Relationship between stereopsis outcome and timing of surgical alignment in infantile esotropia

Yagasaki, Teiji; Tsukui, Makiko

doi:10.1016/j.jaapos.2019.12.015

Cited by 8 publications

(3 citation statements)

References 15 publications

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“…Despite this improvable bias, all patients presented with a stereopsis >160 ′′ . Regarding the optimal timing of surgery in relation to sensory outcome, data in the literature agree on the need for early intervention (30,31). Yagasaki et al (30) found that only 31.8% of patients operated by age 8 months, and no patient operated at older ages developed stereopsis <200 ′′ , whereas Birch and Stager (31) found that 20% of subjects operated by age 8 months vs. only 9% of subjects operated between age 7 and 12 months reached stereopsis <200 ′′ .…”

Section: Discussionmentioning

confidence: 98%

Essential Infantile Esotropia: A Course of Treatment From Our Experience

et al. 2021

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Background: Essential infantile esotropia (EIE) is the most common type of childhood esotropia. Although its classical approach is surgical, less invasive techniques have been proposed as an adjunct or alternative to traditional surgery. Among them, chemodenervation with botulinum toxin (BT) has been investigated, showing variable and sometimes conflicting results.Objectives: To compare the outcomes of bilateral BT injection and traditional surgery in a pediatric population with EIE in order to optimize and standardize the therapeutic approach. Other purposes are to evaluate whether early intervention may prevent the onset of vertical ocular deviation (which is part of the clinical picture of EIE) and/or influence the development of fine stereopsis, and also to assess changes in refractive status over time among the enrolled population.Methods: A retrospective consecutive cohort study was conducted in 86 children aged 0–48 months who underwent correction of EIE. The primary intervention in naïve subjects was either bilateral BT injection (36 subjects, “BT group”) or strabismus surgery (50 subjects, “surgery group”).Results: Overall, BT chemodenervation (one or two injections) was effective in 13 (36.1%) subjects. With regard to residual deviation angle, the outcomes at least 5 years after the last intervention were overlapping in children receiving initial treatment with either injection or surgery; however, the success rate of primary intervention in the surgery group was higher, and the average number of interventions necessary to achieve orthotropia was smaller. Both early treatment with chemodenervation and surgery at a later age were not found to prevent the onset of vertical ocular deviation, whereas, surprisingly, the percentage of subjects developing fine stereopsis was higher in the surgery group. Finally, with regard to the change in refractive status over time, most of the subjects increased their initial hyperopia, whereas 10% became myopic.Conclusions: Our data suggest that a single bilateral BT injection by age 2 years should be considered as the first-line treatment of EIE without vertical component; whereas, traditional surgery should be considered as the first-line treatment for all other cases and in subjects unresponsive to primary single BT injection.

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Section: Discussionmentioning

confidence: 98%

Essential Infantile Esotropia: A Course of Treatment From Our Experience

et al. 2021

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“…They believe that very early surgery, i.e., surgery within 6 months after the onset of infant CE, was beneficial to the infant’s cortical development, the establishment of binocular vision, and the maintenance of ocular alignment stability. In a recent study by Yagasaki and colleagues [ 13 ], compared with early (9–24 months) or late (more than 24 months) surgery, very early surgery (less than 8 months) can achieve better binocular vision. Muz and Sanac [ 14 ] recently followed up 79 infant patients with CE for more than 60 months and found that 37% had measurable stereopsis postoperatively at 6–11 months, while in late (11–17 months) and very late groups (18–27 months) it was 3.8%.…”

Section: Discussionmentioning

confidence: 99%

Development and Validation of a Nomogram for Predicting Second Surgery in Patients with Concomitant Esotropia

Liu

Cao

et al. 2022

Ophthalmol Ther

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Introduction: This study developed and validated a nomogram for predicting the risk of second surgery in patients with concomitant esotropia (CE) based on a cohort in Beijing. Methods: In this retrospective cohort study, the inpatient and outpatient medical records of 419 patients with CE who underwent surgery at the Peking University First Hospital between January 1, 2005 and December 31, 2009 were collected. A total of 357 CE cases were included. For those cases 70% were randomly assigned to the training set (n = 234) and 30% to the validation set (n = 123). Demographic and clinical variables were ascertained at hospital admission and discharge and screened using multivariate Cox proportional hazards regression analysis to construct predictive models and generate a 1-, 4-, and 8-year overall survival nomogram. This nomogram provided an estimate of the risk of second surgery in patients with surgically treated CE. Internal validation was conducted using the concordance index (C-index) and calibration curve for the training and validation sets. Results: Six independent prognostic factors were identified, namely age at surgery, age at onset, amblyopia, deviation angles, surgical amount, and deviation angles 1 week after surgery, and these were entered into the nomogram. The proposed nomogram showed favorable discrimination and accuracy in the training and validation sets. The C-indexes of the training and validation sets were 0.84 (95% CI 0.79-0.89) and 0.80 (95% CI 0.78-0.82), respectively. Conclusions: The proposed nomogram can serve as a predictive tool for prognostic evaluation of CE surgery.

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“…Medical interventions (such as eye muscle surgery, orthoptics, eye patching, and exposure to enriched visual experience) can lead to an improvement in stereopsis. Because the efficacy of therapy decreases with age, early diagnosis and intervention are desirable [ 24 , 30 , 41 , 42 , 43 ].…”

Section: Introductionmentioning

confidence: 99%

Non-Invasive Recording of Ocular-Following Responses in Children: A Promising Tool for Stereo Deficiency Evaluation

Miladinović,

Quaia,

Ajčević

et al. 2024

JCM

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Background: The ability to merge the two retinal images to perceive depth (stereopsis) plays an important role in human vision. Its proper development requires binocular alignment and good visual acuity in both eyes during childhood. Because treatments are more effective when applied early, early diagnosis is important. Unfortunately, assessing stereo deficiencies in infants and young children remains challenging. Recently, it has been shown that ocular-following responses (OFRs; reflexive, short-latency eye movements induced by the sudden motion of a large textured pattern) are sensitive to changes in interocular correlation, making them potentially useful for stereo deficiency assessments. To test this hypothesis, we measured OFRs elicited by dichoptic stimulation in children with normal and compromised stereopsis (due to amblyopia). Methods: Two groups of six children (age- and sex-matched: 3M/3F aged 7–12 yo), one with compromised stereopsis and one with normal stereopsis, were included. OFRs were recorded using a custom high-resolution video eye-tracking system. The relative differences between eye displacement induced by correlated stimuli (up-correlated–down-correlated) and anticorrelated (up-anticorrelated–down-anticorrelated) were compared. Results: We found significant differences between OFRs induced by two dichoptic conditions (correlated and anticorrelated stimuli) in most children with normal stereopsis, whereas no differences were observed in children with compromised stereopsis, indicating a lack of disparity detectors. Conclusions: OFRs might thus be exploited as a diagnostic tool for the objective identification of stereo deficiencies in children. This might lead to improved early diagnosis and treatment outcomes for conditions like amblyopia and strabismus.

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Relationship between stereopsis outcome and timing of surgical alignment in infantile esotropia

Cited by 8 publications

References 15 publications

Essential Infantile Esotropia: A Course of Treatment From Our Experience

Essential Infantile Esotropia: A Course of Treatment From Our Experience

Development and Validation of a Nomogram for Predicting Second Surgery in Patients with Concomitant Esotropia

Non-Invasive Recording of Ocular-Following Responses in Children: A Promising Tool for Stereo Deficiency Evaluation

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