Clinical Features and Natural Course of Superior Oblique Palsy.

Hyun, Joo; Kim, So Young

doi:2013.54.4.627

J Korean Ophthalmol Soc > Volume 54(4); 2013 > Article

Original Article

Journal of the Korean Ophthalmological Society 2013;54(4):627-631.
DOI: https://doi.org/10.3341/jkos.2013.54.4.627 Published online April 30, 2013.

Clinical Features and Natural Course of Superior Oblique Palsy.

Joo Hyun, So Young Kim

Department of Ophthalmology, Soonchunhyang University College of Medicine, Cheonan, Korea. ophdrkim@gmail.com

상사근 마비의 임상 양상과 자연 경과

현 주⋅김소영

Department of Ophthalmology, Soonchunhyang University College of Medicine, Cheonan, Korea

Abstract

PURPOSE
To evaluate the natural course of superior oblique palsy (SOP) with objective criteria, and to show the contemporary etiology and recovery rates among several factors. The clinical features of SOP were compared to previous studies. METHODS: A retrospective chart review of 80 patients diagnosed with SOP between January 1, 2006 and December 31, 2011 was performed. RESULTS: Clinical SOP features showed variation when compared to previous studies. Out of 80 patients, 71 were identified with unilateral isolated and 9 bilateral cases of SOP. Twenty cases were congenital and 60 cases were acquired SOPs. Acquired SOPs were affected most commonly by trauma (31%) and vascular disease (30%). Twenty-four out of 49 patients, who were followed up over 2 months after the first visit recovered, especially vascular origin cases, which was statistically significant (75%, p = 0.000). Patients with initial vertical deviation smaller than 5 Prism diopters (PD) experienced a more successful recovery than patients with an initial deviation larger than 5 PD. CONCLUSIONS: SOP has different recovery rates depending on the etiology. Accurate ocular examination and understanding of SOP etiology are necessary for successful treatment.

Key Words: Etiology;Natural history;Paralytic strabismus;Superior oblique palsy;Trochlear nerve palsy