Long-term evolution of age-related distance esotropia

Abstract

Purpose: To evaluate the evolution of horizontal deviation and fusional amplitudes both at distance and at near in patients with age-related distance esotropia (ARDET).

Methods: The medical records of consecutive patients diagnosed with ARDET between January 2008 and March 2016 were reviewed retrospectively. Patients with at least 60 months' follow-up were eligible for inclusion. Horizontal deviation, fusional convergence amplitude, and fusional divergence amplitude both at distance and at near were compared.

Results: Of 131 cases reviewed, 31 patients were identified for inclusion. Median age at diagnosis was 73 years. Median distance esodeviation was 6^Δ esotropia at initial examination (range, 2^Δ-12^Δ esotropia) and 8^Δ eostropia at final examination (range, 2^Δ-25^Δ esotropia). Median near deviation was orthophoria at initial examination (range, 10^Δ exophoria to 8^Δ esophoria) and 4^Δ esophoria at final examination (range, 4^Δ exophoria to 14^Δ esophoria). Median fusional divergence amplitude at distance was 4^Δ at initial and at final examinations. At near, median fusional divergence amplitude was 8^Δ at initial and at final examinations. Median fusional convergence amplitude at distance was 14^Δ at initial examination and 12^Δ at final examination. At near, median fusional convergence amplitude was 26^Δ at initial and at final examinations. Base-out prisms were prescribed in all patients. In 23 patients the prism correction gradually increased. Strabismus surgery was performed in 3 patients.

Conclusions: Our patients with ARDET experienced a slight increase in distance esodeviation (P < 0.001), whereas no significant change in fusional amplitudes was observed over time (P ≥ 0.05).