Duane眼球后退综合征临床观察

Duane眼球后退综合征 (DRS)是一种以水平直肌运动障碍 ,内转时眼球后退伴睑裂缩小 ,同时向内上或内下偏斜并伴有眼部或全身其它异常的先天发育异常的病征。笔者在临床工作中收集了 9例此病例 ,报告分析如下临床资料1.一般资料 :就诊年龄 5～ 32岁 ,女性 6例 ,男性 3例。其中 4例有同时视 ,5例伴弱视。详见表 1,表中分型采用 Huber分类法 ,其中例 7反向型是指患眼外转时眼球后退 ,睑裂缩小 〔1〕,此型不在 Huber分类之中。2 .手术治疗与结果 :我们对于表 1中例 1～例 4采取手术治疗 ,我们选择手术治疗的条件是 :(1)正前方有斜视。 (2 )有…     

Duane眼球后退综合征临床分析

Duane眼球后退综合征是一种先天性眼肌发育不良或变性的疾病 ,不仅累及眼球运动功能 ,而且还伴有不同程度的眼球和眼睑位置的异常。Duane眼球后退综合征占先天性婴儿麻痹性斜视的 3 8% ,居首位 ,在临床上常被误诊为先天性外直肌麻痹。现将我们在临床工作中收集治疗的 7例 ( 8只眼 )报告分析如下。一、临床资料1.一般资料 :7例患者中年龄最大 2 1岁 ,最小 4岁 6个月 ,平均 9岁 7个月 ;男性 2例 ,女性 5例。其中 6例有同视机一级功能 ,2例有三级功能 ,3例有轻度弱视 ,2例有屈光参差 ;发生于左眼 4例 ,右眼 2例 ,双眼 1例 ,按 Huber分类法 [1…     

双眼不同类型Duane眼球后退综合征一例

Duane眼球后退综合征（duane retraction syndronle，DRS）是一种眼球运动异常，占斜视患者的1％～4％，多为先天性.其主要特点是眼球内转时睑裂缩小，眼球后退，伴外转、内转受限或内外转均受限．或眼部及全身其他先天性发育异常，多为单眼受累我院诊治1例双眼不同类型的DRS患者，临床较为罕见．观报告如下     

Duane眼球后退综合征12例临床分析

目的探讨Duane眼球后退综合征的临床特点和治疗方法。方法对12例眼球后退综合征患者的临床表现、手术治疗和效果进行总结。结果 12例眼球后退综合征患者,2例原在位基本正位,轻微代偿头位,未行手术治疗,仅矫正屈光不正和治疗弱视。10例行单眼内直肌和(或)外直肌后徙术或双眼内直肌后徙术。术后眼位正位,代偿头位消失或减轻,眼球后退、睑裂变化明显改善。3例患者合并内转眼急速上转现象,I型2例行上直肌后徙术,1例同时行下斜肌切断术。III型1例行单眼内外直肌同时后徙术。随访3个月~1年,疗效稳定。结论典型的DRS诊断并不困难,不同类型DRS的临床表现不同,详细的术前检查和合理的手术设计对眼球后退综合征的治疗具有重要意义。     

67例Duane眼球后退综合征的临床分析

目的探讨Duane眼球后退综合征（DRS）的临床特征以及手术治疗的方法和效果。方法对67例因DRS行手术治疗的患者资料进行回顾性总结和分析,观察项目包括患者的性别和年龄、DRS类型和临床表现、手术治疗方式和效果。结果单眼受累63例,双眼受累4例。Ⅰ型内斜视35例,外斜视12例;Ⅱ型外斜视8例;Ⅲ型内斜视1例,外斜视11例。37例患者合并内转眼急速上转和（或）下转现象,其中31例为外斜视者。行单眼内直肌和（或）外直肌后徙术或双眼内直肌后徙术可改善代偿头位、眼球后退及睑裂变小体征,术后斜视度数≤10^Δ者60例（89．6％）。行患眼内直肌和（或）外直肌后徙术,可使内转眼急速上转和下转现象得到明显改善。结论不同类型DRS的临床表现不同,内转眼上、下转现象多见于DRS外斜视者。减弱内、外直肌功能可改善DRS的临床表现;外直肌后徙术是改善内转眼急速上、下转现象的主要方法;内、外直肌同时后徙术适用于眼球后退和急速上、下转现象严重者;减弱一侧直肌功能后,眼球向对侧转动的受限程度得到改善。（中华眼科杂志,2005,41：812-816）     

Duane眼球后退综合征合并先天性鳄鱼泪25例临床分析

目的 探讨Duane眼球后退综合征（Duane‘s retraction syndrome,DRS)合并先天性鳄鱼泪的临床表现。方法 回顾性总结和分析25例DRS合并先天性鳄鱼泪患者的临床特征,包括性别、初诊年龄、眼别、DRS类型、异常流泪特征和其伴随的眼部和非眼部异常表现。结果 男性患者8例,女性患者17例,男女性别比约为1：2;双眼受累患者15例,单眼受累患者10例;双眼DRS患者出现单眼鳄鱼泪者3例,单眼DRS患者出现双眼鳄鱼泪者1例,其余21例患者均为单眼DRS患者鳄鱼泪症状表现在同侧,双眼DRS患者鳄鱼泪症状表现在双侧。结论 DRS合并先天性鳄鱼泪患者在临床虽较为少见,但充分重视和掌握其临床特征,是临床进行正确诊断的基础。     

Duane眼球后退综合征临床和组织病理学研究

目的：研究Ｄｕａｎｅ眼球后退综合征的临床表现及眼外肌的组织病理改变,探讨其发病机理。方法：研究４１例Ｄｕａｎｅ眼球后退综合征的临床表现,手术病例（４例）术中观察眼外肌的形态学并取内、外直肌和上斜肌标本作光镜和电镜检查。结果：４１例患者中,男２７例,女１４例,年龄１～２５岁;双眼发病１０例,单眼发病３１例;所有病例均有典型Ｄｕａｎｅ眼球后退综合征的表现,伴有内斜视１１例,外斜视９例,上斜视１例,１２     

Ⅱ型 Duane 眼球后退综合征临床特征和手术疗效分析

目的：探讨Ⅱ型 Duane 眼球后退综合征（DRS）的临床特征和手术治疗方法及效果。方法6例Ⅱ型 DRS病人,外斜视-30△--110△,均有代偿头位、眼球后退,其中1例内转时有上转和下转现象。2例患者行患眼外直肌后徙术;2例行双眼外直肌后徙术;2例行双眼外直肌后徙术,健眼内直肌缩短术。结果6例患者术后眼位均有明显改善。5例术后眼位正位,1例术后欠矫,6例患者术后代偿头位和内转时上转和下转现象消失或有明显改善。结论患眼外直肌后徙可以有效地治疗Ⅱ型 DRS,如斜视度数大,可同时行健眼外直肌后徙加内直肌缩短术。     

双眼Duane眼球后退综合征31例的临床表现

目的观察３１例双眼Ｄｕａｎｅ眼球后退综合征（Ｄｕａｎｅ′ｓｒｅｔｒａｃｔｉｏｎｓｙｎｄｒｏｍｅ,ＤＲＳ）的临床表现,并对其鉴别诊断进行讨论。方法回顾性总结３１例双眼ＤＲＳ,并对其临床表现包括主诉、年龄、性别分布、疾病类型、第一眼位的眼位偏斜、外转及内转受限、内转时眼球后退、眼球急速上转及下转等进行了分析。结果３１例中,男性１４例,女性１７例;男女之比为０．８１。主诉包括眼球运动异常者１４例（４５％）,眼位偏斜者１０例（３２％）。本征的最常见类型为Ⅰ型２９例（９４％）,余２例为Ⅲ型（６％）,其临床表现包括企图内转时眼球后退伴同侧睑裂缩小,常有外转受限伴不同程度的内转受限及患眼内转时出现急速上转和／或下转。结论非典型患者内转时,眼球后退不明显,诊断ＤＲＳ时应与眼球运动异常疾病即外展神经麻痹、Ｍｏｅｂｉｕｓ综合征、先天性眼球运动不能和先天性或婴儿型内斜视相鉴别。     

Duane's retraction syndrome: its sensory features

Purpose: To investigate binocularity in Duane’s retraction syndrome (DRS) and to evaluate whether or not there is a relationship between the sensory and clinical features of the syndrome. Methods: Clinical and sensory findings of 29 patients with DRS were recorded. Binocularity was tested with the Bagolini glasses (BG), Worth four‐dot (W4D), TNO and the stereo‐fly plate of the Titmus test. Results: Twenty‐four (83%) patients showed fusion with the BG at near and 23 (79%) had fusion at distance. With the W4D, 23 (79%) patients had fusion at near and 19 (65%) had fusion at distance. Seven (24%) patients demonstrated normal stereoacuity, 15 (52%) had reduced stereoacuity and the remaining seven (24%) patients had no measurable stereoacuity. In patients without stereoacuity, amblyopia (p < 0.001), type 2 and 3 DRS (p = 0.031) and exotropia (p = 0.003) in primary position were more common than in those with reduced or with normal stereoacuity. Restriction of ocular ductions was also more severe in patients without stereoacuity than in those with reduced or normal stereoacuity (p = 0.019, p = 0.016). Patients with type 2 and 3 DRS were significantly more likely to have amblyopia (p = 0.037), large‐angle heterotropia (p = 0.005) in primary position, upshoot or downshoot (p = 0.010) than those with type 1 DRS. Conclusions: Although approximately 75% of DRS patients had fusion and measurable stereoacuity, only 25% demonstrated normal binocularity. This report provides new data on the relationship of sensory features to most of the clinical findings of this syndrome. Sensory features, as well as most clinical features of the syndrome, are better in patients with type 1 DRS.     

Duane眼球后退综合征13例手术治疗临床分析

目的:探讨Duane眼球后退综合征(DRS)手术治疗的方法和效果。方法:对13例因DRS行手术治疗患者的临床表现、手术治疗方式和效果进行回顾性总结和分析。结果:单眼受累12例,双眼受累1例。Ⅰ型内斜视9例(双眼1例);Ⅱ型外斜视3例;Ⅲ型1例。其中2例外斜视患者合并内转眼急速上射和(或)下射现象。行单眼或双眼水平肌后徙术后代偿头位、眼球后退及睑裂变小体征均得到改善,术后斜视度数≤10△者11例(85%)。行患眼外直肌后徙术,可使内转眼上射和下射现象得到明显改善。结论:水平肌大量后徙可以使原在位的斜视得到矫正,代偿头位消失或得到明显改善,患眼内转的时候,眼球后退、睑裂变小明显减轻,上射和下射的现象减轻或消失。术前牵拉试验及术中彻底消除牵制因素是手术成功的关键。     

Duane眼球后退综合征21例手术治疗临床观察

目的探讨眼球后退综合征（DRS）的临床特点和手术方法。方法21例眼球后退综合征根据术前不同的斜视度、斜视类型、牵拉实验结果、同视机检查结果以及眼球内转时是否伴有上射和（或）下射现象,在解除限制因素的前提下分别采取内直肌后退或悬吊术,外直肌后退或悬吊术,内外直肌同时后退或悬吊术以及外直肌Y型劈开联合后退术。结果术后内转眼上射和（或）下射现象及代偿头位有不同程度的改善或消失。14例内斜视术后12例斜视度≤10^△,2例斜视度〉10△.其中2例在行内直肌后退术后出现外斜视。7例外斜视中,5例行外直肌后退或悬吊术,2例行外直肌Y型劈开联合后退术,其中6例术后斜视度≤10△,1例斜视度〉10△。结论在解除限制因素的前提下,水平直肌大量后退可以消除或改善代偿头位,亦可恢复原在位的眼位。对于斜视度≤20△且有代偿头位的DRS患者,可以戴棱镜矫正。直肌Y型分开联合后退术或水平直肌同时后退术在解决内转眼上射和（或）下射现象时有显著疗效。     

Duane's retraction syndrome

Duane's retraction syndrome (DRS) is a congenital abnormality of ocular motility that occurs in about 1% of strabismic patients. Three types have been described and the clinical features include incomitant horizontal strabismus, restricted motility and globe retraction. Head turn, upshoot or downshoot of the adducted eye, and bilaterality may occasionally be present. Since strabismus is invariably present in DRS, careful assessment of extraocular motility should be performed on all children with a suspected or confirmed eye turn. Early diagnosis may save practitioners and parents hours of time and financial investment with orthoptic and surgical management attempts. A case of DRS is presented.     

The clinical features of Korean patients with Duane's retraction syndrome

PURPOSE: To describe the clinical features of Duane's retraction syndrome (DRS) in Korean patients. METHODS: We retrospectively analyzed the 78 DRS cases that presented to our department between 1995 and 2004. The clinical features investigated included sex distribution, laterality, type of presentation, deviation in primary position, anomalous vertical movements, face turn, amblyopia and anisometropia. RESULTS: There were 38 (48.7%) affected males and 40 (51.3%) females. Left eye predominance (83.3%) was observed, as was type I presentation (85.9%). Orthotropia was found to be the most common primary position in 46 cases (59.0%). Face turn in unilateral DRS was noted in 13 patients (17.1%). There were 6 cases (7.7%) with anisometropia and 4 (5.1%) with amblyopia. CONCLUSIONS: The clinical manifestations of DRS in our study were different from those of equivalent Caucasian studies yet similar to those previously reported for Asian groups. Racial and regional differences were noted, for which further research is needed to elaborate the reasons and mechanisms.     

Duane眼球后退综合征Ⅲ型的临床特点

目的 探讨眼球后退综合征Ⅲ型的临床特征及治疗方法.方法 回顾性分析眼球后退综合征Ⅲ型8例,观察项目包括眼位、眼球运动、代偿头位、斜视度等临床表现及治疗方式.结果 眼球后退综合征Ⅲ型外斜视7例,内斜视1例,行患眼外、内直肌减弱术可改善代偿头位、眼球后退及睑裂变小.术后斜视度≤10Δ.结论 眼球后退综合征Ⅲ型临床表现特殊易被误诊或漏诊,全面掌握眼球后退综合征Ⅲ型的临床特点,有助于对本病的诊断与治疗.     

Clinical diversity of hereditary Duane's retraction syndrome

OBJECTIVE: To define the spectrum of ophthalmic manifestations of Duane's retraction syndrome (DRS) in a large family. DESIGN: Cross-sectional study of 110 among 114 living relatives in an extended family. METHODS: History and ophthalmic examination obtained on all participants. MAIN OUTCOME MEASURES: Ocular motility, strabismus, visual acuity, binocularity, associated neurologic problems. RESULTS: Twenty-five individuals were affected with DRS. Twenty-four subjects (96%) had bilateral DRS, but there was a broad spectrum of severity. Strabismus occurred in 76% and amblyopia in 48%. Associated findings included fourth cranial nerve palsy, partial third cranial nerve palsy, nystagmus, seizures, and deafness. Fourth cranial nerve palsies and manifest strabismus tended to cluster within single family units. CONCLUSIONS: Strabismus and amblyopia are much more common with bilateral DRS than with unilateral DRS. There is much phenotypic variability among individuals within families with hereditary Duane's syndrome. The responsible gene(s) may affect the development of many cranial nerves. Genetic compounding may play a role in the phenotypic segregation seen within this large family.