Tags

Type your tag names separated by a space and hit enter

Fusion maldevelopment (latent/manifest latent) nystagmus syndrome: effects of four-muscle tenotomy and reattachment.
J Pediatr Ophthalmol Strabismus. 2014 May-Jun; 51(3):180-8.JP

Abstract

PURPOSE

To examine the waveform and clinical effects of the four-muscle tenotomy and reattachment procedure in fusion maldevelopment nystagmus syndrome (FMNS) and to compare them to those documented in infantile nystagmus syndrome (INS) and acquired nystagmus.

METHODS

Both infrared reflection and high-speed digital video systems were used to record the eye movements in a patient with FMNS (before and after tenotomy and reattachment). Data were analyzed using the eXpanded Nystagmus Acuity Function (NAFX) that is part of the OMtools software. Model simulations and predictions were performed using the authors' behavioral ocular motor system model in MATLAB Simulink (The MathWorks, Inc., Natick, MA).

RESULTS

The model predicted, and the patient's data confirmed, that the tenotomy and reattachment procedure produces improvements in FMN waveforms across a broader field of gaze and decreases the Alexander's law variation. The patient's tenotomy and reattachment plots of NAFX after surgery versus gaze angle were higher and had lower slope than before surgery. Clinically, despite moderate improvements in both peak measured acuity and stereoacuity, dramatic improvements in the patient's abilities and lifestyle resulted.

CONCLUSIONS

The four-muscle tenotomy and reattachment nystagmus surgery produced beneficial therapeutic effects on FMN waveforms that are similar to those demonstrated in INS and acquired nystagmus. These results support the authors' prior recommendation that tenotomy and reattachment nystagmus should be added to required strabismus procedures in patients who also have FMNS (ie, perform tenotomy and reattachment on all unoperated muscles in the plane of the nystagmus). Furthermore, when strabismus surgery is not required, four-muscle tenotomy and reattachment may be used to improve FMN waveforms and visual function.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

24694546

Citation

Dell'Osso, Louis F., et al. "Fusion Maldevelopment (latent/manifest Latent) Nystagmus Syndrome: Effects of Four-muscle Tenotomy and Reattachment." Journal of Pediatric Ophthalmology and Strabismus, vol. 51, no. 3, 2014, pp. 180-8.
Dell'Osso LF, Orge FH, Jacobs JB, et al. Fusion maldevelopment (latent/manifest latent) nystagmus syndrome: effects of four-muscle tenotomy and reattachment. J Pediatr Ophthalmol Strabismus. 2014;51(3):180-8.
Dell'Osso, L. F., Orge, F. H., Jacobs, J. B., & Wang, Z. I. (2014). Fusion maldevelopment (latent/manifest latent) nystagmus syndrome: effects of four-muscle tenotomy and reattachment. Journal of Pediatric Ophthalmology and Strabismus, 51(3), 180-8. https://doi.org/10.3928/01913913-20140326-01
Dell'Osso LF, et al. Fusion Maldevelopment (latent/manifest Latent) Nystagmus Syndrome: Effects of Four-muscle Tenotomy and Reattachment. J Pediatr Ophthalmol Strabismus. 2014 May-Jun;51(3):180-8. PubMed PMID: 24694546.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Fusion maldevelopment (latent/manifest latent) nystagmus syndrome: effects of four-muscle tenotomy and reattachment. AU - Dell'Osso,Louis F, AU - Orge,Faruk H, AU - Jacobs,Jonathan B, AU - Wang,Zhong I, Y1 - 2014/04/02/ PY - 2013/12/10/received PY - 2014/01/16/accepted PY - 2014/4/4/entrez PY - 2014/4/4/pubmed PY - 2014/12/17/medline SP - 180 EP - 8 JF - Journal of pediatric ophthalmology and strabismus JO - J Pediatr Ophthalmol Strabismus VL - 51 IS - 3 N2 - PURPOSE: To examine the waveform and clinical effects of the four-muscle tenotomy and reattachment procedure in fusion maldevelopment nystagmus syndrome (FMNS) and to compare them to those documented in infantile nystagmus syndrome (INS) and acquired nystagmus. METHODS: Both infrared reflection and high-speed digital video systems were used to record the eye movements in a patient with FMNS (before and after tenotomy and reattachment). Data were analyzed using the eXpanded Nystagmus Acuity Function (NAFX) that is part of the OMtools software. Model simulations and predictions were performed using the authors' behavioral ocular motor system model in MATLAB Simulink (The MathWorks, Inc., Natick, MA). RESULTS: The model predicted, and the patient's data confirmed, that the tenotomy and reattachment procedure produces improvements in FMN waveforms across a broader field of gaze and decreases the Alexander's law variation. The patient's tenotomy and reattachment plots of NAFX after surgery versus gaze angle were higher and had lower slope than before surgery. Clinically, despite moderate improvements in both peak measured acuity and stereoacuity, dramatic improvements in the patient's abilities and lifestyle resulted. CONCLUSIONS: The four-muscle tenotomy and reattachment nystagmus surgery produced beneficial therapeutic effects on FMN waveforms that are similar to those demonstrated in INS and acquired nystagmus. These results support the authors' prior recommendation that tenotomy and reattachment nystagmus should be added to required strabismus procedures in patients who also have FMNS (ie, perform tenotomy and reattachment on all unoperated muscles in the plane of the nystagmus). Furthermore, when strabismus surgery is not required, four-muscle tenotomy and reattachment may be used to improve FMN waveforms and visual function. SN - 1938-2405 UR - https://www.unboundmedicine.com/medline/citation/24694546/Fusion_maldevelopment__latent/manifest_latent__nystagmus_syndrome:_effects_of_four_muscle_tenotomy_and_reattachment_ L2 - https://www.healio.com/doiresolver?doi=10.3928/01913913-20140326-01 DB - PRIME DP - Unbound Medicine ER -