Clinical Features of Excyclotorsion in the Non-Paretic Eye of Patients with Congenital Unilateral Superior Oblique Palsy

Background To investigate preoperative clinical features and postoperative results according to the correspondence between excyclotorsion and the paretic eye in patients with congenital unilateral superior oblique palsy (USOP).MethodsA retrospective review of medical charts was performed. The patients were divided into the accordance (ocular excyclotorsion in the paretic eye) and discordance (ocular excyclotorsion in the non-paretic eye) groups. The degree of excyclotorsion (scale, 0–4) was measured. Age, sex, hypertropia at the primary position, fixation preference, inferior oblique overaction, and degree of excyclotorsion were measured.ResultsNinety-eight patients were included in this study. There were 70 (71.4%) and 28 patients (28.6%) in the accordance and discordance groups. Sixteen patients (22.9%) in the accordance group and 12 patients (42.9%) in the discordance group were aged under 2 years (p = 0.04). A fixation preference of the paretic eye was observed in 2 (2.9%) and 8 (28.6%) patients in the accordance and discordance groups (p < 0.01). The postoperative degree of excyclotorsion in the accordance group (0.14 ± 0.39) was lower than that in the discordance group (0.28 ± 0.71) (p = 0.01). The residual postoperative excyclotorsion (>1) in the discordance group were observed in the discordance group (14 patients, 50%) and accordance group (16 patients, 22.9%) (p = 0.01).Conclusion Preoperative discordance between excyclotorsion and the paretic eye was observed in patients who were under 2 years of age and preferred fixation of the paretic eye. The postoperative degree of excyclotorsion was lower in the accordance group.

Clinical Features of Excyclotorsion In The Non-Paretic Eye of Patients With Congenital Unilateral Superior Oblique Palsy

To investigate preoperative clinical features and postoperative results according to the correspondence between excyclotorsion and the paretic eye in patients with congenital unilateral superior oblique palsy (USOP). A retrospective review of medical charts was performed. The patients were divided into the accordance (preoperative fundus ocular excyclotorsion in the paretic eye) and discordance (preoperative ocular excyclotorsion in the non-paretic eye) groups. The degree of excyclotorsion (scale, 0–4) was measured. Age, sex, hypertropia at the primary position, fixation preference, inferior oblique overaction, and degree of excyclotorsion were measured at each visit. Ninety-eight patients were included in this study. There were 70 (71.4%) and 28 patients (28.6%) in the accordance and discordance groups, respectively. The mean age in the accordance and discordance groups was 9.2 ± 12.7 and 7.5 ± 8.9 years, respectively. Sixteen patients (22.9%) in the accordance group and 12 patients (42.9%) in the discordance group were aged under 2 years (p=0.04). A fixation preference for the paretic eye was observed in two (2.9%) and eight (28.6%) patients in the accordance and discordance groups, respectively (p < 0.01). The accordance group (2.3 ± 0.67) demonstrated a significantly higher degree of excyclotorsion than the discordance group (1.9 ± 0.64) (p = 0.03). The postoperative degree of excyclotorsion in the accordance group (0.14 ± 0.39) was lower than that in the discordance group (0.28 ± 0.71) (p = 0.01). The prevalence of residual postoperative excyclotorsion (>1) in the discordance group was significantly higher (14 patients, 50%) than that in the accordance group (16 patients, 22.9%) (p = 0.01).Twenty-eight percent of the patients with congenital USOP demonstrated excyclotorsion in the non-paretic eye. Preoperative discordance between excyclotorsion and the paretic eye was observed in patients who were under 2 years of age and preferred fixation of the paretic eye. The postoperative degree of excyclotorsion was significantly lower in the accordance group.

Insufficient Eye Tracking Data Leads to Errors in Evaluating Typical and Atypical Fixation Preferences

Eye tracking provides insights into social processing and its deficits in disorders such as autism spectrum disorder (ASD), especially in conjunction with dynamic, naturalistic stimuli. However, reliance on manual stimuli segmentation severely limits scalability. We assessed how the amount of available data impacts individual reliability of fixation preference for different facial features, and the effect of this reliability on between-group differences. We trained an artificial neural network to segment 22 Hollywood movie clips (7410 frames). We then analyzed fixation preferences in typically developing participants and participants with ASD as we incrementally introduced movie data for analysis. Although fixations were initially variable, results stabilized as more data was added. Additionally, while those with ASD displayed significantly fewer face-centered fixations (p<.001), they did not differ in eye or mouth fixations. Our results highlight the validity of treating fixation preferences as a stable individual trait, and the risk of misinterpretation with insufficient data.

Preference for Infant-Directed Speech in Infants With Hearing Aids: Effects of Early Auditory Experience

Purpose It is well established that (a) infants prefer listening to infant-directed speech (IDS) over adult-directed speech (ADS), and (b) IDS facilitates speech, language, and cognitive development, compared with ADS. The main purpose of this study was to determine whether infants with hearing aids (HAs), similar to their peers with normal hearing (NH), show a listening preference for IDS over ADS. Method A total of 42 infants participated in the study. In Experiment 1, 9 infants with hearing loss, who had approximately 12 months of experience (mean chronological age of 17.57 months) with HAs, and 9 infants with NH, who had similar chronological age (17.54 months), were tested. In Experiment 2, 10 infants with hearing loss, who had approximately 4 months of experience (mean chronological age of 9.86 months) with HAs, and 14 infants with NH, who had similar chronological age (9.09 months), were tested. Infants were tested on their listening preference in 3 randomized blocks: IDS versus silence, ADS versus silence, and IDS versus ADS blocks, using the central fixation preference procedure. Results Experiment 1 showed that infants with HAs, similar to their peers with NH, listened longer to both IDS and ADS relative to silence; however, neither infants with HAs nor infants with NH showed a listening preference for IDS over ADS. In Experiment 2, both infants with HAs and infants with NH showed a listening preference for IDS and ADS relative to silence; in addition, both groups preferred listening to IDS over ADS. Conclusions Infants with HAs appear to have sufficient access to the acoustic cues in the speech that allow them to develop an age-equivalent IDS preference. This may be attributed to a combination of being able to use the hearing they do have before receiving HAs and early device fitting. Given previously demonstrated positive associations between IDS preference and language development, this research encourages early interventions focusing on maximizing early auditory experience in infants with hearing loss. Supplemental Material https://doi.org/10.23641/asha.6906365

Is macular pigment optical density really involved in fixation preference?

Purpose: To evaluate macular pigment optical density in healthy children and to compare the values with those of strabismic children with respect to fixation preference. Methods: The study recruited 54 healthy and 41 strabismic children. Two groups were matched in terms of gestational age, birth weight, and body mass index. All participants underwent complete ophthalmological evaluation and macular pigment optical density measurement and filled a self-reported food frequency questionnaire. Strabismic children were categorized according to fixation preference. Results: The mean age was 9.87 ± 2.39 years in healthy children and 9.07 ± 2.07 years in children with strabismus (p = 0.091). Mean macular pigment optical density was 0.23 ± 0.25 in healthy eyes and 0.25 ± 0.27 in non-preferred eyes of strabismic children (p = 0.964). Macular pigment optical density was significantly higher in preferred eyes of strabismic children (0.43 ± 0.34) compared to non-preferred eyes (p = 0.004) and healthy eyes (p = 0.001). There was a difference of macular pigment optical density between both eyes in patients with grades 1, 2, and 3 fixation preference, whereas patients with grade 4 preference had similar macular pigment optical density in both eyes (p = 0.008). There was a statistically significant positive correlation between macular pigment optical density in preferred eyes and body mass index (r = 0.354, p = 0.023). Conclusion: Preferred eyes of children with strabismus seem to have higher macular pigment optical density readings. This difference may emerge from the higher tendency of recognizing the flicker stimulus while preferred eye is under testing. Similar macular pigment optical density in healthy and non-preferred eyes and the fact that both lower than preferred eyes remain unexplained. It should be kept in mind that macular pigment optical density results should be carefully interpreted and macular pigment optical density in cases with strabismus should be further investigated.