Acute acquired concomitant esotropia associated with myopia: is the condition related to any binocular function failure?

Ruatta, Celeste; Schiavi, Costantino

doi:10.1007/s00417-020-04818-1

Cited by 23 publications

(41 citation statements)

References 16 publications

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“…In fact both SES and HMCE show Magnetic Resonance Imaging degeneration of the superior-lateral rectus band with a consequent lateral rectus inferiorly dislocation. (13) The classic Heavy Eye Syndrome, HES, or strabismus xus shares the same pathogenesis, a nasal displacement of the superior rectus muscle and an inferior displacement of the lateral rectus muscle, but with a superotemporal quadrant posterior globe prolapse (16,17,18,19) The pathogenesis of diplopia in Group C remains uncertain but it seems to be different from the assumed anatomical cause of Groups E and F. Patient of Group C showed a signi cantly higher incidence of acute constant diplopia onset and a signi cantly higher near divergence FA, according to other reports (7) . Other Authors reported a higher accommodative convergence to accommodation ratio (AC/A) in these patients (20) A large proportion of the whole sample showed angle increasing at PAT test, 75% of the total sample, with no signi cant differences between different groups.…”

Section: Mono Xation Syndrome (Mfs) Is a Horizontal Strabismus Characterized By A Small Angle Of Deviation (Less Than <8 Prism Diopters [mentioning

confidence: 86%

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Acute Diplopia of Non-neurological/restrictive Etiology: a Retrospective Comparative Study.

Savino

Scampoli

Piccinni

et al. 2021

Preprint

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PurposeTo describe and compare the clinical features and management of different types of acute diplopia of non-neurological/restrictive etiology.MethodsRetrospective comparative study carried out reviewing medical records of forty-eight patients referred to one tertiary referral center between January 2016 and June 2020.Thirty-two were classified as Acute Acquired Comitant Esotropia (AACE), 3 cases as type I (group A), 12 cases as type II (group B) and 17 cases as type III (group C). Four cases were classified as Decompensated MonoFixation Syndrome (DMFS) (group D), 6 cases as High Myopia-Comitant Esotropia (HMCE) (group E) and 6 cases as Sagging Eye Syndrome (SES) (group F). Patients with diplopia of neurological or restrictive etiology were excluded.All patients underwent a complete orthoptic and ophthalmologic assessment with a postoperative follow-up of 11.4 ± 4.1 months (ranging from 5 to 20 months).ResultsType 3 AACE (Group C) was the most frequent cause of diplopia among the groups (35.4%). High Myopia-Comitant Esotropia (Group E) and Sagging Eye Syndrome (Group F) were significantly older at onset and baseline examination (both P= .001). Constant acute onset was significantly more represented in Group C (P= .026) while all patients in Group F showed an intermittent onset. Near angle of deviation was significantly lower in Group E and Group F compared to Group C (P= .030). A significantly higher near divergence fusion amplitude was detected in Group C (P= .017). Compensation (angle of deviation increasing) at Prism Adaptation Test (PAT) was observed in 75% of total study population, without significant differences among group. Fifty-four % of the total sample underwent surgery as first or secondary treatment choice with good functional results regardless of pathogenesis.ConclusionDemographic characteristics and clinical features (refraction, type of diplopia at onset, angle deviation, fusion amplitudes, response to prismatic correction) can differentiate different types of acute or subacute onset diplopia of not neurological/restrictive etiology.

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Section: Mono Xation Syndrome (Mfs) Is a Horizontal Strabismus Characterized By A Small Angle Of Deviation (Less Than <8 Prism Diopters [mentioning

confidence: 86%

“…Other reports showed a higher myopic range, with a case of 17.5 diopters spherical equivalent, but with a mean value of 4.4 SE, normal ocular motility, normal AC/A ratio and normal divergence motor fusion. (7) For this reasons we included the patients with high myopic SE ( > 8 SE) in a different group (Group E)…”

Section: Discussionmentioning

confidence: 99%

Acute Diplopia of Non-neurological/restrictive Etiology: a Retrospective Comparative Study.

Savino

Scampoli

Piccinni

et al. 2021

Preprint

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“…Acute acquired concomitant esotropia (AACE) is characterized by a sudden onset of concomitant esotropia with diplopia in older children and adults [ 1 – 3 ]. Although AACE is rare, its occurrence has been increasing in recent years; this phenomenon has been associated with excessive near work use of smartphones and other screens [ 4 – 6 ].…”

Section: Introductionmentioning

confidence: 99%

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Feng

et al. 2022

BMC Ophthalmol

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Background This study aimed to assess the efficacy of prismatic treatment in a step-by-step manner to reduce prismatic strength in acute acquired concomitant esotropia (AACE) of 25 prism diopters (PD) or less. Methods In this retrospective comparative study, 36 patients with AACE with deviation angle ≤ 25 PD were treated with Fresnel prism in a step-by-step manner to reduce prismatic strength. The patients were divided into two groups according to whether they regained orthophoria and were weaned off the press-on prisms within 1 year: (1) the treatment-success group, which consisted of patients who had their esotropia eliminated and were weaned off the press-on prisms within 1 year after prism correction, and (2) the treatment-continuing group, which comprised patients who needed to continue wearing a Fresnel prism at 1 year after the beginning of prismatic correction because diplopia and esotropia still existed. Clinical characteristics and cooperation were analyzed and compared between groups. Results Fourteen of 36 patients (38.9%) were weaned off the prism and regained orthophoria and binocular single vision within 1 year after prismatic treatment. Compared with the treatment-continuing group, the treatment-success group showed smaller deviation at near and distant fixations (P = 0.024 and P = 0.006, respectively) measured at the beginning of prismatic correction, a shorter time from onset to prismatic treatment (P = 0.02), and a greater percentage of patients exhibiting good cooperation (P < 0.001). Conclusions Prismatic treatment in a step-by-step manner to reduce prismatic strength can lead to good outcomes of motor alignment and binocular function in patients with AACE of 25 PD or less. Patients showing good cooperation, smaller angle of esotropia, and shorter duration from onset to treatment tend to eliminate esotropia and be weaned off press-on prisms within 1 year after prismatic correction.

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“…Acute acquired concomitant esotropia (AACE) is a relatively rare subtype of esotropia that can develop in older children (> 5 years), adults, and older adults [1][2][3]. Burian and Miller [4] in 1958 de ned three main types: (1) Type-I AACE (Swan type) occurs due to the disruption of fusion precipitated by monocular occlusion or impaired vision in one eye; (2) Type-II AACE (Burian-Franceschetti type) is de ned by large deviation, mild hyperopia, and minimal accommodative element.…”

Section: Introductionmentioning

confidence: 99%

“…The exact mechanism underlying this prevalent type of AACE is not fully understood. Several potential risk factors for Type III AACE have been proposed, including fusion dysfunction and disruption, esophoria, myopia, and anatomical structures [1][2][3][6][7][8]. However, uncorrected myopia as a risk factor for Type III AACE is still controversial.…”

Section: Introductionmentioning

confidence: 99%

Independent Risk Factors for Type III Acute Acquired Concomitant Esotropia: A Matched Case-Control Study

Jing-jin¹,

Chen²,

Lin³

et al. 2021

Preprint

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Background: Acute acquired concomitant esotropia (AACE) is a relatively rare subtype of esotropia that can develop in older children (>5 years) and adults. The etiology of AACE is unknown, but there have been case studies describing risk factors. This study applied multiple regression analysis to explore risk factors and the impact of this subtype's surgical design esotropia and to gain insights into pathogenesis. Methods: Patients with Type III AACE and healthy controls, who were matched for age (±5 years) and refractive diopter (±1 D), were included in this study. All patients were treated between March 2018 to September 2020. We collected information on the number of hours spent performing near work per day, whether the patient wore glasses, and the refractive diopter of both the eyes. We also determined the deviation angles at both near- and far-vision in these individuals. Additionally, we measured the distance from the medial rectus insertion to the limbus in surgical patients.Results: Patients (n=51) with Type III AACE and sixty healthy control persons (n=60) were included in the study. We found that 99.96% of cases and 91.67% of controls had myopia. Among them, 60.8% of cases and 20.0% of controls did not wear glasses for near work. Twelve cases were treated with a prism, and thirty-nine were treated surgically. The average time devoted to near work per day was 7.24±1.91 (range: 4-12) hours and 3.7±1.29 (range: 2-7) in cases and controls, respectively. In univariate and multivariate logistic regression models, Type III AACE was significantly associated with increased hours of near work per day and near work without wearing glasses.Conclusions: Increased hours of near work per day and myopic patients performing near work without glasses are independent risk factors of Type III AACE. A satisfactory result can be obtained by optimizing the foot correction with the maximum and the most stable angles before operation.

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Acute acquired concomitant esotropia associated with myopia: is the condition related to any binocular function failure?

Cited by 23 publications

References 16 publications

Acute Diplopia of Non-neurological/restrictive Etiology: a Retrospective Comparative Study.

Acute Diplopia of Non-neurological/restrictive Etiology: a Retrospective Comparative Study.

Prismatic treatment of acute acquired concomitant esotropia of 25 prism diopters or less

Independent Risk Factors for Type III Acute Acquired Concomitant Esotropia: A Matched Case-Control Study

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