Refraktif akomodatif ezotropya hastalarında stereopsis düzeyi ve ilişkili faktörler

Öz

Amaç: Refraktif akomodatif ezotropyası olan hastalarda stereopsis düzeyini değerlendirmek ve stereopsise etki
eden faktörleri ortaya çıkarmak.
Yöntemler: Ocak 2010- Haziran 2020 yılları arasındaki refraktif akomodatif ezotropya ile takip edilen hastaların
kayıtları retrospektif olarak gözden geçirildi. Yaş, sikloplejik kırma kusuru, iki göz arasındaki kırma kusuru
farkı, yakın ve uzak fiksasyondaki kayma açısı, füzyon kabiliyeti ve stereo keskinlik değerlendirildi. Hastalar
stereopsis düzeyine göre 2 gruba ayrıldı: iyi stereopsis (40-100 sn ark), zayıf stereopsis (>100 sn ark).
Bulgular: Toplam 62 hasta dahil edildi. Bunlardan 14 hasta (22,5%) iyi stereopsis grubundaydı. İlk vizitteki yaş
ortalaması 5,35 idi (3-11 yaş aralığı). İlk vizitteki ortalama yaş, iki göz arasındaki kırma kusuru farkı, son
vizitteki gözlükle kayma açısı, iyi stereopsis grubunda, zayıf stereopsis grubuna göre düşük bulundu. Ancak,
yalnızca uzak fiksasyondaki ortalama kayma açısındaki düşüklük istatistiksel olarak anlamlı olarak bulundu.
(p=0,038)
Sonuç: İyi stereopsise sahip olan refraktif akomodatif ezotropya hastalarında uzak fiksasyondaki artık kayma
miktarı anlamlı derecede düşüktür. 

Anahtar Kelimeler

• akomodatif ezotropya
• binoküler görme
• füzyon
• stereopsis

Evaluation of stereopsis level and it’s associated factors in patients with refractive accommodative esotropia

Abstract

Aim: To investigate the level of stereopsis in patients with refractive accommodative esotropia and to find out
associated factors with good stereopsis.
Methods: The hospital records of patients with refractive accommodative esotropia from January 2010 to June
2020 were retrospectively reviewed. Age, cycloplegic refractive error, the difference of refractive error between
two eyes, angle of deviation at near and distance fixation, fusional ability and stereoacuity were evaluated.
Patients were divided into two groups according to the stereopsis level: good stereopsis (40-100 arcsec) and
poor stereopsis (>100 arcsec).
Results: A total of 62 patients were inclueded. Of them, 14 patients (22.5 %) were in good stereopsis group. The
mean age was 5.35 years (range 3-11 years). The mean age at first visit, refractive differences between eyes and
final deviation angle with spectacle were smaller in the good stereopsis group than in the poor stereopsis group.
But, only the mean deviation angle at distance was found significant statistically between two groups. (p=0.038)
Conclusion: Residual esodeviation at distance fixation was significantly lower in patients with refractive
accommodative esotropia who have good stereopsis.

Keywords

• accommodative esotropia
• binocular vision
• fusion
• stereopsis.

Kaynakça

1. 1. Rutstein RP (2008) Update on accommodative esotropia. Optometry 79:422–431
2. 2. Fielder AR, Moseley MJ. Does stereopsis matter in humans? Eye. 1996;10:233-238.
3. 3. Guclu H, Gurlu VP, Ozal SA, Ozkurt ZG (2015) Prognostic factors for stereopsis in refractive accommodative esotropia.Pak J Med Sci 31(4):807–811
4. 4. Lee HJ, Kim S-J, Yu YS (2017) Stereopsis in patients with refractive accommodative esotropia. J AAPOS.
5. 5. Wilson ME, Bluestein EC, Parks MM. Binocularity in accommodative esotropia. J Pediatr Opthalmol Strabismus 1993;30:233–8.
6. 6. Kose S, Pamukcu K, Haznedaroglu G. Qualitative and quantitative evaluation of binocular function in accommodative esotropia using pattern reversal visual evoked responses (VER).Neuro-ophthalmology 1993;13:275–9.
7. 7. Reddy AK, Freeman CH, Paysee EA, Coats DK. A data-driven approach to the management of accommodative esotropia. Am J Ophthalmology. 2009;148(3):466-470
8. 8. Berk T, Koçak N, Ellidokuz H. Treatment outcomes in refractive accommodative esotropia. JAAPOS. 2004;8(4):384-388

9. 9. Uretmen O, Kose S, Oztas Z, Egrilmez S. Factors influencing stereoacuity in refractive accommodative esotropia. Can J Ophthalmol. 2007;42(4):600-604.
10. 10. Mulvihill A, Maccann A, Flifcroft I, Keefe M. Outcome in refractive accommodative esotropia. Br J Ophthalmol. 2000;84(7):746-749.
11. 11. Tomac S. Binocularity in refractive accommodative esotropia. J Pediatr Ophthalmol Strabismus. 2002;39(4):226-230
12. 12. Lambert SR, Lynn MJ. Longitudinal changes in the spherical equivalent refractive error of children with accommodative esotropia. Br J Ophthalmol. 2006;90(3):367-361.
13. 13. Fawcett SL, Birch EE. Risk factors for abnormal binocular vision after successful alignement of accommodative esotropia. JAAPOS. 2003;7:256-262
14. 14. Cakir B, Bursalı O, Ozmen S, Aksoy NA, Babashli T, Alagoz G. Factors influencing stereopsis in patients with both refractive accommodative esotropia and amblyopia. Int Ophthalmol. 2018. Doi: 10.1007/s10792-018-0937-8.
15. 15. Wong AM, Lueder GT, Burkhalter A, Tychsen L. Anomalous retinal correspondance: neuroanatomic mechanism in strabismus monkeys and clinical findings in strabismic children. J AAPOS 2000;4:168-74.
16. 16. Hatt SR, Mohney BG, Leske DA, Holmes JM. Variability of stereoacuity in intermittent exotropia. Am J Ophthalmol 2008;145:556-61.