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'Extraocular Muscles Anatomy' (5723)


Feb
2018

A complete and accurate understanding of extraocular muscle function is important to the veterinary care of the avian eye. This is especially true for birds of prey, which rely heavily on vision for survival and yet are prone to ocular injury and disease. To better understand the function of extraocular muscles in birds of prey, we studied extraocular muscle architecture grossly and histologically.

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Jan
2018

To investigate the relation between type of motor endplate, acetylcholine receptor (AChR) subunit composition, and fiber types in human extraocular muscles (EOMs).
EOM samples collected from subjects aged 34 to 82 years were serially sectioned and processed for immunohistochemistry, with specific antibodies against different myosin heavy chain (MyHC) isoforms, neurofilament, synaptophysin, and adult epsilon (ε) and fetal gamma (γ) AChR subunits as well as α-bungarotoxin.
A novel type of motor endplate consisting of large, multiterminal en plaque endings was found in human EOMs, in addition to the previously well-described single en plaque and multiple en grappe endplates.

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Jan
2018

Accessory rectus muscles have rarely been reported as muscular 'bands' or 'slips' originating from the common tendinous ring (annulus of Zinn) and inserting in atypical location. This group of muscles is innervated by the inferior branch of the oculomotor nerve, lies on lateral side of the optic nerve and inserts in rectus muscles. Since there are only few descriptions of such unusual findings in the medical literature, the anatomical data on accessory rectus muscles is limited.

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Jan
2018

We examined the pattern and extent of connective tissue distribution in the extraocular muscles (EOMs) and determined the ability of the interconnected connective tissues to disseminate force laterally.
Human EOMs were examined for collagens I, III, IV, and VI; fibronectin; laminin; and elastin using immunohistochemistry. Connective tissue distribution was examined with scanning electron microscopy.

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Jan
2018

Superior Oblique Myokymia: Some Novel Observations.

Middle East Afr J Ophthalmol 2017 Jul-Sep;24(3):162-164
Sanitha Sathyan, Rosemary C Antony
Superior oblique myokymia is a rare condition, characterized by spontaneous rhythmic contractions of the superior oblique muscle and was first described by Duane in 1906. However, the pathophysiology of this condition remains poorly understood even today. A number of medical and surgical treatment modalities have been tried, with variable results.

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Dec
2017

Early postoperative overcorrection in recurrent exotropia.

Can J Ophthalmol 2017 Dec 4;52(6):611-615. Epub 2017 Aug 4.
Suk-Gyu Ha, Seung-Hyun Kim
To investigate the surgical outcome according to the angle of deviation at postoperative day 1 in patients with recurrent exotropia DESIGN: Retrospective case series METHODS: Surgical outcome in patients with recurrent exotropia for at least 1 year was analyzed retrospectively. Patients were divided into 3 subgroups according to the angle of deviation at postoperative day 1: overcorrection group (≥2 prism diopter [PD] of esodeviation), orthotropic group (orthotropia or <5 PD of exodeviation), and undercorrection group (≥5 PD of exodeviation). Success was defined as ≤5 PD of esodeviation or ≤10 PD of exodeviation at the final visit.

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Dec
1969

The objective of this study was to describe the anatomic and histologic features of the Sapajus sp. eye, comparing similarities and differences of humans and other species of non-human primates for biomedical research purposes. Computed tomography (CT) of adnexa, eye and orbit live animal, as well as formolized pieces of the same structures of Sapajus sp.

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Nov
2017

Diabetic oculomotor nerve palsies, also called ischemic third nerve palsies, are the most common etiologic subset of oculomotor nerve palsy in adults. Diabetic oculomotor nerve palsies typically present with ptosis and diplopia, but pupillary function is often spared. The oculomotor nerve separates into superior division and inferior division, with the superior division innervating the superior rectus and levator palpebrae superioris.

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Dec
1969

To investigate the factors affecting recovery of diplopia and limited ocular motility in pediatric patients who underwent surgery for orbital wall fracture.
Retrospective observational case series.
In this retrospective observational case series, 150 pediatric patients (1-18 years old) who were diagnosed with orbital medial wall or floor fracture and underwent corrective surgery between 2004 and 2016 at Seoul National University Bundang Hospital were included.

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Oct
2017

To investigate the relationship between objective ocular torsion and the presence or absence of the trochlear nerve in subjects with unilateral superior oblique palsy (SOP).
A total of 159 subjects with congenital and acquired unilateral SOP were reviewed. Eighty-four subjects who had a normal trochlear nerve (present group) and 75 subjects without a trochlear nerve (absent group) were included.

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Nov
2017

Humans visually process the world with varying spatial resolution and can program their eye movements optimally to maximize information acquisition for a variety of everyday tasks. Diseases such as macular degeneration can change visual sensory processing, introducing central vision loss (a scotoma). However, humans can learn to direct a new preferred retinal location to regions of interest for simple visual tasks.

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Oct
2017

A 17-year-old boy presented with a large exotropia with both eyes fixed in an abduction and upgaze, pupillary involvement since childhood. He had mild optic nerve hypoplasia in the right eye and situs inversus of the retinal vessels in the left optic disc. His ocular motility showed restriction of eye movements in all gazes.

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Oct
2017

Aberrant regeneration of the third nerve following its palsy is commonly seen after trauma and compressive lesions. This phenomenon is thought to result due to misdirection of the regenerating axons. Surgical management is a great challenge in the third nerve palsy owing to multiple muscle involvement and is often accompanied by ptosis and poor Bell's phenomenon.

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Oct
2017

Congenital abduction deficit is most likely due to Duane's retraction syndrome as congenital abducens nerve palsy is very rare. We report two cases of infantile abduction deficit due to sixth nerve palsy associated with other anomalies to highlight the importance of including neuroimaging in the evaluation of an infant presenting with a limitation of abduction.

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Oct
2017

The purpose of this study was to demonstrate two cases of vertical diplopia after cataract surgery and to discuss the mechanism and types of strabismus caused by the local anesthesia with retrobulbar injection. Two cases of vertical diplopia after cataract surgeries were reported. They were operated by the same surgeon and both happened to the left eye and both presented with marked left hypotropia.

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Dec
1969

One major difference between limb and extraocular muscles (EOM) is the presence of an enriched population of Pitx2-positive myogenic precursor cells in EOM compared to limb muscle. We hypothesize that retinoic acid regulates Pitx2 expression in EOM myogenic precursor cells and that its effects would differ in leg muscle. The two muscle groups expressed differential retinoic acid receptor (RAR) and retinoid X receptor (RXR) levels.

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Oct
2017

To analyze in a frontal-eyed mammal (cat) the postnatal development of palisade endings in extraocular muscles (EOMs) and to compare the spatiotemporal and quantitative patterns of palisade endings among individual rectus muscles.
Cats of different ages ranging from birth to adult stage were studied. EOM whole-mount preparations were fluorescently labeled using six combinations of triple staining and analyzed in the confocal laser scanning microscope.

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Dec
2017

To investigate the significance of the anterior ciliary vessels (ACVs) preservation during the conventional horizontal strabismus surgery.
Patients (≥ 8 years) with horizontal strabismus were randomly allocated into group 1 (with ACV preservation) and group 2 (without ACV preservation). The surgical eyes in group 1 were further divided into group A (one rectus muscle operated) and group B (two rectus muscles operated).

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Jan
2017

Congenital cranial dysinnervation disorders (CCDD) is a new term describing a collection of non-progressive neurogenic syndromes. Initially referred to as congenital fibrosis syndrome, it was thought that the primary problem was extraocular muscular maldevelopment. Recent advancements in genetics and neuro-radiology have now determined the initial observation of fibrotic muscles is secondary to a primary lack of innervation from deficient, absent, or misguided cranial nerves.

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Jan
2017

Superior Rectus Intramuscular Lipoma.

Ophthal Plast Reconstr Surg 2017 Sep/Oct;33(5):396-397
Kaveh Vahdani, Katherine Mcveigh, Rebecca Ford

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Oct
2017

To examine the clinical characteristics of patients with concomitant incarceration of the inferior oblique muscle branch of the oculomotor nerve who had suffered from an orbital floor trapdoor fracture with orbital fat incarceration.
Fifty-nine patients were retrospectively reviewed. Concomitant inferior oblique muscle branch incarceration was diagnosed by inferior oblique muscle underaction on the Hess chart and a missing inferior oblique muscle branch on computed tomographic images on baseline examination.

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Sep
2017

Medial rectus motoneurons receive two main pontine inputs: abducens internuclear neurons, whose axons course through the medial longitudinal fasciculus (MLF), and neurons in the lateral vestibular nucleus, whose axons project through the ascending tract of Deiters (ATD). Abducens internuclear neurons are responsible for conjugate gaze in the horizontal plane, whereas ATD neurons provide medial rectus motoneurons with a vestibular input comprising mainly head velocity. To reveal the relative contribution of each input to the oculomotor physiology, single-unit recordings from medial rectus motoneurons were obtained in the control situation and after selective deafferentation from cats with unilateral transection of either the MLF or the ATD.

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Aug
2017

Congenital Brown syndrome is characterized by limited elevation particularly during adduction. The pathogenesis of congenital Brown syndrome is still controversial.
A 6-year-old boy had been tilting his head to the left since infancy.

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Aug
2017

Congenital hypoplasia or aplasia of the inferior rectus muscle is an uncommon condition. The authors present two pediatric patients with hypoplasia of the inferior rectus muscle treated by inferior oblique anterior transposition. The long-term follow-up outcomes of eye position and stereopsis acuity development were favorable.

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Dec
2017

The purpose of our study was to determine whether ocular sighting dominance may influence the ocular torsion in patients with unilateral congenital superior oblique palsy (UCSOP).
This retrospective study included 22 UCSOP patients with radiologic evidence of unilateral superior oblique muscle hypoplasia on orbital magnetic resonance imaging and 66 healthy individuals with normal ocular motility as controls. Ocular torsion was assessed both quantitatively and qualitatively using digital fundus photography.

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Aug
2017

The purpose of this study was to evaluate the incidence and outcome of surgically treated superior oblique palsy (SOP) and the factors involved in its resolution.
We performed a retrospective study of 76 patients who underwent surgery for SOP. We recorded data from the physical examination and the number and type of procedures performed.

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Oct
2017

To evaluate the outcomes of early intra-trochlear steroid injections in patients with acquired Brown syndrome secondary to trochleitis (ABSST).
Retrospective analysis from medical charts of patients diagnosed as affected by unilateral ABSST from January 2008 to June 2015, and treated according to our Institution protocol: intra-trochlear injection of 1ml of triamcinolone acetonide 40 mg/ml is performed under sterile conditions. In cases of no resolution/improvement within 1 month, further monthly injections are performed up to a maximum number of three.

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Dec
1969

We report the histopathological and ultrastructural tissue analysis of extraocular muscle (EOM) obtained from a patient with seronegative myasthenia gravis (MG) with treatment-resistant ophthalmoplegia for 3.5 years. The EOM demonstrated predominantly myopathic features and ultrastructural evidence of mitochondrial dysfunction, but the most striking features were increased endomysial collagen and adipocyte replacement of muscle fibers.

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Dec
1969

To analyze the proportion and cross-sectional area of myofibers containing myosin heavy chain slow-twitch (MyHCI) and myosin heavy chain slow tonic (MyHCsto) in extraocular muscles of autopsied amyotrophic lateral sclerosis (ALS) patients with either spinal or bulbar site of disease onset.
Whole-muscle cross sections from the middle portion of the medial rectus were labeled with antibodies against MyHCI or MyHCsto and laminin. Myofibers labeled with the MyHC antibodies (MyHCI+sto) and the total number of myofibers were quantified in the orbital and global layer of 6 control individuals and 18 ALS patients.

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Dec
2017

To assess the validity of a novel, simplified, noninvasive test for strabismus using video goggles.
Cross-sectional method comparison study in which the new test, the strabismus video goggles, is compared with the existing reference standard, the Hess screen test.
We studied 41 adult and child patients aged ≥6 years with ocular misalignment owing to congenital or acquired paralytic or comitant strabismus and 17 healthy volunteers.

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Sep
2017

The role of imaging in strabismus.

Curr Opin Ophthalmol 2017 Sep;28(5):465-469
Jinali R Patel, Kammi B Gunton
To review the most recent literature regarding the clinical experience of imaging modalities in strabismus.
MRI of extraocular muscles (EOMs) has elucidated the roles of variation in compartmental contraction of EOMs and further evidence of EOM pulley heterotopy in various strabismus patterns, which may contribute to the clinical and surgical management of patients as this mode of imaging becomes more readily available. Ultrasound biomicroscopy (UBM) and anterior-segment optical coherence tomography (AS-OCT) may play a role in determining the location of EOMs which could also aid in devising a preoperative surgical plan, especially in those who have had prior strabismus surgery.

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Dec
1969

We evaluated effect of horizontal rectus surgery on sub-A or sub-V pattern intermittent exotropia. We enrolled patients with sub-A or sub-V pattern intermittent exotropia. The sub-A pattern was diagnosed when the eyes diverged less than 10 prism diopters (PD) from upgaze to downgaze, and sub-V pattern when the divergence was 14 PD or less from downgaze to upgaze.

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Jun
2017

Thyroid-associated opthalmopathy(TAO) is a common autoimmune syndrome affecting the thyroid and orbit, which can result in the fibrosis of extraoular muscles and hyperplasia of adipose tissue. Advanced TAO patients could even lose vision caused by cornea ulcer and congestion of optic nerve from expansion of the extraocular muscles and orbit fat. Currently, there are no therapies shown to prevent it, because its cellular and molecular mechanisms are not clear.

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Jun
2017

To evaluate the effectiveness of maximal orbital decompression in treatment for severe dysthyroid optic neuropathy (DON) of thyroid associated ophthalmopathy (TAO) and predictive factors of this therapy.The group consisted of 21 patients (30 eyes) with DON. The diagnosis was based on the following criteria: Deterioration of best corrected visual acuity (VA≤0.

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Sep
2017

The extraocular muscles consist of the superior, inferior, lateral, and medial rectus muscles and the superior and inferior oblique muscles. This study aimed to create a new teaching model for demonstrating the function of the extraocular muscles. A coronal section of the head was prepared and sutures attached to the levator palpebral superioris muscle and six extraocular muscles.

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Sep
2017

To review current knowledge regarding diagnosis of nonthyroid orbital disorders with extraocular muscle enlargement.
Recent publications have focused on immunoglobulin G4-related disease as a possible cause of enlarged extraocular muscles, on patterns of strabismus that raise a clinical suspicion of intramuscular lymphoma, and on surgical techniques to access the muscles for tissue biopsy.
With enlarged extraocular muscles, features to distinguish between competing diagnostic possibilities are based on imaging in the context of history and clinical signs.

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Dec
1969

Giant cell arteritis (GCA) is a systemic vasculitis of medium and large arteries often with ophthalmic involvement, including ischemic optic neuropathy, retinal artery occlusion, and ocular motor cranial nerve palsies. This last complication occurs in 2%-15% of patients, but typically involves only 1 cranial nerve. We present 2 patients with biopsy-proven GCA associated with multiple cranial nerve palsies.

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Dec
1969

Cavernous hemangioma is the most frequent primary benign vascular tumor of the orbit in the adult; the median age of diagnosis is 42 years with a female predominance. This tumor develops slowly and has no tendency for spontaneous regression; it is electively located at the level of the retro-ocular muscular cone but it can develop in the extraconic space. Clinically it appears as progressive irreducible, non-pulsating, painless (unless there's an unexpected complication) exophthalmia, associated with decrease in visual acuity in 2/3 of cases.

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May
2017

Duane retraction syndrome (DRS) consists of abduction deficit, globe retraction and upshoots or downshoots with adduction. The abducens nerve on the affected side is absent in type 1 DRS. After bilateral medial rectus muscle recession in unilateral type 1 DRS may improve the abduction limitation, but still more than -3 limitation remains.

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Oct
2017

The aims of this study were to elucidate the detailed anatomy of the abducens nerve in the lateral rectus muscle (LRM) and the intramuscular innervation pattern using Sihler staining. In this cohort study, 32 eyes of 16 cadavers were assessed. Dissection was performed from the LRM origin to its insertion.

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Dec
1969

Thyroid associated ophthalmopathy (TAO) is an autoimmune inflammatory disorder which disfigures appearance, threatens vision, and results in a pronounced loss of quality of life. The diversity and ethnic difference of the disease manifestations have made it difficult to tailor therapies for each patient. Few studies have analyzed its characteristics in Chinese populations.

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Dec
1969

Unraveling the genetics of the paralytic strabismus syndromes known as congenital cranial dysinnervation disorders (CCDDs) is both informing physicians and their patients and broadening our understanding of development of the ocular motor system. Genetic mutations underlying ocular CCDDs alter either motor neuron specification or motor nerve development, and highlight the importance of modulations of cell signaling, cytoskeletal transport, and microtubule dynamics for axon growth and guidance. Here we review recent advances in our understanding of two CCDDs, congenital fibrosis of the extraocular muscles (CFEOM) and Duane retraction syndrome (DRS), and discuss what they have taught us about mechanisms of axon guidance and selective vulnerability.

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Jul
2017

Recent studies in patients demonstrated that cerebrospinal fluid does not flow continuously between the intracranial subarachnoid space (SAS) and the space around the optic nerve in the orbit. Its anatomic basis remains elusive. The objective of this study was to use a novel anatomic technology, the epoxy sheet plastination, to reveal the configuration of the fibrous structures within the optic canal and their relationship with the optic nerve, SAS, and ophthalmic artery.

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Apr
2017

The authors report a new technique to treat complete cranial nerve III palsy. A 15-year-old girl underwent botulinum toxin injection into the lateral rectus muscle, nasal transposition of both the superior and inferior oblique muscles to the medial rectus insertion, and absorbable suture globe fixation to the nasal orbital periosteum. Six months postoperatively, her primary position eye deviation was within 12 prism diopters of orthotropia with limitation of ductions in all directions.

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Dec
1969

To spatially and temporally define ocular motor nerve development in the presence and absence of extraocular muscles (EOMs).
Myf5cre mice, which in the homozygous state lack EOMs, were crossed to an IslMN:GFP reporter line to fluorescently label motor neuron cell bodies and axons. Embryonic day (E) 11.

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Jun
2017

Clinical diagnosis has been supplemented by neuroimaging advances, genetic discoveries, and molecular research to generate new neurobiological discoveries pertaining to early maldevelopment of ocular motor control systems. In this focused review, I examine recent paradigm shifts that have transformed our understanding of pediatric ocular motor disease at the prenuclear and infranuclear levels. The pathogenesis of complex ocular motor disorders, such as paradoxical pupillary constriction to darkness, benign tonic upgaze of infancy, congenital fibrosis syndrome, and the constellation of unique eye movements that accompany Joubert syndrome, are elucidated.

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Jun
2017

Accidental removal of the lacrimal gland is a rare complication of ptosis surgery. We report two children who underwent large unilateral levator palpebrae superioris resections (LPSr). After surgery, both patients developed dry eye.

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Jun
2017

Objective The purpose of this study was to determine the performance of the apparent diffusion coefficient in the detection of involvement of the medial and lateral rectus muscles in patients with Graves' orbitopathy. Methods and materials This prospective study was conducted on 33 consecutive patients (16 males, 17 females with a mean age of 36 years) with Graves' orbitopathy and 18 age- and sex-matched volunteers. The patients and volunteers underwent diffusion-weighted magnetic resonance imaging of the orbit in the axial plane using echo-planar imaging.

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Jun
2017

Cranial neuropathies are a spectrum of disorders associated with dysfunction of one or more of the twelve cranial nerves and the subsequent anatomic structures they innervate.
The purpose of this article is to review radiographic imaging findings of end-organ aberrations secondary to cranial neuropathies.
All articles related to cranial neuropathies were retrieved through the PubMed MEDLINE NCBI database from January 1, 1991 to August 31, 2014.

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