Long-term evolution of age-related distance esotropia

To evaluate the evolution of horizontal deviation and fusional amplitudes both at distance and at near in patients with age-related distance esotropia (ARDET).

The medical records of consecutive patients diagnosed with ARDET between January 2008 and March 2016 were reviewed retrospectively. Patients with at least 60 months' follow-up were eligible for inclusion. Horizontal deviation, fusional convergence amplitude, and fusional divergence amplitude both at distance and at near were compared.

Of 131 cases reviewed, 31 patients were identified for inclusion. Median age at diagnosis was 73 years. Median distance esodeviation was 6^Δ esotropia at initial examination (range, 2^Δ-12^Δ esotropia) and 8^Δ eostropia at final examination (range, 2^Δ-25^Δ esotropia). Median near deviation was orthophoria at initial examination (range, 10^Δ exophoria to 8^Δ esophoria) and 4^Δ esophoria at final examination (range, 4^Δ exophoria to 14^Δ esophoria). Median fusional divergence amplitude at distance was 4^Δ at initial and at final examinations. At near, median fusional divergence amplitude was 8^Δ at initial and at final examinations. Median fusional convergence amplitude at distance was 14^Δ at initial examination and 12^Δ at final examination. At near, median fusional convergence amplitude was 26^Δ at initial and at final examinations. Base-out prisms were prescribed in all patients. In 23 patients the prism correction gradually increased. Strabismus surgery was performed in 3 patients.

Our patients with ARDET experienced a slight increase in distance esodeviation (P < 0.001), whereas no significant change in fusional amplitudes was observed over time (P ≥ 0.05).