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Cho, Lee, and Lee: Clinical Evaluation of Excyclotorsion in Patients with Primary Inferior Oblique Overaction
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1324-1329.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1324

Clinical Evaluation of Excyclotorsion in Patients with Primary Inferior Oblique Overaction

Soon Young Cho, MD1, Se Youp Lee, MD, PhD2, Young Chun Lee, MD, PhD1

1Department of Ophthalmology and Visual Science, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea.

2Department of Ophthalmology, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Korea.

Address reprint requests to Young Chun Lee, MD, PhD. Department of Ophthalmology, Uijeongbu St. Mary's Hospital, #271 Cheonbo-ro, Uijeongbu 480-717, Korea. Tel: 82-31-820-3116, Fax: 82-31-847-3418, yclee@cmcnu.or.kr

Received 15 July 2011       Accepted 14 July 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To evaluate the amount of excyclotorsion according to degree of inferior oblique overaction (IOOA) in patients with primary IOOA.

Methods

Fifty-nine primary IOOA patients who underwent inferior oblique muscle surgery were evaluated. Visual acuity, ocular movement test, prism cover test, Bielschowsky head tilt test, fundus photograph and photographic examination for excyclotorsion were performed. The correlation analysis was performed for the excyclotorsion according to the amount of IOOA (Control group; IOOA < 1, Group 1; 1 ≤ IOOA < 2, Group 2; 2 ≤ IOOA < 3, Group 3; 3 ≤ IOOA < 4, Group 4; IOOA = 4).

Results

Excyclotorsion was 7.37 ± 2.36° in the Control group, 9.29 ± 3.79° in Group 1, 10.04 ± 4.39° in Group 2, 17.98 ± 4.62° in Group 3, and 24.70 ± 4.61° in Group 4. The amount of IOOA and excyclotorsion showed a positive correlation (Pearson's correlation coefficient r = 0.675). Asymmetric IOOA was observed in 35 patients (59.3%) and symmetric IOOA was observed in 24 patients (40.7%). Asymmetric IOOA combined with hypertropia was presented in 9 patients (37.5%) and symmetric IOOA combined with hypertropia was presented in 3 patients (8.6%). Therefore, patients with asymmetric IOOA have a higher incidence of vertical diplopia. The amounts of IOOA and excyclotorsion were greater in primary IOOA with esotropia than in subjects with exotropia (p = 0.001).

Conclusions

The excyclotorsion was proportional to the amount of IOOA in Group 3 and Group 4. The aspect of excyclotorsion was widely distributed in Group 1 and Group 2 compared to that in the Control group.

Keywords: Excyclotorsion, Primary inferior oblique overaction

Figures and Tables

Figure 1
The relationship of the inferior oblique overaction and excyclotorsion.
jkos-53-1324-g001
Figure 2
Histogram of distribution of excyclotorsion according to inferior oblique overaction.
jkos-53-1324-g002
Table 1
Demographic data of patients
jkos-53-1324-i001

Values are presented as number (%) or mean ± SD.

IOOA = inferior oblique overaction.

Table 2
The amount of excyclotorsion according to IOOA
jkos-53-1324-i002

Values are presented as mean ± SD.

IOOA = inferior oblique overaction.

*Statistical significances were tested by one-way analysis of variances among groups; †The same letters indicate non-significant difference between groups based on Turkey's multiple comparison test.

Table 3
Comparison of symmetric IOOA and asymmetric IOOA
jkos-53-1324-i003

IOOA = inferior oblique overaction.

Table 4
Comparison of excyclotorsion in IOOA associated with esotropia and exotropia
jkos-53-1324-i004

Values are presented as mean ± SD.

IOOA = inferior oblique overaction.

*Statistical significances were tested by independent t-test between groups.

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