MRI findings in Duane's ocular retraction syndrome

AIM: To investigate the innervation pattern of extra-ocular muscles in patients with clinically diagnosed Duane's ocular retraction syndrome (DRS) using magnetic resonance imaging (MRI). MATERIALS AND METHODS: The study population consisted of 11 patients. Six patients had type I DRS (eight eyes), four patients had type II DRS (five eyes) and one patient had inverse DRS. Images were acquired using a Siemens 3 T MRI system. The type of DRS, corresponding innervation findings, and condition of the affected muscles were evaluated by two experienced neuroradiologists in consensus. RESULTS: All patients with clinically diagnosed DRS type I showed absence of the abducens nerve (CN6), hypoplasia of the superior oblique muscle (SOM), and aberrant innervation of lateral rectus muscle (LRM) by an extra branch of oculomotor nerve (CN3). All patients with type II DRS show dual-innervation of the LRM (by CN6 and an aberrant CN3 branch) and hypoplasia of SOM. The single patient with inverse DRS showed hypoplasia of CN3, the medial rectus muscle (MRM), the inferior rectus muscle (IRM), and the inferior oblique muscle (IOM). CONCLUSION: Each type of DRS has characteristic MRI appearances. Therefore, MRI is a useful diagnostic tool for the confirmation and classification of suspected cases of DRS. (C) 2014 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.