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Browsing by Author "Hercinovic, Amra"
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Item Amblyopia Preferred Practice Pattern(Elsevier, 2023) Cruz, Oscar A.; Repka, Michael X.; Hercinovic, Amra; Cotter, Susan A.; Lambert, Scott R.; Hutchinson, Amy K.; Sprunger, Derek T.; Morse, Christie L.; Wallace, David K.; American Academy of Ophthalmology Preferred Practice Pattern Pediatric Ophthalmology/Strabismus Panel; Ophthalmology, School of MedicineItem Health-related quality of life in children with untreated intermittent exotropia and their parents(Elsevier, 2021) Holmes, Jonathan M.; Hercinovic, Amra; Melia, B. Michele; Leske, David A.; Hatt, Sarah R.; Chandler, Danielle L.; Dean, Trevano W.; Kraker, Raymond T.; Enyedi, Laura B.; Wallace, David K.; Mohney, Brian G.; Cotter, Susan A.; Ophthalmology, School of MedicinePurpose To determine whether health-related quality of life (HRQOL) scores improved or worsened over 3 years of observation in childhood intermittent exotropia without treatment. Methods A total of 111 children aged 3-11 years with intermittent exotropia were assigned to observation in a previously reported randomized trial comparing patching with observation. The intermittent exotropia questionnaire (IXTQ) was administered at baseline, 6 months, and 36 months. Rasch-calibrated IXTQ domain scores (Child, Proxy, Parent-psychosocial, Parent-function, and Parent-surgery) were compared between time points. The Child IXTQ was administered only to children ≥5 years of age (n = 78). Results Overall, Child IXTQ and Proxy IXTQ scores showed no significant change over 36 months (mean improvement from baseline to 36 months of 3.2 points [95% CI, −1.9 to 8.2] and −2.4 points [95% CI: −7.9 to 3.1], resp.). By contrast, Parent-psychosocial, Parent-function, and Parent-surgery domain scores all improved over 36 months (mean improvements of 12.8 points [95% CI, 5.9-19.6] and 14.2 points [95% CI, 8.0-20.3] and 18.5 points [95% CI, 9.7-27.3], resp.). Conclusions HRQOL of children with intermittent exotropia remains stable with observation over 3 years (by both child and proxy report), whereas parental HRQOL improves.Item Improvement in health-related quality of life following strabismus surgery for children with intermittent exotropia(Elsevier, 2021-04-24) Holmes, Jonathan M.; Hercinovic, Amra; Melia, B. Michele; Leske, David A.; Hatt, Sarah R.; Chandler, Danielle L.; Dean, Trevano W.; Kraker, Raymond T.; Enyedi, Laura B.; Wallace, David K.; Donahue, Sean P.; Cotter, Susan A.; Ophthalmology, School of MedicinePurpose: To investigate health-related quality of life (HRQOL) after strabismus surgery in children with intermittent exotropia (IXT) and relationships between HRQOL and surgical success. Methods: A total of 197 children with IXT aged 3-11 years (and 1 parent of each child) were enrolled in a previously reported randomized clinical trial comparing two surgical procedures. The Intermittent Exotropia Questionnaire (IXTQ) was administered before surgery (baseline), and again at 6 and 36 months following surgery. The child version of the IXTQ was only completed by children 5-11 years of age (n = 123). Outcomes were classified as “resolved” (exodeviation of <10Δ, no decreased stereoacuity, and no other nonsurgical treatment for IXT or reoperation), “suboptimal” (exotropia ≥10Δ by simultaneous prism and cover test or constant esotropia ≥6Δ or loss of ≥2 octaves of stereoacuity), or “intermediate.” Mean changes in Rasch-calibrated IXTQ domain scores (Child, Proxy, Parent-psychosocial, Parent-function, and Parent-surgery; converted to a 0-100 scale) were compared. Results: Overall, mean IXTQ domain scores improved for all domains from baseline to 36 months after surgery, ranging from 10.7 points (Child IXTQ; P < 0.0001) to 34.5 points (Parent-surgery IXTQ; P < 0.0001). At 36 months after surgery, 62 (39%) children had resolved IXT, whereas 38 (24%) had suboptimal outcome. Greater improvement was found in all mean domain scores with resolved IXT (range, 19.8-46.0 points) compared with suboptimal outcome (all comparisons P < 0.05). Conclusions: Successful surgery for childhood IXT results in measurable improvement in a child’s quality of life, in parental assessment of the child’s quality of life, and in quality of life for the parent.Item Low- and Very Low-Dose Bevacizumab for Retinopathy of Prematurity: Reactivations, Additional Treatments, and 12-Month Outcomes(Elsevier, 2022) Freedman, Sharon F.; Hercinovic, Amra; Wallace, David K.; Kraker, Raymond T.; Li, Zhuokai; Bhatt, Amit R.; Boente, Charline S.; Crouch, Eric R.; Hubbard, G. Baker; Rogers, David L.; VanderVeen, Deborah; Yang, Michael B.; Cheung, Nathan L.; Cotter, Susan A.; Holmes, Jonathan M.; Pediatric Eye Disease Investigator Group; Ophthalmology, School of MedicinePurpose: Low-dose and very low-dose intravitreal bevacizumab (IVB) have been reported to be successful in short-term treatment of type 1 retinopathy of prematurity (ROP), down to an initial dose of 0.004 mg. We now report 12-month outcomes for these infants. Design: Masked, multicenter, dose de-escalation study. Participants: One hundred twenty prematurely born infants with type 1 ROP. Methods: A cohort of 120 infants with type 1 ROP in at least 1 eye from 2 sequential dose de-escalation studies of low-dose IVB (0.25 mg, 0.125 mg, 0.063 mg, and 0.031 mg) or very low-dose IVB (0.016 mg, 0.008 mg, 0.004 mg, and 0.002 mg) to the study eye; the fellow eye (if also type 1) received 1 dose level higher of IVB. After primary success or failure at 4 weeks, clinical management was at investigator discretion, including all additional treatment. Main outcome measures: Reactivation of severe ROP by 6 months corrected age, additional treatments, retinal and other ocular structural outcomes, and refractive error at 12 months corrected age. Results: Sixty-two of 113 study eyes (55%) and 55 of 98 fellow eyes (56%) received additional treatment. Of the study eyes, 31 (27%) received additional ROP treatment, and 31 (27%) received prophylactic laser therapy for persistent avascular retina. No trend toward a higher risk of additional ROP treatment related to initial IVB doses was found. However, time to reactivation among study eyes was shorter in eyes that received very low-dose IVB (mean, 76.4 days) than in those that received low-dose IVB (mean, 85.7 days). At 12 months, poor retinal outcomes and anterior segment abnormalities both were uncommon (3% and 5%, respectively), optic atrophy was noted in 10%, median refraction was mildly myopic (-0.31 diopter), and strabismus was present in 29% of infants. Conclusions: Retinal structural outcomes were very good after low- and very low-dose IVB as initial treatment for type 1 ROP, although many eyes received additional treatment. The rate of reactivation of severe ROP was not associated with dose; however, a post hoc data-driven analysis suggested that reactivation was sooner with very low doses.Item Pediatric Eye Evaluations Preferred Practice Pattern(Elsevier, 2023) Hutchinson, Amy K.; Morse, Christie L.; Hercinovic, Amra; Cruz, Oscar A.; Sprunger, Derek T.; Repka, Michael X.; Lambert, Scott R.; Wallace, David K.; Ophthalmology, School of Medicine