Sharon Freedman, MD, professor of ophthalmology and pediatric ophthalmology and strabismus division chief and her colleagues have had a productive year with continued clinical research in a variety of areas – childhood glaucoma diagnosis and treatment, retinal and optic nerve imaging using optical coherence tomography (OCT), and retinopathy of prematurity (ROP) research.
Tono-Pen Comparison
Along with former Duke pediatric fellows Allison Umfress, MD, Tanya Glaser, MD and Pimpiroon Ploysangam, MD, Freedman studied the use of a newly-approved device (iCare 200) for measuring the eye pressure of children either sitting up (in clinic) or in the supine position (for babies lying down or children supine under anesthesia). The authors compared the iCare 200 device against the commonly used Tono-Pen for assessing eye pressure under anesthesia in the operating room, and against the gold standard Goldmann applanation device in the clinic. This work validated the new iCare200 device as an important supplemental tool for eye pressure assessment in the operating room for children requiring examination under anesthesia to evaluate the control of their glaucoma. This study was published in the Journal of the American Association for Pediatric Ophthalmology and Strabismus in November 2021.
Risk for Childhood Glaucoma: 10 Year Follow Up
Freedman was the first and corresponding author on a publication in JAMA Ophthalmology in December 2020 that reported the incidence of glaucoma and glaucoma suspect diagnoses among children 10 years following participation in the NIH-sponsored Infant Aphakia Treatment Study. This pivotal study randomized infants having a unilateral cataract removed in the first six months of life, to either receive a primary intraocular lens implantation, or to remain aphakic (and use a contact lens on the surface of the eye). Participating children were re-examined 10 years after surgery, and the group reported that the risk of glaucoma continued to rise after follow-up. The decision to place or to refrain from placing a primary lens implant when removing an infant’s cataract did not affect the risk of that eye developing glaucoma 10 years later, definitively settling a long-running dispute in this regard.
Duke ROPtool May Advance ROP Diagnosis
Continuing their long-standing interest in the way that blood vessels change their thickness and tortuosity in the retina of prematurely born infants with ROP, corresponding author S. Grace Prakalapakorn, MD, MPH, Freedman and co-authors used a semi-automated computer program (ROPtool) developed by the group, to quantitively compare the blood vessel changes over time between infants eventually requiring treatment for severe ROP versus those who never needed treatment. Published in the Journal of the American Association for Pediatric Ophthalmology and Strabismus in February 2021, the study documented clinically relevant quantifiable differences in the retinal blood vessel characteristics of these two groups of eyes. This work shows potential to advance our ability to identify eyes at highest risk of developing severe ROP before they need treatment by utilizing computer-based quantification.