Abstract
ObjectiveIn this study, we aimed to investigate the prevalence of diplopia in cases with type 1 Duane retraction syndrome (DRS).Materials and methodsThis study was a retrospective review of cases involving patients presenting diagnosed with DRS over a period of 24 years. Among these cases, 28 had type 1 DRS and fulfilled the inclusion criteria. The cases were evaluated in terms of age, gender, affected eye, concomitant ocular motility disorders, presence of amblyopia, manifest shift, abnormal head position (AHP), fusion, and stereopsis.ResultsSixteen of the patients (57.1%) in the study were female, and 12 (42.8%) were male; the mean age of the patients was 18.9 years (range: 7-67 years). The right eye was affected in six of the cases (21.4%), and the left eye in 22 (78.6%) of the cases. On examination, diplopia was not observed in 21 (75%) cases, but it was detected in seven (25%). AHP was present in five of the seven cases with diplopia and not present in two, and all seven of the diplopic cases had fusion, while three had stereopsis. The level of stereopsis in all diplopic cases was 400 sn/ark. When the clinical findings of patients with diplopia and those without diplopia were compared, a statistically significant difference was observed only in terms of AHP.ConclusionsAlthough diplopia is not one of the clinical features of DRS, it must be noted that in cases with type 1 DRS, diplopia may occur in directions in which the movement of the eyeball is limited. In the presence of this finding, which might mimic sixth nerve palsy, patient history must be diligently taken, other clinical findings of DRS must be thoroughly examined, and an MRI should be performed when necessary for an easier diagnosis.
Highlights
Duane retraction syndrome (DRS) is a congenital syndrome characterized by globe retraction and the up or down shift of the affected eye at adduction, which may be accompanied by abduction and/or adduction limitations [1]
Diplopia is not one of the clinical features of DRS, it must be noted that in cases with type 1 DRS, diplopia may occur in directions in which the movement of the eyeball is limited
In the presence of this finding, which might mimic sixth nerve palsy, patient history must be diligently taken, other clinical findings of DRS must be thoroughly examined, and an MRI should be performed when necessary for an easier diagnosis
Summary
Duane retraction syndrome (DRS) is a congenital syndrome characterized by globe retraction and the up or down shift of the affected eye at adduction, which may be accompanied by abduction and/or adduction limitations [1]. In cases with DRS, surgical options are explored if abnormal head position (AHP) or overt horizontal shift is present [7,8,9]. The position of the head usually leans toward the weak muscle This way, diplopia can be prevented while binocularity is preserved [2,4,10,11,12]. This is the reason why the presenting symptoms of the cases usually do not include diplopia and diplopia is not observed among the classical clinical findings of DRS; studies that examined the binocular statuses of DRS patients have reported cases with diplopia [13,14]
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