PURPOSE To describe the course of intermittent exotropia (IXT) in children followed up without treatment for 3 years. DESIGN Observation arm from randomized trial of short-term occlusion versus observation. PARTICIPANTS One hundred eighty-three children 3 to 10 years of age with previously untreated IXT and 400 seconds of arc (arcsec) or better near stereoacuity. METHODS Participants were to receive no treatment unless deterioration criteria were met at a follow-up visit occurring at 3 months, 6 months, or 6-month intervals thereafter for 3 years. MAIN OUTCOME MEASURES The primary outcome was deterioration by 3 years, defined as meeting motor criterion (constant exotropia ≥10 prism diopters [Δ] at distance and near) or near stereoacuity criterion (≥2-octave decrease from best previous measure). For the primary analysis, participants also were considered to have deteriorated if treatment was prescribed without meeting either deterioration criterion. RESULTS The cumulative probability of protocol-specified deterioration by 3 years was 15% (95% confidence interval, 10%-22%), but that was likely an overestimate, partly because of misclassification. Among 25 deteriorations, 2 met motor deterioration, 11 met stereoacuity deterioration, and 12 started treatment without meeting either criteria (7 for social concern, 1 for diplopia, 4 for other reasons). Among the 132 participants who completed the 3-year visit and had not been treated during the study, only 1 (<1%) met motor or stereoacuity deterioration criteria at 3 years. Of the 4 participants completing the 3-year visit who met deterioration criteria previously and had not started treatment, none still met deterioration criteria. Between the baseline and 3-year examination for these 132 patients, improvement occurred in distance and near stereoacuity (mean improvement, 0.14 and 0.14 logarithm of arcsec; P ≤ 0.001 and P ≤ 0.001, respectively), distance exotropia control (mean improvement, 0.6 points; P ≤ 0.001), and distance exodeviation magnitude (mean improvement, 2.2 Δ; P = 0.002). CONCLUSIONS Among children 3 to 10 years of age with IXT for whom surgery was not considered to be the immediately necessary treatment, stereoacuity deterioration or progression to constant exotropia over 3 years was uncommon, and exotropia control, stereoacuity, and magnitude of deviation remained stable or improved slightly.

中文翻译：

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对未经治疗的间歇性外斜视的3至10岁儿童的三年观察。

目的描述儿童间歇性外斜视（IXT）的病程，随访3年。设计短期闭塞与观察随机试验的观察组。参与者383名3至10岁的儿童，他们以前未接受过IXT治疗，并且有400秒的弧度（arcsec）或更好的近立体视度。方法除非在3个月，6个月或6个月间隔后的3年随访中符合恶化标准，否则参与者将不接受任何治疗。主要观察指标初步结果是3年恶化，定义为符合运动标准（恒定屈光度≥10棱镜屈光度[Δ]在近和近）或接近立体视力标准（从先前的最佳测量降低≥2倍频程）。对于主要分析，如果在不符合任何恶化标准的情况下开具治疗方案，则参与者也被视为恶化。结果协议规定的3年恶化的累积概率为15％（95％置信区间，10％-22％），但这可能被高估了，部分原因是分类错误。在25例恶化中，有2例发生了运动功能恶化，11例出现了视力下降，还有12例开始治疗而未达到任何标准（社会关注7例，复视1例，其他原因4例）。在完成三年访问并且在研究期间未接受治疗的132名参与者中，只有1名（<1％）在3年时达到了运动或立体视恶化的标准。在完成3年随访的4位参与者中，先前达到恶化标准且未开始治疗的患者中，仍未达到恶化标准。在这132名患者的基线检查和3年检查之间，距离和近立体视的改善（平均改善，arcsec的对数为0.14和0.14； P≤0.001和P≤0.001），距离外斜视的控制（平均改善，0.6点； P≤0.001）和距离骨外翻幅度（平均改善2.2Δ； P = 0.002）。结论在IXT年龄3至10岁的儿童中，不认为手术是当务之急的治疗方法，其立体视力下降或超过3年发展为恒定的屈光性很少见，并且屈光性控制，立体性和偏差幅度保持稳定或略有改善。距离和近立体视的改善（平均改善，arcsec的对数为0.14和0.14； P≤0.001和P≤0.001），距离外斜视控制（平均改善，0.6点； P≤0.001）和距离屈光度（平均）改善2.2Δ; P = 0.002）。结论在IXT年龄3至10岁的儿童中，不认为手术是当务之急的治疗方法，其立体视力下降或超过3年发展为恒定的屈光性很少见，并且屈光性控制，立体性和偏差幅度保持稳定或略有改善。距离和近立体视的改善（平均改善，arcsec的对数为0.14和0.14； P≤0.001和P≤0.001），距离外斜视控制（平均改善，0.6点； P≤0.001）和距离屈光度（平均）改善2.2Δ; P = 0.002）。结论在IXT年龄3至10岁的儿童中，不认为手术是当务之急的治疗方法，其立体视力下降或超过3年发展为恒定的屈光性很少见，并且屈光性控制，立体性和偏差幅度保持稳定或略有改善。P = 0.002）。结论在IXT的3至10岁儿童中，不认为手术是当务之急的治疗方法，其立体视力下降或超过3年发展为恒定的屈光性很少见，并且屈光性控制，立体性和偏差幅度保持稳定或略有改善。P = 0.002）。结论在IXT年龄3至10岁的儿童中，不认为手术是当务之急的治疗方法，其立体视力下降或超过3年发展为恒定的屈光性很少见，并且屈光性控制，立体性和偏差幅度保持稳定或略有改善。