JKOS Journal of the Korean Ophthalmological Society J Korean Ophthalmol Soc 0378-6471 2092-9374 Korean Ophthalmological Society 10.3341/jkos.2010.51.2.254 jkos-51-254 Original Article The Relationship Between Bagolini Test and Other Sensory Tests and Surgical Outcome of Intermittent Exotropia KimJong Eul MD HeoHwan MD ParkSang Woo MD ParkYeoung Geol MD Department of Ophthalmology, Chonnam National University Medical School and Hospital, Gwangju, Korea Address reprint requests to Sang Woo Park, MD Department of Ophthalmology, Chonnam National University Medical School & Hospital #8 Hak-Dong, Dong-Gu, Gwangju 501-757, Korea Tel: 82-62-220-6743, Fax: 82-62-227-1642, E-mail: exo70@jnu.ac.kr 09 2010 07 09 2010 51 2 254 258 18052009 19102009 Copyright © 2010 Korean Ophthalmological Society 2010 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Purpose

To determine the surgical outcome of intermittent exotropia according to preoperative retinal correspondence with the Bagolini striated glasses test and the relationships between the Worth-4-dot test or stereoacuity with the B-VAT test.

 Methods

We analyzed retrospectively preoperative fusion statuses with the Worth-4-dot test, stereoacuity with the B-VAT test and retinal correspondence with the Bagolini striated glasses test to determine any possible relationships with surgical outcome. The surgical outcome and binocular function were further investigated six months postoperatively in 114 patients who had undergone surgery for intermittent exotropia.

 Results

The surgical outcome according to preoperative fusion status and stereoacuity was not statistically significant(p=0.38, p=0.59). whereas, preoperative retinal correspondence with the Bagolini striated glasses test was statistically significant(p<0.01). More over there was a relationship between retinal correspondence and fusion status or stereoacuity(p<0.01, p<0.01).

 Conclusions

The preoperative Bagolini striated glasses test was the factor predicting a favorable surgical outcome and there was a relationship between the preoperative Worth-4-dot test and the B-VAT test.

 Bagolini striated glasses test Intermittent exotropia Retinal correspondence References von Noorden GK Binocular vision and ocular motility. Therapy and management of strabismus 5th ed. St. Louis CV Mosby 1996 34159 Raquel B Michael F The role of stereopsis and early postoperative alignment in long-term surgical results of intermittent exotropia Can J Ophthalmol 19942911924 Yildirim C Assessment of central and peripheral fusion and near and distance stereoacuity in intermittent exotropic patients before and after strabismus surgery Am J Ophthalmol 199912822230 Yeo SI Kim SY Hwang WS Kong SM Surgical results according to sensory function tests in intermittent exotropia J Korean Ophthalmol Soc 19994031749 Heo NH Paik HJ The relationship between binocular function and the surgical outcome of intermittent exotropia J Korean Ophthalmol Soc 200142158893 Parks MM Biocular vision Tasman W Jaeger EA Duane's Clinical Ophthalmology revised ed. Philadelphia JB Lippincott 1993 1 chap. 5 Preito-diaz J Strabismus 5th ed. Boston Butterworth-Heinemann 2000246 Ohtsuki H Hasebe S Kono R Prism adaptation response is useful for predicting surgical outcome in selected types of intermittent exotropia Am J Ophthalmol 200113111722 Forrer HT Retinal correspondence in intermittent exotropia Moore S Orthoptics: past, present, future New York Stratton Inter-continental Medical Books 19765479 Colenbrander MC The limits of stereoscopic vision Ophhalmologica 19481153636 Yildirim C Mutlu FM Chen Y Altinsoy HI Assessment of central and peripheral fusion and near and distance stereoacuity in intermittent exotropic patients before and after strabismus surgery Am J Ophthalmol 199912822230 Han JH Kim DS Shin JC Amblyopia and sensory fusional anomaly in intermittent exotropia J Korean Ophthalmol Soc 2000414959 Umazume F Ohtsuki H Hasebe S Predictors of postoperative binocularity in adult strabismus Jpn J Ophthalmol 19974141421 Ko KH Min BM Factors related to surgical results of intermittent exotropia J Korean Ophthalmol Soc 19963717984 Lee SY Kim SJ Evaluation of factors influencing stereoacuity in exodeviation J Korean Ophthalmol Soc 19994053843 Jeong TS You IC Park SW Park YG Factors of surgical success with unilateral recession and resection in intermittent exotropia J Korean Ophthalmol Soc 2006 47198792 Bielschowsky A Divergence excess Arch Opthalmol 193412 15766 Tables

The clinical characteristics according to retinal correspondence with preoperative Bagolini striated glasses test

NRC* (n=67) ARC† (n=29) Suppression (n=18)
Sex(Male:Female) 23:44 10:19 11:7
Mean age(years) 8.4±3.1 7.8±2.5 9.5±3.8
Preoperative exodeviation (PD‡) 33.2±8.2 29.4±7.6 31.3±9.3
Esodeviation at postoperative 1 week (PD) 8.4±3.2 7.6±4.6 8.3±4.4

NRC=normalous retinal correspondance

ARC=anormalous retinal correspondance

PD=prism diopter.

Comparison of surgical outcome according to preoperative Bagolini striated glasses test

Surgical outcome‡§ * NRC‡§ (n=67) † ARC‡§ (n=29) Suppression‡ (n=18) Total (n=114)
Success group 56(83.6%) 15(51.7%) 9(50.0%) 80(70.2%)
Failure group 11(16.4%) 14(48.3%) 9(50.0%) 34(29.8%)
Total 67(100%) 29(100%) 18(100%) 114(100%)

NRC=normalous retinal correspondance

ARC=anormalous retinal correspondance

p<0.01

p<0.01.

Comparison of surgical outcome according to preoperative worth 4 dot test and streoacuity (B-VAT test)

Surgical outcome*† Worth 4 dot test* (Central fusion)
 Stereoacuity† (Sec of arc)
Present (n=74) Present (n=40) ≤100 (n=68) >100 (n=46)
Success group 54(73.0%) 26(65.0%) 49(73.0%) 31(73.0%)
Failure group 20(27.0%) 14(35.0%) 19(73.0%) 15(73.0%)
Total 74(100%) 40(100%) 68(100%) 46(100%)

p=0.38

p=0.59.

The distribution of worth 4 dot test in Bagolini striated glasses test

Worth 4 dot test* (Central fusion) Bagolini striated glasses test*
NRC† (n=67) ARC‡ (n=29) Suppression (n=18)
Present 47(70.1%) 22(75.9%) 5(27.8%)
Absent 20(29.9%) 7(24.1%) 13(72.2%)
Total 67(100%) 29(100%) 18(100%)

NRC=normalous retinal correspondance

ARC=anormalous retinal correspondance

p<0.01.

The distribution of stereoacuity in Bagolini striated glasses test

Stereoacuity* (Sec of arc) Bagolini striated glasses test*
NRC† (n=67) ARC‡ (n=29) Suppression (n=18)
≤100 51(76.1%) 16(55.2%) 1(5.6%)
>100 16(23.9%) 13(44.8%) 17(94.4%)
Total 67(100%) 29(100%) 18(100%)

NRC=normalous retinal correspondance

ARC=anormalous retinal correspondance

p<0.01