• Pediatric Ophth/Strabismus

    Review of: Can Structural Grading of Foveal Hypoplasia Predict Future Vision in Infantile Nystagmus?

    Rufai S, Thomas M, Purohit R, et al. Ophthalmology, April 2020

    Investigators evaluated whether structural grading of foveal hypoplasia could help in the diagnosis and prognosis of children with infantile nystagmus.

    Study design

    This prospective, longitudinal cohort study comprised 42 patients with infantile nystagmus who were imaged with a hand-held, spectral-domain OCT before 36 months of age. Grade of foveal hypoplasia, quantitative parameters (e.g., photoreceptor length, OS length, FDI) and preferential looking visual acuity were obtained in preverbal children for comparison with future chart visual acuity outcomes.

    Outcomes

    Structural grading of the fovea was the best predictor of vision later in childhood. Vision acuity assessment by preferential looking was inferior to foveal grading by OCT.

    Limitations

    Since handheld OCT devices are relatively new, the OCT features are correlated only to vision in childhood and not to vision in adulthood. 

    Clinical significance

    The ability to predict the visual acuity outcome in patients with nystagmus helps the patient and the family to plan educational and occupational resources to attain the best developmental outcome.