Ivey Eye Institute, Department of Ophthalmology, Western University, London, Ont..
Ivey Eye Institute, Department of Ophthalmology, Western University, London, Ont.
Can J Ophthalmol. 2018 Feb;53(1):45-48. doi: 10.1016/j.jcjo.2017.07.021. Epub 2017 Sep 25.
To describe the presentation, clinical evaluation, work-up, surgical management, and surgical outcomes in children older than 8 years with spontaneous, comitant, acquired nonaccommodative esotropia (ANAET).
Retrospective chart review.
Children who underwent bilateral medial rectus recession surgery for ANAET with initial esotropia onset later than 8 years of age.
The medical records of children older than 8 years presenting with ANAET from 2009 to 2015 were retrospectively reviewed. The clinical presentation, work-up, surgical intervention, preoperative and postoperative deviations, and surgical outcomes were recorded.
A total of 7 healthy patients were identified. The average age of onset was 11.9 years. All patients presented with symptoms of diplopia with large-angle esotropia. Most patients had no preceding illness and presented with minimal refractive error. All 7 patients had unremarkable neurological and general pediatric evaluations without findings of acute intracranial pathology on neuroimaging. Bilateral medial recession surgery was performed for all 7 patients with resolution of diplopia and excellent stereopsis postoperatively.
Diplopia is the most common presenting symptom among older children presenting with ANAET. Bilateral medial recession surgery achieved excellent postoperative results with resolution of diplopia and excellent stereopsis.
描述 8 岁以上儿童自发性、共同性、获得性非调节性内斜视（ANAET）的发病表现、临床评估、检查、手术处理和手术结果。
回顾性病历研究。
8 岁以上因 ANAET 行双眼内直肌后退术的儿童，且最初内斜视发病年龄晚于 8 岁。
回顾性分析 2009 年至 2015 年间患有 ANAET 的 8 岁以上儿童的病历。记录临床发病表现、检查、手术干预、术前和术后斜视度以及手术结果。
共纳入 7 例健康患者。发病的平均年龄为 11.9 岁。所有患者均有复视和大角度内斜视的症状。大多数患者既往无疾病史，表现为最小的屈光不正。所有 7 例患者的神经学和一般儿科评估均未见异常，神经影像学检查也未发现急性颅内病变。所有 7 例患者均行双眼内直肌后退术，术后复视消失，立体视良好。
复视是年龄较大的 ANAET 患儿最常见的发病表现。双眼内直肌后退术可有效缓解复视，获得良好的术后立体视。
