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Characteristics and Long-term Follow-up of Isolated Vertical Nystagmus in Infancy
Insights
Isolated vertical nystagmus in infants often resolves within the first year. However, half of these infants later experienced speech delays requiring intervention.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Infantile nystagmus is an ocular motor disorder characterized by involuntary rhythmic eye movements.
- Vertical nystagmus is less common than horizontal nystagmus in infants.
- Understanding the characteristics and outcomes of isolated vertical nystagmus is crucial for early diagnosis and management.
Purpose of the Study:
- To investigate the clinical features of infants presenting with isolated vertical nystagmus.
- To determine the long-term developmental outcomes in this cohort.
Main Methods:
- Retrospective review of medical records for 114 infants diagnosed with nystagmus (1996-2016).
- Inclusion criteria: vertical nystagmus within the first year, normal brain MRI, and age-appropriate visual behavior.
- Long-term follow-up data obtained via telephone questionnaires with guardians.
Main Results:
- Eight infants met the inclusion criteria for the final cohort.
- Vertical nystagmus onset at a mean of 1.4 months, resolving in 87.5% by a mean of 3.8 months.
- Upbeat nystagmus was observed in 62.5%; 50% of patients experienced speech delay requiring intervention.
Conclusions:
- Isolated vertical nystagmus in infants typically resolves within the first year of life.
- A significant proportion (50%) of these children develop speech delays.
- Long-term monitoring for developmental milestones, particularly speech, is recommended.
Purpose:
To determine the clinical characteristics and long-term outcomes of infants who presented with isolated vertical nystagmus.
Methods:
The medical records of 114 infants who were diagnosed as having nystagmus from 1996 to 2016 were screened. Patients with vertical nystagmus within the first year of life who had unremarkable magnetic resonance imaging of the brain and demonstrated age-appropriate visual behavior were included. The parents of patients in the final study cohort were contacted by telephone to obtain long-term follow-up information.
Results:
Eight patients comprised the final cohort. Vertical nystagmus was first observed at a mean age of 1.4 months (range: 1 to 2.5 months) and resolved in 87.5% of patients at a mean age of 3.8 months (range: 2 to 10 months). Vertical nystagmus was intermittent in 62.5%, upbeat in 62.5%, and pendular in 37.5% of patients. One patient's nystagmus did not resolve. Seventy-five percent of patient guardians participated in the telephone questionnaire. The mean age of patients at follow-up was 3.5 years (range: 0.5 to 8.1 years). Isolated iris transillumination was discovered in one patient without other features of albinism. Fifty percent of patients had speech delay requiring intervention. No other developmental delays or general medical conditions were identified.
Conclusions:
Nystagmus resolved in 87.5% of patients, all before the first year of life, and speech delay was later identified in half of the patients. [J Pediatr Ophthalmol Strabismus. 2018;55(3):159-163.].
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