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Contact: Maureen Hunter
m.hunter@elsevier.com
215-239-3671
Elsevier

Test allows early detection of vision problems in infants with hemangiomas of eyelids

Philadelphia, 1 April 2009 In children with vascular birthmarks around the eye, even partial blockage of vision can lead to visual loss due to amblyopia. Now a simple test can detect early evidence of amblyopia in infants too young for conventional vision testing, reports a study in the April issue of the American Journal of Ophthalmology (http://www.elsevier.com/locate/ajo) published by Elsevier.

Led by Dr. William V. Good of Smith-Kettlewell Eye Research Institute, San Francisco, the researchers performed the early vision test in four infants with vascular birthmarks, or hemangiomas, on the upper or lower eyelids. These birthmarks generally resolve over time without treatment. However, if they are blocking part of the field of vision in the affected eye, they can lead to permanent reductions in vision, called amblyopia.

The test, called "sweep visual evoked potential vernier acuity," works by monitoring brain responses to changes in the alignment of two lines. None of the four infants had had any clinical evidence of amblyopia.

However, the vernier acuity measurements identified early visual abnormalities in the eyes with birthmarks. Brainwave responses to the shifting lines were significantly reduced in the eyes affected by hemangiomas, compared to the fellow eyes.

Vascular birthmarks occurring in the area around the eye have the potential to cause significant vision loss before the abnormality resolves, or before the child is old enough for conventional vision testing. Dr. Good commented, "Many congenital ocular or eyelid abnormalities present physicians with a management conundrum: Is treatment for potential amblyopia necessary?"

The new results show that vernier visual acuity measurements are a promising tool for early detection of "amblyopia-like effects" in children with eyelid hemangiomas, who can then be targeted for treatment. "This study has implications for the management of children with intermittent occlusion, who may develop amblyopia even when the clinical assessment is negative," added Dr. Good. "It is likely that these findings extend to other eyelid problems, including congenital ptosis [drooping eyelid], where amblyopia may be present even in the absence of clinical features for amblyopia."

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About the American Journal of Ophthalmology

The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented on the Internet at www.AJO.com

About Elsevier

Elsevier is a world-leading publisher of scientific, technical and medical information products and services. Working in partnership with the global science and health communities, Elsevier's 7,000 employees in over 70 offices worldwide publish more than 2,000 journals and 1,900 new books per year, in addition to offering a suite of innovative electronic products, such as ScienceDirect (http://www.sciencedirect.com/), MD Consult (http://www.mdconsult.com/), Scopus (http://www.info.scopus.com/), bibliographic databases, and online reference works.

Elsevier (http://www.elsevier.com/) is a global business headquartered in Amsterdam, The Netherlands and has offices worldwide. Elsevier is part of Reed Elsevier Group plc (http://www.reedelsevier.com/), a world-leading publisher and information provider. Operating in the science and medical, legal, education and business-to-business sectors, Reed Elsevier provides high-quality and flexible information solutions to users, with increasing emphasis on the Internet as a means of delivery. Reed Elsevier's ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).



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