Clinical Assessment of Ocular Torsion

Guyton, David L.

doi:10.1080/0065955x.1983.11981591

Cited by 112 publications

(57 citation statements)

References 3 publications

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“…Consequently, objective torsion may be studied with either of the eyes looking fixedly at a target. The Maddox rod test was not performed in the present study because the subjective test results may show absence of torsion due to sensorial adaptations, even if objective tests show changes in eye torsion (9,12,(16)(17)(18) . This is because spatial adaptation offsets the torsion of the image, particularly in patients with congenital torsion alterations or changes acquired very early in life (18) .…”

Section: Discussionmentioning

confidence: 99%

“…Bixenman and Von Noorden (2) also established the normal position of the fovea, located at one-third of the disk diameter below the horizontal line that crosses the optic disc center, creating a mean angle of 7.25° with that line. Guyton (12) described a grading method that classifies the torsion with respect to the optic disc divided into eight parts. In this case, the normal position of the fovea is located 9° below the optic disc center, which corresponds to the union between the central and the lower thirds.…”

Section: Discussionmentioning

confidence: 99%

“…Procedures that weaken anterior fibers result in a greater excycloduction (6,7) . The cycloduction that results from weakening surgeries of the in ferior oblique muscle is widely reported in the literature (2,5,12,13) . However, few studies have evaluated the torsional effect resulting from weakening procedures involving the superior oblique muscle.…”

Section: Introductionmentioning

confidence: 99%

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Measurement of ocular torsion variation following superior oblique tenectomy

Ducca¹,

Souza-Dias²,

Lui³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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Purposes: To objectively evaluate the torsional effect of the superior oblique muscle-weakening surgery using the tenectomy technique proposed by Souza-Dias. Methods: The present prospective study included 10 patients (20 eyes) with horizontal strabismus, bilateral superior oblique overaction and A-pattern of 15 to 30 prism diopters who underwent superior oblique tenectomy. Objective assessment of ocular torsion was performed by retinography immediately before and one month after surgery. The amount of ocular torsion was determined by measuring the angle formed by a horizontal line drawn across the geometric center of the optic disc and a second line connecting this point to the fovea. Results: The median preoperative angle was 5.56° in the right eyes and -3.43° in the left eyes. The median postoperative angle was 1.84° in the right eyes and -3.12° in the left eyes. The angle variation was statistically significant in both eyes (p=0.012 and p=0.01, respectively). Conclusion:The present study suggests that superior oblique tenectomy has an extorter effect, decreasing the intorsion detected on overaction of this muscle.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Measurement of ocular torsion variation following superior oblique tenectomy

Ducca¹,

Souza-Dias²,

Lui³

et al. 2014

Arquivos Brasileiros De Oftalmologia

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show abstract

“…Objective, static torsion can be assessed by measuring the optic nerve head-foveal angle-the angle between the papilla-fovea meridian (straight line between optic nerve head and fovea) and earth horizontal on a fundus photograph taken with head and camera upright [1,5,7,[12][13][14]. An alternate method, evaluating blind spot heterotopia by visual field perimetry was proposed by Locke in 1967 [11].…”

Section: Dear Sirsmentioning

confidence: 99%

Blind spot heterotopia by automated static perimetry to assess static ocular torsion: centro-cecal axis rotation in normals

Versino

Newman‐Toker

2009

J Neurol

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“…10 The relevance of ocular torsion in the diagnosis of SOP is well recognized. 12,13 Identification of bilateral excyclotorsion provides essential information in diagnosing bilateral SOP, 14 and incyclotorsion of the hypertropic eye suggests skew deviation. 15 However, torsional patterns in unilateral SOP have shown inconsistent results, and little is known about the torsional changes in SOP according to its pathogenic etiology.…”

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confidence: 99%

Ocular Torsion According to Trochlear Nerve Absence in Unilateral Superior Oblique Palsy

Lee

Yang

Kim

et al. 2017

Invest. Ophthalmol. Vis. Sci.

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Citation: Lee JE, Yang HK, Kim JH, Hwang J-M. Ocular torsion according to trochlear nerve absence in unilateral superior oblique palsy. Invest Ophthalmol Vis Sci. 2017;58:5526-5531. DOI:10.1167/iovs.17-22452 PURPOSE. To investigate the relationship between objective ocular torsion and the presence or absence of the trochlear nerve in subjects with unilateral superior oblique palsy (SOP). METHODS.A total of 159 subjects with congenital and acquired unilateral SOP were reviewed. Eighty-four subjects who had a normal trochlear nerve (present group) and 75 subjects without a trochlear nerve (absent group) were included. Cyclovertical motility parameters and objective ocular torsion were compared between groups, and factors related to ocular torsion were evaluated. RESULTS.The degree of ''net'' excyclotorsion in the paretic eye was larger in the absent group compared to the present group (P ¼ 0.002). The proportion of net excyclotorsion in the paretic eye was greater in the absent group (11% vs. 37%), while net incyclotorsion was greater in the present group (41% vs. 23%) (P < 0.001). Net excyclotorsion of the paretic eye was associated with absence of the trochlear nerve (P < 0.001) and smaller size of the paretic SO (P < 0.001). Net incyclotorsion of the paretic eye was related with a normal trochlear nerve (P ¼ 0.005), larger size of the paretic SO (P ¼ 0.002), and greater hypertropia during ipsilateral gaze (P ¼ 0.024).CONCLUSIONS. The status of the trochlear nerve, paretic SO size, and hypertropia during ipsilateral gaze which reflects the tensile strength of the ipsilateral superior rectus, significantly contribute to ocular torsion in unilateral SOP.Keywords: superior oblique palsy, trochlear nerve, ocular torsion R ecent investigations based on advanced imaging modalities and functional anatomy have offered novel approaches to understand the etiology and pathophysiology of superior oblique palsy (SOP).1-11 Absence of the trochlear nerve has been well recognized as one of the major pathologic etiologies of SOP. 5,6,10 In our earlier study of congenital SOP, 73% showed ipsilateral trochlear nerve absence and a variable extent of SO hypoplasia, whereas the remainder had a normal-appearing SO and trochlear nerve on both sides. 10The relevance of ocular torsion in the diagnosis of SOP is well recognized.12,13 Identification of bilateral excyclotorsion provides essential information in diagnosing bilateral SOP, 14 and incyclotorsion of the hypertropic eye suggests skew deviation. 15 However, torsional patterns in unilateral SOP have shown inconsistent results, and little is known about the torsional changes in SOP according to its pathogenic etiology. To date, there are only few studies 10,11,16 investigating subjective and objective torsion in SOP according to its major etiologies. In our previous report, 10 objective ocular torsion using fundus photographs with an internal fixator did not show any differences according to the presence of the trochlear nerve; however, the investigation was conducted only in con...

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Clinical Assessment of Ocular Torsion

Cited by 112 publications

References 3 publications

Measurement of ocular torsion variation following superior oblique tenectomy

Measurement of ocular torsion variation following superior oblique tenectomy

Blind spot heterotopia by automated static perimetry to assess static ocular torsion: centro-cecal axis rotation in normals

Ocular Torsion According to Trochlear Nerve Absence in Unilateral Superior Oblique Palsy

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