title: Prevalence of neurological involvement and malformative/systemic syndromes in A- and V-pattern strabismus.
abstract: OBJECTIVE
  To evaluate the prevalence of neurological involvement and malformative/systemic syndromes in A- and V-patterns with respect to other kinds of infantile concomitant strabismus.
  
  
  METHODS
  A retrospective comparative study of 14,006 consecutive patients examined in the Pediatric Ophthalmology and Strabismus Unit at the Catholic University of Rome between January 2002 and February 2010 was carried out. A total of 2.72% (385) of patients presented with concomitant constant infantile strabismus associated with A- and V- patterns (study group; mean age 8 years; range: 8 months - 37 years; male 211, female 174). Another 377 consecutive patients affected by infantile concomitant strabismus without A- or V- patterns were used as controls (control group; mean age 9 years, range: 1-34 years; male 194, female 183). All patients underwent a complete ophthalmologic and orthoptic examination with ocular motility evaluation and prism cover test or the Hirschberg test in primary, up and down gaze positions, as well as cycloplegic retinoscopy. The angle of deviation was evaluated at near (33 cm) and distance fixation (6 m) with full correction of refraction.
  
  
  RESULTS
  Neurological involvement and malformative/systemic syndromes were observed in 30.4% of the study group and in 19.8% of patients in the control group (P < 0.001). Patients with A-pattern showed a greater prevalence of neurological impairment, hydrocephalus and meningomyelocele, while those affected by V-pattern exhibited a greater prevalence of craniosynostosis and malformative syndromes.
  
  
  CONCLUSIONS
  Neurological involvement and malformative/systemic syndromes seem to be more evident in patients presenting with A- and V-pattern strabismus.
authors.affiliation: Institute of Ophthalmology, Catholic University of Sacred Heart of Rome, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Dickmann
authors.forename: Rosa
authors.initials: R
authors.lastname: Parrilla
authors.forename: Stefania
authors.initials: S
authors.lastname: Aliberti
authors.forename: Vittoria
authors.initials: V
authors.lastname: Perrotta
authors.forename: Annabella
authors.initials: A
authors.lastname: Salerni
authors.forename: Gustavo
authors.initials: G
authors.lastname: Savino
authors.forename: Sergio
authors.initials: S
authors.lastname: Petroni
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D000013:Congenital Abnormalities / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007223:Infant; D007558:Italy / Q000453:epidemiology; D008297:Male; D009422:Nervous System Diseases / Q000453:epidemiology*; D015995:Prevalence; D012029:Refraction, Ocular / Q000502:physiology; D042262:Retinoscopy; D012189:Retrospective Studies; D013285:Strabismus / Q000175:diagnosis / Q000453:epidemiology*; D015348:Vision, Binocular / Q000502:physiology; D055815:Young Adult