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Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus

Background and objectives: Supernumerary extraocular muscle (SEOM) is extremely rare. The purpose of this paper was to review the clinical characteristics and surgical outcomes of SEOM patients with atypical restrictive strabismus. Materials and Methods: A retrospective review was conducted on the d...

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Autores principales: Wang, Xiangjun, Shen, Tao, Han, Mengya, Yan, Jianhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693874/
https://www.ncbi.nlm.nih.gov/pubmed/36422229
http://dx.doi.org/10.3390/medicina58111691
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author Wang, Xiangjun
Shen, Tao
Han, Mengya
Yan, Jianhua
author_facet Wang, Xiangjun
Shen, Tao
Han, Mengya
Yan, Jianhua
author_sort Wang, Xiangjun
collection PubMed
description Background and objectives: Supernumerary extraocular muscle (SEOM) is extremely rare. The purpose of this paper was to review the clinical characteristics and surgical outcomes of SEOM patients with atypical restrictive strabismus. Materials and Methods: A retrospective review was conducted on the data from 12 SEOM cases. Pre- and post-operative measurements consisted of visual acuity, cycloplegic refraction, ocular alignment, ocular motility, binocular vision, and imaging. Management strategies included either conservative or surgical treatments. Results: Of the 12 cases reviewed (seven females, five males), the mean ± SD age was 14.3 ± 10.6 years (range: 4–38 years). The right eye was affected in six cases, the left in five, and both eyes in one case. The major clinical manifestations included restrictive ocular motility (12 cases), with seven cases in no less than three directions; varying degrees of horizontal or vertical strabismus; ipsilateral amblyopia (10 cases); and unequal palpebral aperture (10 cases). Imaging results revealed muscular bands originating from the annulus of Zinn and insertion into the globe or other recti, as well as anomalous muscular bands connecting two or more recti, sometimes with optic nerve involvement. Three patients received conservative treatment, while rectus recession with or without resection (seven patients) or rectus disinsertion plus globe fixation (two patients) were performed in those receiving surgical treatments. A surgical success was achieved in four cases. Conclusions: For restrictive strabismus, imaging plays an important role in the diagnosis of SEOM. When the SEOM is difficult to resect, a personalized surgical strategy may be required to achieve a good ocular alignment.
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spelling pubmed-96938742022-11-26 Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus Wang, Xiangjun Shen, Tao Han, Mengya Yan, Jianhua Medicina (Kaunas) Article Background and objectives: Supernumerary extraocular muscle (SEOM) is extremely rare. The purpose of this paper was to review the clinical characteristics and surgical outcomes of SEOM patients with atypical restrictive strabismus. Materials and Methods: A retrospective review was conducted on the data from 12 SEOM cases. Pre- and post-operative measurements consisted of visual acuity, cycloplegic refraction, ocular alignment, ocular motility, binocular vision, and imaging. Management strategies included either conservative or surgical treatments. Results: Of the 12 cases reviewed (seven females, five males), the mean ± SD age was 14.3 ± 10.6 years (range: 4–38 years). The right eye was affected in six cases, the left in five, and both eyes in one case. The major clinical manifestations included restrictive ocular motility (12 cases), with seven cases in no less than three directions; varying degrees of horizontal or vertical strabismus; ipsilateral amblyopia (10 cases); and unequal palpebral aperture (10 cases). Imaging results revealed muscular bands originating from the annulus of Zinn and insertion into the globe or other recti, as well as anomalous muscular bands connecting two or more recti, sometimes with optic nerve involvement. Three patients received conservative treatment, while rectus recession with or without resection (seven patients) or rectus disinsertion plus globe fixation (two patients) were performed in those receiving surgical treatments. A surgical success was achieved in four cases. Conclusions: For restrictive strabismus, imaging plays an important role in the diagnosis of SEOM. When the SEOM is difficult to resect, a personalized surgical strategy may be required to achieve a good ocular alignment. MDPI 2022-11-21 /pmc/articles/PMC9693874/ /pubmed/36422229 http://dx.doi.org/10.3390/medicina58111691 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Wang, Xiangjun
Shen, Tao
Han, Mengya
Yan, Jianhua
Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus
title Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus
title_full Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus
title_fullStr Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus
title_full_unstemmed Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus
title_short Supernumerary Extraocular Muscle: A Rare Cause of Atypical Restrictive Strabismus
title_sort supernumerary extraocular muscle: a rare cause of atypical restrictive strabismus
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9693874/
https://www.ncbi.nlm.nih.gov/pubmed/36422229
http://dx.doi.org/10.3390/medicina58111691
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