Clinical characteristics and surgical outcomes of acute acquired V-pattern esotropia

Abstract

Background To evaluate the clinical characteristics, surgical outcomes and prognosis of acute acquired V-pattern esotropia (AAVE) by comparing with typical V-pattern esotropia (VE). Methods 15 cases of AAVE and 18 cases of VE were retrospectively reviewed in this study. All patients underwent a comprehensive medical history, ophthalmologic and orthoptic examinations, and stereopsis test. Patients with neurological symptoms were received brain and orbital imaging. Surgical intervention was implemented to correct primary position esotropia and inferior oblique overaction (IOOA). Results The mean age at onset of AAVE group and VE group were 8.46 ± 3.60 years and 3.12 ± 1.25 years, respectively (P < 0.0001). One patient of AAVE had a history of febrile convulsion and generalized seizures. The cycloplegic refraction of AAVE was mild to moderate hyperopia or myopia, with a mean diopter (D) of + 0.71 D (spherical equivalent, range, -4.75 to + 3.5 D). The preoperative esodeviation of AAVE was significantly greater, but there was no statistical difference in the severity of IOOA and extent of V pattern between two groups. Overall surgical success rate of AAVE was 73.3%. The stereoacuity of AAVE was obviously improved postoperatively at their last follow-up visit compared with VE group (χ2 = 8.53, P = 0.0362). Conclusions AAVE was a sudden onset of esotropia, occurs more common in older children, with mild to moderate hyperopia or myopia. All the AAVE patients had IOOA and V pattern. Some cases may be associated with neurological disorders. Surgical outcomes of AAVE were highly favorable. Trial registration: ChiCTR2000038600 20/09/24 retrospectively registered.