Publications by authors named "Jamie B Rosenberg"

32 Publications

Gender of Presenters at Ophthalmology Conferences Between 2015 and 2017.

Am J Ophthalmol 2020 05 23;213:120-124. Epub 2020 Jan 23.

Montefiore Medical Center, Bronx, New York, USA. Electronic address:

Purpose: To analyze the proportion of women presenting at 9 major ophthalmology conferences over 3 years.

Design: Retrospective observational study.

Methods: Conference brochures from 9 national ophthalmology conferences from 2015 to 2017 were analyzed. Genders of first author presenters of papers and non-papers (moderators, presenters at symposia, panel discussions, workshops/instructional courses) were recorded. Comparisons were made to the gender ratio of board-certified ophthalmologists. Student t test and Cochran-Armitage trend test was used for analysis, with significance at P < .05.

Results: Of 14,214 speakers, 30.5% were female, statistically higher than the expected 25.4% (P < .001). Paper presenters were 33.1% female (P < .001) and non-paper presenters were 28.5% female (P < .001). When stratified to general or subspecialty conference, general conferences had a higher proportion of women compared to the American Board of Ophthalmology (ABO) expected rates (P < .001) for paper and non-paper presentations. The rates of female presenters increased over the 3 years only at the Association for Research in Vision and Ophthalmology (P = .009). Subgroup analysis showed that women presented 33.1% of papers but only 28.5% of non-paper presentations, which is lower than expected (P < .001).

Conclusions: Our results highlight positive trends: the overall proportions of female speakers exceed ABO estimates of female ophthalmologists. However, the gender gap remains at many subspecialty conferences, especially for non-papers, which are more likely to require invitations rather than being self-submitted. As demographics continue to change, further efforts are needed to assure equitable selection of conference presenters.
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http://dx.doi.org/10.1016/j.ajo.2020.01.018DOI Listing
May 2020

Gender-based differences in letters of recommendation written for ophthalmology residency applicants.

BMC Med Educ 2019 Dec 30;19(1):476. Epub 2019 Dec 30.

Department of Ophthalmology, University of California, Los Angeles, CA, USA.

Background: To determine whether gender-based differences may be present in letters of recommendation written for ophthalmology residency applicants.

Methods: All applications submitted through SF Match to the UCLA Stein Eye Institute Residency Training Program from the 2017-2018 application cycle were analyzed using validated text analysis software (Linguistic Inquiry and Word Count (Austin, TX)). The main outcome measures were differences in language use in letters of recommendation by gender of applicant.

Results: Of 440 applicants, 254 (58%) were male and 186 (42%) were female. The two gender groups had similar United States Medical Licensing Exam (USMLE) Step 1 scores, undergraduate grade point averages (uGPA's), proportions of underrepresented minority (URM) applicants and Gold Humanism Honor Society members, numbers of academic and service activities listed, and gender distributions of their letter writers (all P values > 0.05). However, letters written for male applicants were determined to use more "authentic" words than those written for female applicants (mean difference, 0.800; 95% CI, 0.001-1.590; P = 0.047). Letters written for male applicants also contained more "leisure" words (mean difference, 0.056; 95% CI, 0.008-0.104; P = 0.023) and fewer "feel" words (mean difference, 0.033; 95% CI, 0.001-0.065; P = 0.041) and "biological processes" words (mean difference, 0.157; 95% CI, 0.017-0.297; P = 0.028).

Conclusions: There were gender differences detected in recommendation letters in ophthalmology consistent with prior studies from other fields. Awareness of these differences may improve residency selection processes.
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http://dx.doi.org/10.1186/s12909-019-1910-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6937988PMC
December 2019

Accuracy of online health information on amblyopia and strabismus.

J AAPOS 2019 12 11;23(6):341-344. Epub 2019 Oct 11.

Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York. Electronic address:

The internet is a major source of health information for patients and parents. The information found online influences patients' and caregivers' understanding of diagnoses and decision making regarding management. We report the results of a survey completed by 4 fellowship-trained pediatric ophthalmologists evaluating the accuracy and clarity of various websites that provide information on amblyopia and strabismus.
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http://dx.doi.org/10.1016/j.jaapos.2019.09.007DOI Listing
December 2019

Interventions for orbital lymphangioma.

Cochrane Database Syst Rev 2019 05 15;5:CD013000. Epub 2019 May 15.

Department of Ophthalmology, Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Avenue, 3rd Floor, Bronx, NY, USA, 10467.

Background: Orbital lymphangiomas are a subset of localized vascular and lymphatic malformations, which most commonly occur in the head and neck region. Orbital lymphangiomas typically present in the first decade of life with signs of ptosis, proptosis, restriction of ocular motility, compressive optic neuropathy, and disfigurement. Therefore, early and effective treatment is crucial to preserving vision. Due to proximity to vital structures, such as the globe, optic nerve, and extraocular muscles, treatment for these lesions is complicated and includes a large array of approaches including observation, sclerotherapy, systemic therapy, and surgical excision. Of these options, there is no clear gold standard of treatment.

Objectives: To assess the evidence supporting medical and surgical interventions for the reduction/treatment of orbital lymphangiomas in children and young adults.

Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (2018, Issue 5); Ovid MEDLINE; Embase.com; PubMed; Latin American and Caribbean Health Sciences Literature Database (LILACS); ClinicalTrials.gov and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 22 May 2018.

Selection Criteria: We planned to include randomized controlled trials (RCTs) comparing at least two of the following interventions with each other for the treatment of orbital lymphangiomas: observation; sildenafil therapy; sirolimus therapy; sclerotherapy; surgery (partial or complete resection). We planned to include trials that enrolled children and adults up to 32 years of age, based on a prior clinical trial protocol. There were no restrictions regarding location or demographic factors.

Data Collection And Analysis: Two review authors independently screened the titles, abstracts, and full articles to assess their suitability for inclusion in this review. No risk of bias or data extraction was performed because we did not find any trials for inclusion. If there had been RCTs, two authors would have assessed the risk of bias and abstracted data independently with discrepancies being settled by consensus or consultation with a third review author.

Main Results: There were no RCTs that compared any two of the mentioned interventions (medical or surgical) for treating orbital lymphangiomas in children and young adults.

Authors' Conclusions: Currently, there are no published RCTs of orbital lymphangioma treatments. Without these types of studies, conclusions cannot be drawn regarding the effectiveness of the medical and surgical treatment options for patients with orbital lymphangiomas. The presence of only case reports and case series on orbital lymphangiomas makes it clear that RCTs are needed to address the differences between these options and help guide treatment plans. Such trials would ideally compare outcomes between individuals randomized to one of the following treatment options: observation, sclerotherapy, systemic sirolimus therapy, systemic sildenafil therapy, and surgical excision.
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http://dx.doi.org/10.1002/14651858.CD013000.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6521140PMC
May 2019

Types of materials for frontalis sling surgery for congenital ptosis.

Cochrane Database Syst Rev 2019 04 23;4:CD012725. Epub 2019 Apr 23.

Department of Ophthalmology, Montefiore Medical Center, Albert Einstein College of Medicine, 3332 Rochambeau Avenue, 3rd Floor, Bronx, NY, USA, 10467.

Background: Congenital ptosis is a drooping of one or both eyelids at birth, often due to poor development of the levator palpebrae superioris muscle. This can result in amblyopia, astigmatism, and ocular torticollis and therefore may necessitate surgical intervention in early childhood if visual development is compromised. Patients may have varied levels of levator function. Those with moderate to good function may elect to first attempt ptosis repair with external levator advancement or mullerectomy/Fasanella-Servat procedures. For those with poor function, those procedures are less likely to be effective, so they may undergo frontalis sling surgery, in which the tarsal plate is coupled to the frontalis muscle, so that movement of the brow and forehead result in movement of the eyelid. The optimal material to use in this surgery is unknown.

Objectives: To evaluate the comparative effectiveness and safety of various materials used in frontalis sling surgery for congenital ptosis.

Search Methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (which contains the Cochrane Eyes and Vision Trials Register) (June 2018), Ovid MEDLINE, Ovid MEDLINE E-pub Ahead of Print, Ovid Medline In-Process and Other Non-Indexed Citations, Ovid MEDLINE Daily (January 1946 to 20 June 2018), Embase (January 1947 to 20 June 2018), PubMed (1948 to 20 June 2018), Latin American and Caribbean Health Sciences Literature Database (LILACS) (1982 to 20 June 2018), ClinicalTrials.gov (www.clinicaltrials.gov) and the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) (www.who.int/ictrp/search/en). We did not use any date or language restrictions in the electronic search for trials. We last searched the electronic databases on 20 June 2018.

Selection Criteria: We included randomized trials that compared one material to another for the treatment of congenital ptosis.

Data Collection And Analysis: Two review authors independently completed eligibility screening, data abstraction, 'Risk of bias' assessment, and grading of the evidence.

Main Results: We identified three randomized trials that had compared four different materials, two materials in each trial. The studies included a total of 160 participants. The surgical procedures compared were polytetrafluoroethylene (Gore-Tex), Ethibond suture, Mersilene mesh, and autogenous fascia lata.We judged all studies to be at unclear risk of bias due to incomplete reporting of methods and other methodological deficiencies.Because the three included studies compared different types of implants, we were unable to combine data in a meta-analysis. The limited data preclude any conclusion regarding the optimal implant for frontalis sling surgery.In terms of the primary outcome of functional success, this was defined as widening of the opening between eyelids, assessed either by grade or by millimeter measurement. Bajaj 2004 showed that 93% of the Gore-Tex group and 83% of the Ethibond group had a good or satisfactory outcome (as defined by investigators). Elsamkary 2016 reported that 78.1% of the autogenous fascia group and 61.8% of the Gore-Tex group had a very good or good outcome. Salour 2008 did not include this type of grading system; they showed that the lid fissure increased 4.0 mm ± 1.46 mm in the Mersilene group and 3.13 mm ± 1.72 mm in the fascia lata group.In terms of adverse events, Bajaj 2004, which included 15 patients per group, showed no recurrence in the Gore-Tex group and 1 in the Ethibond group; no need for removal in the Gore-Tex group and 1 in the Ethibond group; and no infections in the Gore-Tex group and 1 in the Ethibond group. Elsamkary 2016, which included 55 patients per group, had 3 recurrences in the fascia group and 6 in the Gore-Tex group; no need for removal in either group; and 1 infection in the fascia group and 2 in the Gore-Tex group. Salour 2008, which included 10 patients per group, had no recurrence, removals, or infections in either the Mersilene or the fascia group.

Authors' Conclusions: The three trials included in this review evaluated four materials for frontalis sling surgery. Assessment of these three studies does not allow us to identify the optimal material. Future randomized trials should be rigorously designed so as to identify the best treatment for this condition.
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http://dx.doi.org/10.1002/14651858.CD012725.pub2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6478334PMC
April 2019

Measurement of resident fatigue using rapid number naming.

J Neurol Sci 2019 02 28;397:117-122. Epub 2018 Dec 28.

Montefiore Medical Center, 111 E 210 Street, Bronx, NY 10467, USA. Electronic address:

Objective: Sleep deprivation has a negative effect on neurocognitive performance. The King-Devick test (KDT), which tests speed and accuracy of number-reading, requires integrity of saccades, visual processing, and cognition. This study investigated effects of sleep deprivation in on-call residents using KDT.

Methods: A prospective cohort study was conducted among 80 residents. KDT was performed at the beginning and end of an overnight call shift for the residents in the experimental group. A control group was tested at the beginning of 2 consecutive day shifts. Estimates of hours of sleep, Karolinska Sleepiness Scale (KSS)(1 = extremely alert, 9 = extremely sleepy), and time and accuracy of KDT were recorded.

Results: 42 residents were tested before and after overnight call shifts and 38 served as controls. Change in test time differed between the groups, with the experimental group performing 0.54(SD = 4.0) seconds slower after their night on call and the control group performing 2.32(SD = 3.0) seconds faster on the second day, p < 0.001. This difference was larger in surgical compared to medical residents.

Conclusions: Sleep deprivation was inversely correlated with neurocognitive performance as measured by KDT, with more effect on surgical than medical residents. Further research could investigate whether this test could help determine fatigue level and ability to continue working after a long shift.
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http://dx.doi.org/10.1016/j.jns.2018.12.034DOI Listing
February 2019

Penetrating ocular injury by Western diamondback rattlesnake.

Can J Ophthalmol 2018 08 13;53(4):e134-e135. Epub 2017 Dec 13.

Loma Linda University VA, Loma Linda, CA.

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http://dx.doi.org/10.1016/j.jcjo.2017.10.017DOI Listing
August 2018

Strabismus After Ocular Surgery.

J Pediatr Ophthalmol Strabismus 2017 Sep 31;54(5):272-281. Epub 2017 Jul 31.

Many types of ocular surgery can cause diplopia, including eyelid, conjunctival, cataract, refractive, glaucoma, retinal, and orbital surgery. Mechanisms include direct injury to the extraocular muscles from surgery or anesthesia, scarring of the muscle complex and/or conjunctiva, alteration of the muscle pulley system, mass effects from implants, and muscle displacement. Diplopia can also result from a loss of fusion secondary to long-standing poor vision in one eye or from a decompensation of preexisting strabismus that was not recognized preoperatively. Treatment, which typically begins with prisms and is followed by surgery when necessary, can be challenging. In this review, the incidence, mechanisms, and treatments involved in diplopia after various ocular surgeries are discussed. [J Pediatr Ophthalmol Strabismus. 2017;54(5):272-281.].
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http://dx.doi.org/10.3928/01913913-20170703-01DOI Listing
September 2017

Screening for Diabetic Retinopathy.

N Engl J Med 2017 04;376(16):1587-1588

From the Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, NY (J.B.R.); and the Stein Eye Institute and the Doheny Eye Institute, University of California, Los Angeles, Los Angeles (I.T.).

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http://dx.doi.org/10.1056/NEJMe1701820DOI Listing
April 2017

Comparison of Pediatric and Adult Ophthalmology Consultations in an Urban Academic Medical Center.

J Pediatr Ophthalmol Strabismus 2017 Jan 27;54(1):17-21. Epub 2016 Sep 27.

Purpose: The purpose of this study was to compare pediatric and adult ophthalmology consultations in an urban academic center.

Methods: A retrospective chart review of patients evaluated by the ophthalmology consultation service from January through June 2014 was conducted.

Results: A total of 751 inpatients and emergency department patients were evaluated by the ophthalmology consultation service, of whom 152 (20.4%) were children and 598 (79.6%) were adults. The emergency department requested most of these consultations (42.8%), followed by internal medicine (39.1%) and pediatrics (18.4%) inpatients. More adult patients (94.5%) than children (76.5%) had abnormal findings on examination (P < .001). Altering management was recommended at a similar rate: 51.6% of pediatric patients and 54.3% of adult patients (P = .59). All children were initially seen by residents; children (38.6%) were more likely than adults (9.0%) to be seen with an attending physician (P < .001). Children (54.9%) were also more likely than adults (42.7%) to attend their recommended outpatient appointments (P = .027).

Conclusions: The authors identified several interesting differences between the pediatric and adult consultation services. Although adult patients were more likely to have abnormal findings, the ophthalmology team recommended a change in management for more than half of each group. These rates of intervention suggest that it is equally important that children be considered for an ophthalmology consultation and examined as soon as possible. In addition, residents may need particular guidance in evaluating pediatric inpatients. [J Pediatr Ophthalmol Strabimus. 2017;54(1):17-21.].
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http://dx.doi.org/10.3928/01913913-20160908-01DOI Listing
January 2017

Proptosis Reduction Using Sirolimus in a Child With an Orbital Vascular Malformation and Blue Rubber Bleb Nevus Syndrome.

Ophthalmic Plast Reconstr Surg 2017 May/Jun;33(3S Suppl 1):S143-S146

Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, U.S.A.

A 15-month-old boy with left congenital proptosis presented to the emergency department with melena. Upper GI endoscopy and magnetic resonance angiography revealed vascular lesions, consistent with gastrointestinal tract manifestations of blue rubber bleb nevus syndrome. MRI revealed vascular malformations in both orbits, with mass effect on the left side. The patient was started on a trial of the antiangiogenic agent sirolimus (also known as rapamycin), and after 6 months of treatment showed clinical improvement in proptosis supported by radiologic evidence of regression in the larger, left orbital mass, with stability of the smaller, right orbital mass. There are 11 published cases of orbital blue rubber bleb nevus syndrome in the English literature. To our knowledge, this is the first reported case of successful, long-term treatment with sirolimus causing a reduction in the size of an orbital vascular malformation.
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http://dx.doi.org/10.1097/IOP.0000000000000692DOI Listing
September 2017

Women in print-reply.

JAMA Ophthalmol 2015 May;133(5):621

Association to Prevent Blindness in Mexico, Mexico City, Mexico.

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http://dx.doi.org/10.1001/jamaophthalmol.2015.223DOI Listing
May 2015

The essentials of informed consent.

J Pediatr Ophthalmol Strabismus 2014 Sep-Oct;51(5):263-5

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http://dx.doi.org/10.3928/01913913-20140819-03DOI Listing
May 2015

Trends in retinopathy of prematurity over a 5-year period in a racially diverse population.

Ophthalmic Surg Lasers Imaging Retina 2014 Mar-Apr;45(2):138-42

Background And Objective: Retinopathy of prematurity presents differently in developing versus developed countries, which may be due to environmental as well as racial differences.

Patients And Methods: Retrospective chart review of infants screened for ROP at a single neonatal intensive care unit. Risk factors were reviewed. Main outcome measures were rates of plus disease or treatment-requiring ROP by race.

Results: The study included 497 infants screened for ROP in an urban neonatal intensive care unit. Gestational age, birth weight, and bronchopulmonary dysplasia were independent risk factors for both plus disease and treatment-requiring ROP with type 3 multivariate analysis. Self-identified white race was also a risk factor for plus disease and treatment-requiring ROP. Race was significantly associated with maternal age, multiple births, and blood transfusions.

Conclusion: In the study population, white race was an independent risk factor for plus disease and ROP treatment.
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http://dx.doi.org/10.3928/23258160-20140306-07DOI Listing
September 2014

A case of congenital myofibroma of the orbit presenting at birth.

Orbit 2013 Feb;32(1):33-5

Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Bronx, NY, USA.

Purpose: The purpose of this report is to highlight a rare cause of congenital proptosis.

Methods: This is a case report.

Results: We present a case of a baby girl born with a large myofibroma in the right retrobulbar space. This case is unusual because it presented from birth and was in a critical location. A prenatal ultrasound performed two days prior to birth did not reveal this mass to the technician or obstetrician. At birth, the tumor induced severe proptosis, with the eyelids unable to close around the globe. Deterioration of the ocular surface secondary to exposure was evident immediately after birth. One week after birth, the mass was excised by the Oculoplastics service in conjunction with a Neurosurgical team using a transcranial approach. The tumor was diagnosed by histopathology and immunologic staining as a myofibroma, a rare condition.

Conclusions: Orbital myofibroma is a rare cause of congenital proptosis presenting at birth.
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http://dx.doi.org/10.3109/01676830.2012.736594DOI Listing
February 2013

Patent ductus arteriosus and indomethacin treatment as independent risk factors for plus disease in retinopathy of prematurity.

J Pediatr Ophthalmol Strabismus 2013 Mar-Apr;50(2):88-92. Epub 2013 Jan 15.

Department of Ophthalmology, Montefiore Medical Center; Albert Einstein College of Medicine, Bronx, NY, USA.

Purpose: To examine whether clinically significant patent ductus arteriosus (PDA) or indomethacin treatment are associated with plus disease or retinopathy of prematurity (ROP) requiring treatment.

Methods: Retrospective, cross-sectional study. Charts were reviewed for gestational age, birth weight, birth head circumference, birth length, maternal characteristics, gender, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, blood transfusions, and sepsis. Main outcome measures were increased rates of plus disease or ROP requiring treatment.

Results: A total of 450 premature infants screened for ROP in a mid-sized, urban neonatal intensive care unit were included. On univariate analysis, gestational age, birth weight, birth head circumference, birth length, bronchopulmonary dysplasia, neurologic comorbidities, PDA and its treatments, gastrointestinal comorbidities, and sepsis were significantly correlated to plus disease and ROP requiring treatment. PDA was significantly associated with bronchopulmonary dysplasia, neurologic comorbidities, sepsis, and blood transfusions (P < .0001). With type 3 multivariate analysis, only gestational age and bronchopulmonary dysplasia were independent risk factors for ROP.

Conclusion: PDA and indomethacin were associated with plus disease and ROP requiring treatment on univariate analysis but this was not significant after adjusting for other risk factors. PDA was also strongly related to bronchopulmonary dysplasia and blood transfusions, which may explain its effect on ROP.
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http://dx.doi.org/10.3928/01913913-20130108-03DOI Listing
December 2013

Strabismus in craniosynostosis.

J Pediatr Ophthalmol Strabismus 2013 May-Jun;50(3):140-8. Epub 2012 Nov 20.

Division of Pediatric Ophthalmology, Department of Ophthalmology, Montefiore Medical Center, Bronx, New York, USA.

Strabismus is common in craniosynostosis, with rates from 39% to 90.9% in Crouzon, Apert, Pfeiffer, and Saethre-Chotzen syndromes. This article reviews the epidemiology of strabismus in these disorders and discusses competing theories of the mechanism, including absent muscles, excyclorotation of muscles, and instability of muscle pulleys. The authors then review options for surgical treatment of the often complex ocular misalignment in these disorders.
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http://dx.doi.org/10.3928/01913913-20121113-02DOI Listing
March 2014

Ganciclovir for cytomegalovirus retinitis.

Ophthalmology 2012 Nov;119(11):2418-9; author reply 2419

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http://dx.doi.org/10.1016/j.ophtha.2012.06.059DOI Listing
November 2012

Monotherapy versus fortified antibiotics for bacterial keratitis.

Cornea 2011 Sep;30(9):1066; author reply 1066-7

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http://dx.doi.org/10.1097/ICO.0b013e31820ce2a1DOI Listing
September 2011

Subconjunctival anesthesia for laser treatment.

Ophthalmology 2011 May;118(5):1013; author reply 1013

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http://dx.doi.org/10.1016/j.ophtha.2011.01.015DOI Listing
May 2011

Refractive surgery: a treatment for and a cause of strabismus.

Curr Opin Ophthalmol 2011 Jul;22(4):222-5

Department of Ophthalmology, Montefiore Medical Center, Bronx, New York 10467, USA.

Purpose Of Review: The purpose of this article is to review refractive surgery as a means of treatment for strabismus and as a potential cause of strabismus and binocular diplopia.

Recent Findings: Numerous studies have reported that refractive surgery is effective in correcting certain types of strabismus such as accommodative and partially accommodative esotropia. Studies on the treatment of exotropia related to anisometropia have demonstrated less favorable outcomes. In patients without manifest strabismus preoperatively, recent studies have shown that strabismus and diplopia can occur after refractive surgery. Appropriate clinical testing and risk stratification are essential to determine whether a patient is at increased risk for postoperative strabismus and diplopia.

Summary: Refractive surgery can be useful in patients with accommodative and partially accommodative esotropia. A thorough history and clinical examination is extremely important to expose potential risk factors in all patients undergoing refractive surgery. Based on the designated risk level, more advanced testing may be warranted.
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http://dx.doi.org/10.1097/ICU.0b013e3283477c60DOI Listing
July 2011

Non-invasive methods of estimating intracranial pressure.

Neurocrit Care 2011 Dec;15(3):599-608

Department of Ophthalmology and Visual Sciences, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA.

Non-invasive measurement of intracranial pressure can be invaluable in the management of critically ill patients. We performed a comprehensive review of the literature to evaluate the different methods of measuring intracranial pressure. Several methods have been employed to estimate intracranial pressure, including computed tomography, magnetic resonance imaging, transcranial Doppler sonography, near-infrared spectroscopy, and visual-evoked potentials. In addition, multiple techniques of measuring the optic nerve and the optic nerve sheath diameter have been studied. Ultrasound measurements of the optic nerve sheath diameter and Doppler flow are especially promising and may be useful in selected settings.
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http://dx.doi.org/10.1007/s12028-011-9545-4DOI Listing
December 2011

Ectrodactyly-ectodermal dysplasia-clefting syndrome causing blindness in a child.

J AAPOS 2011 Feb;15(1):80-2

Department of Ophthalmology, Montefiore Medical Center, Bronx, New York 10467, USA.

Ectrodactyly-ectodermal dysplasia-clefting syndrome, the result of a mutation in the gene encoding tumor protein p63, causes ocular surface disease. It is typically progressive, with vision loss in adulthood. We present a case of severe corneal disease, glaucoma, and blindness related to ectrodactyly-ectodermal dysplasia-clefting syndrome in a 3-year-old female patient.
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http://dx.doi.org/10.1016/j.jaapos.2010.12.001DOI Listing
February 2011

Pediatric sickle cell retinopathy: correlation with clinical factors.

J AAPOS 2011 Feb;15(1):49-53

Montefiore Medical Center, Department of Ophthalmology, Bronx, New York 10467, USA.

Background: Sickle cell disease (SCD) occurs in 1 of every 500 African American births and 1 of every 36,000 Hispanic American births. Of children with SCD, 16.7% to 96.3% develop sickle retinopathy (SR). This study was designed to determine whether certain factors are associated with SR and whether SR is correlated with a greater incidence of other SCD manifestations.

Methods: A retrospective analysis was performed of 258 children with SCD seen in the ophthalmology clinic at a large urban children's hospital. Of these, 54 children with SR were matched for age and sickle variant with 54 children with normal examinations. Data extracted included demographics, type of retinopathy, presence of glucose-6-phosphate dehydrogenase (G6PD) deficiency, and history of acute chest syndrome, transfusions, pulmonary hypertension, renal disease, cerebrovascular accident, aplastic crisis, splenic sequestration, priapism, osteonecrosis, gallstones, pneumonia, leg ulcers, vaso-occlusive pain crises, and death.

Results: Of the children with SR, 11 (20.3%) had active proliferative disease, 32 (56.1%) had hemoglobin SS, 18 (31.6%) had hemoglobin SC, and 4 (7.0%) had hemoglobin S-beta thalassemia. Several factors were correlated with retinopathy: pain crisis (odds ratio [OR], 5.00; p=0.011), male sex (OR, 4.20, p=0.004), and splenic sequestration (OR, 4.00; p=0.013). G6PD deficiency was more common in patients with retinopathy, although this was not statistically significant (OR, 4.20; p=0.054). No other factors, including frequency of pain crisis, were statistically significant.

Conclusions: Patients with pain crisis and splenic sequestration should be considered for early ophthalmic evaluation. Those with G6PD deficiency may also deserve early screening. By identifying patients at high risk for SR, we can refine screening protocols to safeguard patients from vision loss.
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http://dx.doi.org/10.1016/j.jaapos.2010.11.014DOI Listing
February 2011