Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3)
Purpose: To describe a case of incomitant divergence insufficiency esotropia in the setting of Machado-Joseph disease (spinocerebellar ataxia type 3) that recurred completely within one week after augmented bilateral medial rectus recession. Observations: A 53-year-old female with a history of Macha...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-12-01
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| Series: | American Journal of Ophthalmology Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S245199362200500X |
| _version_ | 1811185495244275712 |
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| author | Jeannette Y. Stallworth Nailyn Rasool Maanasa Indaram |
| author_facet | Jeannette Y. Stallworth Nailyn Rasool Maanasa Indaram |
| author_sort | Jeannette Y. Stallworth |
| collection | DOAJ |
| description | Purpose: To describe a case of incomitant divergence insufficiency esotropia in the setting of Machado-Joseph disease (spinocerebellar ataxia type 3) that recurred completely within one week after augmented bilateral medial rectus recession. Observations: A 53-year-old female with a history of Machado-Joseph disease presented with horizontal diplopia primarily at distance consistent with divergence insufficiency esotropia. Augmented bilateral medial rectus recessions were performed which initially produced orthotropia, but recurrence of the esodeviation to the full preoperative amount occurred by post-operative week one. The patient subsequently underwent bilateral lateral rectus resections with excellent result. Conclusions and importance: Divergence insufficiency is common in the spinocerebellar ataxia variants and is thought to be secondary to atrophy of brainstem structures involved in the control of ocular vergence. Strabismus surgery in these patients may be complicated by limited response or even rapid regression despite augmented surgery as suggested for divergence insufficiency in the setting of neurologic disease. Patients should be counseled on these risks as well as the potential for multiple procedures in order to achieve surgical success. |
| first_indexed | 2024-04-11T13:30:19Z |
| format | Article |
| id | doaj.art-c01455fc07494ca0961b739fcfc067b0 |
| institution | Directory Open Access Journal |
| issn | 2451-9936 |
| language | English |
| last_indexed | 2024-04-11T13:30:19Z |
| publishDate | 2022-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | American Journal of Ophthalmology Case Reports |
| spelling | doaj.art-c01455fc07494ca0961b739fcfc067b02022-12-22T04:21:50ZengElsevierAmerican Journal of Ophthalmology Case Reports2451-99362022-12-0128101754Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3)Jeannette Y. Stallworth0Nailyn Rasool1Maanasa Indaram2Department of Ophthalmology, University of California, San Francisco, United States; Corresponding author. University of California, Department of Ophthalmology, 490 Illinois Street, Floor 5, Room 5X8, San Francisco, CA, 94158, United States.Department of Ophthalmology, University of California, San Francisco, United States; Department of Neurology, University of California, San Francisco, United StatesDepartment of Ophthalmology, University of California, San Francisco, United StatesPurpose: To describe a case of incomitant divergence insufficiency esotropia in the setting of Machado-Joseph disease (spinocerebellar ataxia type 3) that recurred completely within one week after augmented bilateral medial rectus recession. Observations: A 53-year-old female with a history of Machado-Joseph disease presented with horizontal diplopia primarily at distance consistent with divergence insufficiency esotropia. Augmented bilateral medial rectus recessions were performed which initially produced orthotropia, but recurrence of the esodeviation to the full preoperative amount occurred by post-operative week one. The patient subsequently underwent bilateral lateral rectus resections with excellent result. Conclusions and importance: Divergence insufficiency is common in the spinocerebellar ataxia variants and is thought to be secondary to atrophy of brainstem structures involved in the control of ocular vergence. Strabismus surgery in these patients may be complicated by limited response or even rapid regression despite augmented surgery as suggested for divergence insufficiency in the setting of neurologic disease. Patients should be counseled on these risks as well as the potential for multiple procedures in order to achieve surgical success.http://www.sciencedirect.com/science/article/pii/S245199362200500XDivergence-insufficiency esotropiaMachado-Joseph diseaseSpinocerebellar ataxia |
| spellingShingle | Jeannette Y. Stallworth Nailyn Rasool Maanasa Indaram Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3) American Journal of Ophthalmology Case Reports Divergence-insufficiency esotropia Machado-Joseph disease Spinocerebellar ataxia |
| title | Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3) |
| title_full | Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3) |
| title_fullStr | Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3) |
| title_full_unstemmed | Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3) |
| title_short | Recurrent divergence-insufficiency esotropia in Machado-Joseph disease (spinocerebellar ataxia type 3) |
| title_sort | recurrent divergence insufficiency esotropia in machado joseph disease spinocerebellar ataxia type 3 |
| topic | Divergence-insufficiency esotropia Machado-Joseph disease Spinocerebellar ataxia |
| url | http://www.sciencedirect.com/science/article/pii/S245199362200500X |
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