| 1. |
- Kristjánsdóttir, Ragnhildur, et al.
(författare)
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Ophthalmological abnormalities in children with cerebral white matter disorders.
- 2002
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Ingår i: European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society. - : Elsevier BV. - 1090-3798. ; 6:1, s. 25-33
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Tidskriftsartikel (refereegranskat)abstract
- The use of magnetic resonance imaging (MRI) in children with severe neurological impairment has defined a subgroup with increased T2-signals from cerebral white matter. The causes of white matter abnormalities are for the most part unknown, despite extensive investigation. Their clinical correlates and characteristics have still to be systematically analysed and described. We have compared clinical, ophthalmological and electro-ophthalmological findings in such children to delineate neurological and MRI patterns and have sought to correlate with the progression of disease. Clinical and electro-ophthalmological investigations were performed in 26 children with cerebral white matter abnormalities of unknown aetiology; 25 of the 26 children showed abnormalities, 23 clinical and 18 electro-ophthalmological. Optic nerve abnormalities, severe visual impairment and strabismus were the most common. Electro-ophthalmological abnormalities were increased latencies and abnormal waveform of the visual evoked potentials (VEP). Children with progressive disease all had abnormal VEP, whereas none of the ten children with a normal VEP deteriorated. We conclude that children with cerebral white matter abnormalities almost invariably had ophthalmological and often VEP abnormalities. Normal VEP was correlated with non-progressive disorder, as was hypoplasia or malformation of the papilla, whereas abnormal VEP were associated with progressive disease.
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| 2. |
- Sjöström, Anders, 1951, et al.
(författare)
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The light-flash-evoked response as a possible indicator of increased intracranial pressure in hydrocephalus.
- 1995
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Ingår i: Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery. - 0256-7040. ; 11:7
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Tidskriftsartikel (refereegranskat)abstract
- Surgical treatment of infantile hydrocephalus by shunt implantation may result in suboptimal intracranial pressure. Major neurological impairments and death are usually prevented by shunt treatment, but minor sequelae may persist or develop. The introduction of adjustable shunts has improved the possibilities of optimizing shunt function and minimizing the risk of such impairments. However, it is still impossible to determine the intracranial pressure without invasive measurements. Clinical findings and procedures such as computed tomography (CT) are not always enough to allow a conclusion as to whether a child's signs and symptoms are the result of suboptimal intracranial pressure (shunt dysfunction) or are of another etiology. With the aim of reducing the number of invasive pressure measurements and CT scans, we investigated the effect of increased intracranial pressure on the visual evoked response (VER). Binocular light flash stimuli of supramaximal intensity were used and VER recordings were performed from Oz and Cz. The VER results from a group of 31 infants and children with hydrocephalus and 2 children with pseudotumor cerebri were compared with responses from a control group of 35 healthy children. The results show that a subpotential, P' (P-prime), usually just preceding P1 (P100), had an increased latency ( > 96 ms) in all hydrocephalic children before surgery. The P' latency in this group was usually even above 110 ms. The latencies of other VER potentials were also increased but not as consistently as P'. After surgical intervention the VER latencies decreased and usually normalized. The P' latency in four children in the control group was just above the borderline latency, but was less than 110 ms.(ABSTRACT TRUNCATED AT 250 WORDS)
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| 3. |
- Abrahamsson, Maths, 1953, et al.
(författare)
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The occurrence of congenital cataract in western Sweden
- 1999
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Ingår i: Acta Ophthalmologica Scandinavica. - : Wiley. - 1395-3907. ; 77:5, s. 578-580
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To estimate the occurrence of congenital cataract in a Nordic country. Methods: In 1980, we constructed a database in the Department of Ophthalmology Goteborg University, containing basic data from all cases in western Sweden diagnosed with congenital cataract. By collecting and processing these data from 1980 onwards, we hoped to improve the management of congenital cataract treatment and to optimize the outcome of the treatment. Results: In this study, the incidence of congenital cataract in the four western counties of Sweden was evaluated. The occurrence rate of all cases with congenital cataract during the study period was 36 cases per 100 000. The occurrence rate for dense bilateral and all unilateral cases were both 14 per 100 000 each. Conclusion: There were no time-related changes in incidence of congenital cataract from 1980 until today, although there was a large variation in the yearly incidence.
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| 4. |
- Aring, Eva, 1959, et al.
(författare)
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Ocular motor function in relation to gross motor function in congenital and childhood myotonic dystrophy type 1.
- 2012
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Ingår i: Acta ophthalmologica. - : Wiley. - 1755-3768 .- 1755-375X. ; 90:4, s. 369-374
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Tidskriftsartikel (refereegranskat)abstract
- Abstract. Purpose: To assess ocular motor function in congenital and childhood myotonic dystrophy type 1 (DM1) and correlate the results with cytosine-thymine-guanine (CTG) repeat size, severity of the disease, myotonia and skeletal muscle function. Methods: A cross-sectional investigation into strabismus, versions/ductions, saccades, smooth pursuit movements and ptosis was performed on 49 individuals with a confirmed diagnosis of DM1, all diagnosed at <18 years of age and with >40 CTG expansion repeats. The results were correlated with myotonia as well as Hammersmith motor ability scale (HMA). In addition, the ocular results were compared to results from an age and- sex-matched control group. Results: Ocular motor abnormalities were seen in 82%; the most frequent findings were altered conjugate eye movements and 'pseudoptosis' while blepharoptosis was rare. Strabismus was most common in the severe congenital subgroup, with a frequency 14 times higher than in the control group. Positive correlations were seen between CTG repeat size and affected eyelids, and between myotonia and affected eyelids; both these findings were most prominent in the mild congenital group. CTG repeat size was also correlated with version/duction defects, and most obviously in the childhood group. Low HMA scores were associated with high occurrence of strabismus and version/duction defects. Conclusion: Abnormalities of ocular motor function are frequently present. CTG repeat size correlates positively with altered versions/ductions and eyelid pathology. Gross motor dysfunction correlates with strabismus and defect versions/ductions, and eyelid pathology indicates involvement of myotonia.
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| 5. |
- Ekström, Anne-Berit, 1960, et al.
(författare)
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Visual function in congenital and childhood myotonic dystrophy type 1.
- 2010
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Ingår i: Ophthalmology. - : Elsevier BV. - 1549-4713 .- 0161-6420. ; 117:5, s. 976-82
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate visual function in a group of individuals with congenital and childhood myotonic dystrophy type 1 (DM1), to correlate the results to the size of the cytosine-thymine-guanine (CTG) repeat expansion and the onset form, and to compare the results with those of a control group. DESIGN: Cross-sectional study with age- and gender-matched control groups. PARTICIPANTS AND CONTROLS: Forty-nine individuals with severe and mild congenital and childhood DM1 and controls matched for age and gender. METHODS: The ophthalmologic examination included best-corrected visual acuity (BCVA), refraction, slit-lamp biomicroscopy, indirect ophthalmoscopy, and flash visual evoked potentials (VEPs). MAIN OUTCOME MEASURES: Visual acuity, refractive error, pathology of lens, fundus, and VEP pathologic features. RESULTS: The study shows a higher prevalence of low visual acuity, hyperopia, and astigmatism in the study population compared with the controls. The size of the CTG repeat expansion had an impact on BCVA in all subgroups with lower values in individuals with larger expansion size. In childhood DM1, individuals with high hyperopia and astigmatism had greater CTG repeat expansion size than those without. No true cataract was found. Subtle nonspecific fundus changes were present in addition to VEP pathology. CONCLUSIONS: Children and adolescents with DM1 have a variety of visual function pathologies, and DM1 has an impact on the developing visual system, necessitating early ophthalmologic assessment and follow-up.
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| 6. |
- Kvarnström, Gun, 1951-
(författare)
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Visual screening of children in Sweden : epidemiological and methodological aspects
- 2004
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The aim of this thesis was to assess the vision screening system and ocular status in Sweden of today, yesterday and tomorrow and to compare the prevalence of ocular disease before and after screening and treatment with special focus on amblyopia.Screening has been defmed by the United States Commission of Chronic Illness (1957) as "the presumptive identification of unrecognized disease or defect by the application oftests, examinations or other procedures, which can be rapidly applied. Screening tests sort out apparently well persons who probably have a disease from those who probably do not". The screening system for eye disorders was introduced in the whole country in the beginning of 1970 and has not been evaluated in a greater area and for a longer period. Neither has an evaluation been done according to WHO's instructions. Amblyopia is the most common cause to visual impairment in one eye. The visual system is developing mostly in the first years of life and it is important to treat amblyopia in early childhood. The three first papers are retrospective studies and the fourth a prospective study. The study group in the first and second paper consisted of all children born 1982 in three Swedish cities from newborn until the age of 10 years. The children have been tested eight to nine times at the Child Health Care Centres and in school during this time. The sensitivity and specificity of visual screening were 92% and 97% respectively. The prevalence of ametropia was 7.7%, strabismus 3.1%, amblyopia ≤ 7 2.9% and organic lesions 0.2%. We compared the prevalence of amblyopia today with the time before screening was introduced in Sweden. This comparison shows that serious amblyopia has been reduced about 10 times with screening and treatment.Loss of vision in the non-amblyopic eye was investigated by studying patients with amblyopia at four visual rehabilitation centres. Approximately 1.2% of the people with amblyopia ≤ 0.3 will eventually become visually handicapped due to lesions in the better eye.Despite visual screening and treatment there are some children left with residual amblyopia. We investigated ways to improve the system by lowering the age for visual acuity examination from 4 to 3 years and at the same time two vision charts were compared. We found that the testability rate for 3-year-olds was almost the same for the Lea Symbol chart and the HVOT chart (82.8% and 84.8% respectively). Testability was about 10% higher at 4 years. The positive predictive value was lower at 3 years (58%) than has previously been found at 4 years (72%).Conclusion: In these studies we have found that screening is justified for the following reasons: visual screening is efficient in terms of sensitivity and specificity and many important ocular conditions are detected in this process; the prevalence of serious amblyopia is greatly reduced by screening and treatment; loss of vision in the non-amblyopic eye is a significant problem, which can be greatly reduced by screening and treatment, thereby saving expenses for the society.The following has been found regarding the design of visual screening: visual acuity testing is efficient in detecting visual disorders from 4 years and up; visual acuity can be tested at 3 years, but with lower positive predictive value; the most widely used charts in Sweden and internationally, the HVOT chart and the Lea Symbols chart perform equally well in visual acuity testing of 3-year-old and 4-year-old children.
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| 7. |
- Sadeghi, André M., et al.
(författare)
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Longterm visual prognosis in Usher syndrome types 1 and 2
- 2006
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Ingår i: Acta Ophthalmologica Scandinavica. - Copenhagen : Blackwell Munksgaard. - 1395-3907 .- 1600-0420. ; 84:4, s. 537-544
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Tidskriftsartikel (refereegranskat)abstract
- Purpose: To estimate the age at diagnosis of retinitis pigmentosa and to determine visual acuity deterioration, visual field impairment and the frequency of cataracts in Usher syndrome types 1 and 2. Methods: We carried out a retrospective study of 328 affected subjects with Usher syndrome types 1 and 2. Study subjects were divided into seven different age groups by decade. Data were analysed using descriptive statistics, general linear model anova and survival analysis. Results: Retinitis pigmentosa was diagnosed significantly earlier in subjects with Usher syndrome type 1 than in those with type 2. Visual acuity was significantly more impaired in affected subjects with Usher syndrome type 1 than in those with type 2 from 50 years of age onwards. Survival analysis revealed a significant difference in visual field loss (≤ 10 degrees) between the two groups, with type 2 subjects tending to be more impaired, while comparison indicated no significant differences between the groups in any of the other visual field categories. Cataract was found to be generally more common in Usher syndrome type 1 than type 2. Conclusions: Progressive loss of visual acuity and visual field begins to be substantial between the second and third decades of life in both Usher types. The rate of degeneration varies between individuals in both groups. The data are useful for the counselling of affected subjects with Usher syndrome types 1 and 2.
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| 8. |
- Sjöström, Anders, 1951, et al.
(författare)
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Subnormal visual acuity (SVAS) and albinism in Mexican 12-13-year-old children.
- 2004
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Ingår i: Documenta ophthalmologica. Advances in ophthalmology. - 0012-4486. ; 108:1, s. 9-15
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: In a previous study the vision of 1046 12-13-year-olds in Sweden was examined. Of those 67 had some kind of visual disturbances and in 20 no obvious cause was found. In this group, defined as children with subnormal visual acuity syndromes (SVAS), albinism was shown to be a major cause to the visual dysfunction giving a prevalence of about 1%. This is about 100 times higher than previous figures. Albinism can therefore be the cause in many cases of unexplained low visual acuity, at least in Sweden. Subnormal visual acuity is usually found in 2-4% in a pediatric population and is often called 'amblyopia'. The Swedish study showed that in many cases 'amblyopia' should be replaced by 'SVAS' and further investigation. The present Mexican study was designed identically to the Swedish study. The objective was to describe the distribution of visual acuity and the prevalence of ocular disorders, including incidence of subnormal visual acuity (SVAS) and the occurrence of albinism in a Mexican population of 12-13-year-olds. SUBJECTS AND METHODS: Altogether 1035 children, 12-13 years of age, were examined. A total number of 344 children were referred to the university pediatric eye clinic for further examination. 272 of these had simple refractive errors, 59 were diagnosed with an ophthalmological disorder and 13 children could not be pathologically classified. These were referred to a second ophthalmological examination, including VEP (Visual Evoked Potential) recordings. VEP reveals an asymmetric (right vs. left) cortical response after monocular stimulation in albinism. RESULTS: No child showed iris translucency or any other typical albinoic sign. VEP was recorded from 11 children. Three children showed an asymmetric VEP and were classified as albinos. The VEP response was normal in 8 of the children. CONCLUSIONS: The results indicate that albinism is common in Mexico, although not as common as in a similar Swedish population. A prevalence of albinism of approximately 0.3% was found in the Mexican population, compared to approximately 1% in the Swedish study group. The number of albinos was much higher in both study groups than to be expected from previous estimates. The difference between the Swedish and the Mexican figures may be explained by the general difference in pigmentation between Sweden and Mexico and thus probably by the subsequent lower number of commonly occurring albino foci in the Mexican heritage. It is emphasised that in investigations of children with SVAS, also in countries with a generally high pigmentation level, electro-physiological examinations are important, to be able to reveal albinism, but also to exclude or verify other conditions in the SVAS group, for example neurometabolic conditions.
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| 9. |
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| 10. |
- Sterner, Bertil, 1959, et al.
(författare)
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The amplitude of accommodation in 6-10-year-old children - not as good as expected!
- 2004
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Ingår i: Ophthalmic & physiological optics. - : Wiley. - 0275-5408 .- 1475-1313. ; 24:3, s. 246-251
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to measure the amplitude of accommodation for junior level school children and to compare it with age-expected values. A junior level school in Göteborg, Sweden, was randomly chosen and the amplitude of accommodation among 76 children aged 6-10 years was examined using Donders' push-up method. The results showed lower amplitude than expected in a large group of children. Results also showed lower amplitude than previously reported for this age group, especially under monocular conditions, which revealed an average dioptric difference from the expected value of -3.60 dioptres (D) right eye (mean 12.40 D, median 12.00 D, S.D. 3.7 D) and -3.50 D left eye (mean 12.50 D, median 12.70 D, S.D. 3.8 D) (p < 0.001 for both eyes). Consequently, we conclude that it cannot be assumed that the amplitude of accommodation is in the expected amplitude range for all children of these ages.
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