Prevalence and clinical characteristics of age-related distance esotropia

Claxton, Matthew R; Bang, Genie M.; Martinez‐Thompson, Jennifer M.; Hodge, David O.; Mohney, Brain

doi:10.1080/09273972.2022.2097707

Cited by 3 publications

(2 citation statements)

References 27 publications

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“…For a long time, Parks' 3-step method, which includes a head-tilt test, has been used to diagnose trochlear nerve palsy (superior oblique palsy: SOP) [ 1 , 15 ]. This test is known to have a low positivity rate, especially in patients with atrophy of the SO muscle, and Demer et al reported a positivity rate of 50% [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy

Yamadera,

Kimura,

Okita

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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Purpose To investigate the distinction between sagging eye syndrome (SES group) and acquired unilateral trochlear nerve palsy (Trochlear group) in the Bielschowsky head tilt test (BHTT). Methods Fifteen patients in the SES group (mean age 74.6 ± 5.2 years) and 14 patients in the Trochlear group (55.2 ± 15.9 years) visited the Department of Ophthalmology, Hyogo Medical University Hospital between November 2016 and October 2022 for treatment of their diplopia. Eye position was measured with the alternate prism cover test, and values for fixation of the dominant eye, or unaffected eye, were used. Cyclodeviation was measured with the synoptophore and the Glaucoma Module Premium Edition of the SPECTRALIS optical coherence tomography. In the BHTT, eye position was measured in three head postures: primary position (PP), head tilt to the side with hypertropia (Hyper), and head tilt to the side with hypotropia (Hypo). The differences in vertical deviation between PP and Hyper (Hyper − PP), PP and Hypo (PP − Hypo) and Hyper − Hypo were measured and compared. Results Vertical deviation in primary position was 7.3 ± 4.5 PD in the SES group and significantly larger (17.1 ± 8.4 PD) in the Trochlear group (p = 0.002). The vertical deviation in Hyper was significantly larger in the Trochlear group with 7.7 ± 4.7 PD and 22.1 ± 9.4 PD, respectively (p < 0.001), whereas the that in Hypo was not significantly different between the two groups with 6.5 ± 3.4 PD and 8.4 ± 6.6 PD, respectively (p = 0.725). The SES group showed no significant difference according to the 3 head postures (p = 0.311), while the Trochlear group showed a significantly different with smaller mean values in vertical deviation in Hypo (p < 0.001). The difference in the vertical deviation for the 3 head postures was the largest in Hyper − Hypo (1.7 ± 2.1 PD and 13.6 ± 7.1 PD, respectively), and the accuracy of SES was at the cutoff value of 6 PD, and it was considered not to be SES if the value was 6PD or higher. The accuracy of SES determination was 100% sensitivity and 100% specificity, and the area under the curve was 1.0. Conclusion The difference in Hyper − Hypo in the BHTT may be the most useful index in differentiating SES from acquired unilateral trochlear nerve palsy; if the difference was more than 6 PD, the probability of SES was very low.

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Section: Discussionmentioning

confidence: 99%

Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy

Yamadera,

Kimura,

Okita

et al. 2023

Graefes Arch Clin Exp Ophthalmol

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“…One study included both types of strabismus in sagging eye syndrome (Goseki et al, 2020). However, previous reports suggested that these two types of strabismus are not totally compatible with sagging eye syndrome (Claxton et al, 2022;Mohney, 2021;Oohira, 2022a).…”

Section: Introductionmentioning

confidence: 99%

Age‐related nonparalytic hypertropia: Clinical features

Oohira

2024

Acta Ophthalmologica

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PurposeAge‐related nonparalytic hypertropia (ARNH) is reported to be involved in sagging eye syndrome, where excyclotorsion is large and the lower eye is more extorted. The primary aim of this study was to describe the clinical profiles of patients with ARNH. The secondary aim was to compare cyclotorsion in patients with ARNH with that in normal individuals.MethodsInclusion criteria for ARNH were insidious onset of diplopia at distance after 50 years of age, nonparalytic hyperdeviation and follow‐up >6 months. Objective cyclotorsion was measured as the disc‐to‐fovea angle (DFA) on fundus photographs obtained from two groups: 75 patients with ARNH (age, 74.1 ± 7.9 years) and 75 sex‐ and age‐matched normal controls (73.9 ± 8.1 years).ResultsThe hypertropia angle was 4.6 ± 2.8 prism dioptres. One patient also experienced diplopia at near‐gaze. DFA in ARNH (right/left eye; 11.0 ± 4.8°/11.6 ± 3.9°) was larger than that of the control (6.6 ± 3.7°/9.2 ± 3.5°) (p < 0.0001). The DFA in the non‐dominant eye (12.5 ± 4.1°) was larger than that in the dominant eye (10.2 ± 4.3°) (p = 0.0003). The lower eye did not have the larger DFA in 29 patients.ConclusionThe angle of hyperdeviation in patients with ARNH was small. The DFA in the ARNH group was larger than that in the normal group. The lower eye was not the eye with a larger DFA in 39% of ARNH, inconsistent with sagging eye syndrome. Decreased phoria adaptation (fusional ability) may trigger diplopia in patients with ARNH.

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Estropie de la personne âgée

Orssaud

2024

Revue Francophone d'Orthoptie

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Prevalence and clinical characteristics of age-related distance esotropia

Cited by 3 publications

References 27 publications

Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy

Comparison of head tilt test between sagging eye syndrome and acquired unilateral trochlear nerve palsy

Age‐related nonparalytic hypertropia: Clinical features

Estropie de la personne âgée

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