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Biomedical subjects

B D Moore

Publications and source records attributed to B D Moore.

58 records · Page 4Linked to original sources

Learning disability subtypes in children with neurofibromatosis.

A high incidence of learning disabilities (LD) has been reported in children with neurofibromatosis Type 1 (NF-1), and many children affected with this disease are thought to have a form of LD that is characterized by selective visuospatial and motor deficits. However, the evidence is subject to sampling biases and is limited by the clinical-inferential methods used to classify children into LD subtypes. In the present study, objective statistical methods were used to categorize LD in 105 children with NF-1 between the ages of 6 and 18 years. A cluster analysis of achievement test scores yielded 10 groups; 6 of which met our criterion for academic deficiency. An analysis of neuropsychological data for 72 children with academic deficiencies with complete neuropsychological data yielded three groups: a neuropsychologically normal group (n = 28), a group with general academic deficiencies (n = 34), and a group with visuospatial-construction deficiencies (n = 10). The low incidence of visuospatial-constructional deficits and the absence of cases involving pure linguistic deficits is notable.

Achievement↗

Results of early treatment of unilateral congenital cataracts.

Twelve infants with unilateral congenital cataracts treated at Boston Children's Hospital between 1978 and 1986 have now reached the age of 3.5 years or older. All infants had cataract extractions, aphakic contact lens fitting, and occlusion of the unaffected eye by 6 months of age. Patients with posterior lenticonus or persistent hyperplastic primary vitreous were excluded from this review. Early improvement of visual acuity in the aphakic eye was monitored by preferential looking tests, and occlusion of the sound eye was adjusted accordingly. E card visual acuities are now available on all 12 children. Five patients have 20/70 or better visual acuity, three patients have between 20/100 and 20/400 vision, and four patients have less than 20/400 in the aphakic eye. Two patients whose cataract surgery was done after 4 months of age had the poorest visual results. Difficulty maintaining occlusion therapy and interruptions of contact lens wear limited the development of better vision in some patients. The visual results to date in these 12 patients suggest that early aggressive treatment of unilateral congenital cataracts is worthy of consideration in most instances.

Cataract↗

Changes in the aphakic refraction of children with unilateral congenital cataracts.

Forty-two infants who presented to the Children's Hospital in Boston with unilateral congenital cataracts and had cataract surgery by 6 months of age received serial refractions (N = 369) of their aphakic eyes during the first 4 years of life. The 14 patients followed most intensively (185 refractions) showed a rapid decrease in mean spherical equivalent during the first year of life from +30.75 D to +26.36 D, with a less rapid decrease thereafter (24 months, +23.02 D; 36 months, +21.19 D; 48 months, +20.86 D). The rate of change per month decreased from .43 D between 1 and 6 months, .37 D between 6 and 12 months, .30 D between 12 and 18 months, .24 D between 18 and 24 months, and less than .19 D per month thereafter. This study shows that the refractive error of the aphakic eye of patients treated for unilateral congenital cataracts decreases most rapidly during infancy and less rapidly during the next few years of childhood. This information will be helpful in facilitating the treatment of these infants by allowing an approximation of their future contact lens refractive power changes.

Aphakia, Postcataract↗

Pediatric aphakic contact lens wear: rates of successful wear.

Two hundred thirty-eight consecutive patients with pediatric cataracts were fitted with a variety of aphakic contact lenses after cataract extraction. Thirty-nine patients did not return for follow up. Of the remaining 199 patients, 40 discontinued contact lens wear. None of the 78 patients with unilateral or bilateral acquired cataracts discontinued contact lens wear due to problems wearing their lenses, although nine discontinued contact lens wear due to poor vision or difficulty maintaining amblyopia treatment. Twenty-two of 84 patients with unilateral congenital cataracts discontinued lens wear, six directly due to difficulties wearing lenses. Sixteen had poor vision in their aphakic eye and inability to maintain patching for amblyopia. Eight of 37 patients with bilateral congenital cataracts discontinued lens wear because of problems wearing their lenses, and one other discontinued lens wear because of poor vision. In summary, 26 of 40 patients (out of a total of 199) that discontinued aphakic contact lens wear did so because of poor vision, while only 14 did so because of difficulties wearing the contact lenses. Eleven of these 14 patients were able to wear aphakic spectacles in lieu of contact lenses. This study shows that most pediatric patients with cataracts fail at treatment because of problems related to treatment of amblyopia, and not problems related to the fitting and wearing of contact lenses.

Adolescent↗