Evaluation of clinical characteristics and risk factors of strabismus cases.

OBJECTIVE: Strabismus, defined as the misalignment of the eyes, is a common disorder that is usually diagnosed in childhood. Strabismus is an important health problem with both functional and psychosocial effects on children. In this study, we aimed to determine the clinical features and risk factors of patients diagnosed with strabismus and followed up in our clinic. METHODS: The data of pediatric patients who were followed up in our strabismus clinic between February 2016 and September 2022 were retrospectively reviewed. The patients' detailed ophthalmological and strabismus examination findings and anamnesis findings concerning the etiology of strabismus were recorded. RESULTS: A total of 391 patients were enrolled in the study. The mean age of the patients was 8.66±4.7 years. Of the patients, 207 (52.9%) had esotropia, 172 (43.99%) had exotropia, and 12 (3.07%) had vertical deviation, with the mean ages of these groups being calculated as (7.27±4.1), (10.45±4.8), and (7.16±4.7) years, respectively. Amblyopia was present in 54 (26.09%) of the 207 esotropia cases, 27 (15.70%) of the 172 exotropia cases. Esotropia is more likely than exotropia to be related to amblyopia, according to our research. Of all the patients, 97 (24.81%) had a family history of strabismus, 38 (9.7%) had a history of preterm birth, 39 (10.0%) had a history of neonatal care unit stay, 38 (9.7%) had epilepsy, 4 (1%) had a history of trauma, and 14 (3.6%) had an additional eye disease. CONCLUSION: Detection of risk factors such as family history, preterm birth, length of stay in the neonatal care unit and epilepsy that may be associated with strabismus can help identify high-risk children for early diagnosis and treatment.

The effect of strabismus surgery performed by preserving the anterior ciliary vessels on the choroid in pediatric patients.

BACKGROUND: Horizontal strabismus surgery is one of the most common eye operations. Many studies have shown that strabismus surgery has an effect on choroidal thicknesses. This study aimed to evaluate choroidal changes after the anterior ciliary vessels (ACV) conservation surgery using Enhanced Depth Imaging-Optical coherence tomography (EDI-OCT). METHODS: This study included 41 eyes of 26 pediatric patients that were diagnosed with esotropia and underwent surgery with the standard procedure and 38 eyes of 25 pediatric patients treated with ACV preservation. Preoperative and postoperative refraction error measurements, biomicroscopic examinations, intraocular pressure measurements, dilated fundus control, and strabismus examinations were performed, and the best corrected visual acuity was determined. The patients were operated on under general anesthesia by the same surgeon using two different procedures: the standard procedure (Group 1) and by preserving the ACV (Group 2). Using EDI-OCT, choroidal measurements were performed preoperatively, on postoperative week 1, month 1, and month 3. RESULTS: The preoperative and postoperative choroidal thickness measurements of the patients in Group 1 decreased in all regions postoperatively (p<0.05) especially at week 1 and month 1, but approached the preoperative values at the third -month evaluations (p>0.05). In Group 2, there was no statistically significant difference in the choroidal measurements between the preoperative ​​and postoperative week 1, month 1, and month 3 values (p>0.05). CONCLUSIONS: ACV preservation is recommended to prevent choroidal changes occurring in the early period after horizontal strabismus surgery.

Effect of inferior oblique muscle myomectomy on choroidal and macular thicknesses in strabismus.

BACKGROUND: In this study, we aimed to determine postoperative changes in macular and choroidal thicknesses in patients who underwent inferior oblique myomectomy. METHODS: The study included 54 eyes of 44 patients who underwent inferior oblique muscle myectomy between January 2018 and April 2022. Visual acuity and macular and choroidal thickness measurements were performed preoperatively and postoperatively (day 1, week 1, month 1, and month 3). RESULTS: When the choroidal thickness measurements were examined, it was determined that choroidal thicknesses decreased especially in the nasal and subfoveal regions on the first day and at the first week after surgery (p < 0.05) but approached their preoperative values ​​at the first- and third-month evaluations (p > 0.05). The macular thickness measurements revealed an increase in all macular regions on the first day and at the end of the first week (p < 0.05) and approached their preoperative values ​​at the end of the first and third months (p > 0.05). CONCLUSIONS: In this study, although choroidal thicknesses decreased in the early postoperative period in patients who had undergone inferior oblique myomectomy, there was an increase in macular thicknesses. However, at the third postoperative month, choroid and macular thicknesses were found to be similar to the preoperative values​.