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Ma MML, Scheiman M. Divergence excess and basic exotropia types of intermittent exotropia: a major review. Part 1: prevalence, classification, risk factors, natural history and clinical characteristics. Strabismus 2023; 31:97-128. [PMID: 37489263 DOI: 10.1080/09273972.2023.2227681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
INTRODUCTION Intermittent exotropia (IXT) is a common form of strabismus. It is an outward deviation of one eye typically when viewing at distance. Symptoms include, but are not limited to double vision, eyes feeling tired, excessive blinking, and reduced quality of life. Its clinical characteristics are distinctive from other types of strabismus. This paper provides a comprehensive review of prevalence, classification, risk factors, natural history and clinical characteristics of the divergence excess and basic exotropia types of IXT. METHODS Search strategies involving combination of keywords including intermittent exotropia, exotropia, divergences excess, basic exotropia, prevalence, incidence, classification, terminology, risk factor, natural history, observation, angle of deviation, control, control score, symptom, quality of life, suppression, anomalous retinal correspondence, AC/A, accommodative convergence/accommodation, accommodative convergence, convergence, accommodation, vergence, incomitance and vertical were used in Medline. All English articles from 1900/01/01 to 2020/09/01 were reviewed. The reference list of the identified article was also checked for additional relevant article. Studies focused on animal model or strabismus associated with neurologic disorder or injury were excluded. RESULTS The estimated prevalence of IXT in children ranges from 0.1% to 3.7%. Hypoxia at birth and being female are potential risk factors of IXT. Using validated measures of control, multicenter prospective studies showed that the rate of conversion from IXT to constant exotropia is low. The angle of deviation is the most reported outcome measure in studies of IXT. It is often used to represent the severity of the condition and has been suggested as one of the four core outcomes for studies of the surgical management of IXT. Control of exodeviation is one of the four suggested core outcomes for study of surgery of IXT and is considered the main parameter of disease severity. Several validated tools for quality of life score are available to evaluate the subjective severity of IXT. DISCUSSION We reviewed the prevalence, classification, risk factors, natural history and clinical characteristics of the divergence excess and basic exotropia types of IXT. Further research into these areas, especially its clinical characteristics (e.g. suppression, dual retinal correspondence), will increase our understanding of this condition and potentially lead to better management of this common form of strabismus.
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Affiliation(s)
- Martin Ming-Leung Ma
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou
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Mestre C, Neupane S, Manh V, Tarczy-Hornoch K, Candy TR. Vergence and accommodation responses in the control of intermittent exotropia. Ophthalmic Physiol Opt 2023. [PMID: 36692334 DOI: 10.1111/opo.13093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 01/25/2023]
Abstract
PURPOSE Individuals with different types of intermittent exotropia (IXT) may use neurally coupled accommodation and vergence responses differently from those without exotropia to achieve eye alignment. This study examined the relationship between simultaneously recorded accommodation and vergence responses in children and young adults with a range of types of IXT while aligned and deviated. METHODS Responses of 29 participants with IXT (4-31 years) and 24 age-matched controls were recorded using simultaneous eye-tracking and eccentric photorefraction while they watched a movie in binocular or monocular viewing at varying viewing distances. Gradient response AC/A ratios and fusional vergence ranges were also assessed. Eight participants had divergence or pseudo-divergence excess type IXT, 5 had convergence insufficiency and 16 had basic IXT. RESULTS Control and IXT participants accommodated similarly both in monocular and binocular-aligned conditions to visual targets at 80 and 33 cm. When deviated in binocular viewing, most participants with IXT exhibited changes in accommodation <0.5D relative to alignment. Gradient response AC/A ratios were similar for control [0.56 MA/D (IQR: 0.51 MA/D)] and IXT participants [0.42 MA/D (0.54 MA/D); p = 0.60]. IXT participants showed larger vergence to accommodation ratios with changes from distance to near fixation [1.19 MA/D (1.45 MA/D)] than control participants [0.78 MA/D (0.60 MA/D); p = 0.02], especially among IXT participants with divergence or pseudo-divergence excess. Participants with IXT exhibited typical fusional divergence ranges beyond their dissociated position [8.86 Δ (7.10 Δ)] and typical fusional convergence ranges from alignment [18 Δ (15.75 Δ)]. CONCLUSIONS This study suggests that control of IXT is typically neither driven by accommodative convergence alone nor associated with over-accommodation secondary to fusional convergence efforts. These simultaneous measurements confirmed that proximal vergence contributed significantly to IXT control, particularly for divergence or pseudo-divergence excess type IXT. For IXT participants in this study, achieving eye alignment did not conflict with having clear vision.
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Affiliation(s)
- Clara Mestre
- School of Optometry, Indiana University, Bloomington, Indiana, USA
| | - Sonisha Neupane
- Department of Psychology, Northeastern University, Boston, Massachusetts, USA
| | - Vivian Manh
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, Washington, USA
| | - Kristina Tarczy-Hornoch
- Division of Ophthalmology, Seattle Children's Hospital, Seattle, Washington, USA.,University of Washington, Seattle, Washington, USA
| | - T Rowan Candy
- School of Optometry, Indiana University, Bloomington, Indiana, USA
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Mlili NE, Ahabrach H, Cauli O. Hair Cortisol Concentration as a Biomarker of Symptoms of Depression in the Perinatal Period. CNS & NEUROLOGICAL DISORDERS DRUG TARGETS 2023; 22:71-83. [PMID: 35297354 DOI: 10.2174/1871527321666220316122605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 12/20/2021] [Accepted: 12/29/2021] [Indexed: 12/16/2022]
Abstract
Pregnancy is a sensitive period when women experience major hormonal and psychological changes. A high prevalence of the symptoms of depression and manifested major depression rates have been reported during this period, leading to negative outcomes both for mothers and the offspring. Despite its prevalence, the aetiology of depression is not yet fully understood. Nonetheless, alterations in cortisol levels have been proposed as a reliable biomarker to identify pregnant women at risk of perinatal depression. Hair cortisol has recently been extensively used in bio-psychological studies as a suitable non-invasive biomarker for several neuropsychiatric disorders. Various studies have published evidence regarding the relationship between cortisol fluctuations during the perinatal period, measured both in hair and in other substrates, and the onset of perinatal symptoms of depression. This current review provides an overview of cortisol level changes measured in women's hair during pregnancy or the postpartum period and its association with perinatal symptoms of depression. Further studies, including repetitive measurement of both hair cortisol and depression throughout the prenatal period, must be performed to clarify the relationship between cortisol levels and perinatal symptoms of depression.
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Affiliation(s)
- Nisrin El Mlili
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Hanan Ahabrach
- Institut Supérieur des Professions Infirmières et Techniques de Santé (ISPITS), Tetouan, Morocco
- Department of Physiology and Physiopathology, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan, Morocco
| | - Omar Cauli
- Department of Nursing, University of Valencia, Valencia 46010, Spain
- Frailty and Cognitive Impairment Group (FROG), University of Valencia, Valencia 46010, Spain
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Ma MML, Kang Y, Scheiman M, Chen Q, Ye X, Chen X. Reliability of step vergence method for assessing fusional vergence in intermittent exotropia. Ophthalmic Physiol Opt 2022; 42:913-920. [PMID: 35243666 DOI: 10.1111/opo.12972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/09/2022] [Accepted: 02/09/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE To evaluate the reliability of the step vergence method in measuring fusional vergence in subjects with intermittent exotropia. METHODS Thirty-two Chinese participants aged 7-20 years with intermittent exotropia (excluding the convergence insufficiency type) were enrolled in this prospective study. At the eligibility screening, visual acuity, cover test and the Office Control Score were performed. For eligible participants at study visit 1, negative and positive fusional vergence at distance and near, eye dominance and the fusion maintenance test were performed. All eligible participants returned for study visit 2 on the same day (2-4 h later), and the testing was repeated. The primary outcome measures were the intra-class correlation coefficient, coefficient of repeatability and smallest detectable change in the break and recovery points of negative and positive fusional vergence between the two study visits. RESULTS The intra-class correlation coefficient for different vergence parameters ranged from 0.64 to 0.87. The coefficient of repeatability and the smallest detectable change for the distance positive fusional vergence break point were ±20.5 and 13.1 ∆, respectively. There was no significant difference in any vergence parameter between the first and second visits. The coefficient of repeatability and the smallest detectable change in all distance vergence parameters were high when compared to the mean value. The association between distance vergence parameters and the Office Control Score was significant only when including subjects who failed to fuse at the beginning of the test. CONCLUSION The data demonstrate that measurement of fusional vergence with a prism bar has low repeatability in subjects with intermittent exotropia. In these individuals, convergence ability at distance is compromised, whereas other vergence parameters are not adversely affected. While the step vergence method is a valuable test in daily practice, caution is warranted when using it in clinical research.
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Affiliation(s)
- Martin Ming-Leung Ma
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Ying Kang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Mitchell Scheiman
- Pennsylvania College of Optometry at Salus University, Elkins Park, Pennsylvania, USA
| | - Qiwen Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xuelian Ye
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
| | - Xiang Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Peng T, Xu M, Zheng F, Zhang J, Chen S, Lou J, Wang C, Wang Y, Yu X. Longitudinal Rehabilitation of Binocular Function in Adolescent Intermittent Exotropia After Successful Corrective Surgery. Front Neurosci 2021; 15:685376. [PMID: 34290584 PMCID: PMC8287070 DOI: 10.3389/fnins.2021.685376] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022] Open
Abstract
Purpose To study the longitudinal rehabilitation of binocular visual function in adolescent intermittent exotropia (IXT) after successful surgery and compare the results with those of a normal population. The role of binocular function in ocular alignment stability was also evaluated postoperatively. Methods In this prospective study, 30 adolescents with IXT successfully corrected after 1 month were followed for 12 months, and 30 children with normal vision were enrolled as controls. Stereopsis, the fusional vergence amplitude, sensory fusion, and accommodative flexibility were measured to assess binocular function at baseline and 6 and 12 months postoperatively. The controls were tested once when they were enrolled in the study. Results The deviation was −32.00 ± 8.60 prism diopters (PD) at distance fixation and −36.0 ± 9.10 PD at near fixation preoperatively with an average correction of 28.53 ± 3.79 PD and 30.67 ± 1.34 PD at 1 month postoperatively. Distance stereoacuity and near stereoacuity improved from 1 to 12 months postoperatively (p = 0.025 and p = 0.041, respectively). Compared with the controls, the fusional convergence reserve at distance (p = 0.025) and near (p = 0.033) fixations and fusion reserve ratio at distance (p = 0.000) and near (p = 0.000) fixations remained subnormal, whereas sensory fusion (p = 0.237), distance stereopsis (p = 0.120), and the fusional divergence amplitude at a distance (p = 0.168) were normal. However, no significant correlations were found between binocular functions at 1 month postoperatively and the postoperative drift. Conclusion Binocular function significantly improved from before to after successful corrective surgery and continued to improve from 1 to 12 months postoperatively in adolescents with IXT. No significant correlations were found between binocular functions at 1 month postoperatively and ocular alignment stability.
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Affiliation(s)
- Tingting Peng
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Meiping Xu
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Fuhao Zheng
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Junxiao Zhang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Shuang Chen
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jiangtao Lou
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Chunxiao Wang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Yuwen Wang
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Xinping Yu
- The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China
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Chung SA, Choi J, Jeong S, Ko J. Block-building performance test using a virtual reality head-mounted display in children with intermittent exotropia. Eye (Lond) 2020; 35:1758-1765. [PMID: 32873945 DOI: 10.1038/s41433-020-01160-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 07/28/2020] [Accepted: 08/20/2020] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To determine whether childhood intermittent exotropia (IXT) affects distance divergence and performance in block-building tasks within a virtual reality (VR) environment. METHODS Thirty-nine children with IXT, aged 6-12 years, who underwent muscle surgery and 37 normal controls were enrolled. Children were instructed to watch the target moving away and perform a block-building task while fitted with a VR head-mounted display equipped with eye- and hand-movement tracking systems. The change in inter-ocular distance with binocular distance viewing, time to stack five cube blocks of different sizes in order, and distance disparities between the largest and farthest cubes were assessed. All children were evaluated at baseline and 3-month time points. RESULTS The patients with IXT exhibited a larger distance divergence than did controls (p = 0.024), which was associated with greater distance angle of deviation and poorer distance control (r = 0.350, p = 0.001 and r = 0.349, p = 0.004). At baseline, the patients with IXT showed larger distance disparities in the block-building task than did controls in terms of the horizontal, vertical, and 3-dimensional (3-D) measurements (all ps < 0.050). Larger horizontal disparity was associated with greater distance angle of deviation (r = 0.383, p = 0.037). Three months after surgery, the horizontal and 3-D disparities in the patients with IXT improved significantly and were not comparably different compared with controls. CONCLUSIONS These preliminary findings suggest that VR-based block-building task may be useful in testing possible deficits in visuo-motor skills associated with childhood IXT.
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Affiliation(s)
- Seung Ah Chung
- Department of Ophthalmology, Ajou University School of Medicine, Suwon, South Korea.
| | - Jaewon Choi
- School of Integrated Technology, College of Engineering, Yonsei University, Incheon, South Korea
| | - Seungchan Jeong
- Department of Software and Computer Engineering, Ajou University College of Information and Technology, Suwon, South Korea
| | - Jeonggil Ko
- School of Integrated Technology, College of Engineering, Yonsei University, Incheon, South Korea
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Abstract
Background: Fusional amplitudes are important for clinical practice in diagnosing and managing binocular vision anomalies. Several measurement methods can be used to assess fusional amplitudes. However, those methods are not interchangeable, and measurement repeatability has been questioned. Objectives: To compare the normative values of tests for the measurement of fusional vergence and to investigate sources of heterogeneity of diagnostic accuracy including: age, variation in method of assessment, study design and size, type (convergent, divergent, vertical, cyclo) and severity of strabismus (constant/intermittent/latent). Data sources: Bibliographic databases were searched up to March 2018, including Cochrane registers, PubMed, Web of ScienceTM, Google Scholar and Science Citation Index. Trial registers and conference proceedings were hand searched. Review methods: The review observed and reported according to the PRISMA guidelines and was registered with PROSPERO. The I2 was used to show the percentage of observed total variation across studies that is due to real heterogeneity rather than chance. The results of the different studies and the overall effect (meta-analysis under the random effects model) are shown. Results: Eighty-one studies were included in the review. Heterogenous information about break vergence amplitudes is reported for the step vergence method (I2 > 50%; p < 0.05) in children. Four parameters were reported consistently to affect measurements; age, method of assessment, order of testing and target size. For the smooth vergence technique break vergence values heterogeneity was not present in children and adults (I2 = 0%; p > 0.05). Limitations: The results are based on cross-sectional studies that were performed independently of each other, with different examiners, methods of examination and different populations. Conclusions: The source of heterogeneity between studies for vergence break points measured with the step vergence method seems to be linked with age. Normal vergences reported in children had considerable heterogeneity compared with adults. In clinical practice, the population-based vergence ranges measured with the step vergence method in children should not be used as one single criterion. For the smooth vergence technique, normative population data can be used.
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Affiliation(s)
| | - Fiona J Rowe
- b Department of Health Services Research, University of Liverpool , Liverpool
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Zhong J, Deng DM, Chen ZD, Li JR, Yuan JP, Feng L, Wang AH, Yu MB. Evaluation of dynamic stereopsis in intermittent exotropia patients. Int J Ophthalmol 2019; 12:83-88. [PMID: 30662845 DOI: 10.18240/ijo.2019.01.13] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Accepted: 09/29/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To delineate the characteristics of the dynamic stereopsis test and analyze related parameters in intermittent exotropia [X(T)] patients. METHODS Fifty-seven X(T) patients and 55 normal subjects were enrolled in this study. The normal and X(T) groups were used to test the reproducibility and reliability of the dynamic stereopsis test, and Bangerter filters with densities of 0.2 were then used to simulate suppression to test for traditional and dynamic stereopsis. In the X(T) group, the measurements included 1) dynamic stereopsis test comprising three parts: motion+disparity, motion only and disparity only; 2) ocular deviation angle; 3) Bagolini striated lens test; 4) disease course; and 5) Titmus stereopsis test. RESULTS The test-retest reliability of the dynamic stereopsis method was 0.901 in the normal and X(T) groups, and none of the X(T) patients were able to pass the static and dynamic stereopsis tests after using the 0.2 Bangerter filter. The accuracy rate was greater than 80% in the normal group and 31.81%, 36.36%, and 45.45% for the motion+disparity, motion-only and disparity-only components of the traditional test for X(T) patients diagnosed with stereoblindness via traditional tests, respectively. Patients with a long disease course (>1y) had worse dynamic stereopsis than those with a short disease course (<1y; P<0.05, Chi-square test). The deviation angle was not correlated with the motion+disparity, disparity-only, or the motion-only test components (all P>0.05, Chi-square test). CONCLUSION Dynamic stereopsis is preserved in certain X(T) patients diagnosed with stereoblindness via traditional tests. A long disease course was shown to be a negative factor for dynamic stereopsis in X(T) patients which might be associated with worse progression, and provide good references clinically.
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Affiliation(s)
- Jing Zhong
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Da-Ming Deng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Zi-Dong Chen
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jin-Rong Li
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Jun-Peng Yuan
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Lei Feng
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
| | - Ai-Hou Wang
- Department of Ophthalmology, Cathay General Hospital, Taipei 10001, Taiwan, China.,Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei 10001, Taiwan, China
| | - Min-Bin Yu
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, Guangdong Province, China
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Abstract
PURPOSE The aims of this study were to compare fusional vergence measurements between orthophoria, esophoria, and exophoria, and to determine the strength of correlations between fusional convergence and divergence and angle of deviation. METHODS AND MATERIALS A cross-sectional study was performed in children with best-corrected visual acuity of 0.0 LogMAR in either eye, compensated heterophoria within 10 prism diopters (PD), full ocular rotations, presence of fusional vergence, and stereopsis (60 seconds of arc or better). Fusional amplitudes were compared between orthophoric and heterophoric children. The fusion reserve ratio was determined as compensating vergence divided by alternating cover test. RESULTS Five hundred and thirty children (7.66±1.20 years) were recruited to this study. The most common heterophoria was exophoria (n=181, 34.2% for near; n=20, 3.8% for distance). Exophoric children had significant lower mean positive fusional vergences (exophoria-orthophoria: P=0.003; exophoria-esophoria: P=0.035) for near (19.54±5.23 base-out) compared with children with orthophoria (20.48±4.83 base-out) and esophoria (22.27±5.60 base-out). Smaller convergence fusion amplitudes were associated with larger angles of deviation at near (rs=-0.115; P=0.008) and lower fusion reserve ratios were associated with larger angles of deviation at distance (rs=-0.848; P<0.001) and at near (rs=-0.770; P<0.001). CONCLUSIONS Exophoric children have reduced convergence break points when compared with orthophoric and esophoric children. Vergence measurements, taking into consideration the baseline heterophoria, give important information about the ability of the patient to increase their vergence demand and maintain ocular alignment.
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Affiliation(s)
- Carla Costa Lança
- a Lisbon School of Health Technology , Lisbon , Portugal.,b Centro de Investigação em Saúde Pública, Escola Nacional de Saúde Pública , Universidade NOVA de Lisboa , Lisbon , Portugal
| | - Fiona J Rowe
- c Department of Health Services Research , University of Liverpool , Liverpool , United Kingdom
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Fusional vergence detected by prism bar and synoptophore in chinese childhood intermittent exotropia. J Ophthalmol 2015; 2015:987048. [PMID: 25954512 PMCID: PMC4411439 DOI: 10.1155/2015/987048] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2015] [Accepted: 03/25/2015] [Indexed: 11/17/2022] Open
Abstract
Purpose. To measure the changes in fusional vergence in Chinese children with intermittent exotropia (IXT) and the association with the control of IXT. Methods. Ninety-two patients with IXT (8–15 years old) were compared with 86 controls. Exodeviation control was evaluated using the Revised Newcastle Control Score. Angle of deviation was measured using prism and alternate cover testing at distance and near. Fusional vergence was measured using prism bar and synoptophore. This study was registered with ChiCTR-RCC-13003920. Results. Using prism bar, convergence break points were lower whereas divergence break points were higher in children with IXT at distance (P < 0.001) and near (P < 0.001) compared with controls. There was no significant difference in mean divergence amplitudes between the two groups when testing using a synoptophore (P = 0.53). In children with IXT, the distance between recovery point and break point in both convergence (distance: P = 0.02; near: P = 0.02) and divergence (distance: P < 0.001; near: P < 0.001) was larger than controls when detected by prism bar and synoptophore (convergence: P = 0.005; divergence: P = 0.006). Conclusions. Children with IXT have reduced convergence amplitudes as detected by both prism bar and synoptophore.
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Kassem IS, Miller MT, Archer SM. One Year of Pediatric Ophthalmology and Strabismus Research in Review. Asia Pac J Ophthalmol (Phila) 2013; 2:388-400. [PMID: 26107151 PMCID: PMC6839686 DOI: 10.1097/apo.0000000000000019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To highlight recent advances in amblyopia and strabismus. DESIGN Literature review. METHODS A literature search of articles published in the English language was performed in PubMed or MEDLINE between May 2012 and April 2013 using the terms amblyopia or strabismus. Articles deemed relevant were selected. RESULTS The review highlights articles that increase our understanding of strabismus and amblyopia as well as newer treatment strategies. CONCLUSIONS The review highlights some new information and possible future advances in amblyopia and strabismus.
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Affiliation(s)
- Iris S Kassem
- From the *University of Illinois at Chicago Eye and Ear Infirmary, Chicago, IL; and †Department of Ophthalmology and Visual Sciences, Kellogg Eye Center, University of Michigan, Ann Arbor, MI
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