The Prevalence and Predictive Factors of Deterioration in Accommodative Esotropia

ABSTRACT

PURPOSE: A number of patients with accommodative esotropia who were initially well controlled with their optical correction will deteriorate. This study aims to examine the cautious clinical features of patients with accommodative esotropia during follow-up period by obtaining the prevalence and the predictive factors of deterioration in accommodative esotropia. METHODS: The records of 89 patients with accommodative esotropia whose eyes were aligned with optical correction (including bifocals) to 8 prism diopters (PD) of esotropia or less were reviewed. All patients were followed for a period of at least 2 years. The patients whose alignment was increased to 10PD of esotropia or greater during the follow-up period were included into the deteriorated group. We obtained the rate of deterioration and compared the clinical features of the deteriorated and controlled group. RESULTS: The mean follow-up period was 64.1+/-29.3 months. Seven (7.8%) of 89 patients was deteriorated. The mean interval of deterioration after initial optical correction was 41.8+/-26.9 months. The stereopsis was significantly worse in the deteriorated group (p=0.024). The frequency of high AC/A ratio was also significantly higher in the deteriorated group (p=0.003). CONCLUSIONS: This study indicates that accommodative esotropia with high AC/A ratio or worse sensory status has an increased likelihood of deterioration.