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Superior oblique muscle overaction

MedGen UID:
699221
•Concept ID:
C1276002
•
Disease or Syndrome
Synonyms: OASO - Overactive superior oblique; ODA - overdepression in adduction; Overactive superior oblique; Overdepression in adduction; Superior oblique overaction
SNOMED CT: Superior oblique overaction (400941009); Superior oblique muscle overaction (400941009); Overdepression in adduction (400941009); Overactive superior oblique (400941009); ODA - overdepression in adduction (400941009); OASO - Overactive superior oblique (400941009)
 
HPO: HP:0025594

Definition

An ocular motility abnormality characterized by an overacting superior oblique muscle resulting to vertical incomitance of the eyes in lateral gaze. On examination, this is commonly seen as a downshoot of the adducting eye occurring when gaze is directed into the field of action of the inferior oblique muscle, producing a greater downward excursion of the adducted eye than of the abducted eye. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVSuperior oblique muscle overaction

Professional guidelines

PubMed

Treatment for "A" and "V" exotropia by slanting muscle insertions.
Ohba M, Nakagawa T
Jpn J Ophthalmol 2000 Jul-Aug;44(4):433-8. doi: 10.1016/s0021-5155(00)00182-9. PMID: 10974302

Recent clinical studies

Etiology

Surgical management of Helveston syndrome (Triad exotropia).
Jin X, Peng Y, Al-Wesabi SA, Deng J, Ming Y, Wu X
Int Ophthalmol 2022 Apr;42(4):1021-1030. Epub 2021 Nov 8 doi: 10.1007/s10792-021-02027-1. PMID: 34748142Free PMC Article
Asymmetric superior oblique split Z-tendon lengthening for face turn in bilateral asymmetric superior oblique overaction and exotropia.
Serafino M, Scaramuzzi M, Specchia C, Bonsignore F, Nucci P
Eur J Ophthalmol 2021 Mar;31(2):716-721. Epub 2020 Jan 14 doi: 10.1177/1120672119897980. PMID: 31937119
The stability of horizontal ocular alignment of triad exotropia after one-step triple surgery.
Wu L, Xia W, Li L, Xi S, Wang X, Wen W, Jiang C, Liu G, Zhao C
Graefes Arch Clin Exp Ophthalmol 2020 Apr;258(4):899-908. Epub 2020 Jan 14 doi: 10.1007/s00417-019-04599-2. PMID: 31932885
Effect of Isolated Oblique Muscle Weakening Procedures on Horizontal Deviation in A- and V-pattern Exotropia.
Wang X, Zhang W, Liu L
Curr Eye Res 2020 Feb;45(2):211-214. Epub 2019 Aug 29 doi: 10.1080/02713683.2019.1660795. PMID: 31461370
Comparison of superior oblique suture spacers and superior oblique silicone band expanders.
Awadein A, Gawdat G
J AAPOS 2012 Apr;16(2):131-5. doi: 10.1016/j.jaapos.2011.11.011. PMID: 22525167

Diagnosis

Anterior plagiocephaly with contralateral superior oblique overaction.
Jethani J, Dagar A, Vijayalakshmi P, Sundaresh K
Indian J Ophthalmol 2008 Nov-Dec;56(6):504-7. doi: 10.4103/0301-4738.43374. PMID: 18974524Free PMC Article
Treatment of inferior oblique paresis with superior oblique silicone tendon expander.
Greenberg MF, Pollard ZF
J AAPOS 2005 Aug;9(4):341-5. doi: 10.1016/j.jaapos.2005.04.003. PMID: 16102484

Therapy

Treatment of inferior oblique paresis with superior oblique silicone tendon expander.
Greenberg MF, Pollard ZF
J AAPOS 2005 Aug;9(4):341-5. doi: 10.1016/j.jaapos.2005.04.003. PMID: 16102484
The efficacy of superior oblique split Z-tendon lengthening for superior oblique overaction.
Bardorf CM, Baker JD
J AAPOS 2003 Apr;7(2):96-102. doi: 10.1016/mpa.2003.S1091853103000752. PMID: 12736621
Downshoot in infra-adduction following selected superior oblique surgical weakening procedures for A-pattern strabismus.
Castanera de Molina A, Fabiani R, Giner MG
Binocul Vis Strabismus Q 1998;13(1):17-28. PMID: 9852423

Prognosis

The stability of horizontal ocular alignment of triad exotropia after one-step triple surgery.
Wu L, Xia W, Li L, Xi S, Wang X, Wen W, Jiang C, Liu G, Zhao C
Graefes Arch Clin Exp Ophthalmol 2020 Apr;258(4):899-908. Epub 2020 Jan 14 doi: 10.1007/s00417-019-04599-2. PMID: 31932885
Comparison of superior oblique suture spacers and superior oblique silicone band expanders.
Awadein A, Gawdat G
J AAPOS 2012 Apr;16(2):131-5. doi: 10.1016/j.jaapos.2011.11.011. PMID: 22525167
Treatment of inferior oblique paresis with superior oblique silicone tendon expander.
Greenberg MF, Pollard ZF
J AAPOS 2005 Aug;9(4):341-5. doi: 10.1016/j.jaapos.2005.04.003. PMID: 16102484
Downshoot in infra-adduction following selected superior oblique surgical weakening procedures for A-pattern strabismus.
Castanera de Molina A, Fabiani R, Giner MG
Binocul Vis Strabismus Q 1998;13(1):17-28. PMID: 9852423
Superior oblique luxation and trochlear luxation as new concepts in superior oblique muscle weakening surgery.
Mombaerts I, Koornneef L, Everhard-Halm YS, Hughes DS, Maillette de Buy Wenniger-Prick LJ
Am J Ophthalmol 1995 Jul;120(1):83-91. doi: 10.1016/s0002-9394(14)73762-6. PMID: 7611332

Clinical prediction guides

Fusion can mask the relationships between fundus torsion, oblique muscle overaction/underaction, and A- and V-pattern strabismus.
Deng H, Irsch K, Gutmark R, Phamonvaechavan P, Foo FY, Anwar DS, Guyton DL
J AAPOS 2013 Apr;17(2):177-83. doi: 10.1016/j.jaapos.2012.10.023. PMID: 23622450
A-pattern strabismus with overdepression in adduction: a special type of bilateral skew deviation?
Donahue SP, Itharat P
J AAPOS 2010 Feb;14(1):42-6. doi: 10.1016/j.jaapos.2009.11.009. PMID: 20227622
Treatment of A-pattern esotropia with marked mongoloid slanting palpebral fissures.
Hatsukawa Y, Ishizaka M, Nihmi A, Mitarai K, Furukawa A, Yamagishi T
Jpn J Ophthalmol 2001 Sep-Oct;45(5):482-6. doi: 10.1016/s0021-5155(01)00392-6. PMID: 11583669

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