Esotropia and Exotropia Preferred Practice Pattern®

Wallace, David K.; Christiansen, Stephen P.; Sprunger, Derek T.; Melia, Michele; Lee, Katherine A.; Morse, Christie L.; Repka, Michael X.

doi:10.1016/j.ophtha.2017.10.007

Cited by 30 publications

(37 citation statements)

References 200 publications

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“…Twenty‐eight patients with XT between 14 to 40 years of age, and 27 age‐ and sex‐ matched healthy controls were recruited from 1 March 2019 to 30 June 2019. Inclusion criteria were 1) intermittent or constant XT, 21 with exodeviation angles between 15 Δ and 80 Δ ; 2) no history of strabismus surgery; 3) coexisting vertical deviation ≤ 5 Δ . Exclusion criteria were (1) amblyopia (i.e., an interocular difference in visual acuity of less than 0.2 logMAR and best‐corrected visual acuity of 0.1 logMAR or worse, in one or both eyes); (2) anisometropia greater than 2.50D; (3) high myopia or hyperopia > 6.00D spherical equivalent; (4) incomitant or acquired strabismus; (5) neurological disorders or psychiatric diseases.…”

Section: Methodsmentioning

confidence: 99%

Disrupted neural signals in patients with concomitant exotropia

Yao

Zhang

et al. 2020

Ophthalmic Physiologic Optic

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Purpose Decreased binocular and oculomotor function in strabismics has recently been considered as cortical in origin. This study aimed to investigate functional abnormalities using a frequency‐specific neuroimaging method in patients with concomitant exotropia (XT), and to demonstrate the clinical implications. Methods Resting‐state functional magnetic resonance imaging data were collected in 26 XT patients and 26 matched controls. To evaluate the local spontaneous neural activity, the amplitude of low frequency fluctuations (ALFF) was calculated in the typical frequency band (0.01–0.08 Hz) as well as five narrowly‐defined frequency bands (slow‐6: 0–0.01 Hz, slow‐5: 0.01–0.027 Hz, slow‐4: 0.027–0.073 Hz, slow‐3: 0.073–0.167 Hz, and slow‐2: 0.167–0.25 Hz), respectively. Results Patients with XT showed decreased ALFF in the bilateral parieto‐occipital sulcus (POS), and increased ALFF in the bilateral thalamus within the typical frequency band. Frequency‐dependent ALFF alterations were found in the higher visual areas such as the right lateral occipital complex (LOC). Furthermore, ALFF in the right LOC in the slow‐5 band was positively correlated with fusion control score (r = 0.70, p < 0.0001) and binocular function score (r = 0.67, p = 0.0002). Regression analyses showed that early age of onset remained the only significant explanatory factor for ALFF reduction in the right POS in the typically‐measured frequency band (also referred to as the typical frequency band) (Odds ratio, 0.038; 95% confidence interval, 0.001 to 0.075). Conclusions Our findings provide spatial information regarding the functionally disrupted regions in XT. Moreover, the frequency‐dependent ALLF alteration in the right LOC might reflect a potential plastic capacity in binocular function, which could be a potential objective index for evaluating disease severity.

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Section: Methodsmentioning

confidence: 99%

Disrupted neural signals in patients with concomitant exotropia

Yao

Zhang

et al. 2020

Ophthalmic Physiologic Optic

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“…Depending upon the clinic-etiological features, primary exotropia was classified into basic non-specific type (exotropia approximately equal for near and distance), convergence insufficiency type (exotropia greater for near than distance, ≥10 prism diopters [PD]), and divergence excess (exotropia greater for distance than near, ≥10 PD). Esotropia was classified into accommodative esotropia (due to overaction of convergence associated with accommodation reflex) and non-accommodative esotropia (all those primary esodeviations in which the amount of deviation is not affected by the state of accommodation and roughly equal in amount at distance and near fixation) [14].…”

Section: Diseases Definition and Classificationmentioning

confidence: 99%

Prevalence and associated risk factors for childhood strabismus in Lhasa, Tibet, China: a cross-sectional, school-based study

Meng

et al. 2020

BMC Ophthalmol

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Background To estimate the prevalence of strabismus and associated risk factors among grade one school children in Lhasa, Tibet, China. Methods The Lhasa Childhood Eye Study (LCES) was a cross-sectional, school-based childhood study conducted in Grade one students from primary schools in Lhasa, Tibet, China. Comprehensive ophthalmic examinations and basic systemic examinations were evaluated. A questionnaire survey containing information about children, as well as parents’ information, was sent to the corresponding parents of eligible children. The prevalence of strabismus and its 95% confidence interval was estimated. Univariate and multivariate logistic regression analyses were conducted to determine the associated risk factors. Results A total of 1942 eligible grade one students were enrolled, of which 1856 participants completed all examinations. The average age was 6.83 ± 0.46 years, 53% of participants were boys and 1762 were the Tibetan Minority. Over all, the prevalence of strabismus was 68/1856 (3.7%) (95%CI: 2.81,4.52), with no difference between the ages, genders, ethnicities and body mass index, while tilting one’s head when writing may be a risk factor for strabismus (P = 0.004). Strabismus students had mean best corrected visual acuity of 0.16 ± 0.28(LogMAR), over 50% patients with esotropia were hyperopic, and participants who had stereopsis impairments showed a significant difference between esotropia and exotropia (P = 0.026). Conclusions The prevalence of strabismus in LCES was 3.7%, which is higher than previous reports from Chinese childhood epidemiology studies. Strabismus is a common contributing factor to amblyopia. Tilting one’s head when writing may be a risk factor. Esotropia is more likely to affect stereopsis and be associated with the refractive state of hyperopia. Trial registration The study has finished the clinical registration on Chinese Clinical Trial Registry. (http://www.chictr.org.cn, ChiCTR1900026693).

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“… 6 Early detection and prompt management of strabismus in children is vital as it can improve their long-term visual and sensorimotor outcomes. 7 It has been reported that strabismus is the most common cause of childhood amblyopia. 8 , 9 Children with apparent strabismus may also be subject to psychosocial sequelae, such as lower self-confidence and self-esteem anxiety.…”

Section: Introductionmentioning

confidence: 99%