[Comparison between photographic analysis and orthopedic goniometer of measurement of compensatory head posture].

OBJECTIVE: To evaluate the application of relative reference point photographic analysis method and goniometer method for head posture measurement, and compare the characteristics of the two methods. METHODS: Thirty patients from March 2011 to April 2011 and August to September with AHP in our hospital were recruited. The AHP were measured by photographic analysis and goniometer method respectively. The data were analyzed by SPSS software. RESULTS: The mean AHP was 15.62° ± 7.48° by photographic analysis measurement, 15.50° ± 6.99° by goniometer measurement. The Pearson's correlation coefficient (r = 0.955, P < 0.001, t = 0.286, P = 0.777). CONCLUSIONS: Relative reference point photographic analysis is a simple and effective way to measure AHP. The results measured by the two methods are highly consistent.

[Recession of both horizontal rectus muscles in Duane Retraction Syndrome with significant globe retraction].

OBJECTIVE: To evaluate the effect of Recession of both horizontal rectus muscles in Duane Retraction Syndrome with significant globe retraction. METHODS: Sixteen cases with DRS were summarized retrospectively. All patients had undergone surgery with recession of both horizontal rectus muscles. All clinical records, including sex, age, types of DRS, clinical features, surgical methods and clinical outcomes were analyzed. All patients were followed up for 3 months to 1 year. RESULTS: Fifteen cases had only monocular involvement while one had both eyes. The number of type I DRS was 3 cases, 1 case was esotropia while others were orthotropic in primary position. Type III DRS was observed 13 cases. Esotropia was seen in 6 cases (7 eyes), exotropia of 1 cases and orthotropic in primary position of 6 cases. 10 cases exhibited marked face turn. An upshoot or downshoot and variable severity of retraction of globe were found in all patients on attempt adduction of the affected eye. All patients had undergone surgery with recession of both horizontal rectus muscles. The medical rectus muscles were recessed from 5 mm to 7 mm and lateral rectus muscles 3 mm to 9 mm simultaneously, which was based on the amount of primary position deviation. Among these 2 cases were combined with Y-splitting of lateral rectus muscle. After surgery, all patients were orthotropic in primary position. Their symptom of unacceptable abnormal head position, significant globe retraction, noticeable narrowing of the palpebral fissure and significant upshoot or downshoot were ameliorated or disappeared. Especially the recession of lateral rectus muscle in addition to Y-splitting combining with the simultaneous medial rectus recession resulted in further amelioration of globe retraction in addition to upshoot and downshoot. CONCLUSION: Recession of both horizontal rectus muscles is effective in the treatment of significant globe retraction in Duane syndrome. Type III DRS with significant globe retraction but has no marked deviation and face turn can adopt this method to ameliorate their aspect. The method of lateral rectus muscle in addition to Y-splitting plays an important role in the treatment of upshoot and downshoot.

[The G990T mutation of the FRMD7 gene in a Chinese family with congenital idiopathic nystagmus].

OBJECTIVE: To study the mutation of FRMD7 gene in a Chinese family with congenital idiopathic nystagmus. METHODS: Forty-six individuals in the Chinese family with congenital idiopathic nystagmus, including 16 patients, 19 normal siblings and 11 spouses, were investigated under informed consent. Genomic DNA of all 46 members was isolated by standard protocol. The X-linked inherited pattern was ascertained by investigating the history of the family members and the clinical feature of each individual. The genome scan on X chromosome was performed after PCR amplification for microsatellite markers. LOD scores were calculated with Linkage 5.1. Direct DNA sequence analysis was carried out to find the gene mutation responsible for the disease. RESULTS: A maximum LOD score of 8.55 (theta=0) was obtained with polymorphic marker DXS1047. Haplotype construction of the family defined the disease interval between DXS8059 and DXS8033. Direct DNA sequence analysis revealed a heterozygous mutation of G990T in exon 9 of the FRMD7 gene in all patients, which was not present in unaffected family members. CONCLUSION: Congenital nystagmus is a clinically and genetically heterogeneous ocular movement disease. The mutation of G990T of the FRMD7 gene is the underlying molecular pathogenesis for this family with congenital nystagmus.

[Stereoacuity before and after surgery in patients with acquired excyclotorsion].

OBJECTIVE: To investigate the stereoacuity before and after superior oblique sagittal transposition in patients with acquired excyclotorsion. METHODS: 14 cases of acquired excyclotorsion who had complaints of forward and downward torsional diplopia were treated with superior oblique sagittal transposition. All patients were examined with Titmus test prior and after surgery. RESULTS: Surgical treatment greatly improved torsional diplopia. The stereoacuity improved gradually from 800 to 60 seconds of arc, peripheral to macular stereoacuity, and even foveal stereoacuity. CONCLUSION: The superior oblique sagittal transposition is an effective method for primary and down gaze acquired excyclotorsion. The operation not only alleviated diplopia in the practical fixation field, but also improved stereoacuity.

[Treatment of dissociated vertical deviation by shifting fixating eye].

OBJECTIVE: To investigate the results of using shifting fixation eye to manage monocular or asymmetrical binocular dissociated vertical deviation (DVD). METHODS: Twenty-three DVD children whose corrected vision was better than 0.5 in the amblyopic eye were studied. The goal of the shifting fixation eye was gained by decreasing the vision of the primary fixation eye to 2 or 3 lines (Snellen Visual Acuity) lower than that of the fellow fixation eye by occlusion or optical methods. The vision, alignment and retinal correspondence were evaluated before and after the treatment. RESULTS: After the treatment, in 10 patients, the vision of the primary fixation eye did not decrease significantly and the vision of the fellow eye increased 2 lines. In 19 patients, a cosmetic result was achieved; the primary fixation eye was shifted in 4 patients that had similar hepertropia in two eyes (