Anomalous superior oblique muscles and tendons in congenital fibrosis of the extraocular muscles
| Autor: | Talia N. Shoshany, Caroline D. Robson, David G. Hunter |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male Adolescent Eye Movements Ophthalmologic Surgical Procedures Tendons Young Adult 03 medical and health sciences 0302 clinical medicine Superior oblique muscle Abnormally thin Congenital fibrosis of the extraocular muscles Humans Medicine Disease process Child Retrospective Studies Ophthalmoplegia business.industry Infant Newborn Infant Oblique case Anatomy Middle Aged medicine.disease Fibrosis Tendon Ophthalmology Tenotomy medicine.anatomical_structure Oculomotor Muscles Child Preschool Pediatrics Perinatology and Child Health 030221 ophthalmology & optometry Female business Follow-Up Studies Superior rectus muscle Strabismus surgery |
| Zdroj: | Journal of American Association for Pediatric Ophthalmology and Strabismus. 23:325.e1-325.e6 |
| ISSN: | 1091-8531 |
| DOI: | 10.1016/j.jaapos.2019.09.014 |
| Popis: | Purpose To evaluate the finding of anomalous superior oblique muscles in congenital fibrosis of the extraocular muscles (CFEOM), a feature not previously emphasized in this condition. Methods The medical records of all patients clinically or genetically diagnosed with CFEOM at Boston Children's Hospital between 2010 and 2018 were reviewed retrospectively. Those who underwent strabismus surgery during the study period were included in the analysis. Baseline patient characteristics, type of CFEOM, results of genetic testing, and intraoperative features of the superior oblique muscle or tendon were recorded. Results Of 24 patients identified (age range, 1 month to 62 years), 10 (42%) had genetically confirmed CFEOM, and 22 underwent strabismus surgery, 14 (64%) involving the superior oblique muscle. Of these, 7 (50%) had anomalously inserted tendons (most commonly attached nasal to the superior rectus muscle), whereas 7 (50%) had increased superior oblique muscle tension. Conclusions Half of CFEOM patients who underwent superior oblique surgery had abnormally inserted superior oblique tendons, and 50% had tight muscles or abnormally thin tendons, findings that have not been well-characterized in this condition. The findings suggest that abnormal insertion of the superior oblique muscles and tendons are additional features of the disease process in CFEOM that have not been described previously. These features may contribute to the severe upgaze limitation in CFEOM and highlight the importance of superior oblique tenotomy in surgical management. |
| Databáze: | OpenAIRE |
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