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Background <p>Acquired adult ocular dysmotility is relatively common, caused by a variety of traumatic and non-traumatic disorders affecting the extra-ocular muscles (EOMs). Computed tomography (CT) is a quick and widely available imaging modality that provides a key role in evaluating these conditions by delineating muscle morphology and providing excellent bone and soft-tissue visualization.</p> Aim of the study <p>This study aims to characterize the MDCT spectrum of acquired adult non-neuromyopathic ocular dysmotility, specifically focusing on traumatic, degenerative, metabolic, and idiopathic EOM pathologies, which are uncommonly discussed in radiology literature. More common neuromuscular disorders, which are typically evaluated using MRI, are excluded to make a more focused study.</p> Methods <p>Forty adult patients were included in this retrospective study (with a mean age of ~ 30&#xa0;years (range 16–50); 70% male) presenting with acquired traumatic and non-traumatic ocular dysmotility with exclusion of congenital, neuromyopathic, or neurogenic causes. All underwent non-contrast orbital CT. Demographic data, clinical features, affected muscles, laterality, and CT findings—including fracture lines, muscle morphology, and associated orbital or sinus abnormalities—were analyzed.</p> Results <p>Traumatic etiologies slightly predominated (52.5%) over non-traumatic causes (47.5%), with blunt orbital trauma being the most common cause (52.5%), while myopia-related disorders (22.5%) and isolated idiopathic cases (20%) comprised the majority of non-traumatic etiologies. The inferior rectus and superior oblique muscles were the most frequently affected EOMs, followed by the medial rectus. CT findings demonstrated thinning or atrophy (50%), with detachment/disinsertion (22.5%). Orbital wall fractures were identified in 22.5%, and sinusitis in 27.5% of cases, with the optic nerve intact in all patients. In non-traumatic cases, thyroid ophthalmopathy manifested as muscle hypertrophy, while high-myopia-related strabismus fixus manifested as muscle elongation and displacement.</p> Conclusion <p>CT provides a non-invasive, available, rapid, and comprehensive tool for evaluating both traumatic and non-traumatic causes of acquired ocular dysmotility in adults. It effectively characterizes the pattern and extent of ocular dysmotility, guiding diagnosis, surgical planning, and follow-up.</p>

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Spectrum of CT findings in acquired adult non-neuromyopathic disorders of extra-ocular muscles

  • 期刊论文

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  • 发表日期：

    2026年6月14日

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  • Lamya A. Eissa,
  • Mohamed Eid,
  • Mohamed Hossameldin Khalifa,
  • Hassan Magdy Abdelrazek,
  • Aya Mohammed Abdel Aziz

摘要

Background

Acquired adult ocular dysmotility is relatively common, caused by a variety of traumatic and non-traumatic disorders affecting the extra-ocular muscles (EOMs). Computed tomography (CT) is a quick and widely available imaging modality that provides a key role in evaluating these conditions by delineating muscle morphology and providing excellent bone and soft-tissue visualization.

Aim of the study

This study aims to characterize the MDCT spectrum of acquired adult non-neuromyopathic ocular dysmotility, specifically focusing on traumatic, degenerative, metabolic, and idiopathic EOM pathologies, which are uncommonly discussed in radiology literature. More common neuromuscular disorders, which are typically evaluated using MRI, are excluded to make a more focused study.

Methods

Forty adult patients were included in this retrospective study (with a mean age of ~ 30 years (range 16–50); 70% male) presenting with acquired traumatic and non-traumatic ocular dysmotility with exclusion of congenital, neuromyopathic, or neurogenic causes. All underwent non-contrast orbital CT. Demographic data, clinical features, affected muscles, laterality, and CT findings—including fracture lines, muscle morphology, and associated orbital or sinus abnormalities—were analyzed.

Results

Traumatic etiologies slightly predominated (52.5%) over non-traumatic causes (47.5%), with blunt orbital trauma being the most common cause (52.5%), while myopia-related disorders (22.5%) and isolated idiopathic cases (20%) comprised the majority of non-traumatic etiologies. The inferior rectus and superior oblique muscles were the most frequently affected EOMs, followed by the medial rectus. CT findings demonstrated thinning or atrophy (50%), with detachment/disinsertion (22.5%). Orbital wall fractures were identified in 22.5%, and sinusitis in 27.5% of cases, with the optic nerve intact in all patients. In non-traumatic cases, thyroid ophthalmopathy manifested as muscle hypertrophy, while high-myopia-related strabismus fixus manifested as muscle elongation and displacement.

Conclusion

CT provides a non-invasive, available, rapid, and comprehensive tool for evaluating both traumatic and non-traumatic causes of acquired ocular dysmotility in adults. It effectively characterizes the pattern and extent of ocular dysmotility, guiding diagnosis, surgical planning, and follow-up.