Suma Unnikrishnan, Ferzana Mohammed, Babitha Valiyaveetil, Jyothi Poothatta
Department of Ophthalmology, Government Medical College, Kozhikode, Kerala, India.
Oman J Ophthalmol. 2022 Jun 29;15(2):147-152. doi: 10.4103/ojo.ojo_133_21. eCollection 2022 May-Aug.
To describe the clinical profile and magnetic resonance imaging findings of the brain in Duane retraction syndrome (DRS) and determine whether there is an association between clinical presentation and magnetic resonance imaging (MRI) brain characteristics.
This was a cross-sectional study done at a tertiary care center in South India. We recruited and analyzed the clinical characteristics of 54 patients with DRS. MRI of the brain with fast imaging employing steady-state acquisition (FIESTA) was performed in 41 cases, and the cisternal segment of the sixth nerve was studied. Statistical analysis was done to determine any association between the radiological and clinical features.
Type 1 DRS was predominant, followed by Type 3 DRS and Type 2 DRS. 9.3% of cases were bilateral and 11.1% were familial. Orthotropia was most common, followed by esotropia and exotropia. The MRI brain showed the absence of the cisternal part of the sixth nerve on the affected side in 82% of Type 1 and 75% of Type 3 unilateral DRS. Both the abducens nerves were visualized in 19.5% of the patients with unilateral DRS. There was no statistically significant association between MRI brain findings and the clinical features.
MRI brain with FIESTA shows absent or hypoplastic sixth nerve in most cases of Type 1 and Type 3 DRS. However, around 20% of DRS cases may show the presence of the cisternal part of the sixth nerve. Hence, clinicians must be cautious when ruling out DRS on the basis of MRI brain findings. Although aplasia of the sixth nerve is the most frequent MRI finding, it may not be the sole etiologic factor.
描述杜安眼球后缩综合征（DRS）患者的临床特征及脑部磁共振成像（MRI）表现，并确定临床表现与脑部MRI特征之间是否存在关联。
这是一项在印度南部一家三级医疗中心进行的横断面研究。我们招募并分析了54例DRS患者的临床特征。对41例患者进行了采用稳态采集快速成像（FIESTA）的脑部MRI检查，并对展神经的脑池段进行了研究。进行统计分析以确定影像学特征与临床特征之间的任何关联。
1型DRS最为常见，其次是3型DRS和2型DRS。9.3%的病例为双侧性，11.1%为家族性。正视最为常见，其次是内斜视和外斜视。脑部MRI显示，在1型单侧DRS的82%和3型单侧DRS的75%中，患侧展神经脑池段缺如。在19.5%的单侧DRS患者中，双侧展神经均可见。脑部MRI表现与临床特征之间无统计学意义上的关联。
采用FIESTA序列的脑部MRI显示，在大多数1型和3型DRS病例中，展神经缺如或发育不全。然而，约20%的DRS病例可能显示展神经脑池段存在。因此，临床医生在根据脑部MRI表现排除DRS时必须谨慎。虽然展神经发育不全是最常见的MRI表现，但它可能不是唯一的病因。
