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International Journal of Ophthalmology 2020To study the different treatment modalities needed in cases of Duane's Retraction Syndrome (DRS).
AIM
To study the different treatment modalities needed in cases of Duane's Retraction Syndrome (DRS).
METHODS
This prospective study undergone in more than four years, in Alexandria, included 238 patients of DRS, including type I, 162 patients (68%), type II 12 patients (5%) and type III 64 patients (27%). Surgery was indicated in 98 (41%) of them, to eliminate abnormal head posture, deviation of the eye in primary position, severe retraction of the globe or cosmetically unacceptable upshoot with attempted adduction.
RESULTS
Type I was the most common and type II was the least. Females were predominant in this study, constituting 125 patients (52.5%), and males 113 patients (47.5%). Left eye was more affected, in 110 patients (46.2%), right eye in 91 patients (38.2%) and bilateral in 37 patients (15.6%). Amblyopia was found in 27 patients (11.3%) and treated in 13 patients under 10 years of age, by patching the normal eye. Ninety-eight patients (41%) were operated, the results were most satisfactory and a nomogram is followed in the surgical plan.
CONCLUSION
The surgical management is needed in less than half of the cases and should be planned for every case individually according to the clinical findings, planned nomogram and modified intraoperatively according to the anatomical findings during surgery.
PubMed: 32090038
DOI: 10.18240/ijo.2020.02.12 -
Ophthalmology Science 2024To investigate the types of strabismus surgeries performed and the reoperation rate in patients with Duane retraction syndrome (DRS).
PURPOSE
To investigate the types of strabismus surgeries performed and the reoperation rate in patients with Duane retraction syndrome (DRS).
DESIGN
Retrospective cohort analysis.
PARTICIPANTS
An insurance claims data set was used to identify patients diagnosed with DRS between 2007 and 2021.
METHODS
We recorded the type of strabismus surgery performed and the timing and frequency of reoperations. The hazard ratios (HRs) for reoperation were estimated according to the surgical methods using Cox regression analysis.
RESULTS
Of the 9435 patients diagnosed with DRS, 1023 (10.8%) underwent ≥ 1 strabismus operation. The median age at surgery was 5.0 years, and patients were followed for an average of 3.8 ± 3.0 years after their initial strabismus surgery. Most of the surgeries only involved horizontal muscle(s) (n = 734 [71.7%]). However, some patients underwent surgeries on vertical muscle(s) (n = 132 [12.9%]), vertical muscle(s) with transposition (n = 102 [10.0%]), and horizontal muscle with transposition (n = 51 [5.0%]). The estimated 5-year rate of reoperation was 18.2% (95% confidence interval [CI], 15.0%-22.2%). Compared with surgery on horizontal muscle(s) only, vertical muscle surgery (HR, 2.01; 95% CI, 1.30-3.11; = 0.002) and vertical muscle surgery coupled with transposition (HR, 1.79; 95% CI, 1.06-3.02; = 0.03) had an increased risk of reoperation.
CONCLUSIONS
Strabismus surgery on ≥ 1 horizontal muscles is the most common type of strabismus surgery performed on patients with DRS. Approximately 1 in 7 patients with DRS who had strabismus surgery underwent a reoperation. Patients who underwent vertical muscle surgery had a higher risk of undergoing a reoperation.
FINANCIAL DISCLOSURES
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
PubMed: 38827492
DOI: 10.1016/j.xops.2024.100479 -
Taiwan Journal of Ophthalmology 2017Duane syndrome (DS) is a common form of congenital cranial dysinnervation disorders. The ocular motility pattern lies in a wide clinical spectrum, and the choice of... (Review)
Review
Duane syndrome (DS) is a common form of congenital cranial dysinnervation disorders. The ocular motility pattern lies in a wide clinical spectrum, and the choice of treatment must be individualized depending on the severity of the clinical findings. There is no perfect method of treatment and no real "cure" in DS. In this paper, the aim is to give some guidelines to the reader for selection of the most appropriate treatment method for the patient.
PubMed: 29018747
DOI: 10.4103/tjo.tjo_20_17 -
Indian Journal of Ophthalmology Jan 2019Duane retraction (or co-contraction) syndrome is a congenital restrictive strabismus which can occur either as an isolated entity or in conjunction with other congenital... (Review)
Review
Duane retraction (or co-contraction) syndrome is a congenital restrictive strabismus which can occur either as an isolated entity or in conjunction with other congenital anomalies and is now listed as a congenital cranial dysinnervation disorder. It is characterized by co-contraction of horizontal recti on attempted adduction causing globe retraction along with variable amounts of upshoots or downshoots. It may have limited abduction or adduction or both and present as esotropic, exotropic, or orthotropic Duane. The diagnosis of this disease is usually clinical. However, recent research has provided a greater insight into the genetic basis of this disease paving a way for a greater role of genetics in the diagnosis and management. This disease can have a varied presentation and hence the treatment plan should be tailor-made for every patient. The indications for surgery are abnormal head posture, deviations in the primary position, retraction and narrowing of palpebral aperture and up- or downshoots during adduction, and sometimes also to improve abduction. The arrival of newer surgical techniques of periosteal fixation (PF) of lateral rectus (LR), partial vertical rectus transposition, or superior or inferior rectus transposition in addition to LR recession with Y-split has vastly improved the management outcomes, providing not only primary position orthophoria but also increased binocular visual fields as well.
Topics: Disease Management; Duane Retraction Syndrome; Eye Movements; Humans; Oculomotor Muscles; Ophthalmologic Surgical Procedures; Vision, Binocular; Visual Fields
PubMed: 30574884
DOI: 10.4103/ijo.IJO_967_18 -
Proceedings of the Royal Society of... Jun 1945
PubMed: 19993096
DOI: No ID Found -
The British Journal of Ophthalmology Mar 1967
Topics: Adult; Humans; Male; Strabismus
PubMed: 6019819
DOI: 10.1136/bjo.51.3.208 -
Cureus Oct 2022Duane retraction syndrome (DRS) with mechanical and innervational upshoot poses a surgical challenge. We discuss a case of DRS with mechanical and innervational upshoot...
Duane retraction syndrome (DRS) with mechanical and innervational upshoot poses a surgical challenge. We discuss a case of DRS with mechanical and innervational upshoot and its surgical management. An 11-year-old boy presented with left eye upward deviation since birth. This deviation was worst on the right gaze. His best corrected visual acuity was 6/6 OD and 6/60 OS. Refraction showed low hyperopia with low astigmatism in both eyes. Stereoacuity was absent and there was suppression on the Worth 4 dot test in the left eye. The left eye had large hypertropia of 50 prism diopter in primary gaze. Extraocular movements showed severe upshoot and narrowing of palpebral fissures on adduction and limited abduction (-2). The patient underwent Y-splitting of the left lateral rectus (LR) muscle of 10 mm, LR recession of 4 mm, and left eye superior rectus recession of 12 mm. A marked reduction in hypertropia in primary gaze was observed on day one and at two months postoperatively with residual upshoot on adduction. His left eye deviation remained stable after six months postoperatively.
PubMed: 36415378
DOI: 10.7759/cureus.30470 -
Journal of Optometry 2024To report the visual and refractive characteristics and the prevalence of amblyopia in patients with different types of Duane's Retraction Syndrome (DRS).
PURPOSE
To report the visual and refractive characteristics and the prevalence of amblyopia in patients with different types of Duane's Retraction Syndrome (DRS).
METHOD
This retrospective study was performed on hospital records of 582 DRS patients at Farabi Hospital, Iran, from 2012 to March 2022.
RESULTS
The mean age of patients was 19.4 ± 11.9 (range, 3-70) years [335 (57.6 %) females and 247 (42.4 %) males (P < .001)]. DRS type I, II, III, and IV were presented in 347 (59.6 %), 148 (25.4 %), 82 (14.1 %), and 5 (0.9 %) patients, respectively. There were 530 (91.1 %) patients with unilateral and 52 (8.9 %) with bilateral involvement. In the unilateral patients, the DRS eyes' corrected distance visual acuity (CDVA) and astigmatism were significantly worse than the Non-DRS Eyes (P < .001). The mean amount of all refractive and visual parameters in bilateral patients' right or left eyes was significantly lower than in unilateral patients' non-DRS eyes (all P < .05). Anisometropia was observed in 75(12.9 %) of the patients. Amblyopia was observed in 18.5 % (98 patients) and 36.5 % (19 patients) of unilateral and bilateral DRS patients, respectively (P < .001). In unilateral patients, amblyopia was found in 57 (16.4 %) patients with Type I, 22 (14.9 %) patients with Type II, 16 (19.5 %) patients with Type III, and 3 (60 %) patients with Type IV. Forty-four (37.6 %) of patients with amblyopia had anisometropia.
CONCLUSION
This large-scale study indicates that DRS types differ in terms of refractive error, visual acuity, and the prevalence of amblyopia and anisometropia. Clinicians should be aware of the clinical features associated with different types of DRS.
Topics: Humans; Amblyopia; Male; Female; Retrospective Studies; Adult; Visual Acuity; Child; Child, Preschool; Middle Aged; Young Adult; Adolescent; Aged; Iran; Duane Retraction Syndrome; Prevalence; Refraction, Ocular; Refractive Errors; Anisometropia
PubMed: 38215611
DOI: 10.1016/j.optom.2023.100508 -
Journal of AAPOS : the Official... Apr 2021Orbital myositis is a rare, commonly idiopathic, inflammatory condition that affects one or more extraocular muscles. We present a case of unilateral orbital myositis...
Orbital myositis is a rare, commonly idiopathic, inflammatory condition that affects one or more extraocular muscles. We present a case of unilateral orbital myositis affecting the lateral rectus muscle presenting with gaze-evoked amaurosis, pain, and diplopia, with restrictive limitation of adduction. With improvement in adduction after initiating treatment, we noted narrowing of the palpebral fissure on attempted adduction, mimicking Duane retraction syndrome (DRS). Reported cases of "pseudo-DRS" are associated with multiple etiologies and are characterized by retraction on attempted abduction rather than adduction, as occurs in true DRS. In this case, pseudo-DRS occurred in the setting of idiopathic orbital inflammatory syndrome (orbital myositis) with a motility pattern more consistent with true DRS.
Topics: Diplopia; Duane Retraction Syndrome; Eyelids; Humans; Oculomotor Muscles; Orbital Myositis
PubMed: 33652102
DOI: 10.1016/j.jaapos.2020.11.012 -
Journal of Neurology, Neurosurgery, and... Dec 1996
Topics: Duane Retraction Syndrome; History, 19th Century; History, 20th Century; Humans
PubMed: 8971107
DOI: 10.1136/jnnp.61.6.600