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Japanese Journal of Ophthalmology

, Volume 63, Issue 6, pp 483–489 | Cite as

Clinical characteristics and surgical outcomes of adults with acute acquired comitant esotropia

  • Haeng-Jin Lee
  • Seong-Joon KimEmail author
Clinical Investigation
  • 57 Downloads

Abstract

Purpose

To investigate clinical characteristics of adults with acute acquired comitant esotropia and to evaluate the muscle recession amount needed to achieve a favorable outcome after performing medial rectus muscle recession.

Study designs

Retrospective study.

Methods

Patients diagnosed with acute acquired comitant esotropia, who underwent medial rectus muscle recession with adjustable suture between 2008 and 2016 were included. Surgical outcomes were classified into motor and sensory. The motor outcomes were evaluated at the 1-year postoperative visit and divided into success (orthotropia or esodeviation ≤ 8 PD) and failure (esodeviation > 8 PD). The successful sensory outcomes were defined as elimination of diplopia in primary gaze. Factors including age, sex, refractive error, deviation angle, and surgical amount were compared between groups.

Results

Sixteen subjects were included whose mean (± SD) age at the initial visit was 27.5 ± 11.0 years. Mean preoperative maximum angle of deviation was 27.9 ± 9.3 PD at distance and 28.6 ± 12.0 PD at near. Mean refractive error was -2.55 ± 2.92 D. Twelve of 16 subjects (75%) had successful motor and sensory outcomes. Age, sex, refractive error and deviation angle were not different between the two groups. Both success and failure groups required a greater amount of medial rectus muscle recession than those indicated by the Parks’ surgical table, with a 40.6 ± 25.8 % augmentation in the success and 7.9 ± 6.9 % in the failure group (P = .028).

Conclusions

To achieve better surgical outcomes in adults with acute acquired comitant esotropia, targeting postoperative orthotropia by increasing the amount of medial rectus muscle recession is recommended.

Keywords

Acute acquired comitant esotropia Adult esotropia Medial rectus recession 

Notes

Acknowledgements

This work was supported by the National Research Foundation of Korea (NRF) Grant funded by the Korean Government (MOE) (No. 2017R1D1A1B03032985).

Conflicts of interest

H. J. Lee, None; S. J. Kim, Grant (National Research Foundation of Korea).

References

  1. 1.
    Burian HM, Miller JE. Comitant convergent strabismus with acute onset. Am J Ophthalmol. 1958;45:55–64.CrossRefGoogle Scholar
  2. 2.
    Swan KC. Esotropia following occlusion. Arch Ophthal. 1947;37:444–51.CrossRefGoogle Scholar
  3. 3.
    Franceschetti A. Acute concomitant strabismus. Ophthalmologica. 1952;123:219–26.CrossRefGoogle Scholar
  4. 4.
    A B. Das Einwartsschielen der Myopen. Ber Dtsch Ophthalmol Ges. 1992;43:245.Google Scholar
  5. 5.
    Hoyt CS, Good WV. Acute onset concomitant esotropia: when is it a sign of serious neurological disease? Br J Ophthalmol. 1995;79:498–501.CrossRefGoogle Scholar
  6. 6.
    Akman A, Dayanir V, Sanaç AS, Kansu T. Acquired esotropia as presenting sign of cranio-cervical junction anomalies. Neuro-Ophthalmology. 1995;15:311–4.  https://doi.org/10.3109/01658109509044620.CrossRefGoogle Scholar
  7. 7.
    Buch H, Vinding T. Acute acquired comitant esotropia of childhood: a classification based on 48 children. Acta Ophthalmol. 2015;93:568–74.  https://doi.org/10.1111/aos.12730.CrossRefPubMedGoogle Scholar
  8. 8.
    Lyons CJ, Tiffin PA, Oystreck D. Acute acquired comitant esotropia: a prospective study. Eye (London, England). 1999;13(Pt 5):617–20.  https://doi.org/10.1038/eye.1999.169.CrossRefGoogle Scholar
  9. 9.
    Spierer A. Acute concomitant esotropia of adulthood. Ophthalmology. 2003;110:1053–6.  https://doi.org/10.1016/s0161-6420(03)00102-7.CrossRefPubMedGoogle Scholar
  10. 10.
    Kassem RR, Elhilali HM. Factors affecting sensory functions after successful postoperative ocular alignment of acquired esotropia. J AAPOS. 2006;10:112–6.  https://doi.org/10.1016/j.jaapos.2006.01.001.CrossRefPubMedGoogle Scholar
  11. 11.
    Chen J, Deng D, Sun Y, Shen T, Cao G, Yan J, et al. Acute acquired concomitant esotropia: clinical features, classification, and etiology. Medicine (Baltimore). 2015;94:e2273.  https://doi.org/10.1097/md.0000000000002273.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Clark AC, Nelson LB, Simon JW, Wagner R, Rubin SE. Acute acquired comitant esotropia. Br J Ophthalmol. 1989;73:636–8.CrossRefGoogle Scholar
  13. 13.
    Gilbert AL, Koo EB, Heidary G. Evaluation and management of acute acquired comitant esotropia in children. Semin Ophthalmol. 2016.  https://doi.org/10.1080/08820538.2016.1228398.CrossRefPubMedGoogle Scholar
  14. 14.
    Legmann Simon A, Borchert M. Etiology and prognosis of acute, late-onset esotropia. Ophthalmology. 1997;104:1348–52.CrossRefGoogle Scholar
  15. 15.
    Parks M, Mitchell P. Concomitant esodeviations. In: Tasman W, Jaeger EA, editors. Duane’s foundations of clinical ophthalmology. Philadelphia, PA: Lippincott Williams & Wilkins; 2002. p. 1–21.Google Scholar
  16. 16.
    Von Noorden GK, Campos EC. Binocular vision and ocular motility: theory and management of strabismus. Mosby: St. Louis; 2002. p. 336–40.Google Scholar
  17. 17.
    Webb H, Lee J. Acquired distance esotropia associated with myopia. Strabismus. 2004;12:149–55.  https://doi.org/10.1080/09273970490489694.CrossRefPubMedGoogle Scholar
  18. 18.
    Fresina M, Giannaccare G, Versura P, Campos EC. Accommodative spasm might influence surgical planning and outcomes in acute acquired distance esotropia in myopia. Med Hypotheses. 2016;94:66–7.  https://doi.org/10.1016/j.mehy.2016.06.023.CrossRefPubMedGoogle Scholar
  19. 19.
    Hussaindeen JR, Mani R, Agarkar S, Ramani KK, Surendran TS. Acute adult onset comitant esotropia associated with accommodative spasm. Optom Vis Sci. 2014;91:S46–51.  https://doi.org/10.1097/opx.0000000000000182.CrossRefPubMedGoogle Scholar
  20. 20.
    Goldstein JH, Schneekloth BB. Spasm of the near reflex: a spectrum of anomalies. Surv Ophthalmol. 1996;40:269–78.CrossRefGoogle Scholar
  21. 21.
    Ali MH, Berry S, Qureshi A, Rattanalert N, Demer JL. Decompensated esophoria as a benign cause of acquired esotropia. Am J Ophthalmol. 2018;194:95–100.  https://doi.org/10.1016/j.ajo.2018.07.007.CrossRefPubMedGoogle Scholar
  22. 22.
    Brodsky MC, Jung J. Intermittent exotropia and accommodative esotropia: distinct disorders or two ends of a spectrum? Ophthalmology. 2015;122:1543–6.  https://doi.org/10.1016/j.ophtha.2015.03.004.CrossRefPubMedGoogle Scholar
  23. 23.
    Savino G, Abed E, Rebecchi MT, Spreca M, Tredici C, Dickmann A. Acute acquired concomitant esotropia and decompensated monofixation syndrome: a sensory-motor status assessment. Can J Ophthalmol. 2016;51:258–64.  https://doi.org/10.1016/j.jcjo.2016.02.003.CrossRefPubMedGoogle Scholar
  24. 24.
    Repka MX, Connett JE, Scott WE. The one-year surgical outcome after prism adaptation for the management of acquired esotropia. Ophthalmology. 1996;103:922–8.CrossRefGoogle Scholar
  25. 25.
    Repka MX, Connett JE, Baker JD, Rosenbaum AL. Surgery in the prism adaptation study: accuracy and dose response. Prism Adaptation Study Research Group. J Pediatr Ophthalmol Strabismus. 1992;29:150–6.PubMedGoogle Scholar
  26. 26.
    Akbari MR, Mehrabi Bahar MR, Mirmohammadsadeghi A, Bayat R, Masoumi A. Short prism adaptation test in patients with acquired nonaccommodative esotropia; clinical findings and surgical outcome. J AAPOS. 2018;22:352–5.  https://doi.org/10.1016/j.jaapos.2018.05.018.CrossRefPubMedGoogle Scholar

Copyright information

© Japanese Ophthalmological Society 2019

Authors and Affiliations

  1. 1.Department of OphthalmologySeoul National University College of MedicineSeoulRepublic of Korea
  2. 2.Seoul Artificial Eye CenterSeoul National University Hospital Clinical Research InstituteSeoulRepublic of Korea

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