Lee Yun Jeong, Lee Haeng Jin, Kim Seong Joon
Department of Ophthalmology, Seoul National University Hospital, Seoul, Korea.
Seoul Artificial Eye Center, Seoul National University Hospital Clinical Research Institute, Seoul, Korea.
Korean J Ophthalmol. 2020 Apr;34(2):158-165. doi: 10.3341/kjo.2019.0100.
We sought to provide a new classification system for Duane retraction syndrome (DRS) according to type and angle of strabismus during primary gaze and to analyze the clinical features of each DRS type.
The medical records of 65 DRS patients who visited the department of pediatric ophthalmology at Seoul National University Children's Hospital between 2010 and 2017 were retrospectively analyzed. Patients whose angle of exotropia at primary gaze exceeded 3 prism diopters (PDs) were classified as "Exo-Duane," those whose angle of strabismus at primary gaze did not exceed 3 PDs were classified as "Ortho-Duane," and those whose angle of esotropia at primary gaze exceeded 3 PDs were classified as "Eso-Duane."
Among 65 DRS patients, Ortho-Duane was the most common (53.8%) type, followed by Eso-Duane (33.8%) and Exo-Duane (12.3%). The mean age at diagnosis was significantly higher in the Exo-Duane group than the Ortho-Duane or Eso-Duane group ( = 0.003 and < 0.001, respectively). A predominance of left eye involvement was observed in the Ortho-Duane (62.9%) and Eso-Duane (90.9%) groups. The frequencies of upshoot, downshoot, fissure narrowing, and globe retraction were not significantly different among the subgroups. Head-turn was more frequent in Eso-Duane patients than in Exo-Duane or Ortho-Duane patients ( = 0.001 and < 0.001, respectively). Myopia accounted for the most common refractive error among Exo-Duane patients (71.4%), while hyperopia was found more often in both Ortho-Duane (64.7%) and Eso-Duane (85.0%) patients. The majority of patients showed gross stereoacuity (93.1%), and a large proportion had good stereoacuity (Exo-Duane 60.0%, Ortho-Duane 81.3%, Eso-Duane 87.5%).
Our newly proposed classification of DRS according to type and angle of strabismus at primary gaze was practically useful and showed potential for use as an objective guideline in the clinical setting.
我们试图根据第一眼位斜视的类型和角度为杜安眼球后退综合征（DRS）提供一种新的分类系统，并分析每种DRS类型的临床特征。
回顾性分析2010年至2017年期间就诊于首尔国立大学儿童医院小儿眼科的65例DRS患者的病历。第一眼位外斜视角度超过3棱镜度（PD）的患者被分类为“外斜型杜安”，第一眼位斜视角度不超过3 PD的患者被分类为“正位型杜安”，第一眼位内斜视角度超过3 PD的患者被分类为“内斜型杜安”。
在65例DRS患者中，正位型杜安是最常见的类型（53.8%），其次是内斜型杜安（33.8%）和外斜型杜安（12.3%）。外斜型杜安组的诊断平均年龄显著高于正位型杜安组或内斜型杜安组（分别为P = 0.003和P < 0.001）。在正位型杜安组（62.9%）和内斜型杜安组（90.9%）中观察到左眼受累占优势。上射、下射、睑裂缩小和眼球后退的频率在各亚组之间无显著差异。内斜型杜安患者比外斜型杜安或正位型杜安患者更频繁地出现代偿头位（分别为P = 0.001和P < 0.001）。近视是外斜型杜安患者中最常见的屈光不正类型（71.4%），而远视在正位型杜安患者（64.7%）和内斜型杜安患者（85.0%）中更常见。大多数患者表现为粗略立体视（93.1%），且很大一部分患者具有良好的立体视（外斜型杜安60.0%，正位型杜安81.3%，内斜型杜安87.5%）。
我们新提出的根据第一眼位斜视类型和角度对DRS进行的分类在实际应用中是有用的，并且显示出在临床环境中作为客观指南使用的潜力。
