Anatomic and topographic features of oculomotor muscles and clinical manifestations in children with vertical strabismus

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Abstract


Aim: To determine the anatomic and topographic features of the lateral (LRM) and medial rectus (MRM) muscles of the eyeball and clinical manifestations in children with vertical strabismus.

Material and methods: We examined 50 children aged 4–10 years with congenital squint (vertical, 38; horizontal, 12). Ophthalmologic, ultrasonography, and intraoperative studies were performed. Using the anatomic and topographic parameters of the LRM and MRM, the α angle (the angle of attachment of the tendons of these muscles) was determined.

Results: With horizontal divergence and convergence deviations of the eyeball from (±) 20 to (±) 70 prism, diopter angle α does not exceed 8°, with a combination of horizontal deviations from (±) 20 to (±) 70 and vertical deviations from 8 to 10 prism diopters and higher, the α angle varies from 10° to 20°. Moreover, the increase in the α angle is proportional to the increase in horizontal and vertical deviations of the eye. The echographic parameters of the thickness of the MRM and LRM in children with vertical and horizontal strabismus significantly exceed intraoperative ones (by 1.5–2.15 mm on average), which could be attributed to technical limitations in measurement.

Conclusion: The identified features, according to the authors, must be taken into account in surgery correction of vertical strabismus in children, that is when determining surgical dosage for resection, recession, and transposition of the horizontal muscles.


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About the authors

Lola S. Khamraeva

Tashkent Pediatric Medical Institute

Author for correspondence.
Email: lola251167@mail.ru
ORCID iD: 0000-0003-0221-702X

Uzbekistan, 100140, Tashkent, Bagishamal str., 223

MD, PhD

Acida O. Giyasova

Tashkent Pediatric Medical Institute

Email: lola251167@mail.ru

Uzbekistan, 100140, Tashkent, Bagishamal str., 223

MD

Lyubava Y. Bobokha

Tashkent Pediatric Medical Institute

Email: lola251167@mail.ru
ORCID iD: 0000-0002-8075-3293

Uzbekistan, 100140, Tashkent, Bagishamal str., 223

MD

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Supplementary files

Supplementary Files Action
1.
Fig. 1. Scans of oculomotor muscles (ocular muscles are visualized as tubular hypoechoic bands) A — internal rectus muscle. B — external rectus muscle.

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2.
Fig. 2. Measurement of the attachment point of the muscle tendon-the distance from the limb.

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3.
Fig. 3. measurement of muscle thickness.

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4.
Fig. 4. Oblique attachment of the external rectus muscle of the eyeball.

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5.
Fig. 5. Diagram of measuring the angle (α) of attachment of the muscle tendon. a — limb, b — muscle tendon attachment line (connects the upper and lower attachment points), с — a line drawn from the point of closest attachment of the muscle tendon, parallel to the limb, α — is the angle formed between lines b and с.

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