Problemi speciali
Esotropia e diplopia a esordio tardivo nel bambino
Diagnosi differenziali e consigli per il pediatra
Late onset esotropia and diplopia in childhood: differential diagnosis and advices for paediatricians
Giuditta Pellino, Silvia Bellonzi, Camilla Lama, Elisa Fiumana
Scuola di Specializzazione in Pediatria, Ospedale Sant’Anna, Ferrara
Marzo 2015 - pagg. 171 -176
Abstract
The acute acquired concomitant esotropia is for the paediatricians a clinical manifestation
of difficult interpretation and management, as generally underlies benign conditions,
but it may be the manifestation of a CNS diseases. “Acute acquired concomitant esotropia”
(acute acquired comitant esotropia, AACE) is defined as acute onset of a convergent
strabismus and diplopia associated with no or minimal refraction defects, in
which the angle between the two visual axes is preserved in all directions of gaze. The
onset usually occurs after the third year of life and includes forms whose etiologies range
from the intracranial hypertension to the functional forms. The forms of AACE are essentially
three: type I (the most common), which follows the iatrogenic break of binocular vision;
type II or functional type, which includes the esotropie associated with a concomitant
high angle of deviation, with little or no hyperopia and binocular vision potentially
normal in the absence of accommodative component and CNS diseases; type III, which
includes the forms secondary to intracranial hypertension, Arnold-Chiari syndrome and
expansive posterior fossa disease. In the differential diagnosis ophthalmological causes
(eg, decompensated esoforie or accommodation defects) and no ophthalmological causes
(CNS diseases and ocular myasthenia) should be considered, so it is necessary to
identify patients who require neuroimaging.
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Suggerite dall'AI
Classificazione MeSH
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