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The use of trypan blue to enhance intraoperative visualization during congenital lacrimal fistulectomy 在先天性泪道瘘管切除术中使用胰蓝增强术中可视性。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.104016
Omar Solyman MD, FRCS , Abdelrahman M. Elhusseiny MD, MSc , Richard C. Allen MD, PhD
We describe the use of trypan blue stain to enhance visualization of the tract of the fistula during congenital lacrimal fistulectomy in a 9-year-old boy. This video demonstrates the surgical technique and the intraoperative finding of deep branching of the fistula in this case. We discuss alternative methods of improving delineation of the fistula’s path during congenital lacrimal fistulectomy.
我们描述了在一名 9 岁男孩的先天性泪瘘管切除术中使用胰蓝染色法来增强瘘管道的可视性。这段视频演示了手术技巧和术中发现瘘管深部分支的情况。我们讨论了在先天性泪道瘘管切除术中改善瘘管路径划定的其他方法。
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引用次数: 0
Geographic disparities and surgical trends of strabismus surgery among Medicare beneficiaries (2016-2021) 医疗保险受益人斜视手术的地域差异和手术趋势(2016-2021 年)。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.104004
Aaron Harris BS , Nora Siegler BS , Hannah L. Walsh BS , Kara M. Cavuoto MD
This study highlights the disparity between the prevalence of adult strabismus in the United States and the limited number of surgeons performing adult strabismus surgery on Medicare beneficiaries. Only 12.2% of pediatric ophthalmologists billed Medicare for adult strabismus procedures during the study period. Additionally, geographic disparities of surgeons performing adult strabismus surgery were evident, with drastically different surgeon-to-patient ratios by state. Overall, the study raises concerns about the adequacy of the surgeon supply to meet the demand for adult strabismus cases.
这项研究凸显了美国成人斜视发病率与为医保受益人实施成人斜视手术的外科医生数量有限之间的差距。在研究期间,只有 12.2% 的小儿眼科医生为成人斜视手术向医保开具账单。此外,进行成人斜视手术的外科医生的地域差异也很明显,各州的外科医生与患者的比例相差悬殊。总体而言,该研究对外科医生是否足以满足成人斜视病例的需求提出了担忧。
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引用次数: 0
Impact of a ROP mentoring program in rural regions of Colombia ROP 辅导计划对哥伦比亚农村地区的影响。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.104013
Claudia Zuluaga-Botero MD , Jose Maria Solano MD , Carolina Serrano-Calderon MD , Marudis Mestra MD , Maria Camila Rojas MD , José Moreno-Montoya PhD , Alexandra Porras MD , Julian Trujillo-Trujillo MD , Juan Carlos Silva MD, MPH , Clare Gilbert MD

Purpose

To assess the impact of a retinopathy of prematurity (ROP) mentoring program in four rural regions with 31 neonatal units in Colombia between 2011 and 2019.

Methods

Indicators recommended by the national program were used for assessment: screening coverage of eligible preterm newborns, proportion screened with any stage of ROP, and proportion of screened infants treated. Data were also collected on the number of units with ROP services and birth weight (BW) and gestational age (GA) of babies treated. Data on the number of preterm births, BWs of infants screened, and their ROP status (any/none) were extracted from the national health information system. Ophthalmologists in each region provided data on the number screened and treated. A linear-by-linear statistic was used to assess trends in the indicators before and during mentoring.

Results

Of the 31 neonatal units, the number providing ROP services increased from 7 (23%) to 26 (84%). The number of eligible infants born in the four regions (total 33,521) was stable over the study period, the proportion screened increased from 14% to 41%, the proportion of those screened who were found to have any ROP tended to decrease over time, and the proportion of those screened who were treated declined from 9% to 3%, with some regional variation. By year 3 no infant with a BW ≥2000 g or GA of >36 weeks was treated.

Conclusions

In our study, mentoring rural providers proved a valuable strategy for inducing new screening programs, increasing coverage, and improving local capacities in neonatal care and ROP services.
目的:评估早产儿视网膜病变(ROP)指导计划在 2011 年至 2019 年间对哥伦比亚四个农村地区 31 个新生儿科的影响:评估采用国家计划推荐的指标:符合条件的早产新生儿筛查覆盖率、筛查出任何阶段视网膜病变的比例以及筛查出的婴儿接受治疗的比例。此外,还收集了提供早产儿视网膜病变服务的单位数量、接受治疗婴儿的出生体重(BW)和胎龄(GA)等数据。有关早产儿数量、接受筛查婴儿的出生体重及其视网膜病变状况(任何/无)的数据均来自国家卫生信息系统。各地区的眼科医生提供了筛查和治疗人数的数据。采用线性-线性统计法评估指导前和指导期间各项指标的变化趋势:结果:在 31 个新生儿科中,提供早产儿视网膜病变服务的数量从 7 个(23%)增加到 26 个(84%)。在研究期间,四个地区符合条件的新生儿数量(共计 33521 名)保持稳定,接受筛查的比例从 14% 增加到 41%,筛查出患有任何早产儿视网膜病变的比例随着时间的推移呈下降趋势,接受治疗的比例从 9% 下降到 3%,各地区之间存在一定差异。到第 3 年,体重≥2000 克或孕期大于 36 周的婴儿均未接受治疗:结论:在我们的研究中,指导农村医疗服务提供者被证明是一项非常有价值的策略,它可以诱导新的筛查计划、提高覆盖率并改善当地新生儿护理和早产儿视网膜病变服务的能力。
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引用次数: 0
Mutations in the ciliary transport gene IFT140 cause syndromic congenital retinal dystrophy 睫状体转运基因 IFT140 的突变导致综合征性先天性视网膜营养不良症。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.104007
Enam Danish MD , Amal Alhashem MD , Nada Naaman MD , Faeeqah Almhmoudi MD , Aziza Mushiba MD , Abdulrahman Almatrafi MD , Abdulaziz Raggam MD , Raghad Bukhari MD
Early-onset, severe retinal dystrophy can be isolated or syndromic, presenting as part of an underlying systemic disease. Mainzer-Saldino syndrome, a rare systemic ciliopathy characterized by skeletal and renal disease, is caused by recessive mutations in the intraflagellar transport 140 chlamydomonas homologue (IFT140) gene. We present a series of 13 cases of early-onset retinal dysfunction with confirmed IFT140 mutations from 8 unrelated Saudi families belonging to 3 well-known tribes. All carried the same homozygous missense IFT140 mutation (c.1990G>A; p.Glu664Lys) except for a single family, which included 4 affected subjects, 3 of whom were aborted fetuses, with compound heterozygous pathogenic IFT140 variants (c.1525-1G>A and c.1990G>A; p.Glu664Lys). Severe retinal dystrophy was present in all living subjects, phenotypically apparent as hyperopia, nystagmus, nyctalopia, poor vision and nonrecordable full-field electroretinography. All affected individuals had skeletal abnormalities, and neurological abnormalities were common, but there was no evidence of chronic renal failure.
早期发病的严重视网膜营养不良可以是孤立的,也可以是综合征,表现为潜在的全身性疾病的一部分。Mainzer-Saldino综合征是一种罕见的全身性纤毛虫病,以骨骼和肾脏疾病为特征,是由衣藻细胞内转运140同源物(IFT140)基因的隐性突变引起的。我们介绍了一系列 13 例早发视网膜功能障碍病例,这些病例均确诊为 IFT140 基因突变,他们来自沙特 3 个著名部落的 8 个无血缘关系的家庭。除一个家族外,所有家族均携带相同的同源错义 IFT140 突变(c.1990G>A;p.Glu664Lys),该家族包括 4 名受影响的受试者,其中 3 名是流产胎儿,他们携带复合杂合致病性 IFT140 变体(c.1525-1G>A 和 c.1990G>A;p.Glu664Lys)。所有在世的受试者都存在严重的视网膜营养不良,表现为远视、眼球震颤、夜视、视力低下和无法记录的全视野视网膜电图。所有患者都有骨骼异常,神经系统异常也很常见,但没有慢性肾功能衰竭的迹象。
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引用次数: 0
Bilateral orbital abscess secondary to pediatric acute rhinosinusitis: a case report and literature review 继发于小儿急性鼻炎的双侧眼眶脓肿:病例报告和文献综述。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.103986
Yotam Heilig MD, Daniel Yafit MD, Shay Schneider MD, Sofia Kordeluk MD, Oren Ziv MD
A 13-month-old boy presented with bilateral periorbital swelling accompanied by rhinorrhea and fever. Nasal endoscopy revealed middle meatus edema and purulent discharge. He was diagnosed with bilateral preseptal cellulitis and treated with intravenous antibiotics. Continuous fever and new-onset proptosis with extraocular muscle restriction the next day prompted imaging, which revealed sinusitis with bilateral subperiosteal abscesses. He underwent endoscopic sinus surgery with bilateral abscess drainage and recovered uneventfully. Bilateral orbital complications of acute sinusitis are exceedingly rare occurrences and nearly always require surgical treatment.
一名 13 个月大的男孩出现双侧眶周肿胀,伴有鼻出血和发烧。鼻内窥镜检查发现中鼻孔水肿并有脓性分泌物。他被诊断为双侧眶前蜂窝织炎,并接受了静脉抗生素治疗。第二天,持续发热和新出现的眼球突出伴眼外肌受限促使他接受造影检查,结果显示他患有鼻窦炎,并伴有双侧骨膜下脓肿。他接受了双侧脓肿引流的内窥镜鼻窦手术,并顺利康复。急性鼻窦炎的双侧眼眶并发症极为罕见,几乎总是需要手术治疗。
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引用次数: 0
Acute bilateral nodular scleritis following strabismus surgery in a patient with Down syndrome 一名唐氏综合征患者在斜视手术后出现急性双侧结节性巩膜炎。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.103985
Babak Masoomian MD , Maryam Saatchi MD , Mohammad Reza Akbari MD , Arash Mirmohammadsadeghi MD , Motahhareh Sadeghi MD
Scleritis is a rare complication of strabismus surgery. We present the case of an 11-year-old girl with Down syndrome who underwent strabismus surgery and developed bilateral symmetric nodular scleritis 3 weeks after surgery. Anterior segment optical coherence tomography revealed localized hyporeflective thickening of the sclera at the primary site of muscle insertion in both eyes. Treatment with topical and oral corticosteroids led to resolution of her condition.
巩膜炎是斜视手术的罕见并发症。本病例是一名患有唐氏综合征的 11 岁女孩,她接受了斜视手术,术后 3 周出现双侧对称性结节性巩膜炎。眼前节光学相干断层扫描显示,双眼主要肌肉插入部位的巩膜局部反射减弱增厚。经过局部和口服皮质类固醇治疗后,她的病情得到缓解。
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引用次数: 0
Agreement between intraoperative and anterior segment optical coherence tomography measurements of the extraocular muscle insertion distance in patients with previous strabismus surgery 曾接受过斜视手术的患者眼外肌插入距离的术中测量值与前段光学相干断层扫描测量值之间的一致性。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.104011
Mónica Rodríguez MD , María Camila Plata MD , María Elisa Mejía MD , Mauricio Lozano MD

Purpose

To evaluate the agreement between anterior segment optical coherence tomography (AS-OCT) measurement of preoperative distance from the limbus to the horizontal rectus muscle insertion and intraoperative measurement in patients who have previously undergone strabismus surgery and required reoperation.

Methods

Subjects from two ophthalmological centers were included. Preoperative AS-OCT was used to measure the muscle insertion from the limbus, and intraoperative measurements were obtained using calipers. Interclass correlation coefficient and Bland-Altman agreement analysis were used.

Results

A total of 53 horizontal rectus muscles from 24 patients with previous strabismus surgery were analyzed: 27 medial rectus (MR) and 26 lateral rectus (LR) muscles, including both previously operated and previously unoperated muscles. Average of AS-OCT measurements of MR was 8.54 ± 2.42 mm and intraoperatively was 9.4 ± 3.09 mm. Average AS-OCT for LR was 8.32 ± 2.25 mm and intraoperatively was 9.34 ± 3.73 mm. 63% of MR muscles and 77% of LR muscles were within 1 mm between AS-OCT and intraoperative measurement. Spearman’s correlation coefficient showed positive correlation between measures for both MR and LR muscles. The interclass correlation coefficient was 0.79 (95% CI, 0.56-0.90) for MR muscles and 0.70 (95% CI, 0.44-0.85) for LR muscles, with a good agreement. Agreement was better for muscles ≤10 mm from the limbus (which included both previously operated and unoperated muscles) than for muscles found >10 mm from the limbus.

Conclusions

Good agreement was observed between the measurement of limbus-insertion distance obtained by AS-OCT and by intraoperative measurement, especially when the muscle insertion was ≤10 mm from the limbus.
目的:评估前节光学相干断层扫描(AS-OCT)对曾接受过斜视手术并需要再次手术的患者的术前测量结果与术中测量结果之间的一致性:方法:纳入两个眼科中心的受试者。方法:纳入来自两个眼科中心的受试者,术前使用 AS-OCT 从角膜缘测量肌肉插入情况,术中使用卡尺进行测量。采用类间相关系数和 Bland-Altman 一致性分析:共分析了 24 名曾接受过斜视手术的患者的 53 块水平直肌:27 块内侧直肌(MR)和 26 块外侧直肌(LR),包括曾接受过手术和未接受过手术的肌肉。MR 的平均 AS-OCT 测量值为 8.54 ± 2.42 毫米,术中测量值为 9.4 ± 3.09 毫米。LR 的平均 AS-OCT 测量值为 8.32 ± 2.25 毫米,术中测量值为 9.34 ± 3.73 毫米。63%的MR肌肉和77%的LR肌肉的AS-OCT和术中测量值在1毫米以内。斯皮尔曼相关系数显示,MR 和 LR 肌肉的测量值之间呈正相关。MR肌肉的类间相关系数为0.79(95% CI,0.56-0.90),LR肌肉的类间相关系数为0.70(95% CI,0.44-0.85),具有良好的一致性。对于距离角膜缘≤10 mm的肌肉(包括曾手术和未手术的肌肉),测量结果的一致性优于距离角膜缘>10 mm的肌肉:通过 AS-OCT 和术中测量获得的睫状肌插入距离具有良好的一致性,尤其是当肌肉插入距离睫状肌≤10 毫米时。
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引用次数: 0
Isolated trochlear nerve palsy: an atypical presentation of multiple sclerosis 孤立性耳蜗神经麻痹:多发性硬化症的非典型表现。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.103999
Marta Carrera Tarrés MD , Josep Visa Nasarre MD , Julia Nash Monsó MD , Roser Monmany Badia MD , Julieta Stefani Vargas MD
A 31-year-old woman presenting with vertical diplopia and history of paresthesia in her hands the previous year was found to have a trochlear nerve palsy. Computed tomography showed no acute intracranial pathology. Magnetic resonance imaging revealed several white matter lesions with a demyelinating pattern. She was diagnosed with relapsing-remitting multiple sclerosis (MS) and started on immunotherapy, with no further exacerbation of MS.
一名 31 岁的女性因垂直复视和前一年的手部麻痹病史而就诊,被发现患有耳蜗神经麻痹。计算机断层扫描显示没有急性颅内病变。磁共振成像显示有多处脱髓鞘模式的白质病变。她被诊断为复发缓解型多发性硬化症(MS),并开始接受免疫治疗,但多发性硬化症没有进一步恶化。
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引用次数: 0
Posterior subcapsular cataract in a patient with Straatsma syndrome Straatsma 综合征患者的后囊下白内障。
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.103994
Marybeth K. Farazdaghi MD, Erick D. Bothun MD, Brian G. Mohney MD
Straatsma syndrome is an uncommon ocular condition generally comprised of myelinated retinal nerve fiber layer, myopia, and amblyopia. Associated ocular disorders include strabismus, nystagmus, optic nerve hypoplasia, and iris heterochromia. We report the case of a 6-year-old girl with unilateral Straatsma syndrome and an acquired cataract that required surgical extraction.
斯特拉斯马综合征是一种不常见的眼部疾病,一般由髓样视网膜神经纤维层、近视和弱视组成。相关眼部疾病包括斜视、眼球震颤、视神经发育不全和虹膜异色症。我们报告了一例 6 岁女孩的病例,她患有单侧斯特拉斯马综合征和后天性白内障,需要进行手术摘除。
{"title":"Posterior subcapsular cataract in a patient with Straatsma syndrome","authors":"Marybeth K. Farazdaghi MD,&nbsp;Erick D. Bothun MD,&nbsp;Brian G. Mohney MD","doi":"10.1016/j.jaapos.2024.103994","DOIUrl":"10.1016/j.jaapos.2024.103994","url":null,"abstract":"<div><div>Straatsma syndrome is an uncommon ocular condition generally comprised of myelinated retinal nerve fiber layer, myopia, and amblyopia. Associated ocular disorders include strabismus, nystagmus, optic nerve hypoplasia, and iris heterochromia. We report the case of a 6-year-old girl with unilateral Straatsma syndrome and an acquired cataract that required surgical extraction.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"28 5","pages":"Article 103994"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299947","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}
引用次数: 0
Does COVID-19 cause retinal hemorrhage? COVID-19 会导致视网膜出血吗?
IF 1.2 4区 医学 Q3 OPHTHALMOLOGY Pub Date : 2024-10-01 DOI: 10.1016/j.jaapos.2024.104014
Brittany M. Wong MD , Alex V. Levin MD, MHSc
{"title":"Does COVID-19 cause retinal hemorrhage?","authors":"Brittany M. Wong MD ,&nbsp;Alex V. Levin MD, MHSc","doi":"10.1016/j.jaapos.2024.104014","DOIUrl":"10.1016/j.jaapos.2024.104014","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"28 5","pages":"Article 104014"},"PeriodicalIF":1.2,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331572","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}
引用次数: 0
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Journal of Aapos
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