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Recent developments in pediatric retina
Sophie Cai1, Anthony Therattil, Lejla Vajzovic
1Department of Ophthalmology, Duke University Medical Center, Durham, North Carolina, USA.
Insights
Recent advances in pediatric retina care include multimodal imaging for infants, gene therapy for inherited retinal diseases, and AI-powered screening for retinopathy of prematurity. Surgical techniques are also improving outcomes for children with retinal conditions.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Medical Technology
Background:
- Pediatric retinal conditions present unique diagnostic and treatment challenges due to patient age and cooperation.
- Inherited retinal degenerations in children are often untreatable, and surgical outcomes differ from adults.
Purpose of the Study:
- To review recent advances and trends in pediatric retinal care.
- To highlight innovations improving diagnosis and treatment for children with retinal conditions.
Main Methods:
- Review of current literature on pediatric ophthalmology.
- Focus on multimodal imaging, gene therapy, machine learning, and surgical techniques.
Main Results:
- Multimodal imaging, including portable optical coherence tomography (OCT) and OCT angiography, is feasible in infants.
- Successful gene therapy (voretigene neparvovec-rzyl) for RPE65 mutation-associated Leber congenital amaurosis shows promise for other inherited retinal degenerations.
- Machine learning and smartphone-based imaging aid retinopathy of prematurity screening, with positive outcomes from anti-VEGF injections.
- Surgical innovations, such as nomograms for pars plana sclerotomy, enhance safety in pediatric retinal surgeries.
Conclusions:
- Multimodal imaging, gene therapy, machine learning, and surgical innovation are crucial for advancing pediatric retina care.
- These advancements offer improved diagnostic capabilities and therapeutic options for children with various retinal conditions.
Purpose Of Review:
Pediatric retina is an exciting, but also challenging field, where patient age and cooperation can limit ease of diagnosis of a broad range of congenital and acquired diseases, inherited retinal degenerations are mostly untreatable and surgical outcomes can be quite different from those for adults. This review aims to highlight some recent advances and trends that are improving our ability to care for children with retinal conditions.
Recent Findings:
Studies have demonstrated the feasibility of multimodal imaging even in nonsedated infants, with portable optical coherence tomography (OCT) and OCT angiography in particular offering structural insights into diverse pediatric retinal conditions. Encouraging long-term outcomes of subretinal voretigene neparvovec-rzyl injection for RPE65 mutation-associated Leber congenital amaurosis have inspired research on the optimization of subretinal gene delivery and gene therapy for other inherited retinal degenerations. In retinopathy of prematurity, machine learning and smartphone-based imaging can facilitate screening, and studies have highlighted favorable outcomes from intravitreal anti-vascular endothelial growth factor (anti-VEGF) injections. A nomogram for pediatric pars plana sclerotomy site placement may improve safety in complex surgeries.
Summary:
Multimodal imaging, gene therapy, machine learning and surgical innovation have been and will continue to be important to advances in pediatric retina.
