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NR 7-9/2007
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Trudności w
diagnostyce i leczeniu zdysocjowanego odchylenia pionowego (DVD).
Część II – doświadczenia własne
Difficulties in diagnosis
and treatment of dissociated vertical deviation (DVD).
Part II – own experiences
Anna Broniarczyk-Loba1,
Olimpia Nowakowska2, Piotr Loba3
1Z Przyklinicznej Poradni Leczenia Zeza przy
Uniwersyteckim Szpitalu Klinicznym nr 1 im. N. Barlickiego w
Łodzi
2Z Kliniki Chorób Oczu Uniwersytetu Medycznego w
Łodzi
3Z Koła Naukowego przy Klinice Chorób Oczu
Uniwersytetu Medycznego w Łodzi
Kierownik: prof. dr hab. n. med. Wojciech Omulecki |
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| Summary: |
Oblique muscles motility
disorders may influence the magnitude of dissociated
vertical deviation (DVD), resulting in greater vertical
deviation in abduction and smaller in adduction. The
diagnosis of this pattern of dissociation is essential
for the selection of appropriate surgical management.
Purpose: The aim of this study was to assess
optimal diagnostic and treatment procedures in patients
with incomitant dissociated vertical deviation, superior
oblique overaction and esotropia.
Patients and methods: Five patients with the
constellation of esotropia, bilateral superior oblique
overaction, A –pattern, and incomitant dissociated
vertical deviation are presented. In each case the
magnitude of vertical deviation was greater in abduction
and minimal or absent in adduction. Four patients
underwent asymmetric bilateral superior rectus
recessions and partial tenotomy of the posterior and
middle fibers of superior oblique tendons. In one case
additional surgery of horizontal muscles was performed.
Results: In all cases the A–pattern, DVD was
markedly reduced or eliminated, and comitancy was
achieved.
Conclusion: Recognition of the described pattern
is important in selecting appropriate surgical
management. Asymmetric bilateral superior rectus
recessions and partial tenotomy of the posterior and
middle fibers of superior oblique tendons is useful in
reducing the A – pattern and incommitancy in DVD. |
| Słowa kluczowe: |
nietowarzyszące
zdysocjowane odchylenie pionowe (DVD), nadczynność
mięśni skośnych górnych, zespół A, zez zbieżny. |
| Key words: |
incomitant dissociated
vertical deviation (DVD), superior oblique overaction, A
pattern, strabismus convergens. |
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