Heavy duty.

Autor: Bhatti MT; The Permanente Medical Group, Department of Ophthalmology, Kaiser Permanente-Northern California, Roseville, CA, USA. Electronic address: muhammad.t.bhatti@kp.org., Fors DH; The Permanente Medical Group, Department of Ophthalmology, Kaiser Permanente-Northern California, Roseville, CA, USA., Muminovic I; The Permanente Medical Group, Department of Ophthalmology, Kaiser Permanente-Northern California, Roseville, CA, USA., Robbins SL; Ratner Children's Eye Center Within the Viterbi Family Department of Ophthalmology, University of California San Diego, La Jolla, CA, USA.
Jazyk: angličtina
Zdroj: Survey of ophthalmology [Surv Ophthalmol] 2024 Nov 08. Date of Electronic Publication: 2024 Nov 08.
DOI: 10.1016/j.survophthal.2024.11.001
Abstrakt: A 54-year-old woman with myopia, hypothyroidism, and asthma presented with intermittent double vision. Serum was positive for anti-low density lipoprotein receptor-related protein 4 (LRP4) antibodies suggesting the diagnosis of myasthenia gravis. There was no improvement with pyridostigmine, prednisone, or azathioprine. Over time her double vision became constant, and she was noted to have mild limitation of abduction in both eyes with an esotropia, left hypotropia, and excyclotorsion. Magnetic resonance imaging showed nasal displacement of the superior rectus and inferior rectus muscles, inferior displacement of the lateral rectus muscles and superotemporal globe prolapse consistent with heavy eye syndrome (HES). The differential diagnosis, clinical and radiological manifestations of HES are discussed.
Competing Interests: Declaration of Competing Interest None of the authors have a conflict of interest in the material contained in the manuscript.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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