Strabismus Combined with Congenital Optic Disc Anomaly
Heeyoung Choi, MD, PhD; Hyeshin Jeon, MD
Pusan National University Hospital
Department of Ophthalmology, Medical Research Institute
179 Gudeok-ro, Seo-gu, Busan, South Korea
Introduction: The clinical manifestations of strabismus in children with optic disc lesions may be different from those without the lesions. We investigated the clinical feature of comitant strabismus combined with congenital optic disc anomaly.
Methods: We retrospectively reviewed the medical records of the patients who are diagnosed as congenital optic disc anomaly and strabismus concomitantly before 20 years old from 2011 to 2017. Patient with restrictive or paralytic strabismus was excluded. Demographics and clinical characteristics were analyzed.
Results: Total of 17 patients (10 male and 7 female) were included. Mean age was 25.94 (4 – 80) months. Six (35.3%) optic nerve hypoplasia, 9 (52.9%) excavated optic disc including 2 disc coloboma and 7 morning glory syndrome, 1 (5.9%) myelinated nerve fiber, 1 (5.9%) tilted optic disc and 1 (5.9%) optic disc atrophy. Three of 6 patients with optic nerve hypoplasia were bilateral. Nine patients had exotropia and 8 had esotropia and mean deviations were 29.29 (15 – 50, prism diopters). The mean follow-up period of 12 patients who are followed up longer than 1 year was 42.5 months. Among them, ocular deviation angle changed more than 10 prism diopters in 5 patients, and three of them showed changed type of strabismus.
Discussion: Excavated optic disc was the most common congenital deformity of optic nerve in the patient with strabismus. Exotropia and esotropia occurred in similar frequency. The clinical features of strabismus often change during the follow-up period in patients with disc anomaly.
Conclusion: Careful attention should be paid to follow-up and decision of surgery in patients with strabismus and congenital optic disc anomaly concomitantly.
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