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The linear vestibulo-ocular reflex in patients with skew deviation
Matthew Schlenker1, Giuseppe Mirabella, Herbert C Goltz
1Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada.
Investigative Ophthalmology & Visual Science
|September 9, 2008
Summary
Patients with skew deviation show reduced linear vestibulo-ocular reflex (LVOR) responses. This asymmetric reduction suggests otolith-ocular pathway imbalance contributes to skew deviation, impacting eye movement control.
Area of Science:
- Neuroscience
- Ophthalmology
- Vestibular System
Background:
- The linear vestibulo-ocular reflex (LVOR) is crucial for stabilizing gaze during head movements, primarily mediated by the otolith organs.
- Skew deviation, a vertical strabismus, is hypothesized to result from disruptions in otolithic pathways to ocular motor neurons.
Purpose of the Study:
- To investigate whether patients with skew deviation exhibit abnormal LVOR responses.
- To determine if damage to otolithic projections underlies skew deviation.
Main Methods:
- Assessed LVOR sensitivity and velocity gain in six patients with skew deviation and ten healthy controls.
- Utilized brief, sudden, interaural head translations (head heaves) while subjects viewed a fixed target monocularly.
- Calculated responses within the first 100 ms of head movement onset.
Main Results:
- Patients demonstrated significantly decreased LVOR sensitivity and velocity gain (56%-62%) in both eyes compared to controls.
- The reduction in LVOR responses was asymmetric between the eyes.
- No significant differences were observed between right and left head heave responses.
Conclusions:
- The findings support the hypothesis that imbalance in the otolith-ocular pathway is a key mechanism in the development of skew deviation.
- Asymmetric reduction in LVOR provides evidence for the role of otolithic pathway dysfunction.
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