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":"https://doi.org/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>. 20XX;X(X):XXXXXX.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","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}
Hadar K Shimshon, Jasmine H Francis, David H Abramson
{"title":"Bilateral Familial Retinoblastoma and Bilateral Familial Aniridia.","authors":"Hadar K Shimshon, Jasmine H Francis, David H Abramson","doi":"10.3928/01913913-20250124-02","DOIUrl":"https://doi.org/10.3928/01913913-20250124-02","url":null,"abstract":"","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"2"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450830","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":"https://doi.org/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>. 20XX;X(X):XXX-XXX.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","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}
Sandra C Ganesh, Rebecca Claire Lusobya, Jogitha, Shilpa G Rao, Muhammed Sithiq Uduman, Renuka Devi, Kalpana Narendran
{"title":"An Analysis of Treatment Success of Acute Acquired Comitant Esotropia With a Single Injection of Botulinum Toxin A: An Observational Case Series Study.","authors":"Sandra C Ganesh, Rebecca Claire Lusobya, Jogitha, Shilpa G Rao, Muhammed Sithiq Uduman, Renuka Devi, Kalpana Narendran","doi":"10.3928/01913913-20250110-04","DOIUrl":"https://doi.org/10.3928/01913913-20250110-04","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the efficacy of a single dose of botulinum toxin A injection into the medial rectus muscle to treat acute acquired concomitant esotropia (AACE).</p><p><strong>Methods: </strong>This observational case series study included patients diagnosed as having AACE from January 2021 to December 2023 at a tertiary eye care center in South India willing to undergo botulinum toxin injections as the first treatment who experienced sudden-onset esotropia with diplopia. Their demographics, duration of symptoms, and visual acuity were recorded. Orthoptic evaluations, including measurement of esodeviation (prism cover test) for distance and near fixation, assessment of binocularity (Worth 4-dot test), anterior and posterior segment evaluations, and cycloplegic refraction, were conducted for all cases. Neurological examinations and relevant imaging studies were performed. All participants received a predetermined botulinum toxin A dose injected into the medial rectus muscle. Evaluations were conducted at 1 week, 1, 3, and 6 months, and 1 year after injection. Main outcome measures were ocular deviation and restoration of binocularity after botulinum toxin A injection. Motor success after injection was defined as angle of deviation less than 8 prism diopters of esotropia and sensory success as absence of diplopia.</p><p><strong>Results: </strong>A total of 72 patients were included in the study. Their mean age was 10.39 ± 5.73 years (range: 2 to 24 years) and 49 (68.1%) were male and 23 (31.9%) were female. Forty-nine (63.88%) had emmetropia, 7 (9.7%) had myopia, and 19 (26.38%) had hyperopia. After injection, the percentage of patients experiencing diplopia reduced from 79.2% at presentation (n = 57) to 18.6% at 1 week after injection (n = 13), 4.9% at 1 month after injection (n = 3), 2.2% at 3 months after injection (n = 1), and none at 6 months and 1 year after injection. Forty-two (58.3%) patients for distance and 41 (56.9%) for near attained motor and sensory success as early as 1 week after injection. Of the 28 patients who attended follow-up visits more than 1 year after injection, 85.7% maintained both motor and sensory success.</p><p><strong>Conclusions: </strong>Botulinum toxin A is an effective first-line treatment for patients with AACE. It provides sustainable motor and sensory restoration, faster rehabilitation, and reduced need for invasive surgery in at least two-thirds of patients. <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":"1-8"},"PeriodicalIF":1.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450829","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}
Betul Tugcu, Humeyra Yildirim, Merve Sena Kunduracı, Ersin Akbulut, Bilge Araz Ersan
{"title":"Botulinum Toxin A for Management of Consecutive Exotropia: Factors Affecting Treatment Success.","authors":"Betul Tugcu, Humeyra Yildirim, Merve Sena Kunduracı, Ersin Akbulut, Bilge Araz Ersan","doi":"10.3928/01913913-20250117-02","DOIUrl":"https://doi.org/10.3928/01913913-20250117-02","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the efficacy of botulinum toxin type A injection as a re-treatment procedure in patients with consecutive exotropia.</p><p><strong>Methods: </strong>The medical records of 34 patients who underwent botulinum toxin type A injection for consecutive exotropia were retrospectively reviewed. Five units of botulinum toxin type A was applied to the unilateral lateral rectus muscle, and the injection was administered under electromyography guidance. Successful motor alignment was defined as a far deviation within 10 prism diopters (PD).</p><p><strong>Results: </strong>A total of 34 patients were included in the study. Twenty-six patients (76.5%) had acquired esotropia and 8 patients (23.5%) had infantile esotropia. The average age of the patients was 169 ± 88.9 months. The mean time elapsed between the last surgery and botulinum toxin injection was 67.8 ± 78 months. The mean before botulinum toxin type A injection deviation was 20.03 ± 8.42 PD at near and 21.41 ± 8.87 PD at distance. The deviation after botulinum toxin type A injection was 9.65 ± 7.42 PD at near and 10.82 ± 7.33 PD at distance. All patients were followed up for 19.8 ± 20 months. The average number of injections was 1.6 ± 1.1. The final success rate was 73.5%. The first month's near deviation was significantly associated with treatment success (<i>P</i> = .012). Post-injection fusion potential had a weak association with the 6-month and overall treatment success (<i>P</i> = .073 and .057, respectively).</p><p><strong>Conclusions: </strong>The results of this study demonstrate that botulinum toxin type A injection can be an effective, safe treatment option in consecutive exotropia. <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":"143450831","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 A Augmentation of Strabismus Surgery for Large-Angle Strabismus: A Retrospective Case Series and Literature Review.","authors":"Funda Dikkaya Çiçek, Sevil Karaman Erdur S, Nisa Karaaslan","doi":"10.3928/01913913-20240708-01","DOIUrl":"10.3928/01913913-20240708-01","url":null,"abstract":"<p><strong>Purpose: </strong>To report the results of botulinum toxin A (BTA)-augmented bilateral recession or monocular recession/resection surgery in a case series of patients with large-angle strabismus and review the relevant literature.</p><p><strong>Methods: </strong>This retrospective study reviewed the medical records of 24 patients treated with BTA-augmented strabismus surgery for large-angle horizontal strabismus (55 prism diopters or greater) with a minimum 6-month follow-up. Patients underwent unilateral recession-resection or bilateral rectus muscle recession surgery with intraoperative BTA injection into the recessed muscle(s). Main outcome measures were postoperative angle of deviation and success rate, defined as a final deviation of 10 prism diopters or less.</p><p><strong>Results: </strong>Of 24 patients (20 esotropia, 4 exotropia), the mean age was 9.2 years (range: 1 to 64 years). Mean preoperative deviation was 61.2 prism diopters for esotropia and 66.2 prism diopters for exotropia. Mean final postoperative deviation was 6.6 prism diopters for esotropia and 14.5 prism diopters for exotropia. Successful outcomes were achieved in 75% of patients with esotropia and 50% of patients with exotropia.</p><p><strong>Conclusions: </strong>BTA augmentation of conventional strabismus surgery dosages is a promising approach for managing large-angle strabismus, particularly esotropia. Optimal patient selection and follow-up are needed to maximize surgical success rates. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(1):5-11.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"5-11"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141983764","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 Analysis of Pediatric Ophthalmology Content on Instagram.","authors":"Rucha K Borkhetaria, Amanda L Ely","doi":"10.3928/01913913-20240926-03","DOIUrl":"10.3928/01913913-20240926-03","url":null,"abstract":"<p><strong>Purpose: </strong>To analyze pediatric ophthalmology-related information on Instagram (Meta Platforms, Inc).</p><p><strong>Methods: </strong>A cross-sectional study queried 112 common eye terms and conditions from the American Association for Pediatric Ophthalmology and Strabismus website as hashtags on Instagram. A categorical classification system was used to analyze the top 9 posts per hashtag for likes, comments, views, and engagement level ratio (ELR). Posts were further characterized by author and content type.</p><p><strong>Results: </strong>Analysis of the top 901 posts that met our inclusion criteria revealed a cumulative 424,608 likes, 15,793 comments, and 2,873,042 views. Authors had a total of 76,076,455 followers. Patients/families created the greatest number of posts (37.6%), followed by companies (20.2%), other (14.9%), medical organizations (12.3%), international ophthalmologists (6.1%), optometrists (5.9%), and American Board of Ophthalmology-certified ophthalmologists (3.0%). Content was mostly patient experience (42.4%), followed by educational (29.7%), self-promotional (13.5%), other (10.5%), and career-related (3.8%). Companies authored the highest number of educational posts (23.5%), followed by medical institutions (20.9%), other (19.4%), international ophthalmologists (13.8%), optometrists (13.4%), and American Board of Ophthalmology-certified ophthalmologists (4.5%) and patients (4.5%).</p><p><strong>Conclusions: </strong>Although pediatric ophthalmology content presented by board-certified ophthalmology Instagram authors had a greater number of followers than most other author categories, ophthalmologist authors on Instagram are still underrepresented. Additional research is warranted to help promote ophthalmologist-authored posts. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(1):50-56.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"50-56"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512103","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":"Should Parents Rely on YouTube for Valuable Information on Retinopathy of Prematurity?","authors":"Leonard B Nelson","doi":"10.3928/01913913-20250102-01","DOIUrl":"https://doi.org/10.3928/01913913-20250102-01","url":null,"abstract":"","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":"62 1","pages":"4"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025637","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}
Hajar Farvardin, Fatemeh Safari, Farima Safari, Hadi Farvardin, Majid Farvardin
{"title":"Y-split Recession of Lateral Rectus With and Without Medial Rectus Recession in the Management of Exotropic Duane Retraction Syndrome With Significant Overshoot and Retraction.","authors":"Hajar Farvardin, Fatemeh Safari, Farima Safari, Hadi Farvardin, Majid Farvardin","doi":"10.3928/01913913-20241105-05","DOIUrl":"10.3928/01913913-20241105-05","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the effectiveness of two surgical approaches in the management of exotropic Duane retraction syndrome (DRS) cases with significant overshoot and retraction.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on patients with exotropic DRS who experienced significant overshoot and globe retraction. Patients with incomplete medical records or previous strabismus surgery were excluded. Overshoot and retraction were graded on a scale of 1 to 3. Surgical outcomes were assessed based on exotropia correction, head turn correction, leash correction, and globe retraction correction.</p><p><strong>Results: </strong>Twenty-one patients with unilateral type III exotropic DRS were included in the study. The Y-split recession of the lateral rectus muscle (LR) group comprised 13 patients who underwent Y-split recession of the LR alone and the Y-split recession of LR + ipsilateral MR recession group consisted of 8 patients who underwent Y-split LR recession combined with medial rectus (MR) recession. The average of exotropia and head turn correction was higher in the Y-split recession of LR group (15.76 prism diopters [PD], 18.46°) compared with the Y-split recession of LR + ipsilateral MR recession group (11.12 PD, 12.12°). On the other hand, the Y-split recession of the LR + ipsilateral MR recession group exhibited higher mean correction grades for leash and retraction (2.63 and 2.5, respectively) compared to the Y-split recession of LR group (2.31 and 1.92, respectively).</p><p><strong>Conclusions: </strong>Both surgical approaches showed promising results in managing exotropic DRS cases with significant overshoot and retraction. Y-split LR recession combined with MR recession could possibly be a better surgical option in cases where severe retraction and overshoot are the main issues. Further investigations with larger sample sizes are necessary to validate these findings and determine the optimal surgical approach. <b>[<i>J Pediatr Ophthalmol Strabismus</i>. 2025;62(1):67-74.]</b>.</p>","PeriodicalId":50095,"journal":{"name":"Journal of Pediatric Ophthalmology & Strabismus","volume":" ","pages":"67-74"},"PeriodicalIF":1.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774203","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}