Study on ocular torsion of V patterns strabismus

Area of Science:

• Ophthalmology
• Strabismus Surgery
• Ocular Motility

Background:

• V pattern strabismus is a common condition characterized by divergent horizontal eye deviation that increases in upgaze.
• Ocular torsion, specifically excyclotropia, is often associated with V pattern strabismus but its objective quantification and response to treatment require further investigation.

Purpose of the Study:

• To investigate the presence and degree of objective ocular torsion in patients diagnosed with V pattern strabismus.
• To evaluate the effectiveness of surgical intervention, specifically bilateral inferior oblique muscle myectomy, in correcting ocular torsion in these patients.

Main Methods:

• A cohort of 22 patients with V pattern strabismus underwent bilateral inferior oblique myectomy for overaction and a recess-resection procedure for horizontal deviation.
• Objective cycloposition was assessed using fundus photography before and 7 days after surgery.
• The disc-fovea angle was measured using digital imaging software to quantify ocular torsion.

Main Results:

• Preoperative measurements revealed significant excyclotropia in V pattern patients (average disc-fovea angle: 15.67° right eye, 16.59° left eye), differing significantly from normal averages (P < 0.001).
• Postoperatively, the average disc-fovea angle significantly reduced (5.24° right eye, 7.17° left eye), showing no statistical difference from normal values (P > 0.5).
• Surgical correction also significantly reduced horizontal deviation and improved inferior oblique muscle overaction.

Conclusions:

• V pattern strabismus is objectively associated with significant excyclotropia.
• Surgical weakening of overacting inferior oblique muscles is an effective treatment for normalizing objective ocular torsion in V pattern strabismus.