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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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