541 - Strabismus is not associated with deformational plagiocephaly

Poster Number: 541
Publication Number: 541.409

Takanori Noto, Nihon university, Nerima, Tokyo, Japan; Nobuhiko Nagano, Department Pediatrics and Child Health, Nihon Uviversity School of Medicine, Itabashi-ku, Tokyo, Japan; Risa Kato, none, Itabashi-ku Oyaguchi kamimachi 30-1, Tokyo, Japan; Katsuya Saito, Kasukabe medical center, Kasukabe, Saitama, Japan; Hiroshi Miyabayashi, Kasukabe medical center, Kasukabe, Saitama, Japan; Ichiro Morioka, Nihon University School of Medicine, Itabashi, Tokyo, Japan

Background: Craniosynostosis is reported to be associated with strabismus due to orbital deformities. However, the relationship between strabismus and deformational plagiocephaly (DP) has not been clarified. If DP is a cause of strabismus, then cranial helmet therapy (CHT), a treatment for DP, could prevent strabismus. The severity of DP in children with strabismus has also not been well studied.

Objective: To determine if strabismus is related to DP in Japanese children 1 yr of age.

Design/Methods: We conducted this prospective cohort study after obtaining the approval of our institutional review board. The subjects were healthy 1-yr-old Japanese children who visited our Clinic from April 2020 to January 2022. Cranial vault asymmetry index (CVAI), anterior symmetry ratio (ASR), and posterior symmetry ratio (PSR) were measured using an Artec’s 3D scanner. Eye position was measured using a Spot Vision Screener® (SVS). DP was defined as a CVAI >5.0%. DP severity was based on CVAI and categorized as: normal: 0-4%; mild: 5-6%; moderate: 7-9%; or severe: >10%. Strabismus was defined as nasal and temporal eye alignment ≥5° and ≥ 8°, respectively.

Results: 134 children were included in this study. 12 (9%) were classified with strabismus (9 with esotropia and 3 with exotropia) and 122 classified as normal (see Table 1). No significant differences were found in evaluation age, gender, CVAI, ASR, PSR, and the number of DP between the two groups. No severe DP was observed in the strabismus group.

Conclusion(s): We conclude that strabismus was not associated with DP in Japanese children 1 yr of age. We suggest that the indication for CHT should be determined based on DP severity.