Publications by authors named "Moug Al-Bakri"

10 Publications

  • Page 1 of 1

Increased incidence of mental disorders in children with cataract - findings from a population-based study.

Am J Ophthalmol 2021 Oct 11. Epub 2021 Oct 11.

Department of Ophthalmology, Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.

Purpose: To examine the incidence of mental disorders in children with cataract compared to children without cataract.

Design: Nationwide cohort study based on entries in comprehensive national databases.

Methods: The incidence of mental disorders in children born between 2000-2017 diagnosed with cataract before 10 years of age (N= 485) was compared to sex- and age-matched controls (N= 4358). Analyses were corrected to somatic disease in the child and parental socio-economic status and psychiatric morbidity.

Setting: The two university hospitals in Denmark managing children ≤6 years of age with cataract.

Results: The incidence of mental disorders was nearly doubled in children with cataract compared to controls (OR = 1.83 95% CI (1.28 - 3.63)). The risk of anxiety disorders was quadrupled (OR = 4.10, 95% CI (1.90 - 8.84)) and the risk of developmental delay was doubled (OR = 2.66, 95% CI (1.45 - 4.90)). The risk of mental disorders was significantly higher in children diagnosed with cataract in the first 3 years of life compared to controls (OR = 2.36, 95% CI (1.53 - 3.64)), whereas those diagnosed with cataract later in childhood did not have an increased risk (OR = 1.24, 95% CI (0.66 - 2.30)).

Conclusions: The risk of mental disorders, in particular anxiety and neurodevelopmental delay, is markedly increased in children with cataract and even more so in those diagnosed within the first three years of life. Psychiatric screening instruments may be integrated in the management of these children.
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http://dx.doi.org/10.1016/j.ajo.2021.09.034DOI Listing
October 2021

Cataract Surgery with or without Intraocular Lens Implantation in Pediatric Uveitis: A Systematic Review with Meta-Analyses.

J Ophthalmol 2021 11;2021:5481609. Epub 2021 Jun 11.

Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.

Purpose: To systematically review the results of comparative studies of modern cataract surgery in pediatric uveitis with or without intraocular lens (IOL) implantation and to perform comparative meta-analyses to compare visual acuity outcomes and complication rates.

Methods: On 12 November 2020, we systematically searched the Cochrane Central, PubMed/MEDLINE, EMBASE, ClinicalTrials.gov, and all affiliated databases of the Web of Science. Two authors independently reviewed studies and extracted data. Studies were reviewed qualitatively in text and quantitatively with meta-analyses. Outcome measures were preoperative and postoperative best-corrected visual acuity (BCVA), inflammation control, and rates of postoperative complications.

Results: Ten studies of 288 eyes were eligible for review of which the majority were eyes with juvenile idiopathic arthritis-associated uveitis. Summary estimates revealed that the BCVA was better in pseudophakic eyes vs. aphakic eyes (1-year postoperative: -0.23 logMAR, 95% CI: -0.43 to -0.03 logMAR, =0.027; 5-year postoperative: -0.35 logMAR, 95% CI: -0.51 to -0.18 logMAR, =0.000036). Pseudophakic eyes had more visual axis opacification (OR 6.76, 95% CI: 2.73 to 16.8, =0.000036) and less hypotony (OR 0.19, 95% CI: 0.04 to 0.95, =0.044).

Conclusions: In modern era cataract surgery on eyes with pediatric uveitis with IOL implantation leads to satisfactory and superior visual outcomes and no differences in complication rates apart from an increased prevalence of visual axis opacification and a decreased prevalence of hypotony when compared to aphakia. However, limitations of the retrospective design and the presence of selection bias necessitate a careful interpretation.
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http://dx.doi.org/10.1155/2021/5481609DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8213487PMC
June 2021

Genetic disease is a common cause of bilateral childhood cataract in Denmark.

Ophthalmic Genet 2021 Jun 25:1-9. Epub 2021 Jun 25.

Departments of Clinical Genetics and Paediatrics, Rigshospitalet, Copenhagen, Denmark.

: Bilateral childhood cataracts can be caused by a metabolic disease, constitute a part of a syndrome, run in families, be sporadic or iatrogenic. The amount of work-up needed to establish a cause is discussed and the aim of the present study was to evaluate causes of bilateral childhood cataract.: Chart review of 211 Danish children with bilateral cataracts. Information on work-up was retrieved with special focus on general health, metabolic screening, evaluation for congenital infections and genetic testing.: Cataract was seen in combination with systemic disease in 40.8%, 29.4% had hereditary cataracts, 27.0% had isolated cataract, in 1.4% it was associated with ocular malformations and 1.4% had been born prematurely without any other sequelae than the cataract. A genetic cause could be demonstrated in 74 children.: Systemic comorbidities are very common in children with cataract and are not always known prior to the diagnosis of cataract. Genetic evaluation, especially targeted analyses, provided a molecular genetic diagnosis in a large proportion of those tested but it also failed to provide a molecular genetic diagnosis in some patients with a family history suggesting autosomal dominant inheritance. Most importantly, in some patients, genetic work-up provided a diagnosis in patients where it had therapeutic consequences and where the systemic disease would have caused irreversible damage, had it not been treated timely. Given the high prevalence of systemic disease, it seems advisable to co-manage children with bilateral cataracts with a pediatrician and to include genetic evaluation as part of the work-up.
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http://dx.doi.org/10.1080/13816810.2021.1941128DOI Listing
June 2021

Socio-economic status in families affected by childhood cataract.

Acta Ophthalmol 2021 Mar 5. Epub 2021 Mar 5.

Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.

Purpose: To investigate the socio-economic status of families affected by childhood cataract and to assess how the socio-economic status is affected by cataract diagnosis.

Materials And Methods: Children born between 2000 and 2017, seen between the age 0 and 10 years in the same period at Rigshospitalet or Aarhus University Hospital for cataract (N = 485), were included and compared to a matched children group without cataract (N = 4358). Socio-economic status was evaluated by the parents' income, employment, education, marital status and family structure.

Results: Parents of children with cataract were more likely to have a low yearly income (OR = 1.60, 95% CI (1.12-2.27)), be out of work (OR = 1.74, 95% CI (1.34-2.26)) and have basic education as the highest attained education (OR = 1.64, 95% CI (1.27-2.13)) prior to diagnosis. This social gradient was not affected by the diagnosis. In addition, a higher number of children with cataract lived in multi-family residencies (13.8% versus 8% in group of children without cataract) and they had a greater number of siblings (6.2% had ≥4 siblings versus 2.1% in group of children without cataract).

Conclusion: Families affected by childhood cataract have a lower socio-economic status and educational background even before cataract is diagnosed but the diagnosis does not aggravate the differences between these families and the background population. The lower socio-economic status and parental educational background should be taken into consideration in the management of these families.
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http://dx.doi.org/10.1111/aos.14768DOI Listing
March 2021

Diagnostic Test Accuracy of the Red Reflex Test for Ocular Pathology in Infants: A Meta-analysis.

JAMA Ophthalmol 2021 01;139(1):33-40

Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.

Importance: Red reflex testing is a simple and inexpensive method implemented in many countries as an important part of infant screening for ocular pathologies.

Objectives: To review the literature on the diagnostic accuracy of the red reflex test in infant screening for ocular pathologies and to perform meta-analyses to provide summary estimates.

Data Sources: The following literature databases were searched for English-language, peer-reviewed literature, published until April 19, 2020: Cochrane Central, PubMed/MEDLINE, Embase, Web of Science Core Collection, BIOSIS Previews, Current Contents Connect, Data Citation Index, Derwent Innovations Index, KCI-Korean Journal Database, Russian Science Citation Index, SciELO Citation Index, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and ClinicalTrials.gov.

Study Selection: Eligibility criteria were defined according to population (studies of consecutively screened infants), exposure (red reflex or Brückner test as the index test), comparator (any ophthalmological examination), and study type (any study with diagnostic test accuracy data).

Data Extraction And Synthesis: The Preferred Reporting Items for Systematic Reviews and Meta-Analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) guidelines were followed. Data were extracted independently by 2 authors. For summary estimates of diagnostic test accuracy, the hierarchical summary receiver operating characteristics curve was used. Prevalence of ocular pathologies was introduced for a prevalence meta-analysis, which was then used in calculations of diagnostic accuracy of the red reflex test when applied in infant screening.

Main Outcomes And Measures: True-positive, false-positive, true-negative, and false-negative findings; sensitivity; specificity; and positive and negative predictive values.

Results: In this meta-analysis, 8713 unique infants from 5 unique studies were eligible for qualitative and quantitative review. All studies used the red reflex test without pupillary dilation and were compared with a reference test performed with pupillary dilation. For any ocular pathology, an estimated sensitivity of 7.5% (95% CI, 7.4%-7.5%) and specificity of 97.5% (95% CI, 97.5%-97.5%) was found. Focusing on ocular pathologies that required a medical or surgical intervention, sensitivity improved to 17.5% (95% CI, 0.8%-84.8%) and specificity remained high at 97.6% (95% CI, 87.7%-99.6%).

Conclusions And Relevance: These findings suggest that an abnormal red reflex finding most likely reflects an underlying ocular pathology. However, a normal red reflex finding during screening does not exclude ocular disease.
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http://dx.doi.org/10.1001/jamaophthalmol.2020.4854DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7662495PMC
January 2021

Ipsilateral Recurrence of Optic Disc Drusen-Associated Anterior Ischemic Optic Neuropathy in a 15-Year-Old Boy.

J Neuroophthalmol 2021 03;41(1):e36-e38

Department of Ophthalmology, Rigshospitalet, University of Copenhagen, Glostrup, Denmark.

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http://dx.doi.org/10.1097/WNO.0000000000000941DOI Listing
March 2021

Children with congenital and childhood cataract require frequent follow-up visits and examinations in general anaesthesia: considerations for the strain on families.

Acta Ophthalmol 2019 Dec 12;97(8):778-783. Epub 2019 Mar 12.

Department of Ophthalmology, Rigshospitalet-Glostrup, Glostrup, Denmark.

Background: Children with cataract require frequent monitoring to detect complications, adjust refractive correction and treat amblyopia. This is time consuming for the families. The aim of the study was to evaluate how often children with cataract are seen as outpatients or under general anaesthesia during the first 7 years of life.

Methods: We performed a retrospective chart review of all children with congenital and childhood cataract born between 2000 primo and 2017 seen at our institution. The cumulated number of outpatient visits and examinations and/or surgeries in general anaesthesia was extracted for age 1, 3, 5 and 7 years.

Results: Children who had cataract surgery were seen significantly more often than children without surgery. During the first year of life, children with bilateral surgery had a median of nine outpatient visits, children with unilateral cataract had 11 and children without surgery had five outpatient visits. At 7 years of age, half of the children operated bilaterally before 1 year of age had undergone at least five procedures/examinations in general anaesthesia versus 1/4 of those with unilateral surgery and none of those without surgery. Children were seen less frequently with advancing age.

Conclusion: The management, treatment and follow-up of children with cataract are demanding, requiring frequent hospital visits and repeated examinations and/or surgical procedures in general anaesthesia over many years, but mainly during the first year of life. Surgical patients are more complex and require closer follow-up. This message is important to convey to the parents at the onset of the disease.
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http://dx.doi.org/10.1111/aos.14081DOI Listing
December 2019

Orbital Volumetry in Graves' Orbitopathy: Muscle and Fat Involvement in relation to Dysthyroid Optic Neuropathy.

ISRN Ophthalmol 2014 2;2014:435276. Epub 2014 Apr 2.

Department of Ophthalmology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark ; Eye Clinic 2061, Rigshospitalet, University of Copenhagen, Blegdamsvej 9, Copenhagen, Denmark.

Purpose. We wanted to investigate the relative significance of fat and muscle enlargement in the development of dysthyroid optic neuropathy (DON) in Graves' orbitopathy (GO). Methods. Preoperative coronal CT scans of 13 patients with and without DON who subsequently underwent orbital decompression were retrospectively analyzed. Thirteen patients imaged for unilateral orbital fractures served as controls. Results. The retrobulbar muscle volume was 2.1 ± 0.5 cm(3) (mean ± SD) in controls, 4.3 ± 1.5 cm(3) in GO without DON, and 4.7 ± 1.7 cm(3) in GO with DON. The retrobulbar fat volume was 5.4 ± 1.6 cm(3) in controls, 8.7 ± 8.0 cm(3) in GO without DON, and 9.4 ± 3.1 cm(3) in GO with DON. The muscle and fat volumes were higher in patients with GO than in controls (P < 0.001), but the volumes in orbits with and without DON were not significantly different. The volume of the optic nerve were similar in the 3 groups. The number of apical, coronal 2 mm thick slices with no fat was 2.9 ± 0.9 in normal orbits, it was 4.1 ± 1.0 in GO orbits without DON and 5.3 ± 0.8 in GO orbits with DON (P = 0.007). Conclusion. Apical muscle enlargement may be more important than orbital fat enlargement in the development of DON. However, the fact that apical crowding and muscle enlargement also occur in orbits without DON suggests that other factors also play a role in the development of DON.
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http://dx.doi.org/10.1155/2014/435276DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004169PMC
August 2014
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