"Heavy Eye" syndrome in the absence of high myopia: A connective tissue degeneration in elderly strabismic patients.
"Heavy Eye" syndrome in the absence of high myopia: A connective tissue degeneration in elderly strabismic patients.
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DOI：
10.1016/j.jaapos.2008.07.008
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发表时间：
2009-02
期刊：
影响因子：
1.6
通讯作者：
Demer, Joseph L.
中科院分区：
文献类型：
--
作者：
Rutar, Tina;Demer, Joseph L.
在伴有“重眼”综合征的轴性高度近视患者中，眼眶磁共振成像（MRI）显示外直肌-上直肌（LR-SR）带变性，从而使外直肌向前滑动，产生内斜视和下斜视。我们询问这种变性是否也可能导致非近视老年患者斜视。3名斜视性老年患者、3名斜视性高度近视患者和12名正交各向异性老年受试者接受了眼科检查和眼眶MRI。根据准冠状面图像确定外直肌相对于地球仪中心的位置，并与LR SR谱带结构相关联。MRI进行了比较，从17个月到93岁的四个尸体眼眶的组织学。两名斜视患者表现为下斜视，一名表现为内斜视。他们的平均眼轴长度为24.1 ± 0.8 mm（平均值±标准差），而近视眼为31.6 ± 1.4 mm。老年斜视患者外直肌位置在地球仪中心下方4.6 ± 1.7 mm，显著低于老年斜视患者（2.1 ± 1.9 mm; P = 0.01），与高度近视患者（5.1 ± 3.2 mm）相似。通过MRI，100%的斜视性老年人眼眶、67%的斜视性近视眼眶和12.5%的对照老年人眼眶显示LR-SR带变薄、不连续或移位。LR-SR带变性仅在老年尸体中存在组织学上的改变。在老年非近视患者中，与斜视相关的LR-SR带变性允许外直肌向前滑动，这是一种类似于近视性“重眼”综合征的斜视机制。影像学检查可以帮助诊断年龄相关性斜视的机械原因。
In axial high myopes with “heavy eye” syndrome, orbital magnetic resonance imaging (MRI) demonstrates degeneration of the lateral rectus-superior rectus (LR-SR) band, so that the lateral rectus muscle slips inferiorly to produce esotropia and hypotropia. We asked if this degeneration might also cause strabismus in nonmyopic elderly patients. Three strabismic elderly patients, three strabismic high myopes, and 12 orthotropic elderly subjects underwent ophthalmic examinations and orbital MRI. Lateral rectus position was determined relative to globe center from quasicoronal images and correlated with LR-SR band structure. MRI was compared to histology of four cadaveric orbits ranging in age from 17 months to 93 years. Two strabismic patients exhibited hypotropia and one exhibited esotropia. Their mean axial length was 24.1 ± 0.8 mm (mean ± SD), compared to 31.6 ± 1.4 mm for myopes. The lateral rectus muscle position of elderly strabismic subjects averaged 4.6 ± 1.7 mm inferior to globe center, which was significantly lower than that of orthotropic elderly subjects (2.1 ± 1.9 mm; P = 0.01) and similar to that of high myopes (5.1 ± 3.2 mm). By MRI, 100% of strabismic elderly orbits, 67% of strabismic myopic orbits, and 12.5% of control elderly orbits showed LR-SR band thinning, discontinuity, or displacement. LR-SR band degeneration was present histologically only in older cadavers. Age-related LR-SR band degeneration permits the lateral rectus muscle to slip inferiorly in elderly non-myopes, a mechanism of strabismus similar to myopic “heavy eye” syndrome. Imaging may assist in diagnosing this mechanical cause of age-related strabismus.
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影响因子：
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