Tehran University of Medical Sciences
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Ahmad Ameri

DUANE'S RETRACTION SYNDROME, A CASE SERIES FROM IRAN


Authors: F. Anvari, A. Ameri, A. Eskandari
Keywords: DUANE'S RETRACTION SYNDROME, LEASH PHENOMENON, HEAD POSTURE
Journal of Current Ophthalmology, Vol.15, No.4, 2005,Page:85-90

Purpose: Duane's retraction syndrome (DRS) has been extensively studied in Western populations, but few comprehensive reports from other countries are available. So, we report the prevalence and clinical features of DRS in a series of strabismus cases from a single institute in Iran.
Materials & Methods: In this retrospective study, 7,349 cases of strabismus seen during 2000-2003 were evaluated. Data regarding the age at onset, type, posture, primary position deviation, palpebral fissure, Leash phenomenon, refractive error, amblyopia, and history of surgery were collected and analyzed using appropriate statistical methods.
Results: One hundred and twenty-five DRS cases were diagnosed (prevalence: 1.7%). The onset was at birth in 35.6%, during infancy in 25.4%, and during childhood in 39% of the cases. The age at referral ranged from 3.5 months to 65 years (median: 10 years). The female to male and left to right eye involvement ratios were 3:2 and 3.5:1 respectively. The most common form of the syndrome was type I (109 patients, 87%). Type II and III were present in 6.5% and 5.7% of the patients respectively. 7.2% had bilateral DRS. Horizontal deviations (median: 20 PD) was resent in 76% and vertical deviations (median: 8.2 PD) in 12.8% of subjects. Leash phenomenon was detected in 37.6% of cases. 26.8% were amblyopic. Head turn, primary position deviation without posture), and orthophoria were observed in 71.2%, 13.6%, and 15.2% of cases respectively. Surgery had been performed in 71.2% of cases. Vertical deviations and Leash phenomenon were more common in types II and III, and hypermetropia was more common in type I (P values: 0.036, < 0.004 and 0.025).
Conclusion: Basic features of our DRS series seem to be comparable with previous reports. The incidences of bilateral involvement and type III DRS were lower. The proportion of cases with posturing and