Reopening cyclodialysis cleft with Nd:YAG laser following trabeculectomy

A patient with primary open-angle glaucoma (POAG) underwent a trabeculectomy according to Watson's technique. Postoperative intraocular pressure (IOP) ranged from 8 to 11 mm Hg. However, repeat slit lamp evaluation revealed the absence of bleb formation. Two months post-filtration surgery the patient developed the sudden onset of nausea, vomiting, supraorbital pain, and blurred vision. The IOP was 46 mm Hg and gonioscopy revealed a hyaline membrane covering a cyclodialysis cleft. A Nd:YAG laser was used to reopen the cleft, with normalization of IOP.     

Neurocognitive test profiles of extremely low birth weight five-year-old children differ according to neuromotor status

The neurocognitive outcome of children born with extremely low birth weight (ELBW) is highly variable due to the complexity of morbidity. So far, no study has compared comprehensive neuropsychological test profiles in groups with different neuromotor status. In a national cohort of ELBW children neuropsychological test profiles were assessed in 4 groups defined according to a neurological examination at 5 years of age: normal neuromotor status (N = 56), motor coordination problems (N = 32), multiple subtle neuromotor signs including both motor coordination problems and deviant reflexes (N = 20), and spastic diplegia (N = 12). The neurocognitive assessment included a test of intelligence, the Wechsler Primary and Preschool Scale of Intelligence-Revised (WPPSI-R) and 14 subtests of attention and executive functions, verbal functions, manual motor functions, visuoconstructional functions and verbal learning (NEPSY). The children with normal neuromotor status performed within the average range; children with motor coordination problems had widespread impairment; and children with spastic diplegia and children with multiple minor neuromotor signs had uneven test profiles with stronger verbal results but weaknesses in attention and executive functions, and in manual motor and visuoconstructional tasks. In conclusion, very preterm children with neuromotor signs, including motor coordination problems, are at risk for neurocognitive impairment, in spite of average intelligence. More impaired children have more irregular test profiles. Follow-up and neuropsychological assessment of very preterm children with minor neuromotor signs are therefore indicated.     

Electric brain responses obtained from newborn infants to changes in duration in complex harmonic tones

Event-related brain potentials of 10 full-term newborns in response to duration changes in complex, harmonic tones known to elicit prominent mismatch negativity (MMN) response in adults were investigated. Here we report that duration changes elicited prominent MMN responses in all newborns tested. In contrast, MMN has been reported in as little as 50% of the infants in some previous studies using other sound attributes. When the infant MMN latency was compared with that obtained from adults, and 4- as well as 8-year-old children, it was found that the MMN latency was a bit later in newborns than in older age groups. This result is consistent with previous findings. The MMN amplitude, however, was surprisingly large in infants compared to older children.