Yearly changes in cases of acute acquired comitant esotropia during a 12-year period

Abstract

Purpose The number of patients with acute acquired comitant esotropia (AACE) has been increasing in Japan. The purpose of this study was to investigate the changes in the number and characteristics of patients with AACE examined in our institution during a 12-year period. Methods We retrospectively reviewed the medical records of patients with AACE aged < 30 years who suddenly developed diplopia or esotropia and were examined in Hyogo College of Medicine Hospital from January 2008 to December 2021. We investigated the association of the yearly changes in the number of patients with the age category, refractive error category, AACE type, esotropia type, and use or nonuse of smartphones. Results The total number of patients with AACE was 171, and this number significantly increased each year (Pearson correlation coefficient, 0.9450; p < 0.0001). Significant increases were found among students in junior high school and beyond, patients with myopia, patients with Bielschowsky type AACE, and patients with basic esotropia (p < 0.0001 for all). We compared two age groups, elementary school students and below versus junior high school students and above, and found that the rate of increase was significantly higher in the junior high school students and above (estimate, 1.951; p < 0.0001), and the non-myopia group and myopia group and found that the rate of increase was significantly higher in the myopia group (estimate, 1.891; p < 0.0001). Excessive use of smartphones was confirmed in 82 of 133 patients, and the rate of the increase in the number of patients with AACE was significantly greater among patients with than without excessive use of smartphones (estimate, 1.098; p = 0.0009). Conclusion This study confirmed a significant increase in the number of patients with AACE in recent years. The excessive use of smartphones may be associated with the increase in AACE.

Conformation of Horizontal Extraocular Muscle Insertions in Acute Acquired Concomitant Esotropia Induced by Excessive Digital Device Usage

“…A previous study indicated that limiting the usage of digital devices led to good binocularity and an improvement in the esotropia. 9 Based on the results of our previous study, we determined that in addition to limiting the usage of digital devices, the administration of topical cycloplegics was also found to be effective among SAACE subjects. 36 Furthermore, Botox injections have also been reported to be effective in treating SAACE.…”

Magnetic resonance imaging of extraocular rectus muscles abnormalities in acute acquired concomitant esotropia

“…To overcome binocular diplopia, the LR muscles of both eyes receive more nerve impulses and are thickened compensatorily. There are many treatment options for AACE [10,[33][34][35][36] . Previous research has suggested that strabismus surgery for AACE can successfully improve diplopia and restore good binocular function in patients who do not have underlying intracranial problems [37][38][39][40] .…”

Acute acquired comitant esotropia induced by excessive digital device usage – literature review

“…Niektóre źródła podają, że AACE występuje u dzieci od 5. roku życia [8,10]. Natomiast można też znaleźć prace wskazujące, że istnieją przypadki zachorowań u młodszych dzieci, a nawet niemowląt [21,24]. Warto podkreślić, że AACE rozwija się również u pacjentów w starszym wieku.…”

“…Okita i wsp. przeprowadzili badanie analizujące liczbę i charakterystykę pacjentów, którzy rozwinęli AACE na przestrzeni 12 lat (2008-2020) [21]. Dokonano retrospektywnej analizy 171 uczestników poniżej 30. roku życia z jednego ośrodka w Japonii.…”

“…Stwierdzono, że tempo wzrostu liczby przypadków AACE było znacznie wyższe w tej drugiej grupie (p < 0,0001). Jeśli chodzi o pacjentów nadmiernie korzystających ze smartfonów, analiza regresji wielorakiej wykazała istotnie wyższy roczny wzrost przypadków w tej grupie [21].…”