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Effect of late surgery for acquired esotropia on visual evoked potential

P Kozma1, A Deák, M Janáky

  • 1Department of Ophthalmology, University of Szeged, Faculty of Medicine, Hungary.

Insights

Strabismus surgery in children over age 5 with acquired esotropia significantly improved visual evoked potential (VEP) amplitudes and binocular fusion. These positive changes occurred even beyond the typical critical period for visual development.

Area of Science:

  • Ophthalmology
  • Neuroscience
  • Pediatric Vision

Background:

  • Acquired esotropia in children can impact visual development.
  • The critical period for visual plasticity typically closes by age 5.
  • The potential for visual improvement after strabismus surgery in older children is an area of ongoing research.

Purpose of the Study:

  • To evaluate the impact of strabismus surgery on visual evoked potential (VEP) amplitude in children aged 5 and older with acquired esotropia.
  • To assess changes in binocular function following surgical correction.

Main Methods:

  • 10 children (aged 5-6 years) with acquired esotropia underwent pattern reversal visual evoked potential (VEP) testing before and 3 months after strabismus surgery.
  • Binocular and monocular VEPs were recorded.
  • Binocular fusion was assessed using a synoptophore post-surgery.
  • Correlation between electrophysiological and clinical outcomes was analyzed.

Main Results:

  • A significant increase in pattern VEP amplitudes was observed post-surgery, particularly with binocular stimulation.
  • Significant improvement in binocular fusion was also noted.
  • Postoperative VEP changes did not consistently correlate with the degree of functional improvement.

Conclusions:

  • Strabismus surgery can positively influence binocular VEPs and promote the development of binocular fusion in children with acquired esotropia, even when performed after the classical critical period.
  • These findings suggest that visual plasticity may extend beyond traditional age limits for intervention.
Abstract

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