최초 발견자 차이와 관련된 간헐외사시 특징
First-finder-related Clinical Features of Intermittent Exotropia
0
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
목적: 수술이 필요한 정도의 간헐외사시를 처음 발견한 사람이 안과의사인 군과 부모를 비롯한 비전문가인 군에서 간헐외사시 특징이다른지 알아보고자 하였다. 대상과 방법: 평균 5.9 ± 1.4세에 20프리즘디옵터(prism diopters, PD) 이상의 간헐외사시로 진단받은 환아 218명의 의무기록을 후향적으로 조사하였다. 간헐외사시 최초 발견자가 안과의사인 군과 비전문가인 군으로 나누어, 프리즘교대가림검사로 측정한 실제사시각과 반투명가리개로 가리고 촬영한 사진을 바탕으로 전문의 2명이 평가한 사진사시각, 간헐외사시 분류, 융합조절, 입체시, 억제, 구면렌즈대응치를 비교하였다. 결과: 평균 원거리사시각이 25.8 ± 6.8 PD인 간헐외사시를 41명(18.8%)은 안과의사가, 177명(81.2%)은 비전문가가 처음 발견하였다. 사시안의 구면렌즈대응치가 안과의사군에서 비전문가군에 비해 근시인 것(-0.77 ± 1.59 디옵터[diopters, D] vs. -0.19 ± 1.48 D, p=0.03)을 제외하고는 두 군 간 차이가 없었다. 두 군에서 나이와 사시안의 구면렌즈대응치를 짝지은 39쌍을 비교하면, 안과의사군에서 원거리, 근거리 실제사시각이 비전문가군에 비해 작았지만(24.0 ± 6.8 PD vs. 28.5 ± 6.4 PD, 26.9 ± 6.6 PD vs. 31.0 ± 6.4 PD, p<0.01), 사진사시각을 비롯한 다른 특징은 차이가 없었다. 결론: 수술이 필요한 정도의 간헐외사시라도 사시각이 작거나 근시가 동반된 경우 안과의사가 검진을 통해 처음 발견하는 경우가 많았다.
Abstract
Purpose: To determine whether the clinical features of intermittent exotropia (IXT) needing muscle surgery were different in the ophthalmologist-detected and non-specialist-detected groups (including parents). Methods: Medical records of 218 children (mean age: 5.9 ± 1.4 years) with IXT of ≥ 20 prism diopters (PD) were reviewed retrospectively. The angles of deviation were measured using the prism and alternate cover test and assessed by two ophthalmologists using photographs with a translucent occluder (photographic angle). The IXT subtype, fusional control, stereopsis, suppression, and spherical equivalent (SE) were compared between the ophthalmologist-detected and non-specialist-detected groups. Results: Mean 25.8 ± 6.8 PD of distant angle of IXT was first detected by the ophthalmologist in 41 patients (18.8%) and the non-specialists in 177 patients (81.2%). The deviated eye was more myopic in the ophthalmologist-detected than non-specialist- detected group (-0.77 ± 1.59 diopters [D] vs. -0.19 ± 1.48 D, p = 0.03). There were no other differences between the two groups. A comparison of 39 age- and non-dominant eye SE-matched pairs demonstrated that the measured angles for distant and near fixation were smaller in the ophthalmologist-detected than non-specialist-detected group (24.0 ± 6.8 PD vs. 28.5 ± 6.4 PD and 26.9 ± 6.6 PD vs. 31.0 ± 6.4 PD, respectively, p < 0.01), while the remaining characteristics, including the photographic angle, were similar. Conclusions: In cases with small angles of deviation or myopia, IXT with angles requiring surgical correction were commonly first detected by ophthalmologists during examinations.
참고문헌 (20)
- Han KE, "Prevalence and risk factors of strabismus in children and adolescents in South Korea : Korea National Health and Nutrition Examination Survey, 2008-2011", PLoS One, 13, pp.e0191857~ (2018)
- Yu YS, "Preschool vision screening in Korea : preliminary study", J Korean Ophthalmol Soc, 32, pp.1092~1096 (1991)
- Govindan M, "Incidence and types of childhood exotropia : a population-based study", Ophthalmology, 112, pp.104~108 (2005)
- Ahn SJ, "Binocular visual acuity in intermittent exotropia : role of accommodative convergence", Am J Ophthalmol, 154, pp.981~986 (2012)
- Serrano-Pedraza I, "Single vision during ocular deviation in intermittent exotropia", Ophthalmic Physiol Opt, 31, pp.45~55 (2011)
- Hirota M, "Relationship between reading performance and saccadic disconjugacy in patients with convergence insufficiency type intermittent exotropia", Jpn J Ophthalmol, 60, pp.326~332 (2016)
- 김지수, "간헐외사시 소아와 정상 소아의 읽기 속도 비교", 대한안과학회지, 61(7), pp.784~794 (2020), 대한안과학회
- Hatt SR, "Quality of life in intermittent exotropia : child and parent concerns", Arch Ophthalmol, 126, pp.1525~1529 (2008)
- Hatt SR, "Variability of control in intermittent exotropia", Ophthalmology, 115, pp.371~376 (2008)
- Hatt SR, "Variability of angle of deviation measurements in children with intermittent exotropia", J AAPOS, 16, pp.120~124 (2012)
- Hatt SR, "Awareness of exodeviation in children with intermittent exotropia", Strabismus, 17, pp.101~106 (2009)
- Rosner J, "Parents as screeners for strabismus in their children", J Vis Impair Blind, 82, pp.193~194 (1988)
- Han KE, "Discrepancies between parental reports and clinical diagnoses of strabismus in Korean children", J AAPOS, 16, pp.511~514 (2012)
- Son W, "Comparison between parental observations and clinical evaluation findings in Korean pediatric patients with intermittent exotropia", J Pediatr Ophthalmol Strabismus, 57, pp.199~203 (2020)
- Chung SA, "Photographic assessment of intermittent exotropia using a translucent cover", J Pediatr Ophthalmol Strabismus, 58, pp.331~338 (2021)
- Burian HM, "Exodeviations : their classification, diagnosis and treatment", Am J Ophthalmol, 62, pp.1161~1166 (1966)
- Stathacopoulos RA, "Distance stereoacuity. Assessing control in intermittent exotropia", Ophthalmology, 100, pp.495~500 (1993)
- Superstein R, "Relationship among clinical factors in childhood intermittent exotropia", J AAPOS, 21, pp.268~273 (2017)
- Yang HK, "Decreased accommodative response in the nondominant eye of patients with intermittent exotropia", Am J Ophthalmol, 151, pp.71~76 (2011)
- Moon Y, "Difference in myopia progression between dominant and non-dominant eye in patients with intermittent exotropia", Graefes Arch Clin Exp Ophthalmol, 258, pp.1327~1333 (2020)