Is infantile esotropia subcortical in origin?

Area of Science:

• Neuroscience
• Ophthalmology
• Developmental Biology

Background:

• Essential infantile esotropia (EIE) is often linked to visual cortex abnormalities.
• Observed asymmetries in optokinetic responses and motion detection suggest cortical involvement.

Purpose of the Study:

• To propose that EIE arises from secondary cortical changes due to prolonged subcortical neuroplasticity.
• To investigate the role of subcortical visuo-vestibular pathways in EIE.

Main Methods:

• Analysis of existing physiological and evolutionary data on optokinetic responses.
• Examination of neuroplasticity in subcortical visual pathways.

Main Results:

• Cortical aberrations in EIE may be secondary to a subcortical optokinetic motion template.
• Prolonged subcortical neuroplasticity can rewire cortical motion pathways.

Conclusions:

• EIE may be generated by persistent subcortical nasalward optokinetic bias.
• This bias results from the reactivation or prolonged plasticity of phylogenetically older subcortical pathways.