Kekunnaya Ramesh, Negalur Mithila
Pediatric Ophthalmology and Strabismus Services, Child Sight Institute, Jasti V Ramannama Children's Eye Care Center, KAR Campus, Hyderabad, India.
Clin Ophthalmol. 2017 Oct 30;11:1917-1930. doi: 10.2147/OPTH.S127481. eCollection 2017.
Duane retraction syndrome (DRS) is a congenital eye movement anomaly characterized by variable horizontal duction deficits, with narrowing of the palpebral fissure and globe retraction on attempted adduction, occasionally accompanied by upshoot or down-shoot. The etiopathogenesis of this condition can be explained by a spectrum of mechanical, innervational, neurologic and genetic abnormalities occurring independently or which influence each other giving rise to patterns of clinical presentations along with a complex set of ocular and systemic anomalies. Huber type I DRS is the most common form of DRS with an earlier presentation, while Huber type II is the least common presentation. Usually, patients with unilateral type I Duane syndrome have esotropia more frequently than exotropia, those with type II have exotropia and those with type III have esotropia and exotropia occurring equally common. Cases of bilateral DRS may have variable presentation depending upon the type of presentation in each eye. As regards its management, DRS classification based on primary position deviation as esotropic, exotropic or orthotropic is more relevant than Huber's classification before planning surgery. Surgical approach to these patients is challenging and must be individualized based on the amount of ocular deviation, abnormal head position, associated globe retraction and overshoots.
杜安眼球后退综合征（DRS）是一种先天性眼球运动异常，其特征为水平向运动功能不同程度受损，试图内收时睑裂缩小且眼球后退，偶尔伴有眼球上转或下转。这种病症的发病机制可通过一系列机械性、神经支配性、神经性和遗传性异常来解释，这些异常可单独发生，也可相互影响，进而导致一系列临床表现以及复杂的眼部和全身异常。胡贝尔I型DRS是DRS最常见的类型，发病较早，而胡贝尔II型则是最不常见的类型。通常，单侧I型杜安综合征患者内斜视比外斜视更常见，II型患者以外斜视为主，III型患者内斜视和外斜视的发生率相同。双侧DRS病例的表现可能因每只眼的表现类型而异。在治疗方面，在计划手术前，根据原在位斜视、外斜视或正位斜视进行的DRS分类比胡贝尔分类更具相关性。对这些患者进行手术具有挑战性，必须根据眼球偏斜程度、异常头位、相关的眼球后退和上转进行个体化治疗。
