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Dissociated vertical deviation (DVD): The saccadic and slow eye movements.

A A Zubcov1, H P Goldstein, R D Reinecke

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Dissociated vertical deviation (DVD) likely stems from an abnormal vertical vergence system, not a general visual disorder. Eye movement analysis revealed specific patterns suggesting motor control issues in the vergence system.

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Area of Science:

  • Ophthalmology
  • Neuroscience
  • Vision Science

Background:

  • Dissociated vertical deviation (DVD) is a vertical strabismus often linked to infantile esotropia, latent nystagmus, and excyclotorsion.
  • DVD typically manifests around three years of age, prompting investigation into its underlying cause.

Purpose of the Study:

  • To investigate whether dissociated vertical deviation (DVD) originates from an abnormal motor vergence system or a broader visual system disorder.
  • To characterize the eye movement dynamics during DVD to elucidate its pathophysiology.

Main Methods:

  • Vertical eye movements of six subjects with DVD were analyzed using the magnetic search eye coil system during cover-uncover and alternate cover tests.
  • Quantification of saccadic asymmetry during DVD upward movements and pure vertical saccades was performed.

Main Results:

  • Three subjects exhibited smooth vertical divergence movements, while the other three showed a combination of smooth and asymmetrical saccade-like movements.
  • Analysis of DVD latencies, peak velocities, time constants, and saccadic asymmetries provided insights into the movement characteristics.

Conclusions:

  • The observed movement patterns, including latencies and saccadic asymmetries, suggest that dissociated vertical deviation (DVD) is a manifestation of an abnormal vertical vergence system.
  • DVD appears to be primarily a motor system disorder rather than a generalized visual processing deficit.