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Published on: March 29, 2022
Clinical features of acute acquired comitant esotropia in the Chinese populations
Tao Fu1, Jing Wang, Moran Levin
1aBeijing Ophthalmology and Visual Science Key Lab, Beijing Tongren Hospital, Capital Medical University, Beijing, China bUniversity of Maryland Medical Center, Baltimore, MD cDepartment of Neurobiology and Beijing Institute for Brain Disorders, Capital Medical University, Beijing, China.
Insights
Acute acquired comitant esotropia (AACE) predominantly affects older children and adults in China. Younger patients show hypermetropia, while older individuals exhibit myopia, with disease duration not impacting binocularity.
Area of Science:
- Ophthalmology
- Strabismus Research
- Pediatric Ophthalmology
Background:
- Acute acquired comitant esotropia (AACE) is an uncommon form of esotropia presenting after infancy.
- Understanding AACE's clinical features across different age groups is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the clinical characteristics of AACE in a Chinese population.
- To compare AACE presentation and outcomes between pediatric and adult patients.
Main Methods:
- Retrospective analysis of 69 AACE patients over 4 years.
- Patients categorized into three age groups: <10, 10-18, and ≥18 years.
- Evaluations included medical history, neuroimaging, and ophthalmological/orthoptic examinations.
Main Results:
- AACE was more prevalent in older children (33.3%) and adults (58.0%).
- Younger children (<10 years) presented with mild hypermetropia, while older patients showed moderate-to-high myopia (P<.001).
- Younger children had larger esotropia angles (P=.005); binocularity and stereopsis were not significantly affected by disease duration.
Conclusions:
- AACE in Chinese populations primarily affects older children and adults.
- Refractive error patterns differ by age: hypermetropia in the young, myopia in older individuals.
- Preoperative binocularity is not influenced by the time from AACE onset to treatment.
Abstract:
Acute acquired comitant esotropia (AACE) is an unusual presentation of esotropia that occurs after infancy. This study was aimed to study the clinical features and the differences between children and adult patients with AACE in the Chinese populations.This was a retrospective analysis of patients diagnosed with AACE over 4 years; 69 patients (25 females and 44 males) were identified. The patients were divided into 3 groups: < 10 year-old (n = 6, 8.7%), 10-18 year-old (n = 23, 33.3%), and ≥18 year-old (n = 40, 58.0%). Patients underwent medical history, brain and orbital computed tomography, and ophthalmological and orthoptic examinations.The refractions of AACE patients varied among age groups: patients < 10 year-old had mild hypermetropia, while older children and adults showed moderate-to-high myopia (P < .001). The mean angles of esotropia were significantly larger in young children compared with older children and adults (P = .005). There was no significant difference in binocularity detected by either synoptophore or TNO stereoscopic testing among different disease durations. Stereopsis detected by synoptophore and TNO testing showed no significant difference at duration within half a year, but the stereopsis measured by TNO was significantly worse than that detected by synoptophore with extending disease duration (P < .05).AACE seems to occur mostly in older children and adults in the Chinese population. Younger children with AACE seem to demonstrate a common trait of mild hypermetropic refractive errors, while myopia can be seen in older children and adult patients. The duration from onset to treatment of esotropia does not affect the preoperative binocularity.
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