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Lee TC, Walker E, Ting MA, Bolar DS, Koning J, Korn BS, Kikkawa DO, Granet D, Robbins SL, Alperin M, Engle EC, Liu CY, Rudell JC. The influence of orbital architecture on strabismus in craniosynostosis. J AAPOS 2024; 28:103812. [PMID: 38219920 DOI: 10.1016/j.jaapos.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Revised: 10/10/2023] [Accepted: 10/15/2023] [Indexed: 01/16/2024]
Abstract
PURPOSE To better characterize the correlation of bony orbital dysmorphology with strabismus in craniosynostosis. METHODS The medical records of patients with craniosynostosis with and without strabismus seen at Rady Children's Hospital (San Diego, CA) from March 2020 to January 2022 were reviewed retrospectively in this masked, case-control study. Computed tomography scans of the orbits were analyzed to obtain dimensions of the orbital entrance and orbital cone. Primary outcome was correlation of strabismus with orbital measurements. RESULTS A total of 30 orbits from 15 patients with strabismus and 15 controls were included. Craniofacial disorders included in the study were nonsyndromic craniosynostosis (63%), Crouzon syndrome (13%), Apert syndrome (13%), and Pfeiffer syndrome (10%). Orbital index (height:width ratio) (P = 0.01) and medial orbital wall angle (P = 0.04) were found to differ significantly between the strabismus and control groups. CONCLUSIONS In our small cohort, bony orbital dimensions, including the ratio of orbital height to width and bowing of the medial orbital wall, were associated with strabismus in craniosynostosis.
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Affiliation(s)
- Tonya C Lee
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Evan Walker
- Viterbi Family Department of Ophthalmology and Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Michelle A Ting
- Division of Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Divya S Bolar
- Center for Functional Magnetic Resonance Imaging, Department of Radiology, University of California San Diego, La Jolla, California
| | - Jeffrey Koning
- Department of Radiology, Rady Children's Hospital, San Diego, California
| | - Bobby S Korn
- Division of Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Don O Kikkawa
- Division of Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - David Granet
- Division of Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Shira L Robbins
- Division of Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Marianna Alperin
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, California; Sanford Consortium for Regenerative Medicine, La Jolla, California
| | - Elizabeth C Engle
- Departments of Neurology and Ophthalmology, Boston Children's Hospital and Harvard Medical School, Boston, Massachusetts; Howard Hughes Medical Institute, Chevy Chase, Maryland
| | - Catherine Y Liu
- Division of Oculofacial Plastic and Reconstructive Surgery, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California
| | - Jolene C Rudell
- Division of Pediatric Ophthalmology and Strabismus, Department of Ophthalmology, Shiley Eye Institute, University of California San Diego, La Jolla, California.
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Long-term ophthalmological outcomes in patients with anterior plagiocephaly managed with a fronto-orbital advancement procedure. J Fr Ophtalmol 2022; 45:537-542. [DOI: 10.1016/j.jfo.2021.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 04/04/2021] [Accepted: 04/07/2021] [Indexed: 11/23/2022]
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Touzé R, Paternoster G, Arnaud E, Khonsari RH, James S, Bremond-Gignac D, Robert MP. Ophthalmological findings in children with unicoronal craniosynostosis. Eur J Ophthalmol 2022; 32:3274-3280. [PMID: 35118895 DOI: 10.1177/11206721221077548] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
INTRODUCTION Among non-syndromic, single-suture craniosynostoses, unicoronal craniosynostosis (UCS) presents the highest rate of ophthalmic manifestations requiring a visual follow-up, due to the high risk of amblyopia. After birth or during childhood, children with UCS have a high risk to present an aniso-astigmatism and a strabismus. The aim of this study was to characterize clinical ophthalmologic findings associated with UCS in a paediatric cohort. METHODS This retrospective study included children admitted in our unit between 2015 and 2021, with isolated UCS treated in our institution and complete ophthalmological assessment comprising visual assessment, refractive status and oculomotor examination. Children with associated craniofacial disorders were excluded. RESULTS A total of 28 children met the inclusion criteria. Median age was 62 [13-192] months with a large proportion of girls (86%) and 71% of right-sided UCS. The mean best corrected visual acuity was 0.07 (±0.13) LogMAR, including 10 (36%) children with an amblyopia or history of amblyopia. Astigmatism was significantly higher on the contralateral side of the UCS than on the ipsilateral side, with a refractive cylinder error of 0.97 (±1.06) vs 0.56 (±0.68) diopters, respectively (p = 0.03). Strabismus was observed in 20 patients (71%) with a main pattern of esotropia with a vertical component. A pseudo-superior oblique palsy was found in 13 children (65%) with a median cyclodeviation of 8.7° [-5,4°-20.6°]. CONCLUSION Children with UCS experience a high rate of various visual manifestations. This study highlights their need for a strict ophthalmological follow-up, in order to early diagnose and prevent visual complications.
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Affiliation(s)
- Romain Touzé
- Service d'ophtalmologie, 37072Hôpital Universitaire Necker - Enfants Malades, Paris, France.,Borelli Centre, UMR 9010 129791CNRS-SSA-ENS Paris Saclay-Paris University, France
| | - Giovanna Paternoster
- Service de neurochirurgie, Unité Fonctionnelle de Chirurgie Craniofaciale, 246596Hôpital Universitaire Necker - Enfants Malades, Paris, France
| | - Eric Arnaud
- Service de neurochirurgie, Unité Fonctionnelle de Chirurgie Craniofaciale, 246596Hôpital Universitaire Necker - Enfants Malades, Paris, France.,Clinique Marcel Sembat, Ramsay - Générale de Santé, Boulogne-Billancourt, France
| | - Roman Hossein Khonsari
- Service de chirurgie maxillo-faciale et chirurgie plastique, Hôpital Universitaire Necker - Enfants Malades, Paris, France
| | - Syril James
- Service de neurochirurgie, Unité Fonctionnelle de Chirurgie Craniofaciale, 246596Hôpital Universitaire Necker - Enfants Malades, Paris, France.,Clinique Marcel Sembat, Ramsay - Générale de Santé, Boulogne-Billancourt, France
| | - Dominique Bremond-Gignac
- Service d'ophtalmologie, 37072Hôpital Universitaire Necker - Enfants Malades, Paris, France.,560861INSERM, UMRS 1138, Team 17, Paris, France
| | - Matthieu P Robert
- Service d'ophtalmologie, 37072Hôpital Universitaire Necker - Enfants Malades, Paris, France.,Borelli Centre, UMR 9010 129791CNRS-SSA-ENS Paris Saclay-Paris University, France
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Rudell JC, McLoon LK. Effect of Fibroblast Growth Factor 2 on Extraocular Muscle Structure and Function. Invest Ophthalmol Vis Sci 2021; 62:34. [PMID: 34293078 PMCID: PMC8300058 DOI: 10.1167/iovs.62.9.34] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Mutations in the fibroblast growth factor (FGF) receptor can result in strabismus, but little is known about how FGFs affect extraocular muscle structure and function. These were assessed after short-term and long-term exposure to exogenously applied FGF2 to determine the effect of enhanced signaling. Methods One superior rectus muscle of adult rabbits received either a series of three injections of 500 ng, 1 µg, or 5 µg FGF2 and examined after 1 week, or received sustained treatment with FGF2 and examined after 1, 2, or 3 months. Muscles were assessed for alterations in force generation, myofiber size, and satellite cell number after each treatment. Results One week after the 5 µg FGF2 injections, treated muscles showed significantly increased force generation compared with naïve controls, which correlated with increased myofiber cross-sectional areas and Pax7-positive satellite cells. In contrast, 3 months of sustained FGF2 treatment resulted in decreased force generation, which correlated with decreased myofiber size and decreased satellite cells compared with naïve control and the untreated contralateral side. Conclusions FGF2 had distinctly different effects when short-term and long-term treatments were compared. The decreased size and ability to generate force correlated with decreased myofiber areas seen in individuals with Apert syndrome, where there is sustained activation of FGF signaling. Knowing more about signaling pathways critical for extraocular muscle function, development, and disease will pave the way for improved treatment options for strabismus patients with FGF abnormalities in craniofacial disease, which also may be applicable to other strabismus patients.
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Affiliation(s)
- Jolene C Rudell
- Department of Ophthalmology, University of California San Diego, San Diego, California, United States
| | - Linda K McLoon
- Departments of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota, United States.,Stem Cell Institute, University of Minnesota, Minneapolis, Minnesota, United States
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