Volume 18 Number 4 / August 2014 e5

Discussion: For 3 of 4 AS-20 domains, poorer HRQOL was associatedwith higher depression scores, indicating subthreshold depressivesymptoms.Conclusion: The association of subthreshold depressive symptomswith poor HRQOL should be considered when interpreting patient re-ported outcomes.

013 The role of health-related quality of life when evaluatingoutcomes of strabismus surgery. Jonathan M. Holmes, Sarah R.Hatt, David A. Leske, Laura LiebermannIntroduction: Strabismus surgery outcomes are typically defined us-ing motor and diplopia criteria. Nevertheless, some patients desig-nated failure by these criteria report subjective improvement. Weaimed to evaluate the role of health-related quality of life (HRQOL)measures in patients who might be classified as failures.Methods:We studied adults undergoing strabismus surgery who hadpreoperative and 1-year postoperative HRQOL data using the AdultStrabismus-20 (AS-20) questionnaire. Motor and diplopia criteriawere applied to classify outcomes as: success, partial success, orfailure. For those classified as failure, the medical record was re-viewed to determine whether there was subjective improvement at1 year, independent of AS-20 scores. Improvement in HRQOL scorewas defined as exceeding 95% limits of agreement on at least oneAS-20 domain. To determine whether HRQOL scores reflected sub-jective improvement in patients otherwise classified as failure, wecompared HRQOL scores between those who reported improvementand those who did not.Results: Of 227 patients, 39 (17%) were classified as failure by motorand diplopia criteria; 25 of 39 reported subjective improvement, ofwhich 16 (64%) met improved HRQOL score criteria. Fourteen of 39had no subjective improvement, of which 5 (36%) met improvedHRQOL criteria.Discussion: For many apparent surgical failures, objective motor anddiplopia criteria do not capture subjective improvement, but improve-ment is often reflected in HRQOL scores. The few patients who hadno subjective improvement but better HRQOL scores may represent aplacebo effect.Conclusion: Quantitative HRQOL criteria should be considered whenevaluating outcomes following strabismus surgery.

014 Factors affecting stereopsis after surgical alignment ofacquired partially accommodative esotropia. Yiannis Iordanous,Inas MakarIntroduction: The goal of strabismus surgery is to correct ocularalignment, promoting the development of stereopsis and binocularsingle vision (BSV). Despite successful surgical ocular alignment,many children do not develop stereopsis postoperatively. The pur-pose of this study was to determine preoperative factors that affectstereopsis in patients with acquired partially accommodative esotro-pia (APAET).Methods:We retrospectively reviewed the charts of all patients whounderwent strabismus surgery for APAET from a single surgeonspractice. Patients were eligible for inclusion if they had a final motoralignment within 8D of orthophoria for distance and near (successfulalignment). We compared preoperative factors between patientsachieving postoperative stereopsis better than 100 arcsec (i.e.achieving BSV) versus those with worse than 100 seconds of stere-opsis. These factors included age of onset, delay in referral, durationof misalignment and age at surgery.

Journal of AAPOS

Results: A total of 65 patients met our inclusion criteria. 27 (42%) hada final stereopsis of 100 arcsec or better. The mean AO for patientsachieving postoperative BSV was 32.3 � 12.5 months, versus 22.4 �9.2 months (P \ 0.0005) for the group not attaining BSV. Thoseachieving BSV presented to clinic later (57.4 � 19.2 vs 41.6 � 23.6months; P 5 0.005) and had a later age at surgery (66.4 � 18.2 vs50.3 � 21.7 months; P 5 0.002) when compared to those notachieving BSV. There was no significant difference in the durationof misalignment between the two groups (34.0� 16.4 for those attain-ing BSV versus 27.9 � 19.0 for those not attaining BSV; P 5 0.2). Aregression analysis found only older age of onset to be predictiveof better postoperative BSV (OR 1.08; 95% CI 1.03-1.14).Discussion: Our results suggest that for every month delay in onsetof esodeviation, a child with APAET is 8% more likely to regain BSVpostoperatively. Surprisingly, DOM did not appear to be related tofinal stereoacuity outcomes in this patient population.Conclusion: These results may allow physicians to better predict sur-gical outcomes for children with APAET. It may also aid in surgicalplanning, as DOM appears to not be correlated with final outcomes.

015 Type I ROP, treatment with bevacizumab versus laser:comparison of visual function, structural outcome and frequencyof follow-up. Maram Isaac, Kamiar Mireskandari, Nasrin TehraniPurpose: To further elucidate the visual function, structural outcomesand frequency of follow up visits for infants with type I ROP treatedwith intravitreal Bevacizumab (IVB) versus laser.Methods: Retrospective comparative chart review.Results: Thirteen infants were treated with IVB and 14 infants withlaser. There was no statistically significant difference in gestationalage or birth weight. Eight eyes developed ROP in zone I and 15 eyesin zone II in each group. None developed unfavorable structuraloutcomeat 6months post treatment (1). Visual acuity (VA)wasmeasur-able for 16/23 eyes in laser and 13/23 eyes for IVB groups at 6-12months corrected age (CA). Mean VA was (1.20 � 0.3) and (0.92 �0.34) logMAR, (P5 0.054) for laser and IVBgroups respectively. Refrac-tion was available for 17/23 eyes for laser and 23/23 eyes for IVBgroups. Mean spherical equivalent (SE) was (-4.41 � 4.71) for laserand (-3.42 � 5.89) for IVB groups (p 5 0.5572), respectively. Infantsin laser group had an average of (5.00 � 3.00) follow up visits versus(14.00� 5.00) in IVB group, (P\0.001) in the 6 months post treatment.Discussion: Both treatments resulted in good structural outcome. At6-12 months CA, there was no statistically significant difference inrefractive error or VA between two groups, however more frequentfollow up was observed in the IVB group.Conclusion: In view of similar structural outcomes between the twogroups, frequency of follow up post IVB may need reconsideration toreduce patient exposure to distressful eye examinations and opti-mize resource allocation.

References

1. Early Treatment for Retinopathy of Prematurity Cooperative Group. Revisedindications for the treatment of retinopathy of prematurity: results of theEarly Treatment for Retinopathy of Prematurity randomized trial. Arch Oph-thalmol 2003;121:1684-94.

016 High sensitivity of binocular retinal birefringence screeningfor anisometropic amblyopia without strabismus. Reed M. Jost,Joost Felius, Eileen E. BirchIntroduction: Binocular retinal birefringence scanning can detectwhether fixation is bifoveal by identifying the unique polarization