Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0028738 (nystagmus)
 7,431 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Several forms of esotropia with a different pathophysiology that meet the criterion of an onset early in life must be distinguished from essential infantile esotropia. A hypothesis is presented, according to which a delayed development or a congenital defect of retinal disparity sensitivity (motor fusion) in an otherwise normal infant with immature sensory functions causes esotropia under the influence of various strabismogenic factors. Some of these factors are genetically determined, hence the familial occurrence of essential infantile esotropia. The absence or marked decrease of stereopsis and the asymmetry of optokinetic nystagmus are interpreted as the consequence of ocular misalignment early in life rather than of structural anomalies in the afferent visual pathways of esotropic patients. The therapeutic results after surgery are classified into four groups: subnormal binocular vision, microtropia, small angle eso- or exotropia and large angle residual or consecutive eso- or exodeviations. Analysis of data from 358 operated patients with a documented onset of esotropia prior to the sixth month of life has shown that the probability of obtaining an optimal functional result is increased when surgical alignment is completed before completion of the second year of life. However, surgery after the age of two or even four years of life does not preclude the development of binocular vision on a subnormal or anomalous basis.
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PMID:Bowman lecture. Current concepts of infantile esotropia. 307 63

Sixty-four patients with nystagmus blockage syndrome (NBS) underwent surgery consisting of unilateral recession-resection, bimedial recession with and without posterior fixation suture, and bimedial recession with resection of one or both lateral recti. The results of the unilateral recession-resection and bimedial recession with or without posterior fixation were comparable. Over- and undercorrections occurred more frequently and the number of reoperations was higher than in a control group of essential infantile esotropia without nystagmus. These unpredictable surgical results in NBS present yet another feature that distinguish this condition from essential infantile esotropia without nystagmus. While restoration of normal binocular vision was not achieved in a single case, a functionally desirable result of subnormal binocular vision or microtropia occurred in 26%. An unusual complication consisting of postoperative asymmetric gaze nystagmus with an anomalous head posture was observed in five patients and required a Kestenbaum-Anderson operation in four to eliminate the head turn.
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PMID:Surgical results in nystagmus blockage syndrome. 376 49

We classified 103 patients (206 eyes) with infantile esotropia and an average of 8.7 years of postoperative follow-up into four outcome groups. Of 103 patients, 28 (27%) had subnormal binocular vision; 24 (23%) had microtropia; 43 (42%) had small-angle deviation (< 20 prism diopters); and eight (8%) had large-angle deviation. A chi 2 analysis showed a significant difference (chi 2 = 16.22, P = .005) in the distribution of amblyopia among these four outcome groups. Visual acuity of 20/30 or better was attained in 174 of the 206 eyes (84%). The eyes of all 28 patients in the subnormal binocular vision group remained aligned after an average of eight years. In contrast, the eyes of six of 30 patients (20%) in the microtropia group and 11 of 43 (26%) in the small-angle deviation group lost the stability of horizontal alignment. We found that the two variables of latent-manifest nystagmus and persistent amblyopia at the time of surgery lead to less satisfactory outcomes. In contrast, patients with smaller preoperative angle of deviation or surgery completed before 1 year of age demonstrated an increased incidence of optimal (subnormal binocular vision) or desirable (microtropia) results. We recommend performing surgery after amblyopia has been thoroughly treated, and, whenever possible, completing the surgical treatment by 1 year of age.
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PMID:Clinical characteristics and long-term postoperative results of infantile esotropia. 794 44