Arroyo-Yllanes ME, Osorio-González DI, Pérez-Pérez JF

Language: Spanish
References: 18
Page: 3-6
PDF size: 46.83 Kb.

ABSTRACT

Background: Variable exotropia is determined by a series of mechanisms that provide different clinical characteristics to outline individual therapy. There is no specific categorization that can identify such an entity. A clinical classification is proposed that includes different clinical features in accordance with the mechanisms involved in the variability genesis of such exotropias. Methods: Patients with a diagnosis of variable angle exotropia without previous surgery were included. A complete ophthalmic and strabismus exploration was performed. Variability characteristics were studied and grouped by entries in the classification proposed.
Results: Ninety patients were examined from the Pediatric Ophthalmology and Strabismus Unit of the General Hospital of Mexico O.D., with a diagnosis of variable angle exotropia. The following forms of presentations were found: secondary variable angle exotropia due to neurological alteration in 32 cases (35.5%), secondary variable angle exotropia due to monocular bad vision in 19 cases (21.2%), dissociated horizontal deviation in 14 cases (15.5%), mixed variable angle exotropia in 22 cases (4.5%) and primary variable angle exotropia in 3 cases (3.33%).
Conclusions: This classification allows categorization of all patients of variable angle exotropia into proposed categories. The most common mechanism responsible for variability is neurological alteration. Primary variable angle exotropias are rare and are present in a minimum percentage.

REFERENCES

1. Wilson ME. Exotropia. Focal Points 1995;13:1-8.

2. Prieto-Díaz J, Souza-Dias C. Strabismus. 4th ed. Woburn, MA: Butterworth-Heinemann;1999.

3. Romero-Apis D. Estrabismo. 1ª ed. México: Auroch; 1998.

4. Wilson ME, Buckley GE, Kivlin JD, Ruttum, MS, Simon, JW, Magoon EH. Pediatric ophthalmology and strabismus. American Academy of Ophthalmology. Basic and Clinical Science Course. Section 6. San Francisco, CA;1998-1999.

5. Von Noorden GK. Binocular Vision and Ocular Motility. Houston, Tx;1990. pp. 323-336.

6. Trejo-Morán A, Arroyo-Yllanes ME, Jeppesen-Martínez E, Arroyo-Moreno JA. Endotropía de ángulo variable: factores etiopatogénicos. Rev Mex Oftalmol 1994;68:191-194.

7. Arroyo-Yllanes ME, Benítez-Nava MA, Garrido E. Ophthalmological changes in patients with cerebral palsy. Am Orthop J 1998;48:104-111.

8. Arroyo-Yllanes ME, Manzo-Villalobos G, Pérez-Pérez JF, Garrido E. Strabismus in patients with cerebral palsy. Am Orthop J 1999;49:141-147.

9. Arroyo-Yllanes ME, Benítez-Nava A, Garrido E. Comportamiento del estrabismo en la parálisis cerebral. Cir Ciruj 1999;67:208-211.

10. Romero-Apis D. Comportamiento clínico de los estrabismos secundarios. Anal Soc Mex Oftalmol 1980;54:145-152.

11. García-Valdespino E, Campomanes-Eguiarte G, Romero-Apis D, Acosta-Silva M. Observaciones clínicas en los estrabismos secundarios. Rev Mex Oftalmol 1996;70:230-233.

12. Biglan RW, Davis JS, Cheng, KP, Pettapiece MC. Infantile exotropia. J Pediatr Ophthalmol Strabismus 1996;33:79-84.

13. Arroyo-Yllanes ME, Del Ángel-Arenas MT, Martínez-Espino A. Estrabismos secundarios y su relación con la refracción del ojo fijador. Rev Mex Oftalmol 1996;70:250-253.

14. Riancho-Sánchez G, Arroyo-Yllanes ME, Pérez-Pérez JF. Frecuencia de las desviaciones verticales asociadas a los estrabismos secundarios. Rev Mex Oftalmol 2000;74:271-276.

15. Romero-Apis D, Castellanos-Bracamontes A. Desviación horizontal disociada. Rev Mex Oftalmol 1990;64:169-173.

16. Romero-Apis D, Castellanos-Bracamontes A. Dissociated horizontal deviation: clinical findings and surgical results in 20 patients. Binocular Vis 1992;7:173-178.

17. Quintana-Palí L. Desviación horizontal disociada. Bol Oftalmol Nta Sra de la Luz 1990;42:91-94.

18. Wilson ME, McClatchey SK. Dissociated horizontal deviation. J Pediatr Ophthalmol Strabismus 1991;28:90-96.