Valmaggia C, Rütsche A, Baumann A, Pieh C, Bellaiche Shavit Y, Proudlock F, Gottlob I
Department of Ophthalmology, Kantonsspital, CH-9007 St Gallen, Switzerland.
Br J Ophthalmol. 2004 Dec;88(12):1577-81. doi: 10.1136/bjo.2004.044222.
Optokinetic nystagmus (OKN) gain is asymmetrical between temporal to nasal (TN) and nasal to temporal (NT) stimulation in infancy and decreases at older ages. The age at which OKN gain becomes symmetrical and decreases is debated. The aim was to investigate OKN over the whole lifespan in a large sample of healthy subjects.
In a prospective, cross sectional study OKN was tested monocularly using TN and NT small field stimulation. Stimulation velocity was 15 degrees /s and 30 degrees /s for children aged under 1 year (n = 97), and 15 degrees /s, 30 degrees /s, 45 degrees /s, and 60 degrees /s for older subjects (1-9 years, n = 66; 10-89 years, n = 86). Gain was measured using infrared oculography.
Significant OKN gain asymmetry in favour of TN versus NT stimulation was found during the first 5 months of life (p<0.05). Only at 11 months of age was OKN symmetrical in 100% of the subjects. The percentage of children with symmetrical OKN decreased with increasing stimulus velocity. OKN gain increased in the second and third years (p<0.05 for 15 degrees /s), remained stable until 50 years of age, and showed a small but significant decrease afterwards for the tested velocities (between 6% and 18%, p<0.05).
Infrared oculography is an accurate method to assess OKN, especially in children. Knowledge about change of OKN in healthy subjects could be helpful to interpret OKN in patients with abnormal binocular vision or lesions of the central nervous system.
在婴儿期,视动性眼震(OKN)增益在颞侧到鼻侧(TN)和鼻侧到颞侧(NT)刺激之间是不对称的,且在年龄较大时会降低。OKN增益变得对称并降低的年龄存在争议。目的是在一大群健康受试者中研究整个生命周期的OKN。
在一项前瞻性横断面研究中,使用TN和NT小视野刺激单眼测试OKN。1岁以下儿童(n = 97)的刺激速度为15度/秒和30度/秒,年龄较大的受试者(1 - 9岁,n = 66;10 - 89岁,n = 86)的刺激速度为15度/秒、30度/秒、45度/秒和60度/秒。使用红外眼动图测量增益。
在生命的前5个月发现了显著的OKN增益不对称,TN刺激优于NT刺激(p<0.05)。仅在11个月大时,100%的受试者OKN是对称的。OKN对称的儿童百分比随着刺激速度的增加而降低。OKN增益在第二和第三年增加(15度/秒时p<0.05),直到50岁保持稳定,之后在所测试的速度下出现小但显著的下降(6%至18%之间,p<0.05)。
红外眼动图是评估OKN的准确方法,尤其是在儿童中。了解健康受试者OKN的变化有助于解释双眼视觉异常或中枢神经系统病变患者的OKN情况。