Refractive Accommodative Esotropia: Duration between Wearing Hyperopic Glasses and Control of Esotropia within 8 PD

Hye Min Jeon; Heon Yang; Sang Won Kim; Sun Ah Kim

doi:10.7469/JKOS.2015.56.05.764

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Jeon, Yang, Kim, and Kim: Refractive Accommodative Esotropia: Duration between Wearing Hyperopic Glasses and Control of Esotropia within 8 PD

Original Article

J Korean Ophthalmol Soc 2015;56(5):764-770.

Published online: 7 September 2015

DOI: https://doi.org/10.7469/JKOS.2015.56.05.764

Refractive Accommodative Esotropia: Duration between Wearing Hyperopic Glasses and Control of Esotropia within 8 PD

Hye Min Jeon, MD, Heon Yang, MD, Sang Won Kim, MD, Sun Ah Kim, MD

Sungmo Eye Hospital, Busan, Korea

￭ Address reprint requests to Sun Ah Kim, MD Sungmo Eye Hospital, #409-1 Haeun-daero, Haeundae-gu, Busan 612-823, Korea Tel: 82-51-743-0775, Fax: 82-51-743-0776 E-mail: sunei2@naver.com

Received 5 June 201414 November 2014 Accepted 9 April 2015

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.

초록

Purpose:

To report clinical aspects of children diagnosed with refractive accommodative esotropia after wearing their first glasses to correct hyperopia accompanied with esodeviation.

Methods:

The present study included 75 children followed up for at least 24 months. Age, spherical equivalent of refractive error, angle of deviation and presence of amblyopia were analyzed according to the duration between first wearing glasses and control of esotropia within 8 PD (≤2 months vs. >2 months).

Results:

The mean age was 4.48 ± 2.08 years and mean follow-up was 50.17 months. Initial deviation angle without glasses was 25.43 ± 10.07 PD at far, 27.72 ± 11.45 PD at near, spherical equivalent was +4.86 ± 2.41 D in right eyes, +5.05 ± 1.06 D in left eyes and 8 of 75 patients (10.67%) had ≤2 D of hyperopia. Esotropia was controlled within 8 PD with hyperopic glasses in 61 of 75 children (81.3%) within 2 months, 6 (8%) within 3-6 months, 4 (5.3%) within 6-12 months and 4 (5.3%) after 12 months. In comparison, esotropia was controlled ≤2 months in 61 of 75 children (81.3%); 14 of 75 children (18.7%) requiring >2 months had less hyperopia (+4.02 D vs. 5.17 D), more severe esodeviation both at far (30.79 ± 10.79 PD vs. 24.17 ± 9.56 PD, p = 0.03) and at near distance (34.00 ± 14.20 PD vs. 26.25 ± 10.31 PD, p = 0.02) and higher initial amblyopia prevalence rates (71.5% vs. 47.5%).

Conclusions:

Several patients needed longer follow-up until esotropia was controlled within 8 PD after wearing hyperopic glasses considering the amount of hyperopia and angle of esodeviation.

Keywords: Esotropia, Hyperopic glasses, Refractive accommodative esotropia

References

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Figure 1.

Cumulative distribution of successful outcomes (correction within 8 PD after wearing glasses). PD = prism diopter.

Table 1.

Clinical features of children diagnosed with refractive accommodative esotropia

Sex (M:F)	29 (38.7):46 (61.3)
Age of wearing glasses (years)	4.74 ± 2.34
Duration of follow-up (months)	50.71 ± 14.18
MRSE at initial visit (diopter)
OD	+3.53 ± 2.59
OS	+3.67 ± 2.49
CRSE at initial visit (diopter)
OD	+4.86 ± 2.41
OS	+5.05 ± 2.38
CRSE-MRSE at initial visit (diopter)
OD	+1.32 ± 1.02
OS	+1.39 ± 1.06
Angle of deviation without glasses (esodeviation, PD)
Far	25.42 ± 10.07
Near	27.72 ± 11.45

Values are presented as mean ± SD unless otherwise indicated.

MRSE = manifest refractive error of spherical equivalent; OD = oculus dexter; OS = oculus sinister; CRSE = cycloplegic refractive error of spherical equivalent; PD = prism diopter.

Table 2.

Baseline spherical equivalent (SE) distribution (n = 75)

SE	Manifest refraction (n, %)		Cycloplegic refraction (n, %)
SE	OD	OS	OD	OS
≤2 D	28 (37.33)	22 (29.33)	9 (12)	10 (13.33)
2< SE ≤4 D	17 (22.67)	22 (29.33)	21 (28)	17 (22.67)
4< SE ≤6 D	17 (22.67)	22 (29.33)	25 (33.33)	20 (26.67)
6< SE ≤8 D	9 (12)	5 (6.67)	11 (14.67)	22 (29.33)
>8 D	4 (5.33)	4 (5.33)	9 (12)	6 (8)

OD = oculus dexter; OS = oculus sinister; D= diopter.

Table 3.

Distribution of angle of deviation (n = 75)

Angle of esotropia without correction (prism diopter)	No. of patients (%)
Angle of esotropia without correction (prism diopter)	At far	At near
10-19	27 (36)	19 (25.3)
20-29	17 (22.7)	19 (25.3)
30-39	25 (33.3)	24 (32.0)
40-49	3 (4.0)	10 (13.3)
50-59	3 (4.0)	2 (2.7)
60-69	0 (0)	0 (0)
70-79	0 (0)	1 (1.3)

Table 4.

Distribution of successful outcomes (correction with-in 8 PD after wearing glasses) (n = 75)

Duration between wearing glasses and successful outcomes within 8 PD	No. of patients (%)
≤1 month	49 (65.3)
<1-≤2 months	12 (16.0)
<2-≤3 months	3 (4.0)
<3-≤6 months	3 (4.0)
<6-≤12 months	4 (5.3)
<12-≤24 months	3 (4.0)
31 months	1 (1.3)

PD = prism diopter.

Table 5.

Comparison according to the duration between wearing glasses and correction of esotropia within 8 PD

	≤2 months	>2 months	p-value
No. of patients (%)	61 (81.3)	14 (18.7)
Age of wearing glasses (years)	4.63 ± 2.32	5.10 ± 2.43	0.50
Refractive error (diopter)	+5.17 ± 2.34	+4.02 ± 2.42	0.02
Angle of deviation without correction at (PD)
Far	24.17 ± 9.56	30.79 ± 10.79	0.03
Near	26.25 ± 10.31	34.00 ± 14.20	0.02
CRSE at initial visit - MRSE at initial visit (diopter)	1.36 ± 1.11	1.29 ± 0.70	0.78
CRSE at initial visit - MRSE at 2 months (diopter)	0.25 ± 0.40	0.35 ± 0.38	0.24

Values are presented as mean ± SD unless otherwise indicated.

PD = prism diopter; CRSE = cycloplegic refractive error of spherical equivalent; MRSE = manifest refractive error of spherical equivalent.

Table 6.

Clinical features of anisometropia group

	Anisometropia	Isometropia	p-value
Number of patients (%)	14 (18.67)	61 (81.33)
Age of onset (years)	5.46 ± 2.47	4.55 ± 2.29	0.190
Angle of deviation without correction (esodeviation, PD)
Far	23.43 ± 8.23	25.88 ± 10.46	0.415
Near	24.86 ± 8.92	28.38 ± 11.93	0.303
Duration between wearing glasses and successful outcomes within 8 PD (months)	1.74 ± 2.58	3.03 ± 5.61	0.403

Values are presented as mean ± SD unless otherwise indicated.

PD = prism diopter.

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