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AIM: To analyze the clinical characteristics of acute acquired concomitant esotropia(AACE)in patients among different age groups.METHODS: Retrospective analysis of clinical data. A total of 112 non-Swan type AACE patients who underwent surgery at Peking University People's Hospital from January 2015 to December 2022 were retrospectively analyzed. Clinical data were collected and the characteristics were compared, including gender, age, diopter, duration of disease, daily time spent on near work, angles of deviation before and after surgery, stereopsis, etc. According to age, patients were divided into three groups: <18 years old group(22 cases), 18-45 years old group(67 cases), and >45 years old group(23 cases). The clinical characteristics of patients were compared in each group.RESULTS: A total of 112 patients were included in the study, comprising 56 males and 56 females, with a median age of 29.50(19.25, 41.75)years old. Among them, 97 patients had myopia(86.6%). There were 93 patients(83.0%)who spent more than 8 h on near work. The age group <18 years old had the shortest duration before surgery, with a median time of 1.00(0.50, 1.00)a, the minimum negative diopter, with a median diopter of -0.75(-3.19, -0.56)D in the right eye and the diopter of -1.25(-2.81, -0.75)D in the left eye, and the maximum preoperative near angle of deviation, with a median angle of 30.00(18.50, 80.00)PD, and the maximum preoperative distant angle of deviation, with a median angle of 35.00(23.75, 80.00)PD. All these differences were statistically significant compared with other two groups(both P<0.05). For the age group from 18 to 45 years old, the median near angle of deviation was 20.00(14.00, 30.00)PD, and the median distant angle of deviation was 25.00(20.00, 35.00)PD, both of which were higher than those in the age group >45 years old(both P<0.05). For the age group >45 years old, the median near angle of deviation after surgery was -4.50(-7.50, 0)PD, and the median distant angle of deviation after surgery was 4.50(0, 9.50)PD, which were smaller than those in other two groups(all P<0.05). The age group >45 years old had the hiughest surgical success rate(100%). The preoperative stereopsis was better in age group >45 years old than the group <18 years old(P<0.05). The postoperative stereopsis of the age group of 18 to 45 years old and the age group >45 years old was better than age group <18 years old(both P<0.05).CONCLUSION: Surgical patients with AACE are mainly in the age group from 18 to 45 years old. The characteristic of angle of deviation is that distant angle of deviation is greater than near angle of deviation. The patients <18 years old have larger preoperative angles of deviation than adults, while their stereoacuity is worse than adults in the early postoperative period. It is recommended that augmented-dose surgery should be performed in AACE patients who are in the age group of 18 to 45 years old(5-10 PD). A conservative surgery should be designed for hyperopia young children without established binocular vision.
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AIM: To analyze the strabismus surgery situation of adolescents and children in Yunnan province.METHODS: A retrospective analysis was conducted on medical records data of 3 068 adolescents and children who received strabismus surgery at Affiliated Hospital of Yunnan University from January 2017 to December 2021. The analysis included gender, constituent ratio of age, distribution of strabismus types and combination with other ocular diseases, etc.RESULTS: Among the included patients, 52.12% were males, and 47.88% were females. Preschool patients(1 to 6 years old)accounted for 32.89%, primary pupils(7 to 12 years old)accounted for 45.89% and high school students(13 to 18 years old)accounted for 21.22%. Exotropia accounted for 63.17% of the total strabismus, of which intermittent exotropia was the most common type. Esotropia accounted for 19.69%, and concomitant esotropia was the most common type. The special type of strabismus accounted for 17.14%, and A-V syndrome and dissociative vertical deviation(DVD)were the most common types. Strabismus combined with ametropia accounted for 61.02% and amblyopia accounted for 10.89%. A few patients also combined with other eye diseases.CONCLUSION: In Yunnan province, intermittent exotropia was the most common type of strabismus among adolescents and children. Some patients combined with other ocular diseases.
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AIM: To analyze the clinical characteristics and treatment of patients with acute acquired concomitant esotropia(AACE)in different refractive status.METHODS: A retrospective analysis was conducted on 110 patients with non-type I AACE treated from January 2020 to January 2022. The non-myopic group(30 cases, spherical equivalent>-0.5D)and the myopic group(80 cases, spherical equivalent≤-0.5D)were divided according to the refractive status. The degree of deviation, accommodative convergence and accommodation ratio(AC/A), visual function, and surgical methods were observed. RESULTS: The non-myopic group had no difference in the degree of near deviation [(47.13±23.54)△] and the degree of distant deviation [(48.90±22.59)△](P>0.05); near deviation [(40.49±26.09)△] of myopic group was less than distant deviation [(50.09±25.41)△](P<0.001); and there was no difference in the same distance between the two groups(P>0.05). AC/A in the non-myopic group(5.40±2.23)was higher than that in the myopic group(3.14±3.10; P<0.05). Patients in the myopic group had better near stereopsis than the non-myopic group(P<0.05). The non-myopic group had a variety of surgical methods, while the myopic group mostly used lateral rectus resection or/and medial rectus recession.CONCLUSION: AACE can occur in different refractive status. Non-myopic patients have the same degree of distant and near strabismus, high AC/A, and varied surgical methods. However, myopic patients have less degree of near deviation than distant deviation and have normal AC/A and better near stereopsis, and lateral rectus resection or/and medial rectus recession are commonly used.
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Purpose: To investigate the risk factors and surgical design for type III acute acquired concomitant esotropia (AACE). Methods: In this retrospective, matched, case–control study, 51 patients developed type III AACE between March 2018 and September 2020, and the control group consisted of 60 patients matched by age and refractive power during the same period. A history of the duration of near work per day and the use of glasses were reviewed, and the refractive power of both eyes, deviation angles at both near and far vision, visual function, and treatment options were analyzed. Additionally, the distance from medial rectus insertion to the limbus was measured in surgical patients. The data were analyzed by logistic regression analysis. Results: We found that 99.96% of the patients and 91.67% of the controls had myopia. Of these, 60.8% and 20.0%, respectively, did not wear glasses for near work. Twelve patients were treated with a prism and 39 were treated surgically. The average time devoted to near work per day was 7.24 and 3.7 h by the patients and controls, respectively. Univariate logistic regression analysis showed that increased hours of near work per day and near work without the use of spectacles were associated with the incidence of type III AACE. Multiple logistic regression analysis revealed that increased hours of near work per day and near work without the use of glasses were independent risk factors for AACE. Conclusion: Increased hours of near work per day and uncorrected myopia in near work are independent risk factors for type III AACE
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The possibility of a central origin should be considered for late-onset concomitant esotropia. Concomitant esotropia has been reported to occur with spinocerebellar ataxia types 1, 2, and 3, but not with other degenerative cerebellar ataxia disorders. We report on a 28-year-old woman with ataxia in whom a detailed ophthalmologic examination revealed concomitant esotropia. She was subsequently diagnosed with dentatorubropallidoluysian atrophy (DRPLA). We suggest that the presence of concomitant esotropia could be used to differentiate DRPLA from other hereditary ataxias.
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Adulto , Femenino , Humanos , Ataxia , Atrofia , Ataxia Cerebelosa , Esotropía , Ataxias Espinocerebelosas , Degeneraciones EspinocerebelosasRESUMEN
Objective To observe the effectiveness of botulinum toxin A (BTXA) in the treatment of small sample patients with acute acquired concomitant esotropia. Design Retrospective case series. Participants 6 patients (3 female and 3 male) with acute acquired concomitant esotropia aged 6 to 34 years. Methods All the patients were received 2.5 units of BTXA injected into the bilateral medial rectus muscles once under electromyographic control. They were performed alter prism-cover test,synoptophore and stereoscopic charts test. Main Outcome Measures The alignment of eyes and binocular vision. Results The follow-up of patients was 4 to 39 months. The pre-injection angle of deviation was 43.3?1.0△; the angle of deviation at the last follow-up was 3.3?8.2△,and 5 patients achieved alignment. In pre-injection,one patient had distance stereopsis,2 patients had near stereopsis with 600 seconds and 40 seconds; after injection,5 patients demonstrated distance and near stereeopsis (3 patients 40 seconds,1 patient 60 seconds,and 1 patient 200 seconds). Conclusion This small sample study shows that BTXA injection is effective alternative in treating acute acquired concomitant esotropia.