Journal of Aapos最新文献

{"title":"Cost as a barrier to eyeglasses in pediatric population: a cross-sectional survey analysis.","authors":"Zara Salem, Amani Mubeen, Rhea Sridhara, Avi Toiv, Pamela Williams, Chris Gappy, Adam Jacobson, Grace Wang, Sharmila Segar, Otana Jakpor, Sharon F Freedman, Olivia J Killeen","doi":"10.1016/j.jaapos.2025.104171","DOIUrl":"10.1016/j.jaapos.2025.104171","url":null,"abstract":"<p><p>Eyeglasses are an essential medical device to maximize visual potential and learning in children. We surveyed parents and pediatric ophthalmologists regarding their perspectives on the cost of pediatric eyeglasses. Parents and ophthalmologists identified cost as a barrier to obtaining eyeglasses. Despite over 80% of patients having some insurance coverage for eyeglasses, less than 1 in 4 reported that insurance fully covered the cost, and parents most frequently spent $100-200 per pair. More than 1 in 4 parents deferred purchasing recommended eyeglasses due to cost. Although over 80% of parents felt comfortable discussing the price of eyeglasses with the ophthalmologist, less than half of ophthalmologists felt comfortable discussing cost.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104171"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587906","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":"Visual and refractive outcomes in pediatric Marfan syndrome.","authors":"Francisco Altamirano, Bharti R Nihalani, Kathryn B Miller, Lois E H Smith, Isdin Oke, Deborah K VanderVeen","doi":"10.1016/j.jaapos.2025.104175","DOIUrl":"10.1016/j.jaapos.2025.104175","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the refractive outcomes and best-corrected visual acuity (BCVA) for pediatric patients with Marfan syndrome.</p><p><strong>Methods: </strong>The medical records of patients with Marfan syndrome seen at a pediatric tertiary care center between 2015 and 2023 were reviewed retrospectively. Patients >21 years of age at presentation or with follow-up <6 months were excluded. Eyes were grouped based on lens and refractive status at last follow-up: (A) no subluxation, (B) subluxation with phakic refraction, (C) subluxation with aphakic refraction or aphakia following lensectomy, and (D) pseudophakia.</p><p><strong>Results: </strong>A total of 210 eyes of 105 patients were included: group A, 59 (28.1%); group B, 77 (36.7%); group C, 43 (20.5%); and group D, 31 (14.7%). Fifty-five patients were male (52.4%). Mean age at initial visit was 5.4 ± 4.5 years, and mean follow-up was 9.0 ± 5.5 years. Groups differed in the proportion of eyes with BCVA worse than 20/40 (A, 1 [1.7%]; B, 7 [9.6%]; C, 9 [20.9%]; D, 1 [3.2%]; P = 0.005) and in mean spherical equivalent (A, -2.1 ± 3.0 D; B, -6.1 ± 6.5 D; C, +10.0 ± 4.1 D; D, -0.7 ± 1.8 D; P < 0.001) at final examination. The most common cause for vision worse than 20/40 was amblyopia. Major postoperative complications included retinal detachment in 3 (1.4%) eyes and glaucoma in 3 (1.4%) eyes.</p><p><strong>Conclusions: </strong>Lens subluxation requires precise refraction measurements and some patients may benefit from aphakic correction. Pseudophakic eyes often demonstrate low residual refractive error and BCVA comparable to phakic eyes without lens subluxation.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104175"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143588027","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":"Long-term outcomes of Ahmed ClearPath in childhood glaucoma: four-year results.","authors":"Abdelrahman M Elhusseiny, Mohamed S Sayed, Mohamed M Khodeiry, Deborah K VanderVeen","doi":"10.1016/j.jaapos.2025.104172","DOIUrl":"10.1016/j.jaapos.2025.104172","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the long-term outcomes of the Ahmed ClearPath (ACP) valveless glaucoma drainage device in childhood glaucoma.</p><p><strong>Methods: </strong>In this multicenter study, the medical records of all patients ≤18 years of age who underwent ACP implantation and had at least 4 years of follow-up were reviewed retrospectively. The outcome measures included the success rate, reduction in intraocular pressure (IOP), the reduction in glaucoma medications, and the complication rate. Success was defined as achieving a postoperative IOP between 6-21 mm Hg, with or without glaucoma medications, without the need for additional glaucoma surgeries, and without vision-threatening complications.</p><p><strong>Results: </strong>Nineteen eyes of 17 children were included, with a mean follow-up of 52.4 ± 7.2 months. The mean IOP significantly decreased from 32.2 ± 4.4 mm Hg preoperatively to 14.2 ± 3.7 mm Hg at 1 year, 15.3 ± 4 mm Hg at 2 years, 16 ± 3.8 mm Hg at 3 years, and 16.1 ± 3.1 mm Hg at 4 years (P < 0.001 for all). The median number of glaucoma medications was significantly reduced from 2.5 preoperatively to 1 from year 1 to year 4 postoperatively. Success rates were 90% at 1 year, 84% at 2 years, 79% at 3 years, and 79% at 4 years. At the final follow-up visit, 5 eyes were off glaucoma medications (complete success). No serious vision-threatening complications occurred in any of our patients.</p><p><strong>Conclusions: </strong>The ACP glaucoma drainage device demonstrated effective long-term control of IOP, reduction in glaucoma medications, and a favorable success rate and safety profile in childhood glaucoma.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104172"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587910","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":"\"Polarized glasses dissociation test\" for detection of suppression in intermittent exotropia.","authors":"Soo Hyun Kim, Daniel J Baik, Seung-Hyun Kim","doi":"10.1016/j.jaapos.2025.104174","DOIUrl":"10.1016/j.jaapos.2025.104174","url":null,"abstract":"<p><p>Detecting suppression is important for monitoring change in and determining surgical timing for intermittent exotropia. Here, we evaluate the results of a prospective, cross-sectional study of the \"polarized glasses dissociation test\" for detection of suppression. A positive result was defined as constant deviation of one eye at 6 m when viewing at distance with polarized glasses. The sensitivity of the test for suppression as assessed using a vectograph was 100%, specificity 95%, positive predictive value 97% and negative predictive value 100%. Due to its simplicity and accuracy, the polarized glasses dissociation test could be an alternative to other suppression tests and can be applied to a wide range of age groups.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104174"},"PeriodicalIF":1.2,"publicationDate":"2025-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587897","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":"Optic nerve head changes in esotropia.","authors":"Christiane Al-Haddad, Andre Slim, Zahi Wehbi, Dalia El Hadi, Elza Rachid, Ahmad M Mansour","doi":"10.1016/j.jaapos.2025.104163","DOIUrl":"10.1016/j.jaapos.2025.104163","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the difference in optic disk morphology in eyes with esotropia compared with normal controls.</p><p><strong>Methods: </strong>In this prospective, comparative study, the optic nerve heads and axial length of participants with esotropia were compared with those of age- and sex-matched controls. Subjects were examined at the Pediatric Ophthalmology Service of the American University of Beirut between January 2020 and January 2024. Outcome measures were acquired using OCT and IOL Master.</p><p><strong>Results: </strong>A total of 174 participants were enrolled: 83 esotropic subjects (mean age, 11.22 ± 4.58 years; female, 57%) and 91 controls (age, 11.47 ± 4.72 years; female, 59%). Mean spherical equivalent was higher in the esotropia group (right eye, 3.62 ± 2.49 D; left eye, 3.63 ± 2.59 D) than in controls (right eye, 0.59 ± 1.67 D; left eye, 0.66 ± 1.64 D) (P < 0.001 for both eyes). Optic disk area and rim area were larger in patients; however, the difference was not statistically significant after adjusting for hyperopia and axial length (AL). Esotropic patients had significantly smaller average cup:disk ratios than controls (0.29 vs 0.36 [P = 0.01] for right eyes and 0.28 vs 0.35 [P = 0.03] for left eyes) and smaller cup volumes (0.06 vs 0.09 mm³ [P = 0.01] for right eyes and 0.05 vs 0.10 mm³ [P = 0.002] for left eyes) After adjusting for hyperopia and AL, cup:disk ratio and cup volume remained significantly smaller among patients. Retinal nerve fiber layer tended to be thicker among patients, though not significantly.</p><p><strong>Conclusions: </strong>Optic nerve head cup volume and cup:disk ratio were significantly smaller in patients with esotropia, independent of refraction and axial length.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104163"},"PeriodicalIF":1.2,"publicationDate":"2025-03-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587998","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":"More than double.","authors":"Eric D Gaier","doi":"10.1016/j.jaapos.2025.104161","DOIUrl":"10.1016/j.jaapos.2025.104161","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104161"},"PeriodicalIF":1.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574538","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":"Etiologies underlying pediatric papilledema at a tertiary care children's hospital.","authors":"Andrew F Fischer, George Muntean, Valérie Biousse, Nancy J Newman, Jason H Peragallo","doi":"10.1016/j.jaapos.2025.104158","DOIUrl":"10.1016/j.jaapos.2025.104158","url":null,"abstract":"<p><strong>Background: </strong>Pediatric papilledema is a common reason for ophthalmology evaluation in high acuity emergency department and inpatient settings. This study describes the frequency of consultation, causative diagnoses, and presenting characteristics of papilledema at a tertiary care children's hospital.</p><p><strong>Methods: </strong>All consecutive patients seen in pediatric ophthalmology consultation or diagnosed with papilledema at a large children's hospital between January 1, 2021, and August 18, 2023, were retrospectively reviewed. Patients with papilledema (disk edema from elevated intracranial pressure) were identified and included in the analysis. Clinical characteristics of their presentations and the diagnoses underlying their elevated intracranial pressures were obtained. Age stratification into three groups for additional analysis was performed.</p><p><strong>Results: </strong>A total of 71 patients were identified with papilledema. Mean patient age was 13 ± 5.2 years (range, 0-20 years), and 68% of patients were girls. The overall rate of papilledema diagnosis among all unique patient consultations was 3.7%. Papilledema was caused by idiopathic intracranial hypertension (IIH) in 36 cases (51%), and 35 cases (49%) were due to secondary causes of IHH with serious vision- and life-threatening implications. IIH was most common in children >12 years of age, comprising 60% of papilledema cases in the age group.</p><p><strong>Conclusions: </strong>Pediatric papilledema is associated with a wide range of extremely serious underlying conditions that require a comprehensive, multidisciplinary evaluation in an emergency setting.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104158"},"PeriodicalIF":1.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568737","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":"Socioeconomic associations of amblyopia in the All of Us research program.","authors":"Rachel Zhang, Jasmine Jeon, Steven Ness","doi":"10.1016/j.jaapos.2025.104160","DOIUrl":"10.1016/j.jaapos.2025.104160","url":null,"abstract":"<p><strong>Purpose: </strong>To identify potential socioeconomic associations of amblyopia in a nationwide cohort.</p><p><strong>Methods: </strong>This is a retrospective, case-control study of participants in the All of Us Research Program. Cases were defined as adults 18-64 years of age with a diagnosis of amblyopia who answered the \"Basics\" survey questions of interest. Age-, sex-, and race-matched controls with no amblyopia diagnosis were sampled at a 4:1 control-to-case ratio. Univariate and multivariable testing was performed to determine socioeconomic associations of amblyopia, with P values of <0.05 considered statistically significant.</p><p><strong>Results: </strong>Of 1,714 patients with a diagnosis of amblyopia, 859 fell within the defined age range. Amblyopic participants were more likely to be of Black or African American (25.8% vs 21.8% [P = 0.004]) or Hispanic race/ethnicity (25.6% vs 22.6% [P = 0.04]) and were significantly older (50.0 vs 46.6 years [P < 0.0001]) than unmatched controls. After applying additional inclusion criteria limiting analysis to those with socioeconomic data available, a restricted set of 601 amblyopic participants were compared to 2,404 age-, sex-, and race/ethnicity-matched controls. Comparing cases and matched controls, participants with a diagnosis of amblyopia were significantly more likely to be unemployed (47.8% vs 39.3% [P = 0.0002]), non-home-owners (61.4% vs 55.8 % [P = 0.01]), have Medicaid insurance (33.8% vs 26.2% [P = 0.0002]), or have a household income under $35,000 annually (50.2% vs. 43.2% [P = 0.002]). Multivariable analysis revealed that amblyopic participants were significantly more likely to be unemployed (OR = 1.56; 95% CI, 1.25-1.94; P = 0.00006) and more likely to have Medicaid insurance (OR = 1.43; 95% CI, 1.13-1.82; P = 0.003).</p><p><strong>Conclusions: </strong>There are potential long-term socioeconomic associations of amblyopia. Given reported differences in both screening rates and treatment outcomes based on race, ethnicity, and income level, it is vital that future studies adequately portray the diversity of the population through broad, representative recruitment.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104160"},"PeriodicalIF":1.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143568288","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":"Acquired torticollis from an upper eyelid ectopic posterior cilium.","authors":"Khaled G Almasri, Zabila Khan, Arif O Khan","doi":"10.1016/j.jaapos.2025.104159","DOIUrl":"10.1016/j.jaapos.2025.104159","url":null,"abstract":"<p><p>An 18-month-old girl was evaluated because of a 2-month history of right head turn with right eyelid redness. Orthoptic evaluation was significant for a large right head turn (left gaze preference) and mild right upper lid swelling. With her abnormal head position there was no strabismus, but it was not possible to coax her into bringing the eyes to primary position or right gaze. There was a recent history of right upper eyelid posterior foreign body removal; recurrent foreign body was suspected. Examination under anesthesia revealed an ectopic eyelash emanating from the right upper eyelid posterior palpebral conjunctiva. After epilation, the abnormal head position resolved and normal ocular motility could be elicited.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104159"},"PeriodicalIF":1.2,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574537","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":"Baseline ophthalmic findings and complications in pediatric patients treated with MEK inhibitors.","authors":"Vikisha Hazariwala, Jennifer L Rossen, Janice Lasky-Zeid, Angela Waanders, Brenda L Bohnsack","doi":"10.1016/j.jaapos.2025.104157","DOIUrl":"10.1016/j.jaapos.2025.104157","url":null,"abstract":"<p><strong>Background: </strong>MEK inhibitors are an increasingly used class of medications associated with ocular complications, including serous retinal detachments, vein occlusions, uveitis, and dry eye syndrome in adults. However, baseline ophthalmic findings and MEK inhibitor-related complications in children are underreported.</p><p><strong>Methods: </strong>The medical records of patients <21 years of age who underwent MEK inhibitor treatment at our institution between 2016 and 2023 were reviewed retrospectively. Patients with baseline examination and at least one follow-up eye examination were included. Systemic and ophthalmic diagnoses, MEK inhibitor treatment course, and ocular findings were extracted from the record.</p><p><strong>Results: </strong>A total of 45 patients (23 males) were treated with a MEK inhibitor for tumor with neurofibromatosis type 1 (NF1, n = 20), tumor without NF1 (n = 22), or non-tumor (n = 3) at a mean age of 9.4 ± 4.8 years. Nineteen patients were treated with trametinib, 20 with selumetinib, and 6 with combined trametinib and dabrafenib. Thirty-three patients (73%), all with neurological tumors, had abnormal baseline eye examinations, including optic nerve abnormalities (n = 20), visual acuity impairment (n = 17), visual field defect (n = 8), strabismus (n = 10), or anterior segment abnormalities (n = 14). Average time on MEK inhibitors was 445.5 ± 377.8 days. Three patients with neurologic tumors without NF1 developed ophthalmic side effects of dry eye syndrome (n = 1) or symptomatic anterior uveitis (n = 2) at 6-7 months after initiation of MEK inhibitor. All 3 patients responded to topical medications.</p><p><strong>Conclusions: </strong>The majority of children started on MEK inhibitors had baseline eye abnormalities due to ocular or visual pathway involvement of neurological tumors. Ophthalmic side effects of MEK inhibitors occurred in 7% of children. Additional studies are required to formulate screening guidelines for the pediatric population.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104157"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143544344","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}