bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pars Plicata Lensectomy/Vitrectomy for Developmental Cataract Extraction: Surgical Results
Authors: Green Beth F , Morin J Donald , Brent Henry P 
Published: April 2021

ABSTRACT
Fifty-two cases of developmental cataracts extracted using the pars plicata lensectomy/vitrectomy technique were reviewed. Eyes with additional ocular anomaly other than microphthalmos were not included. No early complications were detected in a postoperative period ranging from 1.5 to 7 years with a median of 4 years, and late complications were limited to secondary membranes occurring in small eyes. Since secondary membranes occurred only in eyes in which the axial length was ≤ 17.4 mm and the corneal diameter was ≤ 9.5 mm, we suggest that eyes that are small by the absolute dimensions cited here are at greater risk of developing secondary membranes postoperatively. Small eyes by absolute dimensions should be distinguished from microphthalmia eyes, since the relative term microphthalmia is less predictive of risk of complication than are absolute dimensions.
Linear Snellen acuity in 15 patients capable of response ranged as follows: 20/20-20/80 with a median of 20/40 in eyes with partial bilateral cataracts; 20/25-20/80 with a median of 20/50 in eyes with complete bilateral cataracts; 20/30-20/400 with a median of 20/200 in eyes with unilateral partial cataracts; and 20/60-CF with a median of 20/400 in eyes with complete unilateral cataracts. Mean patient ages at surgery were 3 months for those with bilateral complete cataracts, 5 months for those with unilateral complete cataracts, 18 months for those with bilateral partial cataracts, and 25 months for those with unilateral partial cataracts. The earliest possible removal of visually significant opacities must be combined with aggressive postoperative visual rehabilitation to obtain the best possible visual outcome.
Near Retinoscopy in Accommodative Esotropia
Authors: e Cruz Antonio Augusto Velasco , Sampaio Niumara Maria Veitas , Vargas José Amadeu 
Published: April 2021

ABSTRACT
We tested whether near retinoscopy, a noncycloplegic retinoscopic technique, was applicable to the optic correction of patients with accommodative esodeviations. We performed a study in 17 patients with accommodative esotropia to compare the refractive values obtained by near retinoscopy and by cycloplegia, as measured by two examiners.
The interobserver variability was the same for the two techniques for the refractive values of the horizontal and vertical me rid i a and spherical equivalent. For the astigmatism, there was greater variability for near retinoscopy. The correlation between the two methods was good, but the variability of the differences was high.
We recommend that near retinoscopy should be employed only as a noninvasive method for screening refractive errors in children.
Endophytic vs Exophytic Unilateral Retinoblastoma: Is There Any Real Difference?
Authors: Palazzi Maristela , Abramson David H , Ellsworth Robert M 
Published: April 2021

ABSTRACT
A retrospective review of 297 cases of enucleated and histologically proven unilateral retinoblastoma with a minimum of 5-year follow-up was analyzed to see if there were any clinical or prognostic differences between endophytic and exophytic type retinoblastoma. Endophytic retinoblastoma (181 cases) was found more often than exophytic (116 cases).
The following features were not associated with the clinical appearance of either endophytic or exophytic tumors: sex of patient, right vs left eye, propensity for bilateral development, initial sign or symptom, presence of rubeosis, preoperative metastasis, optic nerve invasion, orbital recurrence, survival of the patient, length of follow-up, or age at diagnosis.
Three features were found that correlated with type: a disproportionately higher percentage of patients with endophytic retinoblastoma had a positive family history; a disproportionately high percentage of patients with exophytic retinoblastoma developed glaucoma; and choroidal invasion occurred significantly more often in patients who had exophytic retinoblastoma than in those who had endophytic retinoblastoma.
Retinopathy of Prematurity: The Relationship With Intraventricular Hemorrhage and Bronchopulmonary Dysplasia
Authors: Brown David R , Biglan Albert W , Stretavsky Marinda M A 
Published: April 2021

ABSTRACT
We studied prospectively a cohort of 326 neonates weighing 500-1250 gm at birth. These babies were all born at Magee-Womens Hospital during 1986 and 1987. Sixty-five percent survived and were discharged from the hospital, and 197 of the survivors (93%) had at least one ophthalmological exam before their discharge. Of the patients who were examined, 34% had retinopathy of prematurity (ROP) and 12% had stage 3 or 4 ROP in at least one eye. There were six neonates with at least one blind eye, giving an estimated prevalence of blindness caused by ROP of 301 per million live births. By univariate analysis there was a strong association of ROP with birthweight, oxygen exposure, respirator treatment, and intraventricular hemorrhage (IVH). By multivariate analysis, only the respirator treatment was significantly associated with ROP. When birthweight, oxygen exposure, and IVH were controlled, a baby requiring more than 28 days of ventilator treatment was 4.07 times more likely to have stage 3 or 4 ROP than a baby with less ventilator exposure. These data confirm the strong association of ROP with bronchopulmonary dysplasia (BPD), low birthweight, and IVH, and suggest that the key component among these interrelated variables may be time spent on a ventilator.
Clinical Variations of Trilateral Retinoblastoma: A Report of 13 Cases
Authors: De Potter Patrick , Shields Carol L , Shields Jerry A 
Published: April 2021

ABSTRACT
Of 440 consecutive children with retinoblastoma whom we treated between April 1972 and April 1992, 13 (3%) developed a midline intracranial neoplasm. Four of these 13 patients had bilateral familial retinoblastoma, 7 had bilateral sporadic retinoblastoma, and 1 patient had unilateral familial retinoblastoma. The twin brother of the latter patient developed pinealoblastoma without retinoblastoma. In this series, the incidence of trilateral retinoblastoma was 8% of all bilateral familial retinoblastoma and 5% of all bilateral sporadic retinoblastoma. The retinoblastoma was diagnosed at a mean age of 4.5 months and the midline intracranial tumor was diagnosed at a mean age of 23 months. The mean time interval between the diagnosis of retinoblastoma and the intracranial tumor was 22 months (range, 0 to 48 months). Seven patients (55%) were asymptomatic and their intracranial neoplasm was found on routine brainimaging studies. The primary intracranial neoplasm had a pineal location in 10 cases and parasellar location in three cases. Despite aggressive combined treatment, 12 patients (92%) have died at a mean interval of 11 months after the diagnosis of intracranial malignancy. The mean survival of patients with midline intracranial neoplasm who were asymptomatic was significantly longer than that of symptomatic patients (P = .05). Because an early diagnosis of the intracranial neoplasm is statistically associated with longer survival and despite the high cost of brain-imaging studies, we usually recommend that children with bilateral and/or familial retinoblastoma until age 4 years undergo regular contrast-enhanced magnetic resonance imaging of the brain to detect asymptomatic early pineal and parasellar tumors.
Leber Congenital Amaurosis and Its Association With Keratoconus and Keratoglobus
Authors: Elder Mark J 
Published: April 2021

ABSTRACT
Leber congenital amaurosis has been associated with keratoconus and it has been postulated that this is due to eye rubbing, the oculo-digital sign, because of poor vision. Six schools for the blind were visited, and 174 children with a visual acuity of less than 3/60 examined. Thirty-five children had Leber amaurosis, and 10 of these had keratoconus (29%) and one had keratoglobus (3%). The six pedigrees of the cases with Leber amaurosis and keratoconus are presented in detail. Only 3 of the 139 other blind children had keratoconus (P<.05) and 1 had keratoglobus. Keratoconus seems specifically associated with Leber amaurosis, probably due to genetic factors, rather than poor visual acuity per se.
Posterior Chamber Lens Implantation for Primary Repair of Corneal Lacerations and Traumatic Cataracts in Children
Authors: Anwar Mohammed , Bleik Jamal H , von Noorden Gunter K , El-Maghraby Akef A , Attia Fadia 
Published: April 2021

ABSTRACT
Children older than 3 years of age rarely tolerate contact lenses for unilateral surgical aphakia. This problem is even more pronounced following repair of corneal lacerations or perforations that are associated with traumatic cataracts. Even if surgery is successful, such eyes are functionally doomed because of deep anisometropic amblyopia. We evaluated prospectively in 15 children (3 to 8 years) the results of combined operation of corneal repair, aspiration of traumatic cataract, and primary posterior chamber lens implantation. Postoperative occlusion treatment was carefully monitored. Follow up ranged from 6 to 60 months, with an average of 39.2 months. The final best corrected visual acuity at the patient's last visit was 20/40 or better in 11 of 1 5 children (73.3%). The most frequent complication was a nonfunctional pupil due to traumatic iris damage or posterior synechiae in 13 cases. The most visually significant complication was posterior membrane formation and/or posterior capsule opaclf ication, which required additional surgeries in six children.
Quantitative Magnetic Resonance Morphometry of Extraocular Muscles: A New Diagnostic Tool in Paralytic Strabismus
Authors: Demer Joseph L , Miller Joel M , Koo Edward Y , Rosenbaum Arthur L 
Published: April 2021

ABSTRACT
Paralytic strabismus is often diagnosticai Iy ambiguous due to the similarity of patterns of misalignment produced by different mechanisms. To address this problem, we have developed a new technique employing high-resolution, surface coil magnetic resonance imaging to quantify extraocular muscle size and contractility. Adjacent coronal images are obtained spanning the anteroposterior extent of each orbit, and repeated in multiple directions of gaze. Contractility is evaluated from analysis of muscle cross-sectional areas.
The quantitative size and contractile characteristics of normal rectus and superior oblique muscles are reviewed, along with the effects of superior oblique palsy. The morphometric features of lateral rectus palsy are illustrated by three clinical cases exhibiting deficient contractility and atrophy of the lateral rectus muscle. A case of superior oblique palsy Is presented illustrating atrophy and lack of contractility of the involved superior oblique muscle.
This imaging technique can be employed in any clinical center and permits insight into extraocular muscle function in complex strabismus cases.
VECP Evidence for Binocular Function in Infantile Esotropia
Authors: France Thomas D , Ver Hoeve James N 
Published: April 2021

ABSTRACT
Since commonly used clinical methods of measuring binocular function require subjective responses, this testing has been limited to more cooperative children, usually older than 2 years of age. Recently, we have begun using a clinically practical, visually evoked cortical potential (VECP) method to detect the presence of binocular neurons in infants and young children.
We studied 14 children, ages 4 to 44 months, with infantile esotropia. Nine had surgical correction for esotropia by the age of 2 years. Twenty-five normal infants ages 6 weeks to 22 months served as controls.
Most normal infants showed the development of the "beat" by 2 months of age. The "sum" VECP was not consistently present until age 6 months.
Four of the five esotropic infants less than 1 year of age, demonstrated neither a "sum" nor "beat" response.
All nine patients with corrective surgery performed before 2 years of age developed a significant sum response and three developed a beat. Five patients had not had surgery until after 2 years of age. Two developed a sum and one a beat, but none had both beat and sum responses.
The results suggest that there is a loss of nonlinear binocular response in esotropic children not corrected before the age of 2 years and that these responses can be restored after early treatment even if not present at the time of surgery.
Ocular Pursuit Movement Assessment by Magnetic Resonance Imaging
Authors: Cadera Werner , Karlik Stephen J , Viirre Erik , Bloom Jeffrey N 
Published: April 2021

ABSTRACT
We describe a new technique for generating cinematic magnetic resonance images. This method produces more physiological imaging of extraocular muscles than our previous method. In addition, this technique provides more comfort for the study subject and results in less head movement artifact.
Dichoptic Luminance Beat Visual Evoked Potentials in the Assessment of Binocularity in Children
Authors: Stevens Julia L , Berman Jeffrey L , Schmeisser Elmar T , Baker Robert S 
Published: April 2021

ABSTRACT
Direct evidence of a distinct cortical binocular pathway has been provided by the production of nonlinear (difference) beats from dichoptic luminance stimulation in stereonormal adults and the absence or diminution of these beats in stereoblind subjects. We have investigated a clinically useful application of this technique in a pediatric population with potentially abnormal binocular vision. We recorded dichoptic luminance beat visual evoked potentials (VEPs) from 20 children (ages 7 months to 8 years) with abnormal binocular ability secondary to strabismus and/or amblyopia and compared this to a control group of 20 children with normal binocularity. Stereoblind children generated significantly lower dichoptic signal-to-noise ratios than stereonormal children (P < .001). Responses to monoptic multifrequency flicker were not significantly different between the two groups (P = .936). This dichoptic VEP can be performed quickly and easily on young children and gives a quantitative assessment of cortical binocularity that may not be determinable by standard clinical methods. This technique may also prove useful for the preoperative gradation of binocular potential and prediction of postoperative binocular fusion.
Exaggerated Effect of Bilateral Medial Rectus Recession in Developmentally Delayed Children
Authors: Pickering J Dawn , Simon John W , Lininger Lloyd L , Melsopp Karin B , Pinto Gregory L 
Published: April 2021

ABSTRACT
Many have suggested that the esotropia associated with developmental delay should be considered separately. However, the esotropia surgery recommended for developmentally delayed children has been similar to that performed in normal children. We have noticed a tendency for developmentally delayed children to develop consecutive exotropia following bilateral medial rectus recessions. Of 94 children undergoing such surgery between 1981 and 1991, 31 were developmentally delayed. Follow up ranged from 7 months to 202 months (mean 24 months). Surgical effect, defined as the change in alignment following each amount of surgery, was greater in the developmentally delayed group than in control subjects (P = .002). The increase in effect of the same amount of surgery in a developmentally delayed patient averaged 5.28 prism diopters, but was much larger in specific instances. Variability of effect was more marked among developmentally delayed children. We conclude that bilateral medial rectus recessions in developmentally delayed children may be better postponed in some cases, deferred for smaller angles, or decreased in amount.
Acquired Central Fusion Disruption Following Cataract Extraction
Authors: Sharkey James A , Sellar P William 
Published: April 2021

ABSTRACT
Central sensory and motor fusion of images, once established, is usually maintained throughout life. Under certain circumstances, this ability may be lost. This gives rise to the syndrome known as horror fusionis, or acquired disruption of central fusion. We report the development of central fusion disruption in three patients with uniocular mature senile cataract. We postulate that this is the result of prolonged sensory deprivation in the cataractous eye. The loss of fusion results in a particularly troublesome type of intractable diplopia, characterized by the inability to either fuse or suppress images. To the best of the authors' knowledge, this is the first report of central fusion disruption following cataract surgery for senile cataract.
Outcome of Sixth Nerve Palsy or Paresis in Young Children
Authors: Aroichane Maryam , Repka Michael X 
Published: April 2021

ABSTRACT
This study evaluated the ophthalmological outcome following sixth nerve palsy or paresis in 64 children 7 years of age and younger. The outcomes considered were vision, residual strabismus and the need for strabismus surgery. Etiologies included tumor, hydrocephalus, trauma, infection, malformation, and idiopathic and miscellaneous causes. Strabismus surgery was performed on 24% of the patients, with residual strabismus present in 66% of the patients. Neurologists and ophthalmologists should monitor visual acuity in these young children at frequent intervals be prepared to institute amblyopia therapy early in the course of the ocular misalignment if permanent visual disability is to be avoided.
Effectiveness of Inferior Transposition of the Horizontal Rectus Muscles for Acquired Inferior Rectus Paresis
Authors: Burke John P , Keech Ronald V 
Published: April 2021

ABSTRACT
Full inferior transposition of the horizontal recti (inverse Knapp procedure) was performed on four patients with unilateral inferior rectus muscle weakness. The patients were followed up over time to determine the medium- and long-term effectiveness of the procedure. All of the patients had single binocular vision without the use of prisms in the primary position of gaze and three in the reading position after a mean postoperative followup interval of 2V2 years. The mean primary position preoperative vertical deviation was 20.3 Δ and the mean primary position postoperative vertical correction was 19.5 (range, 16 to 24) Δ. The field of binocular single vision was assessed quantitatively and scored 2.4% preoperatively compared with 52.3% postoperatively. There was no decrease in the effect of the procedure over time. Additional surgery may still be required to correct symptomatic residual vertical down-gaze diplopia.
Brown's Syndrome With Cyclic Characteristic: Case Report and Review of Physiopathologic Mechanism
Authors: Can Izzet , Yarangüeli Alper , Kural Gülcan 
Published: April 2021

ABSTRACT
This article reports on an acquired Brown's syndrome case presenting with cyclic characteristics. Restriction of elevation in adduction was observed in the right eye of a 15-year-old boy who had been referred with a complaint of diplopia that occurred on waking in the morning and continuing until noon. The same situation was noted following afternoon naps. The patient was able to improve his complaint by performing a forced elevation in adduction while massaging his right trochlear region and the restriction did not recur until the next morning.
Retinal Detachment in a Child as the First Sign of Leukemic Relapse: Histopathology, MRI Findings, Treatment, and Tumor-free Follow Up
Authors: Brei Timothy J , Burke Miles J , Rubinstein Jack H 
Published: April 2021

ABSTRACT
Improved leukemia therapies in children have brought about prolonged remissions with extramedullary relapses being reported in sites other than the most common (bone marrow, testes, brain, and spinal cord). A 3-½year-old boy with a history of acute lymphocytic leukemia presented with total retinal detachment in one eye. Painful glaucoma unresponsive to medical therapy necessitated enucleation. Histopathologic examination documented the presence of a dense leukemic cellular infiltrate replacing a totally detached, necrotic retina. Tumor cells also were present in the optic nerve. The child had remained free of leukemia for 3 years after systemic and intrathecal chemotherapy, supplemented by craniospinal radiation. This represents the first case of relapse of acute lymphocytic leukemia presenting solely as a retinal detachment. Our case also underscores the point that the treatment of leukemia after an isolated ocular relapse can be associated with a favorable outcome.
Photoscreening for Amblyogenic Factors
Authors: Ottar Wanda L , Scott William E , Holgado Sandra I 
Published: April 2021

ABSTRACT
Background: The Medical Technology Ine (MTI) Photoscreener™ is a new eccentric photoscreener that Is being marketed as a device for the detection of amblyogenic factors in preverbal children. The purpose of this study was to evaluate the accuracy of the MTI Photoscreener11' in the target population of young, healthy children.
Methods: One thousand and three healthy children between the age of 6 months and 59 months were photoscreened with the MTI Photoscreener™. Nine hundred and forty nine children were included in the study and their results were compared with a complete ophthalmologic examination with cycloplegia.
Results: The sensitivity of the MTI Photoscreener™ was determined to be 81.8% with a specificity of 90.6%. The overall agreement rate was 88.8%. The positive and negative predictive values were 68.9% and 95.2%, respectively. All cases of strabismus and media opacities were detected.
Conclusion: The MTI Photoscreener™ is an accurate and reliable device designed to detect amblyogenic factors in young children. The camera offers promise as a useful mass-screening tool.
Prevalence of Intracranial Lesions in Children Initially Diagnosed With Disconjugate Nystagmus (Spasmus Nutans)
Authors: Arnoldi Kyle A , Tychsen Lawrence 
Published: April 2021

ABSTRACT
A small number of children who develop disconjugate nystagmus, torticollis, and head titubation (spasmus nutans) have been found to have optic chiasm or third ventricle gliomas. However, the prevalence of glioma or other developmental abnormalities in this disorder is unknown because no large series of spasmus nutans cases has previously been reported. A reviewer of the records of 67 consecutive children initially diagnosed with spasmus nutans and followed for an average of 3.3 years at the St Louis Children's Hospital revealed the following: 61% had a history of prematurity, developmental delay, or other systemic abnormality; strabismus, most commonly infantile esotropia, developed in 55%; 43% had neuroimaging studies; and 0% had evidence of a glioma or showed signs of tumor on follow-up examinations. From this consecutive patient series, we estimate the prevalence of tumor in spasmus nutans to be less than 1.4%. Without other evidence of an intracranial mass lesion, neuroimaging of infants initially diagnosed with spasmus nutans may not be immediately warranted.