restrictive extraocular myopathy: a presenting feature of acromegaly
Abstract
A 45-year-old man presented with binocular diplopia in primary gaze for 1 year. Orthoptic evaluation showed 10-prism diopter right eye hypotropia and 6-prism diopter right eye esotropia. The elevation and abduction of the right eye were mechanically restricted. This was associated with systemic features suggestive of acromegaly. Magnetic resonance imaging (MRI) of the brain demonstrated a pituitary macroadenoma. An elevated serum insulin-like growth factor I level and the failure of growth hormone suppression after an oral glucose load biochemically confirmed the diagnosis of acromegaly. Computed tomography (CT) of the orbit demonstrated bilateral symmetrical enlargement of the medial rectus and inferior rectus muscle bellies. All tests regarding Graves-Basedow disease were negative. Although rare, diplopia due to a restrictive extraocular myopathy could be the presenting symptom of acromegaly.
Keywords
Susceptibility
Risk factors
Screening
Microbiology
prism
neuroimaging
acromegaly
survey
refractive errors
risk factor
diplopia
myopia
glaucoma
cataract
treatment outcome
axial length
anterior chamber depth
spectral domain optical coherence tomography
minimum inhibitory concentration
hypermetropia
anthrax
pituitary adenoma
suprasellar tumor
retinoblastoma
prognostic factors
retinopathy of prematurity
progeria
cerebrospinal fluid leakage
macular hole
pars plana vitrectomy
presbyopia
visual impairments
esotropia
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259319
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259319
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10.4103/0301-4738.86330
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Scimatic Chain (ID: 481)
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