Emory University School of Medicine, Atlanta, GA.
Colorado Permanente Medical Group, Denver, CO.
Strabismus. 2022 Sep;30(3):115-120. doi: 10.1080/09273972.2022.2097707. Epub 2022 Jul 7.
Age-related distance esotropia (ARDET) is characterized by an esodeviation greater at distance than near in older aged patients and generally managed with prism spectacles or surgery. The purpose of this study is to describe the prevalence, clinical characteristics, and natural history of age-related distance esotropia in a defined population. The medical records of all adult (≥19 years of age) residents of Olmsted County, Minnesota, diagnosed with an esodeviation at least 2 prism diopters (PD) greater at distance than near, from 1 January 1985, through 31 December 2004, were retrospectively reviewed. Seventy-three (9.7%) of 751 new cases of adult-onset strabismus were diagnosed with age-related distance esotropia during the 20-year period. The mean age of onset was 70 years (range, 19 to 93 years) and 48 (65.8%) were female ( = .007). The mean angle of esodeviation was 7.6 (range, 2 to 20) prism diopters (PD) at distance and 0.4 (range, 10 PD of XT to 12 PD of ET) PD at near. The Kaplan-Meier rate of progression, as defined by a ≥ 6 prism diopter (PD) increase in esotropia, was 50% by 15 years after diagnosis. Half of the patients had hypertension, while one-third had coronary artery disease or other cardiac comorbidities. Age-related distance esotropia comprised 1 in 10 adults with new-onset strabismus in this population and was significantly more common among women. Hypertension and cardiovascular disease may be risk factors for this form of strabismus, and approximately half of the patients worsened over a 15-year period.
年龄相关的远距离内斜视（ARDET）的特征是，在年龄较大的患者中，远距离的斜视度大于近距离，通常采用棱镜眼镜或手术治疗。本研究的目的是描述在一个特定人群中年龄相关的远距离内斜视的患病率、临床特征和自然史。回顾性分析了明尼苏达州奥姆斯特德县所有成年人（≥19 岁）的医疗记录，这些成年人在 1985 年 1 月 1 日至 2004 年 12 月 31 日期间被诊断出至少有 2 棱镜度（PD）的远距离内斜视。在 20 年的时间里，73 例（9.7%）新诊断的成人发病斜视患者被诊断为年龄相关的远距离内斜视。发病的平均年龄为 70 岁（范围为 19 至 93 岁），48 例（65.8%）为女性（ = .007）。远距离斜视的平均斜视角度为 7.6（范围为 2 至 20）PD，近距离斜视的平均斜视角度为 0.4（范围为 XT 10 PD 至 ET 12 PD）。根据斜视度增加≥6 棱镜度（PD）的定义，诊断后 15 年内进展的 Kaplan-Meier 率为 50%。一半的患者患有高血压，三分之一的患者患有冠状动脉疾病或其他心脏合并症。在该人群中，年龄相关的远距离内斜视占新发斜视成年人的 1/10，在女性中更为常见。高血压和心血管疾病可能是这种斜视的危险因素，大约一半的患者在 15 年内病情恶化。
