bluuebunny/crossref_metadata_2025_split huggingface dataset:
Advancement of Medial Rectus Muscle to the Original Insertion for Consecutive Exotropia
Authors: Ohtsuki Hiroshi , Hasebe Satoshi , Tadokoro Yasunori , Kobashi Rie , Watanabe Sei , Okano Masaki 
Published: April 2021

ABSTRACT
Twenty-four patients who underwent surgery to correct consecutive exotropia that developed iatrogenically after surgical overcorrection were studied retrospectively. All patients underwent single or bilateral advancement of the medial rectus muscle to the original muscle insertion. The mean preoperative exodeviation was 26.7 prism diopters at distance and 3S.2 Δ at near. Postoperatively, in cases receiving advancement of a single medial rectus, the mean amount of correction was 23.2 Δ at distance and 29.6 Δ at near. In cases receiving bilateral medial rectus advancement, the mean amount of postoperative correction was 26.3 Δ at distance and 39.8 Δ at near. Adduction deficiency was normalized in five patients (71%), while convergence insufficiency was improved in only nine patients (45%) after surgery. Twelve (50%) patients had binocular single vision at distance on a normal or abnormal basis as determined by the Bagolini lens test.
Vernier Acuity Cards: A Practical Method for Measuring Vernier Acuity in Infants
Authors: Holmes Jonathan M , Archer Steven M 
Published: April 2021

ABSTRACT
The feasibility of a practical preferential looking technique, similar to Teller acuity cards, was investigated for the assessment of vernier acuity in preverbai infants. Forty-two infants ages 1 to 13 months were tested with cards having vernier offsets of 2 to 64 minutes of arc and spatial frequencies of 0.25 to 2.0 cycles per degree. All infants showed a robust preferential looking response to the largest vernier offsets. Vernier thresholds decreased with age from 64 minutes of arc at 1 month to 4 minutes of arc at 13 months. Smaller vernier offsets were more readily detectable when embedded in higher spatial frequency gratings. Vernier acuity can be assessed in preverbai infants using a preferential looking technique similar to that employed with the Teller acuity cards. Vernier acuity is known to be more sensitive to amblyopia than grating acuity; therefore, this technique may prove useful in the assessment of amblyopia.
Visual Alignment From the Midline: A Declining Developmental Trend in Normal, Strabismic, and Monocularly Enucleated Children
Authors: Dengis Carol A , Steinbach Martin J , Gottz Herbert C , Stager Christine 
Published: April 2021

ABSTRACT
Children, 1 .8 to 5.0 years of age, were asked to sight through a tube at targets. There were three groups tested: children with normal binocular vision, children with strabismus, and children with one eye enucleated. The younger normal and strabismic patients placed the tube midway between the two eyes. Surprisingly, the younger enucleated children also placed the tube at the midline. This "Cyclops effect" diminished as the children grew older, with a transition to sighting monocularly by the age of 4 years. The tendency to align with the midline by the younger children, regardless of the degree of their binocular vision, presumably is a natural response to a cyclopean projection center in the midline. As children mature, they learn to meet the demands of monocular preference tasks by aligning objects in front of one eye.
Longitudinal Study of Levodopa/Carbidopa for Childhood Amblyopia
Authors: Leguire Lawrence E , Walson Philip D , Rogers Gary L , Bremer Don L , McGregor Mary Lou 
Published: April 2021

ABSTRACT
To determine the tolerability and efficacy of levodopa/ carbidopa combined with occlusion therapy for childhood amblyopia, a double-masked placebo-controlled randomized longitudinal study was performed on 10 amblyopic children between 6 and 14 years of age. Subjects received, on average, 20/5 mg levodopa/ carbidopa or 20 mg of placebo three times per day combined with part-time occlusion over a 3-week period. Visual function was assessed by Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity charts and by contrast sensitivity. Tolerability was assessed by questionnaire, SMAC (standard laboratory tests; consists of a chem 20 and complete blood count [CBC]) analysis, and physical examination. Compliance with occlusion and capsule consumption were assessed by questionnaire and by capsule count, respectively. At the end of the dosing regimen, the ìevoàopalcarbiàopa group significantly improved in visual acuity by 2.7 lines and in mean contrast sensitivity by 72% in the amblyopic eye. The placebo group improved in visual acuity by 1 .6 lines in the amblyopic eye. Tolerability and occlusion compliance were similar between groups; however, capsule ingestion compliance was significantly lower in the levodopa/carbidopa group. One month after the termination of treatment, the levodopa/carbidopa group maintained a significant 1.2-line improvement in visual acuity and 74% improvement in contrast sensitivity in the amblyopic eye. The placebo group did not maintain an improvement in visual acuity between the eyes. It is concluded that levodopa/carbidopa, at an average of 0.48/0.12 mg/kg, is well tolerated and, when combined with part-time occlusion, is efficacious in improving visual function in amblyopic children.
Accommodative Esotropia in Adults
Authors: Shippman Sara , Weseley Alan C , Cohen Kenneth R 
Published: April 2021

ABSTRACT
The accommodative convergence/accommodation (AC/A) ratio is thought to be fixed throughout life. We present 11 patients who, in adulthood, show a situational increase in their AC/A ratio. Since all patients had a history of accommodative esotropia with and without a nonaccommodative component, we feel the situational increase in the AC/A ratio is in response to the additional effort needed to correct the patients' facultative hyperopia. These patients demonstrate the importance that all adults with acute onset of commitant esotropia and a history of accommodative esotropia should wear full correction before a prism is incorporated into their glasses or surgical intervention is considered.
The Surgical Management of Nontraumatic Ectopic Lenses
Authors: Salehpour Omid , Lavy Tim , Leonard James , Taylor David 
Published: April 2021

ABSTRACT
We report the results of limbal lensectomy for ectopia lentis in 50 eyes of 30 children over a period of 7 years. The reasons for surgery were poor visual acuity in 47 eyes and dislocation of the lens into the anterior chamber in three. Best-corrected visual acuity Improved in all except two patients, both of whom had glaucoma: in one (with an unusual syndrome), a vitreous hemorrhage occurred that resulted in light-perception-only vision; in the other, a persistent uveitis developed that eventually required secondary vitrectomy. Visual acuity was unchanged in two patients. Peaked pupil occurred in seven. We conclude that, unless there are associated ocular diseases, limbal lensectomy in childhood ectopia lentis effectively improves visual acuity with few complications.
Prevalence of Glaucoma After Surgery for PHPV and Infantile Cataracts
Authors: Johnson Christina P , Keech Ronald V 
Published: April 2021

ABSTRACT
The prevalence of glaucoma associated with pediatrie aphakia has been reported to range from 0% to 27%. Few studies have included a significant number of patients with persistent hyperplastic primary vitreous (PHPV) cataracts. The purpose of this study was to evaluate the prevalence of glaucoma in young children undergoing surgery for PHPV and infantile cataracts.
The charts of all of the patients who underwent lensectomy/vitrectomy for infantile and PHPV cataracts at the University of Iowa Hospitals and Clinics between 1975 and 1992 were reviewed. Patients with ocular abnormalities that might predispose to glaucoma and patients with less than 6 months follow up were excluded. A total of 72 patients (109 eyes) were identified: 25 patients (26 eyes) with PHPV cataracts and 47 patients (83 eyes) with infantile cataracts. Mean age at time of surgery for both groups was 3.5 months. Mean follow up was 84.5 months for those with PHPV, and 76.9 months for those with infantile cataracts. Glaucoma developed in eight (32%) of the 25 patients with PHPV and in 15 (32%) of the 47 with infantile cataracts. Mean time to onset of glaucoma was 64.6 months for those with PHPV and 47.5 months for those with infantile cataracts (P=.70).
Although there was no significant difference between the prevalence of postoperative glaucoma in those with infantile and those with PHPV cataracts, the prevalence of glaucoma in these patients is high. Children with aphakia should be closely monitored for glaucoma throughout their lives.
Comparison of Grating and Vernier Acuity in Infants With Developmental Delay
Authors: Holmes Jonathan M 
Published: April 2021

ABSTRACT
Background: Grating acuity measured by Teller cards Is mildly reduced in children with developmental delay. Vernier acuity, the ability to detect offsets, also can be measured, but has not been studied in children with developmental delay.
Methods: In a prospective cross-sectional pilot study, 12 nonverbal children with developmental delay established by pediatrie assessment of developmental milestones were tested blnocularly with vernier and Teller cards. Ages ranged from 4 to 24 months. Vernier offsets ranged from 2 to 64 minutes of arc.
Results: All children were testable with Teller acuity cards. Binocular grating acuity ranged from 1.7 to 7.4 cpd (median, 1.0 octaves below normal). Binocular vernier acuity ranged from unrecordable to 8 minutes of arc (median, "unrecordable"). Only four of the 12 children demonstrated a measurable vernier acuity. Normal children of this age have a vernier acuity of 2 to 16 minutes of arc measured by this technique.
Conclusion: The response to vernier acuity cards appears to be more severely degraded by developmental delay than the response to Teller cards.
Small-Target Random Dot Stereogram and Binocular Suppression Testing for Preschool Vision Screening
Authors: Simons Kurt , Avery Kelly Elhatton , Novak Audrey 
Published: April 2021

ABSTRACT
Background: New, small-target (<1°) random dot stereogram (STRDS) and binocular suppression (STBS) tests appropriate for preschool vision screening were developed to correct the shortcomings of previous such tests, particularly missed cases of anisometropic amblyopia such as found with some RDS-based testing.
Methods: In Experiment 1, the tests were administered to 14 patients with current or a recent history of moderate (≤ 20/60) anisometropic amblyopia, or with accommodative esotropia or monofixation syndrome. All subjects had good binocularity (≤100" contour stereoacuity). In Experiment 2, the new tests were administered in a screening setting to a group of 112 three- to five-yearolds to determine testability. Visual acuity, cover testing, and photoscreening were administered as control measures.
Results: In Experiment 1, eleven of the 14 patients failed both tests. Two anisometropic amblyopes passing one or both tests had an acuity ≤20/30 in the worse eye and ≤25" stereoacuity. Three anisometropic amblyopia patients failing the STRDS passed another RDS test with similar disparity but a larger target size, confirming a report34 that anisometropic amblyopes may pass RDS testing with parafoveal stereopsis despite the presence of central suppression. The STRDS and STBS tests indicated 80% and 96% specificity, respectively, with the original methodologies; STRDS specificity increased to 95% with retesting with a different methodology. Administration time was 30 sec to 60 sec per test.
Conclusion: Small-target RDS or suppression testing may be more effective for strabismus and amblyopia screening of preschoolers than previous RDS test formats.
Retinopathy of Prematurity and Surfactant Treatment
Authors: Axer-Siegel Ruth , Snir Moshe , Ma'ayan Ayala , Na'or N , Davidson Samuel , Weinberger Dov , Yassur Yuval 
Published: April 2021

ABSTRACT
Purpose: Surfactant therapy in premature infants has reduced the severity of respiratory distress syndrome (RDS), thus leading to a reduction in mortality. However, the anticipated effect of surfactant therapy on the incidence and severity of retinopathy of prematurity (ROP) is ambiguous. The acute rise in Pao2 and the increased survival of low-birth-weight infants may augment the risk of ROP, whereas their improved health and respiratory status may lower it.
Methods: We reviewed the findings of sequential ophthalmologic examinations performed in our neonatal intensive care unit. Premature infants of gestational age under 32 weeks and weighing less than 1500 g at birth who received surfactant treatment were compared with a group of historical controls consisting of premature infants of the same mean birth weight and gestational age who did not get this supplement.
Results: ROP was present in 13 (65%) of the 20 surfactant-treated babies, and threshold disease was noted in six (30%). In the historical control group, 20 (77%) of 25 infants had ROP, of whom 10 (40%) were treated for threshold disease. These differences were not statistically significant.
Conclusion: Surfactant therapy was not associated with an increased incidence of ROP in our series.
Observer Sensitivity to Retinal Vessel Diameter and Tortuosity in Retinopathy of Prematurity: A Model System
Authors: Freedman Sharon F , Kylstra Jan A , Capowski Joseph J , Realini Tony D , Rich Cadmus , Hunt David 
Published: April 2021

ABSTRACT
Background: Abnormally increased diameter and tortuosity of retinal blood vessels in the posterior pole, or "plus disease," is recognized as a powerful predictor of poor outcome in eyes with retinopathy of prematurity (ROP). Although the diagnosis of plus disease depends upon the examiner's ability to examine retinal blood vessels, the ability of the human observer to identify changes in retinal blood vessel diameter and tortuosity accurately has not been studied.
Methods: Using computer-aided analysis of fundus photographs from eyes with a wide range of ROP severity, we generated tracings of posterior pole blood vessels which varied by quintiles of mean vessel diameter and tortuosity. Subjects (23 naive and 12 expert observers) ranked groups of tracings in order of increasing mean vessel diameter and tortuosity. These ranking tests were performed on tracings derived from the same fundus and tracings derived from distinct fundi. In a similar fashion, subjects also compared one designated standard fundus tracing with 25 distinct fundus tracings.
Results: Vessel diameter was assessed correctly more often than vessel tortuosity, both among similar (>99% vs 92% of the time, respectively, P<0.001), or among distinct (88% vs 78% of the time, respectively, P<0.001) fundus Images. The mean vessel diameter and tortuosity of 25 distinct fundus images were correctly ranked versus a standard image in 89% of attempts. Assessments of increments in vessel diameter and tortuosity were independent. Naive and expert subjects performed indistinguishably on all tests.
Conclusions: Intelligent human observers have considerable ability to discern clinically relevant increments in blood vessel diameter and tortuosity. This ability may facilitate standardization in the diagnosis of plus disease in ROP.
Second Generation Binocular Polaroid Test
Authors: Nuzzi Giuseppe , Cantù Cristiana , Camparini Monica 
Published: April 2021

ABSTRACT
Background: Jbe aim of the study was to introduce a new test to detect small areas of suppression in the binocular visual field and to lower the minimum age at which a suppression test could be identified correctly. Two tests were compared: the Binocular Polaroid Test (poltest), introduced in clinical practice a few years ago and used in screening programs for vision impairment; and the Second Generation Binocular Polaroid Test (poistar), more recently designed to have simpler answers than the poltest.
Methods: One hundred and eighty-two children were examined consecutively. To assess the validity of the two tests, sensitivity, specificity, predictive value, and phi coefficient were calculated. The applicability of the two tests and the speed of the responses was assessed by means of the test of probability of binomial distribution.
Results: The polstar has appeared to be simpler and easier in younger patients (age range 20 to 36 months, P=0.078), and has shown 100% of specificity with a sensitivity of 84% for the polstar 1 and of 1 00% for the polstar 2.
Conclusion: The results appear to demonstrate that the poltest has been improved, and that the polstar may be considered an interesting investigation device for early detection of monocular visual impairment.
Automated Analysis of Electromyographic (EMG) Recordings During Botulinum Injections
Authors: Hunter David G , Nguyen Thong , Patel Saurabh N , Repka Michael X 
Published: April 2021

ABSTRACT
Purpose: Botulinum toxin is injected into extraocular muscles using electromyographic (EMG) guidance to confirm needle location prior to injection. The purpose of this study was to develop and test an automated, objective method of storing and grading EMG signal quality obtained during botulinum injection. A reliable, nonsubjective estimate of signal quality will enhance future studies of the complications or effectiveness of botulinum toxin injections into extraocular muscle.
Methods: Injections were administered using a standard procedure. The EMG was digitized, recorded, and analyzed using discrete Fourier transform and power spectrum analysis. Audible signal quality was also graded subjectively by the surgeon. Patients were followed to determine the clinical response to the injection.
Results: Eighteen patients 24 injections) were studied. Each sample was collected and analyzed in less than one second. The EMG contained signals over a range of frequencies from 50 to 500 Hz, with an average peak near 90 Hz. Substantial variability of the signal was observed between patients. Contracting muscle had a higher total power and peak frequency in most, but not all, cases. Total signal power correlated moderately with subjective estimates of signal quality. Neither subjective nor computer-derived signal quality estimates correlated with the response to injection or complications.
Conclusions: Computerized signal analysis can automatically characterize EMG signal power and frequency distribution. Although this technique has the potential to identify needle location at the time of botulinum injection accurately, signal variability limited the clinical and research utility of the present protocol.
Extraocular Muscle Fiber Morphometry Following Combined Recession-Resection Procedures in Rabbits
Authors: Christiansen Stephen P , Harral Russell L , Brown Harry 
Published: April 2021

ABSTRACT
Purpose: In earlier studies, we have reported extraocular muscle fiber atrophy following recession and fiber hypertrophy following resection of a horizontal rectus muscle. Changes seen in the operated muscle were mirrored in the antagonist and were thought to be a compensatory response to sustained changes in tension across the muscle pair caused by the surgery and by changes in the rotational position of the globe. The purpose of this study is to examine the effects of combined recession-resection on extraocular muscle fiber diameter.
Methods: In 16 anesthetized rabbits, a 6-mm recession of the medial rectus was combined with a 6-mm resection of the lateral rectus in the left orbit. The horizontal rectus muscles were removed from both orbits of four rabbits at 2-, 4-, 8-, and 16-week postoperative intervals. Cross-sections were cut from the midbelly of each muscle, and muscle fiber diameters were measured with a computerized morphometry unit. Mean fiber diameters from the operated orbit of animals at each postoperative interval were pooled and compared with means from the unoperated orbit using the paired-samples t test.
Results: No statistically significant change in fiber diameter was seen in either the global or orbital fiber layers at any postoperative interval examined.
Conclusions: Because resection would be expected to increase and recession to decrease the resting tension across an agonist-antagonist pair, our results suggest that a combined recession-resection yields no significant net change in resting tension, and minimizes compensatory changes in extraocular muscle fiber diameter.
Binocular Cortical Interactions in the Monofixation Syndrome
Authors: Struck M C , Ver Hoeve James N , France Thomas D 
Published: April 2021

ABSTRACT
This study examines the relationship between clinically assessed binocular sensory status and binocular visual evoked potentials (BVEPs) in 11 patients with monofixation syndrome (MFS) and in 12 patients with absent binocular fusion (ABF). BVEPs were elicited using a two-sinusoid "beat" technique. The luminances of red/green anaglyphic circular fields were modulated independently at temporal rates of 6 and 8 Hz. This stimulus elicits a BVEP at 14 Hz in children with normal stereoscopic vision. In this study, we found that this BVEP also is present in patients with MFS, whereas it is near background noise levels in patients with ABF. These results demonstrate the presence of functional binocular cortical mechanisms in patients with MFS. The findings are consistent with the hypothesis that elicitation of this class of BVEPs requires gross sensory fusion, but not fine stereoscopic vision.
Dissociated Vertical Deviation: Head and Body Orientation Affect the Amplitude and Velocity of the Vertical Drift
Authors: Goltz Herbert C , Irving Elizabeth L , Hill John A , Kraft Stephen P , Steinbach Martin J 
Published: April 2021

ABSTRACT
Purpose: Five subjects with dissociated vertical deviation (DVD) were studied to determine if the amplitude or velocity of the vertical components of the DVD were affected by head/body orientation with respect to gravity.
Methods: Deviations were measured in head upright, head supine, and supine positions, with head hanging postures using a binocular CCD video-based infrared eye tracker. Subjects were required to fixate a target presented in the primary position during alternate or cover/uncover tests.
Results: Amplitude and velocity of DVD both in onset and recovery were affected by head/body orientation with respect to gravity. In four of five subjects, the amplitude of the DVD was asymmetric between the two eyes when the head was upright. When the head/body was moved from an upright to a supine with head hanging backward condition, the amplitude of the DVD in the two eyes inverted. The eye with the larger DVD in the upright position had a smaller DVD in the head-hanging orientation. A similar relationship existed between velocity and head/body orientation. We found that DVD velocity increased with amplitude.
Conclusions: Passive effects of gravity on the eye-inorbit do not influence DVD magnitude or frequency of occurrence. The data suggest, however, that otolithic and possibly neck afferent inputs play a role in DVD magnitude and may be a part of the etiology of the condition.