Incidence of Amblyopia and Its Risk Factors in Children With Isolated Metopic Craniosynostosis

Nguyen, Thuan B.; Shock, Leslie A.; Missoi, Tara G.; Muzaffar, Arshad R.

doi:10.1597/14-212r

Cited by 2 publications

(4 citation statements)

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“…No child with metopic craniosynostosis in our group had strabismus preoperatively, but one patient developed strabismus postoperatively. This is in agreement with other studies, where low prevalence rates of strabismus in metopic craniosynostosis are seen 10 16 21. There are reports on iatrogenic induction of strabismus from the fronto-orbital surgery itself 22 23.…”

Section: Discussionsupporting

confidence: 92%

“…Most studies describe the outcome in metopic and unicoronal craniosynostosis. [10][11][12][13][14][15] Vasco et al 5 followed 29 children, including all subtypes, up to 1 year after surgery and concluded that abnormalities of visual function were more frequent preoperatively and that there was an improvement after surgery, though implying that it could be a sign of delayed visual maturation. Chieffo et al 16 recently reported on a large cohort of 142 children with non-syndromic craniosynostosis and found high rates of neuro-ophthalmological or neuro-visual deficits at the time of diagnosis, improving 1 year after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…There are, however, few studies on the ophthalmological findings before and after surgery in all subtypes of non-syndromic craniosynostosis. Most studies describe the outcome in metopic and unicoronal craniosynostosis 10–15. Vasco et al 5 followed 29 children, including all subtypes, up to 1 year after surgery and concluded that abnormalities of visual function were more frequent preoperatively and that there was an improvement after surgery, though implying that it could be a sign of delayed visual maturation.…”

Section: Discussionmentioning

confidence: 99%

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Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

et al. 2021

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AimsCraniosynostosis is a congenital condition characterised by premature fusion of one or more cranial sutures. The aim of this study was to analyse ophthalmic function before and after cranial surgery, in children with various types of non-syndromic craniosynostosis.MethodsChildren referred to Uppsala University Hospital for surgery of non-syndromic craniosynostosis were examined preoperatively. Visual acuity was measured with Preferential Looking tests or observation of fixation and following. Strabismus and eye motility were noted. Refraction was measured in cycloplegia and funduscopy was performed. Follow-up examinations were performed 6–12 months postoperatively at the children’s local hospitals.ResultsOne hundred twenty-two children with mean age 6.2 months were examined preoperatively. Refractive values were similar between the different subtypes of craniosynostosis, except for astigmatism anisometropia which was more common in unicoronal craniosynostosis. Strabismus was found in seven children, of which four had unicoronal craniosynostosis.Postoperatively, 113 children were examined, at mean age 15.9 months. The refractive values decreased, except for astigmatism and anisometropia in unicoronal craniosynostosis. Strabismus remained in unicoronal craniosynostosis. Two new cases with strabismus developed in unicoronal craniosynostosis and one in metopic, all operated with fronto-orbital techniques. No child had disc oedema or pale discs preoperatively or postoperatively.ConclusionOphthalmic dysfunctions were not frequent in children with sagittal craniosynostosis and preoperative ophthalmological evaluation may not be imperative. Children with unicoronal craniosynostosis had the highest prevalence of strabismus and anisometropia. Fronto-orbital techniques used to address skull deformity may be related to a higher prevalence of strabismus postoperatively.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

et al. 2021

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“…14 Given the risk for amblyopia and the need for treatment early in life, referral to a pediatric ophthalmologist for a formal eye exam and potential treatment is recommended for patients with isolated nonsyndromic CS. 15 The purpose of this study was to describe preoperative and postoperative ophthalmic EICP markers and ophthalmic findings in nonsyndromic CS patients to provide an overview of the early ophthalmology needs in a clinical population.…”

mentioning

confidence: 99%

Early Ophthalmology Findings in Nonsyndromic Craniosynostosis

Tien

Johns

Choi

et al. 2023

Journal of Craniofacial Surgery

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Craniosynostosis (CS) occurs 1 in 2500 births and surgical intervention is indicated partly due to risk for elevated intracranial pressure (EICP). Ophthalmological examinations help identify EICP and additional vision concerns. This study describes preoperative and postoperative ophthalmic findings in CS patients (N=314) from chart review. Patients included nonsyndromic CS: multisuture (6.1%), bicoronal (7.3%), sagittal (41.4%), unicoronal (22.6%), metopic (20.4%), and lambdoidal (2.2%). Preoperative ophthalmology visits were at M=8.9±14.1 months for 36% of patients and surgery was at M=8.3±4.2 months. Postoperative ophthalmology visits were at age M=18.7±12.6 months for 42% with follow-up at M=27.1±15.1 months for 29% of patients. A marker for EICP was found for a patient with isolated sagittal CS. Only a third of patients with unicoronal CS had normal eye exams (30.4%) with hyperopia (38.2%) and anisometropia (16.7%) at higher rates than the general population. Most children with sagittal CS had normal exams (74.2%) with higher than expected hyperopia (10.8%) and exotropia (9.7%). The majority of patients with metopic CS had normal eye exams (84.8%). About half of patients with bicoronal CS had normal eye exams (48.5%) and findings included: exotropia (33.3%), hyperopia (27.3%), astigmatism (6%), and anisometropia (3%). Over half of children with nonsyndromic multisuture CS had normal exams (60.7%) with findings of: hyperopia (7.1%), corneal scarring (7.1%), exotropia (3.6%), anisometropia (3.6%), hypertropia (3.6%), esotropia (3.6%), and keratopathy (3.6%). Given the range of findings, early referral to ophthalmology and ongoing monitoring is recommended as part of CS care.

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Incidence of Amblyopia and Its Risk Factors in Children With Isolated Metopic Craniosynostosis

Cited by 2 publications

References 0 publications

Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

Ophthalmological findings in children with non-syndromic craniosynostosis: preoperatively and postoperatively up to 12 months after surgery

Early Ophthalmology Findings in Nonsyndromic Craniosynostosis

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