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Duane Retraction Syndrome Type 2

DRS


Presentation

  • Clinical manifestations of patients with type 3 Duane retraction syndrome were compared between patients with a present abducens nerve (present group) and absent/hypoplastic abducens nerve (absent or hypoplastic group).[journals.plos.org]
  • In unilateral DRS, Type I was present in 72 (78.26 %), Type II was present in 2 (2.17%), Type III was present in 18 (19.57%) patients.[djo.org.in]
  • It presents during childhood and it accounts for less than 5% of cases of strabismus 1 .[radiopaedia.org]
  • Unilateral lateral rectus cysticercosis presenting as Duane retraction syndrome type IIb 1 Department of Neurology, Dr. S.N.[neurologyindia.com]
  • Hwang Published in Ophthalmology 2012 DOI: 10.1016/j.ophtha.2011.08.001 OBJECTIVE To determine whether the abducens nerve is present in patients with type 2 Duane's retraction syndrome (DRS).[semanticscholar.org]
Asymptomatic
  • […] lateral posterior fixation sutures, simultaneous medial and lateral rectus recessions, and surgery on the normal eye. [10] Y-splitting and recession of the lateral rectus muscle are safe and simple procedure. [5] Conclusion Most patients with DRS are asymptomatic[sjopthal.net]
Excitement
  • Materials and Methods After clearance from the Institutional Ethical Committee, 16 consecutive patients of DRS underwent MRI on SIGNA EXCITE 1.5T GEMSOW (GE) MR scanner. Informed consent was taken and any contraindication for the scan ruled out.[jcor.in]

Workup

  • Duane's Syndrome (type I) It may be confused with a paralysis of the muscle which causes the eye to turn outwards (lateral rectus) resulting in an unnecessary neurological workup.[strabismus.org]
  • Approach to the patient: an overview The above review emphasizes the need to extend patient evaluation in cases of DRS beyond the routine clinical examination by a strabismologist to genetic analysis, systemic workup and neuroimaging.[dovepress.com]
Taenia Solium
  • Neurol India 2017;65:221-2 Orbital cysticercosis is caused by the larval form of Taenia solium in the orbital cavity. It may involve intraocular or extraocular structures.[neurologyindia.com]

Treatment

  • Orthoptic vision therapy is a treatment alternative in DRS patients.[dovepress.com]
  • Treatment Treatment Options: Various treatments can be useful, ranging from prisms for mild cases to muscle surgery for a severe head turn or vertical deviations.[disorders.eyes.arizona.edu]
  • References Rao VB, Helveston EM, Sahare P (2003) Treatment of upshoot and downshoot in Duane syndrome by recession and Y-splitting of the lateral rectus muscle. J AAPOS 7: 389-395. Pressman SH, Scott WE (1986) Surgical treatment of Duane's syndrome.[omicsonline.org]
  • When Is Treatment of Duane Syndrome Required? Treatment is not always necessary for people with Duane syndrome, if their symptoms do not interfere with daily living and they have no eye misalignment.[eyehealthweb.com]

Prognosis

  • Prognosis Isolated DRS is a benign disorder which, if managed appropriately, results in excellent long term prognosis for vision. In some cases, amblyopia or loss of binocular single vision might develop.[orpha.net]
  • With careful follow-up, the long-term prognosis for good vision is usually excellent.[aapos.org]
  • The patient was prescribed glasses, surgical prognosis explained and we are awaiting a follow-up from her.[sjopthal.net]
  • Prognosis Duane syndrome represents a spectrum of motility disorders in which the common feature is retraction of the affected eye on attempted adduction.[emedicine.medscape.com]

Etiology

  • The underlying etiology of DRS is a defect in some of the eye muscles (specifically the lateral and medial rectus muscles) receiving proper signal from the cranial nerves that innervate them.[cags.org.ae]
  • Get a balanced view of etiology, diagnosis, and management, and access unique guidance on the practical problems encountered in real-life clinical cases. Impresses the importance of systemic disease in diagnosis and management.[books.google.com]
  • Neurologia i Neurochirurgia Polska 37(2): 429-435, 2003 Duane's syndrome; observations on the pathogenesis and etiology of different forms of the Stilling-Duane-Turk retraction syndrome . Documenta Ophthalmologica.[eurekamag.com]
  • Etiology DRS results from failure of normal development of the pontine abducens nucleus or nerve resulting in failure of the normal innervation of the lateral rectus muscle on the affected side.[orpha.net]
  • The etiology of this disorder may be due to an environmental or tetrogenic event; for example, thalidomide embryopathy between the fourth and eighth weeks of gestation.[collections.lib.utah.edu]

Epidemiology

  • […] retraction in adduction 6 Duane’s Syndrome Type III: OS -limited adduction and abduction -retraction in adduction/abduction 7 History Squinting Head tilt Loss of binocular vision Reduced ocular movement Facial asymmetry Picture of paralytic squint 8 Epidemiology[slideplayer.com]
  • Summary Epidemiology The prevalence of DRS is about 1/10, 000, representing about 1-5% of all strabismus cases. Females are more affected than males.[orpha.net]
  • "[Epidemiological and clinical aspects of Stilling-Turk-Duane syndrome]". J. Fr. Ophtalmol. (in French). 19 (8–9): 533–42. PMID 8944136. Further reading [ edit ] Andrews, Caroline V.; Hunter, David G.; Engle, Elizabeth C. (1993). "Duane Syndrome".[en.wikipedia.org]
  • Differences in epidemiological and clinical characteristics between various types of Duane retraction syndrome in 331 patients. J AAPOS 2008; 12:576-80. Kekunnaya R, Gupta A, Sachdeva V, Krishnaiah S, Rao BV, Vashist U, Ray D.[djo.org.in]
  • Duane syndrome is also associated with better defined syndromes like Okihiro’s, Wildervanck, Holt-Oram, Goldenhar and Mobius syndromes. [3] Epidemiology One to five percent of people in the general population will acquire strabismus.[syndromespedia.com]
Sex distribution
Age distribution

Pathophysiology

  • Considerations on pathophysiology and aetiology. Transactions of the Fifth International Orthoptic Congress, Cannes., pp.119-125. Journal Kim, J. H. and Hwang, J.[citethisforme.com]
  • […] movement Stilling and Turk : described it first Duane popularised it Classic features Limitation of abduction Slight limitation of adduction Retraction of globe on adduction Adduction narrowing of palpebral fissure Upshoot / downshoot of eye in adduction 3 Pathophysiology[slideplayer.com]
  • As DRS type 3 partly share the same pathophysiology with type 1 and 2 DRS, the classification of DRS may have to be revised according to MRI findings.[journals.plos.org]
  • […] irregularly dominant manner with incomplete penetrance and variable expressivity [2] Duane Retraction Syndrome results from an absent or dysplastic abducens motor neurons with aberrant innervations of the lateral rectus muscle by the oculomotor nerve. [7] Pathophysiology[eyewiki.aao.org]
  • Huber A (1984) Duane’s Retraction Syndrome: Consideration of Pathophysiology and Etiology. In: Grune & Stratton Orlando (Eds.), Florida, USA, pp. 345-361.[medcraveonline.com]

Prevention

  • How do you Prevent Duane’s Syndrome? Sporadic Duane’s syndrome cannot be prevented as they occur spontaneously in offspring of normal parents.[medindia.net]
  • The goal of treatment is to restore satisfactory eye alignment in the straight-ahead position, eliminate abnormal head posture, and prevent amblyopia.[eyehealthweb.com]
  • This condition prevents outward movement of the eye (toward the ear), and in some cases may also limit inward eye movement (toward the nose). As the eye moves inward, the eyelids partially close and the eyeball pulls back (retracts) into its socket.[diseaseinfosearch.org]
  • Surveillance is necessary to prevent or detect amblyopia. Vision therapy is advised for secondary convergence insufficiency.[orpha.net]

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