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CLINICAL SCIENCES Enhanced Vertical Rectus Contractility by Magnetic Resonance Imaging in Superior Oblique Palsy Robert A. Clark, MD; Joseph L. Demer, MD, PhD Objective: To seek evidence for causative secondary Results: In central gaze, the paretic SO was significantly changes in extraocular muscle volume, cross-sectional atrophic (P .001) and the contralesional superior rec- tus (SR) was significantly hypertrophic (P = .02). Across area, and contractility in superior oblique (SO) palsy using the range of vertical duction from supraduction to infra- magnetic resonance imaging, given that vertical devia- duction, both the contralesional SR (P = .04) and inferior tions in SO palsy greatly exceed those explained by loss rectus (P = .001) exhibited significantly supernormal con- of SO vertical action alone. tractile changes in maximum cross-sectional area. Con- tractile changes in the ipsilesional SR and inferior rectus Methods: High-resolution, quasi-coronal orbital mag- exhibited a similar but insignificant trend (.08P .12). netic resonance images in target-controlled central gaze, supraduction, and infraduction were obtained in 12 pa- Conclusions: Central gaze hypertrophy of the contra- tients with chronic unilateral SO palsy and 36 age- lesional SR may be secondary to chronic excess innerva- matched healthy volunteers using an 8-cm field of view tion
JAMA Ophthalmology – American Medical Association
Published: Jul 1, 2011
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