Longitudinal assessment of visual development in non-syndromic craniosynostosis: a 1-year pre- and post-surgical study

Vasco, Gessica; Baranello, Giovanni; Ricci, Daniela; Salerni, Annabella; Tamburrini, Gianpiero; Amante, R; Dickmann, Anna; Rocco, Concezio Di; Velardi, F.; Mercuri, Eugenio

doi:10.1136/adc.2007.128421

Cited by 23 publications

(24 citation statements)

References 22 publications

(21 reference statements)

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“…[25] Although surgery can correct orbital asymmetry, the trochlea may remain asymmetric and ocular muscle dysfunction and subsequent vision abnormalities may persist. [26] Our findings, however, suggest that these potential vulnerabilities do not necessarily produce measurable impairments in visual perception at school age. We observed group differences primarily in fine motor ability and particularly in bimanual dexterity, with fewer meaningful differences in visual-motor integration or visual perception without a motor component (i.e.…”

Section: Discussionmentioning

confidence: 53%

Visuomotor Function in School-Age Children with Single-Suture Craniosynostosis

Wallace

Collett

Kapp-Simon

et al. 2016

J Dev Behav Pediatr

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Objective Previous studies have shown that infants and young children with single-suture craniosynostosis (SSC) perform more poorly on tests of visuomotor function than children without SSC. However, prior studies are limited by small sample sizes and little is known about the persistence of visuomotor problems into the school-age years. The aim of this study was to compare visuomotor function in children with and without SSC at the beginning of elementary school. Methods The study included 179 children with SSC (cases) and 183 children without SSC (controls). Visuomotor function was measured by the NEPSY-II Arrows, the Purdue Pegboard Test, and the Beery-Buktenica Developmental Test of Visual-Motor Integration. Case-control differences were estimated by using linear regression, adjusted for age, sex, socioeconomic status, and maternal IQ. Results Cases scored more poorly on all measures of visuomotor function, although the magnitude of case-control differences varied across measures. The greatest differences were observed for the Purdue Pegboard test, with an average adjusted difference of −0.2 to −0.4 standard deviation (SD) points (p-values ranged from 0.008 to 0.05). Case-control differences were small in magnitude for other measures of visuomotor function, ranging from −0.01 to −0.1 SD points (p-values ranged from 0.22 to 0.88). Conclusion Children with SSC experienced deficits in manual dexterity into the school-age years but were similar to children without SSC on measures of visual processing. These findings advocate for the assessment of fine motor function as part of school readiness evaluations in children with SSC.

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Section: Discussionmentioning

confidence: 53%

Visuomotor Function in School-Age Children with Single-Suture Craniosynostosis

Wallace

Collett

Kapp-Simon

et al. 2016

J Dev Behav Pediatr

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“…Additionally, the trochlea is displaced for the orbital rotation and relative recession of the frontal process in UCS, causing a change in the angle through which the superior oblique turns, creating a mechanical disadvantage for its action [ 15 ]. Some studies have reported a predominance of esotropia (60–100%) [ 4 , 16 – 18 ] and exotropia (36%) [ 19 ] in their patient populations. Our paper is the first to discuss MED in UCS; strabismus surgery must be performed after craniofacial reconstruction because reducing intracranial pressure is the most important treatment for saving lives.…”

Section: Discussionmentioning

confidence: 99%

Ophthalmological outcomes of unilateral coronal synostosis in young children

et al. 2020

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Background: To report refractive outcomes, describe types of strabismus and evaluate the outcomes of surgical intervention for unilateral coronal synostosis (UCS) in paediatric patients. Methods: This study retrospectively included 30 UCS cases. Patients aged from 3 months to 6 years (median: 1.8 years) were enrolled from January 2018 to December 2019 at Shanghai Children's Hospital. Sixteen patients had all types of strabismus; 15 of these patients underwent surgery. Results: Refractive errors of 30 cases were included. In 60% of patients, astigmatism of 1.00D or more existed in not less than one eye at last record. Twenty (66.7%) patients had the larger amount of astigmatism in the contralateral eye. Fifteen patients received strabismus surgery, of whom 6 patients with monocular elevation deficiency (MED) underwent the standard Knapp procedure, with or without a horizontal deviation procedure. Fifteen cases were horizontally aligned within 5 prism dioptres (Δ). Six patients with MED (100%) had attained ≥25% elevation improvement after surgery, and the vertical deviation decreased from 25.83 Δ ± 4.92 Δ (range, 20 Δ-30 Δ) to 0.83 Δ ± 4.92 Δ after surgery (range, 0 Δ-10 Δ), for an improvement of 26.67 Δ ± 4.08 Δ (t = 16 P < 0.05). In 1 patient with esotropia, the horizontal deviation decreased from + 80 Δ to + 5 Δ after surgery. One patient was diagnosed with trichiasis and one with contralateral lacrimal duct obstruction. Conclusions: Contralateral MED was also the main type of strabismus in UCS. Superior oblique muscle palsy was still the most common, as previously reported. There is a risk of developing a higher astigmatism and anisometropia in the contralateral eye to synostosis. Other ophthalmic disorders should be treated in a timely manner. Trial registration: The study was approved by the Institutional Review Board of Shanghai Children's Hospital (approval No. 2020R023-E01) and adhered to the tenets of the Declaration of Helsinki. Ethics approval was procured on March 30, 2020. This was a retrospective study. Written informed consent was sought from the patients' parents or legal guardians. Clinical Trials Registry number: ChiCTR2000034910. Registration URL: http://www.chictr.org.cn/showproj.aspx?proj=56726.

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“…Only 2 studies report on ocular abnormalities in the various types of nonsyndromic craniosynostosis and both concern small patient groups, as shown in Tables 10 and 11 . 255 , 284 The 29 patients reported by Vasco 284 had no refractive errors and all 29 had normal vision 12 months postoperatively. The most frequent abnormality found 12 months postoperatively was strabismus in patients with unicoronal craniosynostosis.…”

Section: Vision Refraction and Motility Abnormalitiesmentioning

confidence: 98%