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Characterization of Inferior Rectus Muscle Action in Normal Subjects Using Real-Time Magnetic Resonance Imaging of the Orbit

Title: Characterization of Inferior Rectus Muscle Action in Normal Subjects Using Real-Time Magnetic Resonance Imaging of the Orbit
Authors: Alexander R. Engelmann; Kailash Singh; Jiachen Zhuo; Néha Datta; Alfredo A. Sadun; Michael P. Grant; Shannath L. Merbs
Source: Craniomaxillofacial Trauma & Reconstruction ; Volume 19 ; Issue 2 ; Pages: 20
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2026
Collection: MDPI Open Access Publishing
Subject Terms: dynamic orbital anatomy; real-time MRI; inferior rectus morphology; eye movement
Description: 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.
Document Type: text
File Description: application/pdf
Language: English
Relation: https://dx.doi.org/10.3390/cmtr19020020
DOI: 10.3390/cmtr19020020
Availability: https://doi.org/10.3390/cmtr19020020
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.3F3B9600
Database: BASE