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Choi and Choi: Clinical Manifestation of Patients with Accommodative Esotropia for 10 Years
Original Article

J Korean Ophthalmol Soc 2011;52(11):1331-1336.

Published online: 7 September 2011

DOI: https://doi.org/10.3341/jkos.2011.52.11.1331

Clinical Manifestation of Patients with Accommodative Esotropia for 10 Years

Duk Kyu Choi, MD, Mi Young Choi, MD, PhD

Department of Ophthalmology, Chungbuk National University College of Medicine, Chungbuk National University Medical Research Institute, Cheongju, Korea

Address reprint requests to Mi Young Choi, MD, PhD Department of Ophthalmology, Chungbuk National University Hospital #410 Seongbong-ro, Heungdeok-gu, Cheongju 361-711, Korea Tel: 82-43-269-6335, Fax: 82-43-264-5263, E-mail: mychoi@chungbuk.ac.kr

Received 24 January 2011       Revised 26 April 2011       Accepted 20 September 2011

Copyright © 2011 Korean Ophthalmological Society

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 clinical features of patients who successfully discontinued correction with hyperopic glasses for refractive accommodative esotropia during a 10 year follow-up.

Methods

The authors of the present study analyzed 29 patients followed-up for a minimum of 10 years after diagnosis of accommodative esotropia. The patients were divided into 2 groups: patients who successfully discontinued correction with hyperopic glasses (10 patients, Group A), and patients who required constant use of hyperopic glasses (19 patients, Group B). The age at first visit, refractive error, deviated angle without correction, stereopsis, and follow-up duration were compared between the 2 groups.

Results

The mean age at first visit for all patients was 3.03 ± 1.46 years, and the follow-up duration was 11.3 ± 1.51 years. Patients in Group A discontinued the use of hyperopic glasses after 10.26 ± 2.08 years. There were no statistical differences in mean age at first visit, deviated angle without correction, stereopsis, follow-up duration, or the amount of change in hyperopia. The initial amount of hyperopia in Group A was 3.81 ± 1.54 D, significantly lower than the 5.12 ± 1.37 D in Group B.

Conclusions

After a 10 year follow-up of accommodative esotropia, 34% of the patients discontinued the use of hyperopic glasses, and the hyperopic amount at initial visit was statistically lower than that of patients who required constant use of hyperopic glasses.

Keywords: Accommodative esotropia, Hyperopic glasses, Refractive error

References

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Figure 1.
The change of refractive error. Group A = patients who successfully discontinued correction with hyperopic glasses; Group B = patients who needed persistent wearing of hyperopic glasses; Refractive error was maintained for 3.7 years in Group A, 3.0 years in Group B then began to decrease.* p-value.
jkos-52-1331f1.tif
Table 1.
Baseline characteristics
Group A (n = 10) Group B (n = 19) p-value
Sex (n) 0.058*
  Male 2 11
  Female 8 8
Age (mean ± SD, yr) 3.42 ± 1.87 2.83 ± 1.19 0.597†
Follow up (mean ± SD, yr) 12.08 ± 1.86 10.89 ± 1.15 0.114†

Group A = patients who successfully discontinued correction with hyperopic glasses; Group B = patients who needed persistent wearing of hyperopic glasses.

* Fisher's exact test

† Mann-Witney U test.

Table 2.
Distribution of refractive error
Group A (20 eyes) Group B (38 eyes) p-value
Spherical equivalent (D)
  1.5–4 11 8
  4–6 7 17 0.047*
  6–8 2 12
  8–10 0 1
Interocular difference of spherical equivalent (mean ± SD, D) 0.52 ± 0.61 0.61 ± 0.57 0.513†

Group A = patients who successfully discontinued correction with hyperopic glasses; Group B = patients who needed persistent wearing of hyperopic glasses.

* Chi-square test

† Mann-Witney U test.

Table 3.
Deviated angle at far distance
Group A (n = 10) Group B (n = 19) p-value*
Deviated angle without correction (mean ± SD, PD)
  Initial 21.70 ± 6.75 28.68 ± 9.26 0.056
  Last 1.20 ± 4.73 16.05 ± 10.36 0.001

Group A = patients who successfully discontinued correction with hyperopic glasses; Group B = patients who needed persistent wearing of hyperopic glasses.

* Mann-Witney U test.

Table 4.
Amblyopia treatment
Group A (n = 10) Group B (n = 19) p-value
Amblyopia (n) 5 9 0.893*
Amblyopia treatment 0.505†
 Occlusion (n) 5 7
 Atropine penalization (n) 0 2
Successful treatment (n) 5 7 0.505†

Group A = patients who successfully discontinued correction with hyperopic glasses; Group B = patients who needed persistent wearing of hyperopic glasses.

* Chi-square test

† Fisher's exact test.

Table 5.
Annual decrease in hyperopia
Group A (n = 20) Group B (n = 38) p-value
Decreasing amount of hyperopia per year (mean ± SD, D/yr) 0.20 ± 0.14 0.17 ± 0.19 0.676*

Group A = patients who successfully discontinued correction with hyperopic glasses; Group B = patients who needed persistent wearing of hyperopic glasses.

* Mann-Whitney U test.

Table 6.
Stereopsis at last visit
Group A (n = 10) Group B (n = 17) p-value
Seconds of arc
 <100 (n) 3 4
 100–400 (n) 5 8 0.849*
 >400 (n) 2 5
Stereopsis (mean ± SD, sec) 537 ± 894 504 ± 703 0.721†

Group A = patients who successfully discontinued correction with hyperopic glasses; Group B = patients who needed persistent wearing of hyperopic glasses.

* Chi-square test

† Mann-Whitney U test.

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