Timing of congenital dacryostenosis resolution and the development of anisometropia
Ma Khin Pyi Son1, David O Hodge2, Brian G Mohney3
1College of Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA.
Insights
Early spontaneous resolution of infant dacryostenosis may increase the risk of anisometropia. Further research is needed to understand this link between dacryostenosis and vision development.
Area of Science:
- Ophthalmology
- Pediatric Medicine
- Public Health
Background:
- Dacryostenosis affects 10% of infants, with anisometropia noted in 10% of cases at age 1.
- Previous research indicated a link between dacryostenosis and anisometropia in infants.
Purpose of the Study:
- To investigate if early spontaneous resolution or surgical intervention for dacryostenosis impacts the risk of developing anisometropia in infants.
- To determine the relationship between the timing of dacryostenosis resolution and the incidence of anisometropia.
Main Methods:
- Retrospective review of 662 infant dacryostenosis cases at Mayo Clinic (1988-1992).
- Included 244 infants examined in ophthalmology, followed until 2011.
- Compared anisometropia rates (≥1 diopter difference) in infants with spontaneous resolution versus surgical intervention.
Main Results:
- 189 infants (77.5%) had spontaneous resolution at a mean age of 4.5 months; 55 (22.5%) underwent surgery at a mean age of 16 months.
- Anisometropia occurred in 9.0% of spontaneously resolved cases versus 3.6% of surgically treated cases (p=0.19).
- Earlier resolution showed a trend towards higher anisometropia rates, though not statistically significant.
Conclusions:
- Early spontaneous resolution of infantile dacryostenosis was associated with a higher, not lower, rate of anisometropia compared to later or surgical resolution.
- Further investigation is required to elucidate the connection between infantile dacryostenosis and the development of hyperopic anisometropia.
Background:
Anisometropia was recently shown to occur in 10% of infants diagnosed with dacryostenosis at a mean age of 1 year. The purpose of this study was to determine whether earlier (<1 year) spontaneous resolution or probing decreases the risk of anisometropia in infants with dacryostenosis.
Methods:
The medical records of all patients diagnosed as infants with dacryostenosis at Mayo Clinic, Rochester, Minnesota, USA, from 1 January 1988 to 31 December 1992 were retrospectively reviewed. Of 662 consecutive infants diagnosed with dacryostenosis, 244 (36.9%) were subsequently examined in the ophthalmology department and included in the study. Each of the study patients was followed through to 30 June 2011. The main outcome measure was the rate of anisometropia (≥1 dioptre between the two eyes) among those who spontaneously resolved and those who underwent surgery.
Results:
Among the 244 cases, 189 (77.5%) spontaneously resolved at a mean age of 4.5 months (range 0.3-35 months), and 55 (22.5%) underwent surgery at a mean age of 16 months (range 0-53 months). Anisometropia was diagnosed in 17 (9.0%) of the 189 who spontaneously resolved and in 2 (3.6%) of the 55 operated children (p=0.19). Although there was no significant trend, earlier resolution was associated with higher rates of anisometropia.
Conclusions:
Early spontaneous resolution of dacryostenosis was more likely to have a higher, not lower, rate of anisometropia than late spontaneous or surgical resolution. Further studies are warranted to clarify the relationship between infantile dacryostenosis and the development of hyperopic anisometropia.
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