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Combining recessions (nystagmus and strabismus) with tenotomy improved visual function and decreased oscillopsia and diplopia in acquired downbeat nystagmus and in horizontal infantile nystagmus syndrome.
J AAPOS. 2007 Apr; 11(2):135-41.JA

Abstract

PURPOSE

To investigate the effects of combined tenotomy and recession procedures on both acquired downbeat nystagmus and horizontal infantile nystagmus.

METHODS

Patient 1 had downbeat nystagmus with a chin-down (upgaze) position, oscillopsia, strabismus, and diplopia. Asymmetric superior rectus recessions and inferior rectus tenotomies reduced right hypertropia and rotated both eyes downward. Patient 2 had horizontal infantile nystagmus, a 20 degrees left-eye exotropia, and alternating (abducting-eye) fixation. Lateral rectus recessions and medial rectus tenotomies were performed. Horizontal and vertical eye movements were recorded pre- and postsurgically using high-speed digital video. The eXpanded Nystagmus Acuity Function (NAFX) and nystagmus amplitudes and frequencies were measured.

RESULTS

Patient 1: The NAFX peak moved from 10 degrees up to primary position where NAFX values improved 17% and visual acuity increased 25%. Vertical NAFX increased across the -10 degrees to +5 degrees vertical range. Primary-position right hypertropia decreased approximately 50%; foveation time per cycle increased 102%; vertical amplitude, oscillopsia, and diplopia were reduced, and frequency was unchanged. Patient 2: Two lateral, narrow high-NAFX regions (due to alternating fixation) became one broad region with a 43% increase in primary position (acuity increased approximately 92.3%). Diplopia amplitude decreased; convergence and gaze holding were improved. Primary-position right exotropia was reduced; foveation time per cycle increased 257%; horizontal-component amplitude decreased 45.7%, and frequency remained unchanged.

CONCLUSIONS

Combining tenotomy with nystagmus or strabismus recession procedures increased NAFX and visual acuities and reduced diplopia and oscillopsia in downbeat nystagmus and infantile nystagmus.

Authors+Show Affiliations

Daroff-Dell'Osso Ocular Motility Laboratory, Louis Stokes Cleveland Department of Veterans Affairs Medical Center and CASE Medical School, Cleveland, Ohio 44106, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

17280849

Citation

Wang, Zhong I., et al. "Combining Recessions (nystagmus and Strabismus) With Tenotomy Improved Visual Function and Decreased Oscillopsia and Diplopia in Acquired Downbeat Nystagmus and in Horizontal Infantile Nystagmus Syndrome." Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus, vol. 11, no. 2, 2007, pp. 135-41.
Wang ZI, Dell'Osso LF, Tomsak RL, et al. Combining recessions (nystagmus and strabismus) with tenotomy improved visual function and decreased oscillopsia and diplopia in acquired downbeat nystagmus and in horizontal infantile nystagmus syndrome. J AAPOS. 2007;11(2):135-41.
Wang, Z. I., Dell'Osso, L. F., Tomsak, R. L., & Jacobs, J. B. (2007). Combining recessions (nystagmus and strabismus) with tenotomy improved visual function and decreased oscillopsia and diplopia in acquired downbeat nystagmus and in horizontal infantile nystagmus syndrome. Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus, 11(2), 135-41.
Wang ZI, et al. Combining Recessions (nystagmus and Strabismus) With Tenotomy Improved Visual Function and Decreased Oscillopsia and Diplopia in Acquired Downbeat Nystagmus and in Horizontal Infantile Nystagmus Syndrome. J AAPOS. 2007;11(2):135-41. PubMed PMID: 17280849.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Combining recessions (nystagmus and strabismus) with tenotomy improved visual function and decreased oscillopsia and diplopia in acquired downbeat nystagmus and in horizontal infantile nystagmus syndrome. AU - Wang,Zhong I, AU - Dell'Osso,Louis F, AU - Tomsak,Robert L, AU - Jacobs,Jonathan B, Y1 - 2007/02/05/ PY - 2006/08/01/received PY - 2006/10/23/revised PY - 2006/10/23/accepted PY - 2007/2/7/pubmed PY - 2007/5/30/medline PY - 2007/2/7/entrez SP - 135 EP - 41 JF - Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus JO - J AAPOS VL - 11 IS - 2 N2 - PURPOSE: To investigate the effects of combined tenotomy and recession procedures on both acquired downbeat nystagmus and horizontal infantile nystagmus. METHODS: Patient 1 had downbeat nystagmus with a chin-down (upgaze) position, oscillopsia, strabismus, and diplopia. Asymmetric superior rectus recessions and inferior rectus tenotomies reduced right hypertropia and rotated both eyes downward. Patient 2 had horizontal infantile nystagmus, a 20 degrees left-eye exotropia, and alternating (abducting-eye) fixation. Lateral rectus recessions and medial rectus tenotomies were performed. Horizontal and vertical eye movements were recorded pre- and postsurgically using high-speed digital video. The eXpanded Nystagmus Acuity Function (NAFX) and nystagmus amplitudes and frequencies were measured. RESULTS: Patient 1: The NAFX peak moved from 10 degrees up to primary position where NAFX values improved 17% and visual acuity increased 25%. Vertical NAFX increased across the -10 degrees to +5 degrees vertical range. Primary-position right hypertropia decreased approximately 50%; foveation time per cycle increased 102%; vertical amplitude, oscillopsia, and diplopia were reduced, and frequency was unchanged. Patient 2: Two lateral, narrow high-NAFX regions (due to alternating fixation) became one broad region with a 43% increase in primary position (acuity increased approximately 92.3%). Diplopia amplitude decreased; convergence and gaze holding were improved. Primary-position right exotropia was reduced; foveation time per cycle increased 257%; horizontal-component amplitude decreased 45.7%, and frequency remained unchanged. CONCLUSIONS: Combining tenotomy with nystagmus or strabismus recession procedures increased NAFX and visual acuities and reduced diplopia and oscillopsia in downbeat nystagmus and infantile nystagmus. SN - 1091-8531 UR - https://www.unboundmedicine.com/medline/citation/17280849/Combining_recessions__nystagmus_and_strabismus__with_tenotomy_improved_visual_function_and_decreased_oscillopsia_and_diplopia_in_acquired_downbeat_nystagmus_and_in_horizontal_infantile_nystagmus_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1091-8531(06)00578-7 DB - PRIME DP - Unbound Medicine ER -