Document Detail

Progression of intermittent, small-angle, and variable esotropia in infancy.
MedLine Citation:
PMID:  17251463     Owner:  NLM     Status:  MEDLINE    
PURPOSE: Esotropia (ET) in infancy may initially manifest as a small-angle, variable-angle, or intermittent deviation. Some patients experience spontaneous resolution and become orthophoric. Others progress to constant large-angle ET and require surgery. The authors examined factors that may be associated with risk for progression to constant large-angle ET. METHODS: Seventy-seven infants who initially presented with intermittent, small (<20 prism diopter [pd]) or variable-angle ET at 2 to 12 months of age were followed up until the ET was resolved, the infants had surgery, or the parents or guardians refused surgery. All infants with refractive correction >/=+3.50 D were treated initially with glasses. Four risk factors were examined: prescription of occlusion therapy, initial visit before 6 months of age, presence of amblyopia, and abnormal stereoacuity. RESULTS: All 12 infants with small or variable angles progressed to constant large-angle ET and surgery. ET resolved spontaneously in 44.6% (29/65) infants in whom it was intermittent. Infants with intermittent ET who received patches as initial treatment and who had abnormal stereoacuity had 3.4x (95% confidence interval [CI], 1.83-6.29) and 3.4x (95% CI, 1.66-6.78) higher risk for progression to constant large-angle ET, respectively. Neither age at initial visit nor amblyopia presented risk for progression. CONCLUSIONS: Abnormal stereoacuity and occlusion therapy pose significant risks for progression from intermittent to constant large-angle ET. Intermittent ET that develops during the first year of life has a high likelihood of spontaneous resolution, whereas constant small-angle or variable-angle ET seldom resolves.
Valeria L N Fu; David R Stager; Eileen E Birch
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  Investigative ophthalmology & visual science     Volume:  48     ISSN:  0146-0404     ISO Abbreviation:  Invest. Ophthalmol. Vis. Sci.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-25     Completed Date:  2007-03-01     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  7703701     Medline TA:  Invest Ophthalmol Vis Sci     Country:  United States    
Other Details:
Languages:  eng     Pagination:  661-4     Citation Subset:  IM    
Pediatric Eye Research Laboratory, Retina Foundation of the Southwest, Dallas, Texas 75231, USA.
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MeSH Terms
Disease Progression
Esotropia / physiopathology*,  therapy
Follow-Up Studies
Oculomotor Muscles / physiopathology*
Ophthalmologic Surgical Procedures
Remission, Spontaneous
Risk Factors
Sensory Deprivation
Visual Acuity
Grant Support

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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