J Pediatr Ophthalmol Strabismus. 2023 May;60(3):218-225. doi: 10.3928/01913913-20220630-01. Epub 2022 Aug 8.
To report the clinical presentations, neuroimaging findings, and surgical outcomes in patients with acute acquired non-accommodative comitant esotropia (AACE).
A retrospective review of records of all patients diagnosed as having AACE between January 2011 and December 2019 across three tertiary eye care centers was done. Cases with AACE onset after age 1 year were included. Patients were divided into two groups based on age of onset of esotropia: childhood (16 years or younger) and adult (older than 16 years). Surgical success was defined as postoperative horizontal deviation of 8 prism diopters (PD) or less at the last follow-up visit.
A total of 338 patients (220 males and 119 females; mean age at presentation: 12.60 ± 9.8 years) met the study criteria. The mean age at onset of esotropia in the childhood and adult onset groups was 3.61 ± 1.1 and 26.6 ± 8.7 years, respectively. There were significantly more individuals with myopia (30%) in the adult onset group compared to the childhood onset group (6%) ( = .004). Thirty-seven (16%) had positive neuroimaging findings (16.4% adult onset vs 9.4% childhood onset). A total of 148 (44%) patients underwent surgery for esotropia, and the overall success rate was 73%. Mean preoperative esotropia was comparable in either group ( = .20), but surgical success was better in the adult onset group (75.6% vs 66.3% in the childhood onset group). Mean duration of follow-up postoperatively was 13.6 ± 12 months.
Two-thirds of the patients had childhood onset of AACE. Intracranial pathology was found in 1 of 6 patients. Surgical success was better in the adult onset group, which was not influenced by preoperative esotropia, neuroimaging findings, or refractive status, but was dependent on age at onset of esotropia and duration between onset and intervention. .
报告急性获得性非调节性共同性内斜视（AACE）患者的临床表现、神经影像学发现和手术结果。
对 2011 年 1 月至 2019 年 12 月期间在三个三级眼科中心诊断为 AACE 的所有患者的记录进行回顾性分析。包括斜视发病年龄 1 岁后的病例。根据斜视发病年龄将患者分为两组：儿童（16 岁或以下）和成人（16 岁以上）。手术成功定义为最后一次随访时术后水平斜视偏差 8 棱镜度（PD）或以下。
共有 338 名患者（220 名男性和 119 名女性；发病时平均年龄：12.60 ± 9.8 岁）符合研究标准。儿童组和成人组斜视发病年龄的平均值分别为 3.61 ± 1.1 岁和 26.6 ± 8.7 岁。成人组中患有近视（30%）的个体明显多于儿童组（6%）（ =.004）。37 名（16%）患者存在阳性神经影像学发现（成人组 16.4%，儿童组 9.4%）。共有 148 名（44%）患者因斜视接受手术，总成功率为 73%。两组患者术前斜视程度相当（ =.20），但成人组手术成功率更高（75.6%比儿童组 66.3%）。术后平均随访时间为 13.6 ± 12 个月。
三分之二的患者斜视发病年龄为儿童期。6 例患者中有 1 例发现颅内病变。成人组手术成功率较高，这不受术前斜视、神经影像学发现或屈光状态的影响，而与斜视发病年龄和发病至干预的时间间隔有关。
