Seydi OKUMUŞ, İbrahim ERBAĞCI, Ayşegül ÇÖMEZ, Ferhat ZORLU, Esra AKDEMİR

Duane retraksiyon sendromu: klinik özellikler ve ayırıcı tanı

Amaç: Kliniğimizde takip ettiğimiz Duane retraksiyon sendromlu (DRS) olguların klinik özelliklerini belirlemek, bu olgularda ayırıcı tanının önemini vurgulamak. Gereç ve yöntem: Duane retraksiyon sendromu tanısı almış 32 olgunun cinsiyet dağılımı, lateralite, sendromun tipi, ambliyopi varlığı, eşlik eden göz içi ve göz dışı anormallikleri geriye dönük olarak incelendi. Bulgular: Yaş ortalamaları 7.40±3.3 yıl olan 32 DRS’li olgu ortalama 14±5.2 ay süreyle takip edilmişti. Olguların 20’si (%62.5) kadın, 12’si (%37.5) erkekti. Olgularımızın 27’si (%84.4) Tip 1, 4’ü (%12.5) Tip 2 ve biri (%3.1) Tip III DRS idi. Olgularımızın 25’inde (%78.1) tek göz tutulumu, 7’sinde (%21.9) iki göz tutulumu mevcuttu. Tek gözünde DRS olan olgularda sol gözde daha fazla tutulum mevcuttu (%56.2). Tip 1 DRS’li olgularda ezotropya (%51.9), ambliyopi (%28), up-shoot ve down-shoot (%34.4), anormal baş pozisyonu (%37.2) oranında gözlenmekteydi. Manyetik Rezonans Görüntüleme (MR) yapılan olgularda kafa içi bir patolojiye rastlanmadı. Ciddi anormal baş pozisyonu(ABP) bulunan Tip 1 DRS’li 5 olguda iç rektusa geriletme operasyonu yapıldı. Sonuç: Duane retraksiyon sendromlu olguların çoğunluğunu Tip 1 DRS’li olgular oluşturmaktaydı. Sendromun kadınlarda daha çok görüldüğü ve sol gözü daha fazla etkilediği izlendi. Olguların büyük çoğunluğunda görme keskinliği normal izlenirken, bazı olgularda ezotropya, ambliyopi, anormal baş pozisyonu mevcuttu. Kayması ve anormal baş pozisyonu mevcut olan 5 tip 1 DRS’li olgunun ameliyat sonrası kayma açıları ve baş pozisyonlarında belirgin düzelme izlendi. Anahtar kelimeler: Duane retraksiyon sendromu, anormal baş pozisyonu, manyetik rezonans görüntüleme.

Duane retraction syndrome: clinical features and differential diagnosis

Objective: To determine the clinical properties of Duane’s Retraction Syndrome (DRS) cases in our clinic, to emphasize the importance of differential diagnosis in these patients. Materials and methods: Gender distribution, laterality, type of the syndrome, amblyopia, and accompanying ocular and non-ocular abnormalities of the 32 cases that were diagnosed as Duane’s retraction syndrome were retrospectively investigated. Results: Thirty-two cases with average age of 7.40±3.34 were followed for 14±5.20 months at average. Twenty (62.5%) of the 32 cases of were female and 12 were male (37.5%). Twenty-seven of the cases (84.7%) were type-I, 4 was type-II (12.5%), and 1 was type-III (3.12%) DRS. Twenty-five (78.1%) of the cases had one eye involvement and 7 (21.9%) had two eyes involvement. Left eye involvement among cases with one eye DRS were higher (56.2%). In type-I DRS cases the rates of exotropia, amblyopia, up-shoot and down-shoot, and abnormal head posture were as follows 43.75%, 28%, 34.37%, 37.20%, respectively. Patients who were applied Magnetic Resonance Imaging techniques had no abnormality about intracranial structure. Five among type-I DRS cases who had serious abnormal head posture had medial rectus recession operation. Conclusion: The majority of Duane retraction syndrome cases were constituted of Type I cases. It was observed that the syndrome was more frequent in women and left eye was more affected. While visual acuity was observed as normal in majority of cases, in some cases exotropia, amblyopia, and abnormal head posture were present. Significant improvements were observed in terms of slippage angles and head postures of 5 cases with type 1 DRS after surgery.

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