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Instability of Ocular Alignment in Childhood Esotropia
Journal article   Open access   Peer reviewed

Instability of Ocular Alignment in Childhood Esotropia

Stephen P. Christiansen, Danielle L. Chandler, Jonathan M. Holmes, Robert W. Arnold, Eileen Birch, Linda R. Dagi, Darren L. Hoover, Deborah L. Klimek, B. Michele Melia, Evelyn Paysse, …
Ophthalmology (Rochester, Minn.), v 115(12), pp 2266-2274
01 Dec 2008
DOI: https://doi.org/10.1016/j.ophtha.2008.08.011
PMID: 18973948
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://europepmc.org/articles/pmc2597336View
Accepted (AM)Open Access (License Unspecified),  Open
url
https://doi.org/10.1016/j.ophtha.2008.08.011View
Published, Version of Record (VoR) Open

Abstract

Life Sciences & Biomedicine Ophthalmology Science & Technology
Objective: Instability of ocular alignment may cause surgeons to delay surgical correction of childhood esotropia. The authors investigated the stability of ocular alignment over 18 weeks in children with infantile esotropia (IET), acquired nonaccommodative esotropia (ANAET), or acquired partially accommodative esotropia (APAET). Design: Prospective, observational study. Participants: Two hundred thirty-three children aged 2 months to less than 5 years with IET, ANAET, or APAET of less than 6 months' duration. Methods: Ocular alignment was measured at baseline and at 6-week intervals for 18 weeks. Main Outcome Measures: Using definitions derived from a nested test-retest study and computer simulation modeling, ocular alignment was classified as unstable if there was a change of 15 prism diopters (PD) or more between any 2 of the 4 measurements, as stable if all 4 measurements were within 5 PD or less of one another, or as uncertain if neither criteria was met. Results: Of those who completed all 3 follow-up visits within time windows for analysis, 27 (46%) of 59 subjects with IET had ocular alignment classified as unstable (95% confidence interval [CI], 33%-59%), 20% as stable (95% Cl, 11%-33%), and 34% as uncertain (95% Cl, 22%-47%). Thirteen (22%) of 60 subjects with ANAET had ocular alignment classified as unstable (95% Cl, 12%-34%), 37% as stable (95% Cl, 25%-50%), and 42% as uncertain (95% Cl, 29%-55%). Six (15%) of 41 subjects with APAET had ocular alignment classified as unstable (95% Cl, 6%-29%),39% as stable (95% Cl, 24%-56%), and 46% as uncertain (95% Cl, 31%-63%). For IET, subjects who were older at presentation were less likely to have unstable angles than subjects who were younger at presentation (risk ratio for unstable vs stable per additional month of age, 0.85; 99% Cl, 0.74-0.99). Conclusions: Ocular alignment instability is common in children with IET, ANAET, and APAET. The impact of this finding on the optimal timing for strabismus surgery in childhood esotropia awaits further study. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article. Ophthalmology 2008;115:2266-2274 (C) 2008 by the American Academy of Ophthalmology.

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23 citations in Web of Science
28 citations in Scopus

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Web of Science research areas
Ophthalmology
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