下斜肌减弱术后的眼底扭转

Fundus torsion following inferior oblique muscle weakening.

作者信息

Rajavi Zhale, Nikanfar Kaveh, Sharahi Dizabadi Marzieh, Abdi Saeid, Kheiri Bahareh, Sheibani Kourosh, Sabbaghi Hamideh

机构信息

Negah Aref Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Ophthalmic Epidemiology Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Department of Ophthalmology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Optometry, School of Rehabilitation, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J AAPOS. 2024 Feb;28(1):103827. doi: 10.1016/j.jaapos.2023.10.010. Epub 2024 Jan 20.

DOI:10.1016/j.jaapos.2023.10.010

PMID:38253286

Abstract

PURPOSE

To determine the postoperative fundus torsion following surgical inferior oblique (IO) weakening in patients with inferior oblique overaction (IOOA).

METHODS

In this interventional case series, 37 patients with IOOA ≥ +1 and reliable preoperative fundus photographs were included. IO weakening was accomplished through myectomy or anterior transposition. Fundus photography was repeated at 3 months' follow-up. The primary outcome was change of disk foveal angle (DFA), measured as the angle between the line connecting the center of the fovea and optic disk and horizontal. Success or normal fundus torsion was defined as a postoperative angle of 0° to 8° of extorsion. Residual extorsion was defined as postoperative extorsion of > 8°. Postoperative intorsion was defined as any amount of induced intorsion.

RESULTS

Mean age of patients (56% females) was 6.46 ± 6.79 years. At follow-up at least 3 months after surgery, the mean change of DFA was 7.79 ± 6.24° of reduction of extorsion after IO myectomy (P < 0.001) and 6.05 ± 6.07° after IO anterior transposition (P = 0.005). Normal fundus torsion was achieved in 50% of patients after myectomy and 36.4% of patients after anterior transposition. Residual extorsion was observed in 49% of patients; induced intorsion in 5%.

CONCLUSIONS

Using objective measurement of fundus photographs, fundus extorsion was decreased in 94.7% of patients after myectomy or anterior transposition.

摘要

目的

确定下斜肌亢进（IOOA）患者行下斜肌（IO）减弱手术后的术后眼底扭转情况。

方法

在这个干预性病例系列中，纳入了37例IOOA≥+1且术前眼底照片可靠的患者。IO减弱通过肌切除术或前徙术完成。在术后3个月随访时重复进行眼底照相。主要观察指标是视盘黄斑角（DFA）的变化，测量方法是连接黄斑中心与视盘的直线与水平线之间的夹角。成功或正常眼底扭转定义为术后外旋角度为0°至8°。残余外旋定义为术后外旋>8°。术后内旋定义为任何程度的诱导性内旋。

结果

患者的平均年龄为6.46±6.79岁（56%为女性）。在术后至少3个月的随访中，IO肌切除术后DFA平均变化为外旋减少7.79±6.24°（P<0.001），IO前徙术后为6.05±6.07°（P=0.005）。肌切除术后50%的患者和前徙术后36.4%的患者实现了正常眼底扭转。49%的患者观察到残余外旋；5%的患者出现诱导性内旋。