{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,2,21]],"date-time":"2025-02-21T19:13:25Z","timestamp":1740165205687,"version":"3.37.3"},"reference-count":8,"publisher":"Wiley","license":[{"start":{"date-parts":[[2017,1,1]],"date-time":"2017-01-01T00:00:00Z","timestamp":1483228800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Reports in Ophthalmological Medicine"],"published-print":{"date-parts":[[2017]]},"abstract":"<jats:p>A 78-year-old woman complained of gradual, painless onset of horizontal binocular diplopia associated with progressive axial weakness. Physical examination revealed esotropia that was greater at distance than at near vision, bilateral levator dehiscence, and normal abducting saccadic speeds. Given the age of the patient and compatible clinical findings, the diagnosis of Sagging Eye Syndrome (SES) was made. However, further work-up with a muscle biopsy suggested Sporadic Late-Onset Nemaline Myopathy (SLONM) as the cause of her progressive muscle weakness. Although rare, external ophthalmoplegia has been described in the literature as a presenting symptom in SLONM. To elucidate the pathological mechanism for the patient\u2019s diplopia, an MRI of the orbits was performed, which revealed findings consistent with SES. This case aims to highlight the importance of integrating clinical findings during the diagnostic process and serves as a reminder that diplopia can be a common symptom for an uncommon diagnosis.<\/jats:p>","DOI":"10.1155\/2017\/1708734","type":"journal-article","created":{"date-parts":[[2017,1,15]],"date-time":"2017-01-15T16:01:49Z","timestamp":1484496109000},"page":"1-3","source":"Crossref","is-referenced-by-count":1,"title":["Sagging Eye Syndrome or Nemaline Rod Myopathy? Divergence Insufficiency with Levator Dehiscence as an Overlapping Symptom between Two Diagnoses"],"prefix":"10.1155","volume":"2017","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8389-127X","authenticated-orcid":true,"given":"Stephanie S. L.","family":"Cheung","sequence":"first","affiliation":[{"name":"Hospital Authority, Hong Kong"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Larissa K.","family":"Ghadiali","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas H.","family":"Brannagan III","sequence":"additional","affiliation":[{"name":"Department of Neurology, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gul","family":"Moonis","sequence":"additional","affiliation":[{"name":"Department of Radiology, Division of Neuroradiology, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phyllis L.","family":"Faust","sequence":"additional","affiliation":[{"name":"Department of Pathology and Cell Biology, Columbia University Medical Center and the New York Presbyterian Hospital, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey G.","family":"Odel","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","reference":[{"key":"1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaophthalmol.2013.783"},{"key":"2","doi-asserted-by":"publisher","DOI":"10.1016\/0022-510X(80)90075-1"},{"key":"3","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/89.2.299"},{"key":"4","doi-asserted-by":"publisher","DOI":"10.1097\/00041327-199703000-00008"},{"key":"5","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/86.4.793"},{"key":"6","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-010-5819-6"},{"key":"7","doi-asserted-by":"publisher","DOI":"10.1016\/j.spen.2011.10.004"},{"key":"8","doi-asserted-by":"publisher","DOI":"10.1212\/01.wnl.0000180362.90078.dc"}],"container-title":["Case Reports in Ophthalmological Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/downloads.hindawi.com\/journals\/criopm\/2017\/1708734.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criopm\/2017\/1708734.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/downloads.hindawi.com\/journals\/criopm\/2017\/1708734.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2017,1,15]],"date-time":"2017-01-15T16:01:50Z","timestamp":1484496110000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.hindawi.com\/journals\/criopm\/2017\/1708734\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017]]},"references-count":8,"alternative-id":["1708734","1708734"],"URL":"https:\/\/doi.org\/10.1155\/2017\/1708734","relation":{},"ISSN":["2090-6722","2090-6730"],"issn-type":[{"type":"print","value":"2090-6722"},{"type":"electronic","value":"2090-6730"}],"subject":[],"published":{"date-parts":[[2017]]}}}