| Characteristics and course of patients with deteriorated monofixation syndrome. | |
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MedLine Citation:
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PMID: 16414518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Monofixation syndrome is characterized by small-angle strabismus with vergence fusional amplitudes and "peripheral fusion." Although it is thought to be a relatively stable condition, some patients with this syndrome deteriorate, resulting in an increasing heterotropia, sometimes associated with diplopia. Deteriorated monofixation syndrome is well known among clinicians; however, there are no studies describing the course and outcomes for these patients. PURPOSE: To assess the clinical characteristics, course, and response to therapy of patients with deteriorated monofixation syndrome. METHODS: We identified all patients from our database that had an ocular deviation of < or =8 Delta on simultaneous prism cover testing, peripheral fusion, and between 3000 and 67 seconds of stereoacuity (monofixators) who subsequently had an increase in their deviation to >8 Delta, loss of fusion, or diplopia. From this group we assessed patient clinical characteristics, course, and response to therapy. RESULTS: We identified 29 patients with deteriorated monofixation syndrome who subsequently underwent treatment. Treatment consisted of surgery in 28 patients and minus lens therapy in one patient. Of the study group, 28 (97%) of the patients had a history of esotropia and 20 patients (69%) had a history of amblyopia. Nine patients noted diplopia at the time of deterioration, which persisted in four patients after treatment. In all, 14 patients (48%) met the criteria for monofixation again after therapy, while 20 patients (69%) had successful motor alignment (< or =8 Delta). There was a trend toward poorer outcomes in the diplopic group when compared with the patients who did not have diplopia, although this was not statistically significant (P = 0.26 for regaining monofixation syndrome). Follow-up ranged from 1 month to 21 years. CONCLUSION: Though monofixation is considered a stable condition, some patients will deteriorate over time as demonstrated by an increase in the ocular deviation and loss of fusion. In this study 31% of our patients noted the onset of diplopia. Following treatment, 48% of the patients regained monofixation. Patients with diplopia following deterioration of their alignment may be less likely to regain good alignment or monofixation after treatment. |
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Authors:
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Michael G Hunt; Ronald V Keech |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus / American Association for Pediatric Ophthalmology and Strabismus Volume: 9 ISSN: 1091-8531 ISO Abbreviation: J AAPOS Publication Date: 2005 Dec |
Date Detail:
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Created Date: 2006-01-17 Completed Date: 2006-04-18 Revised Date: 2006-04-21 |
Medline Journal Info:
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Nlm Unique ID: 9710011 Medline TA: J AAPOS Country: United States |
Other Details:
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Languages: eng Pagination: 533-6 Citation Subset: IM |
Affiliation:
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Department of Ophthalmology and Visual Sciences at the University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Amblyopia
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physiopathology Diplopia / physiopathology Esotropia / physiopathology* Fixation, Ocular* Humans Retrospective Studies Syndrome Vision, Binocular / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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