medigraphic.com
ISSN 1561-3070 (Electronic)

2013, Number S1

<< Back

Rev Cub Oftal 2013; 26 (S1)

Dissociated vertical deviations: now that we know how it develops, how should we treat it?

Parsa CF

Language: Spanish
References: 10
Page: 704-706
PDF size: 23.08 Kb.


Text Extraction

The presence of a dissociated vertical deviation (DVD) attests to an interruption of binocularity reducing fusional potential having occurred prior to the age of 18 months, which allows atavistic pathways of ocular control to become manifest. Despite recent elucidation of the motor mechanisms allowing such apparent violations of Hering's Law1 and its relation to the vestibular system, surgical approaches for the treatment of DVD remain frustrating. Since this movement appears predominantly mediated by the oblique muscles, theoretically, obliteration or immobilization of the oblique muscles could offer improved long-term control in at least some patients.


REFERENCES

  1. Guyton DL. Dissociated vertical deviation: etiology, mechanism, and associated phenomena. Costenbader Lecture. J AAPOS. 2000 Jun;4(3):131-44.

  2. Brodsky MC. Dissociated vertical divergence: a righting reflex gone wrong. Arch Ophthalmol. 1999;117(9):1216-22.

  3. Gamio S. A surgical alternative for dissociated vertical deviation based on new pathologic concepts: weakening all four oblique eye muscles. Outcome and results in 9 cases. Binocul Vis Strabismus Q. 2002;17(1):15-24.

  4. Guyton DL. Surgery for DVD: New Approaches. Am Orthopt J. 2001;51:107-10.

  5. Morad Y, Kowal L, Scott AB. Lateral rectus muscle disinsertion and reattachment to the lateral orbital wall. Br J Ophthalmol. 2005 Aug;89(8):983-5.

  6. Guyton DL, Weingarten PE. Sensory torsion as the cause of primary oblique muscle overaction/underaction and A- and V-pattern strabismus. Binocul Vis Eye Muscle Surg Q. 1994;9(3)209-36.

  7. Guyton DL. Ocular torsion reveals the mechanisms of cyclovertical strabismus: the Weisenfeld lecture. Invest Ophthalmol Vis Sci. 2008 Mar;49(3):847-57.

  8. Bixenman WW, von Noorden GK. Apparent foveal displacement in normal subjects and in cyclotropia. Ophthalmology. 1982;89(1):58-62.

  9. Parsa CF, Kumar AB. Cyclodeviation of the retinal vascular arcades: an accessory sign of ocular torsion. Br J Ophthalmol. 2013 Feb;97(2):126-9.

  10. Irsch K, Guyton DL, Ying HS. Objective analysis of the mechanism of vertical fusional vergence to classify "congenital superior oblique paresis" and guide surgical approach. Transactions 35th European Strabismological Association (in press).




2020     |     www.medigraphic.com