Evidence map›Paper›PMID 42484680›Full record

ArticleGraefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie2026

Dissociation between globe shape-induced rectus muscle pulley displacement and abduction limitation in patients aged 40 years and older with high myopic strabismus.

Reika Kono, Ichiro Hamasaki, Fumiko Kishimoto, Kiyo Shibata, Shin Morisawa, Yuki Morizane

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Article in Graefe's archive for clinical and experimental ophthalmology = Albrecht von Graefes Archiv fur klinische und experimentelle Ophthalmologie, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors.

Reika KonoDepartment of Ophthalmology, Okayama University Graduate School of Medicine Dentistry, and Pharmaceutical Sciences, Okayama City, Okayama, 700-8558, Japan. reikak@icloud.com.ORCID https://orcid.org/0000-0001-6589-8569
Ichiro HamasakiLino Eye Clinic, Okayama City, Okayama, Japan.
Fumiko KishimotoDivision of Ophthalmology, Ibara City Hospital, Ibara City, Okayama, Japan.
Kiyo ShibataLino Eye Clinic, Okayama City, Okayama, Japan.
Shin MorisawaDepartment of Ophthalmology, Okayama University Graduate School of Medicine Dentistry, and Pharmaceutical Sciences, Okayama City, Okayama, 700-8558, Japan.
Yuki MorizaneDepartment of Ophthalmology, Okayama University Graduate School of Medicine Dentistry, and Pharmaceutical Sciences, Okayama City, Okayama, 700-8558, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeWe hypothesized that high myopia (HM)-induced globe deformation displaces rectus muscle (RM) pulleys, contributing to mild ocular motility restriction. This study investigated the effects of globe shape on RM pulley positions in older Japanese patients with acquired strabismus (AS) and mild motility restriction-defined as the ability to abduct both eyes beyond the midline.

methodsIn this retrospective case series, 28 patients (mean age ± standard deviation: 61.2 ± 9.0 years) with adult-onset AS were included: 6 patients with (LAB group) and 22 patients without abduction limitation (NLAB group). In each subject, the eye with the longer axial length (AL ≥ 26 mm), measured using an AL measurement apparatus, was analyzed using magnetic resonance imaging (MRI). RM pulley positions relative to the globe center and equatorial diameter (ED) were measured; the ED-to-AL ratio (EAR) was calculated. We compared these parameters between groups and analyzed correlations of globe-shape factors (EAR, AL, and ED) with pulley positions and age.

resultsNo significant differences in EAR, AL, ED, or pulley positions were detected between LAB and NLAB groups, possibly owing to the limited sample size and group imbalance, in the analyzed eyes. However, as EAR decreased (prolate deformation), the superior rectus (SR) pulley (r = 0.68, P < 0.01) and inferior rectus (IR) pulley (r = 0.40, P = 0.03) significantly displaced nasally. AL (r = -0.52, P < 0.01) correlated with the horizontal SR pulley position. Furthermore, age significantly correlated with AL (r = 0.45, P = 0.02) and decrease in EAR (r = -0.41, P = 0.03).

conclusionsIn older Japanese patients with HM and AS, prolate globe deformation was associated with age and significantly correlated with SR and IR pulley positions. While the direct relationship between these structural changes and the clinical degree of mild abduction limitation requires further investigation in larger cohorts, EAR sensitively reflected age-related morphological shifts; thus, when used in conjunction with AL, EAR may represent a readily measurable MRI-based parameter associated with restrictive motility tendencies in strabismus with high myopia.

Indexed as

Heavy eye syndromeHigh myopiaMagnetic resonance imagingProlate deformationRectus muscle pulleyStrabismus

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.