限制性斜视的病因及分布特点

Etiologies and distribution characters of restricted strabismus

目的探讨限制性斜视的病因及分布情况。方法回顾性病例研究。对2012至2014年间在武汉大学人民医院就诊的122例限制性斜视患者的临床资料进行分析。了解其病因、斜视度数、复视、眼球运动、被动牵拉试验、影像学诊断、血液生化检查等情况。结果成人限制性斜视病因主要为甲状腺相关眼病(TAO)48例(50.5%),其他依次为眼眶骨折25例(26.3%)、高度近视相关性内斜视7例(7.4%)、视网膜脱离术后5例(5.3%)。儿童限制性斜视病因主要为Duane(眼球后退综合征)13例(48.1%),其次为先天性眼外肌纤维化综合征(CFEOM)4例(14.8%),眼眶骨折3例(11.1%)、Brown综合征2例(7.4%)、甲状腺相关眼病2例(7.4%),原因未明的限制性斜视3例(11.1%)。结论 (1)限制性斜视以成人多见,不同人群限制性斜视的病因分布不同。(2)被动牵拉试验及影像学检查对鉴别及诊断限制性斜视有重要意义。

Objective To investigate the etiology and distribution characters of restricted strabismus.Methods Author analyzed the clinical data from 122 cases of patient with restricted strabismus diagnosed in People’s Hospital of Wu-han University from 2012 to 2014.Author studied etiology, degrees of strabismus, presence of binocular diplopia, eye movement, results of forced traction test, imaging results （MRI/CT）, and blood test results.Results （1） Etiologies：In 95 adults, main causes were thyroid associated ophthalmopathy （ n =48, 50.5%）, orbital fracture （ n =25, 26.3%）, myopic strabismus （ n =7, 7.4%）, constant strabismus following retina surgery （ n =5, 5.3%）.In 27 children, main causes were Duane （ n =13, 48.1%）, CFEOM （ n =4, 14.8%）, orbital fracture （ n =3, 11.1%）, thyroid associat-ed ophthalmopathy （ n =2, 7.4%）, Brown syndrome （ n =2, 7.4%）, and unknown causes （ n =3, 11.1%）.Con-clusion Restricted strabismus is more common in adults.The etiology is different in children and in adult.Multiple meth-ods should be used to identify and diagnose the restricted strabismus and to choose the best treatment.