The Myelic Limited Dorsal Malformation: Prenatal Ultrasonographic Characteristics of an Intermediate Form of Dysraphism

2021 ◽  
pp. 1-11
Author(s):  
Saskia Vande Perre ◽  
Lucie Guilbaud ◽  
Timothée de Saint-Denis ◽  
Paul Maurice ◽  
Pauline Lallemant-Dudek ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Retrospective Study ◽  
Magnetic Resonance ◽  
Intermediate Form ◽  
Second Line ◽  
Intermediate Type ◽  
Inclusion Criteria ◽  
Resonance Imaging ◽  
Minor Criteria ◽  
Hybrid Forms

<b><i>Objectives:</i></b> The aim of the study was to report a subtype of dysraphism designated as myelic limited dorsal malformation (MyeLDM) and to describe its characteristics at prenatal ultrasound (US). <b><i>Methods:</i></b> It was a retrospective study from 2014 to 2020 based on second-line US evaluation of patients referred to our institution for myelomeningocele (MMC). Magnetic resonance imaging and acetylcholine esterase evaluation in the amniotic fluid were also offered. Major and minor criteria for open and closed dysraphism were defined and recorded for each patient. Patients were included as MyeLDM when both criteria of closed and open dysraphism were observed in the same fetus. Correlations were obtained with the postpartum data. <b><i>Results:</i></b> Twenty patients fulfilled the inclusion criteria, some of them being very close to MMC, others very close to limited dorsal myeloschisis (LDM), and others lying in between. There were 13 live-born neonates and 7 terminations of pregnancy. Correlations between prenatal and postpartum data were overall very good. <b><i>Conclusion:</i></b> Our series describe the ultrasonographic characteristics of an intermediate type of dysraphism and suggest that there is a continuum between MMC and LDM with numerous possibilities of hybrid forms (MyeLDM) sharing characteristics of both open and closed dysraphisms.

scholarly journals “Yokoyama procedure” efficacy on non-highly myopic patients with acquired esotropia and hypotropia

2019 ◽  
Vol 30 (4) ◽  
pp. 676-679
Author(s):  
Massimiliano Serafino ◽  
Matteo Scaramuzzi ◽  
Edoardo Villani ◽  
Paolo Nucci
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Axial Length ◽  
Lateral Rectus ◽  
Inclusion Criteria ◽  
Resonance Imaging ◽  
Spherical Equivalent Refraction ◽  
Before And After ◽  
Weighted Magnetic Resonance Imaging ◽  
The Mean

Objective: To assess the efficacy of “Yokoyama Procedure,” on non-highly myopic patients with acquired esotropia and hypotropia. Methods: The study involved 10 eyes of 5 patients with eso-hypotropia. Inclusion criteria were acquired esotropic-hypotropic strabismus with lateral rectus inferior displacement and superior rectus nasal displacement confirmed by magnetic resonance imaging, refractive errors between ±6 D, and axial length < 27 mm. Range of full duction movements and maximum angles of abduction-sursumduction was measured in each eye before and after surgery. All patients underwent T1- and T2-weighted magnetic resonance imaging. The surgery was aimed at creating a junction between the muscle bellies of the superior and lateral rectus muscles. This junction was made approximately 14 mm behind the insertions using a non-absorbable mersilene 5/0 suture (Yokoyama procedure). Results: Mean patient age was 64.8 ± 4.8 years. The mean globe axial length was 25.4 ± 0.76 mm and a mean corresponding spherical equivalent refraction of −3.7 ± 1.7 D was observed. Eight eyes on 10 had mild limitation in abduction, while the remaining 2 had no limitation. Three out of 10 eyes showed a moderate limited sursumduction, 5 eyes were categorized as mild, and the remaining 2 had no limitation. No evident post-operative limitation was present in any eye, in both abduction and sursumduction (p < 0.01). Pre-operative esotropia and hypotropia were, respectively, 32 ± 11 prismatic diopters and 25 ± 5 prismatic diopters, and they were significantly reduced after surgery as 9 ± 1.7 prismatic diopters and 6 ±1 prismatic diopters (p = 0.043), respectively. Conclusion: Yokoyama procedure is an effective, fast, reversible procedure to face eso-hypotropic acquired strabismus, even in patients with a clear magnetic resonance imaging displacement of superior and lateral rectus muscles, and absence of globe dislocation and of elevated myopia.

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