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Purpose: To study the effect of the pandemic-related lockdown (physical distance measures and movement restrictions) on the characteristics and management of retinopathy of prematurity (ROP)., Methods: In this controlled, multicenter cohort study, the medical records of patients born prematurely and screened for ROP in the neonatal intensive care unit during four time periods were reviewed retrospectively: (1) November 1, 2018, to March 15, 2019; (2) March 16, 2019, to August 2, 2019 (lockdown control period); (3) November 1, 2019, to March 15, 2020; and (4) March 16, 2020-August 2, 2020., Results: A total of 1,645 patients met inclusion criteria. Among the 1,633 patients with complete data, mean gestational age (GA) at birth was 28.2, 28.4, 28.0, and 28.3 weeks across time periods 1 to 4, respectively (P = 0.16). The mean birth weight of all patients was 1079.1 ± 378.60 g, with no significant variation across time periods (P = 0.08). There were fewer patients screened during the lockdown period (n = 411) compared with the period immediately before (n = 491) and the same period in the prior year (n = 533). Significantly more patients were screened using indirect ophthalmoscopy, compared to digital imaging (telemedicine), during the lockdown (P < 0.01). There were 11.7%, 7.7%, 9.0%, and 8.8% of patients requiring treatment in each time period, respectively (P = 0.42), with a median postmenstrual age at initial treatment of 37.2, 36.45, 37.1, and 36.3 weeks, respectively (P = 0.32)., Conclusions: We recorded a decrease in the number of infants meeting criteria for ROP screening during the lockdown. The GA at birth and birth weight did not differ. Significantly more infants were screened with indirect ophthalmoscopy, compared to digital imaging, during the lockdown., (Copyright © 2023 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: To determine whether vascular endothelial growth factor (VEGF), angiopoeitin-1 (Ang-1), angiopoetin-2 (Ang-2), and matrix metalloproteinase-9 (MMP-9) can be reliably collected and analyzed from infant tears to aid in the diagnosis of retinopathy of prematurity (ROP) and enhance the ability to objectively monitor its clinical course., Methods: In this nonrandomized controlled investigation, tear and saliva samples collected from 20 premature infants during serial ophthalmic examination were analyzed using enzyme-linked immunoassay with results analyzed as a function of disease stage and need for treatment., Results: Tear volume was directly correlated with corrected gestational age (P < 0.001). Tear VEGF levels from samples corresponding to stage 3 ROP were 47.9% lower (P = 0.006) than in samples corresponding to stage 0-1 and 49.1% lower (P = 0.01) than in samples corresponding to stage 2 ROP. There were no between-group differences after normalizing tear VEGF by saliva VEGF levels. Tear/saliva ratio for Ang-1 was 200% greater (P = 0.042) and tear/saliva ratio for Ang-2 was 165% greater (P = 0.035) in samples corresponding to stage 2 versus stage 0-1 ROP disease. Ang-1/Ang-2 ratio was lower in samples from infants who developed stage 2 or worse ROP than in samples from infants who never developed worse than stage 1 ROP (P = 0.031)., Conclusions: In this study cohort, cytokines involved in the pathophysiology of ROP could be reliably identified in and analyzed from infant tears, and showed variation with ROP severity., (Copyright © 2023 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: To identify predictors of visual outcomes in children with open globe injuries., Methods: The medical records of patients (≤18 years of age) with open globe injury from 2012 to 2020 at a single institution were retrospectively reviewed. The Pediatric Ocular Trauma Scores (POTS) and Toddler Ocular Trauma Scores (TOTS) were assessed against our cohort. Univariate and multivariate linear regression analysis was performed to identify predictors of visual outcome., Results: A total of 85 eyes of 85 pediatric patients (63 males [74%]) were included. Median patient age was 8.9 years. Final best-corrected visual acuity was significantly associated with presenting vision (P = 0.0001), age at injury (P = 0.02), lens involvement (P < 0.0001), retinal detachment (P < 0.0001), and location of injury (P < 0.0001). In a multivariate linear regression model, only presenting visual acuity and retinal detachment were independent predictors of outcome. When visual acuity was unknown, age at injury, lens involvement, and retinal detachment were independently associated with final visual acuity. POTS and TOTS scores moderately correlated with final best-corrected visual acuity (R 2  = 0.51 and R 2  = 0.53, resp.)., Conclusions: We identified patient characteristics predicting visual outcomes in a large US-based cohort of pediatric open globe injuries. POTS and TOTS scores moderately correlated with final visual acuity; however, the small study sizes from which they were derived preclude our identifying which predictors are most important. Development of a more predictive model will require a large multicenter study population or registry., (Copyright © 2020 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

The Publisher regrets that this article is an accidental duplication of an article that has already been published, http://dx.doi.org/10.1016/j.jaapos.2017.02.001. The duplicate article has therefore been withdrawn. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal., (Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)

Purpose: To evaluate efficacy of combined vitrectomy with posteriorly placed glaucoma drainage device (GDD) in lowering intraocular pressure (IOP) in children., Methods: The medical records of children who underwent vitrectomy with posteriorly placed GDD were reviewed retrospectively. Patients with a minimum of 6 months' follow-up were included. The first eye operated on for each patient was analyzed. Success was defined as IOP of 5-20 mm Hg and no additional IOP-lowering surgery or visually devastating complications., Results: A total of 20 patients were included, with the following etiologies: primary infantile-onset glaucoma, 5 (25%); traumatic glaucoma, 3 (15%); Peters anomaly, 3 (15%); microphthalmia, 5 (25%); glaucoma following cataract surgery, 2 (10%); microspherophakia, 1 (5%); and retinopathy of prematurity, 1 (5%). Eyes with corneal opacification (8 [40%]) underwent endoscopic vitrectomy (5 [25%]), concurrent penetrating keratoplasty (3 [15%]) and/or keratoprosthesis surgery (1 [5%]). Mean follow-up was 1.9 ± 1.1 years (range, 6.5-49.2 months). Vision remained stable or improved in 17 eyes (85%). Mean IOP decreased from 27.2 ± 10.1 mm Hg to 14.5 ± 6.8 mm Hg (P < 0.0001) at last follow-up or at failure. Kaplan-Meier curves showed 12- and 24-month rate of IOP control of 69% and 62%, respectively. The number of glaucoma medications decreased from a mean of 2.3 ± 1.4 to 1.3 ± 1.2 (P < 0.015) at last follow-up or at failure. Overall success rate was 65%. Complications included hypotony (3 [15%]), vitreous hemorrhage (1 [5%]), and retinal detachment (1 [5%]). Two eyes (10%) required surgery for hypotony; 4 eyes (20%) underwent additional glaucoma surgery., Conclusions: Combined surgical approach with vitrectomy and posteriorly placed GDD decreased IOP in complex pediatric glaucomas. Further, endoscope-assisted vitrectomy is useful in cases with corneal opacification. Complication rates of this combined procedure appear to be comparable to traditional anterior chamber approach., (Copyright © 2017 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.)