{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T03:57:50Z","timestamp":1793159870040,"version":"4.5.0"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objectives<\/jats:title>\n<jats:p>To evaluate the effect of inferior oblique (IO) myectomy on ocular torsion according to the absence of the trochlear nerve in unilateral congenital superior oblique palsy (UCSOP).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>We retrospectively reviewed the clinical data of patients who had been diagnosed with UCSOP and underwent ipsilateral IO myectomy (n = 43). Patients were classified into the present and absent groups according to the absence of the trochlear nerve and superior oblique hypoplasia on magnetic resonance imaging (MRI). For quantitative analysis of ocular torsion, disc-fovea angles (DFA) were collected in both eyes using fundus photographs taken within three months before surgery and one month after surgery.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>DFA of the paretic eye did not differ according to the absence of the trochlear nerve (9.4\u00b15.6\u00b0 in the present group vs. 11.0\u00b15.4\u00b0 in the absent group, <jats:italic>p<\/jats:italic> = 0.508). However, the present group had a larger DFA in the non-paretic eye than the absent group (14.1\u00b16.7\u00b0 in the present group vs. 8.0\u00b15.0\u00b0 in the absent group, <jats:italic>p<\/jats:italic> = 0.003). The change of ocular torsion after IO myectomy in the paretic eye was -5.3\u00b13.7\u00b0 in the present group and -4.8\u00b13.5\u00b0 in the absent group, respectively (<jats:italic>p<\/jats:italic> = 0.801). In the non-paretic eye, the change in DFA was -1.5\u00b13.0\u00b0 in the present group, which was larger than that in the absent group (0.7\u00b12.6\u00b0, <jats:italic>p<\/jats:italic> = 0.047). In the multivariate analysis, the change in DFA was correlated with only the preoperative DFA (standardized <jats:italic>\u03b2<\/jats:italic> = -0.617, <jats:italic>p<\/jats:italic>&lt;0.001 in the paretic eye, and standardized <jats:italic>\u03b2<\/jats:italic> = -0.517, <jats:italic>p<\/jats:italic>&lt;0.001 in the non-paretic eye).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusions<\/jats:title>\n<jats:p>In the paretic eye, there was no significant difference in the change of ocular torsion between both groups, whereas in the non-paretic eye, the present group had a larger change in DFA after IO myectomy than the absent group. However, in the multivariable analysis, the change in ocular torsion was significantly correlated with preoperative excyclotorsion but not with the presence of the trochlear nerve itself.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0283555","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T17:59:10Z","timestamp":1679594350000},"page":"e0283555","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":3,"title":["Effect of inferior oblique myectomy on ocular torsion according to the absence of the trochlear nerve in unilateral congenital superior oblique palsy"],"prefix":"10.1371","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9553-2231","authenticated-orcid":true,"given":"Yeji","family":"Moon","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Byung Joo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"issue":"6","key":"pone.0283555.ref001","doi-asserted-by":"crossref","first-page":"1076","DOI":"10.3174\/ajnr.A1992","article-title":"High-resolution 3D MR imaging of the trochlear nerve","volume":"31","author":"BS Choi","year":"2010","journal-title":"AJNR Am J Neuroradiol"},{"issue":"1","key":"pone.0283555.ref002","doi-asserted-by":"crossref","first-page":"29","DOI":"10.3928\/0191-3913-19970101-07","article-title":"Magnetic resonance imaging in evaluation of congenital and acquired superior oblique palsy","volume":"34","author":"SB Ozkan","year":"1997","journal-title":"J Pediatr Ophthalmol Strabismus"},{"issue":"4","key":"pone.0283555.ref003","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1016\/S0002-9394(98)00329-8","article-title":"Magnetic resonance imaging and tendon anomaly associated with congenital superior oblique palsy","volume":"127","author":"M. Sato","year":"1999","journal-title":"Am J Ophthalmol"},{"issue":"11","key":"pone.0283555.ref004","doi-asserted-by":"crossref","first-page":"2208","DOI":"10.1016\/j.ophtha.2010.02.017","article-title":"Absence of the trochlear nerve in patients with superior oblique hypoplasia","volume":"117","author":"JH Kim","year":"2010","journal-title":"Ophthalmology"},{"key":"pone.0283555.ref005","first-page":"9476749","article-title":"Characteristics of Facial Asymmetry in Congenital Superior Oblique Palsy according to Trochlear Nerve Absence","volume":"2020","author":"HK Yang","year":"2020","journal-title":"J Ophthalmol"},{"issue":"1","key":"pone.0283555.ref006","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.ophtha.2011.06.038","article-title":"Congenital superior oblique palsy and trochlear nerve absence: a clinical and radiological study","volume":"119","author":"HK 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