Functional characterization of orbicularis oculi and extraocular muscles

Sekulic-Jablanovic, Marijana; Ullrich, Nina D.; Goldblum, David; Palmowski-Wolfe, Anja; Zorzato, Francesco; Treves, Susan

doi:10.1083/jcb.2133oia96

Cited by 2 publications

(3 citation statements)

References 17 publications

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“…This could provide valuable clues in the pathophysiology of EOM involvement and in disease pathophysiology in general, since the EOM differ anatomically and physiologically from skeletal muscles. They have distinct fibre type composition, 99 multiple innervation, 100 smaller motor units, 101 higher levels of utrophin expression, 102 a distinct contraction–excitation coupling, 103 have an increased capability of regeneration and preferentially use glucose‐based aerobic metabolic pathways 69 . The latter means that EOM are packed with mitochondria, explaining the predominant ocular phenotype in mitochondrial diseases such as CPEO.…”

Section: Discussionmentioning

confidence: 99%

Clinical and imaging clues to the diagnosis and follow‐up of ptosis and ophthalmoparesis

Keene

Kan

Meeren

et al. 2022

J cachexia sarcopenia muscle

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Ophthalmoparesis and ptosis can be caused by a wide range of rare or more prevalent diseases, several of which can be successfully treated. In this review, we provide clues to aid in the diagnosis of these diseases, based on the clinical symptoms, the involvement pattern and imaging features of extra‐ocular muscles (EOM). Dysfunction of EOM including the levator palpebrae can be due to muscle weakness, anatomical restrictions or pathology affecting the innervation. A comprehensive literature review was performed to find clinical and imaging clues for the diagnosis and follow‐up of ptosis and ophthalmoparesis. We used five patterns as a framework for differential diagnostic reasoning and for pattern recognition in symptomatology, EOM involvement and imaging results of individual patients. The five patterns were characterized by the presence of combination of ptosis, ophthalmoparesis, diplopia, pain, proptosis, nystagmus, extra‐orbital symptoms, symmetry or fluctuations in symptoms. Each pattern was linked to anatomical locations and either hereditary or acquired diseases. Hereditary muscle diseases often lead to ophthalmoparesis without diplopia as a predominant feature, while in acquired eye muscle diseases ophthalmoparesis is often asymmetrical and can be accompanied by proptosis and pain. Fluctuation is a hallmark of an acquired synaptic disease like myasthenia gravis. Nystagmus is indicative of a central nervous system lesion. Second, specific EOM involvement patterns can also provide valuable diagnostic clues. In hereditary muscle diseases like chronic progressive external ophthalmoplegia (CPEO) and oculo‐pharyngeal muscular dystrophy (OPMD) the superior rectus is often involved. In neuropathic disease, the pattern of involvement of the EOM can be linked to specific cranial nerves. In myasthenia gravis this pattern is variable within patients over time. Lastly, orbital imaging can aid in the diagnosis. Fat replacement of the EOM is commonly observed in hereditary myopathic diseases, such as CPEO. In contrast, inflammation and volume increases are often observed in acquired muscle diseases such as Graves' orbitopathy. In diseases with ophthalmoparesis and ptosis specific patterns of clinical symptoms, the EOM involvement pattern and orbital imaging provide valuable information for diagnosis and could prove valuable in the follow‐up of disease progression and the understanding of disease pathophysiology.

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Section: Discussionmentioning

confidence: 99%

Clinical and imaging clues to the diagnosis and follow‐up of ptosis and ophthalmoparesis

Keene

Kan

Meeren

et al. 2022

J cachexia sarcopenia muscle

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“…Collectively, the OOM acts as an antagonist of the LPS muscle. 13 The importance of superior tarsal muscle (Müller's muscle), a smooth muscle adjoining LPS while inserting onto the superior tarsal plate of the eyelid, should not be overlooked. Müller's muscle helps in raising the upper eyelid and is innervated by the postganglionic sympathetic fibers originating from the superior cervical ganglion.…”

Section: Physiology Of the Blink Reflex And Eye Sphincter Complexmentioning

confidence: 99%

“…The palpebral portion, which is subdivided into pretarsal, preseptal, and ciliary segments, is responsible for the blink reflex, which is involuntary. Collectively, the OOM acts as an antagonist of the LPS muscle 13 . The importance of superior tarsal muscle (Müller's muscle), a smooth muscle adjoining LPS while inserting onto the superior tarsal plate of the eyelid, should not be overlooked.…”

Section: Physiology Of the Blink Reflex And Eye Sphincter Complexmentioning

confidence: 99%

Eye Sphincter Reanimation in Facial Paralysis

et al. 2022

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Facial nerve paralysis (FNP) sequela includes dysregulation of the ocular surface protective mechanism, nasolacrimal system pump failure and punctal eversion causing chronic epiphora, foreign body sensation, corneal injury, and, in the most severe cases, visual loss, particularly in the presence of comorbid corneal hypesthesia. Concerns over the ocular surface protection in FNP patients have led to the development of numerous static and dynamic procedures. While initial assessment of the FNP patients is complex and requires a comprehensive understanding of the blink reflex physiology, clinical evaluation and the use of additional work should be directed toward potential eye sphincter reanimation using a multidisciplinary approach. As with any treatment algorithm, numerous factors must be considered to provide an individualized treatment plan. In the case of FNP, it is important to consider denervation time, patient age, cause of paralysis, and neurologic severity of the paralysis. The aim of this article is to provide a thorough review of the physiology of the blink reflex, evaluation of the eye sphincter mechanism in FNP, and a comprehensive treatment algorithm incorporating static and dynamic procedures, along with a historical perspective.

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Functional characterization of orbicularis oculi and extraocular muscles

Cited by 2 publications

References 17 publications

Clinical and imaging clues to the diagnosis and follow‐up of ptosis and ophthalmoparesis

Clinical and imaging clues to the diagnosis and follow‐up of ptosis and ophthalmoparesis

Eye Sphincter Reanimation in Facial Paralysis

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