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Anna Dickmann - One of the best experts on this subject based on the ideXlab platform.
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Walking strategies in subjects with Congenital or early onset Strabismus
Frontiers in human neuroscience, 2014Co-Authors: Irene Aprile, Maurizio Ferrarin, Luca Padua, Enrica Di Sipio, Chiara Simbolotti, Sergio Petroni, Costanza Tredici, Anna DickmannAbstract:Introduction. In Congenital Strabismus, sensory adaptations occur hampering the correct development of normal binocular vision. The aim of this study is to investigate if patients with Congenital or early onset exotropic or esotropic Strabismus adopt different walking strategies with respect to healthy subjects. Our hypothesis is that the abnormal binocular cooperation, occurring in patients with exotropic or esotropic Strabismus, could influence neurosensorial adaptation of the gait pattern. Materials and Methods. Twenty-five patients were enrolled:19 with esotropic (ESO) and 6 with exotropic Strabismus (EXO). All patients underwent a ophthalmological and orthoptic evaluation. Biomechanical data were collected using a stereophotogrammetric system and a force platform. Twenty-seven age-matched healthy subjects (HS) were used as controls. Results. The comparison between patients with ESO and patients with EXO Strabismus showed that the maximal power at the knee and at the ankle was lower in EXO group (p
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walking strategies in subjects with Congenital or early onset Strabismus
Frontiers in Human Neuroscience, 2014Co-Authors: Irene Aprile, Maurizio Ferrarin, Luca Padua, Enrica Di Sipio, Chiara Simbolotti, Sergio Petroni, Costanza Tredici, Anna DickmannAbstract:Introduction. In Congenital Strabismus, sensory adaptations occur hampering the correct development of normal binocular vision. The aim of this study is to investigate if patients with Congenital or early onset exotropic or esotropic Strabismus adopt different walking strategies with respect to healthy subjects. Our hypothesis is that the abnormal binocular cooperation, occurring in patients with exotropic or esotropic Strabismus, could influence neurosensorial adaptation of the gait pattern. Materials and Methods. Twenty-five patients were enrolled:19 with esotropic (ESO) and 6 with exotropic Strabismus (EXO). All patients underwent a ophthalmological and orthoptic evaluation. Biomechanical data were collected using a stereophotogrammetric system and a force platform. Twenty-seven age-matched healthy subjects (HS) were used as controls. Results. The comparison between patients with ESO and patients with EXO Strabismus showed that the maximal power at the knee and at the ankle was lower in EXO group (p<0.01 and p<0.05 respectively). The step width was statistically different between ESO and EXO groups (p<0.01), lower in patients with ESO and higher in patients with EXO Strabismus when compared with HS (though not statistically significant). The deviation angle values showed a relationship with the step width (at the near fixation p<0.05) and with the maximal power at the knee and at the ankle (at the far fixation for the knee p<0.001 and for the ankle p<0.05; at the near fixation for the knee p<0.05): in the patients with EXO the increased angle deviation is related to larger step width and to lower power at the knee and at the ankle. In the patients with ESO Strabismus this relationship is less robust. Discussion. Patients with EXO and ESO Strabismus adopt different strategies to compensate their walking difficulties, and these strategies are likely due to an expanded visual field in patients with EXO and to a reduced visual field in patients with ESO Strabismus.
Elizabeth C Engle - One of the best experts on this subject based on the ideXlab platform.
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Genetic basis of Congenital Strabismus.
Archives of ophthalmology (Chicago Ill. : 1960), 2007Co-Authors: Elizabeth C EngleAbstract:Strabismus is misalignment of one eye in relation to the other, resulting in failure of the 2 eyes to simultaneously focus on the same image and loss of binocular vision. Strabismus affects 2% to 4% of the population and can result in amblyopia, which is often not discovered in time to initiate effective treatment. Thus, an understanding of the genetic underpinnings of Strabismus may help identify patients at risk early enough to prevent disability and may lead to new preventive or therapeutic approaches.
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The Genetic Basis of Complex Strabismus
Pediatric Research, 2006Co-Authors: Elizabeth C EngleAbstract:Members of my research laboratory combine clinical, genetic, and molecular biologic approaches to the study of Congenital Strabismus. Strabismus, which is misalignment of the eyes, affects 2–4% of the population and causes loss of binocular vision and amblyopia (vision loss in a structurally normal eye). The cause of Strabismus when it occurs in the absence of structural brain abnormalities is generally unknown. In the last decade, we have focused our research studies on understanding the genetic etiology of a series of complex Strabismus syndromes in which eye movement in at least one direction is limited or paralyzed. We are discovering that these disorders result from mutations in genes necessary for the normal development and connectivity of brainstem ocular motoneurons, including PHOX2A, SALL4, KIF21A, ROBO3, and HOXA1, and we now refer to these syndromes as the “Congenital cranial dysinnervation disorders,” or CCDD.
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Applications of molecular genetics to the understanding of Congenital ocular motility disorders.
Annals of the New York Academy of Sciences, 2002Co-Authors: Elizabeth C EngleAbstract:The Congenital fibrosis syndromes (CFS), including Congenital fibrosis of the extraocular muscles (CFEOM) and Duane syndrome (DS), are rare Congenital Strabismus syndromes that present with nonprogressive restrictive ophthalmoplegia with or without ptosis. Although historically believed to result from primary extraocular muscle (EOM) fibrosis, our laboratory's work is based on the hypothesis that these disorders result from distinct, but analogous, developmental defects of the oculomotor (nIII), trochlear (nIV), and abducens (nVI) nuclei. We have defined three inherited CFEOM phenotypes (CFEOM1-3) and have mapped each phenotype to a distinct genetic locus (FEOM1-3). Individuals with CFEOM1 are born with bilateral ptosis and both eyes fixed in a downward position with absent upgaze and aberrant horizontal gaze. This disorder maps to the FEOM1 locus on chromosome 12cen.(1,2) Neuropathology studies of CFEOM1 reveal the absence of the superior division of oculomotor nerve and its corresponding alpha motor neurons in the midbrain, with abnormalities of target EOMs.(3) These neuropathology findings parallel those previously identified in Duane syndrome, in which there is an absence of nVI and the abducens nerve.(4,5) Individuals with CFEOM2 are born with bilateral ptosis and exotropia. This atypical form of CFEOM maps to the FEOM2 locus on chromosome 11q13 and results from mutations in ARIX (PHOX2A).(6,7) ARIX encodes a homeodomain transcription factor protein previously shown to be required for nIII/nIV development in mouse and zebrafish.(8,9) Together, these findings support the hypothesis that the Congenital fibrosis syndromes result from parallel defects in nIII, nIV, and nVI nuclear development. Functional studies of the CFEOM genes should provide additional insight into the unique features of the extraocular lower motor neuron axis in health and disease. (For full (refs. 1-9), see reference list of the main paper.)
Jonny Hobbhahn - One of the best experts on this subject based on the ideXlab platform.
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Anaphylactic reaction 5 minutes after the start of surgery: a case report
BMC Research Notes, 2015Co-Authors: Manuela Malsy, Richard Leberle, Katharina Ehehalt, Barbara Sinner, Jonny HobbhahnAbstract:Background Natural latex rubber products have been known to cause severe anaphylactic reactions during surgery. Even 25 years after the first description of anaphylactic reactions in the literature, natural latex rubber products are still used in pediatric surgery. Case presentation The following article describes the case of a healthy 4.5-year old Caucasian boy who simultaneously developed severe hypotension, tachycardia and bronchospasm during surgery for Congenital Strabismus sursoadductorius under uneventful anesthesia. An allergy test conducted afterwards showed natural latex rubber as the trigger for this severe intraoperative anaphylactic reaction. This case was special because of the absence of any previous clinical or anamnestical evidence of natural latex rubber allergy. The fact that the child had been previously exposed to natural latex rubber – because the boy’s mother used disposable gloves for her work as a cosmetician at home – was only discovered later. Such contact may have had a slight sensitizing effect that manifested after the initial contact with the conjunctiva through the surgeon’s natural latex rubber gloves. Conclusion Natural latex rubber products have caused severe anaphylactic reactions time and again. Diagnosis is impeded by the highly variable clinical symptoms of anaphylaxis, the non-responsivity of patients, anesthesia-induced changes in blood pressure, surgical drapes, and blood loss. Therefore, use of alternative products and implementation of the right course of action in clinical routine seems to be even more important than raising awareness for allergies to natural latex rubber.
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Anaphylactic reaction 5 minutes after the start of surgery: a case report
BMC research notes, 2015Co-Authors: Manuela Malsy, Richard Leberle, Katharina Ehehalt, Barbara Sinner, Jonny HobbhahnAbstract:Natural latex rubber products have been known to cause severe anaphylactic reactions during surgery. Even 25 years after the first description of anaphylactic reactions in the literature, natural latex rubber products are still used in pediatric surgery. The following article describes the case of a healthy 4.5-year old Caucasian boy who simultaneously developed severe hypotension, tachycardia and bronchospasm during surgery for Congenital Strabismus sursoadductorius under uneventful anesthesia. An allergy test conducted afterwards showed natural latex rubber as the trigger for this severe intraoperative anaphylactic reaction. This case was special because of the absence of any previous clinical or anamnestical evidence of natural latex rubber allergy. The fact that the child had been previously exposed to natural latex rubber – because the boy’s mother used disposable gloves for her work as a cosmetician at home – was only discovered later. Such contact may have had a slight sensitizing effect that manifested after the initial contact with the conjunctiva through the surgeon’s natural latex rubber gloves. Natural latex rubber products have caused severe anaphylactic reactions time and again. Diagnosis is impeded by the highly variable clinical symptoms of anaphylaxis, the non-responsivity of patients, anesthesia-induced changes in blood pressure, surgical drapes, and blood loss. Therefore, use of alternative products and implementation of the right course of action in clinical routine seems to be even more important than raising awareness for allergies to natural latex rubber.
Irene Aprile - One of the best experts on this subject based on the ideXlab platform.
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Walking strategies in subjects with Congenital or early onset Strabismus
Frontiers in human neuroscience, 2014Co-Authors: Irene Aprile, Maurizio Ferrarin, Luca Padua, Enrica Di Sipio, Chiara Simbolotti, Sergio Petroni, Costanza Tredici, Anna DickmannAbstract:Introduction. In Congenital Strabismus, sensory adaptations occur hampering the correct development of normal binocular vision. The aim of this study is to investigate if patients with Congenital or early onset exotropic or esotropic Strabismus adopt different walking strategies with respect to healthy subjects. Our hypothesis is that the abnormal binocular cooperation, occurring in patients with exotropic or esotropic Strabismus, could influence neurosensorial adaptation of the gait pattern. Materials and Methods. Twenty-five patients were enrolled:19 with esotropic (ESO) and 6 with exotropic Strabismus (EXO). All patients underwent a ophthalmological and orthoptic evaluation. Biomechanical data were collected using a stereophotogrammetric system and a force platform. Twenty-seven age-matched healthy subjects (HS) were used as controls. Results. The comparison between patients with ESO and patients with EXO Strabismus showed that the maximal power at the knee and at the ankle was lower in EXO group (p
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walking strategies in subjects with Congenital or early onset Strabismus
Frontiers in Human Neuroscience, 2014Co-Authors: Irene Aprile, Maurizio Ferrarin, Luca Padua, Enrica Di Sipio, Chiara Simbolotti, Sergio Petroni, Costanza Tredici, Anna DickmannAbstract:Introduction. In Congenital Strabismus, sensory adaptations occur hampering the correct development of normal binocular vision. The aim of this study is to investigate if patients with Congenital or early onset exotropic or esotropic Strabismus adopt different walking strategies with respect to healthy subjects. Our hypothesis is that the abnormal binocular cooperation, occurring in patients with exotropic or esotropic Strabismus, could influence neurosensorial adaptation of the gait pattern. Materials and Methods. Twenty-five patients were enrolled:19 with esotropic (ESO) and 6 with exotropic Strabismus (EXO). All patients underwent a ophthalmological and orthoptic evaluation. Biomechanical data were collected using a stereophotogrammetric system and a force platform. Twenty-seven age-matched healthy subjects (HS) were used as controls. Results. The comparison between patients with ESO and patients with EXO Strabismus showed that the maximal power at the knee and at the ankle was lower in EXO group (p<0.01 and p<0.05 respectively). The step width was statistically different between ESO and EXO groups (p<0.01), lower in patients with ESO and higher in patients with EXO Strabismus when compared with HS (though not statistically significant). The deviation angle values showed a relationship with the step width (at the near fixation p<0.05) and with the maximal power at the knee and at the ankle (at the far fixation for the knee p<0.001 and for the ankle p<0.05; at the near fixation for the knee p<0.05): in the patients with EXO the increased angle deviation is related to larger step width and to lower power at the knee and at the ankle. In the patients with ESO Strabismus this relationship is less robust. Discussion. Patients with EXO and ESO Strabismus adopt different strategies to compensate their walking difficulties, and these strategies are likely due to an expanded visual field in patients with EXO and to a reduced visual field in patients with ESO Strabismus.
Malin Malmsjö - One of the best experts on this subject based on the ideXlab platform.
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Clinical evidence supporting the use of donor sclera as spacer material in complicated cases of Strabismus surgery - retrospective evaluation of surgical results in 117 patients with thyroid-associated ophthalmopathy or Congenital Strabismus.
Acta ophthalmologica, 2018Co-Authors: Rannveig Linda Thorisdottir, Jonas Blohmé, Malin MalmsjöAbstract:Purpose: To examine the outcome of the use of donor sclera as spacer material in complicated cases of Strabismus surgery. Methods: A retrospective cohort study on patients with complicated thyroid-associated ophthalmopathy (TAO) (n = 42) or Congenital Strabismus (n = 75). Patients underwent Strabismus surgery during 1994–2014. The surgical results were evaluated in terms of the reduction in the angle of deviation, the need for re-operation, complications and patient satisfaction. Results: The majority of the TAO patients underwent surgery for vertical Strabismus (n = 25). The vertical angle of deviation in the primary position was significantly reduced from a median of 23 prism dioptres (PD) to 2 PD (n = 35, p < 0.001). The horizontal angle of deviation in primary position for TAO patients with esotropia was significantly reduced, from a median of 35 PD to 2 PD (n = 17, p < 0.001). The majority of the Congenital cases had horizontal Strabismus (esotropia = 29, exotropia = 27). The angle of deviation in esotropia was reduced from a median of 29 PD to 8 PD (n = 36, p < 0.001) and in exotropia from 30 PD to 10 PD (n = 34, p < 0.001). Most of the patients were satisfied with the outcome of surgery, and only 12% required re-operation within 2 years. Conclusion: This is the first clinical study on the use of donor sclera as spacer material in complicated cases of Strabismus surgery. The surgical results were good in terms of the reduction in the angle of deviation, the need for re-operation, complications and patient satisfaction, supporting the use of donor sclera for Strabismus surgery. (Less)