Strabismus最新文献

{"title":"Palpebral myotonia mimicking intermittent strabismus in a child with SCN4A-related sodium channel myotonia.","authors":"Catarina Francisco, Leonor Francisco, Alberto Lemos, Paula Tenedório","doi":"10.1080/09273972.2026.2721447","DOIUrl":"https://doi.org/10.1080/09273972.2026.2721447","url":null,"abstract":"<p><strong>Introduction: </strong>Sodium channel myotonia associated with pathogenic SCN4A variants may present with prominent eyelid involvement. In young children, palpebral myotonia can mimic intermittent strabismus or ptosis and confound ocular alignment assessment.</p><p><strong>Methods: </strong>We report a preschool child with a familial heterozygous SCN4A variant (c.2102 G > A; p. Gly701Asp) referred for suspected intermittent esotropia. Serial pediatric ophthalmology assessments documented high bilateral astigmatism and variable ocular alignment findings. Directed bedside examination was performed during episodes of apparent ocular asymmetry.</p><p><strong>Results: </strong>Examination demonstrated delayed eyelid reopening after sustained forceful closure, intermittently affecting either eye, with preserved ocular motility and no consistent manifest deviation in primary gaze. Neuroimaging and fundus examinations were normal. Recognition of palpebral myotonia reframed the apparent \"strabismus\" episodes, avoided unnecessary escalation of ophthalmic interventions, and supported appropriate multidisciplinary follow-up.</p><p><strong>Discussion: </strong>Palpebral myotonia is an under-recognized mimic of intermittent strabismus in children with SCN4A-related sodium channel myotonia. Delayed eyelid relaxation after forceful closure represents a simple bedside diagnostic clue that may help distinguish myotonia from true strabismus, ptosis, or ocular motor pathology.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-5"},"PeriodicalIF":0.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of macular vascular density following strabismus surgery for exotropia.","authors":"Hüseyin Emek, Leyla Hazar, Ferhat Baver Polat, Doruk Can Sevük, Çimen Baran, Uğur Keklikçi","doi":"10.1080/09273972.2026.2693034","DOIUrl":"https://doi.org/10.1080/09273972.2026.2693034","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of this study was to evaluate retinal vessel density (VD) following horizontal muscle surgery performed to treat exotropia.</p><p><strong>Materials and methods: </strong>This study included 23 patients who underwent unilateral strabismus surgery to treat exotropia in the Department of Ophthalmology at Dicle University. The operated eyes were compared with the contralateral, non-operated eyes. All patients underwent a comprehensive ophthalmological examination preoperatively and postoperatively. Best-corrected visual acuity was measured, and Hirschberg and prism cover tests were performed. All optical coherence tomography angiography measurements were performed by the same technician using an AngioVue OCT device (Optovue, Fremont, CA, USA). Only images with a signal strength of ≥ 70 were included. A 3 × 3 mm scan protocol was used to evaluate the macular region.</p><p><strong>Results: </strong>The mean patient age was 16.6 ± 5.1 years, the mean deviation angle was 25.9 ± 8.2 prism diopters, and the mean follow-up period was 3.6 ± 1.9 months. No significant differences were observed between the operated and control eyes in terms of the foveal avascular zone area and perimeter, superficial capillary plexus VD, and retinal thickness (<i>p</i> > .05). However, the deep capillary plexus (DCP) VD was significantly lower in the operated eyes compared with the control eyes in the parafoveal, parafoveal inferior, parafoveal nasal, and parafoveal superior hemi sectors (<i>p</i> = .022, <i>p</i> = .044, <i>p</i> = .019, and <i>p</i> = .015, respectively). Correlation and regression analyses revealed that age, follow-up duration, deviation angle, and extent of muscle surgery were not associated with these differences.</p><p><strong>Conclusions: </strong>The lower VD observed in the DCP in the operated eyes may indicate that the surgery resulted in subtle alterations in retinal microvascular perfusion. Hence, future studies should investigate whether strabismus surgery has long-term effects on retinal perfusion and sensitivity and elucidate the underlying causes of any such effects.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-8"},"PeriodicalIF":0.7,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148842066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Distance-dependent changes in deviation control after alternate occlusion therapy in children with intermittent exotropia: a retrospective pilot study.","authors":"Ikumi Narita, Akemi Wakayama, Yuko Takezawa, Yukari Shiraishi, Fumi Tanabe, Shunji Kusaka","doi":"10.1080/09273972.2026.2719734","DOIUrl":"https://doi.org/10.1080/09273972.2026.2719734","url":null,"abstract":"<p><p><i>Purpose:</i> To evaluate distance-dependent changes in deviation control after alternate occlusion therapy in children with intermittent exotropia (IXT). <i>Methods:</i> This study included 15 patients (6 males and 9 females) aged 4 to 6 years who had undergone alternate occlusion therapy for more than 2 months at the Department of Ophthalmology, Kindai University Hospital between June 2022 and December 2023. Alternate occlusion was performed at a ratio of 1:1 or 2:1, and daily occlusion time was set to 4 to 6 hours. Patients' control was evaluated at 30 cm, 1, 2, 3, 4, and 5 m and classified using Kushner's 4-grade (Excellent, Good, Fair, Poor) classification method (2019). In this study, an excellent or good level of control was considered favorable and otherwise unfavorable. Control was evaluated at the start (baseline) and the end of the occlusion therapy. Factors for control improvement including the initial age, the occlusion duration, and the initial deviation angle were also analyzed. We further investigated if patients' control varied with viewing distance by examining the viewing distance at which phoria could be maintained. <i>Results:</i> Of 15, 6 (40.0%) patients had unfavorable near control at baseline and 5 (83.3%) of them significantly improved control to a favorable level after occlusion (95% CI: 0.06-0.61). At distance, all 15 patients had unfavorable control at baseline and 5 (33.3%) patients significantly improved control to a favorable level after occlusion therapy (95% CI: 0.09-0.57). Logistic regression analysis revealed no significant factors influencing patients' control improvement. Of 15, 14 patients could be examined for phoria maintenance at all viewing distances and 11 (78.6%) patients showed phoria maintenance in a significantly extended viewing distance after occlusion therapy (<i>p</i> < .01, Wilcoxon signed-rank test).In addition, the proportion of patients maintaining phoria significantly increased at 1 m and 2 m (<i>p</i> = .031 for both). <i>Conclusion:</i> Alternate occlusion therapy was associated with improved deviation control and an extension of the viewing distance over which phoria could be maintained in children with IXT, suggesting a distance-dependent pattern of improvement progressing from near to distance rather than uniformly across distances.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-7"},"PeriodicalIF":0.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global financing of strabismus surgery: a literature review supported by an international survey.","authors":"Victor Do Outeiro, Emmanuel Bui Quoc","doi":"10.1080/09273972.2026.2716783","DOIUrl":"https://doi.org/10.1080/09273972.2026.2716783","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Purpose: &lt;/strong&gt;Strabismus surgery is a well-established intervention with demonstrated functional and psychosocial benefits, supported by extensive clinical and economic literature. Despite this evidence, reimbursement policies remain highly heterogeneous worldwide, often influenced by the persistent ambiguity between functional and cosmetic indications. A comprehensive synthesis of existing cost data, combined with real-world reimbursement practices, is required to better understand barriers to equitable access to care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;We conducted a targeted literature review to identify published data on hospital package costs and physician fees for strabismus surgery across different countries. This review was complemented by a cross-sectional web-based survey distributed to members of the European Strabismological Association between January and April 2025. The 37-item questionnaire explored national health-insurance structures, reimbursement mechanisms, professional fees, and reoperation coverage. Quantitative data were analyzed descriptively, and qualitative responses were reviewed thematically. All monetary values were inflation-adjusted and expressed in 2024 purchasing power parity (PPP)-adjusted U.S. dollars. One-sample Student's t-tests were used to compare international mean costs with French reference tariffs.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The literature review identified six peer-reviewed studies reporting direct costs of strabismus surgery across North America, Europe, Asia, and the Middle East. Survey analysis included 100 complete responses from 39 countries; 90% of respondents were ophthalmologists and 10% orthoptists, mostly practicing in mixed public-private settings. According to OECD classifications, three principal health-financing models were identified: Beveridge, Bismarck, and liberal systems. Public reimbursement of strabismus surgery was reported in 92% of countries when performed in public hospitals, but in only 50% when performed in private facilities. Coverage for aesthetic or psychosocial indications varied widely.The pooled mean international hospital package cost derived from survey and literature data was 2 303 ± 1 543 USD PPP, not significantly different from the French \"&lt;i&gt;GHS/GHM&lt;/i&gt;\" reference tariff (2 233 USD PPP; &lt;i&gt;p&lt;/i&gt; = .87). In contrast, the mean international surgical fee (676 ± 391 USD PPP) was significantly higher than the French \"&lt;i&gt;CCAM\"&lt;/i&gt; benchmark (223 USD PPP; &lt;i&gt;p&lt;/i&gt; &lt; .05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This combined literature review and international survey highlights substantial disparities in the financing of strabismus surgery worldwide. While institutional costs appear broadly comparable across countries, physician remuneration varies markedly and remains particularly undervalued in some systems. Persistent ambiguity regarding functional versus cosmetic indications continues to influence reimbursement policies. Greater harmonization and recognit","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-15"},"PeriodicalIF":0.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research progress in the clinical application of AI in strabismus.","authors":"Tingnan Huang, Lu Yu, Pei Chen, Yimeng Qu, Huijie Yang, Tao Peng, Zheng Wang","doi":"10.1080/09273972.2026.2718344","DOIUrl":"https://doi.org/10.1080/09273972.2026.2718344","url":null,"abstract":"<p><strong>Purpose: </strong>Strabismus diagnosis and management remain subjective due to variable measurement techniques and lack of standardized surgical criteria. Artificial intelligence (AI) has shown potential in ophthalmology, but its clinical translation in strabismus is underexplored. This review systematically summarizes current AI applications and challenges in strabismus diagnosis, surgical planning, and postoperative training.</p><p><strong>Methods: </strong>We searched PubMed, Web of Science, and CNKI for studies up to 2025 using keywords \"artificial intelligence,\" \"machine learning,\" \"deep learning,\" \"strabismus,\" and \"eye tracking.\" Studies on AI-based detection, angle measurement, surgical dosage prediction, and outcome evaluation were included.</p><p><strong>Results: </strong>Fifty-two studies were analyzed. AI applications focus on three areas: (1) Deep learning on corneal reflection and facial photographs achieved diagnostic sensitivity of 94-99.1% and specificity up to 99.3%, outperforming clinicians in some datasets; (2) Eye-tracking technology showed ~90% correlation with prism cover test and higher repeatability (ICC 0.99 vs. 0.91, p<0.02) in children; (3) Surgical planning models (support vector regression, decision trees) predicted muscle recession/resection with mean errors of 0.5-0.8 mm. However, most models lack multi-center prospective validation.</p><p><strong>Conclusion: </strong>Despite promising accuracy, clinical adoption faces challenges: single-center data bias, poor interpretability, infrastructure gaps in remote areas, and no regulatory approvals. Future work requires multi-center trials, explainable AI, and user-friendly deployment to ensure equitable global use.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-14"},"PeriodicalIF":0.7,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative surgical outcomes of rectus muscle plication versus resection in horizontal strabismus correction: a systematic review.","authors":"Anas Alamoudi, Faisal A Altahan, Eyad R Fatani, Maan S Alkharashi","doi":"10.1080/09273972.2026.2708097","DOIUrl":"https://doi.org/10.1080/09273972.2026.2708097","url":null,"abstract":"<p><strong>Purpose: </strong>Rectus muscle resection is a standard strengthening procedure in horizontal strabismus surgery, but it requires muscle disinsertion and tissue excision. Rectus muscle plication has been proposed as a vessel-sparing alternative that preserves the muscle insertion and may reduce selected technical risks. This review evaluates the comparative effectiveness, safety, and short- to medium-term outcomes of plication versus resection in horizontal strabismus surgery.</p><p><strong>Methods: </strong>This systematic review was conducted according to PRISMA guidelines and registered in PROSPERO. MEDLINE, CENTRAL, Google Scholar, and Web of Science were searched for comparative studies published through January 2025. Eligible studies directly compared rectus muscle plication with resection for horizontal strabismus. Risk of bias was assessed using RoB 2 for randomised trials and the Newcastle-Ottawa Scale for non-randomised studies.</p><p><strong>Results: </strong>Fifteen studies were included, comprising six randomised controlled trials and nine non-randomised comparative studies. Overall, 501 patients underwent plication and 576 underwent resection. Both procedures produced clinically meaningful improvement in ocular alignment, with most studies reporting final residual deviations within or near 10 prism dioptres. Across studies reporting formal success rates, plication success ranged from 27.8% to 100% and resection success from 55.3% to 100%; however, success definitions varied substantially, limiting direct comparison. Most studies found no statistically significant difference between procedures. Early overcorrection and postoperative diplopia were lower with plication in some studies. Complications were generally mild. No anterior segment ischaemia was reported, and no slipped or lost muscles were reported in any plication group. Conjunctival swelling or muscle hump after plication was transient and self-resolving.</p><p><strong>Conclusion: </strong>Rectus muscle plication appears to be a safe and effective alternative to resection for horizontal strabismus, with broadly comparable short- and medium-term alignment outcomes. Plication offers technical advantages, including preservation of anterior ciliary circulation and avoidance of muscle disinsertion, but evidence for long-term durability remains less certain, especially in paediatric intermittent exotropia. Future studies should use standardised success definitions, stratify outcomes by strabismus subtype and age group, and include longer follow-up.</p><p><p><b>Registration</b>: PROSPERO [CRD42024560726].</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-15"},"PeriodicalIF":0.7,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantitative analysis of binocular alignment by Hess screen testing in surgery for superior oblique palsy.","authors":"Qi Wei, Thomas Chang, Andrew Ryan, Amad Qureshi, Ningshi Yao, Ben Seiyon Lee, Wei-Yu Lai, Veronika Yehezkeli, Joseph L Demer","doi":"10.1080/09273972.2026.2667310","DOIUrl":"10.1080/09273972.2026.2667310","url":null,"abstract":"<p><strong>Purpose: </strong>Conventional prism-cover strabismus measurement is compromised by nonstandard and poorly repeatable target locations. We developed a general method to quantify incomitant strabismus in repeatable, defined gazes and illustrate its application to commonly performed surgical strategies in anatomically confirmed cases of superior oblique (SO) palsy.</p><p><strong>Methods: </strong>Hess screen alignment data were obtained before, 1 week, and 3-7 months after surgery in 19 patients with unilateral SO atrophy demonstrated by magnetic resonance imaging. Five underwent ipsilateral inferior oblique (IO) recession, four contralateral inferior rectus (IR) recession, and 10 underwent both. An automated program measured scanned Hess charts at 21 fixation targets at ±15° and 30° horizontal and vertical eccentricities for each fixating eye. Heat maps were created across the fixation field, quantifying strabismus angles, surgical effects, and secular trends. Individual heat maps were pointwise averaged for affected and fellow eyes, and according to the type of surgery: ipsilateral IO recession, contralateral IR recession, and combined.</p><p><strong>Results: </strong>Pre-operative alignment maps demonstrated three incomitant hypertropia patterns addressed by distinct surgical approaches. Recession of the IR alone produced immediate and stable correction of hypertropia with minimal incomitant effect. Recession of the IO corrected large lateral incomitance and had progressively improving late effects. Combining these approaches corrected lateral incomitance and hypertropia in infraversion, with progressively improving late effect.</p><p><strong>Conclusion: </strong>Alignment heat maps allow intuitive visualization of selective strabismus surgical strategies treating varied incomitance in SO palsy, reflecting progressive improvement in alignment when surgery includes IO recession.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-10"},"PeriodicalIF":0.7,"publicationDate":"2026-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13641720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148763817","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hypoplastic lateral rectus muscle in a 39-year-old female with esotropia.","authors":"Athanasia Sandali, Theodora Gianni, Lampros Lamprogiannis","doi":"10.1080/09273972.2026.2712953","DOIUrl":"https://doi.org/10.1080/09273972.2026.2712953","url":null,"abstract":"<p><strong>Purpose: </strong>Congenital hypoplasia of the extraocular muscles is a rare cause of strabismus. This article aims to report the case of a 39-year-old female with esotropia and a hypoplastic lateral rectus muscle (LRM).</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>The patient presented with esotropia measuring 35 prism diopters (PD), no evidence of stereoptic vision, and an otherwise normal examination. No surgery had ever been performed on her LRMs. During surgery for bilateral LRM resection, her left LRM was revealed to be severely hypoplastic, allowing for muscle hooks to be visible under the muscle sheath. Her surgery was successful.</p><p><strong>Conclusion: </strong>The patient's presentation and history may suggest myogenic etiology, rather than neurogenic. Diagnosis of Duane's syndrome did not match our differential; we thus hypothesize a congenital, structural hypoplasia of the left LRM. Cases such as the one described are important for timely diagnosis and tailored surgery planning.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-4"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Low-dose atropine-related esotropia in a myopic child: a case report.","authors":"Athanasia Sandali, Michail Angelos Gkikas, Anna Nikolaidou, Theodora Gianni, Lampros Lamprogiannis","doi":"10.1080/09273972.2026.2705934","DOIUrl":"https://doi.org/10.1080/09273972.2026.2705934","url":null,"abstract":"<p><strong>Aims/purpose: </strong>Acute-onset strabismus in highly myopic children raises a broad differential diagnosis. In this article, we report a pediatric case with high myopia and prolonged near focus who presented concomitant esotropia during treatment with atropine 0.05% eye drops.</p><p><strong>Methods: </strong>Case report.</p><p><strong>Results: </strong>A four-year-old male presented with progressive myopia, and a habit of prolonged near focus and excessive screen time. He had moderate myopia in both eyes, with no sign of strabismus. Due to the rapid progression of the refractive error over the next visits, low-dose atropine (LDA) drops 0.05% were prescribed. One month later, the patient developed esophoria which soon converted to esotropia. LDA treatment was discontinued with the child's axial length increasing, consistent with continued progression of myopia. Finally, he was switched over to peripheral defocus spectacles. Three years following his initial visit, his tests show stable visual acuity and AL and an esotropia measuring 45 PD. The patient has been scheduled for strabismus surgery.</p><p><strong>Conclusions: </strong>LDA is an increasingly useful method to control myopia progression; however, any potential side effects should be reported. To our knowledge, this case is one of the first reports of esophoria converting to esotropia in a young patient after atropine was used to control myopic progression.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-4"},"PeriodicalIF":0.7,"publicationDate":"2026-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708550","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scoliosis in strabismus: dominant roles of low BMI and female sex over refractive asymmetry.","authors":"Wei Zhuang, Yiming Yu, Yubin Chen, Pengyi Wu, Yubin Xiao, Wenli Zhang","doi":"10.1080/09273972.2026.2704872","DOIUrl":"https://doi.org/10.1080/09273972.2026.2704872","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with strabismus are at substantially elevated risk for scoliosis. This study aimed to determine whether anisometropia confers any independent or additive risk for scoliosis within this specific, high-risk population.</p><p><strong>Methods: </strong>This retrospective cross-sectional study included 561 strabismus surgery candidates aged 10-35 years. Scoliosis was radiographically defined as a Cobb angle ≥ 10°. Anisometropia was defined as a spherical equivalent difference ≥ 1.0 D. We performed multivariable logistic regression, subgroup analyses, and interaction tests to evaluate associations between scoliosis and demographic, systemic, and ocular factors.</p><p><strong>Results: </strong>The prevalence of scoliosis was 19.6%. Female sex (adjusted OR = 1.62, 95% CI: 1.05-2.51, <i>p</i> = .032) and lower BMI (adjusted OR = 0.85 per 1 kg/m² increase, 95% CI: 0.78-0.91, <i>p</i> < .001) were independent risk factors. In contrast, anisometropia showed no association with scoliosis (<i>p</i> = .901), and no dose-response relationship existed between their severities (<i>p</i> = .593). Interaction effects between anisometropia and other ocular factors were not statistically significant.</p><p><strong>Conclusions: </strong>In strabismus patients, scoliosis risk is primarily associated with systemic factors (low BMI, female sex) rather than refractive asymmetry. The null finding for anisometropia supports the sensory reweighting hypothesis, indicating its impact may be masked in the context of a profound binocular defect. These results redirect clinical screening focus toward anthropometric and sex-based assessment.</p>","PeriodicalId":51700,"journal":{"name":"Strabismus","volume":" ","pages":"1-9"},"PeriodicalIF":0.7,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148671255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}