Journal of Aapos最新文献

{"title":"Unilateral uveitic congenital cataract caused by Spiroplasma ixodetis.","authors":"Vesna Cvitković Špik, Tina Triglav, Petra Kmetič, Patricija Pozvek, Miša Korva, Darja Keše, Miroslav Petrovec, Manca Tekavčič Pompe","doi":"10.1016/j.jaapos.2026.105325","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.105325","url":null,"abstract":"<p><p>Congenital cataract and uveitis caused by Spiroplasma ixodetis are rare, with only a small number of cases reported worldwide. We report 2 infants with unilateral uveitic congenital cataracts. Both underwent lensectomy and anterior vitrectomy, received intracameral antibiotics, and were postoperatively treated with a topical corticosteroid-antibiotic regimen. Routine microbiological tests were negative, but 16S rRNA PCR detected S. ixodetis in the vitreous and lens. Identification was confirmed by partial sequencing of the Mollicutes 16S-23S rRNA intergenic spacer region and a species-specific real-time PCR targeting rpoB gene of S. ixodetis. Targeted assays for S. ixodetis can be incorporated into the diagnostic work-up of neonatal uveitic congenital cataract. Recognizing this rare etiology can help optimize antimicrobial therapy and supports further studies of the clinical significance of S. ixodetis.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105325"},"PeriodicalIF":1.3,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217287","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":"Concentric macular rings: ultrawide-field biomarker in pediatric albinism.","authors":"Marta Caminal-Caramés, Jaume Català Mora, Jesus Díaz-Cascajosa, Eduard Pedemonte Sarrias","doi":"10.1016/j.jaapos.2026.105322","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.105322","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the prevalence and clinical relevance of the concentric macular rings (CMR) sign on ultrawide-field (UWF) imaging as a noninvasive marker of foveal hypoplasia (FH) in pediatric patients with albinism, in whom optical coherence tomography (OCT) acquisition is limited by nystagmus and poor fixation.</p><p><strong>Methods: </strong>The medical records of pediatric patients with albinism who underwent UWF imaging, green-filter UWF, and OCT were reviewed retrospectively. CMR presence, morphology and size were assessed using standard UWF imaging, green-filter, and red-filter modalities. Best-corrected visual acuity (BCVA), cycloplegic refraction, FH grade, macular pigmentation, genetic mutations, and associated features (nystagmus, strabismus) were analyzed.</p><p><strong>Results: </strong>A total of 128 eyes of 64 patients (mean patient age, 11.3 years; 55% males) were analyzed. Mean BCVA was 0.5 logMAR; and 62.5% of eyes had nystagmus. FH stages 3 and 4 were observed in 48.3% and 45.7% of eyes, respectively. CMR sign was identified in 70.4% on UWF retinography and in 75% using the green filter. Mean largest ring diameter was 3.4 ± 1.05 mm; median ring count was 10 per eye. Interobserver agreement was substantial on standard UWF and almost perfect on green-filter UWF (κ = 0.815). Ring number correlated with FH grade (P = 0.006) and BCVA (P = 0.034). The presence of this sign was significantly associated with hyperopia (P = 0.001), macular hypopigmentation, and FH grade (P < 0.001).</p><p><strong>Conclusions: </strong>The CMR sign on UWF retinography, particularly with a green filter, may serve as a noninvasive diagnostic aid for FH in albinism, especially in pediatric patients or those with fixation difficulties.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105322"},"PeriodicalIF":1.3,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149185678","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":"Intraoperative and radiographic indicators of extraocular muscle aberrancy in syndromic craniosynostosis.","authors":"Elisah Huynh, Yoon-Hee Chang, Stephanie Sacharow, Sanjay P Prabhu, Linda R Dagi","doi":"10.1016/j.jaapos.2026.105324","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.105324","url":null,"abstract":"<p><strong>Background: </strong>Strabismus is common in syndromic craniosynostosis, often attributed to abnormal extraocular muscle (EOM) trajectory, and orbital anatomy. Absent EOMs have been reported, but the spectrum of primary dysgenesis remains poorly understood. The purpose of this study was to characterize the range of EOM dysgenesis in a large cohort that had undergone strabismus surgery.</p><p><strong>Methods: </strong>The medical records of patients with syndromic craniosynostosis treated at Boston Children's Hospital (2010-2023) were reviewed retrospectively to identify all cases with neuroimaging and history of strabismus surgery. Genetic testing results and EOM abnormalities noted on neuroimaging or during surgery were recorded. Imaging was reviewed to determine presence of each EOM. Superior oblique muscle (SO) size was classified as \"normal\" if its transverse diameter was at least one-half that of the adjacent medial rectus muscle.</p><p><strong>Results: </strong>A total of 47 patients with syndromic craniosynostosis had undergone strabismus surgery, of whom 43 had available neuroimaging. Syndromic associations were as follows: 10 patients with Crouzon, 21 with Apert, 1 with Muenke, 6 with Pfeiffer, and 5 with Saethre-Chotzen. Rectus and inferior oblique muscles were universally present. SO size was normal in only 15 of 86 eyes (17%). EOM aberrancies were noted intraoperatively in 15 of 43 operative cases (35%), including diaphanous insertions, bifid or fused rectus muscles, and posterior inferior oblique insertions. Results of genetic testing were available for 26 patients, 24 of whom had FGFR2 mutations, including all 10 (of 15) patients with intraoperatively noted EOM aberrancies who underwent genetic testing.</p><p><strong>Conclusions: </strong>In this cohort with syndromic craniosynostosis, thin-section or high-resolution orbital imaging demonstrated presence of all rectus muscles even when insertions were diaphanous. The SO was hypoplastic in 83%. Aberrancies noted intraoperatively in 35% likely underestimate the true incidence, because evaluation was limited to muscles targeted for surgery.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105324"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167423","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 incidence of retinal hemorrhage in pediatric patients following COVID-19 vaccination.","authors":"Brittany M Wong, Jacob M Perkins, Nir Zontag, Alex V Levin","doi":"10.1016/j.jaapos.2026.105323","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.105323","url":null,"abstract":"<p><strong>Background: </strong>Retinal hemorrhages (RHs) are a cardinal finding in abusive head trauma (AHT) for which a broad differential diagnosis is appropriate to consider. The frequency of COVID-19 vaccination and reports of subsequent ocular manifestations have led to the consideration of whether COVID-19 vaccination should be included in the RH differential. This study aimed to investigate the frequency of RH following COVID-19 vaccination in children.</p><p><strong>Methods: </strong>In this single-center, retrospective, observational cohort study, we reviewed the medical records of children ≤8 years of age who received a COVID-19 vaccine from July 1, 2020, to July 1, 2024, and underwent a fundus examination within 21 days of vaccination. The main outcome measure was incidence and characteristics of RH on fundus examination.</p><p><strong>Results: </strong>Of 17,926 children vaccinated during this period, 203 subjects met inclusion criteria and underwent 212 unique examinations, with mean age of 4.56 years (0-8) at the time of first examination. Twenty examinations were also in the setting of prior COVID-19 infection. No examinations revealed RH. Based on Hanley's rule of zero incidence, the 95th percentile upper limit of incidence of RH after COVID-19 vaccination is 4.11% at 7 days, 2.04% at 14 days, and 1.42% at 21 days following vaccination.</p><p><strong>Conclusions: </strong>RHs were not seen in any children within 21 days of COVID-19 vaccination. This suggests that RH is rare following COVID-19 vaccination and perhaps of little relevance to the differential diagnosis of RH in the evaluation for AHT.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105323"},"PeriodicalIF":1.3,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171228","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":"Differences in intraocular pressure measurements by tonometer type in children with glaucoma and suspected glaucoma.","authors":"Yeabsira Mesfin, Keith D Miller, Ying Han, Julius T Oatts","doi":"10.1016/j.jaapos.2026.105321","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.105321","url":null,"abstract":"<p><strong>Purpose: </strong>To compare methods for obtaining intraocular pressure (IOP) measurements in children with glaucoma or suspected glaucoma.</p><p><strong>Methods: </strong>The medical records of children (<18 years) with glaucoma or suspected glaucoma with IOP measured by Goldmann applanation tonometry (GAT) and either pneumotonometry or rebound tonometry at a single institution from March 2018 to August 2024 were reviewed retrospectively. The difference between measurements was recorded for each eye. Correlation and Bland-Altman analysis were used to evaluate the level of agreement between tonometers. A linear mixed effects model identified characteristics associated with IOP differences.</p><p><strong>Results: </strong>A total of 157 eyes of 89 patients were included. GAT was used in all eyes, pneumotonometry in 79 eyes, and rebound tonometry in 78 eyes. The mean IOP by GAT, pneumotonometry, and rebound tonometry was 17.3 ± 5.5 mm Hg, 18.8 ± 5.5 mm Hg, and 20.4 ± 6.0 mm Hg, respectively. Pneumotonometry and rebound tonometry measured higher than GAT with a mean difference of 1.4 ± 3.2 mm Hg (limits of agreement [LOA]: 7.6 mm Hg, -4.3 mm Hg) and 3.1 ± 3.5 mm Hg (LOA: 10.0 mm Hg, -3.9 mm Hg). Correlations between GAT and both pneumotonometry (R = 0.83, P < 0.0001) and rebound tonometry (R = 0.91, P < 0.0001) were strong. Pneumotonometry was associated with a smaller difference from GAT measurements than rebound tonometry (estimate, -1.54 mm Hg). The difference between measurements from rebound tonometry and GAT was influenced by CCT (estimate, 2.35 mm Hg greater discrepancy per 100 μm [P = 0.004]).</p><p><strong>Conclusions: </strong>In our study cohort of children with glaucoma and suspected glaucoma, IOP measurements obtained with pneumotonometry and rebound tonometry measured higher than GAT but showed good correlation.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105321"},"PeriodicalIF":1.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149167040","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":"Eye-related quality of life among children with deprivation amblyopia after cataract surgery.","authors":"Brooke A Koritala, Christina Cheng-Patel, Reed M Jost, Serena X Wang, Jonathan M Holmes, Eileen E Birch","doi":"10.1016/j.jaapos.2026.105320","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.105320","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate eye-related quality of life (ER-QOL) and functional vision in children with deprivation amblyopia due to pediatric cataracts and to assess the impact on their parents.</p><p><strong>Methods: </strong>In this prospective cross-sectional study, the Pediatric Eye Questionnaire (PedEyeQ) was used to assess 53 children aged 0-11 years with a history of visually significant unilateral or bilateral cataracts and 182 age-similar controls with normal vision. Parents completed the Proxy and Parent PedEyeQ; children 5-11 years of age completed the Child PedEyeQ. Rasch-calibrated domain scores were scaled from 0 to 100 (higher scores indicate better ER-QOL). Groups were compared using independent t tests with Bonferroni correction and by comparing proportions falling below established normal thresholds.</p><p><strong>Results: </strong>Children with deprivation amblyopia had significantly lower scores than controls across all child, proxy, and parent domains (all P ≤ 0.0003). Parents reported the greatest impairment in worry about their child's eye condition, proxies reported the lowest scores for functional vision, and children (5-11 years of age) reported the lowest scores for frustration and worry about their eyes. Parent and proxy scores frequently fell below normal thresholds (83%-94% and 58%-89%, resp.), whereas few child self-reports (3%) were subnormal. Domain scores did not differ by laterality, cataract type, or severity of visual acuity deficit.</p><p><strong>Conclusions: </strong>Deprivation amblyopia due to pediatric cataracts is associated with substantial reductions in ER-QOL and functional vision for children and a pronounced psychosocial burden for parents, highlighting the importance of addressing broader quality-of-life impact in clinical care.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105320"},"PeriodicalIF":1.3,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149170506","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":"Assessment of the Spot vision screener performance in detecting amblyopia and strabismus in Nepal: a prospective diagnostic accuracy study.","authors":"Manisha Shrestha, Gopal Bhandari, Sadhan Bhandari, Jocelyn He, Krisianne Aromin, Gui-Shuang Ying, Jeremy D Keenan, Julius T Oatts","doi":"10.1016/j.jaapos.2026.105318","DOIUrl":"10.1016/j.jaapos.2026.105318","url":null,"abstract":"<p><strong>Background: </strong>Photoscreening can quickly detect amblyopia and strabismus, but there is little data on the performances of screening devices in low-income countries. The goal of this study was to assess the diagnostic accuracy of the Spot vision screener in Nepal.</p><p><strong>Methods: </strong>This prospective study enrolled a random sample of children 3-8 years of age seen in a pediatric ophthalmology clinic in Nepal. A trained ophthalmic assistant screened each child with using the Spot. A fellowship-trained pediatric ophthalmologist masked to screening results examined the children and to determine whether amblyopia or strabismus was present. This examination was the reference standard for diagnostic accuracy.</p><p><strong>Results: </strong>Of 219 consecutive children seen in the clinic, 109 were randomly selected for enrollment, of whom 91 were enrolled (mean age, 6.4 ± 1.4 years; 63.2% male). Twenty (22%) were diagnosed with amblyopia; 7 (7.7%), with strabismus. Of the 91, 31 (34.1%) failed the Spot screening according to standardized examination failure criteria. For detecting amblyopia, failure on the Spot for any reason had a sensitivity of 90.0% (95% CI, 68.3%-98.8%) and specificity of 81.7% (70.7%-89.9%). For detecting strabismus, failure on the Spot for any reason had a sensitivity of 71.4% (29.0%-96.3%), and specificity of 69.0% (58.0%-78.7%). For amblyopia or strabismus, sensitivity was 83.3% (62.9%-95.3%), and specificity was 83.6% (72.5%-91.5%). Positive predictive value in the clinic population was 64.5% (45.4%-80.8%) and negative predictive value was 93.3% (83.8%-98.2%).</p><p><strong>Conclusions: </strong>In this cohort, the Spot vision screener had relatively high sensitivity and moderate specificity for detecting amblyopia and strabismus, demonstrating its ability to correctly identify the majority of cases in a low-resource setting, although over-referral may result from its relatively low specificity and inaccurate autorefraction values.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105318"},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149712","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":"Intracranial hypertension in a child with vitamin D deficiency.","authors":"Weilin Chan, Hersh Varma, Shawn C Aylward, Hilliary Inger","doi":"10.1016/j.jaapos.2026.105319","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.105319","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105319"},"PeriodicalIF":1.3,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149148842","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":"Conservative management of anterior segment ischemia following Nishida transposition.","authors":"Amr A Elkamshoushy, Merna M Hossameldin","doi":"10.1016/j.jaapos.2026.105315","DOIUrl":"10.1016/j.jaapos.2026.105315","url":null,"abstract":"<p><p>A 33-year-old man was referred to our clinic for evaluation of right abducens nerve palsy following a excision of an intracranial ependymal cyst 1 year prior to presentation. The patient underwent an uneventful right medial rectus recession with lateral transposition of the muscle bellies of the superior and inferior rectus muscles (a Nishida transposition). Twenty-four hours after surgery the patient presented with severe pain, blurring of vision, and severe corneal edema that precluded visualization of iris details. A diagnosis of anterior segment ischemia was made. The patient received a steroid-antibiotic combination drop every 2 hours. The patient showed gradual improvement over the course of several weeks, without needing to reverse the transposition.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105315"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117694","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":"Central retinal vein occlusion in an adolescent with Klinefelter syndrome.","authors":"Christopher Dandolo, Geoffrey Ambler, Ji Li","doi":"10.1016/j.jaapos.2026.105314","DOIUrl":"10.1016/j.jaapos.2026.105314","url":null,"abstract":"<p><p>In children, central retinal vein occlusion (CRVO) is very rare and typically linked to underlying prothrombotic disorders. We describe a case of pediatric CRVO in the presence of Klinefelter syndrome (KS) with no other comorbidities. KS is associated with hematological abnormalities. This case suggests that a hypofibrinolytic state caused by androgen deficiency along with other genetic factors may contribute to CRVO risk.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"105314"},"PeriodicalIF":1.3,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149117458","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}