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Independence of Optokinetic Nystagmus Asymmetry and Binocularity in Infantile Esotropia

Independence of Optokinetic Nystagmus Asymmetry and Binocularity in Infantile Esotropia Abstract Objective: Children with congenital esotropia, amblyopia, or early visual deprivation have persistent asymmetric monocular pursuit, as measured by optokinetic nystagmus (OKN), and favor targets moving in a temporal to nasal direction. Previous studies suggest that binocular visual development is necessary for the development of symmetric monocular OKN. We recently treated patients with congenital esotropia with unconventionally early surgery to establish good binocularity. We wished to determine if mature symmetric OKN responses could develop in patients with congenital esotropia following the acquisition of good stereopsis. Methods: Electro-oculographic recordings documented horizontal eye movements in response to an electronic OKN stimulus. Patients: The recordings of three patients with congenital esotropia that had been surgically aligned before age 20 weeks and who had achieved high-grade stereopsis with random dot and Titmus stereographic testing were studied. We compared this group of children with groups of age-matched controls, including the following: (1) three patients with congenital esotropia who underwent surgical alignment after age 6 months and who had no amblyopia but poor stereopsis; (2) three children with accommodative esotropia, good ocular alignment when wearing spectacles, and good stereopsis; and (3) three normal children. Results: The normal children and those with accommodative esotropia demonstrated normal symmetrical OKN. The patients with congenital esotropia showed poor nasal to temporal OKN regardless of the degree of stereopsis or timing of surgery. Conclusions: Our results indicate that good binocularity, as measured by stereopsis, is not sufficient for the development of symmetric OKN in patients with congenital esotropia. References 1. Westall CA, Woodhouse JM, Brown VA. OKN asymmetries and binocular function in amblyopia . Ophthalmic Physiol Opt . 1989;9:269-276.Crossref 2. Atkinson J. Development of optokinetic nystagmus in the human infant and monkey infant: an analogue to development in kittens . In: Freeman RD, ed. Developmental Neurobiology of Vision . New York, NY: Plenum Press; 1979: 277-287. 3. Atkinson J, Braddick O. Development of optokinetic nystagmus in infants: an indicator of cortical binocularity? In: Fisher DF, Monty RA, Senders JW, eds. Eye Movements: Cognition and Visual Perception . Hillsdale, NJ: Lawrence Erlbaum; 1981:53-64. 4. Naegele JR, Held R. The postnatal development of monocular optokinetic nystagmus in infants . Vision Res . 1982;22:341-346.Crossref 5. van Hof-van Duin J, Mohn G. Vision in the preterm infant. In: Prechtl HFR, ed. Continuity of Neural Functions from Prenatal to Postnatal Life . Philadelphia, Pa: JB Lippincott; 1984:93-114. 6. van Hof-van Duin J, Mohn G. Visual field measurements, optokinetic nystagmus and the visual threatening response: normal and abnormal development . Doc Ophthalmol Proc Ser . 1986;45:305-316. 7. Roy MS, Lachapelle P, Leporé F. Maturation of optokinetic nystagmus and the role of visual experience in normal and preterm infants . Invest Ophthalmol Vis Sci . 1987;28( (suppl) ):313. 8. Held R, Birch E, Gwiazda J. Stereoacuity of human infants . Proc Natl Acad Sci U S A . 1980;77:5572-5574.Crossref 9. Schor CM, Levi DM. Disturbances of small-field horizontal and vertical optokinetic nystagmus in amblyopia . Invest Ophthalmol Vis Sci . 1980;19:668-683. 10. Maurer D, Lewis TL, Brent HP. Peripheral vision and optokinetic nystagmus in children with unilateral congenital cataract . Behav Brain Res . 1983;10:151-161.Crossref 11. Tychsen L, Hurtig RR, Scott WE. Pursuit is impaired but the vestibulo-ocular reflex is normal in infantile strabismus . Arch Ophthalmol . 1985;103:536-539.Crossref 12. Lewis TL, Maurer D, Brent HP. Optokinetic nystagmus in normal and visually deprived children: implications for cortical development . Can J Psychol . 1989;43:121-140.Crossref 13. von Noorden GK. Amblyopia: a multidisciplinary approach: Proctor Lecture . Invest Ophthalmol Vis Sci . 1985;26:1704-1716. 14. Crawford MLJ, von Noorden GK, Meharg LS, et al. Binocular neurons and binocular function in monkeys and children . Invest Ophthalmol Vis Sci . 1983;24:491-495. 15. Wright KW. Early strabismus surgery for the treatment of congenital esotropia . Invest Ophthalmol Vis Sci . 1991;32( (suppl) ):1240. 16. Wright KW, Edelman P, Terry A, McVey J, Lin M. High-grade stereo acuity after early surgery for congenital esotropia . Invest Ophthalmol Vis Sci . 1993; ( (suppl) )34:710. 17. Tychsen L, Lisberger SG. Visual motion processing for the initiation of smooth-pursuit eye movements in humans . J Neurophysiol . 1986;56:953-968. 18. Mohn G, Sireteanu R, van Hof-van Duin J. The relation of monocular optokinetic nystagmus to peripheral binocular interactions . Invest Ophthalmol Vis Sci . 1986;27:565-573. 19. Schoppmann A. Projections from areas 17 and 18 of the visual cortex to the nucleus of the optic tract . Brain Res . 1981;223:1-17.Crossref 20. Montarolo PG, Precht W, Strata P. Functional organization of the mechanisms subserving the optokinetic nystagmus in the cat . Neuroscience . 1981;6:231-246.Crossref 21. Hoffmann KP. Optokinetic nystagmus and single-cell responses in the nucleus tractus opticus after early monocular deprivation in the cat . In: Freeman RD, ed. Developmental Neurobiology of Vision . New York, NY: Plenum Press; 1979: 63-72. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Ophthalmology American Medical Association

Independence of Optokinetic Nystagmus Asymmetry and Binocularity in Infantile Esotropia

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Publisher
American Medical Association
Copyright
Copyright © 1994 American Medical Association. All Rights Reserved.
ISSN
0003-9950
eISSN
1538-3687
DOI
10.1001/archopht.1994.01090240086030
Publisher site
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Abstract

Abstract Objective: Children with congenital esotropia, amblyopia, or early visual deprivation have persistent asymmetric monocular pursuit, as measured by optokinetic nystagmus (OKN), and favor targets moving in a temporal to nasal direction. Previous studies suggest that binocular visual development is necessary for the development of symmetric monocular OKN. We recently treated patients with congenital esotropia with unconventionally early surgery to establish good binocularity. We wished to determine if mature symmetric OKN responses could develop in patients with congenital esotropia following the acquisition of good stereopsis. Methods: Electro-oculographic recordings documented horizontal eye movements in response to an electronic OKN stimulus. Patients: The recordings of three patients with congenital esotropia that had been surgically aligned before age 20 weeks and who had achieved high-grade stereopsis with random dot and Titmus stereographic testing were studied. We compared this group of children with groups of age-matched controls, including the following: (1) three patients with congenital esotropia who underwent surgical alignment after age 6 months and who had no amblyopia but poor stereopsis; (2) three children with accommodative esotropia, good ocular alignment when wearing spectacles, and good stereopsis; and (3) three normal children. Results: The normal children and those with accommodative esotropia demonstrated normal symmetrical OKN. The patients with congenital esotropia showed poor nasal to temporal OKN regardless of the degree of stereopsis or timing of surgery. Conclusions: Our results indicate that good binocularity, as measured by stereopsis, is not sufficient for the development of symmetric OKN in patients with congenital esotropia. References 1. Westall CA, Woodhouse JM, Brown VA. OKN asymmetries and binocular function in amblyopia . Ophthalmic Physiol Opt . 1989;9:269-276.Crossref 2. Atkinson J. Development of optokinetic nystagmus in the human infant and monkey infant: an analogue to development in kittens . In: Freeman RD, ed. Developmental Neurobiology of Vision . New York, NY: Plenum Press; 1979: 277-287. 3. Atkinson J, Braddick O. Development of optokinetic nystagmus in infants: an indicator of cortical binocularity? In: Fisher DF, Monty RA, Senders JW, eds. Eye Movements: Cognition and Visual Perception . Hillsdale, NJ: Lawrence Erlbaum; 1981:53-64. 4. Naegele JR, Held R. The postnatal development of monocular optokinetic nystagmus in infants . Vision Res . 1982;22:341-346.Crossref 5. van Hof-van Duin J, Mohn G. Vision in the preterm infant. In: Prechtl HFR, ed. Continuity of Neural Functions from Prenatal to Postnatal Life . Philadelphia, Pa: JB Lippincott; 1984:93-114. 6. van Hof-van Duin J, Mohn G. Visual field measurements, optokinetic nystagmus and the visual threatening response: normal and abnormal development . Doc Ophthalmol Proc Ser . 1986;45:305-316. 7. Roy MS, Lachapelle P, Leporé F. Maturation of optokinetic nystagmus and the role of visual experience in normal and preterm infants . Invest Ophthalmol Vis Sci . 1987;28( (suppl) ):313. 8. Held R, Birch E, Gwiazda J. Stereoacuity of human infants . Proc Natl Acad Sci U S A . 1980;77:5572-5574.Crossref 9. Schor CM, Levi DM. Disturbances of small-field horizontal and vertical optokinetic nystagmus in amblyopia . Invest Ophthalmol Vis Sci . 1980;19:668-683. 10. Maurer D, Lewis TL, Brent HP. Peripheral vision and optokinetic nystagmus in children with unilateral congenital cataract . Behav Brain Res . 1983;10:151-161.Crossref 11. Tychsen L, Hurtig RR, Scott WE. Pursuit is impaired but the vestibulo-ocular reflex is normal in infantile strabismus . Arch Ophthalmol . 1985;103:536-539.Crossref 12. Lewis TL, Maurer D, Brent HP. Optokinetic nystagmus in normal and visually deprived children: implications for cortical development . Can J Psychol . 1989;43:121-140.Crossref 13. von Noorden GK. Amblyopia: a multidisciplinary approach: Proctor Lecture . Invest Ophthalmol Vis Sci . 1985;26:1704-1716. 14. Crawford MLJ, von Noorden GK, Meharg LS, et al. Binocular neurons and binocular function in monkeys and children . Invest Ophthalmol Vis Sci . 1983;24:491-495. 15. Wright KW. Early strabismus surgery for the treatment of congenital esotropia . Invest Ophthalmol Vis Sci . 1991;32( (suppl) ):1240. 16. Wright KW, Edelman P, Terry A, McVey J, Lin M. High-grade stereo acuity after early surgery for congenital esotropia . Invest Ophthalmol Vis Sci . 1993; ( (suppl) )34:710. 17. Tychsen L, Lisberger SG. Visual motion processing for the initiation of smooth-pursuit eye movements in humans . J Neurophysiol . 1986;56:953-968. 18. Mohn G, Sireteanu R, van Hof-van Duin J. The relation of monocular optokinetic nystagmus to peripheral binocular interactions . Invest Ophthalmol Vis Sci . 1986;27:565-573. 19. Schoppmann A. Projections from areas 17 and 18 of the visual cortex to the nucleus of the optic tract . Brain Res . 1981;223:1-17.Crossref 20. Montarolo PG, Precht W, Strata P. Functional organization of the mechanisms subserving the optokinetic nystagmus in the cat . Neuroscience . 1981;6:231-246.Crossref 21. Hoffmann KP. Optokinetic nystagmus and single-cell responses in the nucleus tractus opticus after early monocular deprivation in the cat . In: Freeman RD, ed. Developmental Neurobiology of Vision . New York, NY: Plenum Press; 1979: 63-72.

Journal

Archives of OphthalmologyAmerican Medical Association

Published: Dec 1, 1994

References