Changes in Exodeviation after the Monocular Occlusion Test in Adult Patients with Intermittent Exotropia and Its Association with the Level of Control
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Purpose: We investigated the changes in ocular deviation after the monocular occlusion test in adults with intermittent exotropiaand evaluated its association with the level of control. Methods: We retrospectively enrolled adults (aged ≥18 years) with intermittent exotropia who visited our clinic betweenSeptember 2015 and May 2019. Patients with basic intermittent exotropia with a distant deviation within 10 prism diopters(PD) of the near deviation were included. The largest ocular deviations obtained before and after 1 hour of monocular occlusionwere compared. The level of control was measured using the LACTOSE (Look and Cover, then Ten seconds of ObservationScale for Exotropia) control scoring system. Results: Forty-six consecutive adult patients (28 males, 18 females; mean age, 34.3 years) were enrolled. The mean oculardeviation was 36.3 PD (range, 18 to 5 PD) at distant fixation and 38.5 PD (range, 18 to 80 PD) at near fixation, which increasedsignificantly to 38.5 PD (p = 0.043) and 41.1 PD (p = 0.011), respectively, after monocular occlusion. The mean ocular deviationincreased ≥5 PD in 14 (30.4%) and 15 (32.6%) patients at distant and near fixation, respectively. The level of control was measuredin 30 patients. A higher degree of near control was significantly associated with an increase of ≥5 PD in near fixationafter the test (p = 0.009 for a near control score ≤2). Conclusions: The monocular occlusion test may help to determine the largest ocular deviation in adults with intermittent exotropia. Approximately one-third of patients exhibited an increase in ocular deviation ≥5 PD. Patients exhibiting good controlwere more likely to manifest an increase in the ocular deviation.
Abstract
Purpose: We investigated the changes in ocular deviation after the monocular occlusion test in adults with intermittent exotropiaand evaluated its association with the level of control. Methods: We retrospectively enrolled adults (aged ≥18 years) with intermittent exotropia who visited our clinic betweenSeptember 2015 and May 2019. Patients with basic intermittent exotropia with a distant deviation within 10 prism diopters(PD) of the near deviation were included. The largest ocular deviations obtained before and after 1 hour of monocular occlusionwere compared. The level of control was measured using the LACTOSE (Look and Cover, then Ten seconds of ObservationScale for Exotropia) control scoring system. Results: Forty-six consecutive adult patients (28 males, 18 females; mean age, 34.3 years) were enrolled. The mean oculardeviation was 36.3 PD (range, 18 to 5 PD) at distant fixation and 38.5 PD (range, 18 to 80 PD) at near fixation, which increasedsignificantly to 38.5 PD (p = 0.043) and 41.1 PD (p = 0.011), respectively, after monocular occlusion. The mean ocular deviationincreased ≥5 PD in 14 (30.4%) and 15 (32.6%) patients at distant and near fixation, respectively. The level of control was measuredin 30 patients. A higher degree of near control was significantly associated with an increase of ≥5 PD in near fixationafter the test (p = 0.009 for a near control score ≤2). Conclusions: The monocular occlusion test may help to determine the largest ocular deviation in adults with intermittent exotropia. Approximately one-third of patients exhibited an increase in ocular deviation ≥5 PD. Patients exhibiting good controlwere more likely to manifest an increase in the ocular deviation.
참고문헌 (15)
- Kushner BJ, "The distance angle to target in surgery for intermittent exotropia", Arch Ophthalmol, 116, pp.189~194 (1998)
- Gurlu VP, "Diagnostic occlusion test in intermittent exotropia", J AAPOS, 12, pp.504~506 (2008)
- Lin S, "Comparative measurements of exodeviations in intermittent exotropia", Zhonghua Yan Ke Za Zhi, 49, pp.609~614 (2013)
- Han JM, "Efficacy of diagnostic monocular occlusion in revealing the maximum angle of exodeviation", Br J Ophthalmol, 98, pp.1570~1574 (2014)
- Jung EH, "Comparison of the characteristics of patients with intermittent exotropia according to response to diagnostic monocular occlusion", Jpn J Ophthalmol, 62, pp.243~248 (2018)
- Kushner BJ, "Strabismus", pp.73~95 (2017), Springer
- Kim WJ, "The clinical course of recurrent intermittent exotropia following one or two surgeries over 24months postoperatively", Eye(Lond), 28, pp.819~824 (2014)
- Wright KW, "Pediatric ophthalmology and strabismus", pp.306~316 (2012), Oxford University Press
- Jae-Wook Jung, "A Comparison of the Clinical Characteristics of Intermittent Exotropia in Children and Adults", Korean Journal of Ophthalmology, 24(2), pp.96~100 (2010), 대한안과학회
- Szigiato AA, "Population trends in adult strabismus surgery", Can J Ophthalmol, 54, pp.501~508 (2019)
- Kim WJ, "Variability of preoperative measurements in intermittent exotropia and its effect on surgical outcome", J AAPOS, 21, pp.210~214 (2017)
- Kim H, "Proposing a new scoring system in intermittent exotropia : towards a better assessment of control", Can J Ophthalmol, 52, pp.235~239 (2017)
- Hatt SR, "Awareness of exodeviation in children with intermittent exotropia", Strabismus, 17, pp.101~106 (2009)
- Arnoldi KA, "Assessment of amplitude and control of the distance deviation in intermittent exotropia", J Pediatr Ophthalmol Strabismus, 45, pp.150~153 (2008)
- Hatt SR, "Variability of control in intermittent exotropia", Ophthalmology, 115, pp.371~376 (2008)