Journal of Pediatric Ophthalmology and Strabismus最新文献

{"title":"Effect of Probing in Congenital Nasolacrimal Duct Obstruction in Children Older Than 2 Years.","authors":"Vaishali Lalit Une,&nbsp;Sushma Subhash Kulkarni,&nbsp;Varsha Sharad Nandedkar","doi":"10.3928/01913913-20190122-01","DOIUrl":"https://doi.org/10.3928/01913913-20190122-01","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the effect of probing for congenital nasolacrimal duct obstruction in children older than 2 years.</p><p><strong>Methods: </strong>A prospective interventional case series included 110 eyes of 94 patients with congenital nasolacrimal duct obstruction (CNLDO) aged 2 years or older, with no previous intervention. The diagnosis was based on clinical findings (epiphora, discharge, regurgitation test, and fluorescein dye disappearance test). The children were divided into two groups: 2 to 5 years and 6 to 8 years. Probing of the nasolacrimal duct under general anesthesia was done. Success was predefined as resolution of symptoms and signs that persisted 3 months postoperatively. Another probing was done at 4 to 6 weeks when necessary before considering the final outcome as a failure. The chi-square test was used to analyze the result.</p><p><strong>Results: </strong>Patients' ages ranged from 2 to 8 years (average age: 55 months). Twenty-six (28%) patients needed a second probing. The overall success rate was 80%: 85% in the 2 to 5 years group and 73% in the 6 to 8 years group. The success rate was significantly lower in patients with complex obstruction (33.3%). The outcome of probing was not affected by the age of the patients (P = .2305).</p><p><strong>Conclusions: </strong>Probing is a viable primary surgical option in CNLDO in older children and hence should not be withheld in children who are referred late. [J Pediatr Ophthalmol Strabismus. 2019;56(3):141-145.].</p>","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"141-145"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262277","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":"Impact of Early Postnatal Weight Gain on Retinopathy of Prematurity in Very Preterm Infants in Southwestern Ontario.","authors":"Yingxiang Li,&nbsp;Meera Shah,&nbsp;Michael R Miller,&nbsp;David S C Lee,&nbsp;Sapna Sharan","doi":"10.3928/01913913-20190208-01","DOIUrl":"https://doi.org/10.3928/01913913-20190208-01","url":null,"abstract":"<p><strong>Purpose: </strong>To examine the relationship between post-natal growth and development of retinopathy of prematurity (ROP) among preterm infants in southwestern Ontario.</p><p><strong>Methods: </strong>The medical records of 431 preterm infants, born between January 1, 2008, and June 1, 2015, with a gestational age (GA) of less than 31 weeks or birth weight (BW) of less than 1,250 g were reviewed. Information collected included pregnancy and birth history, neonatal characteristics, ROP status, comorbidities, and postnatal weight measurements at specified intervals. Infants diagnosed as having ROP and no ROP were compared.</p><p><strong>Results: </strong>Low weight velocity from day 7 to day 28 (P < .001), high weight velocity from birth to first day of full enteral feeding (FEF) (P < .001), long duration from birth to FEF (P < .001), and long duration from FEF to discharge/transfer (P < .001) were associated with ROP. After controlling for GA and BW, the durations, birth to FEF, and FEF to discharge/transfer remained significant (P < .05). In a multivariable logistic regression analysis adjusting for GA, bronchopulmonary dysplasia, and surgical ligation for patent ductus arteriosus, the only independent risk factor of ROP was duration from FEF to discharge/transfer (P < .05).</p><p><strong>Conclusions: </strong>Low weight velocity from day 7 to day 28 may be a useful predictor for the development of ROP but is dependent on GA and BW. A delay to reach FEF, which is associated with comorbidities of ROP, appears to be a risk factor for ROP that is independent of GA and BW. [J Pediatr Ophthalmol Strabismus. 2019;56(3):168-172.].</p>","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"168-172"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262727","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":"Topical Anesthesia in Children With Intraoperative Adjustable Strabismus Surgery.","authors":"Filippo Franco,&nbsp;Elena Bolletta,&nbsp;Silvia Mancioppi,&nbsp;Elena Franco,&nbsp;Alberto Migliorelli,&nbsp;Paolo Perri","doi":"10.3928/01913913-20190208-02","DOIUrl":"https://doi.org/10.3928/01913913-20190208-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate strabismus surgery with intraoperative adjustment of sutures under topical anesthesia in children.</p><p><strong>Methods: </strong>Nineteen children with horizontal deviation underwent a one-stage surgical technique performed under topical anesthesia. Surgery consisted of unilateral or bilateral recession and/or resection of horizontal muscles or the medial or lateral rectus muscles, with intraoperative adjustment of sutures based on alternate prism cover test. Follow-up was done at 1 day and 1, 3, and 6 months postoperatively.</p><p><strong>Results: </strong>Mean age at surgery was 12.68 ± 2.50 years (range: 8 to 16 years). Mean preoperative angle of deviation was 24.21 ± 11.20 prism diopters (PD) (range: -50 to +30 PD) at distance. Mean postoperative angle of deviation at 6 months was 4.11 ± 2.87 PD (range: -10 to +10 PD) at distance. In esotropic patients, the average angle of deviation decreased from +23.80 ± 5.89 PD preoperatively to +4.80 ± 3.35 PD at 6 months, whereas in exotropic patients it decreased from -24.36 ± 12.76 to -3.86 ± 2.77 PD. Seventeen of 19 patients (89%) remained comfortable during surgery, whereas 2 needed an intravenous injection of propofol. The success rate, defined by a postoperative residual angle of deviation of ±8 PD or less, was 89% at 6 months.</p><p><strong>Conclusions: </strong>Strabismus surgery with intraoperative suture adjustment under topical anesthesia in children is a tolerable procedure with encouraging outcomes, representing an alternative to general anesthesia in well-selected children. Clinical evaluation of children and parents is fundamental to predict a likely poor collaboration of the child during surgery, which, if present, would require surgery under general anesthesia. [J Pediatr Ophthalmol Strabismus. 2019;56(3):173-177.].</p>","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"173-177"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262728","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":"Surgical Outcome of External Dacryocystorhinostomy With Silicone Intubation for Recurrent Lacrimal Abscess in Children Younger Than 6 Years.","authors":"Pradhnya Sen,&nbsp;Elesh Jain,&nbsp;Amit Mohan,&nbsp;Amit Kumar","doi":"10.3928/01913913-20190228-01","DOIUrl":"https://doi.org/10.3928/01913913-20190228-01","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the success rate of external dacryocystorhinostomy (DCR) with silicone intubation for recurrent lacrimal abscess in children younger than 6 years.</p><p><strong>Methods: </strong>A single-center retrospective analysis of 46 eyes of 40 children who underwent DCR with silicone tube intubation for recurrent lacrimal abscess was done. Probing done previously in these cases was unsuccessful. Only those children who underwent incision and drainage of the abscess at least once with antibiotic treatment were included in the study. In all cases, silicone tube removal was done after 3 months. A successful outcome was defined as the absence of subjective complaints of pain and swelling over the medial canthal area and watering and discharge at 6 months postoperatively. Objective assessment of patency of the lacrimal apparatus was done by sac syringing at 6 months postoperatively.</p><p><strong>Results: </strong>The mean age at surgery was 4.93 ± 0.93 years (range: 3 to 6 years) and the mean follow-up duration was 11.80 ± 11.87 months (range: 6 to 84 months). Intra-operative difficulties encountered were excessive perisac adhesion (n = 28) and severe bleeding/hemorrhage (n = 24). A total of 82.61% cases had a successful outcome after DCR with silicon tube intubation. One child had granuloma formation at the wound. Spontaneous tube extrusion occurred in three children.</p><p><strong>Conclusions: </strong>DCR with silicone tube intubation is a safe and effective surgical approach with satisfactory outcomes for treating recurrent lacrimal abscess with congenital nasolacrimal duct obstruction in children younger than 6 years. [J Pediatr Ophthalmol Strabismus. 2019;56(3):188-193.].</p>","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"188-193"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37263634","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":"The Ongoing Controversy of Late Probing for Congenital Nasolacrimal Duct Obstructions.","authors":"Leonard B Nelson","doi":"10.3928/01913913-20190403-01","DOIUrl":"https://doi.org/10.3928/01913913-20190403-01","url":null,"abstract":"","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"140"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262276","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":"Postoperative Nausea and Vomiting and Phase I Post-anesthesia Recovery After Strabismus Operations.","authors":"Kathleen M Kratt,&nbsp;Erick D Bothun,&nbsp;Sree Chandralek Kruthiventi,&nbsp;Erica R Portner,&nbsp;Juraj Sprung,&nbsp;Toby N Weingarten","doi":"10.3928/01913913-20190208-03","DOIUrl":"https://doi.org/10.3928/01913913-20190208-03","url":null,"abstract":"<p><strong>Purpose: </strong>To ascertain postoperative nausea and vomiting (PONV) rates in adult patients after strabismus operations and assess causes for prolonged post-anesthesia recovery.</p><p><strong>Methods: </strong>This was a retrospective observational study of consecutive adult patients who underwent strabismus operations at one institution from January 1, 2010, to May 31, 2017. The anesthetic records were abstracted and PONV rates were ascertained. On the basis of the cohort's 75th percentile of anesthesia recovery duration, patients were categorized into goal recovery (lower three quartiles) and prolonged recovery (upper quartile). Multivariable logistic regression analyses were performed to assess associations between clinical characteristics and prolonged recovery.</p><p><strong>Results: </strong>A total of 794 adult patients who underwent strabismus surgery were identified. PONV was present in 31 (3.9%) patients. The median (interquartile range) post-anesthesia recovery was 45 minutes (range: 33 to 63 minutes). Prolonged recovery was associated with long-term benzodiazepine use (odds ratio [OR]: 3.07; 95% CI [confidence interval]: 1.23 to 7.80; P = .02). Patients with prolonged recovery had higher rates of PONV (15 [7.2%] vs 16 [2.7%], P = .007), oversedation (107 [51.4%] vs 226 [38.6%], P = .001), and postoperative analgesic administration (138 [66.4%] vs 222 [37.9%], P < .001). Inverse associations were found between desflurane and oversedation (OR: 0.63; 95% CI: 0.45 to 0.86; P = .004) and between acetaminophen administration and postoperative analgesic administration (OR: 0.57; 95% CI: 0.38 to 0.86; P = .007).</p><p><strong>Conclusions: </strong>Adult patients undergoing general anesthesia for strabismus surgery had a low PONV rate. However, the presence of PONV was associated with delayed recovery room discharge. Other factors associated with prolonged Phase I recovery were long-term benzodiazepine use and longer operations, which likely resulted in an increased need for anesthetic agents and therefore more intense postoperative sedation. [J Pediatr Ophthalmol Strabismus. 2019;56(3):151-156.].</p>","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"151-156"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262724","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":"Cortical Visual Impairment in Congenital Cytomegalovirus Infection.","authors":"Haoxing Douglas Jin,&nbsp;Gail J Demmler-Harrison,&nbsp;Jerry Miller,&nbsp;Jane C Edmond,&nbsp;David K Coats,&nbsp;Evelyn A Paysse,&nbsp;Amit R Bhatt,&nbsp;Kimberly G Yen,&nbsp;Joseph T Klingen,&nbsp;Paul Steinkuller","doi":"10.3928/01913913-20190311-01","DOIUrl":"https://doi.org/10.3928/01913913-20190311-01","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the presentation, evolution, and long-term outcome of cortical visual impairment (CVI) in patients with symptomatic congenital cytomegalovirus (CMV) infection, and to identify risk factors for the development of CVI in patients with symptomatic congenital CMV.</p><p><strong>Methods: </strong>Retrospective subanalysis of a long-term prospective cohort study with data gathered from 1982 to 2013.</p><p><strong>Results: </strong>Eleven of 77 (14.3%) patients with symptomatic CMV, 0 of 109 with asymptomatic CMV, and 51 control patients had CVI. Overall, patients with symptomatic CMV had worse vision than patients with asymptomatic CMV, who in turn had worse vision than control patients. Microcephaly, intracranial calcification, dilatation of ventricles, encephalomalacia, seizure at birth, optic atrophy, chorioretinitis/retinal scars, strabismus, and neonatal onset of sensorineural hearing loss were risk factors associated with CVI.</p><p><strong>Conclusions: </strong>CVI may result from symptomatic congenital CMV infection. The relationship of CVI and its risk factors in patients with CMV suggests the potential to predict the development of CVI through predictive modeling in future research. Early screening of CVI in children born with symptomatic congenital CMV can facilitate educational, social, and developmental interventions. [J Pediatr Ophthalmol Strabismus. 2019;56(3):194-202.].</p>","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"194-202"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37263635","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":"Managing Strabismus Syndromes.","authors":"Caroline DeBenedictis,&nbsp;Bruce M Schnall,&nbsp;Leonard B Nelson","doi":"10.3928/01913913-20190321-01","DOIUrl":"https://doi.org/10.3928/01913913-20190321-01","url":null,"abstract":"","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"136-138"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262274","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":"My Right Eye Looks Red and Angry.","authors":"Meenakshi Wadhwani,&nbsp;Kritika Chopra,&nbsp;Manika Manika","doi":"10.3928/01913913-20190314-01","DOIUrl":"https://doi.org/10.3928/01913913-20190314-01","url":null,"abstract":"","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"139"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262275","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":"A Cluster of Cyclic Esotropia: White Matter Changes on MRI and Surgical Outcomes.","authors":"Kimberly Merrill,&nbsp;Jill Anderson,&nbsp;Daniel Watson,&nbsp;Raymond G Areaux","doi":"10.3928/01913913-20190211-01","DOIUrl":"https://doi.org/10.3928/01913913-20190211-01","url":null,"abstract":"<p><strong>Purpose: </strong>To report a series of patients with cyclic esotropia, their surgical outcomes, and incidental findings.</p><p><strong>Methods: </strong>The medical records of five patients with cyclic esotropia presenting over 17 months were reviewed. Age at onset, ocular and motility examinations, brain magnetic resonance imaging (MRI), acetylcholine receptor antibodies, thyroid hormone levels and antibodies, calendars documenting phases, surgical treatments, postoperative alignment, and fusion were documented.</p><p><strong>Results: </strong>Three boys and two girls presented at 3 to 4 years old in 2015-2016. Typical periodicity followed a 48-hour cycle. Duration of cycling varied from 1 to 9 weeks. Mean maximum deviation was 37 prism diopters (PD) of esotropia (range: 35 to 40 PD of esotropia). All patients had normal laboratory studies. MRIs showed an abnormal white matter signal in the frontal lobes in 2 patients and were normal in the others. Bilateral medial rectus recessions for the maximum angle were successful in 4 patients at a minimum follow-up of 13 months; the other patient required reoperation for a residual esotropia. Fusion was present in 4 patients preoperatively and all postoperatively. Stereopsis was stable or improved in all postoperatively.</p><p><strong>Conclusions: </strong>This is the first report of frontal white matter changes occurring in the setting of cyclic esotropia. MRI with attention to frontal lobe white matter might be considered in the work-up of cyclic esotropia to determine if this is a common finding. Bilateral medial rectus recessions can restore fusion in these patients. [J Pediatr Ophthalmol Strabismus. 2019;56(3):178-182.].</p>","PeriodicalId":519537,"journal":{"name":"Journal of Pediatric Ophthalmology and Strabismus","volume":" ","pages":"178-182"},"PeriodicalIF":1.2,"publicationDate":"2019-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37262729","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}