Clinical Features of Refractive Accommodative Esotropia: Long-term Study

In Seong Kang; Sang Woo Park; Yeoung Geol Park

doi:10.3341/jkos.2008.49.3.487

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Kang, Park, and Park: Clinical Features of Refractive Accommodative Esotropia: Long-term Study

Original Article

J Korean Ophthalmol Soc 2008;49(3):487-492.

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.3.487

Clinical Features of Refractive Accommodative Esotropia: Long-term Study

In Seong Kang, M.D., Sang Woo Park, M.D., Yeoung Geol Park, M.D.

Department of Ophthalmology, Chonnam National University Medical School & Hospital, Gwang-ju, Korea

Address reprint requests to Sang Woo Park, M.D. Department of Ophthalmology, Chonnam National University Medical School & Hospital #8 Hak-dong, Dong-gu, Gwang-ju 501-757, Korea Tel: 82-62-220-6743, Fax: 82-62-227-1642, E-mail: exo70@jnu.ac.kr

Received 23 February 2007 Accepted 4 September 2007

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 analyze the long-term clinical features and functional outcomes of refractive accommodative esotropia.

Methods

Initial and final age, cycloplegic refraction, distance and near deviation with and without correction, stereoacuity and incidence of amblyopia were evaluated in 45 patients with accommodative esotropia.

Results

The follow-up duration was 65.77±43.98 (6∼151) months, and the mean age was 4.02±1.97 and 9.42±3.77 years at the first and final visits, respectively. The cycloplegic refraction was decreased from 5.16±1.92 diopters (D) to 4.41±1.83D, averaging −0.09±0.40D annually (P<0.01). Of these hyperopic eyes, 55 (61.1%) experienced a decrease, 22 (24.4%) an increase, and 5 (5.6%) showed no changes. From 5 (31.2%) to 12 (75.0%) of 16 patients had a stereoacuity of 100 sec/arc or better (p<0.01). Fusion was achieved in 14 (87.5%) at the final visit, up from 11 (68.8%) at the first visit (P=0.39); 23 (51.1%) of the patients were amblyopic; and anisometropia was found in 9 (39.1%) patients.

Conclusions

Patients whose esotropia was corrected with full cycloplegic hyperopic correction show decreased longitudinal changes in spherical equivalent refractive error with a time course and have excellent binocularity outcomes.

Keywords: Accommodative esotroipia, Spherical equivalent, Stereoacuity

References

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Table 1.

Changes in hyperopia with correction

	Number of eyes	Initial refraction (Mean±SD)	Final refraction (Mean±SD)	Annual change in hyperopia (Mean±SD)	P^†
≤5D^*	45	3.73±0.82D	3.25±1.70D	−0.02±0.27D	0.14
>5D	45	6.67±1.45D	5.28±1.59D	−0.19±0.44D	<0.01
Total	90	5.16±1.92D	4.41±1.83D	−0.09±0.40D	<0.01

^* D=diopters

^† Wilcoxon test.

Table 2.

Binocular function according to amblyopia

		Number of patients (%)
		First visit	Final visit	P^*
Stereoacuity (≤100 sec/arc)	Total (n=16)	5 (31.2%)	12 (75.0%)	0.03
	Amblyopic (n=9)	2 (22.2%)	6 (66.7%)	0.18
	Non-amblyopic (n=7)	3 (42.9%)	6 (85.7%)	0.24
Fusion at near and distance	Total (n=16)	11 (68.8%)	14 (87.5%)	0.39
	Amblyopic (n=9)	6 (66.7%)	8 (88.9%)	0.57
	Non-amblyopic (n=7)	5 (71.4%)	6 (85.7%)	1

^* Fisher exact test.

Table 3.

Mean amount of deviation angle with or without correction

		Amount of deviation angle (PD*)
		First visit	Final visit	P^†
Without correction	Near	29.18±9.40	11.44±12.72	<0.01
Without correction	Distance	26.48±8.93	11.29±12.57	<0.01
With correction	Near	2.83±5.53	1.72±3.22	0.26
With correction	Distance	1.73±4.29	0.71±2.18	0.16

^* PD=prism diopters

^† paired t-test.

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