儿童急性共同性内斜视的临床特征及治疗效果分析

Clinical characteristics and treatment efficacy in children with acute acquired concomitant esotropia

目的分析儿童急性共同性内斜视Ⅱ型和Ⅲ型患者的临床特征及治疗效果。设计回顾性病例系列。研究对象2019年1月至2022年10月西京医院眼科儿童急性共同性内斜视患者Ⅱ型和Ⅲ型31例。方法观察不同分型患者的基本资料,治疗前后斜视度、视功能、治疗方案进行分组比较。主要指标治疗前后斜视度、远近立体视。结果Ⅱ型患者(19例)年龄较小,远近斜视度无差异(P>0.05),Ⅲ型患者(12例)发病年龄大于Ⅱ型(P<0.05)且视近斜视度小于视远斜视度(P<0.05)。Ⅱ、Ⅲ型患者斜视度及立体视比较均无统计学差异(P均>0.05)。经肉毒毒素注射及斜视矫正术斜视度明显下降、视功能改善。结论儿童急性共同性内斜视患者Ⅱ型比Ⅲ型多见。Ⅱ型患者年龄小,远近斜视度相同;Ⅲ型患者年龄较大,视近斜视度小于视远斜视度。不同分型患者均存在视功能异常需尽早治疗,可取得较好疗效。

Objective To explore clinical characteristics and treatment efficacy in children patients with acute acquired concomitant esotropia.Design Retrospective case series.Participants 31 children patients with acute acquired concomitant esotropia between Jan 2019 and Oct 2022 in Xijing Hospital.Methods The different categorization data,including strabismus degree,stereopsis,and treatment plan were reviewed.Onset age,strabismus degree,visual function,treatment outcomes in different subgroups according to the Burian and Miller classification was compared.Main Outcome Measures strabismus degree and near and distance stereopsis before and after treatment.Results There was no difference in the far and near strabismus degree between type II patients(n=19)(P>0.05),while type III patients(n=12)had a higher onset age than type II patients(P<0.05)with a lower near strabismus degree than the far strabismus degree(P<0.05).There was no difference in strabismus degree and stereopsis between type II and III patients(P>0.05).After botulinum toxin injection and strabismus surgery,the degree of strabismus can be significantly reduced and visual function can be improved.Conclusion Acute concomitant esotropia in children can occur in types II,and III,with type II being more common.Type II patients are younger with the similar degree of far and near strabismus degree.Type III patients are older with a lower near strabismus degree than far strabismus degree.Acute concomitant esotropia patients with different types have visual function abnormalities and need to be treated as early as possible,which can lead to a better therapeutic effect.