Duane Retraction Syndrome: Series of 441 Cases

Purpose: To determine the demographic and clinical profile of various subtypes of Duane retraction syndrome (DRS). Methods: Retrospective case series of 441 patients. Results: Of the total 441 patients, 389 (88.2%) and 52 (11.8%) patients had unilateral and bilateral involvement, respectively. In both unilateral and bilateral cases, type I was the most common subtype, followed by types III and II. Mean age of presentation of type I DRS was significantly less (13.3 years) compared with types II (23 years) and III (21.9 years) ( P < .05). Unilateral disease was significantly more common in females (57. 6%, P = .006), whereas there was no gender predilection in bilateral cases ( P = .77). Type 1 DRS was significantly more common among females (57.96%, P = .003) compared with males, whereas there was no such gender predilection in types II and III. The left eye was more commonly involved in patients with types I and III ( P < .05), whereas in type II there was no such predilection for any eye involvement. Esotropia was more common in patients with bilateral disease (53.8%) and exotropia was predominant ocular deviation in patients with types II and III (70% and 66.67%, P = .03). There was no difference in the type of deviation in patients with type I ( P > .05). Upshoots and downshoots were more common in unilateral disease and types I and III compared with type II. Conclusion: Unilateral and bilateral DRS show considerable differences in gender distribution, associated ocular deviation, overshoots, and ocular and systemic associations.