{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T02:49:36Z","timestamp":1775443776749,"version":"3.50.1"},"reference-count":11,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T00:00:00Z","timestamp":1775347200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Alexander Engelmann","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["CMTR"],"abstract":"<jats:p>Orbital floor fractures may cause long-term functional and esthetic impairments. Diplopia due to impaired function of the inferior rectus muscle is frequently an indication for surgical repair, but some cases, such as those where the diagnosis has been delayed or a previous attempt at repair has been made, may not always be amenable to surgical correction. It is advantageous for the surgeon to know whether the proper function of the inferior rectus muscle can be restored for the purposes of surgical planning and prognostication. The authors hypothesized that real-time MRI could be used to characterize the appearance of the inferior rectus muscle in a way that would facilitate future analysis of inferior rectus function in patients with diplopia due to orbital floor fractures. Real-time MRI was performed on 10 volunteer participants with normal ophthalmic function and orbital anatomy to assess inferior rectus appearance during vertical duction testing. ImageJ software was used to measure and record characteristics of the inferior rectus muscle, viewed in a quasi-sagittal plane. The ratios evaluated included inferior rectus muscle length in upgaze versus downgaze (UDR, mean 1.58) as well as inferior rectus muscle length versus distance from inferior rectus origin to inferior rectus inflection point in upgaze (LIR, mean 1.30) and downgaze (mean 1.20). These values were found to be conserved between orbits and individuals. This data offers quantitative insight regarding inferior rectus muscle appearance across the full arc of vertical gaze in healthy individuals. We plan to use this normative baseline dataset as a comparison for future phases of this project, using real-time MRI to evaluate traumatized orbits with diplopia and derangement of the inferior rectus muscle.<\/jats:p>","DOI":"10.3390\/cmtr19020020","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:12:33Z","timestamp":1775437953000},"page":"20","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Characterization of Inferior Rectus Muscle Action in Normal Subjects Using Real-Time Magnetic Resonance Imaging of the Orbit"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4331-1194","authenticated-orcid":false,"given":"Alexander R.","family":"Engelmann","sequence":"first","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Maryland, Baltimore, MD 21201, USA"},{"name":"Department of Oculofacial Surgery, Cole Eye Institute, Cleveland Clinic Foundation, Cleveland, OH 44106, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kailash","family":"Singh","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lerner College of Medicine, Cleveland, OH 44195, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiachen","family":"Zhuo","sequence":"additional","affiliation":[{"name":"Department of Diagnostic Radiology, University of Maryland, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"N\u00e9ha","family":"Datta","sequence":"additional","affiliation":[{"name":"Department of Plastic & Reconstructive Surgery, Johns Hopkins School of Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfredo A.","family":"Sadun","sequence":"additional","affiliation":[{"name":"Doheny Eye Institute, University of California Los Angeles, Pasadena, CA 90095, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P.","family":"Grant","sequence":"additional","affiliation":[{"name":"R. Adams Cowley Schock Trauma Center, University of Maryland, Baltimore, MD 21201, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7492-990X","authenticated-orcid":false,"given":"Shannath L.","family":"Merbs","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology and Visual Sciences, University of Maryland, Baltimore, MD 21201, USA"},{"name":"Department of Ophthalmology, University of Virginia, Charlottesville, VA 22903, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,4,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.1007\/s00405-016-3945-1","article-title":"The functional outcome of blow-out fractures managed surgically and conservatively: Our experience in 100 patients","volume":"273","author":"Felding","year":"2016","journal-title":"Eur. Arch. Otorhinolaryngol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1002\/jmri.28067","article-title":"Magnetic Resonance Imaging Versus Computed Tomography for Three-Dimensional Bone Imaging of Musculoskeletal Pathologies: A Review","volume":"56","author":"Florkow","year":"2022","journal-title":"J. Magn. Reson. Imaging"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1749-6632.2002.tb02805.x","article-title":"The orbital pulley system: A revolution in concepts of orbital anatomy","volume":"956","author":"Demer","year":"2002","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e4308","DOI":"10.1097\/GOX.0000000000004308","article-title":"Is Surgery Needed for Diplopia after Blowout Fractures? A Clarified Algorithm to Assist Decision-making","volume":"10","author":"Lin","year":"2022","journal-title":"Plast. Reconstr. Surg. Glob. Open"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.tjo.2015.12.002","article-title":"Etiology of orbital fractures at a level I trauma center in a large metropolitan city","volume":"6","author":"Chiang","year":"2016","journal-title":"Taiwan. J. Ophthalmol."},{"key":"ref_6","first-page":"3787","article-title":"Three-dimensional location of human rectus pulleys by path inflections in secondary gaze positions","volume":"41","author":"Clark","year":"2000","journal-title":"Investig. Ophthalmol. Vis. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"887","DOI":"10.1111\/joa.14009","article-title":"Functional anatomy of the orbit in strabismus surgery: Connective tissues, pulleys, and the modern surgical implications of the \u201carc of contact\u201d paradigm","volume":"244","author":"Madeira","year":"2024","journal-title":"J. Anat."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e42","DOI":"10.1016\/j.bjoms.2019.10.115","article-title":"Rounding of the inferior rectus muscle, A retrospective analysis of 96 patients with orbital floor fractures","volume":"57","author":"Abdelrahman","year":"2019","journal-title":"Br. J. Oral. Maxillofac. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1097\/SCS.0b013e31802ccdc8","article-title":"Rounding of the Inferior Rectus Muscle as a Predictor of Enophthalmos in Orbital Floor Fractures","volume":"18","author":"Matic","year":"2007","journal-title":"J. Craniofac Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"100332","DOI":"10.1016\/j.medntd.2024.100332","article-title":"Quantifying gender differences in orbital morphology with large MRI datasets","volume":"24","author":"Han","year":"2024","journal-title":"Med. Nov. Technol. Devices"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.mri.2018.04.016","article-title":"Dynamic contrast-enhanced MRI of orbital and anterior visual pathway lesions","volume":"51","author":"Jittapiromsak","year":"2018","journal-title":"Magn. Reson. Imaging"}],"container-title":["Craniomaxillofacial Trauma &amp; Reconstruction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1943-3883\/19\/2\/20\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T01:43:37Z","timestamp":1775439817000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1943-3883\/19\/2\/20"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,5]]},"references-count":11,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["cmtr19020020"],"URL":"https:\/\/doi.org\/10.3390\/cmtr19020020","relation":{},"ISSN":["1943-3883"],"issn-type":[{"value":"1943-3883","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4,5]]}}}