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Surgical Management of Masquerading Superior Oblique Palsy

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机构: [1]Stein Eye Institute and Department of Ophthalmology University of California, Los Angeles, California, USA. [2]Department of Ophthalmology, Peking University People’s Hospital, Beijing, China [3]Department of Neurology, University of California, Los Angeles, California, USA [4]Bioengineering Department, University of California, Los Angeles, California, USA [5]Neuroscience Interdepartmental Program, University of California, Los Angeles, California, USA
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To compare the surgical outcomes between superior oblique (SO) palsy (SOP) and masquerading SO palsy (mSOP).Comparative interventional case series.Medical records of patients with SOP and mSOP were reviewed from 1991 to 2024. Palsy cases had maximum SO cross section in the hypertropic eye no more than 80% of that in the fellow eye, while mSOP cases had bilaterally symmetrical SO muscles on magnetic resonance imaging. Types of surgery and effect on hypertropia (HT) were compared between groups.A total of 39 patients aged 38±20 (standard deviation) years had SOP and 18 aged 36±17 years had mSOP. Maximum palsied SO cross-section was 10.6±3.8mm2, significantly smaller than 18.9±4.0mm2 of the contralateral fellow (P<0.0001), but was bilaterally symmetrical in mSOP. Mean preoperative central gaze HT was similar at 14.7±9.8Δ in SOP and 11.0±6.9Δ in mSOP (P=0.2). The commonest surgery was ipsilateral inferior oblique (IO) weakening combined with contralateral inferior rectus (IR) recession, followed by ipsilateral IO weakening alone and contralateral IR recession alone. After 41±65 months follow-up in SOP and 22±41 months in mSOP, central gaze HT decreased from 14.7±9.8Δ to 1.7±4.1Δ in SOP, and from 11.0±6.9Δ to -2.9±5.4Δ in mSOP (both P<0.0001). Surgical effect was similar at 13.2±10.3Δ in SOP and 14.1±10.0Δ in mSOP. Re-operation rate was low and similar in both groups.Clinical characteristics and surgical effect are similar in mSOP and SOP. Conventional surgeries are comparably effective in both. This suggests that mechanism beyond SO muscle function drive head-tilt dependent cylcovertical strabismus.Copyright © 2025. Published by Elsevier Inc.

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大类 | 1 区 医学
小类 | 1 区 眼科学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 眼科学
第一作者:
第一作者机构: [1]Stein Eye Institute and Department of Ophthalmology University of California, Los Angeles, California, USA. [2]Department of Ophthalmology, Peking University People’s Hospital, Beijing, China
通讯作者:
通讯机构: [1]Stein Eye Institute and Department of Ophthalmology University of California, Los Angeles, California, USA. [3]Department of Neurology, University of California, Los Angeles, California, USA [4]Bioengineering Department, University of California, Los Angeles, California, USA [5]Neuroscience Interdepartmental Program, University of California, Los Angeles, California, USA
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