title: [Vertical retraction syndrome caused by anomalous orbital structures].
abstract: OBJECTIVE
  To described the clinical feature and MRI imaging of six children with vertical retraction syndrome.
  
  
  METHODS
  Six children with unilateral vertical retraction syndrome between 15 months and 8 years of age, mean age was (5.01 ± 1.27) years old. Strabismus examination included diopter, prism diopters, eye movement examination, binocular vision and fundus examination. Imaging of the ocular motor nerves at the brainstem was performed in 0.8 mm thickness image planes using 3D-FIESTA sequence, the orbits were imaged with FSE T1, T2WI using surface coils, and within 2.0 mm thick planes.
  
  
  RESULTS
  Four children showed hypertropia, characterized by limited depression, a light retraction of the globe during downward gaze and eyelid lag. The MRI imaging showed anomalous orbital structure in the superonasal quadrant that between medial rectus and superior rectus or adjacent to the superior rectus. Two children showed intermittent exotropia, characterized by limited elevation, retraction of the globe and narrowing of the palpebral fissure during upward gaze. The MRI imaging showed anomalous orbital structure was present in the inferotemporal quadrant, one originate in inferior rectus and another close to the lateral rectus.
  
  
  CONCLUSIONS
  Anomalous orbital structures are a main cause of vertical retraction syndrome. The presence of specific unusual eye movement and MRI imaging may assist in diagnosis. When the eyelid lag was found since the early age, anomalous orbital structures were implied.
authors.affiliation: Beijing Tongren Eye Centre, Beijing Tongren Hospital, Capital Medical University, Beijing Ophthalmology and Visual Science Key Lab, Beijing 100730, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Yang
authors.forename: Yong-hong
authors.initials: YH
authors.lastname: Jiao
authors.forename: Feng-yuan
authors.initials: FY
authors.lastname: Man
authors.forename: Zhen-chang
authors.initials: ZC
authors.lastname: Wang
authors.forename: Qing-lin
authors.initials: QL
authors.lastname: Chang
authors.forename: Wei
authors.initials: W
authors.lastname: Lu
authors.forename: Jing-hui
authors.initials: JH
authors.lastname: Wang
authors.forename: Kan-xing
authors.initials: KX
authors.lastname: Zhao
mesh_terms: D002648:Child; D002675:Child, Preschool; D004370:Duane Retraction Syndrome / Q000175:diagnosis*; D005133:Eye Movements; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D009915:Orbit / Q000473:pathology*