Spontaneous Recovery of Traumatic Unilateral Superior Oblique Palsy and Ocular Factors for Predicting Prognosis
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Purpose: This study evaluated the prognosis of patients with traumatic unilateral superior oblique palsy (SOP) and clinicalfactors associated with spontaneous resolution. Methods: Medical records of patients with traumatic unilateral SOP who visited two hospitals (Yeungnam University Hospitaland Daegu Catholic University Medical Center) between January 2015 and June 2020 were reviewed retrospectively. Whentraumatic unilateral SOP did not recover within at least 1 year of follow-up, no spontaneous resolution was considered. Bothtraumatic and ocular factors were evaluated to evaluate their association with spontaneous recovery. Results: Fifty-nine patients (mean age, 52.6 years; 48 male patients) were enrolled in this study. The mean interval from traumato initial presentation was 3.9 months. The mean vertical deviation at initial presentation was 6.34 ± 5.22 prism diopters(PD) (range, 0–25 PD). During the mean 24.1-month follow-up period, 28 patients (47.5%) achieved spontaneous resolutionof SOP. Thirteen patients underwent surgical treatment for SOP. Vertical deviation <6 PD at the initial visit and low fundustorsion in the nonparetic eye and both eyes were significantly associated with spontaneous recovery (p < 0.05, logistic regressionanalysis). Traumatic factors, including the trauma type, presence of intracranial lesion, loss of consciousness, andGlasgow Coma Scale score, were not associated with spontaneous recovery. Conclusions: In this multicenter study, spontaneously recovery was achieved in 47.5% patients with traumatic unilateral SOP. Even mild head trauma can lead to permanent SOP. Ocular factors, including the angle of deviation and fundus torsion, maybetter predict spontaneous resolution than traumatic factors in patients with traumatic unilateral SOP.
Abstract
Purpose: This study evaluated the prognosis of patients with traumatic unilateral superior oblique palsy (SOP) and clinicalfactors associated with spontaneous resolution. Methods: Medical records of patients with traumatic unilateral SOP who visited two hospitals (Yeungnam University Hospitaland Daegu Catholic University Medical Center) between January 2015 and June 2020 were reviewed retrospectively. Whentraumatic unilateral SOP did not recover within at least 1 year of follow-up, no spontaneous resolution was considered. Bothtraumatic and ocular factors were evaluated to evaluate their association with spontaneous recovery. Results: Fifty-nine patients (mean age, 52.6 years; 48 male patients) were enrolled in this study. The mean interval from traumato initial presentation was 3.9 months. The mean vertical deviation at initial presentation was 6.34 ± 5.22 prism diopters(PD) (range, 0–25 PD). During the mean 24.1-month follow-up period, 28 patients (47.5%) achieved spontaneous resolutionof SOP. Thirteen patients underwent surgical treatment for SOP. Vertical deviation <6 PD at the initial visit and low fundustorsion in the nonparetic eye and both eyes were significantly associated with spontaneous recovery (p < 0.05, logistic regressionanalysis). Traumatic factors, including the trauma type, presence of intracranial lesion, loss of consciousness, andGlasgow Coma Scale score, were not associated with spontaneous recovery. Conclusions: In this multicenter study, spontaneously recovery was achieved in 47.5% patients with traumatic unilateral SOP. Even mild head trauma can lead to permanent SOP. Ocular factors, including the angle of deviation and fundus torsion, maybetter predict spontaneous resolution than traumatic factors in patients with traumatic unilateral SOP.
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