Journal of Pediatric Ophthalmology & Strabismus最新文献

{"title":"Ocular Cystinosis Experience in Southwestern Ontario.","authors":"Edward Tran, Inas Makar, Joanne Grimmer, Sapna Sharan","doi":"10.3928/01913913-20241001-02","DOIUrl":"10.3928/01913913-20241001-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate ocular treatment adherence and its impact on clinical outcomes in patients with cystinosis in southwestern Ontario, where the disease incidence is higher due to a founder effect in the Old Order Amish population.</p><p><strong>Methods: </strong>This was a retrospective case series of patients with ocular cystinosis seen at Victoria Hospital and the Ivey Eye Institute at St Joseph's Health Care in London, Ontario, Canada, from 2008 to 2023. The authors investigated the demographics, ocular manifestations, and visual outcomes and characteristics in pediatric patients with ocular cystinosis. They also conducted qualitative analysis to characterize medication compliance and identify treatment barriers to compliance.</p><p><strong>Results: </strong>This study included 14 patients with ocular cystinosis. In southwestern Ontario, the incidence of cystinosis is approximately 1 in 4,700 live births. Most patients were Old Order Amish, with a family history of cystinosis and consanguineous parents. During treatment, patients were typically asymptomatic, but photophobia was the most reported symptom. Slit-lamp examination revealed cystine crystals in the cornea of all patients; however, best corrected visual acuity and intraocular pressure were unremarkable in every case. A Fisher's exact test revealed a trend toward lower compliance in Amish patients compared to non-Amish patients (odds ratio: 0.067, <i>P</i> = .103). Significant treatment barriers for patients with ocular cystinosis were identified, including compliance issues with frequent eye drop regimens, educational and financial burdens, and geographical and cultural challenges, all impacting patient care and follow-up.</p><p><strong>Conclusions: </strong>This study highlights the need for improved strategies to improve treatment compliance and overcome barriers to care for patients with ocular cystinosis, particularly within the Old Order Amish population in southwestern Ontario, to ensure better clinical outcomes and quality of life. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(2):105-115.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"105-115"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774110","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":"Atypical Ophthalmological Manifestations of Claes-Jensen Syndrome Without Intellectual Disability: A Case Report.","authors":"Felipe A Murati, Juan B Yepez, Michele Petitto, Igor Kozak, J Fernando Arevalo","doi":"10.3928/01913913-20250227-02","DOIUrl":"10.3928/01913913-20250227-02","url":null,"abstract":"<p><p>An 8-year-old boy with prenatal-onset short stature, ophthalmological abnormalities, and dysmorphic features had a KDM5C variant typically linked to Claes-Jensen syndrome with intellectual disability, which he did not have. This atypical presentation highlights the importance of ophthalmological assessments in X-linked syndromes with variable expressivity, even without classic features. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(2):e22-e26.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"62 2","pages":"e22-e26"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694284","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":"Addressing Inquiries About the Management of Retinopathy of Prematurity.","authors":"Rudolph S Wagner","doi":"10.3928/01913913-20250220-01","DOIUrl":"https://doi.org/10.3928/01913913-20250220-01","url":null,"abstract":"","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"62 2","pages":"80"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143694283","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":"The Relationship of Serum Diabetes Antibodies With the Development of Early Diabetic Retinopathy Findings in Children With Type 1 Diabetes Mellitus.","authors":"Hüseyin Anıl Korkmaz, Beyza Dogan, Ali Devebacak, Cumali Değirmenci, Filiz Afrashi","doi":"10.3928/01913913-20241121-03","DOIUrl":"10.3928/01913913-20241121-03","url":null,"abstract":"<p><strong>Purpose: </strong>To explore how serum diabetes autoantibodies are related to the development of early diabetic retinopathy in children with type 1 diabetes mellitus.</p><p><strong>Methods: </strong>In this prospective and observational study, 62 patients with type 1 diabetes mellitus who had not yet developed clinical diabetic retinopathy were followed up for at least 5 years. Healthy volunteers aged 10 to 20 years were also included. Insulin, pancreatic islet cells, and glutamic acid decarboxylase (GAD) autoantibodies were measured with an RIA kit at the time of type 1 diabetes mellitus diagnosis. Optical coherence tomography angiography (OCTA) was used to evaluate the foveal avascular zone (FAZ) and parafoveal vascular density (PVD) for the development of early diabetic retinopathy among the groups. Patients' OCTA findings were compared with those of healthy volunteers. The obtained data were analyzed via IBM SPSS Statistics for Windows, version 27.0. Spearman's rank correlation test and regression analysis were performed to determine independent predictors of OCTA and type 1 diabetes mellitus parameters.</p><p><strong>Results: </strong>Eighteen boys and 44 girls with type 1 diabetes mellitus with a median age of 15.6 years (range: 10.08 to 20.88 years) were evaluated. Healthy control participants with a median age of 15.3 years (range: 14.2 to 18.2 years) were also included. The mean FAZ was greater in the type 1 diabetes mellitus group than in the healthy control group (<i>P</i> = .013 and .119, respectively). The mean PVD was significantly lower in the type 1 diabetes mellitus group than in the healthy control group. There was no significant correlation between serum diabetes autoantibodies (GAD and insulin autoantibodies) and FAZ or PVD (FAZ and GAD; <i>r</i> = 0.138, <i>P</i> = .286, FAZ and anti-insulin; <i>r</i> = 0.100, <i>P</i> = .441, PVD and GAD; <i>r</i> = -0.151, <i>P</i> = .24, PVD and anti-insulin; <i>r</i> = -0.087, <i>P</i> = .499).</p><p><strong>Conclusions: </strong>Type 1 diabetes mellitus in children without clinically detectable diabetic retinopathy is associated with impaired retinal microcirculation and irregularities at the FAZ margin. Impaired retinal microcirculation and irregularities were associated with glycated hemoglobin levels in the study group. Thus, studies with larger patient series are needed. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(2):135-142.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"135-142"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923813","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":"Evaluation of the PlenOptika QuickSee Free Portable Autorefractor in Schools in The Gambia.","authors":"Alex Loayza, Alston Lewis, Sheila Chamberlin, Rupal Trivedi, Bethany Wolf, M Millicent Peterseim","doi":"10.3928/01913913-20241105-03","DOIUrl":"10.3928/01913913-20241105-03","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the ability of the monocular QuickSee Free (QSF) portable autorefractor (PlenOptika) to detect and measure refractive error relative to gold standard cycloplegic retinoscopy in a population of school-aged children in a low-resource setting in The Gambia.</p><p><strong>Methods: </strong>A total of 101 children, aged between 3 and 17 years (10.2 ± 3.45 years) underwent visual acuity screening, autorefraction by the QSF, and complete ophthalmic examination including cycloplegic retinoscopy. The agreement of the results was evaluated by Bland-Altman plots. The sensitivity and specificity of detecting myopia, anisometropia, and astigmatism were calculated based on the American Association for Pediatric Ophthalmology and Strabismus (AAPOS) 2021 guidelines. The overall accuracy of detecting refractive error was analyzed with receiver operating characteristic curves.</p><p><strong>Results: </strong>Spherical equivalent (SE), sphere, and cylinder of the QSF all displayed moderate interclass correlation with cycloplegic retinoscopy with cylinder correlating the highest with physician measurements followed by SE, then sphere. The average bias for the QSF was slightly negative for sphere and spherical equivalents, indicating that on average the QSF tended to underestimate these measures relative to physicians. Based on AAPOS 2021 guidelines, the sensitivity and specificity (in respective order) were 62% and 93% for detecting myopia, 57% and 86% for detecting anisometropia, and 78% and 95% for detecting astigmatism. The area under the receiver operating characteristic curve was greater than 0.75 for all three conditions, suggesting the QSF has good predictive ability to detect myopia, anisometropia, and astigmatism.</p><p><strong>Conclusions: </strong>The QSF displayed moderate agreement with physician reported refractions and it also tended to underestimate spherical equivalents and sphere. The device exhibited high predictability in detecting refractive error in the low-resource setting. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(2):122-127.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"122-127"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142773921","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":"Ophthalmic Artery Chemosurgery for Optic Nerve Invasion in Retinoblastoma.","authors":"David H Abramson, Y Pierre Gobin, Jasmine H Francis","doi":"10.3928/01913913-20240508-09","DOIUrl":"10.3928/01913913-20240508-09","url":null,"abstract":"","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"150"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181305","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":"Assessing the Responses of Large Language Models (ChatGPT-4, Claude 3, Gemini, and Microsoft Copilot) to Frequently Asked Questions in Retinopathy of Prematurity: A Study on Readability and Appropriateness.","authors":"Serhat Ermis, Ece Özal, Murat Karapapak, Ebrar Kumantaş, Sadık Altan Özal","doi":"10.3928/01913913-20240911-05","DOIUrl":"10.3928/01913913-20240911-05","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the appropriateness and readability of responses provided by four large language models (LLMs) (ChatGPT-4, Claude 3, Gemini, and Microsoft Copilot) to parents' queries pertaining to retinopathy of prematurity (ROP).</p><p><strong>Methods: </strong>A total of 60 frequently asked questions were collated and categorized into six distinct sections. The responses generated by the LLMs were evaluated by three experienced ROP specialists to determine their appropriateness and comprehensiveness. Additionally, the readability of the responses was assessed using a range of metrics, including the Flesch-Kincaid Grade Level (FKGL), Gunning Fog (GF) Index, Coleman-Liau (CL) Index, Simple Measure of Gobbledygook (SMOG) Index, and Flesch Reading Ease (FRE) score.</p><p><strong>Results: </strong>ChatGPT-4 demonstrated the highest level of appropriateness (100%) and performed exceptionally well in the Likert analysis, scoring 5 points on 96% of questions. The CL Index and FRE scores identified Gemini as the most readable LLM, whereas the GF Index and SMOG Index rated Microsoft Copilot as the most readable. Nevertheless, ChatGPT-4 exhibited the most intricate text structure, with scores of 18.56 on the GF Index, 18.56 on the CL Index, 17.2 on the SMOG Index, and 9.45 on the FRE score. This suggests that the responses demand a college-level comprehension.</p><p><strong>Conclusions: </strong>ChatGPT-4 demonstrated higher performance than other LLMs in responding to questions related to ROP; however, its texts were more complex. In terms of readability, Gemini and Microsoft Copilot were found to be more successful. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(2):84-95.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"84-95"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512104","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":"Comparison of Botulinum Toxin A Injection and Bridge Faden Operation Performed With Bimedial Rectus Recession in Patients With Large-Angle Esotropia.","authors":"Aslı Inal, Alev Koçkar, Didem Dizdar Yiğit","doi":"10.3928/01913913-20241121-02","DOIUrl":"10.3928/01913913-20241121-02","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the results of botulinum toxin A injection and bridge Faden operation performed with bimedial rectus recession in the treatment of large-angle esotropia.</p><p><strong>Methods: </strong>The medical charts of patients with large-angle esotropia who underwent bimedial rectus recession combined with the Faden operation or botulinum toxin A injection between January 2018 and March 2022 were retrospectively screened. The degree of deviations measured before surgery and at 1, 3, 6, and 12 months after surgery were compared between the two groups.</p><p><strong>Results: </strong>The sample consisted of 26 patients, of whom 15 (57.7%) were male and 11 (42.3%) were female. In the botulinum toxin A group (n = 11), the mean age was 42.1 ± 22.6 months at admission and 65.3 ± 17.1 months at surgery, and the mean preoperative near and far distance deviations were 49.8 ± 8.4 and 44.3 ± 9.4 PD, respectively. In the Faden group (n = 15), the mean age was 54.9 ± 21.7 months at admission and 71.3 ± 12.6 months at surgery, and the mean preoperative deviations at near and far distances were 49.3 ± 11.2 and 44.3 ± 9.2 PD, respectively. The complete success rates of the botulinum toxin A and Faden groups evaluated 12 months after treatment were 63.6% and 66.7%, respectively, for the near distance deviation and 72.7% and 73.3%, respectively, for the far distance deviation. After the botulinum toxin A injection, 2 patients developed transient ptosis and 1 developed consecutive exotropia.</p><p><strong>Conclusions: </strong>As an alternative to multi-muscle surgery in large-angle esotropia, botulinum toxin A injection and Faden procedures, performed with bilateral medial rectus recession, provide successful results. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(2):128-134.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"128-134"},"PeriodicalIF":1.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923804","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":"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":"https://doi.org/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>. 20XX;X(X):XXX-XXX.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","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}

{"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":"https://doi.org/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>. 20XX;X(X):XXX-XXX.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","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}