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Symptomatic treatment of infantile nystagmus: a systematic review
Xuanwei Li1,2, Bianca Huurneman1,3, Jeroen Goossens1,2
1Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, Netherlands.
Insights
This review summarizes infantile nystagmus (IN) treatments, finding surgery common but perceptual training promising for vision and quality of life. Standardized outcomes are needed for better comparisons.
Area of Science:
- Ophthalmology
- Neuroscience
- Clinical Medicine
Background:
- Infantile nystagmus (IN) is a childhood neuro-ophthalmic condition with involuntary eye movements.
- Diverse causes of IN complicate diagnosis and treatment decisions.
- Recent research highlights the need for a systematic review of IN interventions.
Purpose of the Study:
- To provide an extensive summary of symptomatic treatment options for infantile nystagmus (IN).
- To categorize current IN interventions and evaluate their benefits and limitations.
Main Methods:
- Systematic review of recent literature on infantile nystagmus (IN) treatment.
- Categorization of interventions into surgical, pharmacological, optical, and perceptual training methods.
- Analysis of reported outcomes, including visual acuity (VA) and quality of life (QoL).
Main Results:
- Surgical interventions were the most frequently studied (28/52 studies).
- Perceptual training demonstrated potential improvements in visual acuity (VA) and quality of life (QoL).
- Heterogeneous outcome reporting in studies hindered meta-analysis and direct intervention comparison.
Conclusions:
- Current IN treatments include surgical, pharmacological, optical, and perceptual training modalities.
- Perceptual training shows promise as a non-invasive approach for improving IN patient outcomes.
- Standardized outcome measures, including functional vision and QoL, are crucial for future IN research and clinical practice.
Abstract:
Infantile nystagmus (IN) is a neuro-ophthalmic condition characterized by involuntary rhythmic eye movements that manifest early in childhood. The surge of recent articles focusing on the treatment of IN demonstrates the need for a new systematic review of the intervention options. The diverse causes of IN complicate its differentiation from symptoms secondary to other conditions, presenting challenges for clinical decision-making and systematic review. This study provides the first extensive, focused summary of symptomatic treatment options for IN. We noted that current approaches can be broadly categorized into four types of interventions: surgical, pharmacological, optical, and perceptual training methods, each offering distinct benefits and limitations. Most of the included studies (28/52) focused on invasive surgical interventions. Alternatively, the nascent perceptual training showed promising improvements in both visual acuity (VA) and quality of life (QoL). Heterogeneous reporting of treatment outcomes for IN hindered meta-analysis and precise comparison of intervention effects, underscoring an urgent need for standardized outcome measures in future studies. We further suggest including functional vision measurements and QoL assessments to better address patient well-being, rethinking invasive surgical approaches and exploring non-invasive treatment modalities in clinical practice.
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