title: Distinctive clinical features of bilateral Duane retraction syndrome.
abstract: OBJECTIVE
  To compare the clinical characteristics of unilateral and bilateral forms of Duane retraction syndrome.
  
  
  METHODS
  A retrospective chart review of patients with Duane syndrome over a 10-year span was performed. All participants underwent a complete medical and ophthalmologic examination at the time of diagnosis. Data collected included the following: sex, age at first visit, form (unilateral/bilateral), side, type, ocular duction and version, abnormal head position, best-corrected visual acuity, refractive errors, presence of strabismus, binocular function, and associated congenital anomalies.
  
  
  RESULTS
  Of 94 patients identified, 17% were bilaterally affected. Of the bilateral patients, 12% had familial antecedents; 87.5% had the same type in both eyes with 75% bilateral type 1. Patients with bilateral Duane syndrome had significantly different visual acuity (mean, 0.1214 logMar vs 0.0035; p = 0.045), abnormal head position (56.25% vs 89%; p = 0.04), A or V patterns (69% vs 27.6%; p = 0.003), and associated congenital anomalies (50% vs 14%; p = 0.003) than patients with unilateral disease. There was also a suggestion of higher rates of ametropia, global vertical dysfunction, and abnormal stereoacuity in bilateral Duane syndrome that were not statistically significant.
  
  
  CONCLUSIONS
  Patients with bilateral Duane syndrome had lower visual acuity, a lower incidence of abnormal head posture, and a higher incidence of A or V patterns and associated congenital anomalies. Bilateral Duane retraction syndrome seems to involve multiple instances of deinnervation and fibrosis, resulting in horizontal and vertical oculomotor deficits and functional impairments.
authors.affiliation: Ophthalmology Department, North University Hospital, Chemin des Bourrelly, Marseille, France. emilie.zanin@etumel.univmed.fr
authors.forename: Emilie
authors.initials: E
authors.lastname: Zanin
authors.forename: Nicole
authors.initials: N
authors.lastname: Gambarelli
authors.forename: Danièle
authors.initials: D
authors.lastname: Denis
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D004370:Duane Retraction Syndrome / Q000503:physiopathology*; D005133:Eye Movements / Q000502:physiology*; D005260:Female; D019416:Head Movements; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D015348:Vision, Binocular; D014792:Visual Acuity / Q000502:physiology*; D055815:Young Adult