굴절조절내사시의 임상경과: 대상부전의 발생과 안경의 중단
Long-Term Follow-Up of Refractive Accommodative Esotropia: Decompensation and Cessation of Spectacle Use
1
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적: 굴절조절내사시에서 대상부전의 발생 및 안경을 벗을 수 있을지 예측 가능한 임상양상에 대해 알아보았다. 대상과 방법: 굴절조절내사시 환아 60명을 조절군과 대상부전군으로 분류하고, 조절군 중 장기 경과관찰이 가능했던 29명을 안경유지군과 안경중단군으로 분류하여 각 군의 임상양상을 비교하였다. 결과: 대상부전군은 조절군에 비해 초진 시 교정 전 내사시각이 유의하게 컸으며, 중심융합을 획득하지 못한 경우가 많았다(p＜0.05). 내사시의 발생연령, 초진연령, 초진 시 원시값, 약시, 부등시는 두 군간 차이가 없었다(p＞0.05). 안경중단군은 유지군에 비해 초진연령이 크고, 초진 시 굴절값 및 교정 전 내사시각이 유의하게 작았다(p＜0.05). 내사시의 발생연령, 교정 후 내사시각, 연간 원시값의 변화량, 입체시, 약시, 부등시 등은 두 군에서 차이가 없었다(p＞0.05). 결론: 굴절조절내사시에서 초진 시 교정 전 내사시각이 크고, 중심융합을 획득하지 못한 경우 대상부전이 발생할 위험이 클 것으로예상되며, 초진연령이 높고, 초진 시 굴절값 및 교정 전 내사시각이 작은 경우 원시교정 안경을 벗을 수도 있을 것으로 기대할 수있다.
Abstract
Purpose: To analyze clinical characteristics of refractive accommodative esotropia related with the occurrence of decompensation and cessation of spectacle use. Methods: The records of 60 patients with refractive accommodative esotropia were reviewed. Patients were divided into a control or decompensation group. Twenty-nine patients in the control group who were followed up for long-term were divided into two groups based on spectacle use. Results: In the decompensation group, the amounts of near and distant esodeviation without correction at the first visit and the frequency of failure to achieve central fusion were significantly greater than the control group (p < 0.05). Ages at the onset of esodeviation and first visit, the amount of hyperopia at the first visit, the amounts of controlled esodeviation, amblyopia,and anisometropia were not significantly different between the two groups (p > 0.05). In the group that no longer required glasses, the age at the first visit was greater and the amount of hyperopia and the near and distant esodeviations without correction at the first visit were significantly greater than the glasses-wearing group (p < 0.05). Age at the onset of esodeviation, the amount of controlled esodeviation, refractive change per year, stereopsis, amblyopia, and anisometropia were not significantly different between the two groups (p > 0.05). Conclusions: In refractive accommodative esotropia, a larger amount of esodeviation at the first visit and failure to achieve central fusion are risk factors for developing decompensation. The older age at diagnosis and smaller amounts of hyperopia and esodeviation at the first visit are predictive factors for the cessation of spectacle use.
참고문헌 (21)
- Parks MM, "Abnormal accommodative convergence in squint", AMA Arch Ophthalmol, 59, pp.364~380 (1958)
- Dickey CF, "The deterioration of accommodative esotropia: frequency, characteristics, and predictive factors", J Pediatr Ophthalmol Strabismus, 25, pp.172~175 (1988)
- Baker JD, "Early-onset accommodative esotropia", Am J Ophthalmol, 90, pp.11~18 (1980)
- Swan KC, "Accommodative esotropia long range follow-up", Ophthalmology, 90, pp.1141~1145 (1983)
- Raab EL, "Persisting accommodative esotropia", Arch Ophthalmol, 104, pp.1777~1779 (1986)
- Lambert SR, "Accommodative esotropia", Ophthalmol Clin North Am, 14, pp.425~432 (2001)
- Yan J, "The deterioration of refractive accommodative esotropia", Zhonghua Yan Ke Za Zhi, 31, pp.352~355 (1995)
- von Noorden GK, "Refractive accommodative esotropia: a surgical problem?", Int Ophthalmol, 16, pp.45~48 (1992)
- Mulvihill A, "Outcome in refractive accommodative esotropia", Br J Ophthalmol, 84, pp.746~749 (2000)
- Raab EL, "Follow-up monitoring of accommodative esotropia", J AAPOS, 5, pp.246~249 (2001)
- 최경섭, "굴절조절내사시에서 대상부전과 추가치료의 발생 및 위험요인", 대한안과학회지, 47(1), pp.121~126 (2006), 대한안과학회
- 김동주, "굴절조절내사시에 대한 5년간의 경과관찰결과", 대한안과학회지, 48(2), pp.315~320 (2007), 대한안과학회
- Ludwig IH, "Rate of deterioration in accommodative esotropia correlated to the AC", A relationship, 1988, pp.25, 8~12
- Raab EL, "Monitoring of controlled accommodative esotropia", Trans Am Ophthalmol Soc, 99, pp.225~228 (2001)
- 김관수, "조절내사시에서 대상부전의 발생빈도 및 위험요소", 대한안과학회지, 49(12), pp.1968~1973 (2008), 대한안과학회
- Ludwig IH, "Long-term study of accommodative esotropia", J AAPOS, 9, pp.522~526 (2005)
- Black BC, "The influence of refractive error management on the natural history and treatment outcome of accommodative esotropia (an American Ophthalmological Society thesis)", Trans Am Ophthalmol Soc, 104, pp.303~321 (2006)
- Raab EL, "Etiologic factors in accommodative esodeviation", Trans Am Ophthalmol Soc, 80, pp.657~694 (1982)
- Hutcheson KA, "Weaning children with accommodative esotropia out of spectacles: a pilot study", Br J Ophthalmol, 87, pp.4~7 (2003)
- Lambert SR, "Clinical features predictive of successfully weaning from spectacles those children with accommodative esotropia", J AAPOS, 7, pp.7~13 (2003)
- 이태윤, "안경 없이 정위를 유지하게 된 조절내사시 환자의 임상 양상", 대한안과학회지, 48(12), pp.1699~1705 (2007), 대한안과학회