Journal of Korean Ophthalmic Optics Society (한국안광학회지)

The Korean Ophthalmic Optics Society (한국안광학회)
권호 표지
DOI QR코드

DOI QR Code

Effect of Overcorrection (-)Lens on Stereo-acuity and Angle of Deviation in Intermittent Exotropia

간헐외사시에서 과교정 (-)렌즈가 입체시 및 사시각에 미치는 영향

  • Kim, Young Cheong (Dept. of Medical science, Chonnam National University) ;
  • Park, Sang Woo (Dept. of Ophthalmology, Chonnam National University Medical School and Hospital)
  • 김영청 (전남대학교 의학과) ;
  • 박상우 (전남대학교 의과대학 안과학교실)
  • Received : 2013.07.29
  • Accepted : 2013.09.14
  • Published : 2013.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study was conducted to evaluate the effect of prescription of overcorrection (-) lens, which is the one of the non-surgical treatments, on stereo-acuity and angle of deviation in intermittent exotropia. Methods: Twenty four children with intermittent exotropia were enrolled from October 2011 to December 2011. The angle of deviation(${\Delta}$), stereo-acuity (arcsec), monocular and binocular visual acuity (BVA, LogMAR), control of exodeviation and fusional ability using Worth 4 dot test were evaluated at near (33 cm) and far (6 m), under the overcorrecting (-)lens of -1.00, -.00, and -.00 D. Results: As a baseline finding, the angle of exodeviation was $20.9{\pm}9.7$ at near and $23.0{\pm}7.5$ at far. The angle of exodeviation at near decreased to $18.5{\pm}10.0$ (p<0.01), $15.8{\pm}9.0$ (p<0.01), $14.0{\pm}9.1$ (p<0.01) compared with baseline angle of exodeviation at near, as increasing diopters of (-) lens from -.00 D, -2.00 D and -.00 D, respectively. The angle of exodeviation at far also decreased to $21.4{\pm}5.2$ (p=0.01), $19.6{\pm}6.3$ (p<0.01) compared with baseline, as increasing minus lens from -2.00 D and -3.00 D, respectively. However, BVA, control of exodeviation, fusional ability and stereo-acuity showed no significant decrease despite of increasing diopters of (-)lens. Conclusions: The prescription of overcorrection (-)lens is an effective therapeutic method in intermittent exotropia which can reduce the near and far angle of exodeviation, and binocular visual acuity and stereo-acuity maintained without significant decrease despite of application of overcorrection (-)lens.

목적: 간헐외사시의 비수술적 치료법들 중의 하나인 과교정 (-)렌즈 처방이 입체시와 사시각에 미치는 영향에 대해 연구하였다. 방법: 2011년 10월부터 2011년 12월까지 전남대학교 병원에서 간헐외사시로 진단받은 환자 24명을 대상으로 -1.00, -2.00, 그리고 -3.00 D의 단계적인 과교정 (-)렌즈를 착용하게 한 후 근거리(33 cm)와 원거리(6 m)에서 사시각(prism diopter, ${\Delta}$), 입체시(second of arc, arcsec), 양안시력(LogMAR), 사시조절능력(control of exodeviation) 및 워쓰4등검사를 이용한 융합력의 변화를 측정하였다. 결과: 과교정 전의 평균 사시각은 근거리 $20.9{\pm}9.7$ ${\Delta}$, 원거리 $23.0{\pm}7.5$ ${\Delta}$이다. -1.00, -2.00, -3.00 D의 (-)렌즈 착용 시 근거리 사시각은 각각 $18.5{\pm}10.0$ ${\Delta}$ (p<0.01), $15.8{\pm}9.0$ ${\Delta}$ (p<0.01), 그리고 $14.0{\pm}9.1$ ${\Delta}$ (p<0.01)로 의미 있게 감소하였으며, 원거리 사시각은 -2.00 D 및 -3.00D의 렌즈 착용 시 각각 $21.4{\pm}5.2$ ${\Delta}$ (p=0.01), $19.6{\pm}6.3$ ${\Delta}$ (p<0.01)으로 감소하였다. 이에 반하여 양안시력, 사시조절능력, 융합력, 입체시는 과교정 (-)렌즈를 처방하더라도 의미 있는 감소를 보이지 않고 유지되었다(p>0.05). 결론: 간헐외사시에서 과교정 (-)렌즈 처방은 근거리 및 원거리 외사시각을 줄일 수 있는 효과적인 방법이며 과교정 시 양안시력과 입체시는 감소하지 않고 유지됨을 알 수 있었다.

Keywords

References

  1. Rah SH, Jun HS, Kim SH. An epidemiologic survey of strabismus among school-children in Korea. J Korean Ophthalmol Soc. 1997;38(12):2195-2199.
  2. Nusz KJ, Mohney BG, Diehl NN. The course of intermittent exotropia in a population-based cohort. Ophthalmology. 2006;113(7):1154-1158. https://doi.org/10.1016/j.ophtha.2006.01.033
  3. Romanchuk KG, Dotchin SA, Zurevinsky J. The natural history of surgically untreated intermittent exotropia-looking into the distant future. J AAPOS. 2006;10(3):225-231. https://doi.org/10.1016/j.jaapos.2006.02.006
  4. Stathacopoulos RA, Rosenbaum AL, Zanoni D, Stager DR, McCall LC, Ziffer AJ, et al. Distance stereoacuity. assessing control in intermittent exotropia. Ophthalmology. 1993;100(4):495-500. https://doi.org/10.1016/S0161-6420(93)31616-7
  5. Hatt SR, Mohney BG, Leske DA, Holmes JM. Variability of control in intermittent exotropia. Ophthalmology. 2008; 115(2):371-376. https://doi.org/10.1016/j.ophtha.2007.03.084
  6. Caltrider N, Jampolsky A. Overcorrecting minus lens therapy for treatment of intermittent exotropia. Ophthalmology. 1983;90(10):1160-1165. https://doi.org/10.1016/S0161-6420(83)34412-2
  7. Kennedy JR. The correction of divergent strabismus with concave lenses. Am J Optom. 1954;31(12):605-614. https://doi.org/10.1097/00006324-195412000-00001
  8. Goodacre H. Minus overcorrection: conservative treatment of intermittent exotropia in the young child? a comparative study. Aust Orthopt J. 1985;22(1):9-17.
  9. Reynolds JD, Wackerhagen M, Olitsky SE. Over-minus lens therapy for intermittent exotropia. Am Orthopt J. 1994; 44(1):86-91.
  10. Haggerty H, Richardson S, Hrisos S, Strong NP, Clarke MP. The newcastle control score: a new method of grading the severity of intermittent distance exotropia. Br J Ophthalmol. 2004;88(2):233-235. https://doi.org/10.1136/bjo.2003.027615
  11. Rutstein RP, Fuhr P, Schaafsma D. Distance stereopsis in orthophores, heterophores, and intermittent strabismics. Optm Vis Sci. 1994;71(7):415-421. https://doi.org/10.1097/00006324-199407000-00001
  12. Koklanis K, Georgievski Z, Zhang K. The use of distance stereoacuity assessment in determining the effectiveness of minus lenses in intermittent exotropia. J AAPOS. 2010; 14(6):488-493. https://doi.org/10.1016/j.jaapos.2010.08.010
  13. Rowe FJ, Noonan CP, Freeman G, Debell J. Intervention for intermittent distance exotropia with overcorrecting minus lenses. Eye. 2009;23(2):320-325. https://doi.org/10.1038/sj.eye.6703057
  14. Yildirim C, Mutlu FM, Chen Y, Altinsoy HI. Assessment of central and peripheral fusion and near and distance stereoacuity in intermittent exotropic patients before and after strabismus surgery. Am J Ophthalmol. 1999;128(2): 222-230. https://doi.org/10.1016/S0002-9394(99)00079-3
  15. Matsuo T, Yamane T, Fujiwara H, Ohtsuki H, Watanabe Y. Predictive factors for long-term outcome of stereoacuity in Japanese patients with pure accommodative esotropia. Strabismus. 2005;13(2):79-84. https://doi.org/10.1080/09273970590935084
  16. Chung YR, Yang H, Lew HM, Lee JB, Chang YH. The assessment of stereoacuity in patients with strabismus. J Korean Ophthalmol Soc. 2008;49(8):1309-1316. https://doi.org/10.3341/jkos.2008.49.8.1309
  17. Jin HC, Lee YC, Lee SY. Relationship between control grade and stereoacuity in basic intermittent exotropia. J Korean Ophthalmol Soc. 2012;53(1):133-137. https://doi.org/10.3341/jkos.2012.53.1.133
  18. Scott WE, Mash J. stereoacuity in normal individuals. Ann Ophthalmol. 1974;6(1):99-101.
  19. Wright KW, Spiegel PH. Pediatric ophthalmology and strabismus, 2nd Ed. New York: Springer, 2002;144-149.
  20. Walsh LA, LaRoche GR, Tremblay F. The use of binocular visual acuity in the assessment of intermittent exotropia. J AAPOS. 2000;4(3):154-157. https://doi.org/10.1016/S1091-8531(00)70005-X
  21. Von Noorden GK,Campos EC. Binocular vision and space perception. In: Lampert R. Binocular vision and ocular motility, 6th Ed. St. Louis: Mosby, 2001;7-37.
  22. Kim SH, Suh YW, Song JS, Park JH, Kim YY, Huh K, et al. Clinical research on the ophthalmic factors affecting 3D asthenopia. J Pediatr Ophthalmol Strabismus. 2012;49(4): 248-253. https://doi.org/10.3928/01913913-20120207-03
  23. Arthur BW, Keech RV. The polarized 3-dot test. J Pediatr Ophthalmol Strabismus. 1987;24(6):305-308.
  24. Lee SY, Bae SH. Comparison of various kinds of stereocuity tests in preschool children. J Korean Ophthalmol Soc. 2000;41(9):1983-1988.

Cited by

  1. The Effects of Nonsurgical Treatment in Intermittent Exotropia by Meta-Analysis vol.19, pp.4, 2013, https://doi.org/10.17337/jmbi.2017.19.4.385
  2. The Role of Accessibility in Distribution of Optician’s Shop: Focusing on Seoul Metropolitan Subway Station Area Using Geographic Information System vol.25, pp.1, 2020, https://doi.org/10.14479/jkoos.2020.25.1.1
  3. Refractive Error Changes with Accommodation and Its Component Occurring by Near Vision vol.26, pp.1, 2013, https://doi.org/10.14479/jkoos.2021.26.1.35