Korean J Ophthalmol > Epub ahead of print
DOI: https://doi.org/10.3341/kjo.2021.0149    [Epub ahead of print]
Published online January 24, 2022.
Spontaneous Recovery of Traumatic Unilateral Superior Oblique Palsy and Ocular Factors for Predicting Prognosis
Hyeongjun Park1, Donghun Lee2, Sook Young Kim2, Won Jae Kim1
1Department of Ophthalmology, Yeungnam University College of Medicine, Daegu, South Korea
2Department of Ophthalmology, Catholic University of Daegu School of Medicine, Daegu, Korea
Correspondence:  Won Jae Kim, Tel: 82-53-620-4191, Fax: 82-53-626-5936, 
Email: eyekwj@gmail.com
Received: 16 September 2021   • Revised: 5 December 2021   • Accepted: 20 December 2021
Abstract
Purpose
This study evaluated the prognosis of patients with traumatic unilateral superior oblique palsy (SOP) and clinical factors associated with spontaneous resolution.
Methods
Medical records of patients with traumatic unilateral SOP who visited two hospitals (*** and *** Hospital) between January 2015 and June 2020 were reviewed retrospectively. When traumatic unilateral SOP did not recover within at least 1 year of follow-up, no spontaneous resolution was considered. Both traumatic and ocular factors were evaluated to evaluate their association with spontaneous recovery.
Result
s: Fifty-nine patients (mean age: 52.6 years, 48 men) were enrolled in this study. The mean interval from trauma to initial presentation was 3.9 months. The mean vertical deviation at initial presentation was 6.34 ± 5.22 (range: 0–25) PD. During the mean 24.1-month follow-up period, 28 (47.5%) patients achieved spontaneous resolution of SOP. Thirteen patients underwent surgical treatment for SOP. Vertical deviation <6 PD at the initial visit and low fundus torsion in the non-paretic eye and both eyes were significantly associated with spontaneous recovery (p < 0.05, logistic regression analysis). Traumatic factors, including the trauma type, presence of intracranial lesion, loss of consciousness, and Glasgow Coma Scale score, were not associated with spontaneous recovery.
Conclusions
In this multi-center study, spontaneously recovery was achieved in 47.5% patients with traumatic unilateral SOP. Even mild head trauma can lead to permanent SOP. Ocular factors, including the angle of deviation and fundus torsion, may better predict spontaneous resolution than traumatic factors in patients with traumatic unilateral SOP.
Key Words: Diplopia, Trauma, Trochlear nerve diseases
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