摘要
AIM:To review the demographics,clinical manifestations,and surgical experiences of patients with congenital ocular counter-roll,whose treatments were performed exclusively by ophthalmologists.METHODS:A retrospective review was conducted consisting of patients who received strabismus surgery between 2017 to 2019.Patients with obvious ocular counter-roll were included.RESULTS:A total of 7008 patients who received strabismus surgery,28(12 males,16 females)were diagnosed as congenital ocular counter-roll,accounting for 0.40%.All patients were initially misdiagnosed:21 patients were misdiagnosed as superior oblique palsy(SOP),3 as inferior oblique overaction,2 as dissociated vertical deviation(DVD),1 as superior oblique overaction with A-pattern exotropia,and 1 as medial rectus palsy.The mean±SD age was 12.4±9.4 y(range 2.5-36 y).The most common clinical findings included ocular counter-roll,vertical deviation or vertical deviation combined with outward deviation and head tilt.At follow-up,an excellent surgical result was achieved in 20 patients.Preoperative horizontal deviation of 26±24 prism diopter(PD)and vertical deviation of 18±12 PD were reduced to 0±12 PD(P=0.0001)and 3±4 PD(P=0.001),respectively.CONCLUSION:Congenital ocular counter-roll is a rare supranuclear vertical strabismus caused by congenital abnormalities involving vestibule-ocular reflex pathways.In addition to ocular counter-roll,the most salient clinical features included,but are not limited to,hyperdeviation,outward deviation,overelevation in adduction and head tilt.
