Koç F, Ozal H, Firat E
SSK Ankara Eye Disease Hospital Ankara, Turkey.
Eye (Lond). 2003 Aug;17(6):707-10. doi: 10.1038/sj.eye.6700483.
To determine the frequency of > or =2.50 diopter (D) hyperopia in infantile esotropia with onset up to the age of 6 months and by evaluating the treatment results of these cases retrospectively, to find the factors that may help to differentiate early-onset accommodative esotropia from early-onset essential esotropia.
The charts of 256 patients with infantile esotropia were reviewed. Thirtyseven cases, with hyperopia of > or =2.50 D, no other systemic and neurologic disease, and at least 1 year of follow-up, were included in this study. The age at the start of therapy, refractive error, deviation angle, type of therapy (antiaccommodative therapy, surgery) and the presence of amblyopia, latent nystagmus, inferior oblique overaction, dissociated vertical deviation and cross-fixation were recorded for each case.
The prevalence of high hyperopia was found to be 14.4% (37/256) in infantile esotropia. In 18 of the cases (48.6%), antiaccommodative therapy alone was found to be adequate (Group I). In the remaining 19, although antiaccommodative therapy was found to decrease the deviation angle significantly (P<0.001), surgery was also required (Group II). Groups were compared with respect to age at the initial examination, refractive error, deviation angle, presence of amblyopia, anisometropia, and inferior oblique overaction, but no factor could be determined to predict the pure refractive ones (P>0.05). Essential infantile esotropia-associated findings did not help because they are rarely evident at the time of initial diagnosis.
Half of the high hyperopic infantile esotropes could be corrected fully by antiaccommodative therapy alone, while the remaining ones could also benefit significantly. It is strongly recommended to try spectacles at first in the treatment of infantile esotropia with hyperopia > or =2.5 D.
确定6个月及以内发病的婴儿型内斜视中远视度数≥2.50屈光度（D）的发生率，并通过回顾性评估这些病例的治疗结果，找出有助于鉴别早发性调节性内斜视和早发性先天性内斜视的因素。
回顾256例婴儿型内斜视患者的病历。本研究纳入了37例远视度数≥2.50 D、无其他全身性和神经系统疾病且至少随访1年的病例。记录每个病例的治疗开始年龄、屈光不正、斜视度数、治疗类型（抗调节治疗、手术）以及弱视、潜在性眼球震颤、下斜肌亢进、分离性垂直偏斜和交叉注视的情况。
发现婴儿型内斜视中高度远视的发生率为14.4%（37/256）。其中18例（48.6%）仅抗调节治疗就足够（I组）。其余19例中，虽然抗调节治疗可显著降低斜视度数（P<0.001），但仍需要手术（II组）。比较两组在初次检查时的年龄、屈光不正、斜视度数、弱视、屈光参差和下斜肌亢进情况，但未发现可预测单纯屈光性病例的因素（P>0.05）。先天性婴儿型内斜视相关表现并无帮助，因为它们在初次诊断时很少明显。
一半的高度远视婴儿型内斜视仅通过抗调节治疗即可完全矫正，其余病例也能显著获益。强烈建议在治疗远视度数≥2.5 D的婴儿型内斜视时首先尝试配戴眼镜。
