Utility of Magnetic Resonance Imaging (MRI) in Children With Strabismus

Purpose: Magnetic resonance imaging (MRI) of the brain can provide valuable information about structural abnormalities in strabismus. The aim of this study was to evaluate the utility of MRI in this regard and to identify risk factors for abnormal MRI results in children with strabismus. Methods: A retrospective analysis of children <18 years of age presenting with strabismus, who underwent brain MRI at Pusan National University Hospital (Busan, Korea) between January 2012 and March 2017, was performed. Clinical characteristics, MRI results, and ophthalmologic findings were reviewed. Findings were classified as normal or abnormal according to MRI results. Additionally, patients were divided according to age to compare characteristics of infantile and childhood strabismus. Results: A total of 90 patients (47 [52.2%] male, 43 [47.8%] female; mean age, 2.19 ± 0.53 years) were enrolled. Of those, 64 (71.1%) presented with normal and 26 (28.9%) with abnormal MRI results. The age at presentation was lower and abnormal findings on fundus examination were more common in the abnormal MRI group (P = .002 and P = .008, respectively). Among the patients, 46 (51.1%) had infantile strabismus and 44 (48.9%) had childhood strabismus. Global developmental delays, speech delays, and MRI abnormalities were more common in patients with infantile than in those with childhood strabismus. Ptosis and headaches were more common in patients with childhood strabismus (P = .025, P = .025, respectively). Conclusion: Brain MRI was helpful for accurate diagnosis and treatment of strabismus in younger children, those with abnormal findings on fundus examination, and infants with developmental, especially speech, delays.

[1]  K. Golnik,et al.  Ophthalmologic Findings in Patients with Neuro-metabolic Disorders , 2018, Journal of ophthalmic & vision research.

[2]  İ. Koç,et al.  Bilateral optic disc pathologies as an accompanying feature of comitant strabismus in children , 2018, International Ophthalmology.

[3]  K. Gunton,et al.  The role of imaging in strabismus , 2017, Current opinion in ophthalmology.

[4]  J. Polling,et al.  Neurological Imaging in Acquired Cranial Nerve Palsy: Ophthalmologists vs. Neurologists , 2017, Strabismus.

[5]  J. H. Kim,et al.  Imaging of Cranial Nerves III, IV, VI in Congenital Cranial Dysinnervation Disorders , 2017, Korean journal of ophthalmology : KJO.

[6]  Q. Gong,et al.  Magnetic resonance imaging of the functional anatomy of the superior oblique muscle in patients with primary superior oblique overaction , 2016, Eye.

[7]  N. Ali,et al.  Diagnosis and management of childhood squints: investigation and examination with reference to red flags and referral letters. , 2017, The British journal of general practice : the journal of the Royal College of General Practitioners.

[8]  G. Santorelli,et al.  Prevalence and Risk Factors of Strabismus in a UK Multi-ethnic Birth Cohort , 2016, Strabismus.

[9]  H. Atilla,et al.  Comparison of Surgical Success for Infantile Esotropia and Strabismus Associated with Neurological Impairment , 2016, Strabismus.

[10]  Matteo Porro,et al.  Moebius syndrome: clinical features, diagnosis, management and early intervention , 2016, Italian Journal of Pediatrics.

[11]  E. Karahan,et al.  Ocular, Neurologic and Systemic Findings of the Cases with Optic Nerve Hypoplasia , 2016, The open ophthalmology journal.

[12]  J. Demer,et al.  Size of the Oblique Extraocular Muscles and Superior Oblique Muscle Contractility in Brown Syndrome. , 2015, Investigative ophthalmology & visual science.

[13]  Hu Liu,et al.  Prevalence of amblyopia and strabismus in Eastern China: results from screening of preschool children aged 36–72 months , 2015, British Journal of Ophthalmology.

[14]  C. Lyons,et al.  Cranial nerve palsies in childhood , 2015, Eye.

[15]  Hui-Chen Cheng,et al.  Neuroimaging and clinical features of patients with optic nerve hypoplasia in Taiwan , 2015, Taiwan journal of ophthalmology.

[16]  Manuel J. Amador-Patarroyo,et al.  Congenital anomalies of the optic nerve. , 2015, Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society.

[17]  I. Gottlob,et al.  Risk factors and genetics in common comitant strabismus: a systematic review of the literature. , 2013, JAMA ophthalmology.

[18]  C. Jung,et al.  MR Imaging of Congenital or Developmental Neuropathic Strabismus: Common and Uncommon Findings , 2012, American Journal of Neuroradiology.

[19]  L. Amaral,et al.  Imaging Findings in Congenital Cranial Dysinnervation Disorders , 2011, Topics in magnetic resonance imaging : TMRI.

[20]  P. Lefèvre,et al.  Review of the major findings about Duane retraction syndrome (DRS) leading to an updated form of classification , 2010, Vision Research.

[21]  Sashank Prasad,et al.  Paralytic strabismus: third, fourth, and sixth nerve palsy. , 2010, Neurologic clinics.

[22]  P. Cumberland,et al.  Prevalence of and early-life influences on childhood strabismus: findings from the Millennium Cohort Study. , 2010, Archives of pediatrics & adolescent medicine.

[23]  J. Ott,et al.  Chromosomes 4q28.3 and 7q31.2 as new susceptibility loci for comitant strabismus. , 2009, Investigative ophthalmology & visual science.

[24]  L. Jacobson,et al.  Visual impairment is common in children born before 25 gestational weeks—boys are more vulnerable than girls , 2008, Acta paediatrica.

[25]  P. Garcia-Filion,et al.  The syndrome of optic nerve hypoplasia , 2008, Current neurology and neuroscience reports.

[26]  N. Kadom.  Pediatric strabismus imaging , 2008, Current opinion in ophthalmology.

[27]  L. Skov,et al.  Visual dysfunctions and ocular disorders in children with developmental delay. I. prevalence, diagnoses and aetiology of visual impairment. , 2007, Acta ophthalmologica Scandinavica.

[28]  P. Mitchell,et al.  Factors associated with childhood strabismus: findings from a population-based study. , 2006, Ophthalmology.

[29]  B. Kushner.  Multiple mechanisms of extraocular muscle "overaction". , 2006, Archives of ophthalmology.

[30]  J. Demer,et al.  High-resolution magnetic resonance imaging demonstrates abnormalities of motor nerves and extraocular muscles in patients with neuropathic strabismus. , 2006, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[31]  J. H. Kim,et al.  Presence of the abducens nerve according to the type of Duane's retraction syndrome. , 2005, Ophthalmology.

[32]  J. Pearce.  Parinaud’s syndrome , 2004, Journal of Neurology, Neurosurgery & Psychiatry.

[33]  H. W. Brown.  True and simulated superior oblique tendon sheath syndromes , 1973, Documenta Ophthalmologica.

[34]  R. Leigh,et al.  Nystagmus and Related Ocular Motility Disorders , 2004 .

[35]  J. Nathans,et al.  A strabismus susceptibility locus on chromosome 7p , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[36]  J. Demer,et al.  A 12-year, prospective study of extraocular muscle imaging in complex strabismus. , 2002, Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus.

[37]  B. Källén,et al.  Optic nerve hypoplasia: Risk factors and epidemiology. , 2002, Acta ophthalmologica Scandinavica.

[38]  A. Hellström,et al.  Ocular fundus abnormalities in children born before 29 weeks of gestation: A population-based study , 2000, Eye.

[39]  R. Kono,et al.  Comparative Study of Brain Lesions Detected by Magnetic Resonance Imaging between Strabismus and Nonstrabismus in Infancy , 2000, Ophthalmologica.

[40]  Andrea Guzzetta,et al.  Correlation between visual function, neurodevelopmental outcome, and magnetic resonance imaging findings in infants with periventricular leucomalacia , 2000, Archives of Disease in Childhood: Fetal and Neonatal Edition.

[41]  A. Hellström,et al.  Visual function in school‐aged children born before 29 weeks of gestation: a population‐based study , 2000, Developmental medicine and child neurology.

[42]  J. Flynn,et al.  Pediatric photoscreening for strabismus and refractive errors in a high-risk population. , 1999, Ophthalmology.

[43]  P. Davis,et al.  Imaging of the pediatric orbit and visual pathways: computed tomography and magnetic resonance imaging. , 1999, Neuroimaging clinics of North America.

[44]  S. Galetta,et al.  Sixth nerve palsies in children. , 1999, Pediatric neurology.

[45]  E. Palmer,et al.  Strabismus in premature infants in the first year of life. Cryotherapy for Retinopathy of Prematurity Cooperative Group. , 1998, Archives of ophthalmology.

[46]  G. Cioni,et al.  CORRECTION BETWEEN CEREBRAL VISUAL IMPAIRMENT AND MAGNETIC RESONANCE IMAGING IN CHILDREN WITH NEONATAL ENCEPHALOPATHY , 1996, Developmental medicine and child neurology.

[47]  D. Kumar.  Moebius syndrome. , 1990, Journal of medical genetics.

[48]  A. Stanworth,et al.  Strabismus , 1974 .