A Cluster of Cyclic Esotropia: White Matter Changes on MRI and Surgical Outcomes
| Autor: | Kimberly Merrill, Daniel Watson, Raymond G. Areaux, Jill S. Anderson |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Male
medicine.medical_specialty Time Factors genetic structures Eye Movements Ophthalmologic Surgical Procedures White matter 03 medical and health sciences 0302 clinical medicine Cyclic esotropia 030225 pediatrics medicine Humans Strabismus Retrospective Studies Vision Binocular Esotropia business.industry Thyroid Retrospective cohort study General Medicine medicine.disease White matter changes Magnetic Resonance Imaging White Matter eye diseases Surgery Frontal Lobe Ophthalmology medicine.anatomical_structure Treatment Outcome Frontal lobe Oculomotor Muscles Child Preschool Pediatrics Perinatology and Child Health 030221 ophthalmology & optometry Female sense organs business Follow-Up Studies |
| Zdroj: | Journal of pediatric ophthalmology and strabismus. 56(3) |
| ISSN: | 1938-2405 |
| Popis: | Purpose: To report a series of patients with cyclic esotropia, their surgical outcomes, and incidental findings. Methods: The medical records of five patients with cyclic esotropia presenting over 17 months were reviewed. Age at onset, ocular and motility examinations, brain magnetic resonance imaging (MRI), acetylcholine receptor antibodies, thyroid hormone levels and antibodies, calendars documenting phases, surgical treatments, postoperative alignment, and fusion were documented. Results: Three boys and two girls presented at 3 to 4 years old in 2015–2016. Typical periodicity followed a 48-hour cycle. Duration of cycling varied from 1 to 9 weeks. Mean maximum deviation was 37 prism diopters (PD) of esotropia (range: 35 to 40 PD of esotropia). All patients had normal laboratory studies. MRIs showed an abnormal white matter signal in the frontal lobes in 2 patients and were normal in the others. Bilateral medial rectus recessions for the maximum angle were successful in 4 patients at a minimum follow-up of 13 months; the other patient required reoperation for a residual esotropia. Fusion was present in 4 patients preoperatively and all postoperatively. Stereopsis was stable or improved in all postoperatively. Conclusions: This is the first report of frontal white matter changes occurring in the setting of cyclic esotropia. MRI with attention to frontal lobe white matter might be considered in the work-up of cyclic esotropia to determine if this is a common finding. Bilateral medial rectus recessions can restore fusion in these patients. [ J Pediatr Ophthalmol Strabismus . 2019;56(3):178–182.] |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|