Journal List > J Korean Ophthalmol Soc > v.49(4) > 1008238

Jun, Lee, and Lee: Clinical Features of Refractive Accommodative Esotropia According to Degree of Hypermetropia

Abstract

Purpose

This study examined differences in clinical patterns according to the hyperopia level in refractive-accommodative esotropia patients.

Methods

Ninety-four refractive-accommodative esotropia patients were divided into 3 groups according to hyperopia level: group 1, ≥ +1.00D and < +3.00D group 2, ≥ +3.00D and < +5.00D and group 3, ≥ +5.00D. The following factors were analyzed retrospectively: the initial corrective visual acuity, the final corrective visual acuity, the angle of esotropia with or without hyperopic correction, the recovery time to orthophoria after hyperopic correction, the change in hyperopia level, and the frequency of amblyopia.

Results

The angles of esotropia without hyperopic correction in groups 1, 2 and 3 were 18.4±7.3PD, 22.9±8.5PD, and 25.7±10.4PD, respectively. The angle of esotropia was found to be significantly greater in the group with the higher level of hyperopia (p=0.01). The monthly change in hyperopia in groups 1, 2 and 3 was 0.018±0.02D, 0.028±0.03D and 0.043±0.03D. The change was greater in the group with the higher level of hyperopia (p=0.009).

Conclusions

In refractive-accommodative esotropia patients, the more the hyperopia without correction increases, the more the angle of esotropia without correction increases, and the larger the reduction of hyperopia after correction becomes.

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Table 1.
Clinical features of refractive‐ accommodative esotropia
+1≤∼<3D +3≤∼<5D ≥+5D p-value
Age at onset (Mo*±SD) 25.0±20.6 26.0±20.2 28.5±19.9 0.985
Age at the initiation of therapy (Mo*±SD) 47.5±17.9 48.0±19.9 48.5±23.5 0.808
Duration of ocular misalignment (Mo*±SD) 22.4±21.4 21.9±20.7 20.0±19.7 0.902

* Mo = month

D = diopter.

Table 2.
Comparison of initial best corrected visual acuity and final corrected visual acuity
+1≤∼<3D +3≤∼<5D ≥+5D p-value
BCVA* (Mean±SD) 0.50±0.20 0.51±0.19 0.51±0.21 0.915
FCVA(Mean±SD) 0.79±0.22 0.82±0.22 0.79±0.20 0.530
p-value 0.000 0.000 0.000

* BCVA = best corrected visual acuity

FCVA = final corrected visual acuity

D = diopter.

Table 3.
Angle of esotropia with or without hyperopic correction
+1≤∼<3D +3≤∼<5D ≥+5D p-value
Angle of esotropia without correction Near 18.5±7.2 23.7±8.4 26.1±10.7 0.022
(PD*±SD) Far 18.3±7.6 22.2±8.6 25.3±10.2 0.040
Angle of esotropia with correction Near 8.9±5.4 5.7±5.9 5.2±5.3 0.072
(PD*±SD) Far 7.1±6.1 3.9±4.5 3.9±4.6 0.050

* PD = prism diopter

D = diopter.

Table 4.
Recovery time period to orthophoria after hyperopic correction
+1≤∼<3D +3≤∼<5D ≥+5D p-value
Recovery time of orthophoria (Mo*±SD) 9.5±12.8 4.1±8.2 6.1±8.0 0.116

* Mo = month

D = diopter

Orthophoria = <8PD at near and far after hyperopic correction.

Table 5.
Change in hyperopia between different diopter groups
+1≤∼<3D* +3≤∼<5D* ≥+5D* p-value
Monthly change in hyperopia (D*±SD) 0.018±0.02 0.028±0.03 0.043±0.03 0.009

* D = diopter.

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