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BRIEF COMMUNICATION
Year : 2011  |  Volume : 59  |  Issue : 6  |  Page : 517-519

Restrictive extraocular myopathy: A presenting feature of acromegaly


Department of Ophthalmology, Ghent University Hospital, Ghent, Belgium

Correspondence Address:
Christian E Decock
Department of Ophthalmology, Ghent University Hospital, De Pintelaan 185, 9000 Gent
Belgium
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0301-4738.86330

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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.


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