목적 : 우리나라 소아 감각사시의 임상 특징을 알아보았다. 대상과 방법 : 16세 이전에 감각사시로 진단된 환아 71명을 후향적으로 분석하였으며, 사시약시나 굴절부등약시는 제외하였다. 시각상실의 원인, 발생 시기, 진단 시 나이, 편위 방향, 편위각, 편위안의 시력을 조사하였다. 사시수술을 한 경우 그 결과를 알아보았다. 결과 : 평균 4.6세에 시각상실이 발생하여 평균 7.5세에 감각사시로 진단되었다. 선천 시각상실이 41명(58%)이었다. 원인질환으로 시신경 질환이 35명(49%)으로 가장 많았다. 외사시가 58명(82%)이었으며, 편위안의 시력이 불량한 경우에 외사시의 빈도가 더 높았다(P=0.054). 시각상실의 발생 나이와 진단 시 나이는 내사시군에서 외사시군보다 더 어렸다(P=0.049, P=0.047). 사시 수술을 시행한 32명 중 25명(78%)에서 정위에서 10 프리즘디옵터 이내의 안위를 유지하였다. 내사시 수술 후 속발외사시의 발생 빈도가 40%로 높았다. 결론 : 소아에서 기질약시에 의하여 발생하는 감각사시의 형태는 외사시가 가장 많았고, 편위안의 시력 저하 정도와 시각상실의 발생 나이가 편위 방향과 관련 있었다. 사시 수술 후 성공률은 비교적 양호하였으나, 감각내사시 수술 시 속발외사시가 많이 발생하였다. <한안지 46(8):1374-1381, 2005>

Purpose: To study the clinical characteristics of pediatric sensory strabismus in Korean children. Methods: A retrospective analysis was performed on 71 patients with the diagnosis of sensory strabismus before the age of 16 years. Patients with strabismic amblyopia or anisometropic amblyopia were excluded from consideration. The age at onset of vision loss, diagnosis, type of strabismus, deviated angle, etiologic factors leading to vision loss, and visual acuity of the deviated eye were recorded. The surgical results were analyzed in the case of strabismus surgery for sensory strabismus. Results: The mean age at the onset of vision loss was 4.6 years and the mean age at diagnosis was 7.5 years. Forty-one patients (58%) had congenital vision loss and the most common cause of vision loss was optic nerve disease in 35 (49%). Exotropia developed in 58 (82%), and patients with severely impaired visual acuity were more likely to develop exotropia (P=0.054). The age at the onset of vision loss and the age at diagnosis in esotropia were younger than in exotropia (P=0.049, P=0.047, respectively). Twenty-five (78%) of 32 patients who had undergonewere strabismus surgery had ocular alignment within 10 prism diopters of orthophoria. The frequency of consecutive exotropia was 40% in surgery for esotropia. Conclusions: Children with organic amblyopia tend to develop sensory exotropia. We considered that the age at initial vision loss and the severity of vision loss could play a role in determining the direction of deviation. The surgical results were favorable, but we should pay attention to the development of consecutive exotropia in surgery for esotropia.

Purpose: To study the clinical characteristics of pediatric sensory strabismus in Korean children. Methods: A retrospective analysis was performed on 71 patients with the diagnosis of sensory strabismus before the age of 16 years. Patients with strabismic amblyopia or anisometropic amblyopia were excluded from consideration. The age at onset of vision loss, diagnosis, type of strabismus, deviated angle, etiologic factors leading to vision loss, and visual acuity of the deviated eye were recorded. The surgical results were analyzed in the case of strabismus surgery for sensory strabismus. Results: The mean age at the onset of vision loss was 4.6 years and the mean age at diagnosis was 7.5 years. Forty-one patients (58%) had congenital vision loss and the most common cause of vision loss was optic nerve disease in 35 (49%). Exotropia developed in 58 (82%), and patients with severely impaired visual acuity were more likely to develop exotropia (P=0.054). The age at the onset of vision loss and the age at diagnosis in esotropia were younger than in exotropia (P=0.049, P=0.047, respectively). Twenty-five (78%) of 32 patients who had undergonewere strabismus surgery had ocular alignment within 10 prism diopters of orthophoria. The frequency of consecutive exotropia was 40% in surgery for esotropia. Conclusions: Children with organic amblyopia tend to develop sensory exotropia. We considered that the age at initial vision loss and the severity of vision loss could play a role in determining the direction of deviation. The surgical results were favorable, but we should pay attention to the development of consecutive exotropia in surgery for esotropia.

Children, Esotropia, Exotropia, Sensory strabismus, Surgical outcome