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Purpose: To validate Postnatal Growth and Retinopathy of Prematurity (G-ROP) criteria for Thai infants., Study Design: A retrospective review of infants receiving ROP screening during 2009-2020., Methods: Baseline characteristics, clinical progression and final ROP outcomes were collected. G-ROP was applied to infants who met at least one of the following 6 criteria: birth weight (BW) below 1051 g, gestational age (GA) under 28 weeks, weight gain (WG) less than 120 g during postnatal day 10-19, WG less than 180 g during day 20-29, WG less than 170 g during day 30-39 and hydrocephalus., Results: A total of 684 infants (boys, 53.4%) were included. Median (IQR) BW was 1200 (960-1470) grams and median GA was 30 (28-32) weeks. Prevalence of ROP was 26.6%, with 28 (4.1%) having type 1, 19 (2.8%) type 2 and, 135 (19.7%) having other ROP. Treatment was performed in 26 infants (3.8%). Sensitivity of G-ROP to include type 1, 2 or treatment-requiring ROP cases was 100% with 36.9% specificity, excluding 235 (34.4%) cases of unnecessary screening. To adjust for our setting of initial eye examination at 4 weeks' postnatal date, the last 2 criteria of G-ROP were replaced by the occurrence of grade 3 or 4 intraventricular hemorrhage (IVH). This modified G-ROP criteria yielded 100% sensitivity, 42.5% specificity and excluded 271 (39.6%) cases of unnecessary screening., Conclusion: G-ROP criteria can be applied to our hospital setting. Occurrence of IVH grade 3 or 4 was proposed as an alternative in modified G-ROP criteria., (© 2023. Japanese Ophthalmological Society.)

Purpose: To identify genetic mutations of the XLRS1 gene and to describe the ocular phenotypes in two unrelated Thai patients with X-linked juvenile retinoschisis., Methods: Ophthalmic examination, including best-corrected visual acuity and fundus examination and photography, was performed in all participants. Electroretinography (ERG) and optical coherence tomography were performed when possible. All six exons of the XLRS1 gene were amplified, and mutation screening was determined by denaturing high-performance liquid chromatography and DNA sequencing., Results: Two point mutations were identified, a novel missense mutation c.378A > G (p.D126G) in exon 5 and a reported mutation c.637C > T (p.R213W) in exon 6. The first proband with the p.D126G mutation developed vitreous hemorrhage in both eyes at age 7 months. Foveal and peripheral schisis with several inner layer holes were detected in both eyes. The second proband with the p.R213W mutation developed slightly blurred vision at age 10 years. Fundus examination showed numerous fine white dots at the macula without foveal or peripheral schisis. Electronegative ERG results were documented in both probands., Conclusions: A novel p.D126G mutation appeared to be associated with a severe phenotype with vitreous hemorrhage developing in infancy. Both intra- and interfamilial clinical variabilities were recognized in our patients.

Purpose: Since 1997, our institute has used neoadjuvant chemotherapy for intraocular retinoblastoma. However, some of the patients showed signs of recurrence months to years later. We therefore attempted to determine the prognostic factors of treatment outcomes and survival in our patients., Methods: We reviewed 90 patients treated from 1997 to 2006. The following information was recorded: demographic and ophthalmological data, clinical classification, histopathological data, and treatment methods and outcomes., Results: Enucleation was avoided in two of 57 eyes in the unilateral group. Sixteen of 54 eyes in the bilateral group were salvaged by systemic chemotherapy with local treatment. There was no difference in histopathological findings between the two groups. Nine of 57 patients in the unilateral group demonstrated poor outcomes, compared with four of 27 in the bilateral group. Significant poor prognostic factors for survival were optic nerve head invasion, orbital involvement, abnormal results on bone marrow aspiration, lumbar puncture, bone scan, and group E or F classification., Conclusions: The 15% mortality rate in our patients is slightly higher than that reported in developed countries. Delayed diagnosis and treatment is the main cause of avoidable deaths. Improving education of both clinicians and parents would increase survival rates in this potentially fatal disease.

Purpose: To describe a large Thai family with lattice corneal dystrophy (LCD) type I and to determine whether this LCD is associated with mutations within the transforming growth factor-beta-induced (TGFBI) gene., Methods: A six-generation family with LCD type I was identified and diagnosed on the basis of clinical and/or histopathologic evaluation. Visual acuity testing and slit-lamp biomicroscopic evaluation were carried out and corneal photography was documented. All 17 exons and flanking intron sequences of the TGFBI gene were sequenced., Results: Thirty-three participants demonstrated LCD in both eyes, most of which was symmetrical. Age at onset of decreased vision was the mid- to late twenties. Visual acuity varied from 6/6 to no light perception. Two patients, 74 and 42 years of age, demonstrated a thick yellowish plaque covering the corneal surfaces. DNA sequencing revealed a heterozygous mutation in exon 13 (A1762G), changing histidine to arginine at codon 572 (H572R). Ten of 42 clinically unaffected family members, all under 25 years of age, exhibited the same mutation., Conclusions: This is the first report of a molecular analysis of LCD type I in Thai patients. The novel mutation identified is associated with distinct phenotypes and later onset of the disease compared with the more common R124C mutation., (Copyright Japanese Ophthalmological Society 2006.)

Purpose: To assess the role of serum anticardiolipin IgG antibody and fasting plasma homocysteine levels as risk factors for retinal vascular occlusive disease in Thai patients., Methods: This is a retrospective, case-control study. Forty-one consecutive patients with recent onset of retinal vascular occlusive diseases were enrolled. In conjunction with a routine laboratory work up, serum anticardiolipin IgG antibody and plasma homocysteine were evaluated. Ninety volunteers without a history of retinal vascular occlusive disease were chosen as controls., Results: In general, mean levels of anticardiolipin IgG antibody and homocysteine did not differ between the patients and controls. However, when the groups without a history of underlying systemic diseases were compared, there were statistically significant differences in the anticardiolipin IgG antibody level between patients and controls (mean 12.24 +/- 8.66 and 7.70 +/- 6.69 GPL units/ml, respectively) with a P value of 0.024., Conclusions: No association was found between plasma homocysteine level and retinal vascular occlusion in our patient population. A high level of anticardiolipin IgG antibody is shown to be a risk factor only in patients without a history of underlying systemic diseases. The effect of anticardiolipin IgG antibody on the development of retinal vascular occlusive disease appears to be limited and may not be a major cause.

Purpose: The aim of this study was to verify the applicability of standard guidelines for the screening of retinopathy of prematurity (ROP) and to determine the appropriate criteria for Thai neonates., Methods: Records of ROP screening of infants born in our hospital between 1995 and 2000 with a birth weight below 2000 g or a gestational age of less than 36 weeks were studied. Criteria to screen infants with a birth weight below 1500 g or a gestational age of less than 28 weeks in the American guidelines and similar birth weight but a gestational age of less than 31 weeks in the British recommended guidelines were applied and evaluated in terms of sensitivity and specificity. Criteria reaching 100% sensitivity with the maximum specificity were deemed appropriate., Results: Of the 514 screened infants, 33 had developed stage 2+ ROP and beyond. The mean +/- SD birth weight and gestational age were 1046 +/- 257 (710-1680 g) and 29.2 +/- 2.5 weeks (24-35 weeks), respectively. The age at intervention was 6-16 weeks. Sensitivity for both American and British guidelines was 93.9%. By screening infants with birth weights below 1500 g or gestational age less than 33 weeks, we could achieve 100% sensitivity with 18.3% specificity. We decided that the initial examination should be performed 4-6 weeks after birth. By applying these criteria to 62 referred cases we also were able to include in the screening all cases of concern in this group., Conclusions: Regional criteria for ROP screening is required and should be evaluated periodically and modified accordingly.