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The authors evaluated and compared the cerebral MRI findings in operated infantile esotropia cases with and without consecutive exotropia. This was a retrospective study of 28 patients. Group 1 had 17 cases of consecutive exotropia with a mean follow-up of 50.94 ±38.45 months. Group 2 had 11 cases with satisfactory alignment and a mean follow-up of 47 ±33.54 months. There was no difference for groups in mean age, gender, percent consanguinity, percent prematurity, mean preoperative deviations, percent latent nystagmus, percent dissociated vertical deviation (DVD), mean refractive error, percent amblyopia and fundus findings. Surgery for all cases involved bilateral medial rectus recessions. The incidence of brain lesions was not significantly different for groups. However, type of lesion was different. In group 1, 17.5% had white matter damage of immaturity which was bilateral with a severity grade of 3-4. None of these lesions was evident in group 2. The authors consider white matter damage of immaturity to be a potential risk factor for consecutive exotropia in infantile esotropia patients and propose this warrants further research in a larger cohort.

Brain abnormalities in infantile esotropia s predictors for consecutive exotropia.
Calis F, Atilla H, Kiziltunc PB, Alay C.
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Fiona Rowe (Prof)

Institute of Population Health, University of Liverpool, UK.

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