Long-Term Postoperative Development of Stereopsis in Infantile Exotropia

Seo, Hye Jin; Kim, Seung Hyun

doi:10.1097/apo.0000000000000108

Cited by 5 publications

(6 citation statements)

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“…A high level of binocularity has been reported in some studies where patients were followed up at least for four years [14,15] . This could be due to the intermittent nature of exodeviation before its constancy .In addition, early-onset intermittent exotropia may be associated with infantile exotropia in one-third to one-half of cases, leading to the observed high level of binocularity.…”

Section: Discussionmentioning

confidence: 94%

Motor and Sensory Outcomes of Infantile Exotropia: A 10-Year Study (2008–2017)

Rajavi

Sabbaghi

Behradfar

et al. 2020

Korean J Ophthalmol

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We aimed to determine the long-term motor and sensory outcomes of patients with infantile exotropia. Methods: In this longitudinal retrospective (historical cohort) study, the records of 76 patients with infantile exotropia were Studied. Subjects with constant exotropia manifesting before the age of one year who were at least five years old at recruitment time between 2008 and 2017 were included. Results: The medical records of 26 patients were excluded due to not participating in followup examinations or having incomplete records. In total, 54 infantile exotropic patients (51.9% male) with a mean age of 11.1 ± 6.8 years and follow-up of 4.99 ± 3.58 years were studied. Postoperative sensory outcomes [central stereopsis (< 60 sec/arc), peripheral fusion (60-3,000 sec/arc), and non-stereopsis (> 3,000 sec/arc)] were observed in 38.9%, 38.9%, and 21.2% of patients, respectively. In terms of postoperative motor outcomes, 69%, 24%, and 7% were achieved as orthophoria, residual exotropia, and consecutive esotropia, respectively. Patients with a higher surgical age (p = 0.022) and better visual acuity (p = 0.004) had significantly better sensory outcomes, while higher preoperative deviation resulted in more suppression (p = 0.039; rs = 0.218). Conclusion: With rates of 69% for motor success and 78.8% for sensory success, surgical outcomes of infantile exotropic patients seems to be favorable. Further studies are recommended to verify our findings.

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Section: Discussionmentioning

confidence: 94%

Motor and Sensory Outcomes of Infantile Exotropia: A 10-Year Study (2008–2017)

Rajavi

Sabbaghi

Behradfar

et al. 2020

Korean J Ophthalmol

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“…9 Studies have also been conducted to find out the factors associated with the development of binocularity and stereopsis in these patients. [13][14][15][16][17][18] It has been seen that stereopsis is easier to achieve if the strabismus is intermittent rather than constant. [13][14][15] Most intermittent exotropes attain good binocularity and stereopsis after treatment and many have good binocularity and stereopsis even before treatment due to the lack of amblyopia and the presence of time intervals in which they are orthotropic.…”

Section: Discussionmentioning

confidence: 99%

“…It has also been seen that success in achieving stereopsis after strabismus management is also associated with the age of onset of strabismus. [16][17][18] Iordanous et al did a retrospective review of charts of 57 patients with partially accommodative esotropia and found that only 42% of them achieved stereopsis of 100 arc sec or better after treatment. 16 They found that achievement of stereopsis was significantly correlated with the age of onset of strabismus (31.8 months versus 23.9 months, p=0.012) and not significantly correlated with the duration of alignment (p=0.57) or the age at surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, studies indicate that attainment of stereopsis is significantly correlated with three factors. [13][14][15][16][17][18] First, stereopsis is significantly associated with the age of onset of strabismus and the earlier the onset of strabismus, the lesser the chances of attaining stereopsis after appropriate treatment and the later the onset of strabismus, the higher the chances of attaining stereopsis after treatment. [16][17][18] Second, stereopsis is significantly associated with the intermittency or constancy of strabismus with intermittent strabismics having a higher chance of attaining stereopsis than constant strabismics.…”

Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16][17][18] First, stereopsis is significantly associated with the age of onset of strabismus and the earlier the onset of strabismus, the lesser the chances of attaining stereopsis after appropriate treatment and the later the onset of strabismus, the higher the chances of attaining stereopsis after treatment. [16][17][18] Second, stereopsis is significantly associated with the intermittency or constancy of strabismus with intermittent strabismics having a higher chance of attaining stereopsis than constant strabismics. [13][14][15] Third, stereopsis is significantly associated with the postoperative alignment of the eyes and the closer the patient is to the orthotropic state after treatment, the higher the chances of the patient developing good stereopsis.…”

Section: Discussionmentioning

confidence: 99%

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Extent of Improvement in Binocularity and Stereopsis in Constant Concomitant Horizontal Strabismus After Surgical Management and Its Association With the Postoperative Ocular Alignment

Kohli¹,

Mehta²,

Kumar³

et al. 2017

jebmh

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BACKGROUNDThe gradual decrease in binocularity and stereopsis in patients with concomitant strabismus decreases the depth perception of the patients and adversely affects the reading speed and the motor dexterity skills of the individuals. It had been observed earlier that early management is necessary to help patients regain their binocularity, but recent studies indicate that binocularity and stereopsis may improve in these patients even if they are treated later in life, provided they are managed well. Hence, we undertook this study to determine the extent of improvement in binocularity and stereopsis in patients with long-standing large angle constant concomitant horizontal strabismus after surgical management after the age of 16 years and its association with the postoperative alignment. MATERIALS AND METHODSA prospective clinical trial was conducted in 30 patients with constant concomitant horizontal strabismus of more than 25 prism dioptres who presented after the age of 16 years. Binocularity and stereopsis were measured in the patients with the help of Worth 4-dot test, synoptophore, Lang II test plate, Randot test plates and TNO test plates. The measurements were done preoperatively and 6 weeks after surgical treatment. The changes in the measurements were associated with the postoperative alignment. RESULTSPreoperatively, the patients demonstrated either alternating or unilateral suppression with no measurable stereopsis. Postoperatively, satisfactory surgical alignment defined as tropia less than or equal to 8 Prism Dioptres (PD) was achieved in 23 (76.6%) of the patients. 19 (63.3%) patients achieved binocularity on Worth 4-dot test and synaptophore, but alternating or unilateral suppression was still present in 11 (36.6%) of the patients. 17 (56.6%) of the 30 patients achieved stereopsis on Lang II, Randot and TNO test plates. Development of stereopsis was associated with postoperative alignment with 16 (69.5%) of the 23 satisfactorily aligned patients and only 1 (14.3%) of the 7 patients with a residual deviation of ≥10PD achieving stereopsis. CONCLUSIONSignificant improvement in binocularity and stereopsis can be achieved in patients with long-standing large angle constant concomitant horizontal strabismus after surgical management even after the age of 16 years and the development of binocularity and stereopsis is associated with the final postoperative alignment. BACKGROUNDStrabismus or misalignment of the eyes is a common condition affecting 1-4% of the world population. 1 The presence of strabismus profoundly affects the life of the individual not only due to the cosmetic effect and the associated psychosocial implications, but also due to the decrease in binocularity, fusional amplitudes and stereopsis. It may also lead to a decrease in the visual acuity of an eye due to strabismic amblyopia, if strabismus develops during the early years of life. It has been seen that this decrease in Financial or Other, Competing Interest: None.

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Different surgical outcomes in infantile exotropia according to onset time

Kim

2019

Journal of American Association for Pediatric Ophthalmology and

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Long-Term Postoperative Development of Stereopsis in Infantile Exotropia

Abstract: Even if patients do not show excellent stereopsis of 60 arc seconds in an initial diagnostic test, they should receive regular screenings as they age to assess the development of stereopsis in infantile exotropia.

Cited by 5 publications

References 12 publications

Motor and Sensory Outcomes of Infantile Exotropia: A 10-Year Study (2008–2017)

Motor and Sensory Outcomes of Infantile Exotropia: A 10-Year Study (2008–2017)

Extent of Improvement in Binocularity and Stereopsis in Constant Concomitant Horizontal Strabismus After Surgical Management and Its Association With the Postoperative Ocular Alignment

Different surgical outcomes in infantile exotropia according to onset time

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