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1.
Invest Ophthalmol Vis Sci ; 60(15): 5052-5058, 2019 12 02.
Artigo em Inglês | MEDLINE | ID: mdl-31800963

RESUMO

Purpose: The discovery of extraocular muscle (EOM) pulleys resolved long-standing issues in oculomotor physiology, revived interest in EOM function generally, and led to several new theories. We describe the pulley concept of Miller and Demer (M-D Pulleys) and briefly review evidence, distinguishing this well-supported notion from the Active Pulley Hypothesis (APH) and the EOM Compartments hypothesis, and critically reviewing the methodologies and evidence on which the latter are based. Methods: We analyze evidence on mechanical independence of individual EOM fibers, implications of nerve tracing for functional independence of EOM layers and compartments, validity of image-based methods of assessing EOM contraction, and data analysis issues. Conclusions: M-D Pulleys are well-supported by several lines of evidence from several labs. The APH, which predicts relative movements of EOM lamina sufficient to alter muscle actions, has been effectively disproved. The width-wise articulations of EOM Compartments, in contrast, might produce significant contractile oculorotary force gradients across muscle tendons, although existing evidence is unconvincing. We suggest how this hypothesis could be effectively tested.


Assuntos
Movimentos Oculares/fisiologia , Imagem por Ressonância Magnética/métodos , Músculos Oculomotores , Humanos , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/inervação , Músculos Oculomotores/fisiologia
2.
Turk J Ophthalmol ; 49(5): 305-309, 2019 Oct 24.
Artigo em Inglês | MEDLINE | ID: mdl-31650817

RESUMO

A 78-year-old Caucasian woman presented with pain in her right and only eye that was worse on abduction. Her history was significant for a choroidal melanoma affecting her left eye for which she underwent an orbital exenteration 12 years previously. Computed tomography and magnetic resonance imaging of the right orbit identified a mass lesion affecting the medial rectus, suspicious for metastatic melanoma. A histopathological diagnosis of metastatic melanoma was subsequently made following biopsy of the right medial rectus.


Assuntos
Neoplasias da Coroide/patologia , Melanoma/secundário , Músculos Oculomotores/diagnóstico por imagem , Exenteração Orbitária/efeitos adversos , Órbita/diagnóstico por imagem , Neoplasias Orbitárias/secundário , Idoso , Biópsia , Feminino , Humanos , Imagem por Ressonância Magnética , Melanoma/diagnóstico , Neoplasias Orbitárias/diagnóstico , Tomografia Computadorizada por Raios X
3.
Strabismus ; 27(4): 211-214, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31544571

RESUMO

Scleroderma, "en coup de sabre" is a rare disorder, characterized by linear depressed scarring at frontoparietal area of the face, seldom associated with ophthalmological findings. Extraocular muscle involvement and paralytic strabismus are rarely associated with linear scleroderma. Here we are reporting a case of unilateral linear scleroderma in an 8-year-old child, with features of strabismus fixus secondary to fibrosed medial rectus (MR) muscle, enophthalmos and en coup de saber (sword-like scar) on the eyebrow. MRI orbit was suggestive of the bulky MR and the inferior rectus muscle. MR recession along with partial loop myopexy resulted in cosmetically acceptable ocular alignment in this case. Histopathology of the portion of muscle and intermuscular septum showed diffuse fibrosis of the muscle. Linear scleroderma may be the causative etiology of strabismus fixus in our case, never reported before in literature.


Assuntos
Músculos Oculomotores/patologia , Esclerodermia Localizada/complicações , Estrabismo/etiologia , Criança , Fibrose/diagnóstico por imagem , Fibrose/patologia , Humanos , Imagem por Ressonância Magnética , Masculino , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/cirurgia , Órbita/diagnóstico por imagem , Esclerodermia Localizada/diagnóstico por imagem , Estrabismo/diagnóstico , Estrabismo/cirurgia
4.
J Pediatr Ophthalmol Strabismus ; 56(5): 319-326, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31545866

RESUMO

PURPOSE: To assess the correlation between optical coherence tomography (OCT) and magnetic resonance imaging (MRI) measurements of extraocular rectus muscle thickness in patients with Graves' ophthalmopathy. METHODS: This was a cross-sectional observational study conducted in 62 eyes of 31 patients with Graves' ophthalmopathy. The disease phase was inactive in 20 patients and active in the remaining 11. The OCT measurements obtained were: medial rectus thickness at 7.2 and 9.2 mm from the limbus and lateral rectus thickness at 8.5 mm from the limbus. MRI measurements were maximum transversal diameter (T-MRI), craniocaudal diameter (CC-MRI), and muscle area (A-MRI). RESULTS: For the whole patient cohort, correlation emerged between the OCT-MR and T-MRI measurements (R = 0.428 to 0.576; P ≤ .002), A-MRI (R = 0.562 to 0.674; P < .001), and CC-MRI (R = 0.286 to 0.293; P ≤ .046). In patients with clinically active Graves' ophthalmopathy, correlations with T-MRI (R = 0.576 to 0.604; P ≤ .010) and A-MRI (R = 0.678 to 0.706; P < .001) were higher. No correlations were detected between OCT and MRI measurements of lateral rectus thickness (P ≥ .177), regardless of disease phase. CONCLUSIONS: The correlations observed suggest OCT could be a complementary assessment or screening method to detect thickening of the anterior portion of the medial rectus muscle in patients with Graves' ophthalmopathy, which may be especially useful when MRI is not available. [J Pediatr Ophthalmol Strabismus. 2019;56(5):319-326.].


Assuntos
Movimentos Oculares/fisiologia , Oftalmopatia de Graves/diagnóstico , Imagem por Ressonância Magnética/métodos , Músculos Oculomotores/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos Oculomotores/fisiopatologia , Estudos Retrospectivos
6.
BMC Ophthalmol ; 19(1): 173, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31391009

RESUMO

BACKGROUND: To describe the clinical characteristics and the outcomes of strabismus surgery for acute acquired comitant esotropia (AACE). METHODS: Medical records of 45 AACE patients were retrospectively analyzed. The insertion location of medial rectus was compared between the AACE patients and comitant exotropic patients. The location was also compared with those measured in other studies. Surgical outcome measurements included amount of deviation and level of binocularity at last follow-up. RESULTS: The distance from medial rectus to limbus was shorter in AACE patients than in patients with comitant exotropia. The distance was also shorter in AACE patients than patients in other studies. Out of the 45 patients, 2 had neurological diseases. Neostigmine test was negative in all patients. The age at onset of AACE was 5-47 years (mean 19.1 ± 7.3 years), one patient was 5 years (2.2%), 20 patients were 11-17 years (44.5%) and the other 24 patients were 18-47 years old (53.3%). The mean cycloplegic refraction was - 4.1 ± 3.0 diopters (D) and 41 patients were myopic (91%). The angle of deviation was 40.5 ± 19.5 prism diopters (PD) at distance and 35.6 ± 19.9PD at near preoperatively. The angle was 0.8 ± 1.6 PD at distance and 0.7 ± 1.8 PD at near postoperatively. Diplopia resolved in patients who underwent strabismus surgery, with no recurrence during the follow-up period. Thirty patients had stereopsis postoperatively. CONCLUSIONS: AACE seems to occur mostly in older children and adults and myopes. The distance from the insertion to limbus of medial rectus was shorter in patients with AACE. Good results can be achieved by strabismus surgery.


Assuntos
Percepção de Profundidade/fisiologia , Esotropia/cirurgia , Movimentos Oculares/fisiologia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos/métodos , Acuidade Visual , Doença Aguda , Adolescente , Adulto , Criança , Esotropia/diagnóstico , Esotropia/fisiopatologia , Feminino , Seguimentos , Humanos , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/fisiopatologia , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
8.
Cesk Slov Oftalmol ; 75(1): 14-24, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31382752

RESUMO

BACKGROUND: Shear wave elastography (SWE) is an imaging modality using advantage of ultrasound to detect differences of elastic properties (mechanical rigidity) of tissues. SWE increasingly develops across medical specialities and is already used in hematology, urology and oncology. In the field of ophthalmology using SWE to evaluate corneal mechanical properties, peripapillary biomechanical qualities in glaucoma patients several papers were published Also SWE ultrasound mechanical specificity safety studies were published. Aim of this work is to review SWE technique and its potentional using during examination in patients with endocrine orbitopathy (EO). In practical part of this work is evaluated the elasticity of oculomotor rectus muscles in healthy population, in patients with EO in early stage of disease (oculomotor muscles oedema) and in patients with EO in terminal stage of this disease (oculomotor muscles fibrosis) is determinate. Also possibility of using SWE (in comparison with standard ultrasound examination) for measuring thickness of oculomotor muscles is evaluated. METHODS: There were 60 eyes in 30 patients with EO examined and the elasticity of oculomotor muscles was determined. Results were compared with values of elasticity in 40 eyes in healthy population of 20 people. All measurements were performed with ultrasonic system Aixplorer of SuperSonic manufacturer in standardized terms and been undertaken by the same performer. Each value was measured several times to reduce measurement errors. RESULTS: Oculomotor rectus muscle elasticity values in healthy population measured by using SWE were as follows: musculus rectus superior (MRS) 19.7 ± 3.2 kPa, musculus rectus medialis (MRM) 20.5 ± 3.6 kPa, musculus rectus inferior (MRI) 20.4 ± 3.1 kPa and musculus rectus temporalis (MRT) 20.2 ± 1.7 kPa. As statistical analysis shows, there is no significant difference between muscles (ANOVA test p > 0.05); overall elasticity of oculomotor muscles in healthy population is 20.3 ± 3.0 kPa. Elasticity of muscles in group of EO patients in oedema stage and EO patients in fibrosis stage is 18.4 ± 3.2 kPa and 34.6 ± 7.5 kPa respectively. Both values show statistical significance in the comparison with healthy population (p.


Assuntos
Técnicas de Imagem por Elasticidade , Músculos Oculomotores , Elasticidade , Humanos , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/fisiopatologia , Ultrassonografia
9.
Arch. Soc. Esp. Oftalmol ; 94(8): 400-404, ago. 2019. ilus
Artigo em Espanhol | IBECS | ID: ibc-185627

RESUMO

Mujer de 73 años que acude a consulta con diagnóstico de hipertiroidismo de 8 meses de evolución. Desde entonces comenzó con hiperemia y proptosis ocular. En la exploración se observa exoftalmos bilateral de predominio derecho, ligera hiperemia conjuntival en ojo derecho asociada a vasos epiesclerales aumentados en su calibre con forma de cabeza de medusa. Tomografía computada con recto inferior aumentado de calibre sin datos de compresión de nervio óptico. En el estudio doppler de órbita se encuentra un flujo arteriorizado sobre la vena oftálmica superior con un posible diagnóstico de fístula carótido-cavernosa. La orbitopatía tiroidea relacionada a una fístula carótido-cavernosa es una asociación infrecuente, ya que los datos clínicos de una de las patologías pueden enmascarar a la otra, por lo que es importante el conocimiento de ambas enfermedades para su correcto diagnóstico y tratamiento multidisciplinario


The case concerns a 73 year-old female with a diagnosis of hyperthyroidism of 8 months onset. Since then, she has suffered hyperaemia and ocular proptosis. Bilateral exophthalmos was observed in the physical examination, along with mild conjunctival hyperaemia in the right eye associated with dilated episcleral vessels. Computed tomography showed enlarged inferior rectus with no signs of ocular nerve or ophthalmic superior vein compression. In the orbital Doppler ultrasound scan, there was an arterialised flow over the superior ophthalmic vein, giving a possible diagnosis of cavernous carotid. Thyroid orbitopathy with a cavernous carotid fistula is an unusual combination in which the clinical signs of both pathologies can mask the complete diagnosis; thus it is important to be acquainted with both pathologies for their correct management and multidisciplinary treatment


Assuntos
Humanos , Feminino , Idoso , Fístula Carotidocavernosa/complicações , Oftalmopatia de Graves/complicações , Fístula Carotidocavernosa/diagnóstico por imagem , Olho/irrigação sanguínea , Oftalmopatia de Graves/diagnóstico , Hiperemia/diagnóstico , Hipertireoidismo/complicações , Músculos Oculomotores/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler , Veias/diagnóstico por imagem
10.
J Pediatr Ophthalmol Strabismus ; 56: e49-e52, 2019 Jul 05.
Artigo em Inglês | MEDLINE | ID: mdl-31282961

RESUMO

A 37-year-old man suffered a penetrating left orbital injury with rupture of the inferior rectus muscle and avulsion of the optic nerve. The orbit was explored and the inferior rectus muscle stump was identified 25 mm from the limbus. Despite this, the muscle was successfully reattached and the patient achieved satisfactory postoperative alignment. [J Pediatr Ophthalmol Strabismus. 2019;56:e49-e52.].


Assuntos
Ferimentos Oculares Penetrantes/complicações , Músculos Oculomotores/lesões , Procedimentos Cirúrgicos Oftalmológicos/métodos , Órbita/lesões , Procedimentos Cirúrgicos Reconstrutivos/métodos , Estrabismo/cirurgia , Adulto , Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/cirurgia , Movimentos Oculares , Humanos , Masculino , Músculos Oculomotores/diagnóstico por imagem , Músculos Oculomotores/cirurgia , Órbita/diagnóstico por imagem , Estrabismo/etiologia , Estrabismo/fisiopatologia , Tomografia Computadorizada por Raios X
11.
J Pediatr Ophthalmol Strabismus ; 56(4): 254-260, 2019 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-31322717

RESUMO

PURPOSE: To determine whether suturing to the residual muscle stump induces postoperative muscle migration after superior rectus muscle (SRM) resection in rabbit eyes. METHODS: Twenty-four eyes in 12 rabbits were randomly divided into two groups. Each group underwent a 3-mm SRM resection. The muscle stump was not removed in one randomly assigned eye in each rabbit and the resected muscle was sutured to the residual muscle stump (residual muscle stump group). In the other eye, the muscle stump was completely removed and the resected muscle was sutured to the original insertion site (control group). At postoperative weeks 1, 2, and 4, the distances between the most anterior aspect of the reattached muscle and the corneal limbus were measured. Histopathologic differences at the new attachment sites were assessed between the two groups at postoperative week 4. RESULTS: The mean distance between the corneal limbus and SRM was 2.97 ± 1.00 mm in the residual muscle stump group and 1.99 ± 0.40 mm in the control group at postoperative week 2 (P = .026) and 3.14 ± 0.78 mm in the residual muscle stump group and 1.81 ± 0.44 mm in the control group at postoperative week 4 (P = .002). Connective tissue, fibrosis, and myofibroblast proliferation in the front of the SRM were identified based on histopathologic findings. CONCLUSIONS: Postoperative loosening associated with a stretched scar frequently occurred in cases with suturing to the residual muscle during rectus muscle resection and could result from fibrosis and connective tissue proliferation in front of the rectus muscle. [J Pediatr Ophthalmol Strabismus. 2019;56(4):254-260.].


Assuntos
Cicatriz/etiologia , Músculos Oculomotores/cirurgia , Complicações Pós-Operatórias , Estrabismo/cirurgia , Técnicas de Sutura/efeitos adversos , Suturas/efeitos adversos , Animais , Cicatriz/patologia , Modelos Animais de Doenças , Músculos Oculomotores/diagnóstico por imagem , Coelhos
12.
Arch Soc Esp Oftalmol ; 94(8): 400-404, 2019 Aug.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-31176495

RESUMO

The case concerns a 73 year-old female with a diagnosis of hyperthyroidism of 8 months onset. Since then, she has suffered hyperaemia and ocular proptosis. Bilateral exophthalmos was observed in the physical examination, along with mild conjunctival hyperaemia in the right eye associated with dilated episcleral vessels. Computed tomography showed enlarged inferior rectus with no signs of ocular nerve or ophthalmic superior vein compression. In the orbital Doppler ultrasound scan, there was an arterialised flow over the superior ophthalmic vein, giving a possible diagnosis of cavernous carotid. Thyroid orbitopathy with a cavernous carotid fistula is an unusual combination in which the clinical signs of both pathologies can mask the complete diagnosis; thus it is important to be acquainted with both pathologies for their correct management and multidisciplinary treatment.


Assuntos
Fístula Carotidocavernosa/complicações , Oftalmopatia de Graves/complicações , Idoso , Fístula Carotidocavernosa/diagnóstico por imagem , Olho/irrigação sanguínea , Feminino , Oftalmopatia de Graves/diagnóstico , Humanos , Hiperemia/diagnóstico , Hipertireoidismo/complicações , Músculos Oculomotores/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Ultrassonografia Doppler , Veias/diagnóstico por imagem
15.
Zhonghua Yan Ke Za Zhi ; 55(5): 361-368, 2019 May 11.
Artigo em Chinês | MEDLINE | ID: mdl-31137148

RESUMO

Objective: To explore the imaging features of patients with special forms of strabismus and summarize the subtypes by using MRI imaging techniques. Methods: A retrospective case series study. Among the patients who visited the Beijing Tongren Hospital between 2006 and 2016, 1 113 patients were identified with special forms of strabismus after complete ophthalmic and orthoptic evaluations. These patients were further evaluated using several types of high-resolution MRI techniques of the oculomotor nerves in the brain, the cavernous sinus, and the orbits. Results: Among the 1 113 patients, 818 patients (73.5%) were identified with MRI abnormal conditions, and 295 patients (26.5%) were identified with MRI normal conditions. Nine different disease types were identified in the studied populations, which included 257 patients (23.1%) with congenital cranial dysinnervation disorders, 209 patients (18.8%) with thyroid associated ophthalmopathy, and 169 patients (15.2%) with abnormalities of the extraocular muscles. Other diseases included orbital fractures (3.3%, 37 patients), intraorbital inflammations (2.7%, 30 patients), tumors (2.3%, 26 patients), injuries of medial rectus muscle after endoscopic sinus surgery (1.2%,13 patients), and lesions of cavernous sinus (2.0%, 22 patients). Additional 55 patients (4.9%) were identified with other causes such as high myopia fixed esotropia, and so on. Conclusion: Summarizing the common clinical characteristics and rules with the help of MRI can further clarify the etiology of special forms of strabismus, and accurately guide the diagnosis and treatment of strabismus. (Chin J Ophthalmol, 2019, 55: 361-368).


Assuntos
Seio Cavernoso/diagnóstico por imagem , Imagem por Ressonância Magnética/métodos , Músculos Oculomotores/diagnóstico por imagem , Órbita/diagnóstico por imagem , Estrabismo/diagnóstico , Humanos , Nervo Oculomotor , Estudos Retrospectivos , Estrabismo/diagnóstico por imagem , Estrabismo/etiologia
16.
J Comput Assist Tomogr ; 43(3): 467-471, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31082953

RESUMO

AIM: This study aimed to assess metrics of diffusion tensor imaging in evaluating microstructural abnormalities of the lateral rectus muscle in Duane retraction syndrome (DRS). PATIENT AND METHODS: A prospective study was conducted on 27 patients with DRS and 16 age- and sex-matched controls who underwent diffusion tensor imaging of orbit and forced duction test (FDT). Fractional anisotropy (FA) and mean diffusivity (MD) of the lateral rectus were calculated by 2 observers. RESULTS: Fractional anisotropy of the lateral rectus in patients (0.62 ± 0.07 and 0.59 ± 0.06) was significantly higher (P = 0.001) than that in controls (0.49 ± 0.06 and 0.51 ± 0.06). Selection values of 0.53 and 0.52 as cutoff points of FA of the lateral rectus to differentiate patients from controls revealed areas under the curve of 0.92 and 0.86 and accuracy values of 84.8% and 80.4% by both observers, respectively. Mean diffusivity of the lateral rectus by both observers in patients (1.19 ± 0.13 and 1.23 ± 0.19 × 10 mm/s) was significantly lower (P = 0.001) than that in controls (1.54 ± 0.18 and 1.49 ± 0.16 × 10 mm/s). Selection values of 1.35 and 1.40 × 10 mm/s as cutoff points of MD of the lateral rectus to differentiate patients from the control groups revealed areas under the curve of 0.93 and 0.85 and accuracy values of 91.3% and 80.4% by both observers, respectively. Interobserver agreement for MD and FA of the lateral rectus by both observers were excellent (r = 0.870 and, 0.959). Diffusion tensor imaging metrics of the lateral rectus muscle did not differ significantly between patients with unilateral and bilateral disease (P = 0.05) and patients with DRS type I and type III (P = 0.05). Diffusion tensor imaging metrics of the lateral rectus muscle differed significantly between FDT grades I and II versus grades III and IV, and these metrics were well correlated with the degree of FDT. CONCLUSION: Diffusion tensor imaging metrics are valuable noninvasive tools in evaluating the microstructural abnormalities of the lateral rectus in DRS and are well correlated with degree of FDT.


Assuntos
Imagem de Tensor de Difusão/métodos , Síndrome da Retração Ocular/diagnóstico por imagem , Músculos Oculomotores/diagnóstico por imagem , Estudos de Casos e Controles , Imagem de Difusão por Ressonância Magnética , Feminino , Humanos , Masculino , Variações Dependentes do Observador , Estudos Prospectivos
19.
Indian J Ophthalmol ; 67(5): 659-663, 2019 05.
Artigo em Inglês | MEDLINE | ID: mdl-31007233

RESUMO

Purpose: This study aims to evaluate normal orbital structures with nonenhanced computed tomography (NCCT) and determine normative data for the Indian population. Methods: CT images of the orbits of 100 patients were retrospectively reviewed on a work station to record the normative data of the orbits. Clinical details of all patients were reviewed to ensure that they did not have ocular/orbital diseases. Both axial and coronal images were utilized to record the data. Results: The mean age of the population evaluated was 34.07 years, with male to female ratio of 1.77. The average orbital index for the left orbit was 97 and for the right side was 103. The mean thickness of left inferior rectus, lateral rectus, medial rectus, and the superior rectus was 3.36 mm, 3.14 mm, 3.80 mm, and 3.75 mm, respectively. The right inferior rectus, lateral rectus, medial rectus, and the superior rectus measured 3.46 mm, 3.14 mm, 3.83 mm, and 3.78 mm, respectively. The optic nerve sheath complex diameter varied between 3.05 mm and 7.17 mm for the left eye and 3.05 mm and 7.0 mm for the right eye. Conclusion: The study provides normative data on various orbital structures in an Indian population. This data is likely to be useful for diagnosing various orbital pathologies and in planning surgical orbital procedures.


Assuntos
Músculos Oculomotores/diagnóstico por imagem , Órbita/diagnóstico por imagem , Doenças Orbitárias/diagnóstico , Tomografia Computadorizada por Raios X/métodos , Adolescente , Adulto , Idoso , Criança , Feminino , Humanos , Índia , Masculino , Pessoa de Meia-Idade , Valores de Referência , Estudos Retrospectivos , Adulto Jovem
20.
Acta Med Okayama ; 73(1): 67-70, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30820056

RESUMO

We report a case of congenital multiple ocular motor nerve palsy combined with splitting of the lateral rectus muscle (LR). A 59-year-old Japanese female was investigated for worsening esotropia after corrective surgery. She presented with left hypertropia (35Δ) and esotropia (45-50Δ). Orbital magnetic resonance imaging (MRI) showed reduced belly sizes in the superior rectus, inferior rectus, and superior oblique muscles and splitting of the LR, extending from the origin to the belly, in the left eye. Splitting of the LR belly was detected on MRI in a case of congenital multiple ocular motor nerve palsy.


Assuntos
Músculos Oculomotores/patologia , Doenças do Nervo Oculomotor/congênito , Feminino , Humanos , Imagem por Ressonância Magnética , Pessoa de Meia-Idade , Músculos Oculomotores/diagnóstico por imagem , Nervo Oculomotor/patologia , Doenças do Nervo Oculomotor/cirurgia
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