Kim Jin Hee, Moon Won-Jin, Shin Hyun Jin
School of Medicine, Konkuk University, Chungju, Republic of Korea.
Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Republic of Korea.
PLoS One. 2025 May 27;20(5):e0324078. doi: 10.1371/journal.pone.0324078. eCollection 2025.
To compare orbital magnetic resonance imaging (MRI) findings of age-related distance esotropia (ARDE) with those of age-matched healthy controls and acute acquired concomitant esotropia (AACE) patients.
Coronal MRI scans of 16 ARDE cases, 15 AACE cases, 26 elderly controls cases, and 22 young controls cases were analyzed to measure (1) the displacement angles of the lateral rectus (LR) and medial rectus (MR), (2) the LR tilting angle, (3) the ratio of the MR-to-LR cross-sectional areas (CSAs), and (4) the superior rectus (SR) downward displacement ratio (SDR).
ARDE patients showed significant LR sagging relative to elderly controls, by 5.1° (p = 0.048), while there was no significant LR displacement in AACE relative to young controls. ARDE patients also exhibited marked LR tilting relative to all other groups. Additionally, the MR-to-LR CSA ratios were 26% (p = 0.002) and 27% (p = 0.001) higher in the ARDE and AACE groups than in the controls, respectively, indicating imbalance in the horizontal rectus (HR). Additionally, SDR values were higher in ARDE and elderly controls, suggesting that a closer proximity of the SR muscle to the globe is an age-related alteration.
The findings demonstrate that ARDE is characterized by unique orbital changes, particularly in the LR, that distinguish it from AACE. The observed increase in the MR-to-LR CSA ratio among the esotropia groups points to an imbalance of HR tension. These MRI-based insights enhance our comprehension of the unique pathophysiology of these conditions, helping to distinguish ARDE from AACE in acquired esotropia and guiding customized treatments strategies.
比较年龄相关性远距离内斜视（ARDE）与年龄匹配的健康对照者及急性获得性共同性内斜视（AACE）患者的眼眶磁共振成像（MRI）表现。
分析16例ARDE患者、15例AACE患者、26例老年对照者及22例年轻对照者的冠状位MRI扫描图像，测量（1）外直肌（LR）和内直肌（MR）的移位角度，（2）LR倾斜角度，（3）MR与LR横截面积（CSA）之比，以及（4）上直肌（SR）向下移位率（SDR）。
与老年对照者相比，ARDE患者的LR明显下垂，相差5.1°（p = 0.048），而与年轻对照者相比，AACE患者的LR无明显移位。与所有其他组相比，ARDE患者的LR也有明显倾斜。此外，ARDE组和AACE组的MR与LR CSA之比分别比对照组高26%（p = 0.002）和27%（p = 0.001），表明水平直肌（HR）失衡。此外，ARDE组和老年对照者的SDR值较高，提示SR肌肉与眼球更接近是一种与年龄相关的改变。
研究结果表明，ARDE具有独特的眼眶变化特征，尤其是在LR方面，这使其有别于AACE。在内斜视组中观察到的MR与LR CSA之比增加表明HR张力失衡。这些基于MRI的见解增强了我们对这些疾病独特病理生理学的理解，有助于在获得性内斜视中将ARDE与AACE区分开来，并指导定制治疗策略。
