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Ophthalmic Research 2023Intermittent exotropia is the most prevalent subtype of exotropia in children. Part-time occlusion (PTO) as an anti-suppression therapy was applied for nonsurgical... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intermittent exotropia is the most prevalent subtype of exotropia in children. Part-time occlusion (PTO) as an anti-suppression therapy was applied for nonsurgical management of intermittent exotropia.
OBJECTIVE
The aim of the study was to compare the effectiveness of PTO therapy and observation in the treatment of intermittent exotropia.
METHOD
An exhaustive search of the literature from PubMed, Embase, Web of Science, and Cochrane Library databases was carried out until July 2022. No language restrictions were applied. The literature was rigorously screened against eligibility criteria. Weighted mean differences and 95% confidence interval (CI) were calculated.
RESULTS
A total of 4 articles with 617 participants were included in this meta-analysis. Our pooled results showed that PTO exhibited superior effects compared to observation, with greater decrease in exotropia control at distance and near (MD = -0.38, 95% CI: -0.57 to -0.20, p < 0.001; MD = -0.36, 95% CI: -0.54 to -0.18, p < 0.001); patients subjected to PTO therapy had greater decrease in distance deviations (MD = -1.95, 95% CI: -3.13 to -0.76, p = 0.001), and there was greater improvement in near stereoacuity among the PTO group in comparison with the observation group (p < 0.001).
CONCLUSIONS
The present meta-analysis indicated that PTO therapy showed a better effect in improving control and near stereopsis and decreasing distance exodeviation angle of children with intermittent exotropia in comparison with observation.
Topics: Child; Humans; Chronic Disease; Depth Perception; Exotropia; Randomized Controlled Trials as Topic; Visual Acuity
PubMed: 36996767
DOI: 10.1159/000530059 -
Journal of Integrative Neuroscience Dec 2021Parkinson's disease-related pain has increasingly been investigated in research studies. Still, only a few studies have addressed the prevalence and clinical...
Parkinson's disease-related pain has increasingly been investigated in research studies. Still, only a few studies have addressed the prevalence and clinical characteristics of pain in neurodegenerative disorders with atypical parkinsonism. The existing evidence, although scarce, suggests that, similarly as in Parkinson's disease, individuals with neurodegenerative diseases with atypical parkinsonism might be predisposed to the development of persistent pain. Today, as the global population is aging and we face an epidemic of neurodegenerative disorders, under-treated pain is taking a great toll on an ever-rising number of people. Here, we provide an up-to-date review of the current knowledge on the prevalence of pain, its clinical features, and findings from experimental studies that might signpost altered pain processing in the most prevalent neurodegenerative disorders with atypical parkinsonism: multiple system atrophy, progressive supranuclear palsy, corticobasal syndrome, frontotemporal dementia, and dementia with Lewy bodies. Finally, we point out the current gaps and unmet needs that future research studies should focus on. Large-scale, high-quality clinical trials, coupled with pre-clinical research, are urgently needed to reveal the exact pathophysiological mechanisms underpinning heightened pain and pave the path for mechanistically-driven analgesic interventions to be developed, ultimately leading to an improvement in the quality of life of individuals with neurodegenerative disorders.
Topics: Corticobasal Degeneration; Frontotemporal Dementia; Humans; Lewy Body Disease; Multiple System Atrophy; Musculoskeletal Pain; Neuralgia; Prevalence; Supranuclear Palsy, Progressive
PubMed: 34997730
DOI: 10.31083/j.jin2004108 -
Acta Ophthalmologica Nov 2021To investigate the efficacy of bilateral lateral rectus recession (BLR) versus unilateral recession and resection (RR) for the treatment of patients with basic-type... (Meta-Analysis)
Meta-Analysis
PURPOSE
To investigate the efficacy of bilateral lateral rectus recession (BLR) versus unilateral recession and resection (RR) for the treatment of patients with basic-type intermittent exotropia (IXT).
METHODS
We systematically searched the EMBASE, PubMed, Web of Science and Cochrane Library databases for relevant studies published before April 2020 with no language restrictions. Related studies meeting the eligibility criteria were included. The primary outcomes were success rate and mean postoperative deviation. Odds ratios (ORs) and weighted mean differences (MDs) with 95% confidence intervals (CIs) were calculated.
RESULTS
From 1243 screened articles, a total of 10 studies involving 967 patients were included in the analysis. No differences were observed in success rates between the BLR and RR groups at 1-day to 1-week postoperatively (OR: 0.9, 95% CI: 0.53 to 1.53, p = 0.69), or at 6-month postoperatively (OR: 1.11, 95% CI: 0.59 to 2.11, p = 0.74), or at the last follow-up visit (OR: 0.76, 95% CI: 0.44 to 1.34, p = 0.34). The unsatisfactory effects (the overcorrection and undercorrection rates) between the two groups were comparable. In addition, there were no significant differences between the two groups in postoperative deviation at 1-day to 1-week postoperatively (MD: 0.03, 95% CI: -1.32 to 1.27, p = 0.97), or at 6-month postoperatively (MD: 1.42, 95% CI: -0.43 to 3.27, p = 0.13) or at the last follow-up visit (MD: 0.29, 95% CI: -1.39 to 1.97, p = 0.74).
CONCLUSION
This meta-analysis provides evidence that both the BLR and RR procedures have similar efficacy for the treatment of basic-type IXT.
Topics: Chronic Disease; Exotropia; Humans; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Recurrence; Vision, Binocular; Visual Acuity
PubMed: 33576184
DOI: 10.1111/aos.14726 -
Italian Journal of Pediatrics Jun 2022Ophthalmoplegic migraine, renamed "Recurrent Painful Ophthalmoplegic Neuropathy" (RPON) in 2013 by the International Headache Society is a rare neurologic disorder...
BACKGROUND
Ophthalmoplegic migraine, renamed "Recurrent Painful Ophthalmoplegic Neuropathy" (RPON) in 2013 by the International Headache Society is a rare neurologic disorder characterized by recurrent attacks of ophthalmoplegia associated to ipsilateral headache. The etiology is still unknown. Typical magnetic resonance imaging findings show a focal nerve thickening and contrast enhancement. In the majority of cases, there is a full recovery within days or weeks. There is no evidence supporting a specific treatment. The review defines the characteristics of the recurrent painful ophthalmoplegic neuropathy in patients within 2 years of age underlying the importance of the role of magnetic resonance imaging even in presence of the first attack. Thus, an emblematic case report is presented.
CASE PRESENTATION
The authors present a case of third cranial nerve paresis in a 17-month-old male child, presenting a neuroradiological pattern highly suggestive of schwannoma, aneurism or recurrent painful ophthalmoplegic neuropathy. Thus, a review of the literature with the pediatric casuistry of recurrent painful ophthalmoplegic neuropathy occurred within 2 years of age focusing on diagnostic considerations is presented. The authors highlight the importance to consider recurrent painful ophthalmoplegic neuropathy in presence of magnetic resonance imaging findings and clinical symptoms referable to aneurysm or schwannoma. Thus, the review defines the characteristics and the neuroradiological findings at the first RPON attack occurred under 2 years of age.
CONCLUSION
Although two attacks are necessary, the review strongly suggests to consider recurrent painful ophthalmoplegic neuropathy even at the first attack, in presence of described characteristics and the aforementioned magnetic resonance imaging findings.
Topics: Child; Headache; Humans; Infant; Magnetic Resonance Imaging; Male; Neurilemmoma; Ophthalmoplegia; Ophthalmoplegic Migraine; Pain; Peripheral Nervous System Diseases; Rare Diseases; Tolosa-Hunt Syndrome
PubMed: 35659705
DOI: 10.1186/s13052-022-01274-x -
Medicine Nov 2019This study will explore the efficacy and safety of horizontal muscle augmentation (HMA) combined inferior oblique muscle shortening (IOMS) for the treatment of pediatric...
BACKGROUND
This study will explore the efficacy and safety of horizontal muscle augmentation (HMA) combined inferior oblique muscle shortening (IOMS) for the treatment of pediatric strabismus (PS).
METHODS
Literature search for studies will be carried out in the following databases: Cochrane Library, MEDILINE, EMBASE, CINAHL, Web of Science, PsycINFO, CBM, and CNKI. We will search all these databases without language and publication status restrictions. Two independent authors will perform selection of studies, data collection and management, risk of bias evaluation. A third author will be consulted with the help of discrepancies.
RESULTS
This study will provide a synthesis of existed evidence for HMA combined IOMS for the treatment of PS.
CONCLUSION
The results of this study will provide evidence to evaluate the efficacy and safety of HMA combined IOMS for the treatment of PS, which can help to guide clinical decision-making.
SYSTEMATIC REVIEW REGISTRATION
PROSPERO CRD42019149716.
Topics: Child; Exercise Therapy; Humans; Oculomotor Muscles; Randomized Controlled Trials as Topic; Research Design; Strabismus
PubMed: 31725649
DOI: 10.1097/MD.0000000000017941