Taiwan Journal of Ophthalmology

EDITORIAL
Year
: 2018  |  Volume : 8  |  Issue : 4  |  Page : 179--180

Pediatric retina: A challenging yet fascinating field


Wei-Chi Wu 
 Department of Ophthalmology, Chang Gung Memorial Hospital, Guishan, Taoyuan, Taiwan

Correspondence Address:
Prof. Wei-Chi Wu
Department of Ophthalmology, Chang Gung Memorial Hospital, No. 5, Fuxing Street, Guishan, Taoyuan 33305
Taiwan




How to cite this article:
Wu WC. Pediatric retina: A challenging yet fascinating field.Taiwan J Ophthalmol 2018;8:179-180


How to cite this URL:
Wu WC. Pediatric retina: A challenging yet fascinating field. Taiwan J Ophthalmol [serial online] 2018 [cited 2019 Jun 15 ];8:179-180
Available from: http://www.e-tjo.org/text.asp?2018/8/4/179/247478


Full Text



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This is a TJO pediatric retina special edition. This is the first time TJO has made such an effort to launch a special issue, specifically focusing on a particular topic. The chosen topic of this issue is the pediatric retina. This special issue contains seven review articles, one original study, and one case report. The topics chosen included retinopathy of prematurity (ROP), pediatric retinal detachment, Stickler syndrome, and retinoblastoma. We aim not only to cover the medical aspects of these diseases but also to explore surgical advances in them and not only the clinical presentations of the diseases but also basic theory and hypotheses such as foveal development. Thanks to the contributions of experts from the US, Japan, Hong Kong, Singapore, Malaysia, India, and our local society; we hope this special issue will not only be a milestone for TJO but also be a collectable document for the readers.

Pediatric retina study is a not only a challenging field but also an uncommonly studied one. This is a special field that has been somewhere ignored in the past, but has gained traction recently. However, we all know how important this field is, because it relates to the vision of newborns and small children. We as surgeons know how time-consuming and difficult it can be to deal with a child patient. When I started to get involved in this field about 18 years ago, there were very few people focusing on work related to this topic. Most of us work “part time” in this field, thinking of it as a burden and praying that each case is the last. There were very few surgical instruments available for these small children. There are barely any dedicated textbooks available, either. Relevant topics at conferences are also scant. As a result, most of the time, surgical outcomes have been poor, due to a lack of dedicated doctors, proper instruments, proper training, and information. But gradually, with the efforts of some pioneers such as Dr. Michael Trese in the vitrectomy for Stage 4 and 5 ROP,[1],[2],[3] Dr. William V Good in the work of early treatment of ROP,[4],[5] and Dr. HA Mintz-Hittner on Bevacizumab Eliminates the Angiogenic Threat (BEAT)-ROP,[6] we have seen much better outcomes in the management of ROP patients. Young doctors may feel encouraged by the improved outcomes for the patients. Access to knowledge and information about the pediatric retina has making significant strides, as you can see an increasing number of panels related to the pediatric retina at the major international conferences. The industry has also started to pay more attention to this particular field. For instance, the launching of vitrectomies for the pediatric population (25 + Short, Alcon), specifically designed for tiny eyes with thick vitreous and a thin sclera, can make ROP surgery safer and easier. I truly believe the future of pediatric retina research is much brighter, because we see more and more young doctors becoming interested in this field.

Not only this, ROP, pediatric retinal detachment, Stickler syndrome, and retinoblastoma are challenging diseases as well. Without proper management, such children may become blind or even lose their lives. With these topical articles, we sincerely hope we can offer new knowledge in the diagnosis and management of these patients. In addition, our invited experts provide their valuable experience and tips regarding surgical management of these cases. Kids are not small adults. The philosophy needed to handle these cases is very different from that with adults. The surgical settings and the instruments used during the surgery may also be very dissimilar. It is, therefore, very important to understand the differences before you start to take care of these children. Without such knowledge, a doctor can do far more harm than good for their patients. Of course, there are many more diseases than we can cover in this TJO pediatric retina special edition. If circumstances permit, we hope we can expand the scope of our relevant coverage in a “part two” pediatric retina TJO issue in the near future.

I would like to express my sincere appreciation for the huge efforts of these world-renowned experts in contributing to this special issue. I also owe a big thanks to the Editors and to the Editorial Secretary of TJO. Without their professional assistance, it would have been impossible to achieve this remarkable outcome. Finally, I am hoping to see more and more devoted young doctors “fall in love” with this field and act as an invigorating force.

References

1Capone A Jr., Trese MT. Lens-sparing vitreous surgery for tractional stage 4A retinopathy of prematurity retinal detachments. Ophthalmology 2001;108:2068-70.
2Trese MT. Visual results and prognostic factors for vision following surgery for stage V retinopathy of prematurity. Ophthalmology 1986;93:574-9.
3Trese MT. Two-hand dissection technique during closed vitrectomy for retinopathy of prematurity. Am J Ophthalmol 1986;101:251-2.
4Good WV; Early Treatment for Retinopathy of Prematurity Cooperative Group. Final results of the early treatment for retinopathy of prematurity (ETROP) randomized trial. Trans Am Ophthalmol Soc 2004;102:233-48.
5Good WV, Hardy RJ. The multicenter study of early treatment for retinopathy of prematurity (ETROP). Ophthalmology 2001;108:1013-4.
6Mintz-Hittner HA, Kennedy KA, Chuang AZ; BEAT-ROP Cooperative Group. Efficacy of intravitreal bevacizumab for stage 3+retinopathy of prematurity. N Engl J Med 2011;364:603-15.