Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2024.104096
Jia Jia Zhang BA , Michael T.B. Nguyen MD, FRCSC , Eric D. Gaier MD, PhD
A man in his 60s developed an intermittent, variable left hypotropia with symptomatic diplopia following nasal pterygium surgery in the left eye. No tropia was present for most of the day, but a variable left hypotropia of 25Δ could be provoked with downgaze. There was no history of radiation or other trauma. Magnetic resonance imaging of the brain and orbits with gadolinium was unremarkable. The patient was diagnosed with suspected ocular neuromyotonia secondary to the peribulbar block and temporarily managed with Fresnel prism. A trial of oral carbamazepine partially improved symptoms. He ultimately underwent a left inferior rectus recession with near complete resolution of his symptoms.
{"title":"Ocular neuromyotonia after peribulbar block","authors":"Jia Jia Zhang BA , Michael T.B. Nguyen MD, FRCSC , Eric D. Gaier MD, PhD","doi":"10.1016/j.jaapos.2024.104096","DOIUrl":"10.1016/j.jaapos.2024.104096","url":null,"abstract":"<div><div>A man in his 60s developed an intermittent, variable left hypotropia with symptomatic diplopia following nasal pterygium surgery in the left eye. No tropia was present for most of the day, but a variable left hypotropia of 25<sup>Δ</sup> could be provoked with downgaze. There was no history of radiation or other trauma. Magnetic resonance imaging of the brain and orbits with gadolinium was unremarkable. The patient was diagnosed with suspected ocular neuromyotonia secondary to the peribulbar block and temporarily managed with Fresnel prism. A trial of oral carbamazepine partially improved symptoms. He ultimately underwent a left inferior rectus recession with near complete resolution of his symptoms.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104096"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2024.104102
Andrew Kaler MBA , Natario Couser MD
The FDXR-related disorder is caused by pathogenic variants in the FDXR gene. Including our case, a total of 47 patients have been reported. The most common genotypes are the homozygous c.1174C>T (p.R392W) variant and homozygous c.916C>T (p.R306C) variant. Optic atrophy is the most common feature (89%), but many other ocular manifestations have not previously been characterized. Our review of the existing literature reveals other common ocular findings of myopia, nystagmus, strabismus, retinal dystrophy, attenuation of retinal vessels, and cataracts. Common neurological symptoms include movement disorder, sensorineural hearing loss, developmental delay/regression, and hypotonia.
{"title":"Ocular and neurological manifestations of the FDXR-related disorder","authors":"Andrew Kaler MBA , Natario Couser MD","doi":"10.1016/j.jaapos.2024.104102","DOIUrl":"10.1016/j.jaapos.2024.104102","url":null,"abstract":"<div><div>The FDXR-related disorder is caused by pathogenic variants in the <em>FDXR</em> gene. Including our case, a total of 47 patients have been reported. The most common genotypes are the homozygous c.1174C>T (p.R392W) variant and homozygous c.916C>T (p.R306C) variant. Optic atrophy is the most common feature (89%), but many other ocular manifestations have not previously been characterized. Our review of the existing literature reveals other common ocular findings of myopia, nystagmus, strabismus, retinal dystrophy, attenuation of retinal vessels, and cataracts. Common neurological symptoms include movement disorder, sensorineural hearing loss, developmental delay/regression, and hypotonia.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104102"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To use swept-source optical coherence tomography angiography (SS-OCTA) to investigate the alterations in retinal vascular density (VD) in patients presenting with congenital unilateral trochlear nerve palsy.
Methods
The medical records of patients diagnosed with congenital unilateral trochlear nerve palsy and those of a healthy control group were reviewed retrospectively. Comprehensive ocular examinations and SS-OCTA imaging were conducted. The study population was divided into three subgroups of eyes: paretic eyes, fellow eyes, and controls. All participants underwent comprehensive ophthalmic examinations, which included assessments of ocular motility, cycloplegic refraction, and axial length measurement. Various strabismus tests—the cover-uncover test, prism and alternate cover test, Krimsky test, and Parks-Bielschowsky test—were conducted to confirm the diagnosis and evaluate the extent of the condition.
Results
A total of 34 patients and 39 healthy controls were included. Sex and age distributions were similar between groups. Significant differences were observed in central VD of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) between paretic eyes, fellow eyes, and control eyes. The fellow eye exhibited lower central VD compared to the paretic and control eyes. Inverse correlations between deviation angle and VD were noted in different SCP and DCP quadrants in paretic eyes.
Conclusions
In our study cohort, there were significant changes in retinal VD in fellow eyes of patients with trochlear nerve palsy, which we speculate may be related to compensatory head position.
{"title":"Analysis of the effect of congenital unilateral trochlear nerve paresis on retinal vascular density: a retrospective study","authors":"Murat Karapapak MD, Havva Kaldırım MD, Ece Özal MD, İdil Çelen Arabacı MD, Serhat Ermiş MD","doi":"10.1016/j.jaapos.2025.104103","DOIUrl":"10.1016/j.jaapos.2025.104103","url":null,"abstract":"<div><h3>Purpose</h3><div>To use swept-source optical coherence tomography angiography (SS-OCTA) to investigate the alterations in retinal vascular density (VD) in patients presenting with congenital unilateral trochlear nerve palsy.</div></div><div><h3>Methods</h3><div>The medical records of patients diagnosed with congenital unilateral trochlear nerve palsy and those of a healthy control group were reviewed retrospectively. Comprehensive ocular examinations and SS-OCTA imaging were conducted. The study population was divided into three subgroups of eyes: paretic eyes, fellow eyes, and controls. All participants underwent comprehensive ophthalmic examinations, which included assessments of ocular motility, cycloplegic refraction, and axial length measurement. Various strabismus tests—the cover-uncover test, prism and alternate cover test, Krimsky test, and Parks-Bielschowsky test—were conducted to confirm the diagnosis and evaluate the extent of the condition.</div></div><div><h3>Results</h3><div>A total of 34 patients and 39 healthy controls were included. Sex and age distributions were similar between groups. Significant differences were observed in central VD of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) between paretic eyes, fellow eyes, and control eyes. The fellow eye exhibited lower central VD compared to the paretic and control eyes. Inverse correlations between deviation angle and VD were noted in different SCP and DCP quadrants in paretic eyes.</div></div><div><h3>Conclusions</h3><div>In our study cohort, there were significant changes in retinal VD in fellow eyes of patients with trochlear nerve palsy, which we speculate may be related to compensatory head position.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104103"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143042238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2024.104060
Hari R. Anandarajah MD , Steven Seto MD , Roxana Y. Godiwalla DO , Smith Ann M. Chisholm MD , Judy E. Kim MD , Ryan D. Walsh MD
We present a case of partial optic nerve head (ONH) avulsion in a 15-year-old boy evaluated with optical coherence tomography (OCT) from 2 weeks to 15 months after acute injury. Distinct findings on OCT in the acute setting correlated with the diagnosis and with additional testing, including fundus photography, Humphrey visual fields, and clinical examination. OCT findings became less pronounced in the chronic setting. Our case highlights that OCT may be valuable in the acute setting for evaluating ONH avulsion in certain patients; however, OCT findings are less distinct in the chronic setting.
{"title":"Acute and chronic optical coherence tomography findings in partial optic nerve head avulsion","authors":"Hari R. Anandarajah MD , Steven Seto MD , Roxana Y. Godiwalla DO , Smith Ann M. Chisholm MD , Judy E. Kim MD , Ryan D. Walsh MD","doi":"10.1016/j.jaapos.2024.104060","DOIUrl":"10.1016/j.jaapos.2024.104060","url":null,"abstract":"<div><div>We present a case of partial optic nerve head (ONH) avulsion in a 15-year-old boy evaluated with optical coherence tomography (OCT) from 2 weeks to 15 months after acute injury. Distinct findings on OCT in the acute setting correlated with the diagnosis and with additional testing, including fundus photography, Humphrey visual fields, and clinical examination. OCT findings became less pronounced in the chronic setting. Our case highlights that OCT may be valuable in the acute setting for evaluating ONH avulsion in certain patients; however, OCT findings are less distinct in the chronic setting.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104060"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142741011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2024.104093
Kerri McInnis-Smith MD , Todd Abruzzo MD , Monique Riemann , Luis F. Goncalves MD , Aparna Ramasubramanian MD
Background
There are no clinical parameters that predict response to intra-arterial chemotherapy (IAC), which is a first-line treatment for primary and recurrent unilateral retinoblastoma. We evaluated the utility of ophthalmic ultrasound with color Doppler imaging to predict retinoblastoma response to IAC treatment.
Methods
The medical records of 14 retinoblastoma patients (20 eyes) treated with IAC were reviewed retrospectively. Baseline clinical information and ultrasound metrics were obtained from the medical record, including tumor volume, resistive index (RI) and pulsatility index (PI) of both the central retinal artery (CRA) and tumor feeding vessel (FV). Tumor volume was recorded [from repeat assessment 3-6 weeks after initial IAC.
Results
Median baseline tumor volume was 0.40 cm3 (range, 0.01-2.3); median percent change in volume after initial IAC was 71% (range, 50%-81%). Tumors with baseline volume of <1 cm3 were associated with increased CRA RI (median, 0.73) and PI (median, 1.36) compared with larger tumors (median, CRA RI 0.60 [P = 0.04]; median, CRA PI, 1.03 [P = 0.03]) as well as higher FV RI (median, 0.72) and PI (median, 1.40) than larger tumors (median FV RI, 0.63 [P = 0.02]; median FV PI, 1.01 [P = 0.001]). None of the included Doppler parameters were significantly associated with change in tumor volume following IAC.
Conclusions
In this pilot study, we found that retinoblastoma tumor volume is correlated with various Doppler characteristics of the CRA and feeder artery. Further studies are required to elucidate potential ocular blood flow patterns that may predict response to IAC.
{"title":"Utility of color Doppler imaging in patients with retinoblastoma treated by intra-arterial chemotherapy","authors":"Kerri McInnis-Smith MD , Todd Abruzzo MD , Monique Riemann , Luis F. Goncalves MD , Aparna Ramasubramanian MD","doi":"10.1016/j.jaapos.2024.104093","DOIUrl":"10.1016/j.jaapos.2024.104093","url":null,"abstract":"<div><h3>Background</h3><div>There are no clinical parameters that predict response to intra-arterial chemotherapy (IAC), which is a first-line treatment for primary and recurrent unilateral retinoblastoma. We evaluated the utility of ophthalmic ultrasound with color Doppler imaging to predict retinoblastoma response to IAC treatment.</div></div><div><h3>Methods</h3><div>The medical records of 14 retinoblastoma patients (20 eyes) treated with IAC were reviewed retrospectively. Baseline clinical information and ultrasound metrics were obtained from the medical record, including tumor volume, resistive index (RI) and pulsatility index (PI) of both the central retinal artery (CRA) and tumor feeding vessel (FV). Tumor volume was recorded [from repeat assessment 3-6 weeks after initial IAC.</div></div><div><h3>Results</h3><div>Median baseline tumor volume was 0.40 cm<sup>3</sup> (range, 0.01-2.3); median percent change in volume after initial IAC was 71% (range, 50%-81%). Tumors with baseline volume of <1 cm<sup>3</sup> were associated with increased CRA RI (median, 0.73) and PI (median, 1.36) compared with larger tumors (median, CRA RI 0.60 [<em>P</em> = 0.04]; median, CRA PI, 1.03 [<em>P</em> = 0.03]) as well as higher FV RI (median, 0.72) and PI (median, 1.40) than larger tumors (median FV RI, 0.63 [<em>P</em> = 0.02]; median FV PI, 1.01 [<em>P</em> = 0.001]). None of the included Doppler parameters were significantly associated with change in tumor volume following IAC.</div></div><div><h3>Conclusions</h3><div>In this pilot study, we found that retinoblastoma tumor volume is correlated with various Doppler characteristics of the CRA and feeder artery. Further studies are required to elucidate potential ocular blood flow patterns that may predict response to IAC.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104093"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2024.104095
Mackenzie A. Campbell MS , Nathan C. Grove MS , Robert S. McDuffie Jr. MD , Emily A. Auer MPH , Arden J. McReynolds BS , Emily A. McCourt MD , Erica M. Wymore MD, MPH , Naresh Mandava MD , Brandie D. Wagner PhD , Marc T. Mathias MD , Scott C.N. Oliver MD , Jennifer L. Jung MD , Anne M. Lynch MB, MSPH
The association of low birth weight and development of retinopathy of prematurity (ROP) is well established for singletons; however, the association of birth weight and ROP in twins of discordant weight is understudied. Using an ROP registry, we investigated whether smaller twins were at greater risk for developing any stage ROP (stage 1 or greater in either eye) compared with their larger siblings, after adjusting for birth weight and gestational age. Discordance was defined as a birth weight difference of >25%. In a cohort of 2,083 infants (2006-2021), 36 discordant twin pairs were identified. The smaller twin had an increased odds of developing any ROP (OR = 2.7; 95% CI, 1.3-5.9; P = 0.01) compared with the larger sibling. This relationship was no longer significant following adjustment for gestational age and birth weight (adjusted OR = 0.92; CI, 0.11-7.43; P = 0.94). The results suggest that although the smaller twins in discordant pairs are at an increased risk of any stage ROP, this risk is driven by low birth weight conditional on gestational age.
{"title":"The relationship between discordant birth weight in twin pairs and the development of retinopathy of prematurity","authors":"Mackenzie A. Campbell MS , Nathan C. Grove MS , Robert S. McDuffie Jr. MD , Emily A. Auer MPH , Arden J. McReynolds BS , Emily A. McCourt MD , Erica M. Wymore MD, MPH , Naresh Mandava MD , Brandie D. Wagner PhD , Marc T. Mathias MD , Scott C.N. Oliver MD , Jennifer L. Jung MD , Anne M. Lynch MB, MSPH","doi":"10.1016/j.jaapos.2024.104095","DOIUrl":"10.1016/j.jaapos.2024.104095","url":null,"abstract":"<div><div>The association of low birth weight and development of retinopathy of prematurity (ROP) is well established for singletons; however, the association of birth weight and ROP in twins of discordant weight is understudied. Using an ROP registry, we investigated whether smaller twins were at greater risk for developing any stage ROP (stage 1 or greater in either eye) compared with their larger siblings, after adjusting for birth weight and gestational age. Discordance was defined as a birth weight difference of >25%. In a cohort of 2,083 infants (2006-2021), 36 discordant twin pairs were identified. The smaller twin had an increased odds of developing any ROP (OR = 2.7; 95% CI, 1.3-5.9; <em>P</em> = 0.01) compared with the larger sibling. This relationship was no longer significant following adjustment for gestational age and birth weight (adjusted OR = 0.92; CI, 0.11-7.43; <em>P</em> = 0.94). The results suggest that although the smaller twins in discordant pairs are at an increased risk of any stage ROP, this risk is driven by low birth weight conditional on gestational age.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104095"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2024.104099
Vijitha S. Vempuluru MD , Dilip K. Mishra MD , Swathi Kaliki MD
A 3-year-old girl treated with intravenous chemotherapy for bilateral retinoblastoma (RB) and a standard technique of intravitreal topotecan for vitreous seeds in the left eye developed a conjunctival nodule at the injection site. Ultrasound biomicroscopy showed normal underlying sclera and ciliary body. Fundus examination of the left eye showed partly calcified vitreous seeds. Suspecting extraocular RB extension, we performed extended enucleation. Histopathology revealed partially regressed intraocular RB, and the conjunctival nodule showed subepithelial cystic degeneration with fibroblastic proliferation, a rare complication hitherto not reported with intravitreal or subconjunctival topotecan injections.
{"title":"Intravitreal topotecan injection–induced conjunctival fibrosis mimicking extraocular extension of retinoblastoma: a rare complication","authors":"Vijitha S. Vempuluru MD , Dilip K. Mishra MD , Swathi Kaliki MD","doi":"10.1016/j.jaapos.2024.104099","DOIUrl":"10.1016/j.jaapos.2024.104099","url":null,"abstract":"<div><div>A 3-year-old girl treated with intravenous chemotherapy for bilateral retinoblastoma (RB) and a standard technique of intravitreal topotecan for vitreous seeds in the left eye developed a conjunctival nodule at the injection site. Ultrasound biomicroscopy showed normal underlying sclera and ciliary body. Fundus examination of the left eye showed partly calcified vitreous seeds. Suspecting extraocular RB extension, we performed extended enucleation. Histopathology revealed partially regressed intraocular RB, and the conjunctival nodule showed subepithelial cystic degeneration with fibroblastic proliferation, a rare complication hitherto not reported with intravitreal or subconjunctival topotecan injections.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104099"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2025.104105
Fernando Martinez Guasch BS, Ryan Thompson MD, Desai Oula BS, Sarah Ward, Moran Roni Levin MD, Janet Leath Alexander MD
We report the use of the Harms trabeculotome to facilitate 360° microcatheter advancement during illuminated microcatheter-assisted circumferential trabeculotomy (IMCT) ab externo in a 3-month-old infant with bilateral primary congenital glaucoma who required repeat surgery. The illuminated microcatheter was advanced 270°, from 9 to 6 o’clock; however, a focal blockage occurred, and, despite viscodilation, further advancement was not possible. The surgeon introduced a right Harms trabeculotome in the opposite direction, counterclockwise through the same scleral flap. The trabeculotome approximated and manipulated the illuminated microcatheter tip. The illuminated microcatheter was then able to advance beyond the focal obstruction, and the 360° circumferential trabeculotomy was completed.
{"title":"Use of Harms trabeculotome to assist failed microcatheter advancement during trabeculotomy in primary congenital glaucoma","authors":"Fernando Martinez Guasch BS, Ryan Thompson MD, Desai Oula BS, Sarah Ward, Moran Roni Levin MD, Janet Leath Alexander MD","doi":"10.1016/j.jaapos.2025.104105","DOIUrl":"10.1016/j.jaapos.2025.104105","url":null,"abstract":"<div><div>We report the use of the Harms trabeculotome to facilitate 360° microcatheter advancement during illuminated microcatheter-assisted circumferential trabeculotomy (IMCT) ab externo in a 3-month-old infant with bilateral primary congenital glaucoma who required repeat surgery. The illuminated microcatheter was advanced 270°, from 9 to 6 o’clock; however, a focal blockage occurred, and, despite viscodilation, further advancement was not possible. The surgeon introduced a right Harms trabeculotome in the opposite direction, counterclockwise through the same scleral flap. The trabeculotome approximated and manipulated the illuminated microcatheter tip. The illuminated microcatheter was then able to advance beyond the focal obstruction, and the 360° circumferential trabeculotomy was completed.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104105"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143030277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2025.104115
Agnieszka Rosa CO, PhD , Piotr Rosa BEng , Malgorzata Kochana MD , Agata Joanna Ordon MD , Piotr Loba MD, PhD
Purpose
To determine the effect of low hypermetropia correction and orthoptic exercises on binocular visual function in children with symptomatic convergence insufficiency.
Methods
This was a prospective, randomized intervention with a 3-month follow-up. Consecutive pediatric patients with convergence insufficiency and hypermetropia who met inclusion criteria were randomly assigned to one of three treatment groups: spectacle correction and orthoptic training (group 1), spectacle correction alone (group 2) and orthoptic training alone (group 3). The correction of hypermetropia ranged from +0.50 D to +2.25 D. All patients underwent an orthoptic examination, and the severity of functional symptoms was assessed.
Results
A total of 55 patients (28 females, 27 males) were included. There were no treatment-related changes in visual acuity or angle of phoria. Statistically significant reductions in the near point of convergence occurred in group 1 (−5.5 ± 6.8 cm [P = 0.001]) and in group 2 (−5.1 ± 4.8 cm [P = 0.001]). Fusional convergence for distance improved in groups 1 (P = 0.003), 2 (P = 0.018) and 3 (P = 0.006) but for near only in group 2 (P = 0.004). The largest improvement in the mean accommodative facility occurred in group 1 (P = 0.001). A significant decrease in the severity of functional symptoms was noted in all groups (P < 0.001 in groups 1 and 2 and P = 0.006 in group 3).
Conclusions
In our study cohort, correction of low hypermetropia positively influenced binocular vision parameters in patients with convergence insufficiency, suggesting that low hypermetropia correction should be considered for patients who undergo orthoptic training for convergence insufficiency.
{"title":"The effect of low hypermetropia correction and office-based orthoptic training on binocular vision parameters in children with convergence insufficiency","authors":"Agnieszka Rosa CO, PhD , Piotr Rosa BEng , Malgorzata Kochana MD , Agata Joanna Ordon MD , Piotr Loba MD, PhD","doi":"10.1016/j.jaapos.2025.104115","DOIUrl":"10.1016/j.jaapos.2025.104115","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the effect of low hypermetropia correction and orthoptic exercises on binocular visual function in children with symptomatic convergence insufficiency.</div></div><div><h3>Methods</h3><div>This was a prospective, randomized intervention with a 3-month follow-up. Consecutive pediatric patients with convergence insufficiency and hypermetropia who met inclusion criteria were randomly assigned to one of three treatment groups: spectacle correction and orthoptic training (group 1), spectacle correction alone (group 2) and orthoptic training alone (group 3). The correction of hypermetropia ranged from +0.50 D to +2.25 D. All patients underwent an orthoptic examination, and the severity of functional symptoms was assessed.</div></div><div><h3>Results</h3><div>A total of 55 patients (28 females, 27 males) were included. There were no treatment-related changes in visual acuity or angle of phoria. Statistically significant reductions in the near point of convergence occurred in group 1 (−5.5 ± 6.8 cm [<em>P</em> = 0.001]) and in group 2 (−5.1 ± 4.8 cm [<em>P</em> = 0.001]). Fusional convergence for distance improved in groups 1 (<em>P</em> = 0.003), 2 (<em>P</em> = 0.018) and 3 (<em>P</em> = 0.006) but for near only in group 2 (<em>P</em> = 0.004). The largest improvement in the mean accommodative facility occurred in group 1 (<em>P</em> = 0.001). A significant decrease in the severity of functional symptoms was noted in all groups (<em>P</em> < 0.001 in groups 1 and 2 and <em>P</em> = 0.006 in group 3).</div></div><div><h3>Conclusions</h3><div>In our study cohort, correction of low hypermetropia positively influenced binocular vision parameters in patients with convergence insufficiency, suggesting that low hypermetropia correction should be considered for patients who undergo orthoptic training for convergence insufficiency.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104115"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143048442","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-02-01DOI: 10.1016/j.jaapos.2025.104119
{"title":"2024 Journal of the American Association for Pediatric Ophthalmology and Strabismus","authors":"","doi":"10.1016/j.jaapos.2025.104119","DOIUrl":"10.1016/j.jaapos.2025.104119","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 1","pages":"Article 104119"},"PeriodicalIF":1.2,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143534552","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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