Early predict the outcomes of refractive accommodative esotropia by initial presentations.
BACKGROUND
The differential diagnosis between fully and partially refractive accommodative esotropia (Ac-ET) depends on outcomes after intervention with refraction correction. Whether the differences exist in terms of initial clinical features between these two variants has not been fully explored.


METHODS
Children between the ages of 6 months and 8 years with esotropia and spherical equivalent greater than +3.00 (D) were included in this study. After wearing diopters glasses for at least 2 years, children were classified according to the indexed criteria into the fully Ac-ET group (group A, N=28) partially Ac-ET (group or the B, N=17). Six clinical parameters, including age at onset, age at first visit, visual acuity, refractive error, angle of esodeviation, and presence or absence of inferior oblique overaction at initial presentation were compared between these two groups.


RESULTS
The angle of esodeviation (31.4+/-11.6 PD vs. 42.6+/-12.6 PD, p = 0.004) was significantly different between the fully and partially Ac-ET groups, while refraction (+5.79+/-1.84 D vs. +4.79+/-1.40 D, p = 0.062) had borderline significance. On the contrary, the age at onset (2.35+/-1.74 yrs vs. 2.01+/-1.96 yrs, p=0.539), age at first visit (3.51+/-1.36 yrs vs. 3.01+/-1.70 yrs, p =0.285), inferior oblique overaction (32% vs. 47%, p =0.317), and visual acuity before (LogMAR: 0.40+/-0.25 vs. LogMAR: 0.34+/-0.25, p =0.544) and after treatment (LogMAR: 0.057+/-0.079 vs. LogMAR: 0.051+/-0.19, p = 0.088) were similar in the two groups.


CONCLUSIONS
Children with a smaller angle of esodeviation and higher hyperopia were more likely belonging to fully Ac-ET, which can be treated with glasses without the need of surgical intervention. Early detection and early treatment of accommodative esotropia are needed to prevent strabismus and amblyopia.
Lai
Hui-Chun
HC
Department of Ophthalmology, Chang Gung Memorial Hospital, Taipei.
Chen
Henry Shen-lih
HS
Chen
Yeong-Fong
YF
Chiang
Yih-Shien
YS
Yang
Meng-Ling
ML
D000065:Accommodation, Ocular; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D005139:Eyeglasses; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D012029:Refraction, Ocular; D012030:Refractive Errors / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D012720:Severity of Illness Index; D013285:Strabismus / Q000175:diagnosis / Q000517:prevention & control; D013997:Time Factors; D016896:Treatment Outcome