Journal of Aapos最新文献

{"title":"Information for Readers","authors":"","doi":"10.1016/S1091-8531(25)00086-2","DOIUrl":"10.1016/S1091-8531(25)00086-2","url":null,"abstract":"","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104188"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143820272","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 MD,&nbsp;Andre Slim Pharm D, MPH,&nbsp;Zahi Wehbi MD,&nbsp;Dalia El Hadi MD,&nbsp;Elza Rachid MD,&nbsp;Ahmad M. Mansour MD, FASRS","doi":"10.1016/j.jaapos.2025.104163","DOIUrl":"10.1016/j.jaapos.2025.104163","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the difference in optic disk morphology in eyes with esotropia compared with normal controls.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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) (<em>P</em> &lt; 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 [<em>P</em> = 0.01] for right eyes and 0.28 vs 0.35 [<em>P</em> = 0.03] for left eyes) and smaller cup volumes (0.06 vs 0.09 mm³ [<em>P</em> = 0.01] for right eyes and 0.05 vs 0.10 mm³ [<em>P</em> = 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.</div></div><div><h3>Conclusions</h3><div>Optic nerve head cup volume and cup:disk ratio were significantly smaller in patients with esotropia, independent of refraction and axial length.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104163"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"Socioeconomic associations of amblyopia in the All of Us research program","authors":"Rachel Zhang ,&nbsp;Jasmine Jeon MS ,&nbsp;Steven Ness MD","doi":"10.1016/j.jaapos.2025.104160","DOIUrl":"10.1016/j.jaapos.2025.104160","url":null,"abstract":"<div><h3>Purpose</h3><div>To identify potential socioeconomic associations of amblyopia in a nationwide cohort.</div></div><div><h3>Methods</h3><div>This is a retrospective, case-control study of participants in the <em>All of Us</em> 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 <em>P</em> values of &lt;0.05 considered statistically significant.</div></div><div><h3>Results</h3><div>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% [<em>P</em> = 0.004]) or Hispanic race/ethnicity (25.6% vs 22.6% [<em>P</em> = 0.04]) and were significantly older (50.0 vs 46.6 years [<em>P</em> &lt; 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% [<em>P</em> = 0.0002]), non-home-owners (61.4% vs 55.8 % [<em>P</em> = 0.01]), have Medicaid insurance (33.8% vs 26.2% [<em>P</em> = 0.0002]), or have a household income under $35,000 annually (50.2% vs. 43.2% [<em>P</em> = 0.002]). Multivariable analysis revealed that amblyopic participants were significantly more likely to be unemployed (OR = 1.56; 95% CI, 1.25-1.94; <em>P</em> = 0.00006) and more likely to have Medicaid insurance (OR = 1.43; 95% CI, 1.13-1.82; <em>P</em> = 0.003).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104160"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"Topical insulin in pediatric neurotrophic keratopathy associated with CIPA syndrome","authors":"Taher Eleiwa MD, PhD ,&nbsp;Mohamed F. Farid MD ,&nbsp;Abdelrahman M. Elhusseiny MD, MSc","doi":"10.1016/j.jaapos.2025.104120","DOIUrl":"10.1016/j.jaapos.2025.104120","url":null,"abstract":"<div><div>We present a case, with a 2-year follow-up, of the use of topical insulin in managing neurotrophic keratopathy in a 3-year-old boy diagnosed with congenital insensitivity to pain with anhidrosis (CIPA). Initially, the patient had a corneal perforation in the right eye, for which he underwent tectonic amniotic membrane transplantation. On examination, a central corneal ulcer with stromal infiltration was identified in the left eye, accompanied by a complete absence of corneal sensation in both eyes. Systemic features consistent with CIPA, such as the absence of a normal response to pain stimuli, anhidrosis, and self-injurious behavior, were also observed. Topical insulin, along with preservative-free lubricants (PF-L) and prophylactic antibiotics, was prescribed for both eyes. Within 2 weeks, the left corneal ulcer had healed, and treatment with topical insulin and PF-L was continued. After a 2-year follow-up, the left cornea exhibited a stable small paracentral nebula, whereas the right cornea showed a central non-adherent leucoma. No recurrence of corneal ulceration occurred.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104120"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374960","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":"Down syndrome is a risk factor for developing corneal ulcers following nasolacrimal duct stenting","authors":"Brittany Marks BA ,&nbsp;Michael A. Puente MD","doi":"10.1016/j.jaapos.2025.104126","DOIUrl":"10.1016/j.jaapos.2025.104126","url":null,"abstract":"<div><div>Nasolacrimal duct stents are often used to treat congenital nasolacrimal duct obstruction (NLDO). Rarely, corneal ulcers may develop following stent placement. Of the 349 monocanalicular stents placed in 253 patients with congenital NLDO over a period of 33 months at our institution, 4 stents (1.1%) resulted in corneal ulcers. Three occurred in children with Down syndrome (n = 35); 1 occurred in a child retroactively diagnosed with neurotrophic keratitis. The 3 cases indicate a statistically significant increased relative risk of corneal ulcer formation in children with Down syndrome compared with the remaining patients (9% vs 0.46%; relative risk = 18.68; <em>P</em> = 0.0102).</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104126"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416115","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":"Medial rectus recession combined with bridge faden procedure in esotropia associated with poor vision in the deviating eye","authors":"Aslı İnal MD ,&nbsp;Erdem Erdogdu MD, FEBO ,&nbsp;Muhittin Taskapili MD ,&nbsp;Birsen Gökyigit MD","doi":"10.1016/j.jaapos.2025.104170","DOIUrl":"10.1016/j.jaapos.2025.104170","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the postoperative outcomes of medial rectus recession combined with modified posterior fixation surgery (bridge faden) in esotropia associated with poor vision in the deviating eye.</div></div><div><h3>Methods</h3><div>In this retrospective study, the surgical outcomes of patients who underwent medial rectus recession combined with the bridge faden procedure for esotropia with poor vision in the deviating eye from April 2016 to May 2023 were assessed. The demographic characteristics of the patients and near and distance deviations were determined using the prism cover or the Krimsky test preoperatively and at follow-up of 1 month, 6 months, and 1 year. Orthophoria or ±10^Δ deviation in postoperative near and distance deviations were considered surgical successes. The Wilcoxon signed-rank test was used for statistical analysis. A <em>P</em> value of &lt;0.05 was considered statistically significant.</div></div><div><h3>Results</h3><div>A total of 57 patients (34 males) were included. Mean patient age was 19 ± 12 years; mean follow-up, 27 ± 33 months. Near deviations improved from a mean of 33 ± 8^Δ preoperatively to 4 ± 7^Δ at 1 year (<em>P</em> &lt; 0.05), and distance deviations improved from a mean of 27 ± 10^Δ preoperatively to 3 ± 7^Δ at 1 year (<em>P</em> &lt; 0.05). The surgical success rate at final follow-up was 86%.</div></div><div><h3>Conclusions</h3><div>In our cohort of patients with sensory esotropia associated with poor vision in the deviating eye, our procedure provided long-term improvement in near and distance deviation.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104170"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587952","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":"Pediatric MEK inhibitor–associated retinopathy: 8-year experience at a tertiary academic center and report of 2 cases","authors":"Jintong Liu BS ,&nbsp;Rebecca G. Edwards Mayhew MD, PhD ,&nbsp;Lauren M. Imbornoni MD ,&nbsp;Jennifer L. Jung MD ,&nbsp;Scott C.N. Oliver MD ,&nbsp;Nicholas K. Foreman MD ,&nbsp;Jean M. Mulcahy Levy MD ,&nbsp;Molly Hemenway NP ,&nbsp;Emily A. McCourt MD","doi":"10.1016/j.jaapos.2025.104178","DOIUrl":"10.1016/j.jaapos.2025.104178","url":null,"abstract":"<div><h3>Background</h3><div>An adverse effect of mitogen-activated protein kinase (MEK) inhibitors is MEK inhibitor–associated retinopathy (MEKAR), a fluid collection between the retinal pigment epithelium (RPE) and interdigitation zone (IZ) seen in up to 90% of adults taking these medications. MEKAR is not well described in children. The purpose of this study was to characterize MEKAR screening practices, identify cases of MEKAR, and describe their clinical presentations in children.</div></div><div><h3>Methods</h3><div>We conducted a retrospective study at our tertiary care pediatric hospital, examining pediatric patients who underwent MEK inhibitor (MEK-i) therapy between 2015 and 2023. We describe 2 cases of pediatric MEKAR that arose during the study period.</div></div><div><h3>Results</h3><div>Of 152 patients identified, 104 met inclusion criteria. Trametinib was the most used MEK-i, with plexiform neurofibroma being the predominant indication for therapy. Optical coherence tomography macula screenings were predominantly performed in clinic, with varying screening intervals (mean, 9.85 months; median, 6.5 months). We identified 2 cases of pediatric MEKAR, both of which improved or resolved without altering MEK-i dosage. Our study suggests a lower rate of MEKAR in pediatric patients compared with adults, although limitations in screening frequency and duration may influence this observation.</div></div><div><h3>Conclusions</h3><div>Our findings underscore the importance of systematic MEKAR screening protocols in pediatric patients receiving MEK-i therapy, facilitating early detection and monitoring of ocular toxicity. When MEKAR develops, the risks of stopping treatment must be weighed against the risks of retinopathy, although in our patients, MEKAR resolved without alterations to their medication regimen.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104178"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143630733","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":"Cost as a barrier to eyeglasses in pediatric population: a cross-sectional survey analysis","authors":"Zara Salem MD ,&nbsp;Amani Mubeen ,&nbsp;Rhea Sridhara ,&nbsp;Avi Toiv MD ,&nbsp;Pamela Williams MD ,&nbsp;Chris Gappy MD ,&nbsp;Adam Jacobson MD ,&nbsp;Grace Wang MD, PhD ,&nbsp;Sharmila Segar MD ,&nbsp;Otana Jakpor MD, MSc ,&nbsp;Sharon F. Freedman MD ,&nbsp;Olivia J. Killeen MD, MS","doi":"10.1016/j.jaapos.2025.104171","DOIUrl":"10.1016/j.jaapos.2025.104171","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104171"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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 MD,&nbsp;Bharti R. Nihalani MD,&nbsp;Kathryn B. Miller OD,&nbsp;Lois E.H. Smith MD, PhD,&nbsp;Isdin Oke MD, MPH,&nbsp;Deborah K. VanderVeen MD","doi":"10.1016/j.jaapos.2025.104175","DOIUrl":"10.1016/j.jaapos.2025.104175","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe the refractive outcomes and best-corrected visual acuity (BCVA) for pediatric patients with Marfan syndrome.</div></div><div><h3>Methods</h3><div>The medical records of patients with Marfan syndrome seen at a pediatric tertiary care center between 2015 and 2023 were reviewed retrospectively. Patients &gt;21 years of age at presentation or with follow-up &lt;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.</div></div><div><h3>Results</h3><div>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%]; <em>P</em> = 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; <em>P</em> &lt; 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104175"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"Occult intraorbital BB presenting as unilateral pigmentary retinopathy","authors":"Harrison Huang MPH,&nbsp;Jeffrey Powell MD,&nbsp;Emily Balding BS,&nbsp;Alex Villareal MD,&nbsp;Margaret A. Greven MD","doi":"10.1016/j.jaapos.2025.104128","DOIUrl":"10.1016/j.jaapos.2025.104128","url":null,"abstract":"<div><div>A 7-year-old boy presented with unilateral pigmentary retinopathy in the right eye. Best-corrected visual acuity was 20/200, and a relative afferent pupillary defect was noted. Fundus examination revealed sectoral retinal pigment epithelial changes involving the peripapillary, macular, and inferior peripheral retina. The patient and family denied any history of trauma to the orbit or projectile exposure. Over a year later, he presented with left-sided orbital cellulitis. An orbital computed tomography scan incidentally revealed a 6 mm metallic foreign body consistent with a BB along the posterior and inferior aspect of the right globe. This case underscores the importance of maintaining a high index of suspicion for trauma even in the absence of reported injury, especially in children.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104128"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143484338","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}