Knobby Eye Syndrome.
Knobby Eye Syndrome.
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DOI：
10.1080/09273972.2017.1418393
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发表时间：
2018-03
期刊：
影响因子：
0.9
通讯作者：
Demer JL
中科院分区：
文献类型：
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作者：
Demer JL
传统上认为地球是球形的，但本研究采用磁共振成像 (MRI) 来证明斜视患者经常出现非球形葡萄肿。在 21 名高度近视受试者（36 只眼睛）的多个图像平面上获得了高分辨率表面线圈 MRI，并与 17 名正常对照者（33 只眼睛）进行了比较。分析图像的眼轴长度、眼睛形状的纵横比和肌肉路径的偏转。除两名高度近视外，其他人均患有斜视。虽然在 10 只近视眼（包括正交异性受试者）中，近视眼球通常呈球形，但 15 只眼球表现出弥漫性后葡萄肿，16 只呈现赤道葡萄肿，4 只呈现后葡萄肿和赤道葡萄肿。赤道巩膜扩张被定位为在某些凝视位置接触和拉长水平直肌的路径。近视眼的眼轴长度平均为 28.8 ± 3.8 (SD) mm，并且规则葡萄瘤与不规则葡萄瘤之间没有显着差异。近视患者的冠状面、眼轴和矢状面的眼球纵横比显着大于正常值（P < 0.005），但仅在眼轴和矢状面与眼轴长度显着相关（P < 0.03）。虽然不规则葡萄肿近视患者的年龄为 57 ± 11 岁，而球形眼球患者的年龄为 24 ± 8 岁 (P < 0.0005)，但其他临床特征相似。不规则的赤道或后葡萄肿在斜视轴性高度近视中很常见，其作用就像固定在正常球形球体上的“凸轮”一样，因此它们在相对于肌肉偏心旋转之前不会产生机械效应。旋转接触后，葡萄节会随着进一步的收缩而非线性地增加肌肉张力。影像学可能为这种“肿眼综合征”提供临床信息。
A spherical globe is traditionally assumed, but this study employed magnetic resonance imaging (MRI) to demonstrate frequent occurrence of non-spherical staphylomata in strabismic patients. High-resolution, surface coil MRI was obtained in multiple image planes in 21 highly myopic subjects (36 eyes) and compared with 17 normal controls (33 eyes). Images were analyzed for axial length, aspect ratio of eye shape, and deflection of muscle paths. All but two high myopes had strabismus. While myopic globes were generally spherical in 10 myopic eyes including both orthotropic subjects, 15 globes exhibited diffuse posterior staphylomata, 16 equatorial staphylomata, and 4 both posterior and equatorial staphylomata. Equatorial scleral ectasias were positioned to contact and elongate paths of horizontal rectus muscles in some gaze positions. Axial length in myopes averaged 28.8 ± 3.8 (SD) mm and did not differ significantly between regular vs. irregular staphylomata. Globe aspect ratios in the coronal, axial, and sagittal planes were significantly greater than normal in myopes (P < 0.005), but correlated significantly with axial length only in the axial and sagittal planes (P < 0.03). While myopes with irregular staphylomata were older at 57 ± 11 years than subjects with spherical globes at 24 ± 8 years (P < 0.0005), other clinical features were similar. Irregular equatorial or posterior staphylomata are common in strabismic axial high myopes, acting, like “cams” affixed to the normally spherical globe so that they may have no mechanical effect until rotating eccentrically against muscles. After rotational contact, staphylomata would nonlinearly increase muscle tension with further duction. Imaging may be clinically informative about this “knobby eye syndrome.”