Congenital fibrosis of
extraocular muscle type 1A due to KIF21A mutation: first ease report from Hong Kong.
All patients had previously been diagnosed with Graves' disease, had best corrected visual acuity (BCVA) [greater than or equal to]0.7 (Snellen chart), enlarged
extraocular muscles on multi-slice computed tomography (MSCT) scans, and active TAO confirmed by a clinical activity score [greater than or equal to]4 (13).
The clinical features of the idiopathic inflammation of the
extraocular muscle also known as idiopathic orbital myositis are acute and severe pain of the eyes, proptosis, eyelid swelling, and erythema, and conjunctival redness and chemosis [2, 13].
The wrapping of an implant is done in order to allow attachment of the
extraocular muscles and to prevent exposure.
* The
extraocular muscles showed no movement in all cardinal directions of the eye, and it was centrally fixed in the orbit.
IEA was performed using acupuncture needles (25.0 mm in length, 0.20 mm in diameter) gently inserted into the extraocular acupuncture muscle points (the surface projections of the
extraocular muscles) coordinated with Tongziliao (GB1), Jingming (BL1), and Cuanzhu (BL2) points as well.
Different degrees of confined
extraocular muscle movement with injuries in CNs III, IV, and VI were also observed.
Orbital MRI can clearly show the anatomical structure of the
extraocular muscles, orbital fat, and optic nerve and can be used for the quantitative analysis of some parameters, such as the degree of exophthalmos, thickness or volume of
extraocular muscle, and orbital fat, as well as signal values.
Strabismus typically includes inadequacy coordination between the
extraocular muscles, which bares directing the gaze of both eyes at once to the same point in space; it thus inhibits suitable binocular vision (Bernays and Smith, 1999).
The clinical features of patients with OM as a whole and in the LOOM and SEOM groups are separately provided in Table 2, and the distribution of the
extraocular muscle involvement is provided in Table 3.
Table 1: Extraocular examination of left eye
Extraocular muscle Function Movement of left eye Medial rectus Adduction Absent Superior rectus Elevator in abduction Absent Inferior rectus Depressor in abduction Absent Inferior oblique Elevator in adduction Absent Superior oblique Depressor in adduction Present but not full Lateral rectus Abduction Absent
His cranial nerve exam was within normal limits, including facial and
extraocular muscle function.
