Disk-Macula Relationship in Diagnosis of Vertical Muscle Paresis

Levine, Morris H.; Zahoruk, Ronald M.

doi:10.1016/0002-9394(72)90142-0

Cited by 12 publications

(4 citation statements)

References 2 publications

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“…For Locke (1967) and Levine (1969Levine ( , 1972) the upshoot of the globe during Bielschowsky's head tilting is due to the action of the inferior oblique: this means involvement of the contralateral superior rectus instead of pointing to disturbed ipsilateral torsion. Leese-screen: this diagnostic instrumental method confirms the Parks' three step test.…”

Section: Symptomatologymentioning

confidence: 99%

The superior oblique: A challenging extraocular muscle

Neetens¹,

Janssens²

1979

Doc Ophthalmol

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Isolated paralysis of one or both superior oblique muscles in a consecutive series of 43 patients was found to occur most often by indirect injury to the skull. The etiology in the group of spontaneous cases was mostly vascular. With rare exceptions the latter recovered spontaneously. Those with traumatic palsy may be due to "contrecoup" trauma at the decussation of the nerves or by decompensation of the cerebral fusional mechanism, with dissociation of the images of the two eyes and subsequent vertical deviation. The traumatic cases never recover spontaneously and recession or myectomy of the ipsilateral inferior oblique with or without recession of the contralateral inferior rectus is recommended but only in cases of more than 8 diopters squint, and in cases which do not adapt themselves by minor head-tilting.

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Section: Symptomatologymentioning

confidence: 99%

The superior oblique: A challenging extraocular muscle

Neetens¹,

Janssens²

1979

Doc Ophthalmol

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“…Objective ocular torsion corresponds to a pathological rotation of the globe when the patient is evaluated in a straight head position with no vestibular interference. Objective ocular torsion may be caused by primary cyclovertical strabismus, 15 acquired muscle paresis 16 or vestibular imbalance, 17 changing the DFA to values larger than normal. This term must be differentiated from compensatory ocular torsion, which refers to the physiological torsional eye movement that stabilizes images on the retina during head tilt (also called ocular counter‐roll).…”

Section: Introductionmentioning

confidence: 99%

Minimal detectable change of the disc‐fovea angle for ocular torsion assessment

Piedrahita-Alonso

Valverde-Megías

Martín-García

et al. 2021

Ophthalmic Physiologic Optic

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Purpose The disc‐fovea angle (DFA) is used as a relevant indicator of ocular torsion change in cyclovertical strabismus. However, interpretation of the variation in time must differentiate whether a real change has occurred or if the disparity is due to random measurement error. The aim of the study was to obtain the minimal detectable change (MDC) of the DFA. It represents the minimal variation between two measurements that may be considered a real ocular torsion change. Methods A prospective cross‐sectional study was conducted in San Carlos Clinical Hospital of Madrid, Spain. Sixty healthy right eyes from 60 patients (31 men and 29 women) were recruited. Three digital fundus photographs were obtained, and between measurements, the patient moved their head away from the head support and then returned. Two observers quantified the DFA with software designed with MATLAB. Test‐retest and interrater reliability were calculated. Results Mean participant age was 56.1 years (SD 16.6, range 25–85). Mean DFA was 8.1° (SD 3.5, range 1.3–18.5). Test‐retest reliability for Observer 1 (Ob1), Observer 2 (Ob2) and interrater reliability were excellent (ICC 0.80, 0.83 and 0.95, respectively). Precision was 2.9° (Ob1) and 3.0° (Ob2), and the MDC95 was 4.1° (Ob1) and 4.2° (Ob2). Bland‐Altman analysis revealed an absence of bias and a homoscedastic distribution of the differences. Conclusions The MDC of the DFA in fundus photography was 4°, which represents the minimal change that may be considered a real change in ocular torsion. This result may improve the interpretation of ocular torsion changes in surgery and clinical scenarios.

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“…Objective measurements of ocular torsion are most commonly performed using fundus photography [5] and more recently using infrared imaging by optical coherence tomography (OCT) [6][7][8]. Lee and Kim reported that when comparing the conventional method of measuring ocular torsion with fundus photographs to OCT, the OCT may be useful to automatically calculate the cyclotorsion [9].…”

Section: Introductionmentioning

confidence: 99%

Measuring ocular torsion and its variations using different nonmydriatic fundus photographic methods

et al. 2020

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Purpose To compare the variations in ocular torsion measurements made using different fundus photographic methods. Methods We enrolled subjects with three conditions: (1) patients with intermittent exotropia (IXT) (n = 44), (2) patients with unilateral superior oblique palsy (SOP) (n = 10), and (3) normal subjects as controls (n = 85). Ocular torsion was measured by disc-center–fovea angle (DFA) using three different imaging modalities: (1) conventional fundus photography (CFP) with a 45° field of view (FV), (2) wide-field fundus photography (WFP) with a 200° FV, and (3) optical coherence tomography (OCT) with a 55° FV. Results In the IXT group, the DFAs in the right and left eyes were 5.70±3.35° and 6.37±3.36°, respectively, for CFP, 8.39±5.24° and 8.61±3.67° for WFP, and 5.73±3.61° for 6.16±3.50° for OCT. In the SOP group, the DFAs in paretic and nonparetic eyes were 12.19±1.69° and 6.71±1.09°, respectively, for CFP, 14.29±2.36° and 8.23±3.31° for WFP, and 12.12±1.73° and 6.91±1.12° for OCT. In the control group, the DFAs in the right and left eyes were 5.39±2.65° and 5.71±3.16°, respectively, for CFP, 8.77±5.56° and 8.90±6.24° for WFP, and 5.27±2.67° and 5.72±3.20° for OCT. There was no difference between the results from CFP and OCT among the three groups. However, the torsional angle was larger when measured using WFP than the other two photographic methods (CFP and OCT) in all three groups (all p<0.05). Conclusion The ocular torsion measurement varies with the fundus photographic method used to measure it. Clinicians should be careful to avoid overestimating ocular extorsion when it is evaluated using WFP.

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Disk-Macula Relationship in Diagnosis of Vertical Muscle Paresis

Cited by 12 publications

References 2 publications

The superior oblique: A challenging extraocular muscle

The superior oblique: A challenging extraocular muscle

Minimal detectable change of the disc‐fovea angle for ocular torsion assessment

Measuring ocular torsion and its variations using different nonmydriatic fundus photographic methods

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