Ophthalmology

Advanced maternal age has limited independent effect on early pediatric ophthalmic morbidity.

In a nationwide cohort of 2,500,044 mother–infant pairs, term/normal birth weight (NBW) infants of older mothers had slightly lower composite ophthalmic morbidity (adjusted HR 0.93; 95% CI, 0.92–0.94). The reduced composite risk was mainly driven by less strabismus and did not reduce invasive procedures or hospitalizations. Preterm or low birth weight status, not maternal age, was the dominant driver of ophthalmic risk and procedures (HRs 1.52–1.81; IRRs 1.84–2.00). Higher ROP diagnoses were observed with advanced maternal age (adjusted HR 1.331) but without increased ROP-related invasive treatment. 1

Faster early ONH swelling predicts worse visual outcomes in acute NAION.

Among 715 acute NAION eyes imaged within 14 days, greater early optic nerve head volume (pONHV) increase was linked to subsequent visual decline. Each 0.15 mm3/day faster pONHV increase raised odds of ≥2 dB VF worsening (OR 1.84; 95% CI, 1.3–2.5) and ≥10‑letter BCVA loss (OR 1.52; 95% CI, 1.1–2.1) by Month 6. mGCIPL thinning was detectable within 14 days, preceding overt RNFL atrophy, and early reduction in swelling associated with better outcomes. Similar and larger effect sizes were seen at Month 2, supporting early OCT-guided prognostication in NAION. 2

Postoperative glaucoma affects about one-quarter of Boston Type 1 KPro eyes.

Meta-analysis of 1,482 KPro eyes (mean follow-up 39.4 months) found a pooled postoperative glaucoma incidence of 25.6% (95% CI, 18.1–34.8%). De novo glaucoma occurred in 31.1% of eyes and progression of pre-existing glaucoma in 37.7% of eyes across studies. Ocular hypertension without confirmed glaucoma was reported in 17.1% of eyes, and the event rate was 0.09 events per eye‑year. Certainty is low due to high heterogeneity and variable diagnostic definitions, so individualized surveillance plans remain important. 3