Abstract
Objectives
A remarkable increase in the number and proportion of surgical patients with acute acquired concomitant esotropia (AACE) has been noted in our hospital in recent years. We aimed to analyse the clinical characteristics and associated risk factors of this increasing number of strabismus in last 5 years.
Methods
Medical information was obtained in 62 AACE patients and 73 orthotropic patients as control group completed questionnaires and examination items from March 2017 to May 2020. Data included age at onset, refractive error, angle of deviation, binocular vision, eye care habits, and optical quality of spectacles.
Results
Of the 62 AACE patients, the mean ± standard deviation age at onset was 25.3 ± 8.5 years, with 47 (75.8%) cases showing myopia, 9 (14.5%) showing emmetropia, and 6 (9.7%) showing hypermetropia. Among the AACE patients, 35 (56.5%) performed >8 h of close work daily and 36 (58.1%) reported late-night use of digital devices. When compared with the control group, the risk factors identified for AACE included long durations of close work (odds ratio [OR], 11.72; 95% confidence interval [CI], 3.53–38.91; P < 0.001) and immoderate late-night use of digital devices (OR, 14.29; 95% CI, 4.10–49.72; P < 0.001).
Conclusion
Our study demonstrated that young adults accounted for the majority of the growing number of individuals affected by AACE in last 5 years, and excessive close visual activities and immoderate late-night use of digital devices were found to be associated with the onset of AACE.
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References
Burian HM, Miller JE. Comitant convergent strabismus with acute onset. Am J Ophthalmol. 1958;45:55–64.
Clark AC, Nelson LB, Simon JW, Wagner R, Rubin SE. Acute acquired comitant esotropia. Br J Ophthalmol. 1989;73:636–8.
Chen J, Deng D, Sun Y, Shen T, Cao G, Yan J, et al. Acute acquired concomitant esotropia: clinical features, classification, and etiology. Medicines. 2015;94:e2273.
Spierer A. Acute concomitant esotropia of adulthood. Ophthalmology. 2003;110:1053–6.
Mohney BG. Common forms of childhood strabismus in an incidence cohort. Am J Ophthalmol. 2007;144:465–7.
Lee HS, Park SW, Heo H. Acute acquired comitant esotropia related to excessive Smartphone use. BMC Ophthalmol. 2016;16:37.
Wright KW, Strube, Yi Ning J. Color atlas of strabismus surgery: strategies and techniques., 4th. edn. © Springer Science+Business Media: New York; 2015.
Ali MH, Berry S, Qureshi A, Rattanalert N, Demer JL. Decompensated esophoria as a benign cause of acquired esotropia. Am J Ophthalmol. 2018;194:95–100.
Williams AS, Hoyt CS. Acute comitant esotropia in children with brain tumors. Arch Ophthalmol. 1989;107:376–8.
Lee JM, Kim SH, Lee JI, Ryou JY, Kim SY. Acute comitant esotropia in a child with a cerebellar tumor. Korean J Ophthalmol. 2009;23:228–31.
Hoyt CS, Good WV. Acute onset concomitant esotropia: when is it a sign of serious neurological disease? Br J Ophthalmol. 1995;79:498–501.
Simon JW, Waldman JB, Couture KC. Cerebellar astrocytoma manifesting as isolated, comitant esotropia in childhood. Am J Ophthalmol. 1996;121:584–6.
Versino M, Hurko O, Zee DS. Disorders of binocular control of eye movements in patients with cerebellar dysfunction. Brain. 1996;119:1933–50.
Liu GT, Hertle RW, Quinn GE, Schaffer DB. Comitant esodeviation resulting from neurologic insult in children. J AAPOS: Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 1997;1:143–6.
Patel VR, Zee DS. The cerebellum in eye movement control: nystagmus, coordinate frames and disconjugacy. Eye. 2015;29:191–5.
Sutter FK, Landau K. Heroin and strabismus. Swiss Med Wkly. 2003;133:293–4.
Firth AY. Heroin withdrawal as a possible cause of acute concomitant esotropia in adults. Eye. 2001;15:189–92.
Lieber RL, Roberts TJ, Blemker SS, Lee SSM, Herzog W. Skeletal muscle mechanics, energetics and plasticity. J Neuroeng rehabilitation. 2017;14:108.
Scott AB. Change of eye muscle sarcomeres according to eye position. J Pediatr Ophthalmol strabismus. 1994;31:85–8.
Wright WW, Gotzler KC, Guyton DL. Esotropia associated with early presbyopia caused by inappropriate muscle length adaptation. J AAPOS: Off Publ Am Assoc Pediatr Ophthalmol Strabismus. 2005;9:563–6.
Facer-Childs ER, Campos BM, Middleton B, Skene DJ, Bagshaw AP. Circadian phenotype impacts the brain’s resting-state functional connectivity, attentional performance, and sleepiness. Sleep. 2019;42:zsz033.
Stone LS, Tyson TL, Cravalho PF, Feick NH, Flynn-Evans EE. Distinct pattern of oculomotor impairment associated with acute sleep loss and circadian misalignment. J Physiol. 2019;597:4643–60.
Chen M, Wu A, Zhang L, Wang W, Chen X, Yu X, et al. The increasing prevalence of myopia and high myopia among high school students in Fenghua city, eastern China: a 15-year population-based survey. BMC Ophthalmol. 2018;18:159.
Acknowledgements
We would like to thank Dr. Zhigang Fan for his valuable comments on our paper and Editage (www.editage.com) for English language editing.
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The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
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MZ, YT and JC designed the clinical study. MZ, YT and JC recruited volunteers. MZ, YT, ZW, TS, XQ, JY and JC analysed and interpreted the dada. MZ, YT, and JC wrote the manuscript. JC directed the project.
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Zhu, M., Tang, Y., Wang, Z. et al. Clinical characteristics and risk factors of acute acquired concomitant esotropia in last 5 years: a retrospective case–control study. Eye 37, 320–324 (2023). https://doi.org/10.1038/s41433-022-01939-1
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DOI: https://doi.org/10.1038/s41433-022-01939-1
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