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목적 : To describe the clinical characteristics of patients presenting with acute acquired comitant esotropia (AACE) and features suggestive of possible underlying pathophysiology.
방법 : The charts of all patients with AACE who were examined at university based tertiary referral hospital from 2012 to 2015 were reviewed, and those who developed diplopia when they were older than the age of 10 years were included in the analyses. Angle of deviation and ocular motility measured by the Hess screen test were assessed before and after surgery.
결과 : Among 29 patients, age at presentation was 25.0 ± 10.3 years, and 26 of 29 patients were myopic. Mean esodeviation was 26.9 ± 11.6 prism diopters (PD) at near and 26.1 ± 12.6 PD at distance. All patients had excessive adduction in both eyes, which was shown by the Hess screen chart. Eyelid fissure narrowing at attempted adduction was noted in 16 patients (55%). Strabismus surgery was performed on 20 patients. During strabismus surgery, the fibrous adhesion between the medial rectus muscle and the underlying sclera was noted in all cases.
결론 : This study suggests that excessive adduction was noted in all patients with AACE, and excessive adduction is related to the fibrous adhesions between the medial rectus muscles and underlying sclera. Therefore, the release of the fibrous adhesions is essential to restore binocular single vision in these patients.
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