Duane眼球后退综合征的诊治要点

Diagnosis and treatment keys for Duane's retraction syndrome

Duane眼球后退综合征(Duane retraction syndrome,DRS)的共同临床特征为眼球水平运动障碍,内转时睑裂缩小、伴眼球后退,外转时睑裂开大,部分患者眼球内转时伴有急速的上射或下射;其可分为Ⅰ、Ⅱ、Ⅲ型。DRS的发病机制既往认为是解剖结构异常所致,但目前多认为神经肌肉支配异常是其根本原因。因DRS患者临床表现各异,需对其特征性表现仔细观察方可做出正确诊断。同时,在治疗上,也需遵循一定的原则针对每例患者的特点设计出个性化的治疗方案。

Duane＇s retraction syndrome （DRS） is characterized by limitation of horizontal duction associated with globe retraction and consequent narrowing of the palpebral fissure in adduction, with occasional upshoot or downshoot during adduction. It can be derid- ed into type Ⅰ , Ⅱ, Ⅲ based on different ocular signs. As originally, DRS was thought to be due to anatomical abnormality, but new findings suggested that the pathogenesis was related to congenital dysinnervation of the lateral rectus muscle. The surgical strategy for DRS posed a challenge as all components of the disorders need to be taken into account on a case-by-case basis.