Saumya M Shah1, Jennifer M Martinez-Thompson2, Nancy N Diehl3, Brian G Mohney4. 1. Mayo Clinic School of Medicine, Mayo Clinic, Rochester, Minnesota. 2. Department of Neurology, Mayo Clinic, Rochester, Minnesota. 3. Division of Biostatistics, Mayo Clinic, Jacksonville, Florida. 4. Department of Ophthalmology, Mayo Clinic, Rochester, Minnesota. Electronic address: mohney@mayo.edu.
Abstract
PURPOSE: To describe the prevalence and clinical features of a common but underrecognized disorder of adult vertical strabismus. METHODS: The medical records of all adult (≥19 years of age) residents of Olmsted County, Minnesota, diagnosed with nonparalytic, small-angle hypertropia (NPSAH) from January 1, 1985, through December 31, 2004, were retrospectively reviewed for demographic and clinical features. RESULTS: Of 753 patients diagnosed with adult-onset strabismus, 99 (13.1%) were found to have NPSAH, yielding an annual incidence of 7.50 per 100,000 patients >18 years of age and a cumulative incidence of 1.28%. The median age at diagnosis was 71 years (range, 27-98 years); 63 (64%) were women. Diplopia was reported at the initial diagnosis in 91 patients (93.8%), with 90 (92.8%) having the diplopia in primary or reading position. The median initial angle of hypertropia was 2Δ (range, 1Δ-22Δ) at near and 2Δ (range, 0Δ-12Δ) at distance. After a median follow-up of 10.8 years (range, 6.2 months to 23.7 years), the final median angle of vertical deviation was 4Δ (range, 0Δ-20Δ) at near and 4Δ (range, 0Δ-16Δ) at distance for all 99 patients. CONCLUSIONS: NPSAH is a relatively common but infrequently recognized disorder among adults. More prevalent among elderly and female patients in this study cohort, the vast majority presented with diplopia and a hypertropia of ≤10Δ that progressed over time.
PURPOSE: To describe the prevalence and clinical features of a common but underrecognized disorder of adult vertical strabismus. METHODS: The medical records of all adult (≥19 years of age) residents of Olmsted County, Minnesota, diagnosed with nonparalytic, small-angle hypertropia (NPSAH) from January 1, 1985, through December 31, 2004, were retrospectively reviewed for demographic and clinical features. RESULTS: Of 753 patients diagnosed with adult-onset strabismus, 99 (13.1%) were found to have NPSAH, yielding an annual incidence of 7.50 per 100,000 patients >18 years of age and a cumulative incidence of 1.28%. The median age at diagnosis was 71 years (range, 27-98 years); 63 (64%) were women. Diplopia was reported at the initial diagnosis in 91 patients (93.8%), with 90 (92.8%) having the diplopia in primary or reading position. The median initial angle of hypertropia was 2Δ (range, 1Δ-22Δ) at near and 2Δ (range, 0Δ-12Δ) at distance. After a median follow-up of 10.8 years (range, 6.2 months to 23.7 years), the final median angle of vertical deviation was 4Δ (range, 0Δ-20Δ) at near and 4Δ (range, 0Δ-16Δ) at distance for all 99 patients. CONCLUSIONS:NPSAH is a relatively common but infrequently recognized disorder among adults. More prevalent among elderly and female patients in this study cohort, the vast majority presented with diplopia and a hypertropia of ≤10Δ that progressed over time.
Authors: Kevin K Veverka; Sarah R Hatt; David A Leske; William L Brown; Raymond Iezzi; Jonathan M Holmes Journal: Am J Ophthalmol Date: 2017-04-27 Impact factor: 5.258
Authors: Sarah R Hatt; David A Leske; Lindsay D Klaehn; Andrea M Kramer; Raymond Iezzi; Jonathan M Holmes Journal: Am J Ophthalmol Date: 2019-07-16 Impact factor: 5.258