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Abstract
Purpose
To evaluate the factors affecting the visual acuity and stereoacuity of patients with refractive accommodative esotropia who have successful optical alignment obtained by refractive error management.
Methods
The charts of 60 patients, including medical history, age of onset, chief complaint at first visit, age at which glasses were first worn, refractive error, visual acuities with and without glasses, angle of deviation, and stereoacuity were retrospectively reviewed.
Results
The mean follow-up period was 59.20 ± 40.26 months, and the mean hypermetropia at the initial visit was 4.90 ±1.75 diopters (D). Fifty-three patients had decreased hypermetropia, with a mean of 0.94 ± 0.91 D, while seven patients had increased hypermetropia, with a mean of 0.38 ± 0.17 D. The mean deviation at the initial visit was 28.40 ± 9.05 prism diopters (PD) at near without glasses and decreased to 3.20 ± 3.50 PD with glasses at the final visit. Children who had anisometropia at the initial visit had a higher prevalence for amblyopia at the final visit (p = 0.000). However, the degree of hypermetropia, age at onset, deviation before glasses correction, interval from onset to glasses correction, and amblyopia at diagnosis were not significant risk factors for amblyopia or anomalous streoacuity at the final visit.
Conclusions
The degree of hypermetropia, age at onset, deviation before glasses correction, interval from onset to glasses correction, and amblyopia at diagnosis were not significant risk factors for amblyopia. However, anisometropia was a significant risk factor for the development of amblyopia in patients with refractive accommodative esotropia, and these children should receive careful and long-term follow-up management.
References
1. von Noorden GK. Binocular vision and ocular motility. 6th ed.St Louis: Mosby;2002. p. 311–55.
2. Wilson ME, Bluestein EC, Parks MM. Binocularity in accommodative esotropia. J Pediatr Ophthalmol Strabismus. 1993; 30:233–6.
3. Mulvihill A, MacCann A, Flitcroft I, O'Keefe M. Outcome in refractive accommodative esotropia. Br J Ophthalmol. 2000; 84:746–9.
4. Birch EE. Binocular sensory outcomes in accommodative esotropia. J AAPOS. 2003; 7:369–73.
5. Raab EL. Follow-up monitoring of accommodative esotropia. J AAPOS. 2001; 5:246–51.
6. Berk AT, Kocak N, Ellidokuz H. Treatment outcomes in refractive accommodative esotropia. J AAPOS. 2004; 8:384–8.
7. Fawcett S, Leffler J, Birch EE. Factors influencing stereoacuity in accommodative esotropia. J AAPOS. 2000; 4:15–20.
8. Clarke WN, Noel LP. Stereoacuity testing in the monofixation syndrome. J Pediatr Ophthalmol Strabismus. 1990; 27:161–3.
9. Leske DA, Holmes JM. Maximum angle of horizontal strabismus consistent with true stereopsis. J AAPOS. 2004; 8:28–34.
10. Fawcett SL, Birch EE. Validity of the Titmus and Randot circles tasks in children with known binocular vision disorders. J AAPOS. 2003; 7:333–8.
11. Park SW, Kang IS, Park YG. Clinical features of refractive accommodative esotropia: long-term study. J Korean Ophthalmol Soc. 2008; 49:487–92.
12. Kim MM, Cho YJ. The factors influencing on binocularity in accommodative esotropia. J Korean Ophthalmol Soc. 1997; 38:1847–51.
13. Swan KC. Accommodative esotropia long range follow-up. Ophthalmology. 1983; 90:1141–5.
14. Mulvihill A, MacCann A, Flitcroft I, O'Keefe M. Outcome in refractive accommodative esotropia. Br J Ophthalmol. 2000; 84:746–9.
15. Sohn HJ, Paik HJ. Clinical features of refractive accommodative esotropia according to the age of onset. J Korean Ophthalmol Soc. 2006; 47:941–6.
16. Birch EE. Binocular sensory outcome in accommodative esotropia. J AAPOS. 2003; 7:369–73.
17. Mazow ML, Kaldis LC, Prager TC. An evaluation of accommodative esotropia. Reinecke RD, editor. Strabisbus II. New York: Grune and Stratton;1984. p. 189–93.
Table 1.
Factors associated with amblyopia at final visit
| Factors | Amblyopia*(–)(n = 51) | Amblyopia*(+)(n = 9) | Probability† |
|---|---|---|---|
| Age onset < 2 years | 20 (39.2%) | 3 (33.3%) | p = 0.738 |
| Constant esodeviation on initial visit | 1 (2.0%) | 2 (22.2%) | p = 0.010 |
| ≥ 2 line difference between two eyes† | 14 (27.5%) | 5 (55.6%) | p = 0.095 |
| ≥ 6 Mo interval from onset to 1st glasses | 32 (62.7%) | 5 (55.6%) | p = 0.683 |
| ≥ 5.5 D hyperopia on initial visit | 19 (37.3%) | 4 (44.4%) | p = 0.783 |
| Anisometropia‡ | 3 (5.9%) | 5 (55.6%) | p = 0.000 |
| Deviation§ ≥ 30 PD | 24 (47.1%) | 4 (44.4%) | p = 0.092 |
Table 2.
Factors associated with stereoacuity outcome at final visit
| Factors | < 100 sec of arc (n =17) | ≥ 100 sec of arc (n = 43) | Probability* |
|---|---|---|---|
| Age onset < 2 years | 4 (23.5%) | 19 (44.2%) | p = 0.138 |
| Constant esodeviation on initial visit | 0 (0.0%) | 3 (7.0%) | p = 0.264 |
| ≥ 2 line difference between two eyes† | 5 (29.4%) | 14 (32.6%) | p = 0.776 |
| ≥ 6 Mo interval from onset to 1st glasses | 8 (47.1%) | 29 (67.4%) | p = 0.822 |
| ≥ 5.5 D hyperopia on initial visit | 7 (30.4%) | 16 (37.2%) | p = 0.776 |
| Anisometropia‡ | 2 (11.8%) | 6 (14.0%) | p = 0.822 |
| Deviation§ ≥ 30 PD | 5 (29.4%) | 23 (53.5%) | p = 0.092 |
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