Astigmatism in Duane Retraction Syndrome

Abstract Purpose To compare the prevalence, magnitude, and type of astigmatism among patients with different Duane Retraction Syndrome (DRS) types. Method This retrospective cross-sectional study reviewed the records of 312 DRS patients. Patients were categorized into DRS Types 1, 2, 3, and bilatera...

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Main Authors: Masoud Khorrami-Nejad, Mohammad Reza Akbari, Babak Masoomian, Hayder Ali Mahmood, Kimia Daneshvar, Ali Majdi
Format: Article
Language:English
Published: BMC 2025-01-01
Series:BMC Ophthalmology
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Online Access:https://doi.org/10.1186/s12886-025-03855-w
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author Masoud Khorrami-Nejad
Mohammad Reza Akbari
Babak Masoomian
Hayder Ali Mahmood
Kimia Daneshvar
Ali Majdi
author_facet Masoud Khorrami-Nejad
Mohammad Reza Akbari
Babak Masoomian
Hayder Ali Mahmood
Kimia Daneshvar
Ali Majdi
author_sort Masoud Khorrami-Nejad
collection DOAJ
description Abstract Purpose To compare the prevalence, magnitude, and type of astigmatism among patients with different Duane Retraction Syndrome (DRS) types. Method This retrospective cross-sectional study reviewed the records of 312 DRS patients. Patients were categorized into DRS Types 1, 2, 3, and bilateral cases. Refractive errors and visual acuity were analyzed, emphasizing the prevalence of astigmatism types, specifically with-the-rule (WTR), against-the-rule (ATR), and oblique, as well as the power vectors for each DRS subtype. Results Our study included 312 patients with DRS, comprising 44.6% males and a median age of 18.5 years (interquartile range [IQR]: 7–27). Of these, 280 had unilateral DRS and 32 had bilateral DRS. The median age for unilateral DRS patients was 19 years (IQR: 7–27; 43.2% males), whereas for bilateral DRS patients, it was 16 years (IQR: 6-29.2; 56.3% males). In all DRS patients, 180 (57.7%) were diagnosed with Type 1 DRS, 87 (27.9%) with Type 2 DRS, and 45 (14.4%) with Type 3 DRS. In unilateral cases, WTR astigmatism was the most prevalent (56.8%), followed by oblique (23.6%) and ATR astigmatism (19.6%). Bilateral DRS patients exhibited a similar distribution in both eyes, with WTR astigmatism also being predominant. The comparative analysis of power vectors indicated that Type 1 DRS exhibited a greater prevalence of WTR and oblique astigmatism, whereas ATR astigmatism was the predominant pattern in Types 2 and 3. A comparison of cylindrical powers and power vectors among fellow eyes of different DRS subtypes revealed that Type 2 DRS had significantly higher cylindrical power (p = 0.017) and a greater tendency toward ATR astigmatism (p = 0.038) than fellow eyes in other subtypes, suggesting that astigmatic changes may also occur in fellow eyes. Conclusion Our study demonstrates a high prevalence of astigmatism, particularly WTR astigmatism, in DRS patients. Furthermore, we found significant associations between specific astigmatism patterns and DRS subtypes, suggesting a potential link between extraocular muscle innervation, co-contraction, and corneal shape. These findings highlight the importance of comprehensive astigmatism assessment in DRS patients for optimal refractive management.
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spelling doaj-art-af606f1cc2cb4ea9ad861c3a868f0e822025-08-20T02:56:15ZengBMCBMC Ophthalmology1471-24152025-01-012511910.1186/s12886-025-03855-wAstigmatism in Duane Retraction SyndromeMasoud Khorrami-Nejad0Mohammad Reza Akbari1Babak Masoomian2Hayder Ali Mahmood3Kimia Daneshvar4Ali Majdi5Optometry Department, School of Rehabilitation, Tehran University of Medical SciencesTranslational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesTranslational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesOptometry Department, School of Rehabilitation, Tehran University of Medical SciencesTranslational Ophthalmology Research Center, Farabi Eye Hospital, Tehran University of Medical SciencesMedical Laboratories Techniques Department, College of Health and Medical Techniques, Al-Mustaqbal UniversityAbstract Purpose To compare the prevalence, magnitude, and type of astigmatism among patients with different Duane Retraction Syndrome (DRS) types. Method This retrospective cross-sectional study reviewed the records of 312 DRS patients. Patients were categorized into DRS Types 1, 2, 3, and bilateral cases. Refractive errors and visual acuity were analyzed, emphasizing the prevalence of astigmatism types, specifically with-the-rule (WTR), against-the-rule (ATR), and oblique, as well as the power vectors for each DRS subtype. Results Our study included 312 patients with DRS, comprising 44.6% males and a median age of 18.5 years (interquartile range [IQR]: 7–27). Of these, 280 had unilateral DRS and 32 had bilateral DRS. The median age for unilateral DRS patients was 19 years (IQR: 7–27; 43.2% males), whereas for bilateral DRS patients, it was 16 years (IQR: 6-29.2; 56.3% males). In all DRS patients, 180 (57.7%) were diagnosed with Type 1 DRS, 87 (27.9%) with Type 2 DRS, and 45 (14.4%) with Type 3 DRS. In unilateral cases, WTR astigmatism was the most prevalent (56.8%), followed by oblique (23.6%) and ATR astigmatism (19.6%). Bilateral DRS patients exhibited a similar distribution in both eyes, with WTR astigmatism also being predominant. The comparative analysis of power vectors indicated that Type 1 DRS exhibited a greater prevalence of WTR and oblique astigmatism, whereas ATR astigmatism was the predominant pattern in Types 2 and 3. A comparison of cylindrical powers and power vectors among fellow eyes of different DRS subtypes revealed that Type 2 DRS had significantly higher cylindrical power (p = 0.017) and a greater tendency toward ATR astigmatism (p = 0.038) than fellow eyes in other subtypes, suggesting that astigmatic changes may also occur in fellow eyes. Conclusion Our study demonstrates a high prevalence of astigmatism, particularly WTR astigmatism, in DRS patients. Furthermore, we found significant associations between specific astigmatism patterns and DRS subtypes, suggesting a potential link between extraocular muscle innervation, co-contraction, and corneal shape. These findings highlight the importance of comprehensive astigmatism assessment in DRS patients for optimal refractive management.https://doi.org/10.1186/s12886-025-03855-wDuane retraction syndromeAstigmatismRefractive errorsPower vectors
spellingShingle Masoud Khorrami-Nejad
Mohammad Reza Akbari
Babak Masoomian
Hayder Ali Mahmood
Kimia Daneshvar
Ali Majdi
Astigmatism in Duane Retraction Syndrome
BMC Ophthalmology
Duane retraction syndrome
Astigmatism
Refractive errors
Power vectors
title Astigmatism in Duane Retraction Syndrome
title_full Astigmatism in Duane Retraction Syndrome
title_fullStr Astigmatism in Duane Retraction Syndrome
title_full_unstemmed Astigmatism in Duane Retraction Syndrome
title_short Astigmatism in Duane Retraction Syndrome
title_sort astigmatism in duane retraction syndrome
topic Duane retraction syndrome
Astigmatism
Refractive errors
Power vectors
url https://doi.org/10.1186/s12886-025-03855-w
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