Up-shoot in adduction has no prognostic value for decompensation in refractive accommodative esotropia.
OBJECTIVE
To assess whether up-shoot (elevation) in adduction has any prognostic value for the functional outcome of binocular vision in fully refractive accommodative esotropia (RAET).


METHODS
A retrospective study was performed on 58 patients initially diagnosed with RAET who were followed for at least 4 years.


RESULTS
Without glasses, up-shoot in adduction with or without a V pattern was detected in 22 of 51 patients who maintained normal binocular alignment during the whole follow-up and in 3 of 7 patients who lost normal binocular vision and showed a manifest esotropia despite glasses at any time of the follow-up. Up-shoot in adduction was still present through glasses only in 3 patients among these 25 cases. Two of these remained fully compensated with glasses during the considered period. The third case developed up-shoot in adduction after decompensation of a previously compensated strabismus.


CONCLUSIONS
Up-shoot in adduction is not a common sign in RAET. When present, it does not necessarily represent a negative prognostic sign for preservation of normal binocular vision through glasses in this condition. Up-shoot in adduction can develop after the loss of alignment in some decompensated patients. There is therefore no evidence in favour of a cause-effect relationship between up-shoot in adduction and loss of binocularity in RAET.
Schiavi
C
C
Eye Service, University of Bologna, School of Medicine, Italy.
Bellusci
C
C
Campos
E C
EC
D000065:Accommodation, Ocular / Q000502:physiology*; D002675:Child, Preschool; D004948:Esotropia / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D005139:Eyeglasses; D006801:Humans; D006956:Hyperopia / Q000150:complications*; D007223:Infant; D015835:Ocular Motility Disorders / Q000209:etiology / Q000503:physiopathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome; D015348:Vision, Binocular / Q000502:physiology*