Ratner Children's Eye Center at the Shiley Eye Institute, University of California, San Diego, 9415 Campus Point Drive, La Jolla, San Diego, CA, 92093, USA.
The Goldschleger Eye Institute, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Hashomer, Israel.
Graefes Arch Clin Exp Ophthalmol. 2020 May;258(5):1109-1113. doi: 10.1007/s00417-020-04629-4. Epub 2020 Feb 24.
To evaluate if there is a nasal displacement of the vertical rectus muscles in heavy eye syndrome (HES) and/or sagging eye syndrome (SES) compared with age-matched controls.
We reviewed the charts of all patients with the diagnosis of HES or SES who were seen at the University of California San Diego (UCSD) between the years 2008-2016 who underwent magnetic resonance imaging (MRI) of the brain and orbits. The control group included patients who had brain and orbital MRIs at UCSD in the absence of known pathology in the orbits or globes. Measurements were taken by 3 separate examiners for all groups.
Twenty-four patients (16 with SES and 8 with HES) and 24 age-matched controls were retrospectively reviewed. The superior rectus (SR) of patients with HES and SES was more nasally displaced from the midline compared with that of age-matched controls (p = 0.04, p = 0.03, respectively). The inferior rectus (IR) of patients with HES but not with SES was more nasally displaced from the midline compared with that of age-matched controls (p = 0.04, p = 0.62, respectively). In all groups, the IR nasal displacement from the midline was approximately double compared with the SR.
There is a significant nasal displacement of the SR in HES and SES and IR in HES. The observed IR nasal displacement in HES is a new finding and may explain the residual hypotropia and/or esotropia following surgical interventions for HES not involving the IR.
评估重症肌无力（HES）和/或眼下垂综合征（SES）患者的垂直直肌是否存在向鼻侧移位，以及与年龄匹配的对照组相比是否存在这种移位。
我们回顾了 2008 年至 2016 年间在加利福尼亚大学圣地亚哥分校（UCSD）就诊的所有 HES 或 SES 患者的病历，这些患者均接受了脑部和眼眶磁共振成像（MRI）检查。对照组包括在 UCSD 进行脑部和眼眶 MRI 检查且眼眶或眼球无已知病变的患者。所有组别的测量均由 3 名独立检查者进行。
回顾性分析了 24 例患者（16 例 SES 和 8 例 HES）和 24 名年龄匹配的对照组。与年龄匹配的对照组相比，HES 和 SES 患者的上直肌（SR）更向中线鼻侧移位（p=0.04，p=0.03）。与年龄匹配的对照组相比，仅 HES 患者的下直肌（IR）更向中线鼻侧移位（p=0.04，p=0.62）。在所有组中，IR 从中线向鼻侧的移位大约是 SR 的两倍。
HES 和 SES 患者的 SR 以及 HES 患者的 IR 存在明显的向鼻侧移位。在 HES 中观察到的 IR 向鼻侧移位是一个新发现，可能解释了不涉及 IR 的 HES 手术干预后残留的下斜视和/或内斜视。
