Resection of Amblyogenic Periocular Hemangiomas: Indications and Outcomes
Bibliographic record
Abstract
BACKGROUND: Periocular hemangiomas can induce irreversible amblyopia by multiple mechanisms: visual deprivation, refractive error (astigmatism and/or anisometropia), or strabismus. There is a subset of complicated periocular hemangiomas most effectively managed by resection. METHODS: The authors reviewed all patients from 1999 to 2008 with a periocular hemangioma that was either completely resected or debulked; whenever necessary, the levator apparatus was reinserted. Infants were included in the study if they had complete preoperative and postoperative ophthalmic assessments and there was more than a 6-month follow-up interval. RESULTS: Thirty-three children were treated with a mean operative age of 6.2 months and a mean follow-up interval of 48.2 months. The majority of hemangiomas were well-localized and caused corneal deformation with astigmatism or blepharoptosis. Intralesional or oral corticosteroid administration was attempted in almost one-half of patients. Postoperatively, the degree of astigmatism was statistically improved: from 3.0 diopters to 1.11 diopters (p < 0.001). When resection was performed in infants younger than 3 months (19 patients), astigmatism was less severe preoperatively and the correction was slightly greater postoperatively (from 2.76 diopters to 0.80 diopters). Resection performed after 3 months (14 patients) of age also resulted in improvement of astigmatism (from 3.39 diopters to 1.38 diopters). Reinsertion of the levator expansion was required in 34 percent of patients. CONCLUSIONS: The authors advocate early resection of a well-localized periocular hemangioma to prevent potentially irreversible amblyopia caused by either corneal deformation or blepharoptosis. The longer a complicated periocular hemangioma is observed, the greater the astigmatism and the less amenable it will be to correction following tumor removal.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".