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Torsion in patients with superior oblique palsies: dynamic torsion during saccades and changes in Listing’s plane


Steffen, H; Straumann, D S; Walker, M F; Miller, N R; Guyton, D L; Repka, M X; Zee, D S (2008). Torsion in patients with superior oblique palsies: dynamic torsion during saccades and changes in Listing’s plane. Graefe's Archive for Clinical and Experimental Ophthalmology, 246(5):771-778.

Abstract

BACKGROUND: The purpose was to assess intra- and post-saccadic torsion in superior oblique palsy (SOP) patients and the effect of surgery on torsion. METHODS: Eleven patients with a presumed congenital SOP and five with acquired SOP performed 10 degrees vertical saccades over a range of +/-20 degrees. Eye movements were recorded with dual search coils. Dynamic torsion was calculated by subtracting the expected change in torsion during the saccade (based upon static torsion before and after the saccade) from the maximum intrasaccadic torsion. Eight healthy subjects were controls. We also examined the effects of surgery on dynamic torsion and the orientation of Listing's plane in patients with congenital SOP who were operated on either by weakening of the inferior oblique muscle on the affected eye (n=5), by recession of the inferior rectus muscle on the normal eye (n=4) or by both procedures (n=2). Postoperative recordings were obtained at least 1 month after surgery. RESULTS: Patients with congenital and acquired SOP showed an increased dynamic extorsion, primarily during downward saccades. Following a recession of the inferior oblique muscle in congenital SOP patients, half showed significant decreases in extorsion (up to 1.0 degrees) during downward saccades by the affected eye. Following surgery all showed a temporal rotation of Listing's plane (up to 15 degrees for primary position). CONCLUSION: Patients with a SOP show a characteristic pattern of dynamic torsion during vertical saccades differing from normals. Recession of the inferior oblique muscle leads to rotation of Listing's plane in all congenital SOP patients and causes large changes in dynamic torsion in a subgroup of them, perhaps reflecting the heterogeneity of congenital SOP.

BACKGROUND: The purpose was to assess intra- and post-saccadic torsion in superior oblique palsy (SOP) patients and the effect of surgery on torsion. METHODS: Eleven patients with a presumed congenital SOP and five with acquired SOP performed 10 degrees vertical saccades over a range of +/-20 degrees. Eye movements were recorded with dual search coils. Dynamic torsion was calculated by subtracting the expected change in torsion during the saccade (based upon static torsion before and after the saccade) from the maximum intrasaccadic torsion. Eight healthy subjects were controls. We also examined the effects of surgery on dynamic torsion and the orientation of Listing's plane in patients with congenital SOP who were operated on either by weakening of the inferior oblique muscle on the affected eye (n=5), by recession of the inferior rectus muscle on the normal eye (n=4) or by both procedures (n=2). Postoperative recordings were obtained at least 1 month after surgery. RESULTS: Patients with congenital and acquired SOP showed an increased dynamic extorsion, primarily during downward saccades. Following a recession of the inferior oblique muscle in congenital SOP patients, half showed significant decreases in extorsion (up to 1.0 degrees) during downward saccades by the affected eye. Following surgery all showed a temporal rotation of Listing's plane (up to 15 degrees for primary position). CONCLUSION: Patients with a SOP show a characteristic pattern of dynamic torsion during vertical saccades differing from normals. Recession of the inferior oblique muscle leads to rotation of Listing's plane in all congenital SOP patients and causes large changes in dynamic torsion in a subgroup of them, perhaps reflecting the heterogeneity of congenital SOP.

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4 citations in Web of Science®
5 citations in Scopus®
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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Center for Integrative Human Physiology
04 Faculty of Medicine > Neuroscience Center Zurich
04 Faculty of Medicine > University Hospital Zurich > Clinic for Neurology
Dewey Decimal Classification:570 Life sciences; biology
610 Medicine & health
Language:English
Date:2008
Deposited On:23 Feb 2009 12:05
Last Modified:05 Apr 2016 13:04
Publisher:Springer
ISSN:0721-832X
Additional Information:The original publication is available at www.springerlink.com at http://www.springerlink.com/content/0140503724210086/fulltext.pdf
Publisher DOI:10.1007/s00417-007-0622-5
PubMed ID:17609970

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