Clinical and imaging features of congenital and acquired isolated inferior rectus muscle hypofunction.
J AAPOS
; 25(1): 11.e1-11.e9, 2021 02.
Article
in En
| MEDLINE
| ID: mdl-33601045
BACKGROUND: Inferior rectus (IR) underaction may arise from various causes that are distinguishable through imaging. We investigated clinical and imaging characteristics of congenital and acquired causes of IR underaction. METHODS: Cases of IR underaction were selected from data prospectively collected in a study of orbital imaging in strabismic patients. RESULTS: Review identified 3 cases of congenital IR underaction (2 with bilateral IR aplasia and 1 with unilateral IR hypoplasia), 12 acquired cases, including 4 due to denervation (2 idiopathic, 1 after multiple strabismus surgeries, 1 after head trauma), and 8 cases of direct IR damage (5 with orbital trauma and 3 with previous surgery, including 2 sinus surgery and 1 laser blepharoplasty). Of the 23 cases, 11 adults had high-resolution magnetic resonance imaging, and 2 children had computed tomography. Imaging identified the anatomic diagnosis in congenital cases; in acquired cases, imaging helped to identify atrophy and exclude alternative orbital causes; and in direct mechanical damage, imaging clarified the mechanism of underaction, extent of IR damaged, and the degree of retained contractility. Patients with congenital IR absence or hypoplasia exhibited A pattern exotropia that was typically absent in isolated acquired denervation or direct IR damage. CONCLUSIONS: Orbital imaging demonstrates a variety of abnormalities in patients with congenital or acquired IR hypofunction, helping to clarify the underlying mechanism and guide management.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Ophthalmoplegia
/
Strabismus
Type of study:
Etiology_studies
/
Prognostic_studies
Limits:
Adult
/
Child
/
Humans
Language:
En
Journal:
J AAPOS
Journal subject:
OFTALMOLOGIA
/
PEDIATRIA
Year:
2021
Document type:
Article
Affiliation country:
Chile
Country of publication:
United States