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femida kherani, Emi Sanders, Harvey Sarnat; Clinical Pathology of Pediatric Ptosis. Invest. Ophthalmol. Vis. Sci. 2013;54(15):6367. doi: https://doi.org/.
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© ARVO (1962-2015); The Authors (2016-present)
To describe the muscle pathology in pediatric ptosis with clinical correlation
This study complied with the ARVO statement of use of humans in research and was approved by the University of Calgary Conjoint Health Research Ethics Board. A retrospective, qualitative review of 25 patients (28 eyes) who underwent ptosis surgery at the Alberta Children’s Hospital in Calgary, Canada was conducted. The average age at the time surgery was 53.3 months (range 2-202 months). All tissue samples were sent for histo-pathological examination in formalin fixed, paraffin sections parallel to the eyelid stained with H & E. Samples were stained for smooth muscle myosin, striated slow and fast myosins, vimentin, α-β-crystallin, CD-43 and CD-68. Clinical data including visual acuity and marginal reflex distances (MRD) was obtained pre and post surgery.
Pathology and clinical features were reviewed for the 28 eyes of 25 children (12 male, 13 female). Average visual acuity prior to surgery was 0.56 logMAR (range 1.13-0.1). Average visual acuity post surgery was 0.18 logMAR (range 0.95-0.0) with an average increase of 0.41 logMAR (range 1.1-0.1). Average increase in MRD was 2.4 (range 0.5-4.5). Pathological testing revealed abnormal muscle results in 82% of levator and or Mueller's specimens (hypoplasia, hypertrophic, atrophic and fibrosis). 43% of tissues had inflammatory cells. Average follow up was 14.6 months (range 1-43 months).
All patients had an inprovement in vision and eyelid height with ptosis surgery. Review of pathology confimed abnormal muscle results in 82% of levator and or Mueller's specimens (hypoplasia, hypertrophic, atrophic and fibrosis).
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