Management of anomalous correspondence: efficacy of therapy

The last paper to review thoroughly the success of treatment for esotropia with anomalous correspondence was published by Flom in 1963. In reviewing the literature of that era, which included surgical intervention, Flom found documented cures in only 11 of 262 esotropic patients with anomalous correspondence--a cure rate of less than 5%. We evaluated recent reported success rates for treatment and present an estimate of the prognosis for successful binocular re-education of patients with esotropia and anomalous correspondence. Based on current therapy techniques reported in the literature, with careful aggressive therapy, 50% of esotropic patients with anomalous correspondence should be expected to achieve binocular vision provided sufficient time (up to 12 months) can be devoted to binocular re-education.     

Distance judgement in comitant strabismus with anomalous retinal correspondence

Judgement of distances was evaluated in 19 patients with comitant esotropia and without appreciable stereopsis. In nine patients anomalous retinal correspondence (ARC) was present at Bagolini's striated glasses. In the remaining patients there was suppression with the same test. Distance judgement of strabismics with ARC does not differ statistically from that one of normals. Significantly different results were found in strabismics with suppression. It is concluded that ARC is not only an anti-diplopic mechanism, but provides the patients with useful clues in their daily life.     

Normal retinotopic mapping in human strabismus with anomalous retinal correspondence

Burian proposed that a functional retinotopic remapping of the deviated eye on striate visual cortex may be the physiologic basis for the perceptual phenomenon of anomalous retinal correspondence (ARC) in human strabismus. This investigation searched for this type of retinotopic remapping in five esotropes and one exotrope with ARC by means of visual evoked potential (VEP) topographic mapping. Uniocular stimulation of the foveas (corresponding points) during binocular vision in a normal subject yielded identical VEP scalp topographies from each eye. Stimulation of anomalously corresponding points produced different VEP scalp topographies from each eye in the six strabismic subjects. Uniocular stimulation of the anatomic foveas of each eye (noncorresponding points) in a strabismic subject during binocular vision produced identical VEP scalp topographies. These results suggest that there is no significant functional binocular realignment of retinotopic mapping in the visual cortex of human strabismics with ARC.     

Treatment of esotropia with anomalous correspondence: a case report.

Management of anomalous correspondence in esotropia has been a controversial topic until recently. This case report presents a sequential treatment regimen which resulted in a successful binocular result for the patient. The implementation of overcorrecting prism, vision therapy/orthoptics, and extraocular muscle surgery is covered in the discussion of management strategies.     

Artificial divergence in treatment of anomalous correspondence (author's transl)]

Artificial divergence causes a change of correspondence in about 60% of cases of alternating comitant convergent strabismus. This means a merely formal normalisation, since only one third of the cases can be cured to a level of +/-1degree of arc related to the true position of the eyes. These cases do not show any scotoma under campimetry on the phase difference haploscop (Aulhorn). An other third achieved a status with a tolerance of +/- 2 degrees and microscotomata. The last third did not show a normalisation, mostly due to a preexisting angle smaller than 5 degrees of arc. The number of full cures was limited, since the onset of squint was early in the majority of cases. One half of the 271 cases were treated by surgical overcorrection and following reoperation. The other half by small initial surgery, prismatic overcorrection followed by prismatic compensation and small second operation.