Assessing Divergence in Children With Intermittent Exotropia

Liebermann, Laura; Hatt, Sarah R.; Yamada, Taro; Mohney, Brian G.; Brodsky, Michael C.; Holmes, Jonathan M.

doi:10.3109/09273972.2012.655838

Cited by 12 publications

(16 citation statements)

References 10 publications

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“…Another study in Chinese children showed similar results [ 17 ]. There was no significant correlation between divergence amplitude detected by prism bar and control score, which is similar to the findings by Liebermann et al ( r = −0.29, P = 0.11) [ 10 ].…”

Section: Discussionsupporting

confidence: 90%

“…Sharma et al reported reduced divergence amplitudes in IXT subjects that differed from the results of our present study [ 11 ]. Liebermann et al have reported that most children with IXT have normal near fusional divergence, but that nearly half had reduced distance fusional divergence [ 10 ]. They found that the distribution of fusional divergence break points in IXT was normal at near but bimodal at distance.…”

Section: Discussionmentioning

confidence: 99%

“…In their study, fusional vergence was measured using prisms to neutralize the strabismic deviation. Two other studies determined vergence from a state of spontaneous binocular fusion and have reported subnormal convergence reserves at distance [ 9 ] and normal near fusional divergence but reduced distance fusional divergence [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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Fusional Vergence Detected by Prism Bar and Synoptophore in Chinese Childhood Intermittent Exotropia

Wang

Levin

et al. 2015

Journal of Ophthalmology

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Purpose. To measure the changes in fusional vergence in Chinese children with intermittent exotropia (IXT) and the association with the control of IXT. Methods. Ninety-two patients with IXT (8–15 years old) were compared with 86 controls. Exodeviation control was evaluated using the Revised Newcastle Control Score. Angle of deviation was measured using prism and alternate cover testing at distance and near. Fusional vergence was measured using prism bar and synoptophore. This study was registered with ChiCTR-RCC-13003920. Results. Using prism bar, convergence break points were lower whereas divergence break points were higher in children with IXT at distance (P < 0.001) and near (P < 0.001) compared with controls. There was no significant difference in mean divergence amplitudes between the two groups when testing using a synoptophore (P = 0.53). In children with IXT, the distance between recovery point and break point in both convergence (distance: P = 0.02; near: P = 0.02) and divergence (distance: P < 0.001; near: P < 0.001) was larger than controls when detected by prism bar and synoptophore (convergence: P = 0.005; divergence: P = 0.006). Conclusions. Children with IXT have reduced convergence amplitudes as detected by both prism bar and synoptophore.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

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Fusional Vergence Detected by Prism Bar and Synoptophore in Chinese Childhood Intermittent Exotropia

Wang

Levin

et al. 2015

Journal of Ophthalmology

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“…However, adult subjects were included in the study, and fusion data were collected after the angle of deviation had been corrected using prisms. Furthermore, Liebermann et al (2012) believe that common measurement methods may not reveal the true divergence amplitudes. Most IXT patients have normal fusional divergence at near fixation, and approximately half show decreased fusional divergence at distance fixation.…”

Section: Discussionmentioning

confidence: 99%

Longitudinal Rehabilitation of Binocular Function in Adolescent Intermittent Exotropia After Successful Corrective Surgery

Peng

Zheng

et al. 2021

Front. Neurosci.

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PurposeTo study the longitudinal rehabilitation of binocular visual function in adolescent intermittent exotropia (IXT) after successful surgery and compare the results with those of a normal population. The role of binocular function in ocular alignment stability was also evaluated postoperatively.MethodsIn this prospective study, 30 adolescents with IXT successfully corrected after 1 month were followed for 12 months, and 30 children with normal vision were enrolled as controls. Stereopsis, the fusional vergence amplitude, sensory fusion, and accommodative flexibility were measured to assess binocular function at baseline and 6 and 12 months postoperatively. The controls were tested once when they were enrolled in the study.ResultsThe deviation was −32.00 ± 8.60 prism diopters (PD) at distance fixation and −36.0 ± 9.10 PD at near fixation preoperatively with an average correction of 28.53 ± 3.79 PD and 30.67 ± 1.34 PD at 1 month postoperatively. Distance stereoacuity and near stereoacuity improved from 1 to 12 months postoperatively (p = 0.025 and p = 0.041, respectively). Compared with the controls, the fusional convergence reserve at distance (p = 0.025) and near (p = 0.033) fixations and fusion reserve ratio at distance (p = 0.000) and near (p = 0.000) fixations remained subnormal, whereas sensory fusion (p = 0.237), distance stereopsis (p = 0.120), and the fusional divergence amplitude at a distance (p = 0.168) were normal. However, no significant correlations were found between binocular functions at 1 month postoperatively and the postoperative drift.ConclusionBinocular function significantly improved from before to after successful corrective surgery and continued to improve from 1 to 12 months postoperatively in adolescents with IXT. No significant correlations were found between binocular functions at 1 month postoperatively and ocular alignment stability.

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“…The authors speculate that fusional divergence may indicate how robust fusion is and have prognostic significance. 80…”

Section: Strabismusmentioning

confidence: 99%

One Year of Pediatric Ophthalmology and Strabismus Research in Review

Kassem¹,

Miller²,

Archer³

2013

Asia-Pacific Journal of Ophthalmology

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Assessing Divergence in Children With Intermittent Exotropia

Cited by 12 publications

References 10 publications

Fusional Vergence Detected by Prism Bar and Synoptophore in Chinese Childhood Intermittent Exotropia

Fusional Vergence Detected by Prism Bar and Synoptophore in Chinese Childhood Intermittent Exotropia

Longitudinal Rehabilitation of Binocular Function in Adolescent Intermittent Exotropia After Successful Corrective Surgery

One Year of Pediatric Ophthalmology and Strabismus Research in Review

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