Ocular Torticollis in Children

Levin, I. Michael

doi:10.1001/archpedi.1932.01950120108008

Cited by 2 publications

(1 citation statement)

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“…The most common issues for patients with diplopia are impaired reading , impaired driving , ne gative feelings in self-esteem, and general disability [ 10 ] . In addition, some patients develop a torticollis to maintain binocular single vision, resulting in neckpain [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

Magnetic resonance imaging reveals possible cause of diplopia after Baerveldt glaucoma implantation

Islamaj

Vught²,

Jordaan-Kuip³

et al. 2022

PLoS ONE

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Purpose To assess if ocular motility impairment, and the ensuing diplopia, after Baerveldt Glaucoma device (BGI) implantation, is related to the presence of a large fluid reservoir (bleb), using Magnetic Resonance Imaging (MRI). Methods In a masked observational study (CCMO-registry number: NL65633.058.18), the eyes of 30 glaucoma patients with (n = 12) or without diplopia (n = 18) who had previously undergone BGI implantation were scanned with a 7 Tesla MRI-scanner. The substructures of the BGI-complex, including both blebs and plate, were segmented in 3D. Primary outcomes were a comparison of volume and height of the BGI-complex between patients with and without diplopia. Comparisons were performed by using an unpaired t-test, Fisher’s Exact or Mann-Whitney test. Correlations were determined by using Spearman correlation. Results The median volume and height of the BGI-complex was significantly higher in patients with compared to patients without diplopia (p = 0.007 and p = 0.025, respectively). Six patients had an excessively large total bleb volume (median of 1736.5mm3, interquartile range 1486.3–1933.9mm3), four of whom experienced diplopia (33% of the diplopia patients). Fibrotic strands through the BGI plate, intended to limit the height of the bleb, could be visualized but were not related to diplopia (75% versus 88%; p = 0.28). Conclusions With MRI, we show that in a significant number of diplopia cases a large bleb is present in the orbit. Given the large volume of these blebs, they are a likely explanation of the development of diplopia in at least some of the patients with diplopia after BGI implantation. Additionally, the MR-images confirm the presence of fibrotic strands. As these strands are also visible in patients with a large bleb, they are apparently not sufficient to restrict the bleb height.

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Section: Introductionmentioning

confidence: 99%