Clinical Significance of Torsion Measured by Fundus Photography in Children

Purpose: To investigate the clinical significance of ocular torsion in children by analyzing the associated ophthalmic diseases.Methods: Fundus images were used to detect ocular torsion in one or both eyes of 83 children aged 2-12 years at a pediatric ophthalmology clinic. In cases with ocular torsion, associated ophthalmic diseases, including strabismus, amblyopia, and refractive errors, were investigated.Results: Among the 83 patients, 59 (71.2%) and 45 (54.2%) had strabismus and refractive errors, respectively. Six had amblyopia (five patients with refractive amblyopia and one with strabismus), while six patients (7.2%) had no strabismus, refractive errors, or amblyopia. The extorsion group included 80 eyes in 59 patients, while the intorsion group included 26 eyes in 22 patients. Two patients were in the mixed cyclotorsion group with extorsion in one eye and intorsion in the other eye. There were no differences in the frequencies of exotropia and esotropia based on the torsion type (p = 0.209). The torsion angles in the exotropia and esotropia groups were -16.35 ± 5.20 and -12.71 ± 3.16, respectively (p = 0.002).Conclusions: Children with ocular torsion on fundus photography had a high prevalence of strabismus. Extorsion was more frequent than intorsion with a greater extorsion angle in exotropia than in esotropia.