Purpose: To assess the long-term visual outcomes of children with PCG, irrespective of the type of surgical procedure, and to create visual acuity curves to help in predicting the development of visual function in these patients. The secondary aim is to identify associated factors for visual decline or loss, highlighting differences between neonatal and infantile subgroups. Methods: The medical records of pediatric glaucoma patients from 1996 to 2017 at the University Hospital of Verona (Verona, Italy) were retrospectively reviewed. Visual acuities, surgeries, PCG subtype and etiology of vision impairment were recorded. Statistical analyses were performed to detect factors associated with vision decline. Results: Sixty-seven eyes (40 patients) were included in the study. Developmental predictive curves of visual acuity showed that children with infantile PCG had a better visual outcome than children with neonatal PCG at each step of follow-up. A good-to-moderate VA (< 1 LogMAR) was achieved in 56 eyes (83.6%), while 11 eyes (16.4%) had poor VA (≥ 1 LogMAR). The age at onset, sex, number of surgeries, intraocular pressure (IOP) control (with or without antiglaucoma drugs), axial length (AL) and corneal opacities were statistically associated with vision impairment (p < 0.01). The main cause of visual impairment was amblyopia. Conclusions: Visual outcomes of PCG significantly correlate with the age at diagnosis. Although a good long-term IOP control can often be achieved in PCG, often the visual acuity remains below the lower limits of the normal range. Poor vision in childhood is related to global developmental problems, and referral to third-level services should not be delayed to prevent vision impairment. In this regard, visual acuity curves can be a useful tool for the consultant ophthalmologist to define the visual development of children affected by PCG.

Purpose: Given the known difficulty in sensory processing and in motor skills in patients with Autism Spectrum Disorder (ASD), and since visual impairment could interfere with children’s behaviour, early detection and management of visual-motor difficulties are crucial. This exploratory study aims to evaluate the visual-motor status in a cohort of children affected by ASD.Methods: The records of patients affected by ASD and admitted between 2018 and 2022 to the Pediatric University Hospital of Verona were reviewed. Best Corrected Visual Acuity, cycloplegic refraction, stereopsis, convergence, complete ocular motility, strabismus examination, slit-lamp anterior segment examination and fundus ophthalmoscopy were collected and reviewed.Results: A total of 253 patients (203 ASD and 50 healthy controls) were included in the study. A higher number of total orthoptic defects were detected in the ASD group, in comparison with the control group. Specifically, a higher percentage of stereopsis deficit and convergence insufficiency was observed.Conclusion: In our cohort of children with ASD stereopsis deficit, convergence insufficiency and refractive errors are the most observed ocular conditions. These findings are consistent with the known alterations of motor skills and sensory processing in ASD. Moreover, our study supports the hypothesis that visual acuity is not compromised in children with ASD. As a result, a complete ophthalmic evaluation is highly recommended in children with ASD, to guarantee early detection and treatment of possible visual-motor defects.

Purpose: To summarize the actions taken to give continuity to the surgical treatment of glaucoma patients and to present the volume and characteristics of glaucoma surgery in the first year of pandemic at the Tertiary Glaucoma Center of the University Hospital of Verona (Veneto, Italy). Methods: Demographical and surgical features of patients who underwent glaucoma surgery from March 9th, 2020 to March 8th, 2021 have been collected and compared to the same date range of the previous year. The analyzed data included age, gender, region of origin, glaucoma staging, type of anesthesia and surgical procedure. Results: The surgical volume of glaucoma has dropped by 30.1%. In comparison with the previous year, we found a significant variation in the overall distribution of the performed surgical procedures (p < 0.001). There was a decline in Baerveldt tube implants (− 4.9%), and an increase of non-penetrating surgery (+ 2.6%), cyclo-photo ablative procedures (+ 4.2%) and MIGS (+ 5.7%). Only 24.3% of the procedures were performed under general anesthesia compared to 41.5% in the pre-pandemic period (p < 0.001). The number of procedures performed on eyes affected by advanced or end-stage glaucoma is doubled (p < 0.001). Conclusions: To give continuity to glaucoma surgery, we prioritized interventions on patients with poorer visual fields, rapidly progressing visual field deficit and elevated IOP uncontrolled by maximal medical therapy. Secondly, we have rescheduled the other interventions following the same priority criteria. Finally, we managed some lower priority cases with MIGS, minimizing the need for close post-intervention follow-up. Considering the negative consequences that a delay in the management of glaucoma can have in terms of visual loss, the closure of the operating rooms in the first quarter of the pandemic was detrimental. It appears that glaucoma surgery deserves urgencies that cannot be overshadowed and the greatest effort must be to give continuity to this type of eye surgery.

Purpose: To test reliability and reproducibility of ESASO morphologic OCT-based classification of diabetic maculopathy (DM). Methods: This is a multi-center cross-sectional study including a coordination center (CC) and 18 participating centers (PCs). After instruction on the correct use of ESASO Classification, the validation process was carried out in two consecutive stages. In the first retrospective phase, we evaluated the concordance between PCs and CC in the staging of OCT images collected during PCs’ daily activity (608 images). In a second prospective phase, we analyzed the inter-observer agreement of staging assigned by each PCs to OCT images selected by the CC (22 images). Results: The overall concordance achieved in the retrospective phase was 89.8% (Kappa = 0.83 (95% CI: 0.78–0.87); p<0.0001). In 99.5% of cases, concordance did not differ by more than one stage. In the prospective phase, PCs reached an inter-operator agreement of 93.0% (Krippendorff's Alpha = 0.953, 95% CI: 0.929–0.977, p<0.0001). Any discrepancy among the 22 images was within one stage. Conclusion: The results achieved in this study confirm that ESASO OCT-based Classification can be considered as an easy and reproducible method to stage DM during clinical practice. A diffused use of a common and validated method to describe the progression of retinal damage in DM may offer several clinical and scientific advantages.

Purpose: The aim of this study was to investigate the factors that affect ocular growth in children with primary congenital glaucoma (PCG) who have undergone surgical treatment. We designed an analysis like that proposed by Al-Obaida et al. to assess whether similar results could be obtained in the Caucasian population. Methods: Data on axial length (AxL), intraocular pressure (IOP), and corneal diameter of PCG patients were recorded and analyzed. Results: Patients’ age was significantly influencing the increase in AxL. Also, levels of IOP, number of glaucoma medications, and number of surgeries along the follow-up period were found to significantly influence AxL progression. Conclusions: This study confirms that in PCG patients, there is a curvilinear relationship between AxL and age, which is strongly influenced by IOP, gender, the number of surgical interventions, and the number of anti-glaucoma medications. These data seem to suggest that maintaining IOP values closer to normal ones for age is crucial in the first up to three years of life to avoid permanent ocular anatomic and functional damage caused by elevated intraocular pressure.

To assess the ocular surface status and patient’s satisfaction before and after treatment with urea/crosslinked hyaluronate (U-HACL) tear substitute in dry eye (DE) patients.17 DE patients were inc...