Crouzon syndrome: relationship of rectus muscle pulley location to pattern strabismus

Investigative Ophthalmology & Visual Science
Avery H WeissJohn P Kelly

Abstract

Investigate the relationship between the extorsion of the rectus muscle pulleys and the V-pattern exotropia and "overelevation in adduction" observed in Crouzon syndrome. Twenty children with Crouzon syndrome had assessment of eye alignment. The horizontal and vertical positions of the four rectus muscle pulleys were estimated from coronal CT images. Eye alignment was simulated in Orbit 1.8 software by shifting the corresponding location of the rectus muscle pulley array. Eleven of the 20 patients had a V-pattern exotropia with displacements of each rectus muscle pulley ranging from 2 to 7 mm. The remaining nine patients were orthotropic with <2 mm displacement of the rectus muscle pulleys. Simulated displacements (>2 mm) of either the horizontal or vertical rectus muscle pulleys produced a similar strabismus pattern. The amount of V-pattern exotropia observed clinically was highly correlated with the amount predicted by pulley displacements in Orbit 1.8 (r(2) = 0.63; P < 0.0001). The displacement of vertical and horizontal rectus muscle pairs was significantly higher for patients having overelevation in adduction. Rotation of the four rectus muscle pulleys relative to the corresponding rotation planes of the globe changes the ...Continue Reading

Citations

Sep 1, 2014·Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus·Joseph L Demer
Jul 17, 2015·Middle East African Journal of Ophthalmology·Robert A Clark
Apr 23, 2020·Indian Journal of Ophthalmology·Seung Ah Chung, Seung Yeop Lee
Dec 20, 2019·Journal of Binocular Vision and Ocular Motility·Abdelrahman M ElhusseinyLinda R Dagi
Nov 1, 2020·Graefe's Archive for Clinical and Experimental Ophthalmology = Albrecht Von Graefes Archiv Für Klinische Und Experimentelle Ophthalmologie·Seung Ah ChungJae Ho Jung

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