Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia

Objectives. To summarize the clinical manifestations, diagnosis, treatment, and prognosis for inferior oblique muscle ectopia (IO-E). Subjects and Methods. Patients diagnosed with IO-E during strabismus surgery from March 2017 to September 2018 were included in this retrospective, cross-sectional st...

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Main Authors: Zhipeng Xue, Xiaoshan Min, Jieyue Wang, Ying Zhu, Sujun He, Kangcheng Liu, Yi Ding
Format: Article
Language:English
Published: Wiley 2020-01-01
Series:Journal of Ophthalmology
Online Access:http://dx.doi.org/10.1155/2020/3039180
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author Zhipeng Xue
Xiaoshan Min
Jieyue Wang
Ying Zhu
Sujun He
Kangcheng Liu
Yi Ding
author_facet Zhipeng Xue
Xiaoshan Min
Jieyue Wang
Ying Zhu
Sujun He
Kangcheng Liu
Yi Ding
author_sort Zhipeng Xue
collection DOAJ
description Objectives. To summarize the clinical manifestations, diagnosis, treatment, and prognosis for inferior oblique muscle ectopia (IO-E). Subjects and Methods. Patients diagnosed with IO-E during strabismus surgery from March 2017 to September 2018 were included in this retrospective, cross-sectional study. All patients received preoperative Krimsky test, synoptophore, cycloplegia refraction, fundus torsion, and other strabismus-related specific tests. The anatomic variations of IO-E were always discovered during surgical procedure. Postoperative eye position and binocular visual function (BVF) were all reviewed in early days after operation. Results. A total of 7 patients were enrolled in this study with an average age of 6.4 ± 3.8 yrs. They all presented with significant exotropia and unilateral (or bilateral) overelevation in adduction (OEA). No compensatory head position was detected. Some of them had vertical deviation, V pattern, or excyclotropia, which were indicated by fundus torsion. Monocular or binocular IO-E was distinguished during the surgery, and it could be classified into two types according to its anatomic features. In surgery, the ectopic IO muscle bundle was restored, and different IO weakening methods were employed. Meanwhile, the horizontal deviation was also corrected according to the preoperative examination. Eyes of all patients were properly aligned in the primary position after surgery. Varying degrees of BVF appeared in 3 cases. Conclusions. IO-E is a rare congenital dysplasia variation of the extraocular muscle, which could appear as inferior oblique overaction. It is difficult to diagnose before surgery, and weakening the overactive ectopic inferior oblique was required for better prognosis if this condition was confirmed during surgery.
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spelling doaj-art-094b875ed4914e72bbc9b9eeb105e1332025-02-03T05:49:52ZengWileyJournal of Ophthalmology2090-004X2090-00582020-01-01202010.1155/2020/30391803039180Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle EctopiaZhipeng Xue0Xiaoshan Min1Jieyue Wang2Ying Zhu3Sujun He4Kangcheng Liu5Yi Ding6Department of Ophthalmology, Xiangya Hospital Central South University, Changsha 410000, Hunan, ChinaDepartment of Ophthalmology, Xiangya Hospital Central South University, Changsha 410000, Hunan, ChinaDepartment of Ophthalmology, Xiangya Hospital Central South University, Changsha 410000, Hunan, ChinaDepartment of Ophthalmology, Xiangya Hospital Central South University, Changsha 410000, Hunan, ChinaChangsha Jiqiang Eye Hospital, Changsha 410000, Hunan, ChinaDepartment of Ophthalmology, Xiangya Hospital Central South University, Changsha 410000, Hunan, ChinaDepartment of Ophthalmology, Xiangya Hospital Central South University, Changsha 410000, Hunan, ChinaObjectives. To summarize the clinical manifestations, diagnosis, treatment, and prognosis for inferior oblique muscle ectopia (IO-E). Subjects and Methods. Patients diagnosed with IO-E during strabismus surgery from March 2017 to September 2018 were included in this retrospective, cross-sectional study. All patients received preoperative Krimsky test, synoptophore, cycloplegia refraction, fundus torsion, and other strabismus-related specific tests. The anatomic variations of IO-E were always discovered during surgical procedure. Postoperative eye position and binocular visual function (BVF) were all reviewed in early days after operation. Results. A total of 7 patients were enrolled in this study with an average age of 6.4 ± 3.8 yrs. They all presented with significant exotropia and unilateral (or bilateral) overelevation in adduction (OEA). No compensatory head position was detected. Some of them had vertical deviation, V pattern, or excyclotropia, which were indicated by fundus torsion. Monocular or binocular IO-E was distinguished during the surgery, and it could be classified into two types according to its anatomic features. In surgery, the ectopic IO muscle bundle was restored, and different IO weakening methods were employed. Meanwhile, the horizontal deviation was also corrected according to the preoperative examination. Eyes of all patients were properly aligned in the primary position after surgery. Varying degrees of BVF appeared in 3 cases. Conclusions. IO-E is a rare congenital dysplasia variation of the extraocular muscle, which could appear as inferior oblique overaction. It is difficult to diagnose before surgery, and weakening the overactive ectopic inferior oblique was required for better prognosis if this condition was confirmed during surgery.http://dx.doi.org/10.1155/2020/3039180
spellingShingle Zhipeng Xue
Xiaoshan Min
Jieyue Wang
Ying Zhu
Sujun He
Kangcheng Liu
Yi Ding
Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia
Journal of Ophthalmology
title Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia
title_full Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia
title_fullStr Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia
title_full_unstemmed Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia
title_short Clinical Manifestations, Diagnosis, and Surgery of Inferior Oblique Muscle Ectopia
title_sort clinical manifestations diagnosis and surgery of inferior oblique muscle ectopia
url http://dx.doi.org/10.1155/2020/3039180
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