Journal of Aapos最新文献

{"title":"Baseline ophthalmic findings and complications in pediatric patients treated with MEK inhibitors","authors":"Vikisha Hazariwala DO ,&nbsp;Jennifer L. Rossen MD ,&nbsp;Janice Lasky-Zeid MD ,&nbsp;Angela Waanders MD, MPH ,&nbsp;Brenda L. Bohnsack MD, PhD","doi":"10.1016/j.jaapos.2025.104157","DOIUrl":"10.1016/j.jaapos.2025.104157","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>The medical records of patients &lt;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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104157"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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}

{"title":"Superior oblique tendon elongation with bovine pericardium for Brown syndrome","authors":"Katarzyna Pelińska MD,&nbsp;Justyna Simiera MD, PhD,&nbsp;Piotr Loba MD, PhD","doi":"10.1016/j.jaapos.2025.104155","DOIUrl":"10.1016/j.jaapos.2025.104155","url":null,"abstract":"<div><h3>Purpose</h3><div>To present a novel surgical technique of superior oblique tendon elongation for Brown syndrome using bovine pericardium (Tutopatch).</div></div><div><h3>Methods</h3><div>Ten children (2-7 years old) with unilateral Brown syndrome were included. All patients had significant to severe underelevation in adduction, with hypotropia in primary gaze and anomalous head posture. The superior oblique was tenotomized and a Tutopatch implant, length 8–10 mm, was inserted to elongate the muscle tendon. The children were examined 1 day and 6 months postoperatively.</div></div><div><h3>Results</h3><div>Of the 10 patients, 8 demonstrated significant improvement in duction and anomalous head posture. Two patients required an additional procedure, in one case due to secondary overelevation in adduction, and in the other because of undercorrection.</div></div><div><h3>Conclusions</h3><div>In our small patient cohort, superior oblique tendon elongation using Tutopatch implant improved ductions and anomalous head posture due to Brown syndrome. This technique offers a controlled weakening of the superior oblique muscle similar in effect to an implanted silicon expander but without involving artificial materials.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104155"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143532074","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 after unilateral bevacizumab treatment for infants with asymmetric retinopathy of prematurity","authors":"Daniel G. Nelson MD,&nbsp;G. Baker Hubbard MD,&nbsp;Amy K. Hutchinson MD","doi":"10.1016/j.jaapos.2024.104091","DOIUrl":"10.1016/j.jaapos.2024.104091","url":null,"abstract":"<div><div>In this retrospective study of asymmetric retinopathy of prematurity (ROP) cases treated with unilateral intravitreal bevacizumab (IVB), half of the treated patients did not require further IVB, whereas the other half required sequential IVB at a mean of 12 days after initial treatment.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104091"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142903967","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":"Traumatic transection of the inferior and medial rectus muscles: a rare incident","authors":"Justin C. Muste MD,&nbsp;Marina Eisenberg MD,&nbsp;Jonathan Eisengart MD,&nbsp;Allison Babiuch MD,&nbsp;Nasrine Anais El Salloukh MD,&nbsp;Nicole Rebollo Rodriguez MD","doi":"10.1016/j.jaapos.2025.104124","DOIUrl":"10.1016/j.jaapos.2025.104124","url":null,"abstract":"<div><div>A 68-year-old woman was referred to the emergency room for globe trauma of the left eye. Initial examination demonstrated absent adduction and infraduction. During preliminary repair, total transection of the medial and inferior rectus muscle bellies was noted, but the retracted proximal muscle segments could not be immediately retrieved. On re-exploration 36 hours later, both retracted muscle segments were recovered by tracing Tenon’s capsule and reconnected to the distal portions of the muscles. At her postoperative month 1 visit she was orthotropic in primary gaze, with residual infraduction and adduction defects.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104124"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400613","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 atrophy in Lamb-Shaffer syndrome: two case presentations with ophthalmic imaging studies.","authors":"Ali A Alkhabbaz, Moath O Baeshen, Stuti M Tanya, Daniela Toffoli","doi":"10.1016/j.jaapos.2025.104183","DOIUrl":"https://doi.org/10.1016/j.jaapos.2025.104183","url":null,"abstract":"<p><p>Lamb-Shaffer syndrome is a rare neuro-developmental disorder associated with haploinsufficiency of the SOX5 gene. Clinical manifestations include speech delay, behavioral challenges, intellectual disability, and dysmorphic features. Up to 57% of patients have ophthalmic findings, including strabismus, refractive error, and optic nerve abnormalities. We present 2 siblings who are the first documented cases of Lamb-Shaffer syndrome with the p.R571W: c.1711 C>T SOX5 mutation to demonstrate optic nerve atrophy.</p>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":" ","pages":"104183"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143781308","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 MD, MSc ,&nbsp;Mohamed S. Sayed MD ,&nbsp;Mohamed M. Khodeiry MD ,&nbsp;Deborah K. VanderVeen MD","doi":"10.1016/j.jaapos.2025.104172","DOIUrl":"10.1016/j.jaapos.2025.104172","url":null,"abstract":"<div><h3>Purpose</h3><div>To evaluate the long-term outcomes of the Ahmed ClearPath (ACP) valveless glaucoma drainage device in childhood glaucoma.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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 (<em>P</em> &lt; 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104172"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"Progression of keratoconus secondary to thyroid eye disease: a case report","authors":"Blaze Ann Carbonell BS ,&nbsp;Annabelle Storch OD ,&nbsp;Charlotte Gore MD","doi":"10.1016/j.jaapos.2025.104127","DOIUrl":"10.1016/j.jaapos.2025.104127","url":null,"abstract":"<div><div>Keratoconus is a progressive condition marked by corneal thinning, caused by alterations of the structure and organization of corneal collagen. It is often diagnosed during the teen years, when collagen remodeling occurs at an increased rate. In contrast, Graves’ disease most commonly presents during adulthood. When it does manifest in pediatric cases, patients typically exhibit mild eyelid retraction and proptosis without vision loss. We present the case of a 16-year-old boy with vision loss due to progressive keratoconus changes secondary to Graves’ ophthalmopathy. To our knowledge, concurrent keratoconus and thyroid eye disease (TED) in a child has not been reported in the literature. Nor are there reports of rapid development of keratoconus following proptosis from TED.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104127"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426551","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 MD ,&nbsp;Zabila Khan BMedSci (Orthoptics) ,&nbsp;Arif O. Khan MD","doi":"10.1016/j.jaapos.2025.104159","DOIUrl":"10.1016/j.jaapos.2025.104159","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104159"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"“Polarized glasses dissociation test” for detection of suppression in intermittent exotropia","authors":"Soo Hyun Kim MD,&nbsp;Daniel J. Baik MD,&nbsp;Seung-Hyun Kim MD, PhD","doi":"10.1016/j.jaapos.2025.104174","DOIUrl":"10.1016/j.jaapos.2025.104174","url":null,"abstract":"<div><div>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.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104174"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","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":"Functional muscle insertional changes and strabismus after scleral buckling","authors":"Ana Wert MD,&nbsp;Daniel Gómez Plaza MD,&nbsp;Josep Visa MD","doi":"10.1016/j.jaapos.2025.104125","DOIUrl":"10.1016/j.jaapos.2025.104125","url":null,"abstract":"<div><div>We report 3 cases of esotropia following scleral buckling surgery for retinal detachment, a relatively undocumented complication. All patients exhibited alterations at the site of the rectus muscle insertions. In all cases, the distance from the limbus to the functional muscle insertion was increased, highlighting the importance of considering the functional muscle insertion in strabismus surgery after scleral buckling.</div></div>","PeriodicalId":50261,"journal":{"name":"Journal of Aapos","volume":"29 2","pages":"Article 104125"},"PeriodicalIF":1.2,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143400611","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}