일차하사근기능항진 환자에서 외회선의 임상적 평가
Clinical Evaluation of Excyclotorsion in Patients with Primary Inferior Oblique Overaction
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목적: 일차하사근기능항진 환자의 하사근기능항진 정도에 따른 외회선 양상을 알아보았다. 대상과 방법: 일차하사근기능항진 환자 59명을 대상으로 양안운동검사로 하사근기능항진, 안저사진으로 회선량을 평가하여 하사근기능항진 정도(대조군; IOOA＜1, 1군; 1≤IOOA＜2, 2군; 2≤IOOA＜3, 3군; 3≤IOOA＜4, 4군; IOOA=4)에 따른 외회선과의 상관관계를 조사하였다. 결과: 외회선은 대조군; 7.37 ± 2.36°, 1군; 9.29 ± 3.79°, 2군; 10.04 ± 4.39°, 3군; 17.98 ± 4.62°, 4군; 24.70 ± 4.61°로 하사근기능항진 정도와 외회선은 양의 상관관계를 보였다(Pearson’s 상관계수 r=0.675). 비대칭하사근기능항진에서 상사시의 빈도가 더 높았다. 외사시를 동반하는 경우보다 내사시를 동반한 경우가 하사근기능항진과 외회선 정도가 더 크게 나타났다(p=0.001). 결론: +3 이상의 하사근기능항진에서는 하사근 기능항진 정도에 비례해서 외회선이 증가하며 1군, 2군에서는 대조군에 비해 외회선이크게 증가하지는 않았으나 넓게 분포하였다.
Abstract
Purpose: To evaluate the amount of excyclotorsion according to degree of inferior oblique overaction (IOOA) in patients with primary IOOA. Methods: Fifty-nine primary IOOA patients who underwent inferior oblique muscle surgery were evaluated. Visual acuity,ocular movement test, prism cover test, Bielschowsky head tilt test, fundus photograph and photographic examination for excyclotorsion were performed. The correlation analysis was performed for the excyclotorsion according to the amount of IOOA (Control group; IOOA < 1, Group 1; 1 ≤ IOOA < 2, Group 2; 2 ≤ IOOA < 3, Group 3; 3 ≤ IOOA < 4, Group 4; IOOA = 4). Results: Excyclotorsion was 7.37 ± 2.36° in the Control group, 9.29 ± 3.79° in Group 1, 10.04 ± 4.39° in Group 2, 17.98 ±4.62° in Group 3, and 24.70 ± 4.61° in Group 4. The amount of IOOA and excyclotorsion showed a positive correlation (Pearson’s correlation coefficient r = 0.675). Asymmetric IOOA was observed in 35 patients (59.3%) and symmetric IOOA was observed in 24 patients (40.7%). Asymmetric IOOA combined with hypertropia was presented in 9 patients (37.5%)and symmetric IOOA combined with hypertropia was presented in 3 patients (8.6%). Therefore, patients with asymmetric IOOA have a higher incidence of vertical diplopia. The amounts of IOOA and excyclotorsion were greater in primary IOOA with esotropia than in subjects with exotropia (p = 0.001). Conclusions: The excyclotorsion was proportional to the amount of IOOA in Group 3 and Group 4. The aspect of excyclotorsion was widely distributed in Group 1 and Group 2 compared to that in the Control group.
참고문헌 (22)
- Von Noorden GK, "Binocular Vision and Ocular Motility : Theory and Management of Strabismus, 6th ed", pp.55~56 (2002), Mo Mosby
- Guyton DL, "Sensory torsion as the cause of primary oblique muscle overaction", underaction and A-and V-pattern strabismus, 1994, pp.9, 209~236
- Knapp P, "Vertically incomitant horizontal strabismus: the so-called“A” and “V” syndromes", Trans Am Ophthalmol Soc, 57, pp.666~699 (1959)
- Eustis HS, "Inferior oblique overaction in infantile esotropia: fundus extorsion as a predictive sign", J Pediatr Ophthalmol Strabismus, 33, pp.85~88 (1996)
- Bixenman WW, "Apparent foveal displacement in normal subjects and in cyclotropia", Ophthalmology, 89, pp.58~62 (1982)
- Morton GV, "The role of funduscopy and fundus photography in strabismus diagnosis", Ophthalmology, 90, pp.1186~1191 (1983)
- Duane A, "Binocular movements", Arch Ophthalmol, 9, pp.579~607 (1933)
- Scobee RG, "The oculorotary muscles", Mosby, 2, pp.264~268 (1958)
- Parks MM, "Inferior oblique weakening procedures", Int Ophthalmol Clin, 25, pp.107~117 (1985)
- 이동헌, "정상한국인의 회선상태", 대한안과학회지, 45(5), pp.15~15 (2004), 대한안과학회
- 이현주, "집단검진 환자에서 측정한 안구회선의 범위", 대한안과학회지, 46(10), pp.1684~1689 (2005), 대한안과학회
- 송민혜, "선천 단안상사근마비 환자에서 수직사시, 하사근기능항진과 외회선의 관계", 대한안과학회지, 48(10), pp.1394~1398 (2007), 대한안과학회
- 김은희, "안저사진촬영시 주시 유무에 따른 안구 회선의 차이", 대한안과학회지, 47(3), pp.449~17 (2006), 대한안과학회
- Kushner BJ, "Ocular torsional movements in humans with normal and abnormal ocular motility--Part I: Objective measurements", J Pediatr Ophthalmol Strabismus, 21, pp.172~177 (1984)
- Chang BL, "Superior oblique palsy", J Korean Ophthalmol Soc, 32, pp.300~306 (1991)
- Guyton DL, "Clinical assessment of ocular torsion", Am Orthopt J, 33, pp.7~15 (1983)
- Wilson ME, "Primary inferior oblique overaction in congenital esotropia, accommodative esotropia, and intermittent exotropia", Ophthalmology, 96, pp.950~955 (1989)
- 김재우, "선천 상사근마비 환자에서 하사근 약화술의 효과", 대한안과학회지, 45(11), pp.17~17 (2004), 대한안과학회
- Chang BL, "Inferior oblique overaction", J Korean Ophthalmol Soc, 29, pp.1065~1069 (1988)
- Min BM, "Comparison between myectomy and anterior transposition on inferior oblique overaction", J Korean Ophthalmol Soc, 33, pp.977~982 (1992)
- Rah SH, "An epidemiologic survey of strabismus among school-children in Korea", J Korean Ophthalmol Soc, 38, pp.2195~2199 (1997)
- Steffen H, "Torsion in patients with superior oblique palsies: dynamic torsion during saccades and changes in Listing’s plane", Graefes Arch Clin Exp Ophthalmol, 246, pp.771~778 (2008)