Brain abnormalities in infantile esotropia as predictor for consecutive exotropia

Area of Science:

• Ophthalmology
• Neurology
• Pediatrics

Background:

• Strabismus surgery aims to correct eye alignment, but complications like consecutive deviations can occur.
• Neurological factors, including white matter abnormalities, may impact motor and sensory fusion, affecting eye alignment control.
• White matter damage of immaturity (WMDI) is a specific brain injury affecting premature infants, potentially complicating surgical outcomes.

Purpose of the Study:

• To compare cerebral MRI findings in infantile esotropia patients who developed consecutive exotropia versus those with successful surgical outcomes.
• To investigate the association between specific MRI findings, particularly WMDI, and the occurrence of consecutive exotropia after strabismus surgery.

Main Methods:

• A comparative study involving 17 patients with consecutive exotropia (group 1) and a control group with successful surgical outcomes (group 2) after infantile esotropia surgery.
• Detailed recording and comparison of demographic, clinical, and cerebral MRI findings between the two groups.
• Analysis included age, refractive errors, angle of deviation, prematurity, and specific MRI abnormalities like WMDI, myelinization delay, and cerebellar hypoplasia.

Main Results:

• No significant differences were found in age, refractive errors, preoperative deviation angles, sex, consanguinity, prematurity, or fundus findings between the groups.
• White matter damage of immaturity (WMDI) was exclusively observed in the consecutive exotropia group (group 1).
• Other MRI findings included myelinization delay, septooptic dysplasia, and periventricular cysts in group 1, and cerebellar hypoplasia/atrophy and myelinization delay in group 2.

Conclusions:

• White matter damage of immaturity (WMDI) was present only in patients who developed consecutive exotropia after infantile esotropia surgery.
• These findings suggest that WMDI may be a significant risk factor for developing consecutive deviations in patients with infantile esotropia.
• Cerebral MRI evaluation can help identify potential risk factors for surgical complications in infantile esotropia.