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Biomedical subjects

Yair Morad

Publications and source records attributed to Yair Morad.

At least 19 recordsLinked to original sources
PubMed2006

Optic neuritis associated with etanercept therapy for juvenile arthritis.

PURPOSE: We sought to describe cases of optic neuritis associated with etanercept therapy. METHODS: A retrospective chart review was undertaken on all patients that developed uveitis or optic neuritis associated with etanercept therapy between January 2003 and January 2005 in 2 medical centers: Assaf Harofeh Medical Center, and Kaplan Medical Center, Israel. RESULTS: Four patients (3 girls, 1 boy) treated with etanercept for juvenile idiopathic arthritis (JIA) are presented. The 3 girls had oligoarticular-onset JRA. The boy had HLA-B27-positive juvenile spondyloarthropathy and bilateral uveitis. After a mean follow-up of 10 months (range, 2.5-18 months) all 4 patients had reduced visual acuity due to optic neuritis, which was accompanied by vitreitis in 2 eyes. In 3 patients, the discontinuation of etanercept, together with steroid treatment, resulted in resolution of the inflammation. The fourth patient elected to continue etanercept treatment and experienced no further deterioration in visual acuity. CONCLUSION: Optic neuritis is a potentially sight-threatening complication of etanercept therapy. Patients with JRA who are candidates for therapy should be examined by an ophthalmologist before starting treatment and then regularly thereafter. Ophthalmologists and rheumatologists should be aware of this hazard and be cautious when using etanercept in this patient population.

Adolescent↗
PubMed2006

Brief posturographic test as an indicator of fatigue.

The purpose of the present paper was to analyze the efficiency of an abbreviated, albeit objective posturographic test as an indicator of fatigue. Posturography was measured in 10 healthy adults (age 18-33 years, male/female 7/3). Baseline posturographic measurements were taken for each subject. Later, a shorter (3-min) posturographic test was administered 12 times during 25 h of sleep deprivation. This was correlated with subjective assessment of fatigue using a questionnaire and cognitive performance assessed with a reaction time test (Psychomotor Vigilance Test). Although showing significant individual differences, the score of the abbreviated posturographic examination, normalized to each subject's baseline performance ('fatigue index') had a pronounced circadian pattern with a peak of instability in the early morning hours. Fatigue index was highly correlated with the cognitive test (r=0.80-0.90). A substantial, albeit weaker correlation was found between the fatigue index and the subjective fatigue scores (r=0.59-0.75). Fourier spectral analysis showed that low median sway (0.10-0.50 Hz), considered to be an expression of vestibular control, was most affected by fatigue. The study demonstrates that cognitive deterioration caused by fatigue can be objectively predicted by an abbreviated postural test of <or=3 min. This test is promising to be valid, reliable, and practicable, while being significantly correlated with physiological markers and validated cognitive measures of fatigue obtained by substantially more time-consuming and less convenient methods.

Adolescent↗
PubMed2005

Ocular higher-order aberrations in myopia and skiascopic wavefront repeatability.

PURPOSE: To study the distribution of ocular higher-order aberrations (HOAs) in a myopic population and to assess the repeatability of HOA measurements determined by a commercially available skiascopic wavefront sensor. SETTING: Department of Ophthalmology, Assaf Harofeh Medical Center, Zerifin, Israel. METHODS: Ocular HOAs were examined 3 times across a 6.0 mm naturally dilated pupil in 61 eyes using the Optical Path Difference (OPD)-scan wavefront aberrometer. Root-mean-square (RMS) values of HOAs, total spherical aberration (TSA), total coma (TC), and total trefoil (TT) were analyzed. Correlation analysis was performed to assess the aberration symmetry between right and left eyes. The repeatability of the OPD-scan measurements was assessed by calculating Pearson r correlation coefficients between each pair of measurements and the interclass correlation coefficients between the 3 measurements of each score. RESULTS: The mean RMS values of HOAs, TSA, TC, and TT were 0.347 microm +/- 0.252 (SD), 0.120 +/- 0.174 microm, 0.165 +/- 0.168 microm, and 0.252 +/- 0.157 microm, respectively. The HOAs, TSA, TC, and TT changed slightly and not significantly with increasing refractive error (all P>.05). The RMS level of HOAs and TTR of the 3rd measurement was significantly different from the 1st and 2nd measurements (P<.05), with overall low correlation between the 3 measurements for the HOAs, TSA, TC, and TT. CONCLUSIONS: The ocular wavefront aberrations varied greatly from subject to subject. Ocular HOAs were not correlated with refractive error. The repeatability of HOAs measurements with the OPD-aberrometry was low.

Adolescent↗
PubMed2005

Penetrating keratoplasty for keratoconus: long-term results.

PURPOSE: To study central corneal endothelial cell density and morphology and corneal topography in transplanted corneas for keratoconus 10 to 17 years postoperatively. METHODS: Retrospective, noncomparative case series including all keratoconus patients who underwent penetrating keratoplasty by one surgeon, at the same center, between January 1986 and December 1994. Seventeen patients (22 eyes) met the criteria. Four patients (5 eyes) with unchanged visual acuity during the follow-up period did not agree to return for the last follow-up examination, 1 patient (1 eye) had graft failure, and 3 patients (4 eyes) were lost to follow-up. We reviewed the charts of 9 patients (12 eyes), and collected data including manifest refraction, best corrected visual acuity (BCVA), endothelial cell density, cell morphology, and corneal topography. RESULTS: The mean follow-up period for all eyes evaluated was 13.3 +/- 2.4 years (range 10-17 years). At the last follow-up, 91.7% of eyes achieved BCVA of 20/40 or better, and mean endothelial cell density was 695 +/- 113.6 cells/mm(2). Pleomorphism was detected in 5 eyes. Keratoconus pattern, by corneal topography, was not detected in any eye at the final examination. CONCLUSION: Endothelial cell count 10-17 years post-PKP for keratoconus is very low with pleomorphism and viable grafts, indicating continued endothelial instability.

Adolescent↗
PubMed2005

Acute ophthalmoplegia and nystagmus in infants fed a thiamine-deficient formula: an epidemic of Wernicke encephalopathy.

In 2003, an epidemic of Wernicke encephalopathy (WE) developed in Israeli infants fed a thiamine-deficient soy-based formula. Approximately 20 infants were affected out of an estimated 3500 fed the vitamin-deficient formula. The finding of gaze abnormalities in a single infant by neuro-ophthalmologists led to the unraveling of the epidemic. In this report, the findings in three infants are described. Early diagnosis and treatment with parenteral thiamine led to complete neurologic recovery in two infants; in the third infant, delayed diagnosis may have been responsible for severe lingering deficits. This is the first reported epidemic of WE secondary to thiamine-deficient infant formula. Early diagnosis and treatment are critical to avoid persistent neurologic impairment.

Acute Disease↗
PubMed2005

The changing prevalence of myopia in young adults: a 13-year series of population-based prevalence surveys.

PURPOSE: To determine the changing prevalence of myopia during the years 1990 through 2002 among the 16- to 22-year age group and identify possible risk factors. METHODS: A retrospective study, based on 13 repeated prevalence surveys conducted over a 13-year period. The study subjects were all Israeli nationals belonging to the 16- to 22-year age group from the years 1990 to 2002. Refraction was determined by using subjective visual acuity followed by noncycloplegic autorefraction and subjective validation based on the autorefraction RESULTS: Mild myopia was defined as a refractive error of -0.50 to -3.00 D in at least one eye, moderate myopia as -3.25 to -6.00 D, and high myopia as more than -6.00 D. results. There were 919,929 subjects (382,139 [42%] females and 537,790 [58%] males) included in the study. The overall prevalence of myopia increased from 20.3% in 1990 to 28.3% in 2002. The prevalence of high, moderate, and mild myopia significantly increased in males from 1.7%, 5.7%, and 11.6% in 1990 to 2.05%, 7.2%, and 16.3% in 2002, respectively (P < 0.001). In females, the prevalence of myopia increased from 1.9%, 6.6%, and 13.5% in 1990 to 2.4%, 9.2%, and 20.7% in 2002, respectively (P < 0.001). A correlation between myopia and the number of years of education was observed. Non-Israeli origin was found to be a significant risk factor for myopia. CONCLUSIONS: During the 13 years from 1990 to 2002, the prevalence of myopia significantly increased among the Israeli population. Although there was an association with the level of education, gender, ethnicity, and origin, the prevalence of myopia increased on an annual basis, independent of these factors.

Adolescent↗
PubMed2005

The effect of cataract surgery on postural control.

PURPOSE: Falls are a significant cause of morbidity in the elderly. Because decreased vision is known to be a significant risk factor for falling in this age group, we sought to examine the effect of the removal of cataract, a major cause of visual handicap, on postural stability. METHODS: Postural stability was measured in 23 patients who underwent cataract surgery, before and 1 to 4 months after surgery. Stability indices included Stability Effect, Fourier Spectrum of Postural Sway, and Synchronizations, and, based on these measurements, Falling Index, which had been shown in earlier studies to predict the risk of falling. RESULTS: Visual acuity in the surgical eye significantly improved in all patients after surgery (P < 0.01) and did not change in the fellow eye. Stability improved in most patients (19/23) and Fourier Spectrum of Postural Sway improved in the high-frequency bands (above 0.5 Hz), when viewing with the surgical eye, but not when viewing with the nonsurgical eye (P < 0.05). By Falling Index, before surgery, 12 of 23 patients were at high risk of falling, and only six were at low risk. After surgery, 16 of 23 were at low risk and only three remained at high risk (chi(2) test, P < 0.008). CONCLUSIONS: Cataract surgery significantly improves postural stability. Considering the high cost of treating fall-related injuries in the elderly, the findings may imply that cataract surgery is cost effective in this regard.

Accidental Falls↗
PubMed2005

Treatment of ocular tissues exposed to nitrogen mustard: beneficial effect of zinc desferrioxamine combined with steroids.

PURPOSE: Exposure of the ocular surface to mustard gas chemical warfare leads to a destructive inflammatory reaction. Both steroids and a novel metalocomplex free radical scavenger, zinc desferrioxamine (Zn/DFO), have been shown to be effective separately in reducing ocular damage. The purpose of the present study was to investigate whether the effectiveness of both medications applied simultaneously is superior to the effectiveness of either one applied alone. METHODS: One eye in each of 52 rabbits was exposed to 2% nitrogen mustard (NM). Topical treatment with eye drops of a metal complex-zinc desferrioxamine (Zn/DFO)-combined with dexamethasone phosphate (0.1%), was compared with the administration of saline or treatment with Zn/DFO or dexamethasone alone. Eight eyes (four animals) that were not exposed to NM served as the control. Examiners masked to the treatment groups assessed the extent of ocular injury and the response to treatment using clinical, histologic, and biochemical criteria. RESULTS: Treatment with the combination of Zn/DFO and dexamethasone was significantly more effective than was dexamethasone or Zn/DFO alone in reducing NM injury to ocular anterior segment structures. In combination-treated eyes, corneal re-epithelization was faster, corneal neovascularization was less severe, and intraocular pressure was not as severely elevated as in the saline or the Zn/DFO- or dexamethasone-alone groups. In addition, systemic antioxidant status was better conserved in the combination-treated animals. CONCLUSIONS: The findings suggest that the combination of topically applied Zn/DFO and dexamethasone, by virtue of their additive inhibitory effects on free radical formation and inflammation, should be considered as a basis for the treatment of ocular mustard gas injuries.

Animals↗
PubMed2004

Visual field attention is reduced by concomitant hands-free conversation on a cellular telephone.

PURPOSE: To quantify the central attention-diverting effect of hands-free cellular phone conversation on visual field awareness. DESIGN: Experimental study. METHODS: Twenty male and 21 female healthy participants performed a pretest and baseline Esterman visual field examinations with the Humphrey Systems Visual Field Analyzer II. During the consequent third examination, each participant engaged in a hands-free conversation using a cellular phone. The conversation was the same for all participants. Visual field performance parameters were compared between the second (baseline) examination, and the third (test) examination for each eye. RESULTS: During phone conversation, missed points increased from mean 1.0 +/- 1.5 to 2.6 +/- 3.4 (P < or =.001) in the right eye and from 1.1 +/- 1.53 to 3.0 +/- 3.4 (P <.001) in the left eye. Fixation loss increased from mean 7.8% to 27.4% (P <.0001) and from 7.2% to 34.8% (P <.0001) for the right and left eyes, respectively. Test duration increased by a mean of 0.28 seconds (15%) per stimulus (P <.0001). Approximately half of missed points were inside the central 30 degrees. There was no significant difference in the performance of male and female participants. CONCLUSION: We describe a new model for the quantification of the attention-diverting effect of cellular-phone conversation on the visual field. In the current study, cellular hands-free conversation caused some subjects to miss significantly more points, react slower to each stimulus, and perform with reduced precision. Legislative restrictions on concomitant cellular-phone conversation and driving may need to be based on individual performance rather than a general ban on cellular phone usage.

Adult↗
PubMed2004

Normal computerized tomography of brain in children with shaken baby syndrome.

OBJECTIVE: To characterize the clinical presentation and clinical course of shaken baby syndrome (SBS) with normal cranial computerized tomography (CT) on admission and to suggest further diagnostic procedures in such circumstances. METHODS: Using a worldwide listserv designed to facilitate discussion in the field of child abuse and neglect, we solicited case information for children hospitalized in different medical centers, who were diagnosed with SBS and had a normal CT scan on admission. RESULTS: Nine cases were identified. While all children had an abnormal neurologic examination on admission, eight had a normal CT, and one had "widening of cranial sutures." In four cases, subdural hemorrhage was diagnosed on magnetic resonance imaging (MRI) 3 to 7 days after admission. Five children had bone fractures. The neurological outcome was normal in four of nine cases. Five children had long-term neurologic damage. The diagnosis of SBS was supported by either perpetrator confession, characteristic evolution of brain abnormalities on CT or MRI, inconsistent or absent explanatory history, and/or other social risk factors. CONCLUSION: The diagnosis of SBS can be established even when brain CT is normal on admission. The documentation of retinal hemorrhages is of primary importance in establishing the diagnosis of SBS in these cases.

Brain↗
PubMed2004

Shaken baby syndrome without intracranial hemorrhage on initial computed tomography.

OBJECTIVE: We sought to describe the unique characteristics of children diagnosed with shaken baby syndrome (SBS) despite the absence of intracranial hemorrhage on cranial computerized tomography (CT) on hospital admission. METHODS: Using an international e-mail-based listserv for professionals with an interest in child abuse, we identified and reviewed the charts of children hospitalized in different medical centers who were diagnosed with SBS although CT disclosed no signs of intracranial bleeding. Children with normal imaging were not included. RESULTS: Eight cases were identified. All children had cerebral edema in CT, which was severe on 7/8 cases (88%). All of these children had extensive retinal hemorrhage. The prognosis was poor; 5/8 infants died (63% mortality), and the rest had permanent neurologic damage. CONCLUSION: The diagnosis of SBS can be established even when CT at presentation does not demonstrate intracranial hemorrhage. We hypothesize that rapidly developing cerebral edema may cause increased intracranial pressure and tamponade that prevents the accumulation of intracranial blood. The prognosis in these cases is grave.

Brain Edema↗
PubMed2004

Benign opsoclonus in preterm infants.

Opsoclonus is a rare childhood ocular motility disorder characterized by irregular, chaotic, involuntary bursts of high amplitude, back-and-forth oscillations of the eyes,without pause intervals. Although this disorder is associated with neuroblastoma and other neural crest tumors, as well as with other neurologic abnormalities, it was also reported in healthy infants. The purpose of this study was to prospectively investigate the prevalence of opsoclonus in preterm infants, and to find any conditions associated with this disorder. Between August 2000 and April 2003, 528 consecutive preterm infants with gestation of less than 33 weeks or birth weight of less than 1500 gm were examined in accordance with our medical centers' retinopathy of prematurity screening policy. Opsoclonus was identified in three patients (0.6%), who were all otherwise physically and neurologically intact. One patient developed threshold retinopathy of prematurity that resolved after laser treatment. On follow-up examinations, the opsoclonus gradually disappeared by the age of 6 months in all infants,with no other complications. This study suggests that opsoclonus can be a benign, self-limiting phenomenon in preterm infants as was previously reported in term infants. However, because of the risk of severe associated illnesses, it is prudent to perform several diagnostic procedures and to continue careful follow-up until this phenomenon spontaneously resolves.

Female↗
PubMed2004

Fundus anomalies: what the pediatrician's eye can't see.

BACKGROUND: With increasing workloads for hospital doctors, routine funduscopy may be abandoned. It is not known how often pediatricians perform funduscopy and how skilled they are in performing it. OBJECTIVE: To assess hospital pediatricians' ability to diagnose abnormalities of the ocular fundi and to determine whether a short tutorial can improve their skills. METHODS: Physicians working at the pediatric division of a university-affiliated hospital participated in the study. All participants completed an anonymous questionnaire regarding their experience and skills in performing funduscopy. A pictorial quiz containing 20 fundus pictures of common findings in children was given. After completing the quiz, a 45-minute tutorial on common fundus anomalies was given. At the end of the lecture, the same quiz was given again. The percentage of correct answers for each quiz was scored. RESULTS: Sixteen physicians completed the study (11 pediatric residents and five senior pediatricians). Most participants did not feel competent at performing a fundus examination [mean score on a visual analog scale 1.96; range 0 (not competent at all) to 7]. The mean score for the fundus pictures quiz given before the tutorial was 48% (range 37-58%). The average score of the residents (47%) did not differ significantly from that of the senior pediatricians (42%). After the tutorial the mean grade increased significantly to 60% (P = 0.002). This was true both for residents (63%; P = 0.001) and seniors (55%; P = 0.004). CONCLUSIONS: Our study shows that funduscopy is being neglected by pediatricians. Even a short tutorial may significantly improve the diagnostic value of this test.

Child↗
PubMed2004

No need to tax the sick: clinical guidelines for rofecoxib as an alternative effective method to the copayment policy in the advent of increasing pharmaceutical expenditures.

BACKGROUND: Over the last few years, major health care systems have been trying to control increasing pharmaceutical expenditures by a variety of methods, such as the controversial copayment policy, as essential health expenditures were being jeopardized. OBJECTIVE: To analyze the regulatory intervention of preauthorization on a rofecoxib model in the medical corps of the Israeli Defense Forces (IDF) in terms of indications for prescription, consumption, and cost. INTERVENTIONS: Guidelines established by the medical services branch based on current literature and communication with diverse specialists and hospitals were implemented by a general practitioner who checked each rofecoxib prescription that was written for IDF personnel by a specialist. The intervention was initiated in November 2000 and continued until August 2001 and after the study. DESIGN: The study was divided into two parts. The first part was a retrospective monthly, preintervention analysis of computerized medical records of IDF personnel (N = 247) for whom rofecoxib was prescribed. The second was a prospective monthly, postintervention analysis of filled-out guideline forms (N = 250) of approved rofecoxib prescriptions. PARTICIPANTS: Patients, were IDF personnel, age 18 to 45, treated in military and civilian outpatient clinics for whom rofecoxib was prescribed. SETTING: The study took place at the Medical Service Branch of the IDF between August 2000 and August 2001. RESULTS: We demonstrated a significant decrease in average monthly consumption (43.0%) and estimated monthly expenditures (40.84%) of rofecoxib, as well as significant shifts (p < 0.001) in indications for whom rofecoxib was approved. These shifts (from pre- to postintervention) include the following: others/nonspecified (80 to 12%), known peptic disorder (7 to 32%), peptic complaints (4 to 22%), and rheumatic (8 to 19%). CONCLUSION: This type of intervention can be cost-effective, can provide quality care, and may be a viable alternative to the controversial and problematic copayment policy.

Adolescent↗
PubMed2003

The Ahmed drainage implant in the treatment of pediatric glaucoma.

PURPOSE: To report the safety and efficacy of Ahmed Glaucoma Valve (New World Medical, Inc., Rancho Cucamonga, California, USA) implantation for the management of pediatric glaucoma in the early and intermediate follow-up period. DESIGN: Consecutive interventional case series. METHOD: A retrospective chart review was conducted on 60 eyes (44 patients, age range at surgery 1.5 months to 16 years, average 6 +/- 4.9 years), with pediatric glaucoma that underwent Ahmed Glaucoma Valve implantation for medically uncontrolled intraocular pressure (IOP) between the years 1995 and 2000. Outcome measures were control of IOP below 21 mm Hg, the need for antiglaucoma medications after surgery, and loss of 2 or more lines of Snellen acuity. Complications were monitored. RESULTS: The postoperative follow-up period for each eye averaged 24.3 +/- 16 months (range, 3 to 60 months). At last follow-up, IOP was controlled in 44 eyes (73%), 11 of which did not need antiglaucoma therapy. Kaplan-Meier life-table analysis showed probability of success with or without medications of 93% (95% confidence interval [CI], 86%-100%), 86% (95% CI, 77%-96%), 71% (95% CI, 59%-87%), and 45% (95% CI, 28%-80%) after 12, 24, 36, and 48 months of follow-up. Average IOP decreased from 32.8 +/- 6.2 before surgery to 16.6 +/- 8.0 postoperatively (P <.0001). The average number of medications used decreased from 4.4 +/- 1.97 to 2.0 +/- 2.0 (P <.0001). Kaplan-Meier survival analysis did not reveal any difference in survival profiles related to specific diagnosis of glaucoma, age (above or below 18 months), or prior surgery. Complications occurred in 30 eyes (50%). Although most resolved or were treated successfully, four patients had severe visual loss during the follow-up. Uveitis was a significant risk factor for tube exposure (Fisher exact test, P =.006). CONCLUSIONS: Ahmed Glaucoma Valve implantation is an effective treatment for pediatric glaucoma, although patients frequently require antiglaucoma medications. However, a high rate of potentially sight-threatening postoperative complications warrants ongoing close follow-up.

Adolescent↗
PubMed2003

Contact lenses for the treatment of pediatric cataracts.

OBJECTIVE: To evaluate the experiences, attitudes, and perceptions of the caregivers of children with cataracts who were visually rehabilitated with contact lenses. PARTICIPANTS: One hundred twenty-three caregivers of children <8.1 years old treated for unilateral and bilateral cataracts at one pediatric hospital. DESIGN: Survey by questionnaire. INTERVENTION: Primary caregivers were asked to complete an anonymous questionnaire. MAIN OUTCOME MEASURES: Caregiver responses to questions assessing background and demographic and clinical information, as well as perceptions, attitudes, levels of compliance, and anxiety with respect to treatment, were reviewed. Caregivers were also asked to choose between aphakic rehabilitation with contact lenses, aphakic glasses, or intraocular lenses, given various hypothetical scenarios differing in regard to their final visual prognosis, risks of treatment complications, and cost. RESULTS: The response rate was 82.9%. Absolute average stress levels for contact lens use were 1.36 +/- 1.79 and 0.79 +/- 1.48 (scale, 0-5) for insertion and removal, respectively, compared with 4.03 +/- 1.64 and 2.40 +/- 1.92 for cataract surgery and patching therapy, respectively. Although average paired initial resistance to treatment (RT) levels for contact lens insertion and removal on a scale of 0 to 3 were high (2.09 +/- 1.15) and moderate (1.63 +/- 1.20), respectively, final RT levels were significantly lower (1.09 +/- 1.14 and 0.66 +/- 1.07, respectively; P < 0.0001). The vast majority of caregivers chose contact lens use in hypothetical scenarios that depicted realistic expectations for other forms of aphakic rehabilitation. CONCLUSIONS: In our study, contact lenses seemed to be well tolerated by most patients, as assessed by caregivers. Although initial resistance to contact lens use is high, this decreases with time. Relative to other events in the treatment of pediatric cataracts, contact lens use is not a major stressor for most caregivers and patients. This study supports the notion that contact lenses should continue to receive serious consideration as a treatment option for pediatric cataracts.

Aphakia, Postcataract↗
PubMed2003

Assessment of extraocular muscles position and anatomy by 3-dimensional ultrasonography: a trial in craniosynostosis patients.

PURPOSE: To determine whether 3-dimensional ultrasonography (3D US) provides information about anatomy and position of extraocular muscles to better guide surgeons approaching strabismus in patients with craniosynostosis who often have anomalous or absent eye muscles. METHODS: The 4 rectus eye muscles were imaged using 3D US for 7 children with craniosynostosis before or after strabismus surgery. Reconstructed 3D images were interpreted as having normal or abnormal anatomy and position, based on comparison with images acquired from 6 normal eyes. Interpretation was validated against the intraoperative findings from strabismus surgery. RESULTS: A total of 34 scans from the study group were used for comparison and validation purposes. Accuracy of anatomical assessments was 85% +/- 12% (percentage +/- confidence interval) and of positional assessments was 62% +/- 16%. Sensitivity and specificity of anatomical assessments was 80% +/- 14% and 88% +/- 10%, respectively. Anatomic anomalies detected by 3D US included excessively thick, thin, scarred and fibrotic, and absent muscles. Sensitivity and specificity of positional assessments was 48% +/- 17% and 85% +/- 12%, respectively. Positional anomalies such as muscle displacement off the normal clock hour axis or posteriorly displaced insertion were also detected. CONCLUSIONS: The 3D US may have an adjunctive role in determining anatomy and position of rectus muscles in patients with craniosynostosis, although it was more accurate in assessing anatomic features rather than positional features of rectus muscles.

Adolescent↗