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Surgery for the treatment of vertical head posturing associated with infantile nystagmus syndrome: results in 24 patients.
MedLine Citation:
PMID:  20662845     Owner:  NLM     Status:  In-Data-Review    
Background:  The study of the clinical and electrophysiological effects of eye muscle surgery on patients with infantile nystagmus has broadened our knowledge of the disease and its interventions. Design:  Prospective, comparative, interventional case series. Participants:  Twenty-four patients with a vertical head posture because of electrophysiologically diagnosed infantile nystagmus syndrome. The ages ranged from 2.5 to 38 years and follow up averaged 14.0 months. Methods:  Thirteen patients with a chin-down posture had a bilateral superior rectus recession, inferior oblique myectomy and a horizontal rectus recession or tenotomy. Those 11 with a chin-up posture had a bilateral superior oblique tenectomy, inferior rectus recession and a horizontal rectus recession or tenotomy. Main Outcome Measures:  Outcome measures included: demography, eye/systemic conditions and preoperative and postoperative; binocular, best optically corrected, null zone acuity, head posture, null zone foveation time and nystagmus waveform changes. Results:  Associated conditions were strabismus in 66%, ametropia in 96%, amblyopia in 46% and optic nerve, foveal dysplasia or albinism in 54%. Null zone acuity increased at least 0.1 logMAR in 20 patients (P < 0.05 group mean change). Patients had significant (P < 0.05) improvements in degrees of head posture, average foveation time in milliseconds and infantile nystagmus syndrome waveform improvements. Conclusions:  This study illustrates a successful surgical approach to treatment and provides expectations of ocular motor and visual results after vertical head posture surgery because of an eccentric gaze null in patients with infantile nystagmus syndrome.
Richard W Hertle; Dongsheng Yang; Kenneth Adams; Roxanne Caterino
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical & experimental ophthalmology     Volume:  39     ISSN:  1442-9071     ISO Abbreviation:  Clin. Experiment. Ophthalmol.     Publication Date:  2011 Jan 
Date Detail:
Created Date:  2011-02-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896531     Medline TA:  Clin Experiment Ophthalmol     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  37-46     Citation Subset:  IM    
Copyright Information:
© 2010 The Authors. Clinical and Experimental Ophthalmology © 2010 Royal Australian and New Zealand College of Ophthalmologists.
Children's Hospital Medical Center of Akron and SUMMA Medical Center, Akron The Northeastern Ohio Universities College of Medicine, Rootstown, Ohio Family and Childrens Eye Center, Albuquerque, New Mexico UPMC Mercy Hospital, Pittsburgh, Pennsylvania, USA.
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