Four-year follow-up of an elderly Japanese patient with distance Esotropia using magnetic resonance imaging

This report describes a case involving a Japanese patient with distance esotropia, who was followed-up for 4 years using magnetic resonance imaging (MRI). A 68-year-old woman with high myopia exhibited esotropia of 10 prism diopters (Δ) and right hypotropia of 5Δ; her axial lengths were 31.0 mm oculus dextrus (OD) and 30.7 mm oculus sinister (OS). Bilateral enlarged lateral rectus (LR)-superior rectus (SR) bands and posterior staphylomata were observed on orbital MRI. At the 4-year follow-up, her ocular deviation had deteriorated to esotropia of 18 Δ and right hypotropia of 8Δ; however, her axial lengths had scarcely changed (31.0 mm OD; 30.8 mm OS). The enlargement and rupturing of the bilateral LR-SR bands had worsened. Progressive enlargement and rupturing of the LR-SR bands, which are presumably related to aging and possibly linked to progressive connective tissue degeneration, may increase ocular deviation.