McCall L C, Rosenbaum A L
Jules Stein Eye Institute, Department of Ophthalmology, University of California, Los Angeles 90024.
Ophthalmology. 1991 Jun;98(6):911-7; discussion 917-8. doi: 10.1016/s0161-6420(91)32202-4.
When superior oblique overaction coexists with dissociated vertical deviation, it may produce a pattern of disparity in the amount of dissociated vertical deviation in different horizontal gaze fields, which the authors have termed incomitance. Seven patients with the constellation of esotropia, bilateral superior oblique overaction, "A"-pattern, and incomitant dissociated vertical deviation are presented. In each case, a distinctive incomitant pattern of dissociated vertical deviation was noted in which dissociated vertical deviation was least in adduction, moderate in primary position, and greatest in abduction. Four patients underwent asymmetric superior rectus recessions and partial tenotomy of the superior oblique tendons at their insertions as the initial treatment for their incomitant dissociated vertical deviation. Recognition of such a pattern of incomitant dissociated vertical deviation is important in choosing appropriate surgical management.
当上斜肌亢进与分离性垂直偏斜共存时，可能会在不同水平注视视野中产生分离性垂直偏斜量的差异模式，作者将其称为非共同性。本文报告了7例患有内斜视、双侧上斜肌亢进、“A”征和非共同性分离性垂直偏斜的患者。在每例患者中，均观察到一种独特的非共同性分离性垂直偏斜模式，即内收时分离性垂直偏斜最小，第一眼位时中等，外展时最大。4例患者接受了不对称性上直肌后徙术和上斜肌腱在附着处的部分切断术，作为其非共同性分离性垂直偏斜的初始治疗。认识到这种非共同性分离性垂直偏斜模式对于选择合适的手术治疗很重要。
