Clinical Features of Duane Retraction Syndrome: A New Classification
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Purpose: We sought to provide a new classification system for Duane retraction syndrome (DRS) according totype and angle of strabismus during primary gaze and to analyze the clinical features of each DRS type. Methods: The medical records of 65 DRS patients who visited the department of pediatric ophthalmology atSeoul National University Children’s Hospital between 2010 and 2017 were retrospectively analyzed. Patientswhose angle of exotropia at primary gaze exceeded 3 prism diopters (PDs) were classified as “Exo-Duane,”those whose angle of strabismus at primary gaze did not exceed 3 PDs were classified as “Ortho-Duane,”and those whose angle of esotropia at primary gaze exceeded 3 PDs were classified as “Eso-Duane.”Results: Among 65 DRS patients, Ortho-Duane was the most common (53.8%) type, followed by Eso-Duane(33.8%) and Exo-Duane (12.3%). The mean age at diagnosis was significantly higher in the Exo-Duane groupthan the Ortho-Duane or Eso-Duane group (p = 0.003 and p < 0.001, respectively). A predominance of lefteye involvement was observed in the Ortho-Duane (62.9%) and Eso-Duane (90.9%) groups. The frequenciesof upshoot, downshoot, fissure narrowing, and globe retraction were not significantly different among the subgroups. Head-turn was more frequent in Eso-Duane patients than in Exo-Duane or Ortho-Duane patients (p =0.001 and p < 0.001, respectively). Myopia accounted for the most common refractive error among Exo-Duanepatients (71.4%), while hyperopia was found more often in both Ortho-Duane (64.7%) and Eso-Duane (85.0%)patients. The majority of patients showed gross stereoacuity (93.1%), and a large proportion had good stereoacuity(Exo-Duane 60.0%, Ortho-Duane 81.3%, Eso-Duane 87.5%). Conclusions: Our newly proposed classification of DRS according to type and angle of strabismus at primarygaze was practically useful and showed potential for use as an objective guideline in the clinical setting.
Abstract
Purpose: We sought to provide a new classification system for Duane retraction syndrome (DRS) according totype and angle of strabismus during primary gaze and to analyze the clinical features of each DRS type. Methods: The medical records of 65 DRS patients who visited the department of pediatric ophthalmology atSeoul National University Children’s Hospital between 2010 and 2017 were retrospectively analyzed. Patientswhose angle of exotropia at primary gaze exceeded 3 prism diopters (PDs) were classified as “Exo-Duane,”those whose angle of strabismus at primary gaze did not exceed 3 PDs were classified as “Ortho-Duane,”and those whose angle of esotropia at primary gaze exceeded 3 PDs were classified as “Eso-Duane.”Results: Among 65 DRS patients, Ortho-Duane was the most common (53.8%) type, followed by Eso-Duane(33.8%) and Exo-Duane (12.3%). The mean age at diagnosis was significantly higher in the Exo-Duane groupthan the Ortho-Duane or Eso-Duane group (p = 0.003 and p < 0.001, respectively). A predominance of lefteye involvement was observed in the Ortho-Duane (62.9%) and Eso-Duane (90.9%) groups. The frequenciesof upshoot, downshoot, fissure narrowing, and globe retraction were not significantly different among the subgroups. Head-turn was more frequent in Eso-Duane patients than in Exo-Duane or Ortho-Duane patients (p =0.001 and p < 0.001, respectively). Myopia accounted for the most common refractive error among Exo-Duanepatients (71.4%), while hyperopia was found more often in both Ortho-Duane (64.7%) and Eso-Duane (85.0%)patients. The majority of patients showed gross stereoacuity (93.1%), and a large proportion had good stereoacuity(Exo-Duane 60.0%, Ortho-Duane 81.3%, Eso-Duane 87.5%). Conclusions: Our newly proposed classification of DRS according to type and angle of strabismus at primarygaze was practically useful and showed potential for use as an objective guideline in the clinical setting.
참고문헌 (17)
- Duane A., "Congenital deficiency of abduction, associated with impairment of adduction, retraction movements, contraction of the palpebral fissure and oblique movements of the eye. 1905", Arch Ophthalmol, 114, pp.1255~1256 (1996)
- Kekunnaya R, "Duane retraction syndrome:causes, effects and management strategies", Clin Ophthalmol, 11, pp.1917~1930 (2017)
- Yuksel D, "Review of the major findings about Duane retraction syndrome(DRS)leading to an updated form of classification", Vision Res, 50, pp.2334~2347 (2010)
- Huber A, "Electrophysiology of the retraction syndromes", Br J Ophthalmol, 58, pp.293~300 (1974)
- Mohan K, "Differences in epidemiological and clinical characteristics between various types of Duane retraction syndrome in 331 patients", J AAPOS, 12, pp.576~580 (2008)
- O’Malley ER, "Duane’s retraction syndrome : plus", J Pediatr Ophthalmol Strabismus, 19, pp.161~165 (1982)
- Shauly Y, "Ocular and systemic characteristics of Duane syndrome", J Pediatr Ophthalmol Strabismus, 30, pp.178~183 (1993)
- Lee KH, "Clinical characteristics of Duane’s retraction syndrome", J Korean Ophthalmol Soc, 37, pp.1747~1752 (1996)
- Isenberg S, "Clinical observations in 101 consecutive patients with Duane’s retraction syndrome", Am J Ophthalmol, 84, pp.419~425 (1977)
- Park WH, "The clinical features of Korean patients with Duane’s retraction syndrome", Korean J Ophthalmol, 19, pp.132~135 (2005)
- DeRespinis PA, "Duane’s retraction syndrome", Surv Ophthalmol, 38, pp.257~288 (1993)
- Khan AO, "Duane retraction syndrome on the Arabian Peninsula", Strabismus, 15, pp.205~208 (2007)
- Kekunnaya R, "Duane retraction syndrome : series of 441 cases", J Pediatr Ophthalmol Strabismus, 49, pp.164~169 (2012)
- Khan AO, "Clinical characteristics of bilateral Duane syndrome", J AAPOS, 10, pp.198~201 (2006)
- Singh A, "Congenital cranial dysinnervation disorders", Int Ophthalmol, 37, pp.1369~1381 (2017)
- Ahluwalia BK, "Study of Duane’s retraction syndrome", Acta Ophthalmol(Copenh), 66, pp.728~730 (1988)
- Rosenbaum AL, "Clinical strabismus management:principles and surgical techniques", pp.326~328 (1999), Saunders
