Clinical characteristics of acute acquired concomitant esotropia in China: a retrospective study

Abstract

Purpose To compare the clinical characteristics of acute acquired concomitant esotropia (AACE) patients in different age of onset groups before and after the coronavirus disease 2019 (COVID-19) pandemic. Methods A retrospective study included 126 patients who underwent AACE surgery from January 2015, and December 2023. Detailed information on demographic data and clinical characteristics was collected and compared between different age of onset groups. Results A total of 115 patients (91.3%) spent more than four hours a day for near work. The near and distance deviations were 20.00 (12.00, 30.00) prism diopters (PD) and 25.00 (20.00, 35.00) PD, respectively, which has significant difference (P < 0.001). The mean spherical equivalent (SE) of non-dominant and dominant eye were − 4.00 (-5.31, -2.50) diopters (D) and − 4.00 (-5.31, -2.25) D, respectively (P = 0.001). The child group included 40 patients, while the adult group included 86 patients. The near and distance deviations in the child group were 25.00 (16.50, 70.00) PD and 35.00 (25.00, 71.50) PD, respectively, and those in the adult group were 20.00 (12.00, 30.00) PD and 25.00 (18.00, 35.00) PD, respectively. The near and distance deviation were both significantly larger in the child group compared with the adult group (P = 0.02 and P = 0.004), while no statistically significant difference was observed in duration of disease (P = 0.128). The mean SE of dominant eye and non-dominant eye both had larger degrees of myopia in the adult group than the child group (P = 0.001 and P = 0.028). The duration of disease in the pre-pandemic group was significantly longer than the post-pandemic group (P < 0.001). Conclusions The non-dominant eye had a larger degree of myopia than the dominant eye, and the distance esodeviation was larger than the near esodeviation in AACE patients. Children presented a larger esodeviation and were less myopic than that of adults. The disease progressed more quickly to require surgery and the number of AACE surgeries increased remarkably after the COVID-19 pandemic.