Torsion in patients with superior oblique palsies

Dynamic torsion during saccades and changes in Listing's plane

Heimo Steffen, Dominik S. Straumann, Mark F. Walker, Neil R Miller, David Lee Guyton, Michael X Repka, David Samuel Zee

Research output: Contribution to journalArticle

Abstract

Background: The purpose was to assess intra- and post-saccadic torsion in superior oblique palsy (SOP) patients and the effect of surgery on torsion. Methods: Eleven patients with a presumed congenital SOP and five with acquired SOP performed 10° vertical saccades over a range of ±20°. Eye movements were recorded with dual search coils. Dynamic torsion was calculated by subtracting the expected change in torsion during the saccade (based upon static torsion before and after the saccade) from the maximum intrasaccadic torsion. Eight healthy subjects were controls. We also examined the effects of surgery on dynamic torsion and the orientation of Listing's plane in patients with congenital SOP who were operated on either by weakening of the inferior oblique muscle on the affected eye (n=5), by recession of the inferior rectus muscle on the normal eye (n=4) or by both procedures (n=2). Postoperative recordings were obtained at least 1 month after surgery. Results: Patients with congenital and acquired SOP showed an increased dynamic extorsion, primarily during downward saccades. Following a recession of the inferior oblique muscle in congenital SOP patients, half showed significant decreases in extorsion (up to 1.0°) during downward saccades by the affected eye. Following surgery all showed a temporal rotation of Listing's plane (up to 15° for primary position). Conclusion: Patients with a SOP show a characteristic pattern of dynamic torsion during vertical saccades differing from normals. Recession of the inferior oblique muscle leads to rotation of Listing's plane in all congenital SOP patients and causes large changes in dynamic torsion in a subgroup of them, perhaps reflecting the heterogeneity of congenital SOP.

Original languageEnglish (US)
Pages (from-to)771-778
Number of pages8
JournalGraefe's Archive for Clinical and Experimental Ophthalmology
Volume246
Issue number5
DOIs
StatePublished - May 2008

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Saccades
Paralysis
Oculomotor Muscles
Eye Movements
Healthy Volunteers
Muscles

Keywords

  • Dynamic torsion
  • Listing's plane
  • Superior oblique palsy

ASJC Scopus subject areas

  • Ophthalmology

Cite this

@article{295d68bc2b374a05a26cb00c679cf7f5,
title = "Torsion in patients with superior oblique palsies: Dynamic torsion during saccades and changes in Listing's plane",
abstract = "Background: The purpose was to assess intra- and post-saccadic torsion in superior oblique palsy (SOP) patients and the effect of surgery on torsion. Methods: Eleven patients with a presumed congenital SOP and five with acquired SOP performed 10° vertical saccades over a range of ±20°. Eye movements were recorded with dual search coils. Dynamic torsion was calculated by subtracting the expected change in torsion during the saccade (based upon static torsion before and after the saccade) from the maximum intrasaccadic torsion. Eight healthy subjects were controls. We also examined the effects of surgery on dynamic torsion and the orientation of Listing's plane in patients with congenital SOP who were operated on either by weakening of the inferior oblique muscle on the affected eye (n=5), by recession of the inferior rectus muscle on the normal eye (n=4) or by both procedures (n=2). Postoperative recordings were obtained at least 1 month after surgery. Results: Patients with congenital and acquired SOP showed an increased dynamic extorsion, primarily during downward saccades. Following a recession of the inferior oblique muscle in congenital SOP patients, half showed significant decreases in extorsion (up to 1.0°) during downward saccades by the affected eye. Following surgery all showed a temporal rotation of Listing's plane (up to 15° for primary position). Conclusion: Patients with a SOP show a characteristic pattern of dynamic torsion during vertical saccades differing from normals. Recession of the inferior oblique muscle leads to rotation of Listing's plane in all congenital SOP patients and causes large changes in dynamic torsion in a subgroup of them, perhaps reflecting the heterogeneity of congenital SOP.",
keywords = "Dynamic torsion, Listing's plane, Superior oblique palsy",
author = "Heimo Steffen and Straumann, {Dominik S.} and Walker, {Mark F.} and Miller, {Neil R} and Guyton, {David Lee} and Repka, {Michael X} and Zee, {David Samuel}",
year = "2008",
month = "5",
doi = "10.1007/s00417-007-0622-5",
language = "English (US)",
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TY - JOUR

T1 - Torsion in patients with superior oblique palsies

T2 - Dynamic torsion during saccades and changes in Listing's plane

AU - Steffen, Heimo

AU - Straumann, Dominik S.

AU - Walker, Mark F.

AU - Miller, Neil R

AU - Guyton, David Lee

AU - Repka, Michael X

AU - Zee, David Samuel

PY - 2008/5

Y1 - 2008/5

N2 - Background: The purpose was to assess intra- and post-saccadic torsion in superior oblique palsy (SOP) patients and the effect of surgery on torsion. Methods: Eleven patients with a presumed congenital SOP and five with acquired SOP performed 10° vertical saccades over a range of ±20°. Eye movements were recorded with dual search coils. Dynamic torsion was calculated by subtracting the expected change in torsion during the saccade (based upon static torsion before and after the saccade) from the maximum intrasaccadic torsion. Eight healthy subjects were controls. We also examined the effects of surgery on dynamic torsion and the orientation of Listing's plane in patients with congenital SOP who were operated on either by weakening of the inferior oblique muscle on the affected eye (n=5), by recession of the inferior rectus muscle on the normal eye (n=4) or by both procedures (n=2). Postoperative recordings were obtained at least 1 month after surgery. Results: Patients with congenital and acquired SOP showed an increased dynamic extorsion, primarily during downward saccades. Following a recession of the inferior oblique muscle in congenital SOP patients, half showed significant decreases in extorsion (up to 1.0°) during downward saccades by the affected eye. Following surgery all showed a temporal rotation of Listing's plane (up to 15° for primary position). Conclusion: Patients with a SOP show a characteristic pattern of dynamic torsion during vertical saccades differing from normals. Recession of the inferior oblique muscle leads to rotation of Listing's plane in all congenital SOP patients and causes large changes in dynamic torsion in a subgroup of them, perhaps reflecting the heterogeneity of congenital SOP.

AB - Background: The purpose was to assess intra- and post-saccadic torsion in superior oblique palsy (SOP) patients and the effect of surgery on torsion. Methods: Eleven patients with a presumed congenital SOP and five with acquired SOP performed 10° vertical saccades over a range of ±20°. Eye movements were recorded with dual search coils. Dynamic torsion was calculated by subtracting the expected change in torsion during the saccade (based upon static torsion before and after the saccade) from the maximum intrasaccadic torsion. Eight healthy subjects were controls. We also examined the effects of surgery on dynamic torsion and the orientation of Listing's plane in patients with congenital SOP who were operated on either by weakening of the inferior oblique muscle on the affected eye (n=5), by recession of the inferior rectus muscle on the normal eye (n=4) or by both procedures (n=2). Postoperative recordings were obtained at least 1 month after surgery. Results: Patients with congenital and acquired SOP showed an increased dynamic extorsion, primarily during downward saccades. Following a recession of the inferior oblique muscle in congenital SOP patients, half showed significant decreases in extorsion (up to 1.0°) during downward saccades by the affected eye. Following surgery all showed a temporal rotation of Listing's plane (up to 15° for primary position). Conclusion: Patients with a SOP show a characteristic pattern of dynamic torsion during vertical saccades differing from normals. Recession of the inferior oblique muscle leads to rotation of Listing's plane in all congenital SOP patients and causes large changes in dynamic torsion in a subgroup of them, perhaps reflecting the heterogeneity of congenital SOP.

KW - Dynamic torsion

KW - Listing's plane

KW - Superior oblique palsy

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U2 - 10.1007/s00417-007-0622-5

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JO - Albrecht von Graefes Archiv für Klinische und Experimentelle Ophthalmologie

JF - Albrecht von Graefes Archiv für Klinische und Experimentelle Ophthalmologie

SN - 0721-832X

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