus 12 (75.0 %), pulmonary stenosis 5 (31.3 %), ventricular septal defect 5 (31.3 %) and small branch pulmonary artery5 (31.3 %). Systemic conditions recorded included hearing defects 7 (43.8 %), microcephaly 7 (43.8 %), failure to thrive 5 (31.3 %) and mental retardation 2 (12.5 %). Conclusion: Cataract, microcornea and microphthalmia were the main ocular manifestations in children presenting with CRS at the Korle Bu Teaching Hospital. Patent ductus arteriosus and hearing defects were the main cardiac and systemic defects among children presenting with CRS at the Korle Bu Teaching Hospital.

Ocular manifestations in children with developmental delay in an eye hospital of northern Bangladesh

Background: The aim of this study was to identify common ocular manifestations in children with developmental delay in an eye hospital of northern part of Bangladesh.Methods: It was a retrospective medical record review of children with developmental delay who attended the pediatric ophthalmology department in an eye hospital from January 2019 to December 2019. Data were collected for their age, gender, past medical history, ophthalmic examination findings and systemic problems. Ophthalmic examination included examination of lid and adnexa, anterior and posterior segment examination and assessment of squint and refraction.Results: Medical records of 102 with developmental delay were identified and studied (59 boys and 43 girls, mean age 1.57 years, 53.9% aged &lt;1 year). Of these children, 44 (43.1%) were referred by the pediatricians. The most common past medical histories were perinatal asphyxia (42.2%), history of convulsion (30.4%), neonatal seizures (9.8%) and history of speech delay (1%). On ophthalmic examination, 30 (29.5%) had poor vision, 20 (19.6%) had refractive error, 23 (22.5%) had Strabismus and 11 (10.8%) had nystagmus. Optic atrophy was also observed among 11 children (10.8%).Conclusions: Ocular manifestations are commonly seen in children with developmental delay which can be cause of severe visual impairment and overall disability in later life. Hence an early ophthalmologic screening and intervention in these children by developing good referral network between ophthalmologist and pediatricians can help to substantially improve the developmental and academic achievement.

Изменения органа зрения у детей и взрослых на фоне COVID-19 и противоэпидемических мероприятий

The COVID-19 pandemic revealed several aspects of the problems directly related to the Ophthalmologists: damage to the eyes of patients with the SARS-CoV-2 virus; organization of medical work in a pandemic, including in a medical department redesigned to treat patients infected with SARS-CoV-2; side effects of personal protective equipment usage and anti-epidemic measures aimed to protect the organ of vision. Ocular manifestations were noted in 15–23% of children and 4–31% of adults with COVID-19. They were usually limited to acute conjunctivitis with «clear» discharge, hyperemia, edema and folliculosis of the conjunctiva, which reduced in 7–14 days without any treatment or on symptomatic therapy. The presence of SARS-CoV-2 in the tear and epithelium of the conjunctiva does not always correlated with the presence and severity of conjunctivitis and therefore had no clinical significance. There were also other problems associated with anti-epidemic measures (dry eye syndrome when wearing personal protective equipment, computer visual syndrome, etc.), which also requires attention of Ophthalmologists. Key words: COVID-19, SARS-CoV-2, ocular manifestations in children and adults.

Ocular Parameter Changes in Pediatric Patients with Nephrotic Syndrome

Abstract Background: Nephrotic syndrome has a relapsing nature that necessitates prolonged use of steroids and other immu-nosuppressive drugs. Systemic steroid administration is asso-ciated with multiple ocular side effects. This study was conducted to report various ocular manifestations in pediatric patients with nephrotic syndrome. Aim Study: The aim of our study is to report various ocular manifestations in children with idiopathic nephrotic-syndrome. Patients and Methods: This cross-sectional case control study included 100 cases diagnosed with nephrotic syndrome and 50 healthy controls. All subjects were subjected to detailed history taking, general examination, and laboratory investiga-tions. Also, comprehensive ophthalmological examination (including visual acuity, slit lamp microscopy, intraocular pressure measurement, and fundus examination) were per-formed. Results: Unaided visual acuity was significantly increased in cases compared to controls, and that was evident in both right and left eyes. IOP was significantly elevated in cases compared to controls (p 0.05). Conclusion: There is an increased incidence of ocular complications in pediatric cases with nephrotic syndrome. It is recommended that these cases should have regular ophthal-mological examination for early detection of these compli-cations.

Ocular manifestations of congenital insensitivity to pain: a long-term follow-up

AimTo describe ocular manifestations in children with congenital insensitivity to pain with and without anhidrosis (CIPA and CIP).MethodsWe reviewed records of eye examinations of 39 children diagnosed with CIPA or...

Hemoglobinopathies: ocular manifestations in children and adolescents.

Hemoglobinopathies are genetic disorders that lead to abnormal structure of the hemoglobin molecule. Sickle cell disease, the most common inherited blood disorder, is characterized by defective oxygen transport. Almost every part of the eye can be affected by sickle cell disease; however, proliferative sickle cell retinopathy is the primary cause of vision loss, either from vitreous hemorrhage or retinal detachment. Here we review the various manifestations of hemoglobinopathies on the eyes of children and adolescents, with a specific focus on sickle cell disease and its different phenotypes. Newer, more sensitive ophthalmological imaging modalities, including ultra-widefield fluorescein angiography, spectral-domain optical coherence tomography, and optical coherence tomography angiography, are available. These sensitive modalities allow for a more thorough examination of the retinal periphery where sickle cell retinopathy is often present. Utilization of such modalities will help with the early detection of the disease in children, which provide a better understanding of the pathogenesis of the disease and guide future screening and treatment regimens.

Ocular manifestations in children with developmental delay at a tertiary center in South India.

PURPOSE:Developmental delay occurs when a child exhibits a significant delay in the acquisition of milestones, in one or more domains of development. This study was planned to determine the distribution of ocular disorders and to assess the correlation between ocular findings and systemic co morbidity, antenatal and postnatal factors, and perinatal history.METHODS:This cross-sectional study included children with developmental delay <16 years of age. All children underwent complete ophthalmological evaluation including full cycloplegic refraction. Vision assessment was done as appropriate for age. Spearman's correlation test was used to analyze the correlation between ocular findings and causes for developmental delay and antenatal, perinatal, and postnatal history.RESULTS:A total of 128 children were evaluated. Mean age of the study group was 5.59 ± 2.12 years, 64.8% were males, and 76.6% of children were from rural area. Ocular findings were seen in 110 (85.93%) children, refractive error being the most common finding seen in 87 children (astigmatism n = 47, hypermetropia n = 28, and myopia n = 12). Strabismus was seen in 65 children, esotropia being the most common (n = 36). Vision impairment was present in 39.84% of children. Other ocular findings included disc pallor, cataract, ptosis, amblyopia, keratoconus, telecanthus, lagophthalmos, blepharitis, retinitis pigmentosa, and morning glory syndrome. Spearman's correlation showed no statistical association between ocular findings and various causes for developmental delay. There was a weak negative correlation between antenatal history, mode of delivery, gestational age, and ocular findings.CONCLUSION:More than three-fourths of children with developmental delay had ocular findings which necessitates the need for ocular evaluation.

Optical coherence tomography (OCT) and OCT angiography allow early identification of sickle cell maculopathy in children and correlate it with systemic risk factors.

To determine the presence of sickle cell retinopathy and maculopathy and to identify associations between markers of hemolysis and systemic and ocular manifestations in children affected by sickle cell disease. Eighteen children with sickle cell disease, aged 5-16 years, underwent complete eye examination including best-corrected visual acuity, slit-lamp biomicroscopy, ophthalmoscopy after pharmacological mydriasis, spectral-domain optical coherence tomography (SD-OCT), and optical coherence tomography angiography (OCTA). Blood test results and clinical history information were collected for each child, including fetal hemoglobin (HbF), hemoglobin (Hb), hematocrit (Htc), mean corpuscular volume (MCV), mean corpuscular hemoglobin concentration (MCHC), reticulocytes percentage (%ret), lactic dehydrogenase (LDH), total and direct bilirubin, glomerular filtration rate, number of painful crises, acute chest syndromes, and splenic sequestration. Therapeutic regimen and transfusion therapy were also evaluated. Sixteen of 36 eyes (44.4%) had non-proliferative sickle cell retinopathy on ophthalmoscopic evaluation. No patients had proliferative sickle cell retinopathy. In 13 of 36 eyes (36.1%), SD-OCT and OCTA detected signs of sickle cell maculopathy. Nine eyes (25%) presented sickle cell retinopathy and maculopathy, 7 eyes (19.4%) sickle cell retinopathy alone, and 4 eyes (11.1%) sickle cell maculopathy alone. A statistically significant association was found between sickle cell retinopathy; lower levels of HbF, Hb, and Htc; and higher MCV and percentage of reticulocytes. Sickle cell maculopathy was associated with lower values of H and Htc and higher levels of reticulocytes and total bilirubin. We identified early signs of sickle cell retinopathy and maculopathy in a pediatric population with SD-OCT and OCTA. These two retinal complications were more frequent in children with higher hemolytic rates.

Ocular manifestations in children and adolescents with sickle cell disease attending a Pediatric Hematology Unit in Damanhur Teaching Hospital

Background Sickle cell disease (SCD) is the most common genetic disease worldwide. It is usually accompanied with painful crisis. Microvascular occlusions are common and affect different systems, among which is the ocular manifestations.Aim This study aimed to assess retinal changes in patients with SCD and its correlation with hematological parameters and if there is a link between a pretransfusion hemoglobin level and ocular manifestations or not.Patients and methods This study was conducted in the Pediatric Hematology Unit of Damanhur Teaching Hospital including patients coming regularly to sickle cell OPD for follow-up, those who were admitted for sickle cell crisis in internal medicine ward, as well as obstetrics/gynecology patients who were found to be sickle cell positive (SS pattern). In this cross-sectional study, 30 steady-state patients (60 eyes) aged 2–26 years (22 children and eight young adults) with an established diagnosis of SCD (16 with homozygous SS and 14 with S/b thalassemia) underwent complete ophthalmic examination with dilated fundoscopy. Hematologic investigations and ophthalmic investigations (visual acuity, slit-lamp biomicroscopy, and fundoscopy) were done and compared. For statistical analysis, SPSS software was used.Results The study showed that 70% of the patients with SCD with hemoglobin less than or equal to 7 g or less had ocular abnormalities in the form of nonproliferative retinopathy, proliferative retinopathy, and refractive errors.Recommendations Based on these observations, we recommend that all children with SCD (SS, S/B) should have regular ophthalmic examination including fundoscopic examination to screen for sickle cell retinopathy beginning at the age of 12 years.

Changes in refractive characteristics in Japanese children with Down syndrome.

To investigate the refractive characteristics of Japanese children with Down syndrome. Retrospective study. The clinical records of refractive errors and ocular manifestations in children with Down syndrome who visited the Aichi Children's Health and Medical Center between November 2001 and January 2016 were retrospectively reviewed. The children were divided into the 3 following groups depending on their age: group 1 (≤6years), group 2 (7-12years), and group 3 (13-19years). The collection of refractive error data was performed only for the right eyes and only once for each child, when the children were last examined with their pupils dilated. The study included 416 children (224 boys, 192 girls; average age, 6.1±4.1years). Group 3 had significantly stronger myopia than did groups 1 and 2. The mean cylindrical power in all the children was -2.1±1.2 diopters (D), and cylindrical power ≤-1.0 D (stronger than -1.0 D) was seen in 366 eyes (88%). No significant difference in cylindrical power was found among the 3 groups. The spherical equivalent refraction showed an age-dependent myopic shift. Given that the amount of astigmatism did not show age-dependent differences, the age-dependent myopic shift could be due mainly to the change in spherical power.