ABSTRACT
PURPOSE: Torsional eye position by the disc-fovea angle (DFA) is a relevant objective parameter in vertical strabismus. DFA measurement with OCT has proven to be a good alternative to the gold standard measurement in fundus photography. Our study aims to analyze the validity and reliability of two undescribed Cirrus HD-OCT methods that offer clinical advantages for measuring objective cycloposition in normal patients compared to the Spectralis SD-OCT and the reference method. DESIGN: Prospective validity and reliability analysis. METHODS: Objective cycloposition by means of the DFA was measured in the right eyes of 59 binocularly normal individuals attending the ophthalmology service of a medical institution. DFA was obtained by fundus photography (gold standard), FoDi software of Spectralis SD-OCT, HD 1 Line scan of Cirrus HD-OCT and Macular Cube of Cirrus HD-OCT (Fundus, FoDi, Line and Cube methods, respectively). Measurements were performed three times for each method and the patient was repositioned and realigned between captures. For Fundus and Cube methods posterior manual quantification was made by two observers with external protractor software. RESULTS: The three OCT methods showed and excellent agreement with the fundus photography (ICC 0.83 to 0.84) with no significant differences comparing mean values (pâ¯=â¯0.36 for Fundus-FoDi, pâ¯=â¯0.09 for Fundus-Line, pâ¯=â¯0.09 for Fundus-Cube). Absolute differences between methods were 1.5 degrees. All methods showed an excellent reliability (ICC 0.92 for FoDi, 0.91 for Line, 0.92 for Cube, 0.91 for Fundus). Minimal detectable change was lower than 3 degrees and the absolute difference between repeated measurements was 1 degree for all methods. Interrater reliability was excellent for methods requiring manual quantification (ICC 0.98 for Cube, ICC 0.94 for Fundus). CONCLUSIONS: Measurement of the DFA by Cirrus HD-OCT methods in normal patients was a valid and reliable alternative for the cycloposition assessment. Among the methods, the Cirrus OCT HD 1 Line improved clinical performance due to the simplicity and speed of measurement, with no need to export the image for quantification.
ABSTRACT
BACKGROUND: Childhood myopia represents a global concern with increasing prevalence in recent decades. Lifestyle factors significantly impact myopia. AIM: To evaluate lifestyle factors in myopic children from a metropolitan area in Europe. METHODS: This was a descriptive study including myopic subjects aged 4-18 years. Patient demographic and clinical data were collected, including cycloplegic refraction in spherical equivalent refraction (SER) and axial length (AL). In addition, a questionnaire on lifestyle factors was conducted between September 2022 and April 2023. RESULTS: A total of 321 myopic children were included, aged 10.72 ± 3.05 years, of whom 51.4% were boys, with SER -2.25 ± 1.9 D and AL 24.54 ± 0.98 mm. The mean age of myopia onset was 7.69 ± 3.05 years. A total of 59.8% had family history of myopia. Those children who had <2 h/day of screen time (on weekdays) presented SER -2 ± 1.91 D, compared to those who had >2 h/day, SER: -2.50 ±1.88 D (p = 0.009). Children who spent <2 h/day doing near work after school were less myopic compared to those who spent >2 h/day (SER: -1.75 ± 1.83 vs. SER: -2.75 ± 1.82, respectively, p = 0.03). However, no significant association was observed between SER and AL and time spent outdoors nor between SER and AL and academic performance (p > 0.05). CONCLUSIONS: Screen time and near-work time appear to be lifestyle factors related to myopia.
ABSTRACT
Objetivo: Este trabajo intenta estimar la aparición de inconcomitancia lejos-cerca y de un componente acomodativo en pacientes con endotropia congénita tratados con toxina botulínica. Métodos: Para ello hemos realizado un estudio retrospectivo de 26 pacientes con endotropia congénita, menores de tres años, tratados con TB sin I-LC ni componente acomodativo al inicio. El 42 por ciento de los pacientes se corrigió con toxina botulínica. La densidad de incidencia de I-LC fue de 0,079 pacientes-año. Resultados: Un 42,31 por ciento de los pacientes desarrollaron distinto grado de componente acomodativo. La aparición de ambos factores puede condicionar nuestras indicaciones quirúrgicas.
Purpose: Estimate the presence of convergence excess and refractive deviation in a group of patients with infantile esotropia treated with botulinic toxin. Method: Retrospective analysis of 26 patients with infantile esotropia treated with botulinic toxin before the age of three without convergence excess or refractive factor in their deviation. Results: 42 percent were controlled with botulinic toxin. The subsequent incidence of convergence excess was 0,079 patients/year. 42,31 percent of patients developed some degree of refractive component in their deviation. Both factors can modify our surgical indications.
Subject(s)
Humans , Child , Adaptation, Physiological , Esotropia/physiopathology , Esotropia/drug therapy , Age of Onset , Convergence, Ocular , Esotropia/congenital , Follow-Up Studies , Refraction, Ocular , Retrospective Studies , Botulinum Toxins/therapeutic useABSTRACT
Introducción y objetivos: Analizar la modificación del estrabismo vertical tras la corrección de la endotropía con Toxina Botulínica (TB). Métodos: 51 endotropías consecutivas, tratadas con TB por debajo de 36 meses de edad. Resultados: 51.85 por ciento de las endotropías congénitas (EC) y 12.5 por ciento de las endotropías adquiridas (ETA) requirieron cirugía vertical. Cuando se corrigió la desviación horizontal, se redujo la necesidad de cirugía vertical a 38.51 por ciento (EC) y 4.54 por ciento (ETA) respectivamente. También se modificaron los patrones alfabéticos. Conclusiones: Se debe ser cauto en la indicación de la cirugía vertical asociada a un cuadro horizontal en la primera infancia.
Introduction and objectives: To study changes in vertical strabismus following treatment of esotropia using Botulinum Toxin. Methods: Fifty one consecutive patients with esotropia treated with Botulinum Toxin at the age of 36 months or less. Results: 51.85 percent of congenital esotropias (CE) and 12.5 percent of acquired esotropias (AET) required vertical surgery. When the horizontal deviation was completely corrected the requirement for vertical surgery was reduced to 38.51 percent (CE) y 4.54 percent (AET) respectively. Alphabet patterns were also affected. Conclusions: One should be cautious about the indications for vertical surgery associated with esotropia in early infancy.