Comparative study of brain lesions detected by magnetic resonance imaging between strabismus and nonstrabismus in infancy.

PURPOSE To elucidate the causative factors in infantile esotropia, we evaluated morphological abnormalities in brain structures of esotropia patients showing any abnormal neurological signs in comparison to those of normal controls. METHODS Sixty-five developmentally normal children participated in this study. Of these 65, 38 demonstrated infantile esotropia and 27 were normal controls. All underwent magnetic resonance imaging (MRI) of the brain between 2 and 30 months. RESULTS Abnormal brain findings were noted in 3 (7. 9%) children in the strabismus group, whereas none of the children in the normal control group showed brain lesions. In these 3 cases, brain lesions involved periventricular leukomalacia, enlargement of the lateral ventricles with hypoplasia of the corpus callosum and myelination delay at the anterior horn adjacent to the lateral ventricles. CONCLUSIONS Brain lesions that may disturb normal maturation of the visuomotor system and eventually lead to strabismus could be found in some patients without any episode that would cause birth injury.