The Relationship of Hypertropia, Inferior Oblique Overaction and Extorsion in Congenital Superior Oblique Palsy

Min Hye Song; Se Youp Lee; Young Chun Lee

doi:10.3341/jkos.2007.48.10.1394

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Song, Lee, and Lee: The Relationship of Hypertropia, Inferior Oblique Overaction and Extorsion in Congenital Superior Oblique Palsy

Original Article

J Korean Ophthalmol Soc 2007;48(10):1394-1398.

Published online: 30 August 2007

DOI: https://doi.org/10.3341/jkos.2007.48.10.1394

The Relationship of Hypertropia, Inferior Oblique Overaction and Extorsion in Congenital Superior Oblique Palsy

Min Hye Song, M.D.¹, Se Youp Lee, M.D.², Young Chun Lee, M.D.¹

¹Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Korea

²Department of Ophthalmology, Keimyung University School of Medicine, Daegu, Korea

Address reprint requests to Young Chun Lee, M.D., Department of Ophthalmology, Uijeongbu St. Mary's Hospital, The Catholic University of Korea, College of Medicine, #65-1 Gumoho-dong, Uijeongbu, GyeonggI-do 480-821, Korea, Tel: 82-31-820-3022, Fax: 82-31-847-3418, E-mail: leeyc@cmc.cuk.ac.kr

Received 26 December 2006 Accepted 4 July 2007

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the correlation among hypertropia, inferior oblique overaction (IOOA), and extorsion.

Methods

Thirty-one patients with congenital unilateral superior oblique palsy were evaluated. Visual acuity tests, refraction tests, ocular movement tests, prism cover tests, and fundus photography were performed. The correlations of vertical deviation, IOOA, and extorsion were analyzed. The operation method involved weakening the inferior oblique muscle, and then a comparison was made between measurements 1 month preoperative and 1 month postoperative for vertical deviation, inferior oblique overaction, and extorsion.

Results

On average, preoperative hypertropia was 8.84±6.88 prism diopters (PD), IOOA was 2.20±0.69, and extorsion was 18.06±5.83°. The Pearson's correlation of IOOA and extorsion, hypertropia and IOOA, and extorsion and hypertropia were r=0.620, r=0.327, and r=0.126, respectively. Postoperative hypertropia, IOOA, and extorsion were reduced to 1.42±3.11PD, 0.42±1.11, and 8.63±5.09, respectively.

Conclusions

Both extorsion and hypertropia showed significant positive correlations with IOOA, whereas hypertropia and extorsion revealed somewhat weaker positive correlations in congenital monocular superior oblique palsy. In addition, the amount of hypertropia was reduced, and extorsion and IOOA improved after recession of the inferior oblique muscle.

Keywords: Extorsion, Hypertropia, Inferior oblique overaction, Superior oblique palsy

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Figure 1.

Correlation between inferior oblique overaction and extorsion. (Pearson's correlation r=0.620)

Figure 2.

Correlation between hypertropia and inferior oblique overaction. (Pearson's correlation r=0.327)

Figure 3.

Correlation between hypertropia and extorsion. (Pearson's correlation r=0.126)

Table 1.

Comparison of preoperative and postoperative values in hypertropia, inferior oblique overaction and extorsion

	Hypertropia (PD)		Inferior oblique overaction		Extorsion (°)
	Preop^*	Postop^†	Preop	Postop	Preop	Postop
Mean±SD	8.84±6.88	1.42±3.11	2.20±0.69	0.42±1.11	18.06±5.83	8.63±5.09
P value	<0.001		<0.001		<0.001

^* Preop = Preoperative;

^† Postop = Postoperative.

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