正常国人眼外肌厚度的B型超声测量

目的研究B型超声不同测量方法对不同年龄正常国人眼外肌的厚度测量。方法正常国人120例,按年龄分成5组:3岁～、10岁～、20岁～、40岁～、60～80岁组。采用B超的3种测量方法(切线、最厚处、横切测量法)测量眼外肌厚度,分析眼外肌厚度与年龄的关系。结果切线测量法测量眼外肌厚度比最厚处测量法约小0.2mm,二者有统计学差异(P<0.05),最厚处测量法与横切测量法结果相近,无统计学差异(P>0.05);3～、10～与20～39岁组三组之间眼外肌厚度随年龄而增长,有统计学差异(P<0.05),其中内直肌、下直肌增长最快。结论B型超声最厚处测量法与横切测量法测量眼外肌厚度值相近,切线测量法测量值偏小。20岁前眼外肌厚度随年龄的增加而增长,内直肌、下直肌增长较快。     

眼外肌炎1例

患者齐××　男　55岁　教师　住院号14870　1998年12月31日诊断为海绵窦综合症收入病房。于11月30日无明显诱因出现右眼红肿、疼痛,复视。用抗炎治疗后,症状消失。12月10日无明显诱因双眼红肿、疼痛,眼球转动受限,视力进行性下降,双眼球逐渐突出,发病两天后双目失明。在?..     

眼外肌广泛纤维化综合征2例

1　临床资料例 1:患儿 ,男 ,11个月 ,出生至今双眼不能睁大 ,仰头视物 ,随年龄增大上述症状无变化。眼部检查 :头后仰 ,下颌上举。双眼上睑下垂 ,睑缘于瞳孔下缘处 ,不能上举 ,Bell现象因患儿不配合未能引出。扶正头位 ,提起双上睑 ,角膜映光法检查 ,见双眼固定于下方 ,离水平线约 2 0°。眼球不能上转 ,水平转动约 5°,试图上转时见双眼异常水平散开样颤动。余未见异常。5 g· L- 1 地卡因表麻后 ,牵拉眼球向各方转动均受限。诊断 :眼外肌广泛纤维化综合征。例 2 :患者 ,女 ,2 3岁 ,例 1之母。患者从小双眼不能睁大 ,仰视 ,病情无发展和缓…     

观察20MHz高频B型超声在眼外肌的应用

了解眼外肌在20MHz高频超声中的声像图特点,明确20MHz超声在眼外肌疾病中的适用范围及应用价值。 方法：自2011-01/12分别利用10MHz及20MHz高频超声对眼外肌进行对比观察,归纳总结正常人群眼外肌20MHz B型超声的声像图特点及其厚度,以及在不同眼外肌疾病中的表现。 结果：20MHz高频超声在正常人群及斜视患者中可以清晰地显示眼外肌的形态特点,正常人群双眼对称眼外肌厚度无明显差别。与10MHz超声相比,其测量值明显增大,两者差异有统计学意义。而在其他眼外肌疾病中表现各不相同。 结论：20MHz高频B型超声适合正常人群及斜视患者的眼外肌观察,其显示效果明显优于10MHz超声,而在眼外肌厚度增加类型的眼外肌疾病中的应用存在一定的限制。     

眼外肌断裂伤修复的体会

眼外肌断裂伤 ,虽然临床上比较少见 ,但如果不能进行正确的诊断和及时的手术修复 ,变成陈旧性 ,就会给今后的手术治疗造成极大的困难。甚至给患者带来终生的复视或配戴三棱镜的后果。我院近 15年来曾对 2例新鲜眼外肌断裂伤及时进行手术修复 ,取得完全治愈的效果 ,恢复患者的双眼视觉功能。现就诊断和手术的点滴体会总结如下 :例 1,男性 ,2 5岁。病史 :左眼被铁丝挂伤 2小时 ,自觉复视及头昏 ,闭合一眼症状消失。眼科检查 :视力右眼 1 5 ,左眼 1 0 ,左眼下穹窿部结膜及结膜下组织不规则撕裂伤 ,角巩膜、前房、虹膜及眼底正常 ,眼位检查 :角…     

超声波在眼外肌炎诊断中的应用

超声波在眼外肌炎诊断中的应用北京医院眼科刘向利，夏群急性眼外肌炎临床上较为少见，且缺少特征性表现，很难作出正确诊断，影像学检查在本病的诊断和鉴别诊断中有较重要的意义。本文报告两例经超声检查确诊的眼外肌炎。方法我科采用美国生产的Ｓｏｎｏｍｅｄｓ眼科专用...     

B型超声对眼外肌的观察

目的:了解正常人及不同眼外肌疾病患者的眼外肌B型超声的图像特点。方法:回顾性分析我院2007-10/2010-10间利用10MHzB型超声进行眼外肌检查的情况,归纳总结正常人群眼外肌的厚度以及不同眼外肌疾病B超声像图特点。结果:正常人群双眼对称眼外肌厚度无明显差别;4条直肌中,内直肌最厚;20岁之前4条眼外肌厚度随年龄增大而增厚。不同眼外肌疾病眼外肌B超表现各不相同。结论:B型超声可以较好的显示4条眼外肌的形态,便于眼外肌疾病的随诊观察。B型超声是检查眼外肌的有效手段。     

眼外肌皮脂瘤误诊一例

患者魏×× ,男 ,73岁 ,退休教师。住院号 1336,患者 3个月前发现右眼球颞侧有一肿物 ,约米粒样大小 ,质软、无痛、伴有眼红等症状。当时未在意 ,近来发现肿物渐增大 ,约花生米样大小 ,遂来院就诊。收住院治疗。患者平素身体健康 ,否认家族史。全身查体无明显其它异常。眼部检查 :视力右 1 2、左 1 2 ,右眼球结膜颞侧可见一炎黄色肿物 ,质软、无触痛 ,肿物约花生米样大小 ,距角膜缘约 7 5ｍｍ ,向颞下后方延伸。ＣＴ提示 :右眼球壁囊性占位 ,不排除结膜囊肿。初步诊断 :右眼球结膜表皮样囊肿 ,常规点眼治疗后于 1998年 4月 16日在局麻下行右…     

Echographic measurement of extraocular muscle thickness in proptosis.

Echographic extraocular muscle thickness was measured in 102 eyes of 51 patients with proptosis of varied etiology. That of vascular origin was associated with extraocular muscle enlargement in all cases. Enlargement of the medial rectus was found to be statistically significant in thyroid orbitopathy. Sixty percent of cases with nonspecific orbital inflammatory disease had enlarged extraocular muscles. We discuss the supportive role of determining echographic measurements of extraocular muscle thickness in proptosis and highlight the uniform extraocular muscle enlargement found in proptosis of vascular origin.     

Echographic findings in metastization in an extraocular muscle

Clinical, echographic, radiological (CT, NMR), and histopathological findings in a 57-year-old male patient who presented with proptosis of the left eye and diplopia caused by a histologically proven metastasis of a clinically silent small-cell carcinoma of the lung. Echographic problems of the differential diagnosis of orbital metastases are discussed.     

Diltiazem reduces the contractility of extraocular muscles in vitro and in vivo

Diltiazem, a Ca-channel blocker that is used clinically for the treatment of hypertension and cardiac arrhythmias, reduces the contractility of extraocular muscles. Exposure of rabbit extraocular muscle to diltiazem in vitro reduces the sustained tension that is generated by the tonic, multiply innervated fibers, and decreases the baseline, or resting, tension of the muscle. When diltiazem is injected into a selected extraocular muscle in the rabbit in vivo, it causes a temporary weakening of the muscle, which is indicated by a deviation of eye position. These in vivo effects are of short duration, are easily reproducible, and vary with dosage. The results of this study raise the possibility that diltiazem may be used as an alternative to the surgical treatment of strabismus and other oculomotor dysfunctions including blepharospasm.     

Echographic study of extraocular muscle thickness in normal Indian population

Purpose

To establish normative data of extraocular muscle (EOM) dimensions, both vertically and horizontally, using a reproducible echographic method in various age groups.

Methods

Two hundred eyes of 100 healthy subjects (50 males and rest females) were included in this prospective observational study. All subjects were divided into 5 groups with an interval of 10 years from 10 to 60 years. Each group contained 10 male and 10 female healthy subjects. A single operator took measurements at 4 mm distance from the globe plane after drawing a perpendicular line on the globe to the muscle belly.

Results

The average age of subjects was 37.28 ± 17.14 years. Intraobserver reproducibility was very high (intersession concordance correlation co-efficient = 0.995). Mean horizontal and vertical diameters of recti were 3.0775 and 8.26 mm, respectively. Mean muscle thickness of superior rectus/levator palpebral superioris (LPS) muscle complex and LPS was 4.56 and 1.45 mm, respectively. Extraocular muscle diameter increases up to the middle age, then it starts decreasing. There was no statistically significant correlation between diameter of each EOM, both eye and gender (p ⩾ 0.05). There was a non-significant change in extraocular muscle thickness with age.

Conclusion

The study provides normative data for extraocular muscle thickness in both genders of various age groups in Indian population. Muscle dimensions do not change significantly with age, between the eyes and gender.     

Intramuscular hemangiomas of extraocular muscles

PURPOSE: To report two patients, 3 and 40 years of age, respectively, each of whom had an isolated intramuscular hemangioma of an extraocular muscle. DESIGN: Two retrospective, interventional case reports. INTERVENTION: Incisional biopsy and short-term oral corticosteroids. MAIN OUTCOME MEASURES: Clinical observation and pathologic examination of specimens and tumor status, visual acuity, and ocular motility at final follow-up. RESULTS: Orbital magnetic resonance imaging revealed that, compared with other extraocular muscles, the tumor was isointense on T1-weighted scans and hyperintense on T2-weighted images. Marked homogeneous enhancement was observed after contrast agent administration. Biopsy results showed a hemangioma of the lateral rectus muscle with predominantly capillary-like small vessels in the child and a mixed small and large vessel type hemangioma of the medial rectus muscle in the adult. CONCLUSIONS: Intramuscular hemangiomas may cause painless, isolated extraocular muscle enlargement in children and in adults without disturbing the ocular motility. The tumors do not seem to be sensitive to systemic corticosteroid therapy.     

Peripheral innervation of extraocular muscles

In order to avoid injury to the nerves supplying the extraocular muscles during orbital surgery, I studied the anatomy of these nerves in five human orbits that had been serially sectioned. Each of the nerves, except for the trochlear, exists as bundles of fascicles rather than as a discrete trunk. I made two other observations of surgical importance. First, the nerve to the inferior oblique muscle may pass through the belly of the inferior rectus muscle and then course beneath it before it reaches its normal position. Second, a fibrous septum at the orbital apex separates the abducent nerve from the other motor nerves.