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Long-term follow-up of children with acute acquired concomitant esotropia
Veit Sturm1, Marcel N Menke, Pascal B Knecht
1Department of Ophthalmology, University Hospital of Hamburg, Hamburg, Germany. veit_sturm@yahoo.com
Insights
This study on acute acquired concomitant esotropia (AACE) type 2 found that strabismus surgery effectively realigns eyes, with many children regaining binocular vision and stereopsis over time.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Strabismus
Background:
- Acute acquired concomitant esotropia (AACE) type 2, also known as Burian-Franceschetti, is a specific form of strabismus.
- Understanding its clinical features and surgical outcomes is crucial for effective management.
Purpose of the Study:
- To investigate the clinical characteristics of AACE type 2.
- To evaluate the surgical outcomes and visual recovery in children with AACE type 2.
Main Methods:
- Retrospective analysis of 25 children diagnosed with AACE type 2.
- All patients underwent strabismus surgery for ocular alignment.
- Comprehensive pre- and postoperative ophthalmological and orthoptic assessments with a minimum 12-month follow-up.
Main Results:
- 92% of patients achieved ocular alignment within 8 prism diopters post-surgery.
- 60% regained normal stereovision, with an additional 24% demonstrating some binocular vision.
- Full stereopsis recovery averaged 18 months post-surgery, with some cases taking several years.
Conclusions:
- AACE type 2 is characterized by concomitant strabismus, lack of accommodative involvement, and absence of neurological issues.
- The potential for achieving normal binocular vision is a defining feature of this condition.
- Restoration of full stereopsis after surgery can be a prolonged process, often taking years.
Purpose:
To study the clinical features and surgical outcome of type 2 (Burian-Franceschetti) acute acquired concomitant esotropia (AACE).
Methods:
Retrospective analysis of children with AACE type 2. All patients underwent strabismus surgery to restore ocular alignment. All children underwent a complete assessment including medical history and pre- and postoperative ophthalmological and orthoptic examinations. Postoperative follow-up was at least 12 months in all cases.
Results:
A total of 25 consecutive patients were included. All but 2 patients (92%) were aligned within 8(∆) or less of orthotropia. Of the 25, 15 (60%) regained normal stereovision. In 6 additional cases (24%) some level of binocular vision (Titmus test, 200'' to 3000'') was demonstrated. All of the patients who finally achieved normal stereopsis had lower levels of binocularity on the first postoperative day. The mean interval between surgery and first occurrence of full stereovision was 18 months (range, 2 to 58 months).
Conclusions:
General features of AACE type 2 are concomitance of strabismus, absence of an accommodative component even in the presence of hyperopic refractive errors, and no neurological pathology. The potential for normal binocular vision plays a key role in defining this entity. The reemergence of full stereopsis may take several years.