28例后天性上斜肌麻痹的临床分析

Clinical analysis of 28 cases of acquired superior obliquepalsy

目的 :探讨后天性上斜肌麻痹的临床特点和治疗方法。方法 :回顾分析 2 8例后天性上斜肌麻痹病例。结果 :临床特点 :(1)发病原因较多 ,以外伤占首位。 (2 )复视主要表现在前下方或侧下方。 (3)同视机及双 4 △ 三棱镜检查均表现外旋斜视。 (4)眼底摄影视盘和黄斑的位置发生改变。 2 8例患者中 2 6例经药物治疗基本痊愈 ,2例行手术治疗 ,术后第一眼位外旋斜视消失。结论 :后天性上斜肌麻痹症状隐匿 ,易漏诊 ,应详细行眼肌专科检查 。

Objective:To study the clinical feacures and treatment of acquired superior obliquepalsy.Method:Deta of 28 cases of acquired superior obliquepalsy were reviewed retrospectively.Results:Clinical features were as follows:1)etiologic factors were various,but trauma was the first one.2)had diplopia appeared when looking anteroinferiorly or lateralinferiorly.3)examination with double synoptiscope and prismatic spectacles test showed excyclotorsion.4)fundus photograph showed changes of the positions of optic disc and maculae fovea.Of 28 cases,26 cases were cured with medical treatmeut to the etiology,and 2 cases by surgery after which the excyclotorsion disappeared.Conclusion:The symptom of acquired superior obliquepalsy is latent,may be missed easily during diagnosis.Special examinations for extraocular muscles should be done and take the best therapeutic program after confirmed diagnosis.