Long-term study of accommodative esotropia.
OBJECTIVE
This study aimed, using a large sample size, to determine the long-term results of standard treatment of accommodative esotropia and identify predictors of outcome while minimizing bias in data collection and analysis.


METHODS
Data from all the files of a large, long-established pediatric ophthalmology practice were collected and analyzed using a masked protocol. The study included every esotropic patient who had been prescribed glasses. Criteria for patient inclusion were designed to conform to earlier studies by the authors.


RESULTS
The database totaled 1307 patients, of who 354 met inclusion criteria. A greater difference between near and distance esodeviation (AC/A relationship) correlated with a higher rate of deterioration of accommodative esotropia control (P < 0.0001). Deterioration also positively correlated with earlier age of onset (P < 0.0001), inferior oblique overaction (P = 0.0005), and amblyopia (P < 0.005).


CONCLUSIONS
This study demonstrates that a high AC/A relationship increases the likelihood of deterioration of accommodative esotropia, supporting the earlier studies, as well as the accuracy of this database. It also represents a new model for the utilization of clinical trials' bias-reduction principals in the analysis of retrospective data.
Ludwig
Irene H
IH
LSU Eye Center, New Orleans, Louisiana, USA.
Imberman
Susan P
SP
Thompson
Hilary W
HW
Parks
Marshall M
MM
D000065:Accommodation, Ocular; D002648:Child; D002675:Child, Preschool; D004948:Esotropia / Q000503:physiopathology* / Q000628:therapy; D005139:Eyeglasses; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D042262:Retinoscopy; D015348:Vision, Binocular / Q000502:physiology