e4 Volume 18 Number 4 / August 2014

Conclusion: Polypseudophakia does not cause accelerated axialgrowth in patients undergoing primary placement within the first 24months of life. However, the age at planned IOL removal variesfrom less than 1 year to more than 7 years after implantation.

010 Optic nerve volumetric measurements in pediatricpapilledema with spectral domain OCT. Jose Efren GonzalezMonroy, Frank Weng, Linda R. Dagi, Gena HeidaryIntroduction: In pediatric patients with papilledema, determiningresponse to treatment may be difficult due to inherent limitations inthe clinical exam. Spectral domain optical coherence tomography(SD-OCT) of optic nerve volume (ONV) has begun to be explored asa relevant measure in adult patients with papilledema.1,2 We evalu-ated whether SD-OCTof ONV may be a useful adjunct in the assess-ment of pediatric papilledema.Methods: Single center, three year retrospective review of patientswith confirmed papilledema. Patients with Heidelberg SpectralisSD-OCT ONV measurements within 1 month of diagnosis wereincluded. Data including gender, age, visual field results, opticnerve edema grade and lumbar puncture opening pressure wererecorded.Results: Eighteen patients (10 female [53%]) were included. Meanage at presentation was 12 years (SD � 5.6 years). Data from theright eyes only were evaluated; no difference between eyes wasnoted (P 5 0.26). Mean ONV OD in patients with papilledema wassignificantly increased at 4.74 mm3 (SD � 1.52) compared with 2.51mm3 (SD � 0.25) in age and sex matched control subjects (P \0.001). A moderate positive correlation of 0.55 was identified betweeninitial ONV and lumbar puncture opening pressure. Longitudinally,ONV measurements improved with a significant decrease in volu-metric measurements at most recent follow-up (P 5 0.001).Discussion: ONV appeared to reflect well optic nerve edema at timeof diagnosis and correlated well with response to treatment asmeasured by improved edema longitudinally.Conclusion: SD-OCT ONV measurements may provide an importanttool towards the assessment of treatment response in pediatricpatients with papilledema.

References

1. Kaufhold F, Kadas EM, Schmidt C, et al. Optic nerve head quantification inidiopathic intracranial hypertension by spectral domain OCT. PLOS One2012;7:e36965.

2. Wang J-K, Kardon RH, Kupersmith MJ, Garvin MK. Automated quantifica-tion of volumetric optic disc swelling in papilledema using spectral-domainoptical coherence tomography. Invest Ophthalmol Vis Sci 2012;53:4069-75.

011 Serial fundus photography and fluorescein angiography afteroff-label intravitreal bevacizumab treatment for retinopathy ofprematurity: importance of monitoring regression by angiographyin off-label bevacizumab treated eyes. Luxme Hariharan,Aleksandra Rachitskaya, Ditte J. Hess, CRA, Ann Rodriquez, RN,Catherine Negron, BA, Audina M. Berrocal, MDIntroduction: Intravitreal bevacizumab has been reported as an off-label treatment in retinopathy of prematurity (ROP). The purpose ofthis study is to demonstrate the importance of fluorescein angiog-raphy (FA) in the management of ROP regression after an intravitrealbevacizumab treatment.Methods: This is an IRB-approved retrospective consecutive caseseries of 38 eyes of 19 infants with ROP from 2006 to 2013. Eleven pa-tients were treated solely with intravitreal bevacizumab while 8

received both bevacizumab and laser. Clinical exam, RetCam (Clarity,Pleasanton, CA) fundus photography and fluorescein angiographywere performed prior to the treatment. A 10% solution of sodium fluo-rescein dye was administered intravenously as a bolus at a dose of7.7 mg/kg followed by a saline flush. All eyes were injected with 0.625mg of bevacizumab. RetCam photos and fluorescein angiogramswere documented post-treatment. All treatments including clinicalexamination, fundus photography, fluorescein angiography, bevaci-zumab injections and laser were performed at the bedside.Results: All 38 eyes showed regression of ROP by the appearance ofadvanced vascular growth as depicted by FA. It was difficult toassess regression or progression of disease solely by digital fundusphotographs and clinical exam. Serial photography and clinical examwere often hazy and did not show the distinct nature of the enhancedvasculature as clearly as the FA.Discussion: For advanced and referral warranted ROP it is critical tohave fluorescein angiograms to follow infants post-treatment, espe-cially those treated with off-label bevacizumab. If digital photographsand clinical examination are done alone, changes in vasculature maybe often missed.Conclusion: Fluorescein angiograms are critical in demonstrating thedetails in the vasculature needed to follow post-bevacizumab treatedeyes and to more clearly demonstrate regression or progression ofROP.

References

1. Lepore, et al. Atlas of florescein angiographic findings in eyes undergoinglaser for retinopathy of prematurity. Ophthalmology 2011;118.

2. Yokoi, et al. Vascular abnormalities in aggressive posterior retinopathy de-tected by fluorescein angiography. Ophthalmology 2009;116.

012 Depressive symptoms associated with poor health-relatedquality of life in adult strabismus. Sarah R. Hatt, David A. Leske,Laura Liebermann, Kemuel L. Philbrick, Jonathan M. HolmesIntroduction: Health-related quality of life (HRQOL) often improvesfollowing successful surgery in adult strabismus. Nevertheless, incases where HRQOL does not improve there may be other factorsreducing HRQOL. We investigated associations between psycholog-ical, clinical or demographic factors, and HRQOL in adults with stra-bismus.Methods: A total of 177 adult strabismus patients were prospectivelyrecruited and completed the following questionnaires: Adult Stra-bismus-20 (AS-20) HRQOL questionnaire (self-perception, interac-tions, reading function and general function domains), CESD-Rdepression questionnaire, DS-14 type D (distressed) personalityquestionnaire and the diplopia questionnaire. Factors consideredfor association with HRQOL score were: CESD-R score, type D per-sonality (Yes/No), diplopia score, best-eye VA, comorbidity affectingfacial appearance, deviation direction, deviation magnitude, age atassessment, age at onset, and sex. Multiple linear regression ana-lyses were performed for each AS-20 domain. Factors were consid-ered associated with poor HRQOL if P\ 0.05.Results: For both reading function and general function, lower scores(poorer HRQOL) were associated with higher (worse) CESD-R scores(P5 0.0001 and P5 0.0008, resp.) and higher (worse) diplopia scores(P\ 0.0001 for both). For Interaction, lower scores were associatedwith higher CESD-R score (P5 0.02), greater magnitude of deviation(P 5 0.0002), and younger age (P 5 0.0007). For Self-Perception,lower scores were associated with younger age (P \ 0.0001) andgreater magnitude of deviation (P\0.0001).

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