von Noorden G K
Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.
Am J Ophthalmol. 1988 Jan 15;105(1):1-10. doi: 10.1016/0002-9394(88)90113-4.
Essential infantile esotropia is an early acquired, not a congenital, condition, although congenital factors may favor its development between the ages of 3 and 6 months. It must be distinguished from other forms of esotropia with an onset between birth and the first six months of life. The cause of essential infantile esotropia remains unknown, but advances in our knowledge can be expected from the rapidly emerging discipline of infant psychophysics. In analyzing treatment results, a clear distinction must be made between normal, subnormal, and anomalous forms of binocular cooperation. While complete restoration of normal binocular function is rarely, if ever, achieved, anomalous binocular cooperation has many functional advantages over suppression or diplopia and should not be disturbed by overzealous treatment. Subnormal binocular vision is considered to be an optimal, microtropia a desirable, and a residual small angle heterotropia an acceptable end stage of surgical therapy. In a study of 358 surgically treated patients with a documented onset of essential infantile esotropia before age 6 months, subnormal binocular vision was present in 71 (20%), a microtropia in 25 (7%), and a small angle esotropia or exotropia in 140 (39%) of the patients. Surgical alignment before completion of the second year of life improved the chances for an optimal treatment result.(ABSTRACT TRUNCATED AT 250 WORDS)
先天性婴儿内斜视是一种早期获得性而非先天性疾病，尽管先天性因素可能有利于其在3至6个月龄时发展。必须将其与出生至出生后前六个月内发病的其他形式的内斜视区分开来。先天性婴儿内斜视的病因尚不清楚，但随着婴儿心理物理学这一迅速兴起的学科的发展，我们有望在知识上取得进展。在分析治疗结果时，必须明确区分双眼合作的正常、亚正常和异常形式。虽然很少能完全恢复正常的双眼功能，但异常的双眼合作比抑制或复视有许多功能优势，不应因过度积极的治疗而受到干扰。亚正常双眼视觉被认为是手术治疗的最佳、微小斜视是理想的，而残余小角度斜视是可接受的终末期。在一项对358例记录在案的6个月龄前发病的先天性婴儿内斜视手术治疗患者的研究中，71例（20%）存在亚正常双眼视觉，25例（7%）存在微小斜视，140例（39%）存在小角度内斜视或外斜视。在生命的第二年结束前进行手术矫正，可提高获得最佳治疗效果的机会。（摘要截短至250字）
