Elsevier

Ophthalmology

Volume 105, Issue 5, 1 May 1998, Pages 846-850
Ophthalmology

Congenital esotropia in Olmsted County, Minnesota1,

https://doi.org/10.1016/S0161-6420(98)95024-2Get rights and content

Abstract

Objective

To determine the birth prevalence of and risk factors associated with congenital esotropia.

Design

Population-based prevalence study with nested case-control study.

Participants

All residents of Olmsted County, Minnesota who were diagnosed with congenital esotropia and born between January 1, 1980 and December 31, 1989 (n = 47). Control subjects were chosen by selecting the next two sequential births to parents residing in Olmsted County, Minnesota (n = 94).

Methods

Cases were identified through the Medical Diagnostic Index of Mayo and the Rochester Epidemiology Project. The community medical records were reviewed to confirm case status and ascertain risk factor information.

Main outcome measure

Birth prevalence of congenital esotropia.

Results

Forty-seven cases were identified from 17,536 live births, for a birth prevalence of 27 per 10,000 (95% confidence interval [CI], 20–35). Congenital esotropia was associated with prematurity (odds ratio [OR], 11.5; 95% CI, 3.4–39.2), a birth weight less than 2500 grams (OR, 4.6; 95% CI, 1.7–12.9), a low Apgar score at 1 minute (OR, 4.3; 95% CI, 1.7–11.2) and at 5 minutes (OR, 6.3; 95% CI, 1.3–30.7), and a family history of strabismus (OR, 3.5; 95% CI, 1.5–8.3).

Conclusions

The birth prevalence of congenital esotropia in Olmsted County, Minnesota is lower than previous estimates. Prematurity, low birth weight, low Apgar scores, and a family history of strabismus are significant risk factors for congenital esotropia.

Section snippets

Source of data

A population-based study of the prevalence of congenital esotropia combined with a nested case-control study is possible in Olmsted County, Minnesota because the city and county are relatively isolated from other urban centers and because the population is served by a largely unified medical care system that has accumulated comprehensive clinical records for many years. Rochester, Minnesota (1990 population, 69,995) is located 90 miles southeast of Minneapolis and St. Paul. Approximately 70% of

Results

The population-based study ascertained 47 cases of congenital esotropia from 17,536 live births during the 10-year study period from 1980 through 1989. These findings correspond to a birth prevalence of 27 per 10,000 (95% CI, 20–35), or 0.27%. All 47 children (24 males and 23 females) were white, a reflection of the racial composition of this geographic area.

Ninety-four Olmsted County children (49 males and 45 females) born during the period 1980 through 1989 were selected as gender- and birth

Discussion

Our population-based birth prevalence of 0.27% for congenital esotropia is lower than most previous studies, which reported a prevalence of 0.67% to 2%.9, 15, 18, 23, 24 Previous reports may have overestimated the prevalence of congenital esotropia for various reasons. First, many studies either included all forms of strabismus8, 9, 10, 24, 25, 26, 27, 28 or evaluated all esodeviations without distinguishing among individual entities, including congenital, acquired, or accommodative esotropia.6

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  • Cited by (0)

    This study was supported in part by a grant from the National Institutes of Health (AR30582), Bethesda, Maryland; an unrestricted grant from Research to Prevent Blindness, Inc., New York, New York; and Mayo Foundation, Rochester, Minnesota.

    1

    The authors have no commercial or proprietary interest in any products or instruments mentioned in this article.

    2

    Dr. Mohney is currently affiliated with the Division of Ophthalmology, East Tennessee State University, Johnson City, Tennessee.

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