Back to Journals » Clinical Ophthalmology » Volume 8

Retrospective study of recession of four horizontal rectus muscle in periodic alternating nystagmus

Authors Mimura O, Ishikawa H, Kimura N, Kimura A, Borlongan C

Received 6 August 2014

Accepted for publication 1 October 2014

Published 11 December 2014 Volume 2014:8 Pages 2523—2528

DOI https://doi.org/10.2147/OPTH.S72349

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Scott Fraser


Supplemental video showing nystagmus "after" surgery in case number 1

Views: 1990

Osamu Mimura,1 Hiroto Ishikawa,1,2 Naoki Kimura,1 Akiko Kimura,1 Cesar V Borlongan2

1Department of Ophthalmology, Hyogo College of Medicine, Nishinomiya, Hyogo, Japan; 2Department of Neurosurgery and Brain Repair, University of South Florida, Tampa, FL, USA

Purpose:
Periodic alternating nystagmus (PAN) is a spontaneous horizontal nystagmus observed in disorders of the central nervous system. Patients with congenital PAN complain of oscillating vision at high rates. Medication is the first-choice treatment for PAN; however, clinicians still seek better therapy. The aim of this study was to evaluate outcomes of recession of four horizontal rectus muscle (R-FHR) in patients with congenital PAN.
Patients and methods: This study reports a retrospective case series of ten patients (seven males and three females; mean age 24.4±10.9) with congenital PAN who underwent R-FHR between 2007 and 2012, which was performed by the same surgeon at the Hyogo College of Medicine. Patients were evaluated for complications, recession amount, deviation angle, eye movements including a nystagmus amplitude, and visual acuity during pre- and post-operative periods.
Results: Pre-operatively, patients complained of oscillating vision, abnormal head posture, esotropia, and congenital superior oblique palsy. Post-operatively, changes from the previous observations of nystagmus amplitudes and abnormal head posture demonstrated a complete reversal in all patients. In addition, visual acuity determined with a Snellen chart improved in two patients. However, esotropia occurred in three patients who underwent additional strabismus surgery 2 days after R-FHR. R-FHR was particularly effective in eight patients who pre-operatively had periodic oscillating vision with a regular pattern of periodic nystagmus.
Conclusion: We demonstrated that ten patients with congenital PAN had improved vision following R-FHR, indicating that R-FHR was an effective procedure, especially in patients suffering PAN with periodic oscillating vision.

Keywords:
congenital nystagmus, null point nystagmus, strabismus surgery, ocular torticollis, oscillating vision, electro-oculogram

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]