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Purpose: To determine the feasibility of a new technique for suprathreshold automated static perimetry in children. Design: Evaluation of diagnostic test or technology. Participants: The study included 29 subjects comprising 4 groups: 12 adults with normal fields, 4 children aged less than 10 years with normal fields, 8 adults with visual field defect, and 5 children aged less than 10 years with suspected visual field defects. Methods: The system comprises a personal computer, display, and eye tracker to monitor gaze position when stimuli are presented in the visual field. The natural saccadic eye movement to fixate on the stimuli, if seen, can be detected and measured to produce a visual field plot. Subjects performed 3 eye-tracking tests, unless unable to do so for any reason: a 40-point binocular test and two 41-point tests for each eye. The tests were based on the Humphrey Field Analyzer (HFA) Central-40 point screening test with a stimulus size of Goldmann III and intensity of 14 decibels (dB). Adults also performed the equivalent Humphrey screening test in each eye for comparison. Main Outcome Measures: Comparison of visual field plot results between the eye-tracking tests and HFA tests in adults. Correlation between the eye-tracking tests and the clinical assessment in the children with suspected visual field defects. Results: In the eyes of all normal adult and child subjects performing the eye-tracking test, the percentage of points in agreement with a healthy visual field was 99.2% and 99.1%, respectively. The percentage of points agreeing with the HFA''s screening test in the adult eyes with visual field defects was 89.8%. Visual field defects were also correctly identified by the eye-tracking system in the eyes of children with suspected visual field defects. Conclusions: The results demonstrate that suprathreshold automated static perimetry using eye tracking is a promising method of perimetry for use with children. Financial Disclosure(s): Proprietary or commercial disclosure may be found after the references. [Copyright &y& Elsevier]

Abstract: Retinopathy of Prematurity (ROP) occurs when premature birth interrupts normal retinal vascular development. Postnatal tissue oxygen levels are significantly higher than those present in utero. Oxygen therapy further increases oxygen levels in the developing retina. Hypoxia driven, VEGF mediated, retinal endothelial cell proliferation is reduced. Low IGF-1 levels may also contribute to delayed retinal vascular development. The neural structures of the peripheral avascular retina continue to develop, and become more metabolically active. Complex, as yet poorly understood abnormalities of structural and molecular interactions between immature endothelial cells and immature astrocytes at the anterior “leading edge” of retinal vascular development leads to the development of an ROP ridge. VEGF produced by the hypoxic peripheral retina, along with structural abnormalities of cell relationships within, and at the vitreoretinal interface of the ROP ridge, results in extraretinal angiogenesis – stage 3 ROP. Stage 3 ROP may resolve spontaneously, or may progress to traction retinal detachment and blindness. [Copyright &y& Elsevier]

The International Classification of Retinopathy of Prematurity is a consensus statement that creates a standard nomenclature for classification of retinopathy of prematurity (ROP). It was initially published in 1984, expanded in 1987, and revisited in 2005. This article presents a third revision, the International Classification of Retinopathy of Prematurity, Third Edition (ICROP3), which is now required because of challenges such as: (1) concerns about subjectivity in critical elements of disease classification; (2) innovations in ophthalmic imaging; (3) novel pharmacologic therapies (e.g., anti–vascular endothelial growth factor agents) with unique regression and reactivation features after treatment compared with ablative therapies; and (4) recognition that patterns of ROP in some regions of the world do not fit neatly into the current classification system. Review of evidence-based literature, along with expert consensus opinion. International ROP expert committee assembled in March 2019 representing 17 countries and comprising 14 pediatric ophthalmologists and 20 retinal specialists, as well as 12 women and 22 men. The committee was initially divided into 3 subcommittees—acute phase, regression or reactivation, and imaging—each of which used iterative videoconferences and an online message board to identify key challenges and approaches. Subsequently, the entire committee used iterative videoconferences, 2 in-person multiday meetings, and an online message board to develop consensus on classification. Consensus statement. The ICROP3 retains current definitions such as zone (location of disease), stage (appearance of disease at the avascular–vascular junction), and circumferential extent of disease. Major updates in the ICROP3 include refined classification metrics (e.g., posterior zone II , notch , subcategorization of stage 5, and recognition that a continuous spectrum of vascular abnormality exists from normal to plus disease). Updates also include the definition of aggressive ROP to replace aggressive-posterior ROP because of increasing recognition that aggressive disease may occur in larger preterm infants and beyond the posterior retina, particularly in regions of the world with limited resources. ROP regression and reactivation are described in detail, with additional description of long-term sequelae. These principles may improve the quality and standardization of ROP care worldwide and may provide a foundation to improve research and clinical care. [ABSTRACT FROM AUTHOR]

Purpose: To describe the predisposing pathology and clinical features of all incident cases of rhegmatogenous retinal detachment (RRD) recruited in Scotland during a 2-year period. Design: Prospective surveillance study of incident cases of RRD. Participants: All incident cases of RRD recruited as part of the Scottish Retinal Detachment Study. Methods: During a 2-year period, we coordinated a comprehensive system in which every case of primary RRD presenting to 1 of 6 vitreoretinal surgical sites in Scotland was examined and approached for study inclusion. Main Outcome Measures: Rhegmatogenous retinal detachment incidence, predisposing features, and clinical characteristics. Results: A total of 1202 cases were recruited. Detailed clinical information was available on 1130 (94%) of cases. By causative break, the proportions of RRD were horseshoe tear (HST) associated with posterior vitreous detachment (PVD) in 86.2%, giant retinal tear (GRT) and PVD in 1.3%, non-PVD round hole (RH) in 4.9%, retinal dialysis in 5.9%, and retinoschisis RRD in 1.6%. One in 10 cases reported significant ocular trauma. One in 5 cases were pseudophakic. Round hole RRD more frequently presented with multiple retinal breaks compared with HST RRD (67.8% vs. 48.7%; P = 0.003). In PVD-associated RRD, 56.1% (95% confidence interval [CI], 53.8–58.3) of breaks were identified in the superotemporal retina. In non-PVD RRD, 54.6% (95% CI, 47.9–61.1) of breaks were inferotemporal, followed by superotemporal in 34.9% (95% CI, 28.7–41.5). Lattice degeneration was present in 18.7% of affected eyes and more common in RH RRD (35.7%) than in HST RRD (19.3%) (P = 0.003). Seven percent reported an affected first-degree relative, and these cases were significantly more myopic than nonfamilial cases. Conclusions: More than 85% of RRD cases are associated with PVD and related tractional tears. Non-PVD RH RRD occurred in younger and more myopic individuals. The majority of cases are caused by more than 1 retinal break, and the macula is affected in more than 50% at presentation. Ocular trauma, previous cataract surgery, family history, and lattice degeneration are important predisposing features. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. [Copyright &y& Elsevier]