The influence of the complete correction of refractive anomalieson the outcome of the treatment of esotropia in the children at the age of up to 3 years


Cite item

Full Text

Abstract

The objective of the present study was to estimate the effectiveness of the treatment of esotropia in the children. The study involved 231 children at the age of up to 3 years presenting with esotropiaincluding those with hypermetropia (n = 21, 9,1%), hypermetropic astigmatism (n = 135, 58.4%), mixed astigmatism (n = 26, 11,3%), and mild ametropia (n = 49, 21,2%). Examination of the patients was followed by the complete correction of the spherical and cylindrical components designed to reduce astigmatism down to 0.5 Dptr. The correction was aimed not only to improveaccommodation but also to maximally enhance the acuity of vision to ensure a clear image on the retina of both eyes. The children were re-examined 1.6 and 12 months after the initiation of the study. The age at which strabismus became manifest varied from 3 to 35 (mean 10.73 ± 10) months and the mean age at which the spectacles were prescribed varied from 3 to 36 (mean 21,93 ± 11) months. The angle of deviation estimated by the Hirshchberg test varied from 5 to 60 degrees. 138 (59,7%) and 93 (40,3%) children presented with infantile and acquired esotropia respectively. The eye alignment was achieved in 178 (77,1%) children and reduction of the angle of deviation in 27 (11,7%) ones within 12 months after the onset of the treatment. Strabismus remained uncorrected in 26 (11,3%) children. The best results of the treatment were obtained in the children with a shorter period between the appearance of strabismus andthe prescription of the spectacles (p< 0,001). It is concluded that the complete correction designed to bring to a minimum the changes of refraction between the two eyes (reduce astigmatism down to 0,5 Dptr) immediately after theappearance of strabismus effectivelypromotes alignment of the eyes in the overwhelming majority of the children provided the medical assistance was sought in due time. The identification number of the trial NCT01404324 at Clinicaltrials.gov.

About the authors

E. M Kasimov

Academician Zarifa Alieva National Centre for Ophthalmology

AZ 1114, Baku, Azerbaijan

Narmina Rasimkizi Gadzhieva

Academician Zarifa Alieva National Centre for Ophthalmology

Email: nаrminahajiyeva@htmail.com
AZ 1114, Baku, Azerbaijan

References

  1. Аветисов Э.С., Хведелидзе Т.З. Особенности содружественного косоглазия, возникающего с рождения. Вестник офтальмологии. 2001; 4: 46-8.
  2. Greenberg A.E., Mohney B.G., Diehl N.N., Burke J.P. Incidence and types of childhood esotropia: a population-based study. Ophthalmology. 2007; 114 (1): 170-4.
  3. Tarczy-Hornoch K., Varma R., Cotter S., DiLauro A. et al. Prevalence of amblyopia and strabismus in African American and Hispanic children ages 6 to 72 months the multi-ethnic pediatric eye disease study. Ophthalmology. 2008; 115 (7): 1229-36.
  4. Louwagie C.R., Diehl N.N., Greenberg A.E., Mohney B.G. Is the incidence of infantile esotropia declining?: a population-based study from Olmsted County, Minnesota, 1965 to 1994. Arch. Ophthalmol. 2009; 127 (2): 200-3.
  5. Kenneth W. Pediatric Ophthalmology and Strabismus. 2-nd Ed. Weston; 2002.
  6. Pediatric Eye Desease Investigator Group. The clinical spectrum of early-onset esotropia: experience of the Congenital Esotropia Observational Study. Am. J. Ophthalmol. 2002; 133 (1): 102-8.
  7. Birch E., Stager D., Wright K., Beck R. The natural history of infantile esotropia during the first six months of life. J. AAPOS. 1998; 2: 325-9.
  8. Valeria L., David R., Birch E.E. Progression of intermittent, small-angle, and variable esotropia in infancy. Invest. Ophthalmol. Vis. Sci. 2007; 48: 661-4.
  9. Pediatric Eye Desease Investigator Group. Spontaneous resolution of early-onset esotropia: experience of the Congenital Esotropia Observational Study. Am. J. Ophthalmol. 2002; 133: 109-18.
  10. Wong A.M. Timing of surgery for infantile esotropia: sensory and motor outcomes. Can. J. Ophthalmol. 2008; 43 (6): 643-51.
  11. Kitzmann A.S., Mohney B.G., Diehl N.N. Short-term motor and sensory outcomes in acquired nonaccommodativeesotropia of childhood. Strabismus. 2005; 13 (3): 109-14.
  12. Birch E.E., Fawcett S., Stager D.R. Why does early surgical alignment improve stereoacuity outcomes in infantile esotropia? J. AAPOS. 2000; 4: 10-4.
  13. Birch E.E., Stager D.R., Berry P., Leffler J. Stereopsis and longterm stability of alignment in esotropia. J. AAPOS. 2004; 8: 146-50.
  14. Birch E.E., Stager D.R. Sr. Long-term motor and sensory outcomes after early surgery for infantile esotropia. J. AAPOS. 2006; 10: 409-13.
  15. Birch E.E., Felius J., Stager D.R., Weakley D.R., Bosworth R.G. Pre-operative stability of infantile esotropia and post-operative outcome. Am. J. Ophthalmol. 2004; 138: 1003-9.
  16. Simonsz H.J., Elikemans M.J. Predictive value of age, angle, and refraction on rate of reoperation and rate of spontaneous resolution in infantile esotropia. Strabismus. 2010; 18 (3): 87-97.
  17. Fawcett S.L., Yi-Zhong Wang, Birch E.E. The critical period for susceptibility of human stereopsis. Invest. Ophthalmol. Vis. Sci. 2005; 46 (2): 521-5.
  18. Birch E., Marshall Parks lecture. Binocular sensory outcomes in accommodative ET. J. AAPOS. 2003; 7 (6): 369-73.
  19. Birch E.E., Salomao S. Infant random dot stereo acuity cards. J. Pediatr. Ophthalmol. Strabismus. 1998; 35: 86-90.
  20. Birch E.E., Petrig B. FPL and VEP measures of fusion, stereopsis and stereoacuity in normal infants. Vision Res. 1996; 36: 1321-7.
  21. Wright K.W., Edelman P.M., McVey J.H., Terry A.P., Lin M. Highgrade stereo acuity after early surgery for congenital esotropia. Arch. Ophthalmol. 1994; 112 (7): 913-9.
  22. Tychsen L. Can ophthalmologists repair the brain in infantile esotropia? Early surgery, stereopsis, monofixation syndrome, and the legacy of Marshall Parks. J. AAPOS. 2005; 9 (6): 510-21.
  23. Birch E.E., Stages D.R., Everett M.E. Prospective assessment of acuity and stereopsis in amblyopic infantile esotropes following early surgery. Invest. Ophthalmol. Vis. Sci. 1990; 31: 758-65.
  24. Гаджиева Н.Р., Гаджиев Р.В. Анизометропия как основной фактор развития содружественного косоглазия у детей до 2-летнего возраста. Офтальмология. 2011; 2 (6): 64-9.

Copyright (c) 2015 Eco-Vector


 


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies