Pub Date : 2024-06-01DOI: 10.1016/j.jaapos.2024.103899
Nader Bayoumi MD, FRCS(Glasg), Nihal El Shakankiry MD, PhD
An 8-month-old girl referred from her pediatrician with a diagnosis of neurofibromatosis type 1 (NF1) presented with an enlarged cloudy cornea of the left eye and a swollen left side of the face. Her left eye had intraocular pressure (IOP) of 21 mm Hg, corneal diameter of 16 mm, ectropion uvea, cup:disk ratio of 0.9, axial length of 28.06 mm, and S-shaped upper lid deformity. Uneventful combined trabeculotomy-trabeculectomy with mitomycin C was performed. On postoperative day 1, there was a new total hyphema that persisted for 2 weeks. An anterior chamber washout was performed, revealing the source of bleeding to be a persistent tunica vasculosa lentis along the zonules of the lens. Viscotamponade was performed, and the corneal wounds were closed, with the ocular tension slightly elevated. Bleeding did not recur for the following 5 months, and IOP was controlled until final follow-up.
{"title":"Postoperative hyphema due to persistent tunica vasculosa lentis in glaucoma associated with neurofibromatosis—a case report","authors":"Nader Bayoumi MD, FRCS(Glasg), Nihal El Shakankiry MD, PhD","doi":"10.1016/j.jaapos.2024.103899","DOIUrl":"10.1016/j.jaapos.2024.103899","url":null,"abstract":"<div><p>An 8-month-old girl referred from her pediatrician with a diagnosis of neurofibromatosis type 1 (NF1) presented with an enlarged cloudy cornea of the left eye and a swollen left side of the face. Her left eye had intraocular pressure (IOP) of 21 mm Hg, corneal diameter of 16 mm, ectropion uvea, cup:disk ratio of 0.9, axial length of 28.06 mm, and S-shaped upper lid deformity. Uneventful combined trabeculotomy-trabeculectomy with mitomycin C was performed. On postoperative day 1, there was a new total hyphema that persisted for 2 weeks. An anterior chamber washout was performed, revealing the source of bleeding to be a persistent tunica vasculosa lentis along the zonules of the lens. Viscotamponade was performed, and the corneal wounds were closed, with the ocular tension slightly elevated. Bleeding did not recur for the following 5 months, and IOP was controlled until final follow-up.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140295077","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 : 2024-06-01DOI: 10.1016/j.jaapos.2024.103928
Grayson Ashby MD, Saraniya Sathiamoorthi MD, Brian G. Mohney MD
Purpose
To report the incidence, clinical characteristics, and outcomes of acute dacryocystitis among a large, population-based cohort of children born with congenital nasolacrimal duct obstruction (CNLDO) over a 10-year period.
Methods
This multicenter retrospective, population-based cohort study included all patients diagnosed with acute dacryocystitis in a cohort of patients diagnosed with CNLDO before age 5 years in Olmsted County, Minnesota, United States of America from January 1, 1995, through December 31, 2004.
Results
Of 1,998 patients with CNLDO, there were 70 cases (36 female [(51%)]) of acute dacryocystitis during the study, yielding an incidence rate of 243 per 100,000 children (95% CI, 170-316). Mean age at diagnosis was 9.0 months. Patients who developed dacryocystitis were significantly less likely to be born via C-section (OR = 0.29, P = 0.009). Less than half of patients with dacryocystitis were treated with oral/intravenous antibiotics (46%), but whose who were had a significantly higher odds of requiring probing (OR = 8.50, P = 0.004). Spontaneous CNLDO resolution was significantly less likely to occur in patients diagnosed with acute dacryocystitis compared with those without (OR = 2.46, P = 0.001). The median age of spontaneous resolution in the dacryocystitis group (6.0 months) was significantly older than the uncomplicated CNLDO group (P = 0.012).
Conclusions
Pediatric acute dacryocystitis is an uncommon complication of CNLDO and is associated with both a lower likelihood of and older age at spontaneous resolution of CNLDO symptoms.
{"title":"The incidence of pediatric dacryocystitis among a population-based cohort of infants with congenital nasolacrimal duct obstruction","authors":"Grayson Ashby MD, Saraniya Sathiamoorthi MD, Brian G. Mohney MD","doi":"10.1016/j.jaapos.2024.103928","DOIUrl":"10.1016/j.jaapos.2024.103928","url":null,"abstract":"<div><h3>Purpose</h3><p>To report the incidence, clinical characteristics, and outcomes of acute dacryocystitis among a large, population-based cohort of children born with congenital nasolacrimal duct obstruction (CNLDO) over a 10-year period.</p></div><div><h3>Methods</h3><p>This multicenter retrospective, population-based cohort study included all patients diagnosed with acute dacryocystitis in a cohort of patients diagnosed with CNLDO before age 5 years in Olmsted County, Minnesota, United States of America from January 1, 1995, through December 31, 2004.</p></div><div><h3>Results</h3><p>Of 1,998 patients with CNLDO, there were 70 cases (36 female [(51%)]) of acute dacryocystitis during the study, yielding an incidence rate of 243 per 100,000 children (95% CI, 170-316). Mean age at diagnosis was 9.0 months. Patients who developed dacryocystitis were significantly less likely to be born via C-section (OR = 0.29, <em>P</em> = 0.009). Less than half of patients with dacryocystitis were treated with oral/intravenous antibiotics (46%), but whose who were had a significantly higher odds of requiring probing (OR = 8.50, <em>P</em> = 0.004). Spontaneous CNLDO resolution was significantly less likely to occur in patients diagnosed with acute dacryocystitis compared with those without (OR = 2.46, <em>P</em> = 0.001). The median age of spontaneous resolution in the dacryocystitis group (6.0 months) was significantly older than the uncomplicated CNLDO group (<em>P</em> = 0.012).</p></div><div><h3>Conclusions</h3><p>Pediatric acute dacryocystitis is an uncommon complication of CNLDO and is associated with both a lower likelihood of and older age at spontaneous resolution of CNLDO symptoms.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863052","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 : 2024-06-01DOI: 10.1016/S1091-8531(24)00223-4
{"title":"Access to JAAPOS online","authors":"","doi":"10.1016/S1091-8531(24)00223-4","DOIUrl":"https://doi.org/10.1016/S1091-8531(24)00223-4","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1091853124002234/pdfft?md5=e0b324732f7d3eb2ab0693e9139e1f0e&pid=1-s2.0-S1091853124002234-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141250409","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.jaapos.2024.103936
Leo Meller BS , Angel Bert Sambo BS , Nam Nguyen , Shira L. Robbins MD , David B. Granet MD
Presently, little is known regarding the characteristics and publication rates of registered strabismus trials from ClinicalTrials.gov. We queried registered strabismus trials that were completed prior to January 1, 2021, from ClinicalTrials.gov. Publication of trials in peer-reviewed journals was confirmed using PubMed.gov, ClinicalTrials.gov, and Google Scholar. Of the 117 trials found, only 69 (59%) were published with a publication delay of nearly 2.5 years. Interventional trials were associated with publication status compared with observational trials. The low publication rates and significant publication delay indicate potential bias in information dissemination of completed strabismus trials.
{"title":"Publication rates of registered strabismus trials from ClinicalTrials.gov","authors":"Leo Meller BS , Angel Bert Sambo BS , Nam Nguyen , Shira L. Robbins MD , David B. Granet MD","doi":"10.1016/j.jaapos.2024.103936","DOIUrl":"10.1016/j.jaapos.2024.103936","url":null,"abstract":"<div><p>Presently, little is known regarding the characteristics and publication rates of registered strabismus trials from <span>ClinicalTrials.gov</span><svg><path></path></svg>. We queried registered strabismus trials that were completed prior to January 1, 2021, from <span>ClinicalTrials.gov</span><svg><path></path></svg>. Publication of trials in peer-reviewed journals was confirmed using <span>PubMed.gov</span><svg><path></path></svg>, <span>ClinicalTrials.gov</span><svg><path></path></svg>, and Google Scholar. Of the 117 trials found, only 69 (59%) were published with a publication delay of nearly 2.5 years. Interventional trials were associated with publication status compared with observational trials. The low publication rates and significant publication delay indicate potential bias in information dissemination of completed strabismus trials.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1091853124002064/pdfft?md5=14c5c2fc894922b9a46f60d90723994e&pid=1-s2.0-S1091853124002064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140904319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-06-01DOI: 10.1016/j.jaapos.2024.103924
Suzanna Joseph BS, Rizul Naithani DO, MPH, Samuel Alvarez MD, Tanya Glaser MD, Sharon Freedman MD, Mays El-Dairi MD
Background
Infantile nystagmus syndrome can be associated with an afferent problem (anterior or posterior segment) or constitute an isolated idiopathic disorder. With a normal ophthalmic examination, current guidelines recommend electroretinography (ERG) rather than magnetic resonance (MRI) for preliminary workup. Given the limited use of optical coherence tomography (OCT) in preverbal children, the purpose of this study was to evaluate the role of handheld OCT (HH-OCT) in the initial diagnostic evaluation of infantile nystagmus.
Methods
In this cross-sectional case series, the medical records of all children with infantile nystagmus and HH-OCT imaging at the Duke Eye Center from August 2016 to July 2021 were retrospectively reviewed. Children with anterior segment disorders or obvious retina/optic nerve structural pathology, bilateral ophthalmoplegia, or Down syndrome were excluded. Two masked pediatric ophthalmologists graded HH-OCT images for optic nerve head and macular abnormalities. A neuro-ophthalmologist reviewed clinical findings of each patient’s presenting visit and recommended appropriate testing (MRI vs ERG), initially without, and again with HH-OCT image review.
Results
A total of 39 cases were included, with mean presenting age of 1.3 years. Final diagnoses included retinal or foveal abnormalities (7), optic nerve pathology (13), idiopathic (10), or unknown (9). HH-OCT findings included optic nerve hypoplasia (1), optic nerve elevation (3), persistence of the inner layers at the fovea (9), thin ganglion cell layer (8), ellipsoid zone abnormality (3), and thin choroid (1). HH-OCT findings altered initial clinical-only management in 16 cases (41%), including avoiding MRI (5) and ERG (10) testing.
Conclusions
Our results suggest that HH-OCT has the potential to augment and streamline the evaluation of infantile nystagmus.
{"title":"Modernizing the evaluation of infantile nystagmus: the role of handheld optical coherence tomography","authors":"Suzanna Joseph BS, Rizul Naithani DO, MPH, Samuel Alvarez MD, Tanya Glaser MD, Sharon Freedman MD, Mays El-Dairi MD","doi":"10.1016/j.jaapos.2024.103924","DOIUrl":"10.1016/j.jaapos.2024.103924","url":null,"abstract":"<div><h3>Background</h3><p>Infantile nystagmus syndrome can be associated with an afferent problem (anterior or posterior segment) or constitute an isolated idiopathic disorder. With a normal ophthalmic examination, current guidelines recommend electroretinography (ERG) rather than magnetic resonance (MRI) for preliminary workup. Given the limited use of optical coherence tomography (OCT) in preverbal children, the purpose of this study was to evaluate the role of handheld OCT (HH-OCT) in the initial diagnostic evaluation of infantile nystagmus.</p></div><div><h3>Methods</h3><p>In this cross-sectional case series, the medical records of all children with infantile nystagmus and HH-OCT imaging at the Duke Eye Center from August 2016 to July 2021 were retrospectively reviewed. Children with anterior segment disorders or obvious retina/optic nerve structural pathology, bilateral ophthalmoplegia, or Down syndrome were excluded. Two masked pediatric ophthalmologists graded HH-OCT images for optic nerve head and macular abnormalities. A neuro-ophthalmologist reviewed clinical findings of each patient’s presenting visit and recommended appropriate testing (MRI vs ERG), initially without, and again with HH-OCT image review.</p></div><div><h3>Results</h3><p>A total of 39 cases were included, with mean presenting age of 1.3 years. Final diagnoses included retinal or foveal abnormalities (7), optic nerve pathology (13), idiopathic (10), or unknown (9). HH-OCT findings included optic nerve hypoplasia (1), optic nerve elevation (3), persistence of the inner layers at the fovea (9), thin ganglion cell layer (8), ellipsoid zone abnormality (3), and thin choroid (1). HH-OCT findings altered initial clinical-only management in 16 cases (41%), including avoiding MRI (5) and ERG (10) testing.</p></div><div><h3>Conclusions</h3><p>Our results suggest that HH-OCT has the potential to augment and streamline the evaluation of infantile nystagmus.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140873125","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 : 2024-06-01DOI: 10.1016/j.jaapos.2024.103916
Nathalie E. Perez BS , Sugi Panneerselvam MD , Ta Chen Peter Chang MD , Kara M. Cavuoto MD , Zelia Maria Correa MD, PhD , Michelle M. Falcone MD
A 4-month-old girl was referred for evaluation of an anterior chamber cyst in the left eye. Examination under anesthesia (EUA) revealed a large iris stromal cyst in the anterior chamber involving the angle and the pupillary border, with touch of the corneal endothelium and anterior lens capsule. Intraocular pressure was normal. There was no anisometropic refractive error by retinoscopy. Close observation with amblyopia management was recommended as the pupil was only partially occluded by the cyst, and there was a clear red reflex around the cyst. Repeat EUA 6 months following diagnosis showed spontaneous collapse of the cyst. There was no recurrence noted at her most recent follow-up, 2 years after presentation, and most of the pupillary axis remains unobstructed by the cyst. The patient continues to be followed to monitor for possible cyst progression, anisometropia, and development of amblyopia. Though rare, spontaneous resolution of an iris stromal cyst may occur and thus, observation may be considered, particularly if the cyst is not causing anterior segment complications or obstruction of the visual axis.
{"title":"Spontaneous collapse of an iris stromal cyst in a young child","authors":"Nathalie E. Perez BS , Sugi Panneerselvam MD , Ta Chen Peter Chang MD , Kara M. Cavuoto MD , Zelia Maria Correa MD, PhD , Michelle M. Falcone MD","doi":"10.1016/j.jaapos.2024.103916","DOIUrl":"10.1016/j.jaapos.2024.103916","url":null,"abstract":"<div><p>A 4-month-old girl was referred for evaluation of an anterior chamber cyst in the left eye. Examination under anesthesia (EUA) revealed a large iris stromal cyst in the anterior chamber involving the angle and the pupillary border, with touch of the corneal endothelium and anterior lens capsule. Intraocular pressure was normal. There was no anisometropic refractive error by retinoscopy. Close observation with amblyopia management was recommended as the pupil was only partially occluded by the cyst, and there was a clear red reflex around the cyst. Repeat EUA 6 months following diagnosis showed spontaneous collapse of the cyst. There was no recurrence noted at her most recent follow-up, 2 years after presentation, and most of the pupillary axis remains unobstructed by the cyst. The patient continues to be followed to monitor for possible cyst progression, anisometropia, and development of amblyopia. Though rare, spontaneous resolution of an iris stromal cyst may occur and thus, observation may be considered, particularly if the cyst is not causing anterior segment complications or obstruction of the visual axis.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860027","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 : 2024-06-01DOI: 10.1016/j.jaapos.2024.103905
Aaron M. Miller MD , Jonathan M. Holmes BM, BCh , Rui Wu MS , Raymond T. Kraker MSPH , Eric R. Crouch MD , Katherine A. Lee MD , Monte A. Del Monte MD , Justin D. Marsh MD , Courtney L. Kraus MD , David K. Wallace MD, MPH , Jeffrey D. Colburn MD , Pavlina S. Kemp MD , Susan A. Cotter OD, MS , Pediatric Eye Disease Investigator Group (PEDIG)
We evaluated whether doses of bilateral medial rectus recessions greater than Parks’s tables yielded superior outcomes for adult-onset divergence insufficiency. Forty-two patients underwent bilateral medial rectus recessions. Dose was analyzed as the average total per muscle (surgery + suture adjustment if performed) and compared with the standard dose tables (based on preoperative distance esodeviation), as difference between dose performed and dose indicated by Parks’s tables. Each participant was classified as having received either Parks’s dose (within 0.5 mm) or a dose greater than Parks’s dose. Success was defined as “rarely” or “never” diplopia in distance straight-ahead gaze and reading. For patients classified as success, the mean difference between actual surgical dose performed and Parks’s dose was calculated. Success was 91% (29/32) in those receiving greater than Parks’s dose versus 67% (6/9) with Parks’s dose (difference = 24%; 95% CI, −5% to 60%). The mean surgical dose was 1.0 mm greater than Parks’s tables for the 35 successes (at 10 weeks) versus 0.7 mm greater for the 6 failures (difference = 0.4 mm; 95% CI, −0.2 to 0.9). For medial rectus recessions in adult-onset divergence insufficiency-type esotropia, a surgical dose 1 mm greater than Parks’s tables, for each muscle, is a reasonable strategy.
我们评估了双侧内侧直肌凹陷的剂量是否大于帕克斯表的剂量,从而为成人发散性视力障碍带来更好的治疗效果。42 名患者接受了双侧内侧直肌凹陷手术。剂量分析为每块肌肉的平均总剂量(手术+缝合调整(如果进行)),并与标准剂量表(基于术前距离esodeviation)进行比较,以显示进行的剂量与Parks剂量表显示的剂量之间的差异。每位参与者被分为接受了 Parks 剂量(0.5 毫米以内)或接受了大于 Parks 剂量的剂量。成功的定义是 "很少 "或 "从未 "在远距离直视和阅读时出现复视。对于被归类为成功的患者,计算实际手术剂量与 Parks 剂量之间的平均差异。接受大于 Parks 剂量的成功率为 91%(29/32),而接受 Parks 剂量的成功率为 67%(6/9)(差异 = 24%;95% CI,-5% 至 60%)。35 名成功者(10 周时)的平均手术剂量比 Parks 表大 1.0 毫米,而 6 名失败者的平均手术剂量比 Parks 表大 0.7 毫米(差异 = 0.4 毫米;95% CI,-0.2 至 0.9)。对于成人发散功能不全型内斜视的内侧直肌凹陷,每块肌肉的手术剂量比Parks的表格大1毫米是一个合理的策略。
{"title":"Doses of medial rectus muscle recessions for divergence insufficiency-type esotropia","authors":"Aaron M. Miller MD , Jonathan M. Holmes BM, BCh , Rui Wu MS , Raymond T. Kraker MSPH , Eric R. Crouch MD , Katherine A. Lee MD , Monte A. Del Monte MD , Justin D. Marsh MD , Courtney L. Kraus MD , David K. Wallace MD, MPH , Jeffrey D. Colburn MD , Pavlina S. Kemp MD , Susan A. Cotter OD, MS , Pediatric Eye Disease Investigator Group (PEDIG)","doi":"10.1016/j.jaapos.2024.103905","DOIUrl":"10.1016/j.jaapos.2024.103905","url":null,"abstract":"<div><p>We evaluated whether doses of bilateral medial rectus recessions greater than Parks’s tables yielded superior outcomes for adult-onset divergence insufficiency. Forty-two patients underwent bilateral medial rectus recessions. Dose was analyzed as the average total per muscle (surgery + suture adjustment if performed) and compared with the standard dose tables (based on preoperative distance esodeviation), as difference between dose performed and dose indicated by Parks’s tables. Each participant was classified as having received either Parks’s dose (within 0.5 mm) or a dose greater than Parks’s dose. Success was defined as “rarely” or “never” diplopia in distance straight-ahead gaze and reading. For patients classified as success, the mean difference between actual surgical dose performed and Parks’s dose was calculated. Success was 91% (29/32) in those receiving greater than Parks’s dose versus 67% (6/9) with Parks’s dose (difference = 24%; 95% CI, −5% to 60%). The mean surgical dose was 1.0 mm greater than Parks’s tables for the 35 successes (at 10 weeks) versus 0.7 mm greater for the 6 failures (difference = 0.4 mm; 95% CI, −0.2 to 0.9). For medial rectus recessions in adult-onset divergence insufficiency-type esotropia, a surgical dose 1 mm greater than Parks’s tables, for each muscle, is a reasonable strategy.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871250","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 : 2024-06-01DOI: 10.1016/j.jaapos.2024.103918
Alex Christoff CO, COT
Purpose
To investigate the association of strabismic angle obtained by simultaneous prism and cover test (SPCT) and prism alternate cover test (PACT) with the final power of Press-On prism used in adults with symptomatic strabismus.
Methods
The medical records of consecutive patients seen by a single orthoptist at an urban, tertiary care hospital over a 36-month period were reviewed retrospectively. All subjects had been prescribed Press-On prism for diplopia after evaluation with SPCT and PACT measurements at distance fixation. Prism dispensed was chosen by the patient using a trial Press-On prism set.
Results
A total of 244 charts were reviewed. Of these, 108 adult patients had prism dispensed, and 32 had both SPCT and PACT measurements. Mean SPCT measurement was 7Δ (median, 6Δ; range, 3Δ-14Δ); mean PACT, 13Δ (median, 11Δ; range, 8Δ-20Δ). The mean prism power dispensed was 7Δ (median, 6Δ; range, 1Δ-15Δ); this was not significantly different from mean SPCT (P = 0.35). There was a large difference (6Δ) between mean PACT measurements and mean prism dispensed (P < 0.001). At follow-up of 1 year, 21 patients (66%) remained in prism. Nine patients (4%) elected to undergo eye muscle surgery, 7 with horizontal strabismus, 6 of whom had SPCT measurements of >10Δ and PACT measurements of >15Δ.
Conclusions
Press-On prism power used was more closely tied to the angle of strabismus obtained by SPCT. Overall success rate of Press-On prism was good when the prism power dispensed was close to the SPCT measurement, suggesting that it is reasonable to initiate treatment with a weaker prism, approximating the SPCT measurement, building up only if there are continuing symptoms.
{"title":"Comparison of simultaneous prism and cover test (SPCT) and prism and alternate cover test (PACT) measurements with final power of Press-On prism power dispensed","authors":"Alex Christoff CO, COT","doi":"10.1016/j.jaapos.2024.103918","DOIUrl":"10.1016/j.jaapos.2024.103918","url":null,"abstract":"<div><h3>Purpose</h3><p>To investigate the association of strabismic angle obtained by simultaneous prism and cover test (SPCT) and prism alternate cover test (PACT) with the final power of Press-On prism used in adults with symptomatic strabismus.</p></div><div><h3>Methods</h3><p>The medical records of consecutive patients seen by a single orthoptist at an urban, tertiary care hospital over a 36-month period were reviewed retrospectively. All subjects had been prescribed Press-On prism for diplopia after evaluation with SPCT and PACT measurements at distance fixation. Prism dispensed was chosen by the patient using a trial Press-On prism set.</p></div><div><h3>Results</h3><p>A total of 244 charts were reviewed. Of these, 108 adult patients had prism dispensed, and 32 had both SPCT and PACT measurements. Mean SPCT measurement was 7<sup>Δ</sup> (median, 6<sup>Δ</sup>; range, 3<sup>Δ</sup>-14<sup>Δ</sup>); mean PACT, 13<sup>Δ</sup> (median, 11<sup>Δ</sup>; range, 8<sup>Δ</sup>-20<sup>Δ</sup>). The mean prism power dispensed was 7<sup>Δ</sup> (median, 6<sup>Δ</sup>; range, 1<sup>Δ</sup>-15<sup>Δ</sup>); this was not significantly different from mean SPCT (<em>P</em> = 0.35). There was a large difference (6<sup>Δ</sup>) between mean PACT measurements and mean prism dispensed (<em>P</em> < 0.001). At follow-up of 1 year, 21 patients (66%) remained in prism. Nine patients (4%) elected to undergo eye muscle surgery, 7 with horizontal strabismus, 6 of whom had SPCT measurements of >10<sup>Δ</sup> and PACT measurements of >15<sup>Δ</sup>.</p></div><div><h3>Conclusions</h3><p>Press-On prism power used was more closely tied to the angle of strabismus obtained by SPCT. Overall success rate of Press-On prism was good when the prism power dispensed was close to the SPCT measurement, suggesting that it is reasonable to initiate treatment with a weaker prism, approximating the SPCT measurement, building up only if there are continuing symptoms.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870297","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 : 2024-04-01DOI: 10.1016/j.jaapos.2024.103852
Christopher M. Edwards BS , Daniel Elefant MD , Michael S. Isakoff MD , Majida A. Gaffar MD
We report the case of a 12-year-old girl with stage 4 neuroblastoma who developed tonic pupils secondary to immunotherapy with dinutuximab, an anti-GD2 antibody, based on the timeline provided by her mother with regard to onset of symptoms. The patient presented with difficulty reading and chronic dilated pupils bilaterally, according to her mother’s observations over 6 months prior to presentation. Testing with dilute pilocarpine supported our presumption of tonic pupils.
{"title":"Bilateral tonic pupils secondary to anti-GD2 antibody therapy for neuroblastoma","authors":"Christopher M. Edwards BS , Daniel Elefant MD , Michael S. Isakoff MD , Majida A. Gaffar MD","doi":"10.1016/j.jaapos.2024.103852","DOIUrl":"10.1016/j.jaapos.2024.103852","url":null,"abstract":"<div><p>We report the case of a 12-year-old girl with stage 4 neuroblastoma who developed tonic pupils secondary to immunotherapy with dinutuximab, an anti-GD2 antibody, based on the timeline provided by her mother with regard to onset of symptoms. The patient presented with difficulty reading and chronic dilated pupils bilaterally, according to her mother’s observations over 6 months prior to presentation. Testing with dilute pilocarpine supported our presumption of tonic pupils.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900819","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 : 2024-04-01DOI: 10.1016/j.jaapos.2024.103871
Shashikant Shetty MS , Marushka Aguiar MS , Gargi Shah MS , Monisha Mohan MS , P. Vijayalakshmi MS , R. Janani MS
Purpose
To analyze and compare the outcome of two different surgical procedures in patients with complete oculomotor nerve palsy with large-angle exotropia.
Methods
The medical records of patients with total oculomotor nerve palsy and large-angle exotropia operated on at a single center from January 2006 to June 2020 were reviewed retrospectively. One group underwent lateral rectus deactivation with medial rectus resection (resection group); the other group underwent lateral rectus deactivation with medial rectus fixation to the medial palpebral ligament (fixation group). Surgical outcomes on the first postoperative day and at 6 months postoperatively were analyzed, including alignment and postoperative complications. All statistical analyses were performed using STATA version 14. A P value of <0.05 was considered significant.
Results
A total of 35 patients were included. There was a trend toward greater surgical success in the fixation group (93%) than in the resection group (65%), but these results were not statistically significant. Postoperative exotropic drifts were noted in both the procedures but tended to be more with patients in the resection group. Postoperative complications were noted only in the fixation group.
Conclusions
Lateral rectus deactivation with medial rectus fixation to the medial palpebral ligament requires more time and greater surgical expertise but appears to better prevent postoperative exotropic drift compared with lateral rectus deactivation combined with medial rectus resection.
{"title":"Surgical management of oculomotor nerve palsy: a comparison of lateral rectus deactivation combined with either medial rectus resection or medial rectus fixation to the medial palpebral ligament","authors":"Shashikant Shetty MS , Marushka Aguiar MS , Gargi Shah MS , Monisha Mohan MS , P. Vijayalakshmi MS , R. Janani MS","doi":"10.1016/j.jaapos.2024.103871","DOIUrl":"10.1016/j.jaapos.2024.103871","url":null,"abstract":"<div><h3>Purpose</h3><p>To analyze and compare the outcome of two different surgical procedures in patients with complete oculomotor nerve palsy with large-angle exotropia.</p></div><div><h3>Methods</h3><p>The medical records of patients with total oculomotor nerve palsy and large-angle exotropia operated on at a single center from January 2006 to June 2020 were reviewed retrospectively. One group underwent lateral rectus deactivation with medial rectus resection (resection group); the other group underwent lateral rectus deactivation with medial rectus fixation to the medial palpebral ligament (fixation group). Surgical outcomes on the first postoperative day and at 6 months postoperatively were analyzed, including alignment and postoperative complications. All statistical analyses were performed using STATA version 14. A <em>P</em> value of <0.05 was considered significant.</p></div><div><h3>Results</h3><p>A total of 35 patients were included. There was a trend toward greater surgical success in the fixation group (93%) than in the resection group (65%), but these results were not statistically significant. Postoperative exotropic drifts were noted in both the procedures but tended to be more with patients in the resection group. Postoperative complications were noted only in the fixation group.</p></div><div><h3>Conclusions</h3><p>Lateral rectus deactivation with medial rectus fixation to the medial palpebral ligament requires more time and greater surgical expertise but appears to better prevent postoperative exotropic drift compared with lateral rectus deactivation combined with medial rectus resection.</p></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140068892","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}