This study aimed to evaluate foveal avascular zone (FAZ) features and macular flow density (FD) in various retinal layers in a cohort of patients with foveal hypoplasia (FH) using optical coherence tomography angiography (OCTA), in order to characterize microvascular abnormalities and explore their potential clinical significance. FAZ parameters and FD, as well as retinal thickness and volume values were analyzed and compared between patients with FH and an age- and gender-matched control cohort. Correlations between disease severity and visual acuity (VA), as well as between disease severity and FAZ features were evaluated. A total of 19 eyes with FH and 19 control eyes were included. The study group showed significantly higher FD values in the foveal sectors of the superficial and deep capillary plexus compared to controls. FAZ area, perimeter, and acircularity index (ACI) were noticeably altered in eyes with FH; however, they did not correlate with disease severity. Visual acuity was negatively correlated with disease severity. The results of this study provide evidence of altered microvasculature architecture specifically in the foveal sectors of patients with FH. The higher FD values in the foveal sectors of FH patients suggest a potential compensatory response of the retinal microvasculature. FAZ parameters and FD values of the foveal sectors could be used as part of an OCTA-based grading system in FH patients. 

Characterizing Foveal Hypoplasia Using Optical Coherence Tomography Angiography: Evaluation of Microvascular Abnormalities and Clinical Significance

Objetivo: Realizar um levantamento bibliográfico sobre as alterações oculares que ocorrem na hipoplasia foveal em pacientes albinos. Métodos: Trata-se de uma revisão integrativa da literatura, onde os artigos foram extraídos das bases de dados da SCIELO, PUBMED e SCIENCE DIRECT no período de agosto a setembro de 2023. Como critérios de inclusão para a busca das produções científicas foram artigos disponíveis na íntegra, online e de livre acesso, em português e inglês, que remetam a associação entre hipoplasia foveal ou hipoplasia do nervo óptico com albinismo publicados nos últimos cinco anos. Resultados: Os resultados desta pesquisa foram construídos por meio da análise e interpretação de 12 artigos científicos nesse seguimento. Assim, o albinismo é comumente associado à hipoplasia foveal, onde há falha total ou parcial na formação e especialização da fossa foveal. A gravidade da hipoplasia foveal varia e a detecção pode ser melhorada. Consideraciones finales: Logo, foi possível verificar que a hipoplasia foveal está constantemente presente, e os indivíduos com albinismo geralmente apresentam atraso no desenvolvimento visual, visão reduzida, nistagmo, estrabismo, transiluminação da íris e ausência ou redução do pigmento melanina no fundo.

Hipoplasia foveal relacionada ao albinismo

Objective: 
This study aimed to assess the knowledge levels of parents in the Albaha region regarding pediatric eye emergencies, explore demographic influences, and propose tailored interventions to enhance awareness.
Methods: 
The study was conducted in the Albaha region of Saudi Arabia, employing a quantitative design with an online questionnaire. 
Results: 
The study was conducted among 402 participants, with an even gender distribution of (n=201, 50%) males and (n=201, 50%) females. There was a significant representation in the 41–50 years age range (n=125, 31.1%), with majority holding a diploma or university degree (n=264, 65.7%). The experiences of participants with pediatric ocular emergencies showed that 153 individuals (38.1%) had come across such circumstances. As a whole, 171 (42.5%) were judged inadequate, and 231 (57.5%) showed adequate knowledge. Significant associations were observed between knowledge levels and gender in favor of females (p-value = 0.003) and having experienced an eye emergency in children (p-value = 0.021), with no significant difference considering age, educational level, or residency.
Conclusion: 
This study revealed that participants exhibited a moderate level of knowledge, while the study underscores the need for targeted educational interventions addressing gender-specific disparities and leveraging personal experiences. Tailored programs can enhance awareness and improve outcomes in pediatric eye emergencies. This research lays the groundwork for future initiatives aimed at fostering a well-informed community in the Albaha region.

Assessment of knowledge of pediatric ocular emergencies among parents in Albaha, Saudi Arabia

BACKGROUND
We investigated the impact of social distancing policies (SDPs) on ophthalmic severity in children who underwent emergency ophthalmic referrals during the coronavirus disease 2019 pandemic period.


METHODS
We reviewed all children with ophthalmic referrals in a single academic hospital emergency department during the period from February 2017 to December 2019 (prepandemic) or February 2020 to December 2022 (pandemic). Baseline features, diagnosis-based severity, and outcomes were compared between the two periods. The Government Response Stringency Index (GRSI), which ranges from 0 to 100, was used as a surrogate for the intensity of SDPs during the pandemic. Poisson regression was used to quantify the association of the GRSI with the severity.


RESULTS
Among 1074 children with ophthalmic referrals, 437 (40.7%) visited during the pandemic. This was 31.4% lower than that during the prepandemic period. In numbers, pandemic-related declines were more modest in high severity than in medium-to-low severity (35.1% vs. 55.0%), and for injury than for illness (28.5% vs. 36.1%). In percentages, high severity increased from 63.3% to 71.3% (p = 0.016). The hospitalization rate increased from 1.7% to 3.9% (p = 0.029). For every 10-point increase in GRSI, there was a 20.0% decrease in high severity (95% confidence interval, 5%-30%).


CONCLUSIONS
This study shows an inverse association of SDPs with ophthalmic severity and an increase in severe cases along with consistent flow of injury cases, amid the overall decline in eye-related visits to the emergency department during the pandemic period.

Impact of social distancing policy on pediatric emergency ophthalmic severity during the coronavirus disease 2019 pandemic.

Comparison of OCT imaging in children with foveal hypoplasia born full term versus preterm

Introduction The use of the emergency department (ED) has been increasing, and many visits occur for non-urgent conditions. A similar trend was found among adult visits to the ED for ocular conditions. In this study we analyzed the impact of sociodemographic factors, presentation timing, and the COVID-19 pandemic on pediatric ED (PED) encounters for ophthalmologic conditions. It is important to identify the multifold factors associated with overutilization of the ED for non-urgent conditions. Caring for these patients in an outpatient clinical setting is safe and effective and could decrease ED crowding; it would also prevent delays in the care of other patients with more urgent medical problems and lower healthcare costs. Methods We retrospectively reviewed electronic health records of PED ocular-related encounters at two children’s hospitals before (January 2014–May 2018) and during the COVID-19 pandemic (March 2020–February 2021). Encounters were categorized based on the International Classification of Diseases codes into “emergent,” “urgent,” and non-urgent” groups. We analyzed associations between sociodemographic factors and degrees of visit urgency. We also compared visit frequencies, degrees of urgency, and diagnoses between pre-pandemic and pandemic data. Results Pre-pandemic ocular-related PED encounters averaged 1,738 per year. There were highly significant sociodemographic associations with degrees of urgency in PED utilization. During the 12-month pandemic timeframe, encounter frequency contracted to 183. Emergent visits decreased from 21% to 11%, while the proportions of urgent and non-urgent encounters were mostly unchanged. The most common pre-pandemic urgent diagnosis was corneal abrasion (50%), while visual disturbance was most common during the pandemic (92%). During both time periods, eye trauma was the most frequent emergent encounter and conjunctivitis was the most common non-urgent encounter. Conclusion Sociodemographic factors may be associated with different types of PED utilization for ocular conditions. Unnecessary visits constitute major inefficiency from a healthcare-systems standpoint. The marked decrease in PED utilization and differing proportions of ocular conditions encountered during the pandemic may reflect a decrease in incidence of many of those conditions by social distancing; these changes may also reflect altered parental decisions about seeking care.

/pdf/visits-to-the-pediatric-emergency-department-for-eye-1jxpo7gr.pdf

Visits to the Pediatric Emergency Department for Eye Conditions Before and During the COVID-19 Pandemic

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Comparison of OCT imaging in children with foveal hypoplasia born full term versus preterm

Visits to the Pediatric Emergency Department for Eye Conditions Before and During the COVID-19 Pandemic