27
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Ridge at the medial rectus muscle insertion: A new anatomical landmark

      other

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background and Aim:

          Rectus muscle insertions are usually linear or slight curved with the anterior convexity. While operating squint surgeries, we found a presence of ridge-like structure at the medial rectus insertion. None of the other rectus muscle insertions had such structure.

          Materials and Methods:

          Patients undergoing squint surgery were included in the study. All the patients had negative forced duction test for all the gazes and had comitant strabismus. The patients underwent surgery through the fornix route. All the squint surgeries were primary. None of the patients undergoing resurgery were included in the study. The ridge seen is actually an elevated curved structure and shows discontinuation of the actual medial rectus insertion. The measurements were taken from the superior and inferior end of the medial rectus muscle insertion.

          Results:

          In a total of 76 medial rectus surgery (for recession or resection), we found the ridge was present in 68 (89.5%) of cases. The ridge was located at an average distance of 6.33 ± 1.5 mm inferior and 3.82 ± 0.9 mm superior to the superior and inferior point of medial rectus insertion, respectively.

          Conclusion:

          We describe the presence, morphology, and measurements of a ridge as an anatomical landmark at medial rectus insertion.

          Related collections

          Most cited references10

          • Record: found
          • Abstract: found
          • Article: not found

          The origins and insertions of the extraocular muscles: development, histologic features, and clinical significance.

          D Sevel (1986)
          The tendinous origins and insertions of the extraocular muscles were studied embryologically by macroscopic and microscopic methods. It is concluded from this investigation that these tendons of origin and insertion arise from mesenchymal tissue similar to that of their respective muscles. These tendon-muscle groups have developed from superior and inferior mesenchymal complexes. The origins of the extraocular muscles are attached to the periorbita by an interlocking of the tendinous and muscular fibers, which allows for mobility of the extraocular muscles in all extreme directions of gaze and also results in a strong mechanical mooring for these muscles. Avulsion at the origins of the extraocular muscles following severe traction or trauma is rare. The additional origin of the superior and medial rectus muscles to the dura of the optic nerve explains the pain that may occur on movement of the eye in optic neuritis. Optic nerve compression and thyroid myopathy is explained by mucopolysaccharide and inflammatory cell infiltration of the muscular interdigitations that extend up to the site of origin of the rectus muscles. Findings of this investigation suggest that the association of ptosis and superior rectus muscle underaction may be due to a persistence of fibrous tissue that has endured from embryologic development between the superior rectus and levator palpebrae superioris muscles. Superior oblique tendon sheath syndrome is explained by embryologic strands remaining between the tendon of the superior oblique muscle and the trochlea. The insertions of the rectus muscles extend from the equator of the eye to the limbus early on in development. By processes of differential degeneration between the sclera and the rectus tendon, posterior recession of the tendon from the limbus, and contemporaneous growth of the anterior segment of the eye, these tendons reach their adult location only between the ages of 18 months and 2 years. In strabismus surgery, measurements for muscle adjustments should be assessed from the limbus rather than from the sites of insertion of these tendons. In the series of patients with esotropia, no mechanical abnormalities were noted in relationship to the insertions of the medial or lateral recti muscles. Furthermore, no correlation was found between the site of insertion of the medial rectus muscle and the degree of esotropia.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            An anatomical reevaluation of rectus muscle insertions.

            L Apt (1980)
            Certain strabismus operations require a thorough knowledge of the anatomy of rectus muscle insertions. Earlier anatomical studies were based on a small sample size and did not use precise microscopic techniques for measurements. To obtain accurate measurements of rectus muscle insertion relationships, 100 consecutive normal adult autopsy eyes were examined with a Vernier caliper and a dissecting microscope for high magnification. Statistical analysis of these data provided a set of normal values for (1) distances from anterior and posterior limbus to rectus muscle insertions, (2) distances between anterior and posterior limbus, (3) length of line ("width") of rectus muscle insertions, and (4) distances between rectus muscle insertions. Although most of the determinations were somewhat similar to previous studies, statistically they were significantly different. The ophthalmologist can make use of the revised set of figures for rectus muscle insertion relationships in operations such as transposition procedures for A-V patterns and cranial nerve palsies, large recessions, and advancements in reoperations after recessions.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              A reappraisal of the origin of human extraocular muscles.

              D Sevel (1981)
              It has previously been suggested that extraocular muscles develop from mesoderm surrounding the head cavities and grow anteriorly into the orbit. A reappraisal of 54 specimens ranging in size from 8 mms to term indicates that human extraocular muscles develop from the mesoderm within the orbit and that these muscles do not develop from the apex of the orbit and grow anteriorly. Furthermore, the origin, belly, and insertion of the extraocular muscles develop contemporaneously, and each individual muscle develops at the same time. The morphogenesis of extraocular muscles includes the stages of mesenchymal cell, early myoblasts cells, myoblast cell, fusion of myoblast cell, myotube cell, and mature muscle cell.
                Bookmark

                Author and article information

                Journal
                Indian J Ophthalmol
                Indian J Ophthalmol
                IJO
                Indian Journal of Ophthalmology
                Medknow Publications & Media Pvt Ltd (India )
                0301-4738
                1998-3689
                May 2017
                : 65
                : 5
                : 396-398
                Affiliations
                [1]Department of Pediatric Ophthalmology, The Eye Clinic, Synnove Enclave, Vadodara, Gujarat, India
                [1 ]Phaco and Refractive Surgery, The Eye Clinic, Vadodara, Gujarat, India
                [2 ]Pediatric Ophthalmologist, Anuj Eye Hospital and Laser Centre, Anand, Gujarat, India
                Author notes
                Correspondence to: Dr. Jitendra Jethani, Department of Pediatric Ophthalmology, The Eye Clinic, Synnove Enclave, Behind Essar Petrol Pump, Vasna Bhyalli Road, Vasna, Vadodara - 390 015, Gujarat, India. E-mail: xethani@ 123456rediffmail.com
                Article
                IJO-65-396
                10.4103/ijo.IJO_214_14
                5565885
                28573996
                fc19a1f7-57ea-49a8-aa93-607df933c4cd
                Copyright: © 2017 Indian Journal of Ophthalmology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                : 24 October 2014
                : 16 April 2017
                Categories
                Ophthalmology Practice

                Ophthalmology & Optometry
                linear muscle insertion,medial rectus,muscle insertion,rectus muscle insertion

                Comments

                Comment on this article