Therapy for Nystagmus

Thurtell, Matthew J.; Leigh, R. John

doi:10.1097/wno.0b013e3181e7518f

Cited by 41 publications

(39 citation statements)

References 141 publications

(157 reference statements)

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“…Several medications, particularly memantine and gabapentin, appear to be effective in treating pendular nystagmus associated with MS [129,134,135]. A masked, crossover, therapeutic trial of ten patients with acquired nystagmus compared gabapentin 1200 mg/day with memantine 40 mg/day and demonstrated decreased median eye speed (gabapentin by 32.8% and memantine by 27.8%; p < 0.001) and improved visual acuity (p < 0.05) for both medications [135].…”

Section: Nystagmusmentioning

confidence: 95%

“…In general, failure of visual fixation, imbalance of the vestibular system or impairment of gaze-holding mechanisms are the most common causes of nystagmus [16]. Mechanisms for visual fixation suppress unwanted saccades and maintain the eye fixed on the visual target [129]. The vestibular system, through the VOR, generates eye movements to stabilize gaze during head movements [129].…”

Section: Nystagmusmentioning

confidence: 99%

“…Mechanisms for visual fixation suppress unwanted saccades and maintain the eye fixed on the visual target [129]. The vestibular system, through the VOR, generates eye movements to stabilize gaze during head movements [129]. Gaze-holding mechanisms convert eye velocity signals to position-holding signals necessary for counteracting the orbital viscoelastic forces that pull the eyes back toward primary position [16].…”

Section: Nystagmusmentioning

confidence: 99%

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The Neuro-Ophthalmology of Multiple Sclerosis

2012

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Multiple sclerosis (MS) is a disease marked by focal demyelinating inflammatory plaques throughout the CNS. Neuro-ophthalmologic sequelae are common in MS and may arise from the disease itself or from treatment of the disease. Both afferent and efferent functions may be affected. Despite much progress, our understanding of the pathophysiology of MS, and the efficacy of our available treatments, remain inadequate. Here, we review the chief neuro-ophthalmologic abnormalities associated with MS and discuss the emerging diagnostic and therapeutic advances that are likely to further our understanding of MS and its treatment.

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Section: Nystagmusmentioning

confidence: 95%

Section: Nystagmusmentioning

confidence: 99%

Section: Nystagmusmentioning

confidence: 99%

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The Neuro-Ophthalmology of Multiple Sclerosis

2012

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“…For an overview of management options for nystagmus, including pharmacological, optical, surgical, and botulinum toxin, see Thurtell and Leigh (2010). …”

Section: Interventionsmentioning

confidence: 99%

The treatment methods for post‐stroke visual impairment: A systematic review

2017

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AimTo provide a systematic overview of interventions for stroke related visual impairments.MethodA systematic review of the literature was conducted including randomized controlled trials, controlled trials, cohort studies, observational studies, systematic reviews, and retrospective medical note reviews. All languages were included and translation obtained. This review covers adult participants (aged 18 years or over) diagnosed with a visual impairment as a direct cause of a stroke. Studies which included mixed populations were included if over 50% of the participants had a diagnosis of stroke and were discussed separately. We searched scholarly online resources and hand searched articles and registers of published, unpublished, and ongoing trials. Search terms included a variety of MESH terms and alternatives in relation to stroke and visual conditions. Article selection was performed by two authors independently. Data were extracted by one author and verified by a second. The quality of the evidence and risk of bias was assessed using appropriate tools dependant on the type of article.ResultsForty‐nine articles (4142 subjects) were included in the review, including an overview of four Cochrane systematic reviews. Interventions appraised included those for visual field loss, ocular motility deficits, reduced central vision, and visual perceptual deficits.ConclusionFurther high quality randomized controlled trials are required to determine the effectiveness of interventions for treating post‐stroke visual impairments. For interventions which are used in practice but do not yet have an evidence base in the literature, it is imperative that these treatments be addressed and evaluated in future studies.

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“…There is a large body of data supporting the hypothesis that foveation periods occurring during each beat of nystagmus can be lengthened or increased by therapeutic interventions (i.e., medicines, surgery, contact lenses, etc.) [32,35,[41][42][43]. Quantitating these foveation periods is accomplished with accurate, calibrated, eye movement recordings using various foveation programs.…”

Section: ]mentioning

confidence: 99%

Visual rehabilitation of patients with oculocutaneous albinism Type I (OCA1): Results in 85 patents

Hertle¹,

Yang²,

Ma³

et al. 2017

New Front Ophthalmol

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Purpose: To test the hypothesis that a systematic, combination treatment of patients with oculocutaneous albinism type 1 (OCA 1) results in improvement in multiple measures of visual and ocular motor function.Methods: This is a prospective, interventional case series analysis of clinical and electrophyisological data before and after multimodal visual system therapy in 85 patients with OCA 1 who had no previous treatment. Therapy included a three step approach after adaptation to spectacle correction: 1) extraocular muscle surgery, 2) contact lens correction, 3) oral baclofen (Lioresal R ). Outcome measures included: 1) routine demography and clinical characteristics, 2) binocular best-corrected visual acuity in the null position (BVA), 3) gaze dependent visual acuity (GDVA), 4) primary position strabismic deviation (SD), 5) anomalous head posture (AHP), 6) contrast sensitivity function (CS), and 7) the expanded nystagmus acuity function (eNAFX). All patients were followed at least 12 months. Parametric and nonparametric statistical analysis of outcome measure data above pre-and post-treatment were perfomed using standard software on grouped data using computerized software.Results: Patient age ranged from 3.6 to 43.1 years (average 16 years). 63% were male. Follow up ranged from 12-50 mos (ave 15.1 mos). 7% had an associated systemic diagnosis, 95% had a significant refractive error, 88% percent had an AHP, 36% had a periodic or aperiodic component to their nystagmus. 97% had strabismus. There were no serious complications from surgery with a reoperation rate of 12%. There were signficant post treatment improvements in mean/median group BVA, GDVA, SD, AHP, CS, and eNAFX. Conclusion:This study supports the hypothesis that using a combination of standard optical, medical and surgical treatments in patients with OCA1 will result in improvements in multiple aspects of ocular motor and visual functions.Synopsis: This study demonstrates how using a combination of standard medical, optical and surgical therapy results in improvements in ocular motor and visual functions in patients with OCA1.

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Therapy for Nystagmus

Cited by 41 publications

References 141 publications

The Neuro-Ophthalmology of Multiple Sclerosis

The Neuro-Ophthalmology of Multiple Sclerosis

The treatment methods for post‐stroke visual impairment: A systematic review

Visual rehabilitation of patients with oculocutaneous albinism Type I (OCA1): Results in 85 patents

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