Stereopsis in patients with refractive accommodative esotropia

Abstract

Purpose: To investigate the factors associated with stereopsis in patients with refractive accommodative esotropia.

Methods: The medical records of patients with refractive accommodative esotropia from January 2008 to June 2016 were analyzed retrospectively. Age, sex, cycloplegic refractive error, presence of amblyopia, angle of deviation, and stereoacuity and fusional ability were evaluated. Patients were divided into good stereopsis (40-100 arcsec) and poor stereopsis (>100 arcsec) groups.

Results: A total of 85 patients were included, 31 (36.5%) in the good stereopsis group. The initial mean refractive error was 4.21 ± 1.76 D. The initial mean angle of deviation without correction was 20.5^Δ ± 11.4^Δ at distance and 23.8^Δ ± 11.6^Δ at near fixation; the final angle, with correction, was 1.3^Δ ± 2.2^Δ at distance and 2.0^Δ ± 2.6^Δ at near. The initial mean refraction, differences between both eyes, and final deviation angle with correction were smaller in the good stereopsis group than in the poor stereopsis group. Those with orthotropia both at distance and near had better stereopsis than those with residual esotropia (P < 0.001). Patients with >4^Δ of deviation at distance or >5^Δ of deviation at near had only gross or nil stereopsis.

Conclusions: The refractive error, angle of deviation, and fusional ability were associated with stereopsis in patients with refractive accommodative esotropia. Good stereopsis may be only achievable with a misalignment of ≤4^Δ at distance and ≤5^Δ at near fixation.