Abstract
Purpose::
Infantile exotropia is a divergent strabismus which appears from the first day of life to the second year. It can be isolated or associated to a pathological context requiring a cerebral imagery. The aim of this study is to present the result of MRI in the infantile exotropia.
Methods::
51 children with infantile exotropia underwent a complete ophthalmologic assessment (visual acuity, binocular vision, refraction under cycloplegia, eye fundus) and a cerebral MRI (average age of realization: 22 month). The children were classified according to the degree of deviation: under 4°, between 4° and 10°, between 10° and 20°, more than 20°. MRI results are classified in: anatomical defects (cerebral atrophy, gliosis, delay of maturation, white matter atrophy, necroses, enlarged subarachnoid space, periventricular leukomalacia, ventriculomegaly, anomaly of cerebral growth), malformations (central nervous system, corpus callosum and septum pellucidum), compressive pathologies, anomalies of metabolism, external hydrocephalus. Two groups of MRI are individualized: group 1- isolated exotropia (exclusive ophthalmological context) and group 2- exotropia associated with neurological pathology: fetal suffering, psychomotor retardation, cranio-facial malformation, epilepsy.
Results::
13 children have a natural history of fetal and perinatal suffering or prematurity. The authors report MRI results according to the isolated (group 1) or associated (group 2) character of the exotropia and the severity of the strabismus. In groups with bigger angle deviation and with increased associated general and neurological pathologies, the rate of pathological MRI was statistically higher.
Conclusions::
This study shows fundamental contribution of the cerebral MRI in the infantile exotropia.
Keywords: esotropia and exotropia • imaging methods (CT, FA, ICG, MRI, OCT, RTA, SLO, ultrasound) • strabismus: etiology