Risk Of Visual Impairment Research Articles

Human toxocariasis seroprevalence among patients with uveitis in Alborz Province, Iran.

Toxocariasis, predominantly caused by Toxocara canis, is a common zoonotic parasitosis worldwide. Toxocara infection is a cause of vision impairment and blindness. The presented study investigates the frequency of antibodies against Toxocara among uveitis patients and the epidemiological factors associated with disease. Fifty-four patients with uveitis and 59 healthy subjects were studied. Anti-Toxocara antibodies status was determined in all serum samples using enzyme linked immunosorbent assay (ELISA), and seropositive samples analyzed by Western blot (WB) technique. The frequency of Toxocara canis infection was found to be significantly higher in uveitis patients, compared to healthy controls by the use of ELISA test, being 14.8% and 1.7%, respectively. From 8 seropositive samples, 5 (62.5%) patients exhibited Toxocara immunoglobulin G (IgG) antibodies in response to Western blot, whereas in the control group, none were detected positive by Western blot. No significant difference was found between pet owners, nor between different places of residence. The seroprevalence to Toxocara among uveitis patients was significantly related to gender, age and medical diagnosis. The highest prevalence was found in patients with posterior uveitis (27.8%). Anti-Toxocara antibody titers are associated with the risk of vision impairment -uveitis. The risk factor associated with Toxocara exposure identified in this study warrants further investigation.

Prevalence status and influencing factors of visual impairment in the elderly people in rural areas of Yugan County, Jiangxi Province

Objective: To assess the prevalence of visual impairment and the influencing factors among rural residents aged 60 years and above in Yugan county, Jiangxi province. Researchers analyzed influencing factors and provided scientific rationale for blindness prevention and control. Methods: Stratified cluster random sampling was used in randomly selecting 3 789 rural residents aged ≥ 60 in Yugan county. Eligible residents were invited to receive ophthalmic examinations and epidemiological investigations. Multivariate logistic regression was performed to analyze any influencing factors. Results: Three thousand seven hundred and eighty-nine rural residents completed the ophthalmic examination and investigation. Based on presenting visual acuity, the prevalence of visual impairment was 24.1%(915), of which blindness and moderate and severe was 2.9%(108) and 21.3%(807). The top five causes ranked are (1) cataract (283, 30.9%), (2) Refractive error (81, 8.9%), (3) macular degeneration (29, 3.2%), (4) Corneal opacity (14, 1.5%). Multivariate logistic regression showed that age, gender, education, occupation, marital status, ophthalmic anamnesis, smoking situation, and daily fruit intake were the main factors that were the influencing factors of visual impairment. Conclusions: The prevalence of visual impairment in the elderly population in rural areas of Yugan County is quite high. Keep a healthy diet, timely correction of eye disease, could reduce the risk of visual impairment. (Chin J Ophthalmol, 2018, 54:605-610).

Unhealthy behaviours and risk of visual impairment: The CONSTANCES population-based cohort

Unhealthy behaviours are linked to a higher risk of eye diseases, but their combined effect on visual function is unknown. We aimed to examine the individual and combined associations of diet, physical activity, smoking and alcohol consumption with visual impairment among French adults. 38 903 participants aged 18–73 years from the CONSTANCES nationwide cohort (2012–2016) with visual acuity measured and who completed, lifestyle, medical and food frequency questionnaires were included. Visual impairment was defined as a presenting visual acuity <20/40 in the better eye. After full multivariate adjustment, the odds for visual impairment increased with decreasing diet quality (p for trend = 0.04), decreasing physical activity (p for trend = 0.02) and increasing smoking pack-years (p for trend = 0.03), whereas no statistically significant association with alcohol consumption was found. Combination of several unhealthy behaviours was associated with increasing odds for visual impairment (p for trend = 0.0002), with a fully-adjusted odds ratio of 1.81 (95% CI 1.18 to 2.79) for participants reporting 2 unhealthy behaviours and 2.92 (95% CI 1.60 to 5.32) for those reporting 3 unhealthy behaviours. An unhealthy lifestyle including low/intermediate diet quality, low physical activity and heavy smoking was associated with visual impairment in this large population-based study.

Prevalence and causes of low vision and blindness in an elderly population in Nepal: the Bhaktapur retina study

BackgroundThis study aims to explore the prevalence and causes of low vision and blindness focused on retinal disease in a population above 60 years in Nepal.MethodsTwo thousand one hundred subjects were enrolled in a population-based cross-sectional study. History, presenting and best corrected visual acuity after subjective refraction, anterior and posterior segment examinations was obtained in detail.ResultsAmong the total subjects, 1860 (88.57%) had complete information. Age varies from 60 to 95 (mean age: 69.64 ± 7.31) years. Low vision and blindness in both eyes at presentation was found in 984 (52.90%, 95% confidence interval (CI): 50.60–55.19) and 36 (1.94%, 95% CI: 1.35–2.66) subjects respectively. After best correction, bilateral low vision and blindness was found in 426 (22.92%, 95% CI: 21.01–24.88), and 30 (1.61%, 95% CI: 0.10–2.30) subjects respectively. As compared to 60–69 years old, risk of visual impairment was four times higher (95% CI:3.26–5.58) in the 70–79 year olds and 14 times higher (95% CI: 9.72–19.73) in the age group 80 years and above.Major causes of bilateral low vision were cataract (68.07%), followed by retinal disorders (28.64%), and for blindness; retinal disorders (46.66%), followed by cataract (43.33%). Illiteracy was significantly associated with visual impairment.ConclusionAmong the elderly population, prevalence of visual impairment was high. Refractive error, cataract and retinal disorders were the major cause of low vision. Screening the population at the age 60 years and above, focused on cataract and posterior segment diseases, providing glasses and timely referral can help reduce visual impairment.

The particularities of corneal infectious diseases in children

SummaryCorneal infections in children can affect subjects of all ages with a high frequency in newborns and infants. In infant, children and teenagers the most common ocular pathogens, that differ from the adult, are Haemophilus Influenzae, Staphylococcus aureus, Streptococcus pneumonia and also Moraxella species. These infections could lead to ulcers and sight‐threatening complications. Infectious keratitis in children is not common but can cause a severe visual impairment if late diagnosed with delayed treatment established or with weak efficacy. In children corneal infections can be difficult to diagnose because the pathology can develop without pain. In addition, the examination may be difficult to perform. Identification of the pathogen must be performed as far as possible. The treatment should be provided earlier and aims to eliminate the bacteria, virus or fungus pathogens. Specific epidemiology of pathogens will be detailed according to age. Risks of visual impairment and amblyopia must be integrated. An update on topical antibiotics and current options will be reviewed with practical aspects, diverse clinical cases and considering quality of life of children and parents.

Evaluation of Cognitive Functioning in the Context of Rehabilitation for Visual Impairment in Older Adults: A Case Series

ABSTRACTAims: As the risk of visual impairment increases with age, so does the risk of developing cognitive impairment. Detection of cognitive deficits in people with visual impairments is a challenge and it remains unclear to what extent cognitive issues impact daily habits and the rehabilitation process. The present study aimed to (1) verify the consistency between the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) (“Blind” versions) and the therapist's observations of elderly individuals in low-vision rehabilitation (LVR), and (2) document how cognitive difficulties may influence LVR and the satisfactory carrying-out of life habits. Methods: Six elderly individuals who received LVR completed the MMSE and MoCA (“Blind” versions) and Assessment of Life Habits (LIFE-H). The therapist rated the achievement of rehabilitation objectives, clients' cognitive functioning and its impact on the rehabilitation process. Results: All participants obtained scores within the normative score range for both tests except for one participant on the MoCA. The therapist perceived that four out of six participants had cognitive difficulties significant enough to hinder the rehabilitation process and these persons required more adaptations to therapy. All participants were satisfied with their life habits despite remaining functional limitations and the need for assistance. Conclusions: In this sample, standardized cognitive tests had limited utility to predict the complexity of LVR. Even if present, cognitive difficulties do not preclude rehabilitation for even severe visual impairment in elderly persons and does not imply significantly longer or more intense rehabilitation.

Association of Axial Length With Risk of Uncorrectable Visual Impairment for Europeans With Myopia

Myopia (ie, nearsightedness) is becoming the most common eye disorder to cause blindness in younger persons in many parts of the world. Visual impairment due to myopia is associated with structural changes of the retina and the globe because of elongation of the eye axis. How axial length-a sum of the anterior chamber depth, lens thickness, and vitreous chamber depth-and myopia relate to the development of visual impairment over time is unknown. To evaluate the association between axial length, spherical equivalent, and the risk of visual impairment and to make projections of visual impairment for regions with high prevalence rates. This cross-sectional study uses population-based data from the Rotterdam Study I (1990 to 1993), II (2000 to 2002), and III (2006 to 2008) and the Erasmus Rucphen Family Study (2002 to 2005) as well as case-control data from the Myopia Study (2010 to 2012) from the Netherlands. In total, 15 404 individuals with data on spherical equivalent and 9074 individuals with data on axial length were included in the study; right eyes were used for analyses. Data were analyzed from September 2014 to May 2016. Visual impairment and blindness (defined according to the World Health Organization criteria as a visual acuity less than 0.3) and predicted rates of visual impairment specifically for persons with myopia. Of the 15 693 individuals included in this study, the mean (SD) age was 61.3 (11.4) years, and 8961 (57.1%) were female. Axial length ranged from 15.3 to 37.8 mm; 819 individuals had an axial length of 26 mm or greater. Spherical equivalent ranged from -25 to +14 diopters; 796 persons had high myopia (ie, a spherical equivalent of -6 diopters or less). The prevalence of visual impairment varied from 1.0% to 4.1% in the population-based studies, was 5.4% in the Myopia Study, and was 0.3% in controls. The prevalence of visual impairment rose with increasing axial length and spherical equivalent, with a cumulative incidence (SE) of visual impairment of 3.8% (1.3) for participants aged 75 years with an axial length of 24 to less than 26 mm and greater than 90% (8.1) with an axial length of 30 mm or greater. The cumulative risk (SE) of visual impairment was 5.7% (1.3) for participants aged 60 years and 39% (4.9) for those aged 75 years with a spherical equivalent of -6 diopters or less. Projections of these data suggest that visual impairment will increase 7- to 13-fold by 2055 in high-risk areas. This study demonstrated that visual impairment is associated with axial length and spherical equivalent and may be unavoidable at the most extreme values in this population. Developing strategies to prevent the development of myopia and its complications could help to avoid an increase of visual impairment in the working-age population.

Specificities of corneal infectious diseases in children

SummaryInfectious keratitis in children is not common but can cause a severe visual impairment if late diagnosed with delayed treatment established or with weak efficacy. Corneal infections in children can affect subjects of all ages with a high frequency in newborns and infants. In infant, children and teenagers the most common ocular pathogens, that differ from the adult, are Haemophilus Influenzae, Staphylococcus aureus, Streptococcus pneumonia and also Moraxella species. These infections infections could lead to ulcers and sight‐threatening complications. In children corneal infections can be difficult to diagnose because the pathology can develop without pain. In addition, the examination may be difficult to perform. Identification of the pathogen must be performed as far as possible. The treatment should be provided earlier and aims to eliminate the bacteria, virus or fungus pathogens. Specific epidemiology of pathogens will be detailed according to age. Risks of visual impairment and amblyopia must be integrated. An update on topical antibiotics and current options will be reviewed with practical aspects, diverse clinical cases and considering quality of life of children and parents.

Surgical Timing of the Orbital "Blowout" Fracture: A Systematic Review and Meta-analysis.

The orbital blowout fracture is a common facial injury, carrying with it a risk of visual impairment and undesirable cosmetic results unless treated properly. Optimal timing of the surgical treatment is still a matter of debate. We set out to determine whether a meta-analysis would bring us closer to an answer to this question. PubMed, EMBASE, Web of Science, and the Cochrane Library were searched from January 1980 to August 2014. We applied the following inclusion criteria: isolated blowout fractures, presenting early and late surgery groups (<14 and >14 days). Patients were evaluated for diplopia and enophthalmos. We followed the statements of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses). Pooled odds ratios were estimated with the fixed effects method of Mantel-Haenszel. We identified 5 studies with available outcome data (N = 442). Patients in the late group showed an odds ratio of 3.3 (P = .027) for persistent postoperative diplopia as compared with the early group. We found no significant difference between the groups when assessing postoperative enophthalmos as an isolated symptom. We found a significantly increased risk of persistent diplopia in patients who were operated >14 days after the trauma.

Reduced Expression of Cytoskeletal and Extracellular Matrix Genes in Human Adult Retinal Pigment Epithelium Cells Exposed to Simulated Microgravity

Background/Aims: Microgravity (µg) has adverse effects on the eye of humans in space. The risk of visual impairment is therefore one of the leading health concerns for NASA. The impact of µg on human adult retinal epithelium (ARPE-19) cells is unknown. Methods: In this study we investigated the influence of simulated µg (s-µg; 5 and 10 days (d)), using a Random Positioning Machine (RPM), on ARPE-19 cells. We performed phase-contrast/fluorescent microscopy, qRT-PCR, Western blotting and pathway analysis. Results: Following RPM-exposure a subset of ARPE-19 cells formed multicellular spheroids (MCS), whereas the majority of the cells remained adherent (AD). After 5d, alterations of F-actin and fibronectin were observed which reverted after 10d-exposure, suggesting a time-dependent adaptation to s-µg. Gene expression analysis of 12 genes involved in cell structure, shape, adhesion, migration, and angiogenesis suggested significant changes after a 10d-RPM-exposure. 11 genes were down-regulated in AD and MCS 10d-RPM-samples compared to 1g, whereas FLK1 was up-regulated in 5d- and 10d-RPM-MCS-samples. Similarly, TIMP1 was up-regulated in 5d-RPM-samples, whereas the remaining genes were down-regulated in 5d-RPM-samples. Western blotting revealed similar changes in VEGF, β-actin, laminin and fibronectin of 5d-RPM-samples compared to 10d, whereas different alterations of β-tubulin and vimentin were observed. The pathway analysis showed complementing effects of VEGF and integrin β-1. Conclusions: These findings clearly show that s-µg induces significant alterations in the F-actin-cytoskeleton and cytoskeleton-related proteins of ARPE-19, in addition to changes in cell growth behavior and gene expression patterns involved in cell structure, growth, shape, migration, adhesion and angiogenesis.

Comparison of visual impairment caused by trachoma in China between 1978 and 2006

To understand the distribution of visual impairment caused by trachoma in China and provide evidences for evaluation of eliminating blinding trachoma in China in the mission of Vision 2020. Sampling study. The results from the first year 1987 and second (year 2006) national sampling surveys of disabled persons were analyzed. Chi-square test was performed using SAS 9.30 to analyze the rates of visual impairment caused by trachoma in different groups. Unifactor and multifactor analyses were applied to analyze the relevance between visual impairment caused by trachoma and risk factors, including gender and age. The rate of visual impairment caused by trachoma was 102.01 persons/100 000 in 1987 and 17.62 persons/100 000 in 2006. The percentage of trachoma in all kinds of visual impairment was 14.25% in 1987 and 1.87% in 2006, and the difference was significant (F = 1 382.6, P < 0.01). Spatial aggregation was obvious in visual impairment caused by trachoma. H-aggregation areas included Hubei, Sichuan, Anhui, Shannxi, Guizhou, Hunan provinces and Chongqing Municipality. Survival time without trachoma between 1987 and 2006 was significantly different (F = 2 745.9, P < 0.01). The rate and risk of visual impairment caused by trachoma increased with age. Except the group of > 85 years, the rate of visual impairment caused by trachoma in all age groups in 1987 was significantly higher than that in 2006. The risk of visual impairment caused by trachoma in 1987 was 5.8 times that in 2006. If the other risk factors were not involved, the risk in 1987 was 8.75 times that in 2006. The risk in females was twice that in males. Both, the rate and risk of visual impairment caused by trachoma were significantly reduced in China. Impressive progresses were achieved in trachoma prevention and control.

Visual evoked potentials in children and adolescence with neurofibromatosis type 1

Children with neurofibromatosis type 1 (NF1) have an increased risk of developing optic pathway gliomas (OPGs) during childhood. The role of visual evoked potential (VEP) in the management of children with NF1, are controversial. The purpose of this investigation was to determine: if VEP abnormalities could be identified in children with NF1 with no MRI evidence of OPGs; and can screening for OPG in patient with NF1 be performed with VEP testing? We retrospectively reviewed VEP records of the 29 patients with NF1. Pattern reversal visual evoked potentials (PR-VEP) were performed using standardized technique, on Medelec Sapphire Premiere device. A total of 29 children and adolescents were examined. Of those, 18 had pathological VEP: eight with the P100 latency prolongation, six with decreased amplitude, four with significant interocular amplitude difference. One of four patients with OPG has normal VEP. Our study showed that some degree of abnormalities could be identified in a significant number of patients, independently of presence of OPG. This may represent a marker of abnormal visual processing. Despite their limitations, VEPs would have provide useful adjunct to clinical ophthalmologic review to identified children at risk for visual impairment.

Update on orbital decompression as emergency treatment of traumatic blindness

IntroductionBlindness is a rare and severe complication of craniofacial trauma. The management of acute orbital compartment syndrome (AOCS) is not well defined and there is no standard treatment. Our objective was to find indications for orbital decompression, the best time for treatment, and the appropriate techniques. Materials and methodsA literature review was made from articles published between 1994 and 2014 in the PubMed database, on the emergency treatment of AOCS. Results59 of the 89 patients treated surgically for AOCS presented with significant improvement of visual acuity (VA) after orbital decompression. The delay between trauma and surgery was short. A lateral canthotomy with inferior cantholysis (LCIC) was the most frequently used technique. DiscussionAOCS with a risk of visual impairment must be decompressed in emergency, at best in the 2 hours following trauma, most often by LCIC to have the best chance of recovering VA. Adjuvant medical treatment (acetazolamide, mannitol, corticosteroids) should not delay surgery. Postoperative corticosteroid therapy is not indicated, especially in patients with severe head trauma.

Visual health inequalities: findings from UK Biobank

BackgroundLittle is known about inequalities in eye health. Between 2009 and 2010, 117 908 UK Biobank participants (aged 40–69 years) undertook an ophthalmic assessment, which included distance visual acuity. UK Biobank was not designed to be a fully representative population sample so prevalence estimation is precluded. However, the size and diversity of the sample provide a unique opportunity for investigation of socioeconomic influences on visual health in UK adults. MethodsHabitual (usual optical correction) distance acuity was measured with a standardised computer-based system. 112 314 participants were reliably assigned, on the basis of acuity in the better eye, into one of six categories spanning the spectrum of vision from bilateral normal vision (log of minimum angle of resolution [logMAR] 0·2 or better) to low-vision–blind (≤0·5, WHO taxonomy). Socioeconomic information included educational qualifications and Townsend Index. Multinomial and ordinal regression analyses were undertaken. FindingsThe frequency of normal bilateral vision decreased with age (age 40–49 years, 86% [21 934/25 645]; 50–59 years, 77% [27 482/35 786]; and 60–70 years, 72% [36 461/50 883]). Overall, risk of visual impairment across severity categories was associated with an increasing gradient of key demographic and socioeconomic variables, indicating deprivation. These patterns of visual health inequalities were not explained by risk of underlying eye disease. For example, compared with normal vision, socially significant visual impairment (SSVI), a mid-range category of visual impairment, was associated with increasing age (risk ratio 1·05, 95% CI 1·046–1·06), being female (1·09, 1·01–1·16), no educational qualifications (1·7, 1·4–1·9), a higher deprivation score (1·08, 1·07–1·09), and being part of any minority ethnic group (eg, Asian 2·5, 2·1–2·9). Participants unable to work or unemployed were at least 30% more likely to be in the SSVI category than were those with normal vision and, if employed, at least 9% more likely to have a lower status job. InterpretationThere are consistent patterns of associations between visual impairment across the full spectrum including, importantly, people with mild impairment, and known health determinants as well as key social outcomes. To our knowledge, our study provides evidence for the first time that policies tackling health inequalities as well as initiatives to address inequalities in ophthalmological clinical settings have the potential to improve visual health outcomes. FundingThis work was funded by the National Eye Research Centre. PMC is funded by the Ulverscroft Foundation and JSR receives part funding from the National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and University College London Institute of Ophthalmology. The study was undertaken at University College London Institute of Child Health, which receives a proportion of its funding from the Department of Health's NIHR Biomedical Research Centres funding scheme.

Corneal infectious diseases in children

AbstractCorneal infections in children can affect subjects of all ages with a high frequency in newborns and infants. Severe visual impairment can result from corneal infectious disease especially if late diagnosed with delayed treatment. In infant, children and teenagers the most common ocular pathogens, that differ from the adult, are Haemophilus Influenzae, Staphylococcus aureus, Streptococcus pneumonia and also Moraxella species. These infections infections could lead to ulcers and sight‐threatening complications. In children corneal infections can be difficult to diagnose because the pathology can develop without pain. In addition the examination may be difficult to perform. The treatment should be provided earlier and aims to eliminate the bacteria, virus or fungus pathogens. Specific epidemiology of pathogens will be detailed according to age. Risks of visual impairment and amblyopia must be integrated. An update on topical antibiotics and current options will be reviewed with practical aspects, diverse clinical cases and considering quality of life of children and parents. Commercial interest

Idiopathic intracranial hypertension in pregnancy

Key content Idiopathic intracranial hypertension is a rare condition that usually affects overweight women. It is a diagnosis of exclusion in a pregnant woman presenting with headache. It is important to understand the medical and surgical treatment options in pregnancy. The mode of delivery is usually decided by obstetric factors. The risk of visual impairment is the same in pregnant and non‐pregnant women with idiopathic intracranial hypertension. Learning objectives To identify how idiopathic intracranial hypertension presents in pregnancy. To know how to monitor and manage women with this condition during pregnancy. To understand the intrapartum, postpartum and long‐term implications of this condition. Ethical issues What is the extent of investigation before reaching the diagnosis of idiopathic intracranial hypertension? Do we need a high index of suspicion in all pregnant women presenting with headache? What is the preferred mode of delivery in idiopathic intracranial hypertension – do they all need a caesarean section?

The particularities of corneal infectious diseases in children

AbstractOcular surface bacterial infections affect subjects of all ages with a high frequency in newborns and children. In infant, children and teenagers, the most common ocular pathogens, which differ from adults, are Haemophilus influenzae, Staphylococcus aureus, Streptococcus pneumoniae and also Moraxella species. These infections could lead to ulcers and sight‐threatening complications. Corneal infections are not common but can be difficult to diagnose because the pathology can develop without pain. In addition the examination may be difficult to perform. The treatment should be provided earlier and aims to eliminate the bacteria, virus or fungal pathogens. The specific epidemiology of pathogens will be detailed according to the age. Risks of visual impairment and amblyopia must be integrated. An update on topical antibiotics and current options will be reviewed with practical aspects, diverse clinical cases and considering quality of life of the children and parents.

Vision problems causing and not causing visual impairment in a working population of Catalonia

To analyze the distribution of visual problems which cause and do not cause visual impairment in a working population, and their relation to social class. This was a cross-sectional study of 86,831 employed workers (59,397 men, and 27,421 women) in Catalonia ages 16 to 65 years who, in 2009, underwent health surveillance exams at the Asepeyo Health Prevention. The prevalence of visual problems that cause and do not cause visual impairment was calculated by age, sex and occupational social class, and associations were analyzed using logistic regression. 2.2% (95% CI 2.1-2.3) of the active working population studied had vision problems that cause visual impairment, even while wearing corrective lenses. After adjusting for age, workers in Class V show a 2.4-fold greater risk of visual impairment than those in Class I. Women, older workers and disadvantaged social groups showed the highest prevalence and risk of visual impairment. Conversely, problems resolved by vision correction that do not cause visual impairment are concentrated in non-manual workers.

EXUDATES DETECTION AND CLASSIFICATION ALGORITHM OF DIABETIC PATIENTS' RETINA IMAGES

The chronic hyperglycemia of diabetes is associated with long-term damage, dysfunction, and failure of different organs, especially the eyes, kidneys, nerves, heart and blood vessels. The regular examination of diabetic patients can potentially reduce the risk of vision impairment and in the last instance blindness. Early diabetic retinopathy detection enables application of laser therapy treatment in order to prevent or delay loss of vision. The diagnostics and detection of diabetic retinopathy is performed by specialized ophthalmologists manually and represents expensive procedure. Automatic exudates detection and retina images classification would be helpful for reducing diabetic retinopathy screening costs and encouraging regular examinations. We proposed the automated algorithm that applies mathematical modeling which enables light intensity levels emphasis, easier exudates detection, efficient and correct classification of retina images. The proposed algorithm is robust to various appearance changes of retinal fundus images which are usually processed in clinical environments.

Intermediate Uveitis in a Pediatric Italian Population

Purpose: To investigate clinical data, outcome, and treatment of intermediate uveitis in children.Methods: Retrospective cohort study, including 116 children affected by intermediate uveitis.Results: Sixty-two percent of patients were males. Ocular involvement was bilateral in 84%. Mean age at uveitis onset was 10.3 ± 3.6 years and 12.2 ± 7 years at first visit. Ninety-seven percent were classified as having idiopathic uveitis. The incidence of ocular complications during follow-up was 0.131/eye-year. Macular edema or a marked vitreous haze at presentation may be risks factors for incident visual loss. The most frequent causes of visual loss were macular edema (64%) and cataract (21%).Conclusions: Most cases are idiopathic (pars planitis); only few children presented associated systemic disease. Macular edema and severe vitritis at presentation are associated with increased risk of visual impairment. Cystoid macular edema is the main cause of visual impairment.