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Assessing Binocular Central Visual Field and Binocular Eye Movements in a Dichoptic Viewing Condition

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Radiographic Horizontal Conjugate Gaze Deviation: Clinical Correlates.

Shervin Badihian¹, Elias Samaha¹, David E Newman-Toker¹

¹Department of Neurology (SB), Neurological Institute, Cleveland Clinic, OH; Department of Neurology (ES, JCK), University of Illinois College of Medicine, Peoria; and Departments of Neurology (DEN-T, DSZ), Otolaryngology and Ophthalmology, The Johns Hopkins University School of Medicine, Baltimore, MD.

Neurology. Clinical Practice

|October 14, 2024

Summary

This summary is machine-generated.

Radiographic, horizontal, conjugate gaze deviation (Rad h-CGD) aids in diagnosing neurologic and vestibular disorders by correlating ocular findings with lesion location. Understanding Rad h-CGD possibilities improves patient management.

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Area of Science:

Neurology
Ophthalmology
Radiology

Background:

Radiographic, horizontal, conjugate gaze deviation (Rad h-CGD) has emerged as a potential marker for various neurologic and vestibular conditions since 2003.
Over two decades, clinical correlates linking Rad h-CGD to supratentorial and infratentorial lesions have been identified.

Purpose of the Study:

To elucidate the diagnostic value of Rad h-CGD in localizing and lateralizing neurologic and vestibular lesions.
To provide clinicians and radiologists with a comprehensive understanding of Rad h-CGD's diagnostic possibilities for improved patient care.

Main Methods:

Correlating measured angles of deviation in Rad h-CGD with clinical findings and underlying lesion mechanisms.
Reviewing existing literature on lesion localization and integrating it with clinical experience.
Developing a practical algorithm for interpreting Rad h-CGD findings.

Main Results:

Rad h-CGD provides valuable diagnostic and localization information, potentially revealing subtle ocular findings.
The clinical context is crucial as Rad h-CGD alone cannot differentiate between supratentorial and infratentorial lesions.
Rad h-CGD can be associated with various conditions including large vessel occlusion strokes, acute vestibular syndrome, and ischemic events in the cerebellum, brainstem, or labyrinth.

Conclusions:

Rad h-CGD is a useful tool for diagnosing and localizing neurologic and vestibular disorders.
Integrating Rad h-CGD interpretation with clinical context enhances diagnostic accuracy.
Further understanding of Rad h-CGD aids in managing a spectrum of central and peripheral nervous system conditions.