Journal of Aapos最新文献

We investigated the relationship between self-reported history of visual impairment in youth and development of dementia in later life using data from the Panel Study of Income Dynamics (PSID) household survey, which included the Eight-item Informant Interview to Differentiate Aging and Dementia (AD-8) screen. Adults with a reported history of childhood visual impairment were found to have significantly higher odds of positive dementia screening. After adjusting for confounders, we found a twofold increase in those reporting early visual impairment compared with those who did not report early visual impairment.

We present the case of a 57-year-old man with vertical diplopia who was diagnosed with acquired left eye supranuclear double depressor palsy after ischemic stroke, with small infarcts at the bilateral medial posterior thalami, left midbrain, and left occipital lobe. Given the different innervation of the two depressors, intact vestibulo-ocular reflex, and the healthy inferior rectus muscle morphology observed intraoperatively, the lesion likely involved the supranuclear vertical gaze center or its pathway. His strabismus was treated successfully with recession and resection of vertical rectus muscles, resulting in no significant deviation in either the vertical or horizontal directions in primary gaze at 6 months' follow-up.

Purpose: To evaluate risk factors associated with severe retinopathy of prematurity ROP (sROP) in two separate cohorts of infants.

Methods: We performed a retrospective study of the Merative MarketScan Commercial Database between 2003 and 2022. Infants with ROP were stratified into two cohorts: group A (defined as infants with both birth weight [BW] <1000 g and gestational age [GA] <29 weeks) and group B (defined as infants with either BW ≥1000 g or GA ≥29 weeks). Infants with sROP were defined as those who received treatment for ROP. Outpatient and inpatient claims using International Classification of Diseases and Current Procedural Terminology codes were used to identify neonatal comorbidities. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for sROP requiring treatment with respect to various comorbidities.

Results: A total of 425 of 8,789 infants with ROP developed sROP (4.8%). We identified 2,726 infants in group A, of whom 387 (14.2%) required a procedure, and 6,063 in group B, of whom 38 (0.6%) required a procedure. In group A, intraventricular hemorrhage (OR = 1.38; 95% CI, 1.09-1.74) and patent ductus arteriosus ligation (OR = 1.65; 95% CI, 1.25-2.16) were the comorbidities that significantly increased the odds of sROP on multivariable analysis. In group B, infection (OR = 1.96; 95% CI, 1.01-3.80) was the only comorbidity that significantly increased the adjusted odds of sROP.

Conclusions: Risk factors for sROP may differ between smaller and larger infants. Infection may serve as an important risk factor for ROP progression amongst larger infants due to its connection with poor postnatal growth.

Purpose: To investigate whether immigrant generation is associated with caregiver-reported receipt of vision testing.

Methods: Nationally representative data from the 2018-2019 National Survey of Children's Health was used. The primary exposure was immigrant generation, with first generation defined as child and all reported parents born outside the United States; second generation, as child born in the United States but at least one parent born outside the United States; and third generation, as all parents in the household born in the United States. The main outcome was caregiver-reported vision testing during the previous 12 months. Odds ratios adjusted for sociodemographic characteristics and 95% confidence intervals were computed based on immigrant generation.

Results: The sample included 49,442 US children 3-17 years of age. The proportion of children who had vision testing in any setting was lower for first- (60.3%) than third-generation children (74.6%; aOR = 0.54; 95% CI, 0.41-0.71). This association remained after excluding children without health coverage. For Hispanic children, both first- (aOR = 0.58; 95% CI, 0.36-0.94) and second-generation children (aOR = 0.73; 95% CI, 0.55-0.96) had lower odds of a vision test in any setting compared with third-generation Hispanic children.

Conclusions: First-generation children had lower odds of vision testing than third-generation children, even when adjusting for sociodemographic characteristics, especially in Hispanic households.

Background: Intravitreal injection of anti-vascular endothelial growth factor (anti-VEGF) agents is used to treat posterior type 1 retinopathy of prematurity (ROP). Recent reports indicate that anti-VEGF therapy may be associated with white matter brain injury, according to animal studies, and neurodevelopmental impairments in children born preterm. We investigated whether type 1 ROP treated with bevacizumab is associated with structural brain injury on infant term magnetic resonance images (MRIs) in very low birth weight infants compared with those treated with laser ablation.

Methods: We retrospectively reviewed the medical records of very low birth weight infants from 2006 to 2021 with type 1 ROP who had been treated with laser or anti-VEGF therapy. Intravitreal bevacizumab injection was used for type 1 ROP in zone 1 or very posterior zone 2 or when laser treatment was not feasible. A pediatric neuroradiologist reviewed brain MRIs at term equivalent age (36-46 weeks' postmenstrual age) and classified infants for severity (no/mild vs moderate/severe) of overall brain and white matter injury using the validated Kidokoro scoring system.

Results: Fifty-two infants met inclusion criteria: 35 (67%) treated with laser and 17 (33%) with bevacizumab. Moderate-to-severe brain injury scores were not statistically different between bevacizumab and laser treatment groups in either continuous or binary adjusted analyses, for either the overall score or the white matter subscore.

Conclusions: Severity of structural injury on term brain MRI (total and white matter) did not differ between infants with type 1 ROP treated with anti-VEGF agent (bevacizumab) and those treated with laser ablation.

Background: To measure patient satisfaction with synchronous telehealth care, we administered the Telemedicine Satisfaction Questionnaire (TSQ) to assess the quality of care provided, its similarity to face-to-face meetings, and patients' perception of the interaction.

Methods: The Portuguese version of the TSQ was administered during 2022 to patients who received postoperative synchronous telehealth care after strabismus surgery in Curitiba, Brazil, from 2020 to 2022. The interval between the questionnaire application and teleconsultation ranged from 2 to 22 months after the telehealth encounter. All patients received synchronous telehealth care from the same surgeon (LMH) between postoperative days 7 and 10 and attended an in-person consultation on postoperative day 30 6 months after surgery, and yearly thereafter.

Results: We analyzed the data for 53 patients, of whom 26 (49%) were male and 28 (53%) were <18 years of age. Synchronous telehealth care was considered an excellent experience, with an overall average TSQ rating of 4.3 on a scale of 1-5. The mean score for quality of care provided was 4.1; for similarity of care to face-to-face meetings, 4.5; and for patients' perception of the interaction, 4.5.

Conclusions: Ratings of the synchronous telehealth care were strongly associated with the 30-day postoperative evaluation, and patient perceptions of the quality of care in the telehealth encounter were positive.

Background: Congenital nasolacrimal duct obstructions that persist after 9 months of age often require surgical intervention through probing and stenting of the tear duct. These procedures typically occur under general anesthesia in an operating room setting. We propose a novel approach using intravenous sedation outside the operating room.

Methods: We reviewed the medical records of patients at a tertiary pediatric hospital treated for nasolacrimal duct obstruction from 2018 to 2023 using monocanalicular Monoka, Masterka, and LacriJet nasolacrimal stents. All procedures were performed outside of the operating room under intravenous sedation provided by a specialized sedation team. Symptom resolution, sedation duration and complications were reviewed for each type of stent.

Results: A total of 64 patients (81 stents) were included in our analysis. Of the 81 stents used, 32 were Monoka, 15 Masterka, and 34 LacriJet. Symptoms resolved in 86% of the eyes. Sedation side effects were minor and infrequent. Occasionally brief apnea, hypoxia, hypotension or laryngospasm occurred, but in no cases were patients harmed or was hospitalization required. A single factor analysis of variance showed no statistically significant difference between the stents for recurrence or sedation time. The Fisher exact test suggested a higher risk of side effects in the Monoka group.

Conclusions: In our pediatric patient cohort, nasolacrimal duct stenting procedures have a high success rate and safety profile when performed under deep sedation outside of the operating room.

Stickler syndrome, a rare connective tissue disorder, presents with a broad spectrum of ocular manifestations, including myopia, vitreoretinal degeneration, glaucoma, and retinal detachment. While extensive data exists on the treatment outcomes of retinal detachment repair in Stickler syndrome, the potential risks associated with acute postoperative intraocular pressure elevation remain underexplored. We report the case of a 10-year-old boy with Stickler syndrome who underwent scleral buckling surgery and subsequently experienced ocular hypertension.

Purpose: To compare the outcomes of augmented-dose surgery for acute acquired concomitant esotropia (AACE) based on either the single Maddox rod test (SMRT), or the prism and alternate cover test (PACT), in cases where there is a clinically significant difference in the deviation using the two tests.

Methods: The medical records of AACE patients who underwent augmented-dose surgery with a difference of ≥5^Δ in preoperative deviations on PACT and SMRT were reviewed retrospectively. Augmented-dose surgery was based on the SMRT or PACT. Success was defined as elimination of diplopia and deviations ≤10^Δ assessed with the PACT (PACT success) or with the SMRT (SMRT success) at both near and distance.

Results: There were 18 patients in the SMRT group and 15 in the PACT group. In the SMRT group, the rate of PACT success was 94%, and SMRT success, 78%; postoperative distance esodeviation on PACT and SMRT were 0.72^Δ ± 1.64^Δ and 5.94^Δ ± 4.73^Δ, respectively. In the PACT group, the rate of PACT success was 80%, and SMRT success, 33%; postoperative distance esodeviation was 4.07^Δ ± 5.15^Δ (PACT) and 13.71^Δ ± 8.26^Δ (SMRT). The SMRT success rate was significantly higher in the SMRT group than in the PACT group (P = 0.010). The postoperative distance deviation was smaller in the SMRT group (P < 0.05).

Conclusions: In our cohort of AACE patients, those whose augmented-dose surgery was based on the SMRT achieved more favorable surgical outcomes than those based on the PACT when there was a difference of ≥5^Δ in preoperative deviations assessed with the two methods.

Background: Abnormalities in mitochondrial energy homeostasis can lead to various disorders, including ocular motility aberrations. Previous studies have suggested the involvement of mitochondrial aberrations in strabismus etiology. We compared the blood-derived mitochondrial DNA (mtDNA) copy number from comitant strabismus patients with that from age-matched controls, and also compared expression of mitochondrial biogenesis genes in a separate set of extraocular muscle samples from strabismic and control subjects.

Methods: Blood samples from 93 strabismic (39 esotropic, 54 exotropic) and 93 control subjectswere analyzed for mtDNA copy number through quantitative polymerase chain reaction. We also examined the expression of 6 genes involved in mitochondrial biogenesis in cDNA obtained from extraocular muscles of a separate group of 26 strabismus patients and 4 healthy controls.

Results: The mtDNA content was significantly higher in strabismus patients as compared to the control group, both overall (fold change, 1.39; Z = -2.43 [P = 0.01]) and in strabismus subgroups (esotropia: fold change,1.42; Z = 2.59 [P = 0.0096]; exotropia: fold change, 1.41, Z = 3.35 [P = 0.00078]). No significant difference was observed in the expression of the examined biogenesis genes between strabismus and control groups.

Conclusions: Our results suggest an association between mtDNA copy number and strabismus; however, further studies are required to elucidate the significance of altered mtDNA in strabismus and its possible significance with regard to the etiology of strabismus.