The Initial Factors Influencing Successful Final Stereoacuity in Refractive Accommodative Esotropia

Sang Hun Hyun; Hae Jung Paik

doi:10.3341/jkos.2014.55.6.877

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Hyun and Paik: The Initial Factors Influencing Successful Final Stereoacuity in Refractive Accommodative Esotropia

Original Article

J Korean Ophthalmol Soc 2014;55(6):877-881.

Published online: 30 August 2014

DOI: https://doi.org/10.3341/jkos.2014.55.6.877

The Initial Factors Influencing Successful Final Stereoacuity in Refractive Accommodative Esotropia

Sang Hun Hyun, MD, Hae Jung Paik, MD, PhD

Department of Ophthalmology, Gachon University Gil Medical Center, Incheon, Korea

Address reprint requests to Hae Jung Paik, MD, PhD, Department of Ophthalmology, Gachon University Gil Medical, Center, #21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 405-760, Korea, Tel: 82-32-460-3364, Fax: 82-32-460-3358, E-mail: hjpaik@gilhospital.com

Received 8 July 2013 Revised 22 January 2014 Accepted 15 May 2014

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 evaluate the initial factors influencing successful final stereoacuity in patients with refractive accommodative esotropia.

Methods

The charts of 48 refractive accommodative esotropia patients 2 years of age or older andassessed using the Titmus stereoacuity test were retrospectively reviewed. Hyperopic refractive error on post-cycloplegic refraction, age at first glasses, stereoacuity after refractive correction and amblyopia were categorized and evaluated as the factors influencing final stereoacuity.

Results

The mean follow-up period was 43.51 ± 30.02 months. The mean hypermetropia at the initial examination was 4.67 ± 2.18 diopters (D), the mean age at first glasses was 48.09 ± 20.22 months and the mean stereoacuity after refractive correction was 1243.75 ± 1378.24 seconds of arc. The rates of successful stereoacuity at the final visit were 83.3% without amblyopia, 75.0% with mild amblyopia and 42.9% with moderate amblyopia which were statistically significant (p = 0.039). Hyperopic re-fractive error and age at first glasses were categorized as +1.0 to <3.0 D, +3.0 to <5.0 D, ≥+5.0 D and 2 to <4 years, 4 to <6 years and ≥6 years, respectively, and the rates of successful stereoacuity at the final visit were 83.3%, 66.7%, 61.9% (p = 0.362) and 71.4%, 75.0% and 54.5% (p = 0.334), respectively.

Conclusions

The amblyopia at the initial examination was significantly associated with the outcome of stereoacuity at the final visit in patients with refractive accommodative esotropia.

Keywords: Amblyopia, Hyperopic refractive error, Refractive accommodative esotropia, Stereoacuity

References

1. Scott WE, Mash J. Stereoacuity in normal individuals. Ann Ophthalmol. 1974; 6:99–101.

2. Held R, Birch E, Gwiazda J. Stereoacuity of human infants. Proc Natl Acad Sci USA. 1980; 77:5572–4.

3. Wilson ME, Bluestein EC, Parks MM. Binocularity in accom-modative esotropia. J Pediatr Ophthalmol Strabismus. 1993; 30:233–6.

4. Fawcett S, Leffler J, Birch EE. Factors influencing stereoacuity in accommodative esotropia. J AAPOS. 2000; 4:15–20.

5. Matsuo T, Yamane T, Fujiwara H, et al. Predictive factors for long-term outcome of stereoacuity in Japanese patients with pure ac-commodative esotropia. Strabismus. 2005; 13:79–84.

6. Mulvihill A, MacCann A, Flitcroft I, O'Keefe M. Outcome in re-fractive accommodative esotropia. Br J Ophthalmol. 2000; 84:746–9.

7. Dobson V, Sebris SL. Longitudinal study of acuity and stereopsis in infants with or at-risk for esotropia. Invest Ophthalmol Vis Sci. 1989; 30:1146–58.

8. Birch EE. Marshall Parks lecture. Binocular sensory outcomes in accommodative ET. J AAPOS. 2003; 7:369–73.

9. Raab EL. Follow-up monitoring of accommodative esotropia. J AAPOS. 2001; 5:246–9.

10. Berk AT, Koçak N, Ellidokuz H. Treatment outcomes in refractive accommodative esotropia. J AAPOS. 2004; 8:384–8.

11. Nagata S. The binocular fusion of human vision on stereoscopic displays–field of view and environment effects. Ergonomics. 1996; 39:1273–84.

12. The Korean strabismus and pediatric ophthalmological society. Current concepts in strabismus. 3rd ed.Seoul: Naewae Haksool;2013. p. 129–40.

13. Von Noorden GK. Binocular vision and ocular motility: theory and management of strabismus. 6th ed.St. Louis: Mosby;2002. p. 21–5.

14. Cho YA, Cho SW, Roh GH. Evaluation of criteria of stereoacuity for Titmus, Randot & TNO stereotests. J Korean Ophthalmol Soc. 1999; 40:532–7.

15. Lee SY, Bae SH. Comparison of various kinds of stereoacuity tests in preschool children. J Korean Ophthalmol Soc. 2000; 41:1983–8.

16. Yang JW, Son MH, Yun IH. A study on the clinical usefulness of digitalized random-dot stereoacuity test. Korean J Ophthalmol. 2004; 18:154–60.

17. Uretmen O, Kose S, Oztas Z, Egrilmez S. Factors influencing ster-eoacuity in refractive accommodative esotropia. Can J Ophthalmol. 2007; 42:600–4.

18. Fawcett SL, Birch EE. Risk factors for abnormal binocular vision after successful alignment of accommodative esotropia. J AAPOS. 2003; 7:256–62.

19. Lee CE, Lee YC, Lee SY. The factors influencing the visual acuity and streoacuity outcome in refractive accommodative esotropia. J Korean Ophthalmol Soc. 2010; 51:1380–4.

20. Mazow ML, Kaldis LC, Prager TC. An evaluation of accom-modative esotropia. In : Reinecke RD, editor. Strabismus II. New York: Grune and Stratton;1984. p. 189–93.

21. Coats DK, Avilla CW, Paysse EA, et al. Early-onset refractive ac-commodative esotropia. J AAPOS. 1998; 2:275–8.

22. Choi MY, Chang BL. Binocularity in refractive accommodative esotropia. J Korean Ophthalmol Soc. 1999; 40:1663–70.

Table 1.

Baseline characteristics at the initial examination (the time of presentation)

Parameters (range)	Mean
Total number of patients	48
Sex (M:F)	27:21
Mean age (months)	49.82 ± 25.27 (34-97)
Mean BCVA	0.60 ± 0.24 (0.3-1.0)
Mean refractive error (diopter)	4.67 ± 2.18 (1-9)
Mean age to 1st glasses (months)	48.09 ± 20.22 (34-101)
Mean stereoacuity (seconds of arc)	1243.75 ± 1378.24 (100-3000)
Mean deviation without glasses (PD)	29.55 ± 13.98 (12-70)
Mean deviation with glasses (PD)	5.02 ± 9.24 (0-9)
Mean follow-up (months)	43.51 ± 30.02 (30-124)

Values are presented as mean ± SD.

BCVA = best corrected visual acuity; PD = prism diopter.

Table 2.

Association of hypermetropia at the initial examination and stereoacuity outcome at the final visit

Refractive error (diopter)	Number of patients	Number of patients ≤100 sec of arc (%)	p-value
≥ + 1.0∼ < +3.0	12	10 (83.3)	0.362^*
≥+3.0∼ < +5.0	15	10 (66.7)
≥+5.0	21	13 (61.9)

^* Kruskal-Wallis test.

Table 3.

Association of age with 1st glasses and stereoacuity outcome at the final visit

Age to 1st glasses (years)	Number of patients	Number of patients ≤100 sec of arc (%)	p-value
≥2-<4	21	15 (71.4)	0.334^*
≥4-<6	16	12 (75.0)
≥6	11	6 (54.5)

^* Kruskal-Wallis test.

Table 4.

Association of amblyopia at initial examination with stereoacuity outcome at final visit

Amblyopia	Number of patients	Number of patients ≤100 sec of arc (%)	p-value
Nonamblyopic	18	15 (83.3)	0.039^*
Mild amblyopic	16	12 (75.0)
Moderate amblyopic	14	6 (42.9)

^* Kruskal-Wallis test.

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