Duane's Retraction Syndrome in a Cohort of South African Children: A 20-Year Clinic-Based Review

To describe the clinical features of Duane's retraction syndrome in a cohort of South African children and to analyze the differences between ethnic groups.

A retrospective case series of 120 patients seen between 1997 and 2017 at a tertiary referral center in Cape Town, South Africa.

Type 2 Duane's retraction syndrome was most common in black children (54%), whereas type 1 was predominant in mixed race (68%) and white (94%) children. In this cohort, 63% of black children with Duane's retraction syndrome were boys, whereas 69% of white children and 59% of mixed race children were girls. Left eye involvement was the most common in all ethnic groups (44%), followed by right eye (41%) and bilateral (14%) involvement. The average age at presentation was 34.2 months (range: 1 to 144 months). Strabismus in primary position was present in 57 patients (46%), of whom 39% had esotropia and 61% had exotropia. A deviation in the primary position was more common in black (71%) children than in mixed race (39%) or white (41%) children. Ametropia was found in 94 patients (79%), amblyopia was present in 15 patients (13%), and 41 patients (34%) underwent surgery.

This is the first study to provide robust data on the profile of pediatric Duane's retraction syndrome in the three main ethnic groups in South Africa, and it showed clear ethnic differences. Among black children, boys are affected more often, the proportion with type 2 Duane's retraction syndrome is more frequent, and surgery is required more often. Among white and mixed race children, girls are affected more often and type 1 Duane's retraction syndrome is predominant. [J Pediatr Ophthalmol Strabismus. 2019;56(4):248-253.].