Sreelatha O K, Al-Marshoudi Hajar Ali, Mameesh Maha, Al Zuhaibi Sana, Ganesh Anuradha
Department of Ophthalmology, Directorate of Health Services, Thiruvananthapuram, Kerala, India.
Department of Ophthalmology, College of Medicine and Health Sciences, Sultan Qaboos University, Seeb, Oman.
Oman J Ophthalmol. 2022 Nov 2;15(3):274-278. doi: 10.4103/ojo.ojo_80_22. eCollection 2022 Sep-Dec.
The aim of this study is to determine the outcome of accommodative esotropia (ET) and influencing factors in young Omani children.
In this retrospective cohort, children diagnosed with accommodative ET who had followed up in a tertiary hospital from 2006 to 2011 were identified. Parameters studied included cycloplegic refraction and its change with time, ocular alignment, binocularity, visual acuity (VA), amblyopia, and requirement for surgery.
A total of 51 patients were identified. Twenty-four patients were diagnosed with fully accommodative ET (FAET) and 27 with partially accommodative ET (PAET). The mean (± standard deviation [SD]) age of onset and reporting were 2.6 (±1.58) and 3.2 (±1.84) years in the two groups, respectively. The mean (SD) cycloplegic refraction at presentation was 4.50 (±1.66) in the FAET group and 3.65 (±1.67) in the PAET group. Anisometropia was present in 28% of patients. The mean follow-up period was 4.9 years. The following were detected in the final visit. A reduction in amblyopia from 43% to 6% of patients, binocularity in 75% of patients, and a mean increase of 0.64 (±1.3) D in cycloplegic refraction from the first visit ( = 0.005). The mean angle of deviation at near and distance was 29.86 (±15.21) and 17.80 (±10.14) prism diopters, respectively, in FAET patients and 30.15 (±14.83) and 29.53 (±15.53), respectively, in PAET patients. Thirty-seven percent of the PAET patients underwent surgery within 5 years from diagnosis. All participants in this cohort continued to wear glasses in the last follow-up visit.
Most children with refractive accommodative ET have an excellent outcome in terms of VA and binocular vision. The PAET group was characterized by delayed reporting, the presence of anisometropia, and lower hypermetropia. Further study is required to determine the possibility of weaning glasses in FAET patients.
本研究旨在确定阿曼幼儿调节性内斜视（ET）的治疗结果及影响因素。
在这项回顾性队列研究中，确定了2006年至2011年在一家三级医院接受随访的被诊断为调节性ET的儿童。研究参数包括睫状肌麻痹验光及其随时间的变化、眼位、双眼视、视力（VA）、弱视以及手术需求。
共确定了51例患者。24例患者被诊断为完全调节性ET（FAET），27例为部分调节性ET（PAET）。两组的平均（±标准差[SD]）发病年龄和报告年龄分别为2.6（±1.58）岁和3.2（±1.84）岁。FAET组初诊时的平均（SD）睫状肌麻痹验光度数为4.50（±1.66），PAET组为3.65（±1.67）。28%的患者存在屈光参差。平均随访期为4.9年。在末次随访时发现以下情况。弱视患者比例从43%降至6%，75%的患者获得双眼视，睫状肌麻痹验光度数较初诊时平均增加0.64（±1.3）D（P = 0.005）。FAET患者近距和远距的平均斜视度分别为29.86（±15.21）和17.80（±10.14）棱镜度，PAET患者分别为30.15（±14.83）和29.53（±15.53）。37%的PAET患者在诊断后5年内接受了手术。该队列中的所有参与者在最后一次随访时仍继续佩戴眼镜。
大多数屈光性调节性ET患儿在视力和双眼视方面预后良好。PAET组的特点是报告延迟、存在屈光参差和远视度数较低。需要进一步研究以确定FAET患者停用眼镜的可能性。
