Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management

Apatsa Lekskul, Nichaboon Chotkajornkiat, Wadakarn Wuthisiri, Phantaraporn Tangtammaruk Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Phantaraporn Tangtammaruk 270 Rama 6 Road, Thung Phayathai Subdistrict, Ratchathewi District, Bangkok, 10400...

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Autores principales:	Lekskul A, Chotkajornkiat N, Wuthisiri W, Tangtammaruk P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	aace acute acquired comitant esotropia strabismus acquired esotropia etiologies Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/6aba52e2f3114e3894783de19e573e30
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spelling	oai:doaj.org-article:6aba52e2f3114e3894783de19e573e302021-12-02T14:16:43ZAcute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management1177-5483https://doaj.org/article/6aba52e2f3114e3894783de19e573e302021-04-01T00:00:00Zhttps://www.dovepress.com/acute-acquired-comitant-esotropia-etiology-clinical-course-and-managem-peer-reviewed-article-OPTHhttps://doaj.org/toc/1177-5483Apatsa Lekskul, Nichaboon Chotkajornkiat, Wadakarn Wuthisiri, Phantaraporn Tangtammaruk Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Phantaraporn Tangtammaruk 270 Rama 6 Road, Thung Phayathai Subdistrict, Ratchathewi District, Bangkok, 10400, ThailandTel +66 61 194 7887Email pp.phantaraporn@gmail.comPurpose: To identify the etiologies, clinical course and management of acute acquired comitant esotropia in Ramathibodi Hospital, Thailand.Methods: Thirty patients who were diagnosed with acute acquired comitant esotropia at Ramathibodi Hospital from January 1 2017 to December 31 2019 were identified using electronic medical records, from which demographic, etiology, clinical course and management, laboratory, and neuroimaging data were collected.Results: The etiologies of acute acquired comitant esotropia were Swan (16.67%), Burian–Franceschetti (30.00%), Bielschowsky (36.67%), Arnold Chiari malformation (3.33%) and decompensated esophoria (13.33%). Mean age of onset was 19.8 ± 18.3 years. Mean angle of esodeviation was 28.4 ± 12.1 prism diopters for distance fixation and 29.3 ± 11.8 prism diopters for near fixation. Refraction differed between age groups: children under 10 years had mild hyperopia (median +0.63 diopters, first quartile +0.25 diopters, third quartile +0.75 diopters) and teenagers (10– 18 years old) had emmetropia to mild myopia (median +0.25 diopters, first quartile − 2.50 diopters, third quartile +0.75 diopters), whereas adults had mild to moderate myopia (median − 0.75 diopters, first quartile − 5.25 diopters, third quartile ± 0.00 diopters). Twelve patients (40.00%) were prescribed spectacles and surgical intervention was performed in 26 patients (86.67%). All patients except one case of Arnold Chiari malformation (96.67%) maintained normal binocular function and alignment following strabismus surgery or spectacles correction.Conclusion: Bielschowsky was the most common etiology of acute acquired comitant esotropia in our study. We suggest that refraction should be performed in all patients with acute acquired comitant esotropia. Most etiologies were benign and might not require neuroimaging. However, neuroimaging is recommended in those with atypical presentations, such as nystagmus, headache, or cerebellar signs. Surgical intervention with a 0.5– 1.0 mm increase in recession was effective for restoring ocular alignment and binocular function in our patients.Keywords: AACE, acute acquired comitant esotropia, strabismus, acquired esotropia, etiologiesLekskul AChotkajornkiat NWuthisiri WTangtammaruk PDove Medical Pressarticleaaceacute acquired comitant esotropiastrabismusacquired esotropiaetiologiesOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 1567-1572 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	aace acute acquired comitant esotropia strabismus acquired esotropia etiologies Ophthalmology RE1-994
spellingShingle	aace acute acquired comitant esotropia strabismus acquired esotropia etiologies Ophthalmology RE1-994 Lekskul A Chotkajornkiat N Wuthisiri W Tangtammaruk P Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management
description	Apatsa Lekskul, Nichaboon Chotkajornkiat, Wadakarn Wuthisiri, Phantaraporn Tangtammaruk Department of Ophthalmology, Ramathibodi Hospital, Mahidol University, Bangkok, ThailandCorrespondence: Phantaraporn Tangtammaruk 270 Rama 6 Road, Thung Phayathai Subdistrict, Ratchathewi District, Bangkok, 10400, ThailandTel +66 61 194 7887Email pp.phantaraporn@gmail.comPurpose: To identify the etiologies, clinical course and management of acute acquired comitant esotropia in Ramathibodi Hospital, Thailand.Methods: Thirty patients who were diagnosed with acute acquired comitant esotropia at Ramathibodi Hospital from January 1 2017 to December 31 2019 were identified using electronic medical records, from which demographic, etiology, clinical course and management, laboratory, and neuroimaging data were collected.Results: The etiologies of acute acquired comitant esotropia were Swan (16.67%), Burian–Franceschetti (30.00%), Bielschowsky (36.67%), Arnold Chiari malformation (3.33%) and decompensated esophoria (13.33%). Mean age of onset was 19.8 ± 18.3 years. Mean angle of esodeviation was 28.4 ± 12.1 prism diopters for distance fixation and 29.3 ± 11.8 prism diopters for near fixation. Refraction differed between age groups: children under 10 years had mild hyperopia (median +0.63 diopters, first quartile +0.25 diopters, third quartile +0.75 diopters) and teenagers (10– 18 years old) had emmetropia to mild myopia (median +0.25 diopters, first quartile − 2.50 diopters, third quartile +0.75 diopters), whereas adults had mild to moderate myopia (median − 0.75 diopters, first quartile − 5.25 diopters, third quartile ± 0.00 diopters). Twelve patients (40.00%) were prescribed spectacles and surgical intervention was performed in 26 patients (86.67%). All patients except one case of Arnold Chiari malformation (96.67%) maintained normal binocular function and alignment following strabismus surgery or spectacles correction.Conclusion: Bielschowsky was the most common etiology of acute acquired comitant esotropia in our study. We suggest that refraction should be performed in all patients with acute acquired comitant esotropia. Most etiologies were benign and might not require neuroimaging. However, neuroimaging is recommended in those with atypical presentations, such as nystagmus, headache, or cerebellar signs. Surgical intervention with a 0.5– 1.0 mm increase in recession was effective for restoring ocular alignment and binocular function in our patients.Keywords: AACE, acute acquired comitant esotropia, strabismus, acquired esotropia, etiologies
format	article
author	Lekskul A Chotkajornkiat N Wuthisiri W Tangtammaruk P
author_facet	Lekskul A Chotkajornkiat N Wuthisiri W Tangtammaruk P
author_sort	Lekskul A
title	Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management
title_short	Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management
title_full	Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management
title_fullStr	Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management
title_full_unstemmed	Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management
title_sort	acute acquired comitant esotropia: etiology, clinical course, and management
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/6aba52e2f3114e3894783de19e573e30
work_keys_str_mv	AT lekskula acuteacquiredcomitantesotropiaetiologyclinicalcourseandmanagement AT chotkajornkiatn acuteacquiredcomitantesotropiaetiologyclinicalcourseandmanagement AT wuthisiriw acuteacquiredcomitantesotropiaetiologyclinicalcourseandmanagement AT tangtammarukp acuteacquiredcomitantesotropiaetiologyclinicalcourseandmanagement
_version_	1718391671250485248

Acute Acquired Comitant Esotropia: Etiology, Clinical Course, and Management

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