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Visual Acuity Improves in Children and Adolescents With Idiopathic Infantile Nystagmus
Ben W R Balzer1, Caroline J Catt2,3, Milia Bou-Abdou3
1South-Western Sydney Clinical School, University of New South Wales, Sydney, New South Wales, Australia.
Insights
Children and adolescents with idiopathic infantile nystagmus show gradual improvements in visual acuity. This natural history provides a crucial baseline for future treatment studies.
Area of Science:
- Ophthalmology
- Pediatric Ophthalmology
- Neuro-ophthalmology
Background:
- Idiopathic infantile nystagmus (IIN) is characterized by reduced visual acuity.
- Extraocular muscle surgery has shown potential for improving visual acuity in children with IIN.
- Long-term secular trends in visual acuity for IIN patients remain under-documented.
Purpose of the Study:
- To describe the long-term changes in visual acuity for children and adolescents diagnosed with IIN.
- To establish a baseline for comparison with future interventional studies in IIN.
Main Methods:
- Retrospective chart review of patients diagnosed with IIN up to age 18.
- Visual acuity was measured using Snellen visual acuity charts.
- Patient informed consent was obtained for data review.
Main Results:
- Observed significant improvements in best-corrected visual acuity (BCVA) in 43 pediatric IIN patients.
- Binocular BCVA improved at a rate of -0.16 logarithm of the minimum angle of resolution (logMAR) per log year of age (P < 0.001).
- This represents an average improvement of 0.05 logMAR (half a Snellen line) as age doubles, with high reliability (ICC=0.95).
Conclusions:
- A natural history of gradual improvement in binocular visual acuity exists for infantile nystagmus.
- This study provides essential normative data for comparison with emerging interventional strategies for IIN.
- Understanding these secular trends is vital for evaluating the efficacy of future treatments.
Purpose:
Idiopathic infantile nystagmus is associated with reduced visual acuity. Recent work has linked extraocular muscle surgery to improvements in visual acuity through childhood but no work has reported long-term secular trends in visual acuity in infantile nystagmus. Our aim is to describe visual acuity changes for children and adolescents with idiopathic infantile nystagmus to allow comparison for future interventional studies.
Design:
Retrospective chart review.
Methods:
Review of patients attending our center up to the age of 18 with a diagnosis of idiopathic infantile nystagmus and visual acuity measured using Snellen visual acuity. Patients provided informed consent.
Results:
We observed improvements in best corrected visual acuity in 43 children and adolescents with idiopathic infantile nystagmus. Binocular best corrected visual acuity improved at a rate of -0.16 logarithm of the minimum angle of resolution (logMAR)/log year of age (P < 0.001), an improvement of 0.05 logMAR (half a Snellen line) as the age doubles. Intraclass correlation was 0.95 and interindividual correlation between visual acuity and age was significant (r = -0.24, P < 0.001).
Conclusions:
We describe a natural history of gradual improvement in binocular visual acuity in infantile nystagmus and provide a baseline against which future interventional work can be compared.
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