{"title":"Botulinum Toxin Injection With Reduced Volume in the Absence of Electromyographic Assistance for Acute Acquired Comitant Esotropia of 25 Prism Diopters or Less.","authors":"Jianming Zheng, Bingbin Ma, Ying Wang, Tao Shen, Xinping Yu, Jingchang Chen","doi":"10.3928/01913913-20250124-03","DOIUrl":"10.3928/01913913-20250124-03","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effectiveness and safety of botulinum toxin type A (BTXA) injection with reduced volume without electromyographic guidance for the treatment of acute acquired comitant esotropia (AACE) of 25 prism diopters (PD) or less.</p><p><strong>Methods: </strong>The authors reviewed the medical records of 60 patients with AACE of 25 PD or less, including 40 patients treated with BTXA injections (BTXA group) and 20 patients treated with Fresnel prism (Fresnel prism group). Patients in the BTXA group were injected with 5 to 6.25 U of BTXA in 0.04 mL of saline into bilateral medial rectus muscles in the absence of electromyography. Patients in the Fresnel prism group wore Fresnel prisms at a minimum amount that could eliminate diplopia. Success was defined with deviations of 10 PD or less at both distance and near fixations and with resolution of diplopia.</p><p><strong>Results: </strong>In the BTXA group, the success rate of the first injection was 100% after 1 week, but decreased to 57.5% (23/40) after 6 months; the cumulative success rate of two injections was 77.5% (31/40) after 6 months; and one eye (0.93%, 1/108) had complicated mild ptosis. In the Fresnel prism group, the success rate was 5% (1/20) after 6 months of treatment. The difference in cumulative success rate between the two groups was significant (chi-square = 28.158, <i>P</i> < .01).</p><p><strong>Conclusions: </strong>BTXA injection with reduced volume in the absence of electromyography is a simple, effective, and safe modality for patients with AACE who have a small to moderate deviation. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):271-277.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"271-277"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143449838","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}
Iniya K Adhan, Jacob Martin, Tracey Strombeck, Smith Ann M Chisholm, Heather Stiff
{"title":"Neurotoxic Implications of Vincristine in Pediatric: Ophthalmology: A Case Series.","authors":"Iniya K Adhan, Jacob Martin, Tracey Strombeck, Smith Ann M Chisholm, Heather Stiff","doi":"10.3928/01913913-20250530-01","DOIUrl":"10.3928/01913913-20250530-01","url":null,"abstract":"<p><p>The authors report a retrospective case series of three pediatric patients receiving vincristine who developed varying degrees and laterality of ptosis and abduction deficits. Treatment for these patients included use of thiamine, pyridoxine, and adjusting vincristine administration. These cases add to the variability of findings and treatment of vincristine neurotoxicity. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):e51-e53.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"62 4","pages":"e51-e53"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700228","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}
{"title":"An Alternative to Medial Rectus Muscle Recession for Acute Acquired Esotropia.","authors":"Rudolph S Wagner","doi":"10.3928/01913913-20250618-01","DOIUrl":"https://doi.org/10.3928/01913913-20250618-01","url":null,"abstract":"","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"62 4","pages":"232"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700224","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}
Ilana B Friedman, Mitchell Strominger, Ronald G W Teed, Rudolph S Wagner
{"title":"Management of a Case of Dragged-Fovea Diplopia Syndrome.","authors":"Ilana B Friedman, Mitchell Strominger, Ronald G W Teed, Rudolph S Wagner","doi":"10.3928/01913913-20250423-01","DOIUrl":"https://doi.org/10.3928/01913913-20250423-01","url":null,"abstract":"","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"62 4","pages":"233-236"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700227","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}
Avery S Gold, Sarah A Weitzman, Mark Hans, Norman Medow, Jee Young Moon, Steven A Kane
{"title":"Mobile Graphic Device Vision Screening for Unilateral Amblyopia in Pediatric Patients.","authors":"Avery S Gold, Sarah A Weitzman, Mark Hans, Norman Medow, Jee Young Moon, Steven A Kane","doi":"10.3928/01913913-20250110-01","DOIUrl":"10.3928/01913913-20250110-01","url":null,"abstract":"<p><strong>Purpose: </strong>To determine whether inter-ocular brightness disparity during a self-directed video game on a mobile graphic device can effectively detect unilateral amblyopia.</p><p><strong>Methods: </strong>Forty-nine children of ages 3 to 17 years participated in this prospective, non-interventional study. A series of sample image pairs were presented on an iPad (Apple, Inc) to illustrate the concept of relative brightness. Participants subsequently wore spectacles with orthogonally polarized lenses to dissociate image pairs between eyes. The video game employed a forced-choice algorithm that varied relative brightness disparity between image pairs in a stepwise manner. Participants chose the brighter of each pair of images until the end point of equal brightness was detected. The game was repeated to assess consistency. Eye examination records with acuities measured in logarithm of the minimum angle of resolution units were subsequently reviewed to compare with the video game results.</p><p><strong>Results: </strong>The study had a mean game time of 108 seconds. Inter-ocular brightness disparity greater than 0.3 log units indicated a relative afferent brightness sense defect. The video game detected unilateral amblyopia with 88% sensitivity and 95% specificity. The positive predictive value was 78% and the negative predictive value was 98%.</p><p><strong>Conclusions: </strong>This iPad video game can be played by children at least as young as 3 years of age. Inter-ocular brightness disparity is a sensitive and specific sign of unilateral amblyopia in a general pediatric population. The non-threatening nature and engaging format of this video game make it a promising and accessible method for early amblyopia screening. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):245-251.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"245-251"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450348","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}
Jannis A Koulalis, Pieter Nelis, Wilfried Cools, Fatma Tezcan, Robert W Kuijpers
{"title":"The Short-term Effect of Atropine 0.1% on the Axial Length and Choroid of Children Treated for Myopia Progression Prevention, Measured by Optical Coherence Tomography Angiography.","authors":"Jannis A Koulalis, Pieter Nelis, Wilfried Cools, Fatma Tezcan, Robert W Kuijpers","doi":"10.3928/01913913-20250124-01","DOIUrl":"10.3928/01913913-20250124-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the short-term effect of atropine to better understand its mechanism of action in myopia prevention. The current study investigates whether atropine's effect on the axial length arises from an increase in choroidal thickness using swept-source optical coherence tomography angiography (OCTA).</p><p><strong>Methods: </strong>Twenty-five myopic children (25 eyes) (9 boys and 16 girls; mean age: 11.8 years, range: 7 to 15 years) were enrolled following documented myopia progression and axial length increase in the preceding 6 months. Using swept-source OCTA, choroidal thickness and choroidal stromal volume (CSV) were measured at baseline and after 1 month of daily atropine 0.1% use. Axial length measurements were taken on the same days.</p><p><strong>Results: </strong>Following 1 month of daily atropine 0.1% instillation, choroidal thickness increased from 284.24 ± 65.05 to 308.04 ± 70.65 µm (Δ 22.41 ± 4.20 µm, <i>P</i> < .01), CSV increased from 11.88 ± 5.20 to 12.96 ± 5.86 mm<sup>3</sup> (Δ 1.08 ± 1.02 mm<sup>3</sup>, <i>P</i> < .01), and axial length decreased from 25.37 ± 1.21 to 25.33 ± 1.21 mm (Δ 0.044 ± 0.016 mm, <i>P</i> < .05). The CSV and choroidal thickness increase show a negative correlation with the axial length decrease of -0.462 and -0.374, respectively, demonstrating a weak to moderate correlation.</p><p><strong>Conclusions: </strong>One month of daily atropine 0.1% eye drop administration results in an acute decrease in axial length concurrent with an increase in choroidal thickness and CSV. A direct cause-and-effect relationship between these two parameters is plausible. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):265-270.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"265-270"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450534","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}
{"title":"Globe Volume Asymmetry After Intra-arterial Chemotherapy for Retinoblastoma.","authors":"Hartej Singh, Deepthi E Kurian, Carol L Shields","doi":"10.3928/01913913-20250520-01","DOIUrl":"10.3928/01913913-20250520-01","url":null,"abstract":"<p><p>Retinoblastoma, a potentially fatal pediatric intraocular malignancy, is now curable with intravenous and intra-arterial (IAC) chemotherapy. In this report, the authors describe globe volume asymmetry, a lesser-known sequela of IAC, as well as the hemodynamics of a tumor-laden eye, pattern of eyeball growth following IAC, and potential mechanisms of amblyopia in retinoblastoma survivors. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):e46-e50.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"62 4","pages":"e46-e50"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144700226","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}
{"title":"One-Year Results of 0.01% and 0.05% Atropine Eye Drops in Childhood Myopia Progression.","authors":"Sibel Coşkun Akdemir, Irfan Akalın, Betul Önal Günay","doi":"10.3928/01913913-20250227-07","DOIUrl":"10.3928/01913913-20250227-07","url":null,"abstract":"<p><strong>Purpose: </strong>To compare 0.01% and 0.05% atropine eye drops with every other day treatment for slowing myopia progression in children.</p><p><strong>Methods: </strong>Children aged 5 to 15 years who had myopia of -1.00 to 8.00 diopters (D), astigmatism less than -2.50 D, and myopic progression of at least 1.00 D in the past year were included in the retrospective study. The 0.01% and 0.05% atropine eye drops were applied every other day. At each visit, all patients underwent complete ophthalmic examination including cycloplegic refraction, axial length (AL), and photopic-mesopic pupil sizes. Spherical equivalent (SE), AL, and photopicmesopic pupil sizes were evaluated.</p><p><strong>Results: </strong>In total, 92 eyes of 46 patients were included in the study (22 in the 0.01% atropine group and 24 in the 0.05% atropine group). At the end of the 12-month follow-up period, the mean SE changes were -0.41 ± 0.28 and -0.19 ± 0.22 D in the 0.01% and 0.05% atropine groups, respectively (<i>P</i> < .001). The AL changes were 0.19 ± 0.16 and 0.16 ± 024 mm in the 0.01% and 0.05% atropine groups, respectively (<i>P</i> = .52). Side effects such as photophobia and blurred near vision were not observed in the 0.01% atropine group, but in the 0.05% atropine group, photophobia was observed in 3(12.5%) cases and blurred near vision was observed in 8 (33%) cases.</p><p><strong>Conclusions: </strong>The 0.01% and 0.05% atropine eye drops significantly slowed the progression of myopia with every other day use. The 0.01% atropine was better tolerated than 0.05% atropine. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):297-302.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"297-302"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711946","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}
{"title":"Effects of Orthokeratology in Patients With Convergence Insufficiency Exophoria and Myopia.","authors":"Yuelan Feng, Guangjiang Wang, Yuangyuan Wang, Xueming Liang, Yongsun Wang, Wei Zhang","doi":"10.3928/01913913-20250110-03","DOIUrl":"10.3928/01913913-20250110-03","url":null,"abstract":"<p><strong>Purpose: </strong>To observe and analyze the effects of orthokeratology in patients with convergence insufficiency, exophoria, and myopia.</p><p><strong>Methods: </strong>Thirty patients (60 eyes) between 8 and 15 years old with myopia and convergence insufficiency exophoria treated with orthokeratology at the First Affiliated Hospital of the Baotou Medical College from December 2022 to December 2023 were prospectively enrolled. General information was gathered and examinations were performed at baseline and at 2 weeks and 1, 3, and 6 months after switching to orthokeratology lenses. Examinations included assessments of distance/near visual acuity, near point of convergence, distance and near horizontal phoria, near positive fusional vergence, and monocular amplitude of accommodation.</p><p><strong>Results: </strong>The median age of the participants was 10 years (range: 8 to 15 years), and 40% were female. The baseline refractive error was -2.00 diopters (D) (range: -4.00 and -1.00 D). After 6 months of treatment, we found statistically significant differences in near point of convergence (95% confidence interval: -13.99 to -8.67), positive fusional vergence (95% confidence interval: 15.32 to 11.42), and monocular amplitude of accommodation (95% confidence interval: 6.62 to 4.51) compared with baseline. In addition, the mean pretreatment near horizontal phoria decreased from 6.83 ± 1.44 to -4.90 ± 1.29 prism diopters after the 6 months of treatment (95% confidence interval: -2.92 to -0.94).</p><p><strong>Conclusions: </strong>This study showed that the use of orthokeratology lenses with an increased compression factor of 1.75 D may improve near point of convergence, positive fusional vergence, and monocular amplitude of accommodation for the treatment of convergence insufficiency with myopia. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):252-257.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"252-257"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450023","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}
{"title":"Therapeutic Effect Observation of Surgery on Congenital Fibrovascular Pupillary Membrane.","authors":"Zheng Shao, Feijia Xie, Yusen Huang","doi":"10.3928/01913913-20250227-06","DOIUrl":"10.3928/01913913-20250227-06","url":null,"abstract":"<p><strong>Purpose: </strong>To retrospectively analyze the clinical characteristics and therapeutic outcomes of congenital fibrovascular pupillary membrane (CFPM).</p><p><strong>Methods: </strong>Twelve children (13 eyes) diagnosed as having CFPM between November 2017 and January 2024 in Qingdao Eye Hospital were retrospectively reviewed. Basic information and ophthalmic examination results were analyzed. Different treatment outcomes were monitored. Pathological analysis was performed using hematoxylin-eosin staining.</p><p><strong>Results: </strong>Three eyes (25%) received conservative treatment, whereas 10 eyes (83.3%) underwent membranectomy. Compared to fellow eyes, the affected eyes exhibited increased central corneal and lens thickness, with decreased central anterior chamber depth (all <i>P</i> < .05). No significant difference was observed in mean preoperative intraocular pressure between the affected and fellow eyes, both within normal range. The median best corrected visual acuity (BCVA) for non-surgical cases was 0.9 llogarithm of the minimum angle of resolution (og-MAR) (Snellen equivalent of 0.125) with miosis. Surgical treatment improved the natural pupil size and median BCVA to 0.4 logMAR (Snellen equivalent of 0.4). Postoperative amblyopia was 100% and 33.3% in patients who underwent surgery after age 3 years and at or before 3 years, respectively (<i>P</i> = .035). No surgery-induced cataracts or recurrence in cases of unilateral involvement was noted. Histopathological analysis revealed that the excised tissue consisted of proliferative fibrous and vascular tissues with infiltrated inflammatory cells.</p><p><strong>Conclusions: </strong>Affected eyes in CFPM exhibit a thickened cornea and lens with a shallow anterior chamber, typically without glaucoma. Surgery is a safe and effective treatment with low recurrence and fewer complications compared to limited conservative treatment. Performing surgery before age 3 years reduces amblyopia risk. CFPM may be linked to chronic inflammation from incomplete degeneration of fetal eye vasculature. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(4):286-296.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"286-296"},"PeriodicalIF":1.0,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711952","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}