2005 Fiscal Year Final Research Report Summary
Studies for the etiology and the treatment of abnormal eye movement with MRI
| Project/Area Number |
16591745
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
Ophthalmology
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| Research Institution | Hamamatsu University School of Medicine |
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Principal Investigator |
SATO Miho Hamamatsu University School of Medicine, Ophthalmology, Associate Professor, 医学部, 助教授 (50252242)
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| Co-Investigator(Kenkyū-buntansha) |
ISODA Haruo Hamamatsu University School of Medicine, Radiology, Associate Professor, 医学部, 助教授 (40223060)
ITO Yasuki Nagoya University School of Medicine, Ophthalmology, Assistant Professor, 医学部, 講師 (10313991)
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| Project Period (FY) |
2004 – 2005
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| Keywords | Strabismus / Superior oblique palsy / Endoscopic sinus surgery / disruption of medial rectus / MRI / extraocular muscles |
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| Research Abstract |
Endoscopic sinus surgery sometimes damage orbital inner wall and disruption of medial rectus muscle, which is followed by inability of abduction. Patients start complaining diplopia right after the injury, and it causes a cosmetically serious problem. Strabismus surgery for ocular alignment is performed, but the result is not always satisfactory. There is no established surgical technique and the optimal timing for strabismus surgery is unanswered. There are two widely used methods for strabismkus surgery, one is utilizing the damaged medial rectus, and the other is transposition surgery. If the surgery is not performed in an adequate timing, the adhesion between the eye and the orbit progresses. In order to establish the ideal surgical technique and the ideal timing for the surgery, we evaluated the following points. 1)Cine- mode MRI was performed on 2 patients who has injury on medial rectus muscle. We evaluated the amount of the adhesion between the eye and the surrounding tissue. W
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e performed recess lateral rectus muscle and transposition of the superior rectus and the inferior rectus muscles. The case who underwent strabismus surgery within 5 months achieved good binocular single vision, but the case who left untreated until 11 months after the injury, could not obtain useful single binocular visual field. We reviewed 10 cases including these two cases, and analyzed the possible causes for unsatisfactory surgical results. As a result, 6 cases achieved single binocular vision, and the average waiting period for the strabismus surgery was 5.4 months. On the contrary, 4 cases who did not achieve single binocular vision in the primary position waited for surgery about 16.5 months. We strongly recommend performing cine-mode MRI before the surgery, which gives us the information about the surgical result.
We examined the volume of the superior oblique muscle among normal subjects and superior oblique palsy patients. The fellow eye of the paretic superior oblique has significantly larger than those of normal controls. When we study the relative size of the superior oblique muscle with imaging, we need to consider that the fellow eye does not have the normal volume of extraocular muscles. Less
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