Preterm birth is associated with adverse health outcomes underlying greater mortality in this population. Despite risk associations, this metric does not inform current screening paradigms owing to often incomplete patient medical histories. An objective measure demonstrating likelihood of preterm birth could inform adult risk stratification and screening.

AIM: To assess the impact of anticoagulation on patients having cataract surgery. METHODS: Patients who underwent cataract surgery with phacoemulsification and intraocular lens insertion between 1 January 2015 and 31 December 2015 at Christchurch Hospital were identified and retrospectively audited. The outcome measures were the occurrence of intraoperative and postoperative haemorrhage, and thromboembolic events within two weeks after surgery. A control group was included to assess the outcome measures in a sample of patients who were not on anticoagulants or antiplatelets. RESULTS: Forty-four anticoagulated patients (46 eyes) and 41 controls (46 eyes) were identified. Seventy-four percent of those anticoagulated were on warfarin and 26% were on dabigatran. The incidence of haemorrhagic complications was 18%, 25% and 11% in the warfarin, dabigatran and control groups, respectively, although these differences were not statistically significant. Apart from one vitreous haemorrhage, which may have been present preoperatively, the haemorrhages that occurred were minor and not visually significant. No thromboembolic events were noted in any of the groups. CONCLUSION: There is no statistically significant increase in haemorrhagic complications in cataract surgery patients who were on warfarin or dabigatran. Therefore, continuing the anticoagulation in this setting may be appropriate.

Transfusion MedicineVolume 29, Issue 1 p. 69-71 LETTER TO THE EDITOR A retrospective crossover study of autologous and allogeneic serum eye drops for the management of ocular surface disease Y. Hung, Corresponding Author yu-chieh.hung@cdhb.health.nz orcid.org/0000-0003-4324-3953 Department of Ophthalmology, Christchurch Hospital, Christchurch, New Zealand Correspondence: Yu-Chieh Hung, Department of Ophthalmology, Christchurch Hospital, Private Bag 4710, Christchurch 8140, New Zealand. Tel.: +64 3 364 0640; fax: +64 3 364 1479; e-mail: yu-chieh.hung@cdhb.health.nzSearch for more papers by this authorM. J. Elder, Department of Ophthalmology, Christchurch Hospital, Christchurch, New ZealandSearch for more papers by this authorJ. A. Rawstron, Department of Ophthalmology, Christchurch Hospital, Christchurch, New ZealandSearch for more papers by this authorK. G. Badami, New Zealand Blood Service, Christchurch, New ZealandSearch for more papers by this author Y. Hung, Corresponding Author yu-chieh.hung@cdhb.health.nz orcid.org/0000-0003-4324-3953 Department of Ophthalmology, Christchurch Hospital, Christchurch, New Zealand Correspondence: Yu-Chieh Hung, Department of Ophthalmology, Christchurch Hospital, Private Bag 4710, Christchurch 8140, New Zealand. Tel.: +64 3 364 0640; fax: +64 3 364 1479; e-mail: yu-chieh.hung@cdhb.health.nzSearch for more papers by this authorM. J. Elder, Department of Ophthalmology, Christchurch Hospital, Christchurch, New ZealandSearch for more papers by this authorJ. A. Rawstron, Department of Ophthalmology, Christchurch Hospital, Christchurch, New ZealandSearch for more papers by this authorK. G. Badami, New Zealand Blood Service, Christchurch, New ZealandSearch for more papers by this author First published: 25 December 2018 https://doi.org/10.1111/tme.12572Citations: 6Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume29, Issue1February 2019Pages 69-71 RelatedInformation

Objective There are few data on visual outcomes in adulthood of former very low birthweight (VLBW; <1500 g) infants. We aimed to assess vision at 27–29 years in a national cohort of VLBW infants born in 1986 and assessed for retinopathy of prematurity (ROP) when no treatment was available, compared with term born controls. Methods The cohort and controls attended a 2-day assessment in Christchurch as part of a larger study. Visual assessment included glasses prescription measured by focimeter, logarithm of the minimum angle of resolution (logMAR) distance visual acuity (VA), contrast sensitivity, autorefraction, retinal photographs and a questionnaire on vision-related everyday activities. Rates of reduced VA and myopia in the VLBW cohort at 27–29 were compared with the results of vision testing at 7–8 years. Results 250 VLBW adults (77% those alive) gave study consent and 229 (45 with a history of ROP) were assessed in Christchurch, plus 100 term born controls. VLBW adults with ROP had reduced VA compared with no ROP and controls (mean logMAR score (SD); 0.003 (0.19), –0.021 (0.16), –0.078 (0.09), P=0.001). There were no differences in myopia (>2 D) between the groups but high myopia (>5 D) was confined to those with ROP. VLBW adults with ROP drove a car less often and had higher difficulties with everyday activities scores due to eyesight. Between 7–8 and 27–29 years rates of reduced VA were stable but myopia increased. Conclusion Former VLBW young adults with ROP have ongoing problems with vision affecting daily living and should continue in regular ophthalmological review. Trial registration number ACTRN12612000995875, Pre-results .

Introduction: Acute retinal artery occlusion (ARAO) is a major cause of sudden, painless visual loss, often leaving no useful vision in the affected eye. Its incidence is cited at 0.85 per 100,000 persons per year but may be higher because of under-reporting. The natural history is difficult to study, but a spontaneous resolution rate of < 1-8% for acute, non-arteritic ARAO has been cited. Occurrence in an only eye is devastating for the patient. There is currently no consensus regarding management of ARAO and little evidence to support any treatment modality. Despite only limited case series, hyperbaric oxygen treatment (HBOT) is recommended for ARAO by the Undersea and Hyperbaric Medical Society (UHMS) and by the European Committee for Hyperbaric Medicine. Methods: Between early 2003 and December 2012, all ARAO patients presenting to Christchurch Hospital were referred for consideration of HBOT. These 31 consecutive patients' medical records were reviewed retrospectively. The time delay from onset of visual loss to commencing HBOT; the presenting visual acuity; various demographic data; the HBOT administered and the outcome visual acuity were documented. Results: All 31 patients underwent at least one HBOT (median 4, range 1-7) at a pressure of 203-284 kPa for 1.5 to 2.0 h. One patient's treatment was terminated after 60 min at their request; another declined further HBOT and one suffered middle ear barotrauma. Thirteen patients also received anticoagulants at the discretion of the referring ophthalmologist. Twenty-three patients had temporarily improved vision with the first HBOT. Seven patients had permanent, good visual recovery (6/18 or better; Snellen chart); and two only modest improvement (6/60). All nine patients who improved permanently were treated within 10 hours of symptom onset. Conclusions: Where available, HBOT is indicated for ARAO. Our protocol may not have been aggressive enough and the UHMS protocol is recommended. A multi-centre, randomised controlled trial is feasible, but would be logistically difficult and expensive and may be ethically unsupportable given the lack of alternative, effective treatments.

Very low birth weight (less than 1500 g) is associated with increased morbidity and costs of health care in childhood. Emerging evidence suggests these infants face a range of health and social problems as young adults. We studied all New Zealand very low birth weight infants born in 1986 (when 58 % were exposed to antenatal corticosteroids) in infancy, with later follow-up at 7 to 8 years and 23 to 24 years. We now aim to assess the cohort at 26–28 years compared with controls.

Objective To assess whether an oxygen saturation (Spo(2)) target of 85%-89% compared with 91%-95% reduced the incidence of the composite outcome of death or major disability at 2 years of age in infants born at <28 weeks' gestation.Study design A total 340 infants were randomized to a lower or higher target from <24 hours of age until 36 weeks' gestational age. Blinding was achieved by targeting a displayed Spo(2) of 88%-92% using a saturation monitor offset by +/- 3% within the range 85%-95%. True saturations were displayed outside this range. Followup at 2 years' corrected age was by pediatric examination and formal neurodevelopmental assessment. Major disability was gross motor disability, cognitive or language delay, severe hearing loss, or blindness.Results The primary outcome was known for 335 infants with 33 using surrogate language information. Targeting a lower compared with a higher Spo(2) target range had no significant effect on the rate of death or major disability at 2 years' corrected age (65/167 [38.9%] vs 76/168 [45.2%]; relative risk 1.15, 95% CI 0.90-1.47) or any secondary outcomes. Death occurred in 25 (14.7%) and 27 (15.9%) of those randomized to the lower and higher target, respectively, and blindness in 0% and 0.7%.Conclusions Although there was no benefit or harm from targeting a lower compared with a higher saturation in this trial, further information will become available from the prospectively planned meta-analysis of this and 4 other trials comprising a total of nearly 5000 infants.

PURPOSE:The Age-Related Eye Disease Study Group (AREDS) has found high-dose vitamin supplementation may have a role in preventing the progression of Category 3 and 4 age-related maculopathy. The aim of this study is to compare dietary antioxidant, zinc, and copper intakes of Australia, New Zealand, United Kingdom, and the United States to determine the difference between the actual and suggested AREDS intakes for these nutrients. A further aim is to investigate the constituents of commonly available single and multivitamin preparations in New Zealand and carry out a cost analysis.METHODS:The total median intake of vitamins A, C, and E; zinc; and copper is analysed from the most recent nutrition data published by the four countries. Forty multivitamin brands and 32 individual nutrient brands were analysed. An average price per tablet for each brand has been calculated in New Zealand dollars.RESULTS:The median intakes of antioxidants, zinc, and copper for these countries were comparable, but lower than the AREDS suggested intakes. Sixteen of the 40 multivitamin preparations contained all recommended nutrients. Of these, only two fulfilled the AREDS-recommended levels. The cost of different preparations is similar.CONCLUSION:Dietary supplementation is required to achieve the AREDS nutrient intake recommendations. This may be achieved by using any combination of multivitamin and individual supplement preparations available. Comprehensive tables have been constructed to guide ophthalmologists in the process of suggesting supplementation to prevent the progression of Category 3 and 4 age-related maculopathy.

BACKGROUND:To examine the current practice and changing trends for cataract and refractive surgery in New Zealand (NZ) between 1997 and 2007.METHODS:A self-administered confidential postal questionnaire was sent to all consultant ophthalmologists practising in NZ in 2007, eliciting surgical volumes and technique, anaesthetic, preferred equipment and patient management. Results were compared with previous NZ surveys and international surveys of surgeons in Northern America, Europe and the UK.RESULTS:From the 113 ophthalmologists surveyed 88% responded, comprising 86 cataract surgeons and 20 refractive surgeons. Key findings for cataract surgeons were: 65% routinely used sub-Tenon's anaesthetic, 20% topical anaesthetic, 24% favoured intracameral antibiotics, 88% operated via clear corneal or anterior limbal incisions and 61% used temporal incisions. Acrylic foldable intraocular lenses (IOLs) were preferred, 27% of surgeons routinely used aspheric IOLs, 31% used presbyopia-correcting IOLs and 63% expressed high interest in toric IOLs. Of the refractive surgeons, 83% would perform bilateral LASIK at the same surgical event; phakic IOL was the treatment of choice for 30-year-old -12D myopes, and clear lens exchange for 45-year-old +5D hyperopes.CONCLUSIONS:The majority of NZ cataract surgical practice remains comparable with results from international surveys. A notable exception, as in previous comparisons, is a lower use of topical anaesthetic in NZ with a higher use of sub-Tenon's anaesthetic instead. Refractive surgery practice in NZ is generally comparable with that of American Society of Cataract and Refractive Surgery members.

PURPOSE:We aimed to indirectly assess the contribution from observer bias to between centre variability in the incidence of acute retinopathy of prematurity (ROP). METHODS:The Australian and New Zealand Neonatal Network (ANZNN) collected data on the highest stage of acute ROP in either eye in 2286 infants born at less than 29 weeks in 1998-1999 and cared for in one of 25 neonatal intensive care units (NICUs). Chi-squared analysis was used to detect differences in the proportion of stages of ROP for each neonatal intensive care unit. These proportions were compared with those reported in two large studies of treatment for ROP. RESULTS:The incidence of acute ROP in the ANZNN cohort was 42% and the ratio of stage 1:2:3 ROP was 1.5:1.9:1. There was considerable variation in both the incidence of acute ROP and the proportions with stage 1:2:3 ROP between centres. A chi-squared test determined that the assignment of stages 1, 2 and 3/4 ROP was not independent of centre (chi(2)(48) = 165.2; P < 0.0001). Treatment of stage 3 ROP varied between 15% and 120%, indicating some eyes were treated at less than stage 3. CONCLUSION:The data are highly suggestive of observer bias contributing to the observed between centre variation in the incidence of acute ROP. In neonatal intervention studies where acute ROP is an outcome it would seem important to have an accreditation process for examining ophthalmologists, and there are similar arguments for neonatal networks which collect these data.

The ongoing supply of quality ophthalmic care to the New Zealand (NZ) population depends on a sustainable ophthalmology workforce. The NZ population is growing and aging rapidly, placing increasing demands on ophthalmic services. Predicting future supply of NZ ophthalmologists requires an accurate description of the current workforce.A confidential postal workforce survey, the fourth since 1997, was sent to all NZ consultant ophthalmologists in October 2007. A second survey conducted in January 2008 by email and direct telephone contact gained a complete dataset of NZ ophthalmologists. Results were compared with NZ population data, and the Australian Ophthalmology Workforce Model 2006 was used to estimate future demands on NZ ophthalmic services.There are currently 16-24 vacancies for consultant ophthalmologists in NZ, with another eight positions planned to be created by 2010, bringing the shortfall to 24-32. Retirement rates average to three per year, although 28 consultants are planning to retire by 2013. Retention of new NZ Fellows stands at around 71%. Increasing demands of an aging population are likely to increase the shortfall of ophthalmologists to 40-50 by 2015, and 46-69 by 2025.This report identifies a growing gap between supply of NZ ophthalmologists and demand for their services. We highlight the need for a comprehensive model with a detailed analysis of the many factors influencing supply and demand, enabling planning for an appropriate supply of ophthalmologists meeting the needs of the future NZ population.

Our website uses cookies to enhance your experience. By continuing to use our site, or clicking "Continue," you are agreeing to our Cookie Policy | Continue JAMA Ophthalmology HomeNew OnlineCurrent IssueFor Authors Podcast Publications JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry (1919-1959) JN Learning / CMESubscribeJobsInstitutions / LibrariansReprints & Permissions Terms of Use | Privacy Policy | Accessibility Statement 2023 American Medical Association. All Rights Reserved Search All JAMA JAMA Network Open JAMA Cardiology JAMA Dermatology JAMA Forum Archive JAMA Health Forum JAMA Internal Medicine JAMA Neurology JAMA Oncology JAMA Ophthalmology JAMA Otolaryngology–Head & Neck Surgery JAMA Pediatrics JAMA Psychiatry JAMA Surgery Archives of Neurology & Psychiatry Input Search Term Sign In Individual Sign In Sign inCreate an Account Access through your institution Sign In Purchase Options: Buy this article Rent this article Subscribe to the JAMA Ophthalmology journal

Purpose To examine the reasons for unplanned overnight hospital admission in paediatric patients undergoing strabismus repair, to identify preventable causes (particularly postoperative nausea and vomiting), and to compare the rate of unplanned overnight stay with a group undergoing inguinal hernia repair.Method A retrospective review of consecutive patients under age 17 having strabismus surgery over a 5-year period between January 1995 and December 1999 was undertaken at Christchurch Hospital, New Zealand. A control group, from a similar period, of children having elective inguinal hernia repair was used to compare the rate of overnight stay.Results 375 patients had strabismus surgery, of which 51 stayed overnight; 19 of these were from remote locations and stayed for geographic reasons only, 9 stayed overnight preoperatively only, thus leaving an unplanned overnight stay rate of 6.4%. This compared to a rate of 1.1% in those having hernia surgery. The reasons for overnight stay were postoperative nausea and vomiting (50%), anaesthetic complications (18%), late afternoon surgery (14%), social factors (14%), and pain (5%). Significant associations were found between postoperative nausea and vomiting and the extent and duration of surgery. Possible associations not reaching significance included a higher rate of postoperative nausea and vomiting in those receiving nitrous oxide, and those with evidence of stimulation of the oculo-cardiac reflex.Conclusions The provision of suitable accommodation and careful planning of the type and timing of surgery would be expected to reduce the overnight stay rate after strabismus surgery.

The incidence of cataract continues to increase with the ageing of the population. Surgical treatment with phacoemulsification and intraocular lens implantation remains the only proven treatment. This, however, is associated with significant cost and is not readily available especially in the developing countries where the prevalence of cataract is the highest. Medical treatment of cataract is therefore a highly desired alternative. Since the last major review of medical treatment of cataract the search for an anti-cataract agent has advanced on many fronts. Some anti-cataract drugs, such as carnosine, have now reached clinical trials and showed encouraging results that warrant further investigation. The discovery of an effective medical treatment for cataract is likely to make global impact on eye health. The aims of this paper are to review the literature on the drug therapy of cataract and provide updates of the latest development.

OBJECTIVE:To review the natural history and ocular and systemic adverse effects of patients taking hydroxychloroquine sulfate who attended an ophthalmic screening program.DESIGN:Retrospective study.RESULTS:Records of 262 patients who were taking hydroxychloroquine and screened in the Department of Ophthalmology were reviewed. Of the 262 patients, 14 (18%) of 76 who had stopped treatment at the time of the study experienced documented adverse effects. Systemic adverse effects occurred in 8 patients (10.5%) and ocular adverse effects, in 5 (6.5%). Thirty-five patients (13.4%) had visual field abnormalities, which were attributed to hydroxychloroquine treatment in 4 patients (1.5%). Three of the 4 patients were taking less than 6.5 mg/kg per day and all patients had normal renal and liver function test results.CONCLUSIONS:The current study used a protocol of visual acuity and color vision assessment, funduscopy, and Humphrey 10-2 visual field testing and shows that visual field defects appeared before any corresponding changes in any other tested clinical parameters; the defects were reproducible and the test parameters were reliable. Patients taking hydroxychloroquine can demonstrate a toxic reaction in the retina despite the absence of known risk factors. Screening, including Humphrey 10-2 visual field assessment, is recommended 2 years after the initial baseline and yearly thereafter.

ANZ Journal of SurgeryVolume 76, Issue 4 p. 279-279 Surgical masks may reduce serious postoperative cataract complications Rebecca R. Stack, Rebecca R. Stack Ophthalmology Department,Christchurch Hospital;Search for more papers by this authorMark J. Elder, Mark J. Elder Christchurch School of MedicineOtago University, New ZealandSearch for more papers by this author Rebecca R. Stack, Rebecca R. Stack Ophthalmology Department,Christchurch Hospital;Search for more papers by this authorMark J. Elder, Mark J. Elder Christchurch School of MedicineOtago University, New ZealandSearch for more papers by this author First published: 27 April 2006 https://doi.org/10.1111/j.1445-2197.2006.03602.xCitations: 1Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article.Citing Literature Volume76, Issue4April 2006Pages 279-279 RelatedInformation