Early predict the outcomes of refractive accommodative esotropia by initial presentations

Area of Science:

• Ophthalmology
• Pediatric Ophthalmology
• Strabismus Research

Background:

• Distinguishing between fully and partially refractive accommodative esotropia (Ac-ET) is crucial for effective treatment planning.
• Initial clinical features differentiating these Ac-ET variants remain underexplored, impacting diagnostic accuracy.

Purpose of the Study:

• To investigate the differences in initial clinical features between fully and partially Ac-ET.
• To identify predictors for classifying Ac-ET subtypes based on early presentation characteristics.

Main Methods:

• A cohort of children aged 6 months to 8 years with esotropia and hyperopia (spherical equivalent > +3.00 D) was studied.
• Children were classified into fully Ac-ET (N=28) and partially Ac-ET (N=17) groups after at least 2 years of spectacle wear.
• Initial clinical parameters including age at onset, visual acuity, refractive error, esodeviation angle, and inferior oblique overaction were compared.

Main Results:

• A significantly smaller angle of esodeviation (31.4 PD vs. 42.6 PD) was observed in the fully Ac-ET group compared to the partially Ac-ET group.
• Refractive error showed borderline significance (p=0.062), with higher hyperopia in the fully Ac-ET group.
• Age at onset, age at first visit, inferior oblique overaction, and visual acuity were similar between the two groups.

Conclusions:

• Children presenting with a smaller esodeviation angle and higher hyperopia are more likely to have fully Ac-ET, often manageable with glasses.
• Early detection and timely intervention for accommodative esotropia are essential to prevent amblyopia and long-term strabismus.