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"Retinal diplopia" associated with macular wrinkling.
1Department of Neurology, KS-452, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, USA. jbarton@bidmc.harvard.edu
Neurology
|September 15, 2004
Summary
Macular displacement from retinal wrinkling can cause chronic vertical double vision (diplopia). This uncommon cause of diplopia requires detailed eye examination for diagnosis.
Area of Science:
- Ophthalmology
- Neuroscience
- Retinal Diseases
Background:
- Binocular diplopia typically arises from ocular motor dysfunction leading to eye misalignment.
- Understanding the diverse etiologies of diplopia is crucial for accurate diagnosis and management.
Observation:
- Three patients presented with chronic binocular vertical diplopia.
- These patients exhibited small, comitant hypotropic deviations.
- The deviations were linked to macular displacement (heterotopia) caused by monocular retinal wrinkling.
Findings:
- Macular heterotopia associated with retinal wrinkling is an unusual cause of binocular diplopia.
- The underlying cause of maculopathy was idiopathic in two patients and secondary to treated retinal detachment in one.
- Vitreoretinal traction leading to macular displacement was identified as the mechanism.
Implications:
- This condition highlights the importance of thorough ophthalmoscopy in diagnosing diplopia.
- Recognizing macular displacement as a cause of diplopia can lead to earlier and more accurate diagnosis.
- Further research into vitreoretinal traction mechanisms may reveal new therapeutic targets for diplopia.