Abstract
Craniopagus conjoined twins are extraordinarily rare and present unique challenges to the multidisciplinary team. There is a paucity of literature on optimizing neuro-ophthalmologic evaluation in craniopagus twins. Herein, we present our enhanced neuro-ophthalmologic evaluation and management in 17-month-old male craniopagus twins, uniquely using handheld optical coherence tomography (OCT) plus portable slit-lamp biomicroscopy, indirect ophthalmoscopy and modified forced-choice preferential looking assessment. Staged surgical separation was supported by enhanced neuro-ophthalmologic evaluation, detailed radiology, three-dimensional printing and virtual reality simulation. This represents the fourth separation of craniopagus twins by our unit.
Highlights
Craniopagus conjoined twins are extraordinarily rare, occurring in one in 2.5 million births and representing only 2–6% of conjoined twins [1, 2]
A recent systematic review [3] outlined factors for surgical success, but there is a paucity of literature on optimizing ophthalmologic evaluation in craniopagus twins where highly specialized methods are required
optical coherence tomography (OCT) image acquisition is possible in craniopagus twins
Summary
Craniopagus conjoined twins are extraordinarily rare, occurring in one in 2.5 million births and representing only 2–6% of conjoined twins [1, 2]. Craniopagus conjoined twins are extraordinarily rare and present unique challenges to the multidisciplinary team. There is a paucity of literature on optimizing neuro-ophthalmologic evaluation in craniopagus twins.
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