Occurrence and subsequent development of vertical deviations in patients treated surgically for infantile esotropia.

Publisher: Medknow Publications Country of Publication: India NLM ID: 0405376 Publication Model: Print Cited Medium: Internet ISSN: 1998-3689 (Electronic) Linking ISSN: 03014738 NLM ISO Abbreviation: Indian J Ophthalmol Subsets: MEDLINE

Publication: Mumbai : Medknow Publications
Original Publication: Bombay : All-India Ophthalmological Society

Esotropia*/surgery ; Strabismus*/surgery ; Ocular Motility Disorders*/surgery ; Refractive Errors* ; Orbital Diseases*; Humans ; Retrospective Studies ; Oculomotor Muscles/surgery ; Vision, Binocular ; Ophthalmologic Surgical Procedures ; Treatment Outcome

Purpose: The purpose of this study was to evaluate the onset of dissociated vertical deviation (DVD) and inferior oblique overaction (IOOA), their subsequent development, and their correlation with pre and postoperative parameters.
Methods: Medical records of patients with infantile esotropia who underwent surgery between 2005 and 2017 were retrospectively reviewed. DVD and IOOA were measured before and after surgery. Patients were divided into two groups based on horizontal and vertical deviation at the time of presentation: those with infantile esotropia only (group A) and patients with infantile esotropia who developed vertical deviation (group B).
Results: Out of a total of 102 patients, DVD occurrence was seen in 53 patients (51.9%) and IOOA was seen in 50 patients (48.04%). DVD was seen in 22 patients at the time of initial examination and in 31 patients postoperatively. IOOA at presentation was seen in 45 patients (44.1%) and 5 patients (8.8%) postoperatively. No statistical difference was found in the age of surgery, angle of deviation, mean follow-up, and mean refractive error within both groups. The postoperative motor outcome was statistically comparable between the two groups (P = 0.29). Sensory outcomes of fusion (P = 0.048) and stereopsis (P-value = 0.00063) were better in group A.
Conclusion: No correlation was found between the age of occurrence and development of vertical deviation with refractive error, angle of deviation, age, or type of surgery. We found that motor outcomes are not affected but sensory outcomes are affected in patients with vertical deviations. This indicates that DVD and IOOA are developed due to inherent disruption of fusion and stereopsis.
Competing Interests: None

Am J Ophthalmol. 1988 Jan 15;105(1):1-10. (PMID: 3337186)
Ophthalmology. 1983 Oct;90(10):1178-85. (PMID: 6657193)
J AAPOS. 2009 Feb;13(1):8-12. (PMID: 18993096)
Int Ophthalmol Clin. 1971 Winter;11(4):88-92. (PMID: 5155092)
Strabismus. 2005 Dec;13(4):169-99. (PMID: 16361188)
Trans Am Acad Ophthalmol Otolaryngol. 1972 Nov-Dec;76(6):1465-78. (PMID: 4580497)
Arch Ophthalmol. 1980 Apr;98(4):697-703. (PMID: 7369904)
J AAPOS. 1999 Dec;3(6):325-7. (PMID: 10613573)
J AAPOS. 2006 Oct;10(5):409-13. (PMID: 17070474)
Int J Ophthalmol. 2016 Dec 18;9(12):1802-1807. (PMID: 28003983)
Indian J Ophthalmol. 2021 Jan;69(1):130-134. (PMID: 33323597)
J AAPOS. 2000 Jun;4(3):131-44. (PMID: 10849388)
Br J Ophthalmol. 2010 Jun;94(6):740-2. (PMID: 20508049)
Ophthalmology. 2001 Mar;108(3):487-90. (PMID: 11237902)
Ophthalmology. 1989 Jul;96(7):950-5; discussion 956-7. (PMID: 2771362)
Eye (Lond). 1988;2 ( Pt 4):343-57. (PMID: 3075563)

Keywords: Dissociated vertical deviation; infantile esotropia; inferior oblique overaction

Date Created: 20230707 Date Completed: 20230710 Latest Revision: 20231116

20240829

PMC10491062

10.4103/IJO.IJO_2777_22

37417130