Journal of Aapos最新文献

{"title":"Characteristic ocular features of pediatric patients with Loeys-Dietz syndrome.","authors":"Waleed K Alsarhani, Reem Al Nabulsi, Alaa AlAli, J Raymond Buncic, Ajoy Vincent, Roberto Mendoza, Constance O'Connor, Asim Ali","doi":"10.1016/j.jaapos.2026.104853","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104853","url":null,"abstract":"<p><strong>Purpose: </strong>To present a comprehensive analysis of ocular features observed in pediatric patients diagnosed with Loeys-Dietz syndrome (LDS).</p><p><strong>Methods: </strong>This prospective observational study included pediatric patients with a confirmed diagnosis of LDS who presented to the Eye Clinic at The Hospital for Sick Children, Toronto, Ontario, from January 2016 to September 2024. Comprehensive ophthalmic examinations were performed, including refraction, corneal imaging, and optic nerve evaluation. Genetic testing results were reviewed to correlate ocular findings with pathogenic variants in TGFBR1, TGFBR2, or TGFB2.</p><p><strong>Results: </strong>Seventeen pediatric patients (34 eyes) were included, with a mean age of 10.6 ± 3.8 years (range, 4-17 years). The mean spherical equivalent was +0.79 ± 2.39 D. Retinal vascular tortuosity was observed in 18 patients (53%). The mean central corneal thickness was 511 ± 42 μm. Flat corneal curvature (mean K ≤ 42.00 D) was present in 21 eyes (66%). Supernumerary optic disk vessels were noted in 12 eyes (40%), and seven (23%) had an optic disk area >2.50 mm². No lens abnormalities were identified. A single patient had significant myopia (> -1.00 D). No significant associations were found between genetic variants and ocular biometric parameters.</p><p><strong>Conclusions: </strong>In our small cohort of pediatric patients with LDS, ocular findings included retinal vascular tortuosity, reduced corneal thickness, and optic nerve anomalies. Lenticular abnormalities were absent, and significant myopia was nearly so.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104853"},"PeriodicalIF":1.3,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147857438","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":"Sequential correction of blepharophimosis syndrome: comparison of anatomical outcomes for surgery before and after 24 months of age.","authors":"İbrahim Edhem Yılmaz, Semih Doğan, Levent Doğan, Necip Kara, Şeyhmus Arı","doi":"10.1016/j.jaapos.2026.104852","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104852","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the safety and morphometric outcomes of early sequential surgical correction in pediatric patients with blepharophimosis-ptosis-epicanthus inversus syndrome (BPES) with significant functional impairment, comparing patients under and over 24 months of age.</p><p><strong>Methods: </strong>The medical records of consecutive BPES patients undergoing two-stage treatment of Y-V epicanthoplasty followed by silicone frontalis suspension from 2019 to 2021 were retrospectively analyzed. Primary outcomes included morphometric parameters: ratio of inner intercanthal distance (IICD) to horizontal palpebral fissure length (HPFL), margin reflex distance-1 (MRD1), and vertical palpebral fissure length (VPFL). Secondary outcomes were visual axis clearance, compensatory posture resolution, and complications. Statistical analysis employed repeated measures ANOVA with Bonferroni correction.</p><p><strong>Results: </strong>A total of 20 patients were included. Mean age at surgery was 43.4 ± 32.4 months (range, 6-120), with 11 patients (55%) under 24 months. At 6 months' follow-up, all morphometric parameters demonstrated significant improvement (P < 0.001): IICD/HPFL ratio decreased from 1.82 ± 0.23 to 1.13 ± 0.08; VPFL increased from 3.92 ± 0.71 mm to 8.22 ± 0.44 mm; and MRD1 improved from 0.45 ± 0.91 mm to 4.17 ± 0.40 mm. Visual axis clearance and resolution of compensatory chin-up posture were achieved in 100% of cases; surgical success (IICD/HPFL <1.3), in 95% of patients (19/20). Age-stratified analysis revealed no significant differences in outcomes between cohorts (P > 0.05). Grade I complications occurred in 5 patients (25%) and resolved conservatively.</p><p><strong>Conclusions: </strong>In select infants with severe BPES, early two-stage sequential correction can achieve visual axis clearance and anatomical outcomes comparable to those achieved in older children.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104852"},"PeriodicalIF":1.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845382","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":"Reply to: Separating Model Discrimination From Imaging Workflow in Autonomous ROP Screening.","authors":"Lizanne A Derks, J Peter Campbell, Angela M Tjiam","doi":"10.1016/j.jaapos.2026.104850","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104850","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104850"},"PeriodicalIF":1.3,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147845387","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":"Comment On: \"External validation of an artificial intelligence-based model for retinopathy of prematurity screening using Phoenix ICON retinal images\".","authors":"Henry Bair","doi":"10.1016/j.jaapos.2026.104849","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104849","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104849"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823069","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":"Frontalis flap advancement versus PTFE (Gore-Tex) frontalis sling operations in the management of congenital blepharoptosis.","authors":"Zahra Zia, Behzad Khademi","doi":"10.1016/j.jaapos.2026.104851","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104851","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104851"},"PeriodicalIF":1.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823084","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":"Real-world outcomes of retinopathy of prematurity treated with primary laser versus primary anti-vascular endothelial growth factor and deferred laser.","authors":"Melissa Yuan, Daniel Hu, Francisco Altamirano, Sandra Hoyek, Celine Chaaya, Muhammad Abidi, Hanna De Bruyn, Anne Fulton, Iason S Mantagos, Carolyn Wu, Efren Gonzalez, Deborah K VanderVeen, Nimesh A Patel, Ryan Gise","doi":"10.1016/j.jaapos.2026.104848","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104848","url":null,"abstract":"<p><strong>Purpose: </strong>To compare visual and anatomic outcomes between primary laser photocoagulation and anti-vascular endothelial growth factor (VEGF) therapy with early or late deferred laser treatment (for reactivation or peripheral avascular retina [PAR]) in management of retinopathy of prematurity (ROP).</p><p><strong>Methods: </strong>In this retrospective cohort study, eyes were divided into three groups: primary laser, anti-VEGF with early (<4 months) deferred laser, and anti-VEGF with late (≥4 months) deferred laser (treated prophylactically for PAR per protocol or for reactivation if needed).</p><p><strong>Results: </strong>A total of 260 eyes of 139 patients treated for ROP between 2013 and 2023 were included: 159 eyes in the primary group, 20 in the early-deferred group, and 81 in the late-deferred group. The primary laser group was older at first treatment (median postmenstrual age, 39.1 weeks vs 36.1 and 35.7 weeks for early- and late-deferred laser groups [P < 0.01]). Zone 1 disease was more common in anti-VEGF groups (43%-45% vs 1.9% [P < 0.01]). At median follow-up of 35 months, visual acuity was better in the early-deferred laser group (logMAR 0.14) than in the primary laser (0.18) and late-deferred laser (0.18) groups (P < 0.001; 162 eyes of 91 patients). Retinal detachment rates were not significantly different (3.1% primary laser vs 0.0% in anti-VEGF groups [P = 0.31] when excluding 2 eyes of 1 patient with numerous missed examinations and an atypical follow-up schedule due to medical instability in the early deferred laser group). At 2 years, the early-deferred laser group was more myopic (median, -1.50 D vs 0.0 D and 0.50 D [P = 0.031]). There were no differences in adverse events, strabismus, or amblyopia (P > 0.05 for all).</p><p><strong>Conclusions: </strong>Primary laser and anti-VEGF with deferred laser showed comparable anatomic outcomes. Refractive outcomes were comparable, though myopia was common in all groups. Anti-VEGF was more commonly used for posterior disease, reflecting contemporary practice patterns at this quaternary referral center.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104848"},"PeriodicalIF":1.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823013","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":"Comparative outcomes for treatment of type 1 retinopathy of prematurity in a contemporary cohort.","authors":"Anne Strong Caldwell, Jennifer Patnaik, Lauren Mehner, Emily McCourt, Anne Lynch, Emily Auer, Marc Mathias, Scott Oliver, Jennifer Jung","doi":"10.1016/j.jaapos.2026.104847","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104847","url":null,"abstract":"<p><strong>Background: </strong>The current mainstays of treatment for type 1 retinopathy of prematurity (ROP) are laser therapy and anti-VEGF intravitreal injections (IVI) or a combination of the two. Data comparing treatment outcomes between these modalities are heterogenous and limited by short-term follow-up. There is limited data on visual acuity after treatment. The purpose of this study was to investigate visual acuity, structural outcomes, and refractive error (RE) between primary laser and primary IVI in a contemporary cohort treated for ROP.</p><p><strong>Methods: </strong>The medical records of patients treated for type 1 ROP at a tertiary care center from 2006 to 2022 were reviewed retrospectively. Demographics, treatment, visual acuity, adverse outcomes, and RE were analyzed between primary IVI and primary laser treatment groups. Adverse outcomes that were analyzed were strabismus, macular dragging, optic atrophy, retinal detachment, and amblyopia.</p><p><strong>Results: </strong>A total of 179 patients (358 eyes) received treatment for type 1 ROP. Most patients received primary laser therapy (83.5%). We were able to collect formal visual acuity testing on 92 eyes. Most had vision of 20/40 or better (60%), and all patients had vision better than 20/200 in at least one eye. There was no difference in adverse ocular outcomes or RE between the primary laser and primary IVI groups.</p><p><strong>Conclusions: </strong>In contrast to prior studies, there were no differences in adverse ocular outcomes between primary IVI and primary laser for ROP. Our study demonstrates high effectiveness of both anti-VEGF and ROP laser, with low rates of retinal detachment and blindness.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104847"},"PeriodicalIF":1.3,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147823052","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":"Strabismus or prior successfully treated amblyopia does not impair binocular reading speed in adolescents.","authors":"Guy Barnett-Itzhaki, Etti Libovits, Zohar Barnett-Itzhaki, Michal Blau-Most, Anat Bachar-Zipori, Daphna Mezad-Koursh","doi":"10.1016/j.jaapos.2026.104844","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104844","url":null,"abstract":"<p><strong>Background: </strong>Childhood strabismus and amblyopia may affect reading ability. Previous studies have demonstrated slower reading speed among amblyopic children compared with controls, but the relationships between strabismus without amblyopia or prior treated amblyopia and reading speed have not been established. The purpose of this study was to investigate whether strabismus or history of successfully treated amblyopia independently affect binocular reading speed in adolescents and to characterize the clinical parameters associated with reading performance.</p><p><strong>Methods: </strong>A total of 124 adolescents (10-17 years) were enrolled and divided into four groups: strabismic with prior successfully treated amblyopia, strabismic without prior amblyopia, nonstrabismic with prior successfully treated amblyopia, and control. Binocular reading speed was assessed using standardized passages from the IReST-Hebrew. Statistical analysis involved Wilcoxon tests to compare reading speeds between groups and Spearman correlations to explore associations with clinical variables.</p><p><strong>Results: </strong>No statistically significant differences in binocular reading speed were found between the four groups (all P > 0.05). Subgroup analysis revealed no significant differences based on strabismus type (esotropia vs exotropia). Within-group associations were observed: in the strabismic with prior amblyopia group, a significant negative correlation existed between reading speed and stereopsis (r = -0.51, P = 0.01), whereas in the nonstrabismic with prior amblyopia group, reading speed correlated negatively with near point of convergence (r = -0.47, P = 0.02).</p><p><strong>Conclusions: </strong>In our study cohort, nonamblyopic adolescents with a history of strabismus, amblyopia, or both did not exhibit slower binocular reading speed than controls. These findings suggest that in adolescents without current amblyopia or after successful amblyopia treatment, reading performance is preserved.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104844"},"PeriodicalIF":1.3,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147822199","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":"Characterizing pediatric blepharokeratoconjunctivitis in an underserved urban setting.","authors":"Matthew E Wei, Joann J Kang","doi":"10.1016/j.jaapos.2026.104843","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104843","url":null,"abstract":"<p><strong>Background: </strong>Pediatric blepharokeratoconjunctivitis (PBKC) is a chronic inflammatory disease of the eyelid margin with secondary conjunctival and corneal involvement. The purpose of this study was to characterize the clinical features, visual outcomes, and treatment of PBKC in a diverse, underserved metropolitan community in the United States.</p><p><strong>Methods: </strong>A retrospective study was conducted of patients 16 years old or younger diagnosed with PBKC, who were identified using relevant Systematized Nomenclature of Medicine - Clinical Terminology (SNOMED CT) codes and manual chart review.</p><p><strong>Results: </strong>A total of 60 patients were included. Most patients were female 35 (58%) and identified as Hispanic or Latino 33 (55%). Bilateral involvement was observed in 38 patients (63%). The most common symptoms were eye redness 52 (87%), recurrent chalazia 38 (63%), tearing 30 (50%), and ocular itching 30 (50%). All patients had concurrent lid, conjunctival, and corneal involvement. Based on corneal findings, 15 (25%) had mild, 34 (57%) moderate, and 11 (18%) severe disease, with 8 (73%) of severe cases being Hispanic. Mean age at corneal involvement was 8.3 years old, with moderate and severe cases occurring about 3 years earlier than mild ones. Amblyopia only occurred in moderate-to-severe cases 11 (18%). Final visual acuity varied by severity, with improvement in moderate disease and decline in severe cases. Recurrence was observed in 37 (62%) patients, especially in severe cases 11 (100%). Severe patients received topical antibiotic or combination antibiotic/steroid drops and ointments 11 (100%), topical steroid drops 9 (82%), and oral antivirals 4 (36%) more frequently than other groups.</p><p><strong>Conclusions: </strong>The high rates of corneal complications, visual impairment, and disease recurrence in our underserved urban cohort suggest the importance of early diagnosis and consistent follow-up.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104843"},"PeriodicalIF":1.3,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787803","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":"Outcomes of probing with or without bicanalicular intubation in children aged three years and older: a decade of experience at a tertiary eye hospital.","authors":"Fatma Poslu Karademir, Selvihan Sağdıç Özçelik, Ayşe Çetin Efe, Mehmet Göksel Ulaş, İsmail Diri, Pelin Kaynak, Muhittin Taşkapılı","doi":"10.1016/j.jaapos.2026.104841","DOIUrl":"https://doi.org/10.1016/j.jaapos.2026.104841","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the clinical efficacy of probing with or without bicanalicular intubation (BCI) for congenital nasolacrimal duct obstruction (CNLDO) in children at least 3 years of age and to identify factors influencing surgical success.</p><p><strong>Methods: </strong>The medical records of children treated between 2014 and 2024 at Health Sciences University Beyoğlu Eye Training and Research Hospital were reviewed retrospectively. All patients underwent probing with or without bicanalicular silicone intubation (BCI) using the square knot technique. Surgical success was defined as resolution of symptoms and a normal fluorescein dye disappearance test.</p><p><strong>Results: </strong>A total of 95 children (116 eyes) were included. Mean patient age was 4.57 ± 1.98 years (range, 3-14). Mean follow-up was 15.5 ± 15.4 months. BCI was performed initially in 102 eyes. Mean tube retention was 66.8 ± 43.0 days. Overall success was 87%, increasing to 95% after reprobing and BCI in failed cases. Age, sex, obstruction type, canalicular stenosis, Rosenmüller's valve hypertrophy, and inferior turbinate infracture were not significantly associated with success (P > 0.05). Tube retention for 45-90 days was significantly associated with higher success compared with retention <45 days (P = 0.013; OR = 12.75; 95% CI, 1.72-94.48).</p><p><strong>Conclusions: </strong>In our study cohort of children undergoing surgery for CNLDO at 3 years of age and older, probing and BCI achieved high success, especially if the tube was successfully retained for at least 45 days. Reintubation in failed cases can improve outcomes.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104841"},"PeriodicalIF":1.3,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787783","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}