Opthalmology Department, Dalhousie University, Clinical Vision Science, Halifax, Canada.
Opthalmology Department, IWK Health Centre, Halifax, Canada.
Strabismus. 2021 Jun;29(2):106-111. doi: 10.1080/09273972.2021.1914681. Epub 2021 Apr 27.
Strabismic deviations can be horizontal, vertical, cyclorotational, or a combination of all three. Previous literature has established the difference between subjective and traditional objective torsional angles; however, often there is a failure to consider the physiological position of a normal fovea-optic nerve head (ONH) relationship. Using the temporal raphe (TR) orientation has been suggested as a solution for this discrepancy. The current study, approved by IWK Health Center research ethics board was created to assess the viability of using the TR in assessment of ocular torsion as well as investigate the effect of the physiological position of the fundus. Subjective tests were compared to traditional fundus photographs and novel TR scans in patients with long-standing unilateral fourth nerve palsies. Results found no differences between subjective and objective angles when considering the physiological fundus position and that TR angles were not comparable to other torsional testing methods. Therefore, it was concluded that the physiological position should be considered when determining the true amount of abnormal fundus torsion. As well, we found no significant value to using TR imaging by optical coherence tomography compared to the traditional fovea-ONH relationship by fundus photography to assess ocular torsion.
斜视偏差可以是水平的、垂直的、旋转的，也可以是三者的组合。先前的文献已经确立了主观和传统客观扭转角度之间的差异；然而，人们往往忽略了正常黄斑视神经乳头（ONH）关系的生理位置。有人建议使用颞部皱襞（TR）方向来解决这一差异。这项由 IWK 健康中心伦理委员会批准的研究旨在评估使用 TR 评估眼球扭转的可行性，并研究眼底生理位置的影响。对长期单侧第四神经麻痹患者进行了主观测试与传统眼底照片和新的 TR 扫描的比较。结果发现，当考虑眼底的生理位置时，主观角度和客观角度之间没有差异，并且 TR 角度与其他扭转测试方法不可比。因此，结论是在确定真正的眼底扭转异常量时应考虑生理位置。此外，我们发现与使用眼底摄影评估眼球扭转的传统黄斑 ONH 关系相比，使用光学相干断层扫描的 TR 成像并没有显著的价值。
