Duane retraction syndrome: Clinical features and differential diagnosis

Abstract

Objective: To determine the clinical properties of Duane\'s Retraction Syndrome (DRS) cases in our clinic, to em­phasize the importance of differential diagnosis in these patients. Materials and methods: Gender distribution, laterality, type of the syndrome, amblyopia, and accompanying ocular and non-ocular abnormalities of the 32 cases that were diagnosed as Duane\'s retraction syndrome were retrospectively investigated. Results: Thirty-two cases with average age of 7.40±3.34 were followed for 14±5.20 months at average. Twenty (62.5%) of the 32 cases of were female and 12 were male (37.5%). Twenty-seven of the cases (84.7%) were type-I, 4 was type-II (12.5%), and 1 was type-III (3.12%) DRS. Twenty-five (78.1%) of the cases had one eye involve­ment and 7 (21.9%) had two eyes involvement. Left eye involvement among cases with one eye DRS were higher (56.2%). In type-I DRS cases the rates of exotropia, am­blyopia, up-shoot and down-shoot, and abnormal head posture were as follows 43.75%, 28%, 34.37%, 37.20%, respectively. Patients who were applied Magnetic Reso­nance Imaging techniques had no abnormality about in­tracranial structure. Five among type-I DRS cases who had serious abnormal head posture had medial rectus recession operation. Conclusion: The majority of Duane retraction syndrome cases were constituted of Type I cases. It was observed that the syndrome was more frequent in women and left eye was more affected. While visual acuity was observed as normal in majority of cases, in some cases exotropia, amblyopia, and abnormal head posture were present. Significant improvements were observed in terms of slip­page angles and head postures of 5 cases with type 1 DRS after surgery.

Keywords

• Duane retraction syndrome, abnormal head posture, magnetic resonanceimaging.

Duane retraksiyon sendromu: Klinik özellikler ve ayırıcı tanı

Abstract

Amaç: Kliniğimizde takip ettiğimiz Duane retraksiyon sendromlu (DRS) olguların klinik özelliklerini belirlemek, bu olgularda ayırıcı tanının önemini vurgulamak. Gereç ve yöntem: Duane retraksiyon sendromu tanısı almış 32 olgunun cinsiyet dağılımı, lateralite, sendromun tipi, ambliyopi varlığı, eşlik eden göz içi ve göz dışı anor­mallikleri geriye dönük olarak incelendi. Bulgular: Yaş ortalamaları 7.40±3.3 yıl olan 32 DRS\'li olgu ortalama 14±5.2 ay süreyle takip edilmişti. Olguların 20\'si (%62.5) kadın, 12\'si (%37.5) erkekti. Olgularımızın 27\'si (%84.4) Tip 1, 4\'ü (%12.5) Tip 2 ve biri (%3.1) Tip III DRS idi. Olgularımızın 25\'inde (%78.1) tek göz tutulumu, 7\'sinde (%21.9) iki göz tutulumu mevcuttu. Tek gözünde DRS olan olgularda sol gözde daha fazla tutulum mev­cuttu (%56.2). Tip 1 DRS\'li olgularda ezotropya (%51.9), ambliyopi (%28), up-shoot ve down-shoot (%34.4), anor­mal baş pozisyonu (%37.2) oranında gözlenmekteydi. Manyetik Rezonans Görüntüleme (MR) yapılan olgular­da kafa içi bir patolojiye rastlanmadı. Ciddi anormal baş pozisyonu(ABP) bulunan Tip 1 DRS\'li 5 olguda iç rektusa geriletme operasyonu yapıldı. Sonuç: Duane retraksiyon sendromlu olguların çoğun­luğunu Tip 1 DRS\'li olgular oluşturmaktaydı. Sendromun kadınlarda daha çok görüldüğü ve sol gözü daha fazla etkilediği izlendi. Olguların büyük çoğunluğunda görme keskinliği normal izlenirken, bazı olgularda ezotropya, ambliyopi, anormal baş pozisyonu mevcuttu. Kayması ve anormal baş pozisyonu mevcut olan 5 tip 1 DRS\'li olgu­nun ameliyat sonrası kayma açıları ve baş pozisyonların­da belirgin düzelme izlendi.

Keywords

• Duane retraksiyon sendromu, anor­mal baş pozisyonu, manyetik rezonans görüntüleme.

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