Pub Date : 2025-10-01DOI: 10.1016/j.jaapos.2025.104641
Manjushree Bhate MD , Venkatesh Pochaboina MSc , Ravi Varma MD, DM , Sarah Bailur DNB, FICG , Alex V. Levin MD, MHSc , Frank J. Martin FRANZCO
We describe the ophthalmic features in 2 siblings with genetically confirmed Cousin syndrome. Each sibling had a very large–angle exotropia with minimal ocular motility in any position of gaze. The younger had severe ptosis. Magnetic resonance imaging of the brain revealed multiple skull abnormalities but normal cranial nerve pathways and normal extraocular muscles. On exploration, the lateral rectus muscles were extremely tight. Forced duction testing was positive for all rectus muscles, with no rotation of the globe toward adduction and least positive for abduction. A homozygous pathogenic variant in TBX15 was identified.
{"title":"Ophthalmic manifestations of Cousin syndrome","authors":"Manjushree Bhate MD , Venkatesh Pochaboina MSc , Ravi Varma MD, DM , Sarah Bailur DNB, FICG , Alex V. Levin MD, MHSc , Frank J. Martin FRANZCO","doi":"10.1016/j.jaapos.2025.104641","DOIUrl":"10.1016/j.jaapos.2025.104641","url":null,"abstract":"<div><div>We describe the ophthalmic features in 2 siblings with genetically confirmed Cousin syndrome. Each sibling had a very large–angle exotropia with minimal ocular motility in any position of gaze. The younger had severe ptosis. Magnetic resonance imaging of the brain revealed multiple skull abnormalities but normal cranial nerve pathways and normal extraocular muscles. On exploration, the lateral rectus muscles were extremely tight. Forced duction testing was positive for all rectus muscles, with no rotation of the globe toward adduction and least positive for abduction. A homozygous pathogenic variant in <em>TBX15</em> was identified.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104641"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092856","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}
Gender representation in academic pediatric ophthalmology has shifted significantly in recent decades, with increasing female participation. This study examines academic rank, leadership roles, and research productivity as a function of gender.
Methods
This cross-sectional study analyzed publicly available data from 126 US academic ophthalmology programs listed in the Fellowship and Residency Electronic Interactive Database (FREIDA) during August 2024. Data collected from institutional websites identified 451 fellowship-trained pediatric ophthalmologists. Variables included gender, fellowship graduation year, academic rank, leadership roles (eg, department chair, fellowship director, program director), and research productivity metrics (publications, citations, h-index). Statistical comparisons used Pearson’s χ2 test, the Fisher exact test, and Mann-Whitney U or t tests, where appropriate, with significance defined as P < 0.05.
Results
Women now account for 55.9% (252/451) of academic pediatric ophthalmologists. Among those who completed fellowships before 2000, males constitute a larger proportion than females (69.7% vs 30.3%); since 2000, females comprise a greater share of fellowship graduates (65.3% vs 34.7% [P < 0.01]). Men more frequently serve as full professors (40.9% vs 18.0%, P <0.01]) and department chairs (6.5% vs 2.0% [P = 0.02]; women, more often as assistant professors (54.5% vs 40.1% [P = 0.01]) and program directors (3.6% vs 0.5% [P = 0.03]). Research productivity and academic rank are similar between genders in post-2000 graduates.
Conclusions
Gender disparities persist in senior roles, but recent cohorts of currently practicing faculty demonstrate similar levels of academic rank and research productivity. Women now account for 55.9% of academic pediatric ophthalmologists and 65.3% of post-2000 graduates.
背景：近几十年来，随着女性参与的增加，学术儿科眼科的性别代表性发生了显著变化。本研究考察了学术等级、领导角色和研究生产力作为性别的功能。方法：这项横断面研究分析了2024年8月在奖学金和住院医师电子互动数据库（FREIDA）中列出的126个美国学术眼科项目的公开数据。从机构网站收集的数据确定了451名接受过奖学金培训的儿科眼科医生。变量包括性别、奖学金毕业年份、学术等级、领导角色（如系主任、奖学金主任、项目主任）和研究效率指标（出版物、引用、h指数）。统计学比较采用Pearson χ2检验、Fisher精确检验和Mann-Whitney U或t检验，在适当的情况下，显著性定义为P < 0.05。结果：女性占学院派儿童眼科医生的55.9%（252/451）。在2000年以前完成奖学金的人中，男性的比例比女性大（69.7%比30.3%）；自2000年以来，女性占奖学金毕业生的比例更大（65.3%对34.7% [P < 0.01]）。男性更多地担任正教授（40.9% vs 18.0%）。结论：在高级职位上，性别差异仍然存在，但最近的在职教师群体显示出相似的学术等级和研究生产力水平。目前，女性在学术儿科眼科医生中占55.9%，在2000后毕业生中占65.3%。
{"title":"Progress toward gender equity in leadership and representation in academic pediatric ophthalmology","authors":"Brenton T. Bicknell BS , Josephine Rudd Zhong Manis BS , Haley Chishom BS , Yejin Heo BS , Lance Dzubinski BS , Taylor L. Aaserud BS , Alvina Liang BS , Shayan Massoumi BS , Thanushri Srikantha BS , Stephanie Goei MD , Robert Tauscher MD","doi":"10.1016/j.jaapos.2025.104608","DOIUrl":"10.1016/j.jaapos.2025.104608","url":null,"abstract":"<div><h3>Background</h3><div>Gender representation in academic pediatric ophthalmology has shifted significantly in recent decades, with increasing female participation. This study examines academic rank, leadership roles, and research productivity as a function of gender.</div></div><div><h3>Methods</h3><div>This cross-sectional study analyzed publicly available data from 126 US academic ophthalmology programs listed in the Fellowship and Residency Electronic Interactive Database (FREIDA) during August 2024. Data collected from institutional websites identified 451 fellowship-trained pediatric ophthalmologists. Variables included gender, fellowship graduation year, academic rank, leadership roles (eg, department chair, fellowship director, program director), and research productivity metrics (publications, citations, h-index). Statistical comparisons used Pearson’s χ<sup>2</sup> test, the Fisher exact test, and Mann-Whitney <em>U</em> or <em>t</em> tests, where appropriate, with significance defined as <em>P</em> < 0.05.</div></div><div><h3>Results</h3><div>Women now account for 55.9% (252/451) of academic pediatric ophthalmologists. Among those who completed fellowships before 2000, males constitute a larger proportion than females (69.7% vs 30.3%); since 2000, females comprise a greater share of fellowship graduates (65.3% vs 34.7% [<em>P</em> < 0.01]). Men more frequently serve as full professors (40.9% vs 18.0%, <em>P</em> <0.01]) and department chairs (6.5% vs 2.0% [<em>P</em> = 0.02]; women, more often as assistant professors (54.5% vs 40.1% [<em>P</em> = 0.01]) and program directors (3.6% vs 0.5% [<em>P</em> = 0.03]). Research productivity and academic rank are similar between genders in post-2000 graduates.</div></div><div><h3>Conclusions</h3><div>Gender disparities persist in senior roles, but recent cohorts of currently practicing faculty demonstrate similar levels of academic rank and research productivity. Women now account for 55.9% of academic pediatric ophthalmologists and 65.3% of post-2000 graduates.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104608"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144977302","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 : 2025-10-01DOI: 10.1016/j.jaapos.2025.104644
B. Michelle Kim BS , Grayson B. Ashby MD , Brian G. Mohney MD
Background
Published reports, all of which are underpowered to detect a difference, demonstrate conflicting findings on the benefit of inferior turbinate infracture during congenital nasolacrimal duct (CNLD) probing. The purpose of this study was to report the effect of inferior turbinate infracture on outcomes of CNLD probing and assess for long-term complications from the procedure.
Methods
The medical records of all patients <6 years of age who underwent probing for congenital nasolacrimal duct obstruction (CNLDO) at a single referral center from January 1, 2002, through December 31, 2018, were retrospectively reviewed.
Results
Of 987 consecutive probing procedures, 184 (18.6%) underwent inferior turbinate infracture. The mean age at diagnosis and surgery, prevalence of prematurity, race, and sex did not differ between the infracture and control groups. Probing success was similar between infracture (80.4%) and control (80.6%) groups (P = 0.916). The subsequent development of long-term nasopharyngeal disorders including sleep apnea, chronic rhinitis, and chronic sinusitis was no different between groups. Subgroup analysis comparing outcomes of first-time probing versus first-time probing with infracture and single-surgeon analysis maintained no significant difference in outcomes between the two groups. Only late probings (age ≥24 months) tended to be more successful (but not significantly so; P = 0.16) when combined with an infracture (87.3%) compared with those without infracture (78.8%).
Conclusions
Concurrent inferior turbinate infracture did not significantly improve probing success for children with CNLDO in this cohort. However, because potential nasopharyngeal complications are unlikely, the procedure may safely be considered. Future studies should clarify the benefit of infracture for children ≥24 months of age.
{"title":"Effect of inferior turbinate infracture on outcomes of probing for congenital nasolacrimal duct obstruction","authors":"B. Michelle Kim BS , Grayson B. Ashby MD , Brian G. Mohney MD","doi":"10.1016/j.jaapos.2025.104644","DOIUrl":"10.1016/j.jaapos.2025.104644","url":null,"abstract":"<div><h3>Background</h3><div>Published reports, all of which are underpowered to detect a difference, demonstrate conflicting findings on the benefit of inferior turbinate infracture during congenital nasolacrimal duct (CNLD) probing. The purpose of this study was to report the effect of inferior turbinate infracture on outcomes of CNLD probing and assess for long-term complications from the procedure.</div></div><div><h3>Methods</h3><div>The medical records of all patients <6 years of age who underwent probing for congenital nasolacrimal duct obstruction (CNLDO) at a single referral center from January 1, 2002, through December 31, 2018, were retrospectively reviewed.</div></div><div><h3>Results</h3><div>Of 987 consecutive probing procedures, 184 (18.6%) underwent inferior turbinate infracture. The mean age at diagnosis and surgery, prevalence of prematurity, race, and sex did not differ between the infracture and control groups. Probing success was similar between infracture (80.4%) and control (80.6%) groups (<em>P</em> = 0.916). The subsequent development of long-term nasopharyngeal disorders including sleep apnea, chronic rhinitis, and chronic sinusitis was no different between groups. Subgroup analysis comparing outcomes of first-time probing versus first-time probing with infracture and single-surgeon analysis maintained no significant difference in outcomes between the two groups. Only late probings (age ≥24 months) tended to be more successful (but not significantly so; <em>P</em> = 0.16) when combined with an infracture (87.3%) compared with those without infracture (78.8%).</div></div><div><h3>Conclusions</h3><div>Concurrent inferior turbinate infracture did not significantly improve probing success for children with CNLDO in this cohort. However, because potential nasopharyngeal complications are unlikely, the procedure may safely be considered. Future studies should clarify the benefit of infracture for children ≥24 months of age.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104644"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103118","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 : 2025-10-01DOI: 10.1016/j.jaapos.2025.104654
Jenny Chun Ling Kuo MD, MPH , Xinxing Guo MD, PhD , Megan E. Collins MD, MPH
Obtaining parental consent is a crucial step for students to receive eye examinations in school-based vision programs (SBVPs). Using paper consent forms is challenging and may limit responses. We explored a novel, phased, multimodal consent approach in a Baltimore SBVP to increase program participation during the 2022-23 school year. Vision screenings were provided for all students as part of the program. Consent outreach was conducted for all students prior to vision screening (universal phase) and again after for students who failed a vision screening (targeted phase). Email consent only was used during the universal phase, whereas a tiered approach that combined email, paper, and telephone was used in the targeted phase. Of the 46 schools that implemented multimodal consenting, the mean overall consent response rate was 86% ± 9.3% (range, 62%-99%). Mean universal and targeted consent response rate was 15% (95% CI, 13%-18%) and 71% (95% CI, 68%-74%), respectively. Among targeted consent responses, 10% were obtained by email, 26% by paper, and 64% by telephone.
{"title":"Phased multimodal consent in a Baltimore school-based vision program: a novel approach","authors":"Jenny Chun Ling Kuo MD, MPH , Xinxing Guo MD, PhD , Megan E. Collins MD, MPH","doi":"10.1016/j.jaapos.2025.104654","DOIUrl":"10.1016/j.jaapos.2025.104654","url":null,"abstract":"<div><div>Obtaining parental consent is a crucial step for students to receive eye examinations in school-based vision programs (SBVPs). Using paper consent forms is challenging and may limit responses. We explored a novel, phased, multimodal consent approach in a Baltimore SBVP to increase program participation during the 2022-23 school year. Vision screenings were provided for all students as part of the program. Consent outreach was conducted for all students prior to vision screening (universal phase) and again after for students who failed a vision screening (targeted phase). Email consent only was used during the universal phase, whereas a tiered approach that combined email, paper, and telephone was used in the targeted phase. Of the 46 schools that implemented multimodal consenting, the mean overall consent response rate was 86% ± 9.3% (range, 62%-99%). Mean universal and targeted consent response rate was 15% (95% CI, 13%-18%) and 71% (95% CI, 68%-74%), respectively. Among targeted consent responses, 10% were obtained by email, 26% by paper, and 64% by telephone.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104654"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145187261","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 : 2025-10-01DOI: 10.1016/j.jaapos.2025.104648
Praveen Jeyaseelan MD, Daniel Timothy Harrast
A 5-year-old girl was brought to the emergency room with unequal pupil size, fever, and ear pain. Computed tomography and magnetic resonance imaging showed left otomastoiditis complicated with a subperiosteal abscess in the posteromedial left temporomandibular joint. Magnetic resonance angiography revealed enhancement of the left canalicular carotid vessel wall due to adjacent inflammatory process, with irritation of post synaptic sympathetic fibers, causing left Horner syndrome. Horner syndrome can be caused by apical lung tumors, carotid artery dissection, and metastatic neuroblastoma, but otomastoiditis is an uncommon etiology. Recognition and further workup of anisocoria is crucial to management of extracranial complications of otomastoiditis.
{"title":"Horner syndrome secondary to otomastoiditis","authors":"Praveen Jeyaseelan MD, Daniel Timothy Harrast","doi":"10.1016/j.jaapos.2025.104648","DOIUrl":"10.1016/j.jaapos.2025.104648","url":null,"abstract":"<div><div>A 5-year-old girl was brought to the emergency room with unequal pupil size, fever, and ear pain. Computed tomography and magnetic resonance imaging showed left otomastoiditis complicated with a subperiosteal abscess in the posteromedial left temporomandibular joint. Magnetic resonance angiography revealed enhancement of the left canalicular carotid vessel wall due to adjacent inflammatory process, with irritation of post synaptic sympathetic fibers, causing left Horner syndrome. Horner syndrome can be caused by apical lung tumors, carotid artery dissection, and metastatic neuroblastoma, but otomastoiditis is an uncommon etiology. Recognition and further workup of anisocoria is crucial to management of extracranial complications of otomastoiditis.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104648"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145103130","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 : 2025-10-01DOI: 10.1016/j.jaapos.2025.104649
R. Michael Siatkowski MD, MBA
{"title":"How do we fix this mess?","authors":"R. Michael Siatkowski MD, MBA","doi":"10.1016/j.jaapos.2025.104649","DOIUrl":"10.1016/j.jaapos.2025.104649","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104649"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145114760","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}
Moebius syndrome is a rare congenital disorder in which bilateral abduction is impaired, resulting in moderate- to large-angle esotropia. Various surgical procedures have been developed to correct esotropia in Moebius syndrome, including bilateral medial rectus (bimedial) recessions for moderate angles and bimedial recessions combined with vertical rectus transpositions or superior rectus transpositions for larger deviations. We describe a case of Moebius syndrome treated with modified Nishida’s procedure and bimedial recession to correct large-angle esotropia.
{"title":"Modified Nishida’s procedure combined with medial rectus recession in a case of Moebius syndrome","authors":"Sowmya Raveendra Murthy MS, FICO, Sahil Sharma MS, FPOS","doi":"10.1016/j.jaapos.2025.104652","DOIUrl":"10.1016/j.jaapos.2025.104652","url":null,"abstract":"<div><div>Moebius syndrome is a rare congenital disorder in which bilateral abduction is impaired, resulting in moderate- to large-angle esotropia. Various surgical procedures have been developed to correct esotropia in Moebius syndrome, including bilateral medial rectus (bimedial) recessions for moderate angles and bimedial recessions combined with vertical rectus transpositions or superior rectus transpositions for larger deviations. We describe a case of Moebius syndrome treated with modified Nishida’s procedure and bimedial recession to correct large-angle esotropia.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104652"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145132207","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 : 2025-10-01DOI: 10.1016/j.jaapos.2025.104655
Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD
Purpose
To determine associations of income and education level with a diagnosis of strabismus and to identify socioeconomic variables that may affect timely access to diagnosis.
Methods
Annual income, highest level of education completed, and ZIP code income, high school completion, poverty, and socioeconomic deprivation metrics were collected from 413,360 participants in the database. A χ2 test was used to determine significant differences in distributions of income, education, and ZIP code metrics in 3,734 strabismus patients compared with the overall database.
Results
Participants living in ZIP codes with lower multidimensional deprivation indices (less deprivation) are more likely to be diagnosed with strabismus. Participants with annual income below $10,000 (10.10%) or who completed education between fifth grade and a high school diploma or GED (20.06%) are less likely to receive a diagnosis for certain strabismus subtypes. Participants with annual income over $200,000 (7.07%), advanced degrees (27.02%), living in ZIP codes with higher income, and higher high school completion rates were more likely to be diagnosed with certain strabismus subtypes.
Conclusions
Participants diagnosed with strabismus tend to have higher incomes, an advanced degree, and reside in more affluent ZIP codes, whereas those with lower income and education levels are less likely to be diagnosed. These findings reveal potential socioeconomic disparities in access to ophthalmic diagnostic services and care. Findings emphasize the importance of addressing socioeconomic barriers in eye care to enable equitable access.
{"title":"Socioeconomic trends of adult strabismus in the United States: an analysis of the All of Us database","authors":"Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD","doi":"10.1016/j.jaapos.2025.104655","DOIUrl":"10.1016/j.jaapos.2025.104655","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine associations of income and education level with a diagnosis of strabismus and to identify socioeconomic variables that may affect timely access to diagnosis.</div></div><div><h3>Methods</h3><div>Annual income, highest level of education completed, and ZIP code income, high school completion, poverty, and socioeconomic deprivation metrics were collected from 413,360 participants in the database. A χ<sup>2</sup> test was used to determine significant differences in distributions of income, education, and ZIP code metrics in 3,734 strabismus patients compared with the overall database.</div></div><div><h3>Results</h3><div>Participants living in ZIP codes with lower multidimensional deprivation indices (less deprivation) are more likely to be diagnosed with strabismus. Participants with annual income below $10,000 (10.10%) or who completed education between fifth grade and a high school diploma or GED (20.06%) are less likely to receive a diagnosis for certain strabismus subtypes. Participants with annual income over $200,000 (7.07%), advanced degrees (27.02%), living in ZIP codes with higher income, and higher high school completion rates were more likely to be diagnosed with certain strabismus subtypes.</div></div><div><h3>Conclusions</h3><div>Participants diagnosed with strabismus tend to have higher incomes, an advanced degree, and reside in more affluent ZIP codes, whereas those with lower income and education levels are less likely to be diagnosed. These findings reveal potential socioeconomic disparities in access to ophthalmic diagnostic services and care. Findings emphasize the importance of addressing socioeconomic barriers in eye care to enable equitable access.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104655"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208123","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 : 2025-10-01DOI: 10.1016/j.jaapos.2025.104657
Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD
Purpose
To determine the prevalence of adult-diagnosed strabismus and its associations with sex, age, and race in a large, diverse population database in the United States.
Methods
Sex, age, and race data were collected from 413,457 individuals in the All of Us database. The χ2 test with post hoc pairwise comparisons was used to determine significant differences in distributions of sex, age, and race data in 3,734 strabismus patients compared with the overall database.
Results
There is a higher proportion of males among patients with strabismus compared with the overall database (43.34% vs 38.34% [P < 0.001]). There is a significantly higher proportion of patients aged over 65 years among patients with strabismus compared with the overall database (45.77% vs 24.7% [P < 0.001]). There is also a significantly different racial distribution of individuals with strabismus compared with the overall database (P < 0.001). Pairwise comparisons showed a significantly lower proportion of Asian individuals among patients with strabismus or heterotropia, a lower proportion of Black individuals with most subtypes, and a higher proportion of White individuals among patients with any strabismus.
Conclusions
These results suggest that there is a lower proportion of females, Asian, and Black participants with diagnosed strabismus compared with the overall population in the All of Us database. These findings may indicate that strabismus affects patient populations differently, or that there is differential access to care and diagnosis of strabismus across sex, age, and race.
目的：在美国一个大型、多样化的人口数据库中确定成人诊断的斜视患病率及其与性别、年龄和种族的关系。方法：从All of Us数据库中收集了413457个人的性别、年龄和种族数据。采用事后两两比较的χ2检验来确定3734例斜视患者的性别、年龄和种族数据分布与整个数据库的差异。结果：斜视患者中男性比例高于整体数据库（43.34% vs 38.34% [P < 0.001]）。在斜视患者中，65岁以上患者的比例明显高于整体数据库（45.77% vs 24.7% [P < 0.001]）。与整个数据库相比，斜视个体的种族分布也有显著差异（P < 0.001）。两两比较显示，在斜视或异斜视患者中，亚洲人的比例明显较低，大多数亚型的黑人患者比例较低，而在任何斜视患者中，白人患者比例较高。结论：这些结果表明，与All of Us数据库中的总体人群相比，女性、亚洲人和黑人被诊断为斜视的比例较低。这些发现可能表明斜视对患者群体的影响不同，或者斜视的治疗和诊断在性别、年龄和种族上存在差异。
{"title":"Epidemiology of strabismus among adults in the United States: insights from the All of Us database","authors":"Alexander C. Lieu BS, Evan H. Walker MS, Shira L. Robbins MD, David B. Granet MD , Jolene C. Rudell MD, PhD","doi":"10.1016/j.jaapos.2025.104657","DOIUrl":"10.1016/j.jaapos.2025.104657","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prevalence of adult-diagnosed strabismus and its associations with sex, age, and race in a large, diverse population database in the United States.</div></div><div><h3>Methods</h3><div>Sex, age, and race data were collected from 413,457 individuals in the All of Us database. The χ<sup>2</sup> test with post hoc pairwise comparisons was used to determine significant differences in distributions of sex, age, and race data in 3,734 strabismus patients compared with the overall database.</div></div><div><h3>Results</h3><div>There is a higher proportion of males among patients with strabismus compared with the overall database (43.34% vs 38.34% [<em>P</em> < 0.001]). There is a significantly higher proportion of patients aged over 65 years among patients with strabismus compared with the overall database (45.77% vs 24.7% [<em>P</em> < 0.001]). There is also a significantly different racial distribution of individuals with strabismus compared with the overall database (<em>P</em> < 0.001). Pairwise comparisons showed a significantly lower proportion of Asian individuals among patients with strabismus or heterotropia, a lower proportion of Black individuals with most subtypes, and a higher proportion of White individuals among patients with any strabismus.</div></div><div><h3>Conclusions</h3><div>These results suggest that there is a lower proportion of females, Asian, and Black participants with diagnosed strabismus compared with the overall population in the All of Us database. These findings may indicate that strabismus affects patient populations differently, or that there is differential access to care and diagnosis of strabismus across sex, age, and race.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104657"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145208205","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 : 2025-10-01DOI: 10.1016/j.jaapos.2025.104607
Kathryn E. Tobert BA , Nicole Liberio MD , Kerri Becktell MD , Aparna Ramasubramanian MD
MYCN amplification within the tumor has emerged as an important factor in the oncogenesis of a subset of retinoblastomas, most of which are caused by pathogenic variants in the RB1 gene. We present the case of a 3-month-old girl with unilateral cavitary retinoblastoma that initially responded well to intra-arterial chemotherapy but later recurred. After enucleation, the tumor was found to exhibit MYCN amplification, but there were no RB1 variants. Retinoblastoma tumors with MYCN amplification are known to carry a poor prognosis and often require enucleation. On the contrary, cavitary retinoblastomas tend to be well differentiated, with favorable prognosis. To our knowledge, this is the first report of a MYCN-amplified tumor presenting as cavitary retinoblastoma.
{"title":"Cavitary retinoblastoma with MYCN amplification","authors":"Kathryn E. Tobert BA , Nicole Liberio MD , Kerri Becktell MD , Aparna Ramasubramanian MD","doi":"10.1016/j.jaapos.2025.104607","DOIUrl":"10.1016/j.jaapos.2025.104607","url":null,"abstract":"<div><div>MYCN amplification within the tumor has emerged as an important factor in the oncogenesis of a subset of retinoblastomas, most of which are caused by pathogenic variants in the <em>RB1</em> gene. We present the case of a 3-month-old girl with unilateral cavitary retinoblastoma that initially responded well to intra-arterial chemotherapy but later recurred. After enucleation, the tumor was found to exhibit MYCN amplification, but there were no <em>RB1</em> variants. Retinoblastoma tumors with MYCN amplification are known to carry a poor prognosis and often require enucleation. On the contrary, cavitary retinoblastomas tend to be well differentiated, with favorable prognosis. To our knowledge, this is the first report of a MYCN-amplified tumor presenting as cavitary retinoblastoma.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 5","pages":"Article 104607"},"PeriodicalIF":1.3,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144823141","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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