Purpose: Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis (ITS) in children. This study aims to investigate whether superior oblique palsy (SOP) poses a higher risk for developing ITS among children and adolescents.

Methods: A cross-sectional study. The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years; Patients within the same age range with ocular trauma were enrolled as the control group. Preoperative chest plain radiographs were used to measure the Cobb angle. Demographic information and clinical data, including diopter, best corrected visual acuity, deviation degree, and binocular function, were analyzed.

Results: A significantly higher prevalence of ITS was found in study group compared with control group (12.68% vs 4.18%，p< 0.001) . Additionally, the mean Cobb angle was lagrger in SOP group than that in control group (5.02°±3.87° vs 3.84°±3.09°, p < 0.001). Males in SOP group showed a higher prevalence of ITS  (12.9% vs 2.87%, p = 0.007), but there was no significant difference in females between two groups (12.3% vs 7.69%, p = 0.295). Good near stereopsis acuity was  significantly associated with high prevalence of thoracic scoliosis (p<0.001). Multivariate logistic regression analysis revealed that a large distant magnitude of deviation (>20PD) and near stereoacuity were significantly associated with ITS.

Conclusions: Patients with SOP have a significantly  higher risk of developing idiopathic thoracic scoliosis, especially those with good near stereoscopic and large distant magnitude of deviation. 

Purpose: Strabismus is associated with a higher prevalence of idiopathic thoracic scoliosis (ITS) in children. This study aims to investigate whether superior oblique palsy (SOP) poses a higher risk for developing ITS among children and adolescents.

Methods: A cross-sectional study. The study group comprised 347 consecutive candidates for SOP surgery aged 4 to 18 years; Patients within the same age range with ocular trauma were enrolled as the control group. Preoperative chest plain radiographs were used to measure the Cobb angle. Demographic information and clinical data, including diopter, best corrected visual acuity, deviation degree, and binocular function, were analyzed.

Results: A significantly higher prevalence of ITS was found in study group compared with control group (12.68% vs 4.18%，p< 0.001) . Additionally, the mean Cobb angle was lagrger in SOP group than that in control group (5.02°±3.87° vs 3.84°±3.09°, p < 0.001). Males in SOP group showed a higher prevalence of ITS  (12.9% vs 2.87%, p = 0.007), but there was no significant difference in females between two groups (12.3% vs 7.69%, p = 0.295). Good near stereopsis acuity was  significantly associated with high prevalence of thoracic scoliosis (p<0.001). Multivariate logistic regression analysis revealed that a large distant magnitude of deviation (>20PD) and near stereoacuity were significantly associated with ITS.

Conclusions: Patients with SOP have a significantly  higher risk of developing idiopathic thoracic scoliosis, especially those with good near stereoscopic and large distant magnitude of deviation. 

目的：探讨以Base-out恢复点为目标手术量的急性共同性内斜视(acute acquired comitant esotropia，AACE)的治疗效果。方法：随诊以Base-out恢复点为目标手术量、且术后随访时间超过4个月的AACE患者，分析术前及末次随诊时斜视度、双眼视功能参数及术后立体视恢复的影响因素。结果：将43例患者纳入研究，其中男27例(63%)，女16例(37%)，手术年龄9~53(23.7±11.4)岁，术前斜视持续时间3个月~11年(24.8±24.5个月)，术后随访4~62(15.8±14.5)个月。术前Base-out恢复点比斜视度更大[远距差值(9.3±6.9) PD，P<0.001；近距差值(11.4±6.7) PD，P<0.001]；术前视远和视近斜视度分别为(38.4±13.2) PD和(37.6±13.7) PD，末次随诊时视远和视近斜视度分别为(0.74±2.4) PD和(0.70±2.4) PD(均P<0.001)，38例(88%)患者无眼位偏斜，5例(12%)有轻微内隐斜视。末次随诊时视远和视近立体视锐度显著改善(P<0.001)，末次立体视功能与术前近距立体视水平和术前斜视持续时间相关。结论：以Base-out恢复点为目标手术量的AACE手术能取得较好的矫正效果，未见眼位过矫者；术后立体视恢复与术前近距立体视和术前斜视持续时间相关，提示适当早期手术可能有助于术后立体视功能的恢复。

Objective: To evaluate the effect of using the amount of base-out (BO) recovery point as the surgical target for acute acquired comitant esotropia (AACE). Methods: Patients with AACE underwent surgery based on the target angle of the base-out recovery point and were followed up at least 4 months. The deviation, binocular functions before and after the surgery were analyzed and the factors related the post-operative stereopsis were evaluated. Results: Totally 43 patients were included in the study, including 27 males (63%) and 16 females (37%), aged from 9 to 53 years (23.7±11.4 years), duration of preoperative strabismus ranged from 3 months to 11 years (24.8±24.5 months), and postoperative follow-up ranged from 4 to 62 (15.8±14.5 months). Both distant and near pre-operative Base-out recovery point were larger than the angle of esotropia [(9.3±6.9) PD for distant; (11.4±6.7) PD for near, both P<0.001]. The pre-operative esotropia for distant and near viewing were (38.4±13.2) PD and (37.6±13.7) PD respectively and reduced to (0.74±2.4) PD and (0.70±2.4) PD at the last visit time (P<0.001). Thirty-eight cases were orthosia without any phoria and five cases still had some esophoria or minimal esotropia at the last visit. The stereoacuity improved significantly after the surgery. The post-operative stereopsis significantly correlated with the pre-operative stereopsis and the duration from onset of esotropia to the time of surgery. Conclusion: The acute acquired comitant esotropia can be corrected with strabismus surgery based on the target angle of base-out recovery point. The post-operative stereopsis correlated with the pre-operative stereo function and the time of esotropia lasting. It suggested the earlier esotropia was corrected the better the stereopsis recovered.

目的：探讨以Base-out恢复点为目标手术量的急性共同性内斜视(acute acquired comitant esotropia，AACE)的治疗效果。方法：随诊以Base-out恢复点为目标手术量、且术后随访时间超过4个月的AACE患者，分析术前及末次随诊时斜视度、双眼视功能参数及术后立体视恢复的影响因素。结果：将43例患者纳入研究，其中男27例(63%)，女16例(37%)，手术年龄9~53(23.7±11.4)岁，术前斜视持续时间3个月~11年(24.8±24.5个月)，术后随访4~62(15.8±14.5)个月。术前Base-out恢复点比斜视度更大[远距差值(9.3±6.9) PD，P<0.001；近距差值(11.4±6.7) PD，P<0.001]；术前视远和视近斜视度分别为(38.4±13.2) PD和(37.6±13.7) PD，末次随诊时视远和视近斜视度分别为(0.74±2.4) PD和(0.70±2.4) PD(均P<0.001)，38例(88%)患者无眼位偏斜，5例(12%)有轻微内隐斜视。末次随诊时视远和视近立体视锐度显著改善(P<0.001)，末次立体视功能与术前近距立体视水平和术前斜视持续时间相关。结论：以Base-out恢复点为目标手术量的AACE手术能取得较好的矫正效果，未见眼位过矫者；术后立体视恢复与术前近距立体视和术前斜视持续时间相关，提示适当早期手术可能有助于术后立体视功能的恢复。

Objective: To evaluate the effect of using the amount of base-out (BO) recovery point as the surgical target for acute acquired comitant esotropia (AACE). Methods: Patients with AACE underwent surgery based on the target angle of the base-out recovery point and were followed up at least 4 months. The deviation, binocular functions before and after the surgery were analyzed and the factors related the post-operative stereopsis were evaluated. Results: Totally 43 patients were included in the study, including 27 males (63%) and 16 females (37%), aged from 9 to 53 years (23.7±11.4 years), duration of preoperative strabismus ranged from 3 months to 11 years (24.8±24.5 months), and postoperative follow-up ranged from 4 to 62 (15.8±14.5 months). Both distant and near pre-operative Base-out recovery point were larger than the angle of esotropia [(9.3±6.9) PD for distant; (11.4±6.7) PD for near, both P<0.001]. The pre-operative esotropia for distant and near viewing were (38.4±13.2) PD and (37.6±13.7) PD respectively and reduced to (0.74±2.4) PD and (0.70±2.4) PD at the last visit time (P<0.001). Thirty-eight cases were orthosia without any phoria and five cases still had some esophoria or minimal esotropia at the last visit. The stereoacuity improved significantly after the surgery. The post-operative stereopsis significantly correlated with the pre-operative stereopsis and the duration from onset of esotropia to the time of surgery. Conclusion: The acute acquired comitant esotropia can be corrected with strabismus surgery based on the target angle of base-out recovery point. The post-operative stereopsis correlated with the pre-operative stereo function and the time of esotropia lasting. It suggested the earlier esotropia was corrected the better the stereopsis recovered.