J Korean Ophthalmol Soc.  2015 May;56(5):759-763. 10.3341/jkos.2015.56.5.759.

Long-Term Binocularity in Accommodative Esotropia

• Youm DJ
• Chang HR

• KMID: 2121176
• DOI: http://doi.org/10.3341/jkos.2015.56.5.759

Abstract

PURPOSE
To find clinical factors related to the long-term outcome of binocularity in accommodative esotropia.
METHODS
Forty-nine patients with accommodative esotropia who were followed over 5 years after successful optical alignment within 8 prism diopters of orthophoria at near and distance with glasses including bifocals were included. The patients who had stereo acuity better than 50 seconds/arc and central fusion without suppression scotoma at the final visit were divided into the bifoveal fusion group and the others were divided into the peripheral fusion group. Clinical factors were analyzed between the two groups (Chi-square test, student t-test).
RESULTS
Of the 49 patients, 15 patients were included in the bifoveal fusion group and 34 patients were included in peripheral fusion group. Mean follow-up was 88.9 +/- 25.4 months. Clinical factors that were significantly related to the bifoveal fusion group were older age of onset, shorter duration of misalignment, intermittent esotropia at the initial visit and after initial optical correction, smaller residual deviations at distance after initial optical correction and at the final visit, and lesser amblyopia.
CONCLUSIONS
To obtain better levels of long-term binocularity, optical correction should be done as early as possible, before the presence of constant eye misalignment or amblyopia, and the residual esodeviations after optical correction should be kept as small as possible.

Keyword

Accommodative esotropia; Binocularity; Stereoacuity

MeSH Terms

Age of Onset
Amblyopia
Esotropia*
Eyeglasses
Follow-Up Studies
Glass
Humans
Scotoma
Telescopes*

Reference

References

1. Kim MM, Cho YJ. The factors influencing on binocularity in accommodative esotropia. J Korean Ophthalmol Soc. 1997; 38:1847–51.

2. Tomaç S. Binocularity in refractive accommodative esotropia. J Pediatr Ophthalmol Strabismus. 2002; 39:226–30.

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

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

5. Wilson ME, Bluestein EC, Parks MM. Binocularity in accommodative esotropia. J Pediatr Ophthalmol Strabismus. 1993; 30:233–6.

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

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

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

9. Swan KC. Accommodative esotropia long range follow-up. Ophthalmology. 1983; 90:1141–5.

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

11. 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.

12. Hyun SH, Paik HJ. The initial factors influencing successful final stereoacuity in refractive accommodative esotropia. J Korean Ophthalmol Soc. 2014; 55:877–81.

13. Parks MM. Binocular vision. Tasman W, Jaeger EA, editors. Duane's clinical ophthalmology. revised ed.Philadelphia: JB Lippincott;1993. v. 1:chap. 5.

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

15. Goodwin RT, Romano PE. Stereoacuity degradation by experimental and real monocular and binocular amblyopia. Invest Ophthalmol Vis Sci. 1985; 26:917–23.

16. Richardson SR, Wright CM, Hrisos S, et al. Stereoacuity in unilateral visual impairment detected at preschool screening: outcomes from a randomized controlled trial. Invest Ophthalmol Vis Sci. 2005; 46:150–4.

17. Robaei D, Huynh SC, Kifley A, et al. Stereoacuity and ocular associations at age 12 years: findings from a population-based study. J AAPOS. 2007; 11:356–61.

18. Dobson V, Miller JM, Clifford-Donaldson CE, Harvey EM. Associations between anisometropia, amblyopia, and reduced stereoacuity in a school-aged population with a high prevalence of astigmatism. Invest Ophthalmol Vis Sci. 2008; 49:4427–36.