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Progression of intermittent, small-angle, and variable esotropia in infancy
Valeria L N Fu1, David R Stager, Eileen E Birch
1Pediatric Eye Research Laboratory, Retina Foundation of the Southwest, Dallas, Texas 75231, USA. vfu@retinafoundation.org
Investigative Ophthalmology & Visual Science
|January 26, 2007
Summary
Infantile esotropia (ET) can resolve spontaneously or progress. Abnormal stereoacuity and occlusion therapy increase the risk of progression from intermittent to constant large-angle ET.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus Research
Background:
- Infantile esotropia (ET) presents with varied initial deviations, including small-angle, variable-angle, or intermittent forms.
- Some infants spontaneously resolve ET, while others progress to constant large-angle deviations requiring surgical intervention.
Purpose of the Study:
- To identify risk factors associated with the progression of infantile esotropia (ET) to a constant large-angle deviation.
- To understand the natural history of infantile ET and factors influencing its progression or resolution.
Main Methods:
- Seventy-seven infants with initial intermittent, small (<20 pd), or variable-angle ET (2-12 months old) were followed prospectively.
- Risk factors analyzed included occlusion therapy, early presentation (<6 months), amblyopia, and abnormal stereoacuity.
- Infants with refractive errors >/+3.50 D received initial glasses treatment.
Main Results:
- All 12 infants with initial small or variable-angle ET progressed to constant large-angle ET and required surgery.
- Spontaneous resolution occurred in 44.6% of infants with intermittent ET.
- Intermittent ET with abnormal stereoacuity or treated with occlusion therapy showed a 3.4x higher risk of progression to constant large-angle ET.
Conclusions:
- Abnormal stereoacuity and occlusion therapy are significant risk factors for the progression of intermittent esotropia to constant large-angle ET.
- Intermittent ET in the first year of life has a high chance of spontaneous resolution, unlike constant small-angle or variable-angle ET, which rarely resolves spontaneously.
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