Abstract
Purpose:
New insights have shown an increase in the proportion of ‘Congenital Esotropia (CE) associated with central nervous system disorders’. In this longitudinal study we aim to determine the association between central nervous system disorders and CE using advanced diagnostic skills.
Methods:
Since March 2012 all neonates with central nervous system disorders (e.g. cerebral palsy or hemiparesis) and strabismus who visited the out-patient clinic of Pediatric Neurology were referred to the department of Ophthalmology for full orthoptic examination. The neurological documentation also included gestational age, birth weight, Apgar score, CRIB (Clinical Risk Index for Babies) score and the presence of epilepsy. In addition to the standard imaging techniques, more advanced techniques were used, e.g. Diffusion Tensor Imaging and volume MRIs, to assess the brain development, brain damage and the correlation with neurological outcome later in life.
Results:
So far, thirteen children with a central nervous system disorder and strabismus have been referred.
Conclusions:
These advanced imaging techniques will allow specific lesions in the brain to be correlated with neurological outcome on the one hand and with CE on the other. It could be of interest for the analysis that parallels exist between congenital esotropia and cerebral palsy following the definition of the Surveillance of Cerebral Palsy in Europe, not only concerning abnormal posture and movement, but also increased muscle tone and, possibly, hyperreflexia (convergence excess).
Keywords: 723 strabismus: diagnosis and detection •
724 strabismus: etiology