A Comprehensive Epidemiological Study on Ocular Outcomes in Suture-Specific Nonsyndromic Craniosynostosis: National Database Review

ObjectiveThis investigation aimed to quantify the prevalence and associated risks of clinically significant ocular outcomes (refractive errors, strabismus, amblyopia, and papilledema) across 4 subtypes of nonsyndromic single suture craniosynostosis (NSCS) and compare these findings against those of matched controls.DesignThis investigation was executed as a large-scale, retrospective cohort study using deidentified electronic health record data, performed in compliance with STROBE guidelines.SettingThis investigation used aggregated, geographically diverse U.S. patient data within the TriNetX Research Network.ParticipantsThe sample consisted of 5060 NSCS patients categorized by suture type (sagittal, metopic, unilateral coronal, lambdoid), inclusive of all surgical statuses (unstratified). Patients were matched 1:1 with a control patient using propensity scores from age (>5 years), sex, and race.InterventionsAnalysis identified differential rates of ocular abnormalities in patients with an NSCS diagnosis compared with nonaffected controls.Main Outcome MeasureRisk ratios were calculated based on specific ICD-10-CM-coded ocular abnormalities.ResultsUnilateral coronal synostosis (UCS) demonstrated the highest risk for refractive disorders, strabismus, and amblyopia. Metopic synostosis (MCS) was also associated with an increased risk of refractive disorders and showed a significant association with congenital eyelid malformations. Sagittal synostosis (SCS) exhibited the lowest overall risk, though significant associations were observed for hyperopia and papilledema.ConclusionsNSCS is associated with increased ocular morbidity with all suture patterns. UCS carries the highest burden, MCS is associated with refractive disorders and congenital eyelid malformations, and SCS shows increased risks of hyperopia and papilledema. These findings support early and continued ophthalmologic surveillance for all affected children.