목적: 안경교정으로 성공적 눈위치를 보였던 조절내사시 환자들의 일부에서 대상부전이 발생할 수 있다. 저자들은 대상부전의 발생빈도와 대상부전 발생에 영향을 주는 요소를 알아봄으로써 조절내사시 환자의 추적관찰 중 주의를 요하는 임상양상을 알아보고자 하였다. 대상과 방법: 안경교정(이중초점안경 포함)만으로 내사시각이 8프리즘디옵터(PD) 이하로 유지되었던 조절내사시 환자 중 2년 이상의 추적관찰이 가능했던 89명을 대상으로 하였다. 추적 관찰 중 굴절이상의 완전 교정으로도 내사시각이 10PD 이상으로 증가했던 환자(대상부전군)의 빈도를 알아보고, 안경만으로 내사시가 잘 조절되었던 조절군과의 임상양상을 비교하였다. 결과: 추적관찰기간은 64.1±29.3개월이었다. 대상 환자 89명 중 7.8%에서 대상부전이 발생하였으며 첫 안경교정 후 41.8±26.9개월에 대상부전이 발생하였다. 대상부전군에서 입체시가 유의하게 나빴으며(p=0.024), 빈도분석에서는 대상부전군에서 AC/A비가 높은 경우가 유의하게 많았다(p=0.003). 결론: 입체시가 나쁘거나 높은 AC/A비를 보이는 조절내사시 환자들은 추적관찰 중 대상부전 발생의 위험이 높을 수 있을 것으로 보인다.

Purpose: A number of patients with accommodative esotropia who were initially well controlled with their optical correction will deteriorate. This study aims to examine the cautious clinical features of patients with accommodative esotropia during follow-up period by obtaining the prevalence and the predictive factors of deterioration in accommodative esotropia. Methods: The records of 89 patients with accommodative esotropia whose eyes were aligned with optical correction (including bifocals) to 8 prism diopters (PD) of esotropia or less were reviewed. All patients were followed for a period of at least 2 years. The patients whose alignment was increased to 10PD of esotropia or greater during the follow-up period were included into the deteriorated group. We obtained the rate of deterioration and compared the clinical features of the deteriorated and controlled group. Results: The mean follow-up period was 64.1±29.3 months. Seven (7.8%) of 89 patients was deteriorated. The mean interval of deterioration after initial optical correction was 41.8±26.9 months. The stereopsis was significantly worse in the deteriorated group (p=0.024). The frequency of high AC/A ratio was also significantly higher in the deteriorated group (p=0.003). Conclusions: This study indicates that accommodative esotropia with high AC/A ratio or worse sensory status has an increased likelihood of deterioration.

Purpose: A number of patients with accommodative esotropia who were initially well controlled with their optical correction will deteriorate. This study aims to examine the cautious clinical features of patients with accommodative esotropia during follow-up period by obtaining the prevalence and the predictive factors of deterioration in accommodative esotropia. Methods: The records of 89 patients with accommodative esotropia whose eyes were aligned with optical correction (including bifocals) to 8 prism diopters (PD) of esotropia or less were reviewed. All patients were followed for a period of at least 2 years. The patients whose alignment was increased to 10PD of esotropia or greater during the follow-up period were included into the deteriorated group. We obtained the rate of deterioration and compared the clinical features of the deteriorated and controlled group. Results: The mean follow-up period was 64.1±29.3 months. Seven (7.8%) of 89 patients was deteriorated. The mean interval of deterioration after initial optical correction was 41.8±26.9 months. The stereopsis was significantly worse in the deteriorated group (p=0.024). The frequency of high AC/A ratio was also significantly higher in the deteriorated group (p=0.003). Conclusions: This study indicates that accommodative esotropia with high AC/A ratio or worse sensory status has an increased likelihood of deterioration.