Mohan Kanwar, Sharma Ashok
Squint Centre, Chandigarh, India.
J AAPOS. 2012 Jun;16(3):266-8. doi: 10.1016/j.jaapos.2012.01.003.
To determine the clinical characteristics of children with pseudoesotropia who later develop refractive accommodative esotropia.
We retrospectively reviewed the records of consecutive patients diagnosed with pseudoesotropia from 2003 to 2010. Inclusion criteria included age 3 years or younger at the time of diagnosis, history of strabismus, verifiable positive or negative family history of strabismus, hypermetropia detected with atropine refraction, prism and cover test measurements performed with and without refractive correction at follow-up visits, and a minimum follow-up of 1 year.
A total of 51 children met inclusion criteria (average age, 1.48 ± 0.79 years; range, 3-36 months; mean follow-up, 2.9 years). Refractive accommodative esotropia developed in 15.7% of the children at a mean age of 2.78 ± 1.06 years. It developed in 53.9% of the children with pseudoesotropia who had >1.50 D of hypermetropia compared to 2.6% of those who had ≤ 1.50 D hypermetropia (P = 0.0001). A positive family history of strabismus (P = 0.193) and initial age at presentation with pseudoesotropia (P = 0.571) were not predisposing factors.
Children aged ≤ 3 years diagnosed with pseudoesotropia should undergo cycloplegic refraction. If >1.50 D hypermetropia is detected, patients should be monitored for the development of refractive accommodative esotropia.
确定后来发展为屈光性调节性内斜视的假性内斜视儿童的临床特征。
我们回顾性分析了2003年至2010年连续诊断为假性内斜视患者的病历。纳入标准包括诊断时年龄3岁及以下、斜视病史、可证实的斜视阳性或阴性家族史、用阿托品验光检测出的远视、随访时在有和无屈光矫正情况下进行的棱镜遮盖试验测量，以及至少1年的随访。
共有51名儿童符合纳入标准（平均年龄1.48±0.79岁；范围3 - 36个月；平均随访2.9年）。15.7%的儿童在平均年龄2.78±1.06岁时发展为屈光性调节性内斜视。在远视度数>1.50 D的假性内斜视儿童中，53.9%发展为此种斜视，而在远视度数≤1.50 D的儿童中这一比例为2.6%（P = 0.0001）。斜视家族史阳性（P = 0.193）和假性内斜视初发时的年龄（P = 0.571）不是诱发因素。
诊断为假性内斜视的3岁及以下儿童应进行睫状肌麻痹验光。如果检测出远视度数>1.50 D，应对患者进行监测，观察是否发展为屈光性调节性内斜视。
