Development and surgical removal of an epiretinal membrane in infantile nystagmus syndrome: a new type of oscillopsia
- 104 Downloads
To report and discuss a focal oscillopsia in a small area of the visual field produced by, and after the removal of, an epiretinal membrane (ERM) in an individual with infantile nystagmus syndrome (INS) since birth with no associated afferent visual deficits.
A retrospective case report.
A chart review, including clinical and electrophysiological data. A 74 y/o man with INS and an epiretinal membrane was studied. Detailed studies of the retina post-removal of an epiretinal membrane, with consequent changes in best-corrected visual acuity (BCVA), and subjective oscillopsia compared to INS waveforms. OCT measurements and eye-movement data from digital video and scleral search-coil systems were used.
The monocular ERM produced an unexpected focal area of torsional/vertical oscillopsia (noted 1 year prior to the ERM surgery) in the portion of the visual field that corresponded with distortions from the ERM. The remainder of the visual field, corresponding with normal healthy retina was unaffected and stable in all planes. Post-removal, BCVA improved with redevelopment of the foveal pit and focal oscillopsia became less noticeable but remained due to the retinal distortion.
In patients with INS, complete oscillopsia suppression across the visual field requires undistorted vision. If a retinal area of visual distortion develops or results from retinal surgery, a symptomatic island of oscillopsia in one or more planes may result.
KeywordsEpiretinal membrane Nystagmus Oscillopsia Surgery
This work was supported in part by the Office of Research and Development, Medical Research Service, Department of Veterans Affairs.
Conflicts of interest
L. F. Dell’Osso, None; S. S. Huang, None.
- 1.CEMAS_Working_Group (2001) A National Eye Institute Sponsored Workshop and Publication on the classification of eye movement abnormalities and strabismus (CEMAS). In The National Eye Institute Publications. Bethesda, MD. https://nei.nih.gov/sites/default/files/nei-pdfs/cemas.pdf. Accessed 17 August 2017.
- 5.Kommerell G, Horn R, Bach M. Motion perception in congenital nystagmus. In: Keller EL, Zee DS, editors. Adaptive processes in visual and oculomotor systems. Oxford: Pergamon Press; 1986. p. 485–91.Google Scholar
- 6.Leigh RJ, Rushton DN, Thurston SE, Hertle RW. Optical treatment of oscillopsia due to acquired nystagmus. Neurology. 1986;36:252.Google Scholar
- 8.Leigh RJ. Management of oscillopsia. In: Barber HO, Sharpe JA, editors. Vestibular disorders. Chicago: Yearbook; 1988. p. 201–11.Google Scholar
- 20.Dell’Osso LF. Interesting effects of a moncular epiretinal membrane and developing cataracts in the infantile nystagmus syndrome. OMLAB Rep. 2014;071514:1–8.Google Scholar
- 21.Dell’Osso LF, Leigh RJ. Required ocular motor conditions for visual constancy. Invest Ophthalmol Vis Sci. 1991;32:901.Google Scholar
- 24.Dell’Osso LF, Leigh RJ, Daroff RB, Remler BF. Foveation dynamics and oscillopsia in latent/manifest latent nystagmus. Invest Ophthalmol Vis Sci. 1993;34:1125.Google Scholar
- 26.Dell’Osso LF. The mechanism of oscillopsia and its suppression. In: Rucker J, Zee DS, editors. Basic and clinical ocular motor and vestibular research—Ann NY Acad Sci 1233. Boston, MA: Blackwell Publishing; 2011. p. 298–306.Google Scholar