Abstract
Infantile esotropia, a common form of strabismus with onset prior to 6 months of age, occurs at a time of rapid visual development. While monocular visual acuity is relatively unaffected in these patients, the majority of them fail to achieve fully normal stereopsis. In addition, these patients show a spectrum of abnormalities in their ocular following responses, visual perception and visual evoked potentials (VEPs) that suggest a failure to develop a normal complement of motion processing mechanisms. While abnormalities of stereopsis have been studied for many years, motion processing in strabismus is a rapidly evolving area of current research. Motion mechanisms are normally binocular and may form a distinct binocular sub-system. This review summarises what is known about sensory and motor abnormalities in infantile esotropia, with special emphasis on recent motion VEP recordings. The monocular motion VEP shows directional biases early in infancy that are consistent with a nasalward/ temporalward response bias. Patients with infantile esotropia maintain their neonatal biases beyond the age at which they normally disappear. The motion VEP biases persist into visual maturity in patients whose strabismus is treated after about 2 years of age. Treatment prior to age 2 can lessen the magnitude of the motion VEP asymmetry and these improvements can be maintained into visual maturity. A recording from the striate cortex of a visually deprived macaque monkey indicates that the motion VEP asymmetry arises early in the visual pathway.
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References
Costenbader F . Infantile estropia. Trans Am Ophthalmol Soc 1961; 59: 397–429.
Ciancia AO . La esotropia con limitacion bilateral de la abduccion en el lacante. Arch Oftalmol Buenos Aires 1962; 36: 207–11.
von Noorden GK . A reassessment of infantile esotropia. XLIV Edward Jackson Memorial Lecture. Am J Ophthalmol 1988; 105: 1–10.
Birch EE . Stereopsis in infants and its developmental relationship to visual acuity. In: Simons K, editor. Early visual development, normal and abnormal. New York: Oxford University Press, 1993: 224–34.
Shimojo S . Development of interocular vision in infants. In: Simons K, editor. Early visual development, normal and abnormal. New York: Oxford University Press, 1993: 201–23.
Day SH, Orel-Bixler DA, Norcia AM . Abnormal acuity development in infantile esotropia. Invest Ophthalmol Vis Sci 1988; 29: 327–9.
Birch EE, Stager DR . Monocular acuity and stereopsis in infantile esotropia. Invest Ophthalmol Vis Sci 1985; 26: 1624–30.
Schiavi C, Chiesi C, Campos E . Visual acuity maturation is negatively affected by alternating essential esotropia. In: Kaufmann H, editor. Transactions of the 19th Meeting of the European Strabismological Association, 1991: 281–4.
Tychsen L, Lisberger SG . Maldevelopment of visual motion processing in humans who had strabismus with onset in infancy. J Neurosci 1986; 6: 2495–508.
Schor CM, Levi DM . Disturbances of small-field horizontal and vertical optokinetic nystagmus in amblyopia. Invest Ophthalmol Vis Sci 1980; 19: 668–83.
Mein J . The asymmetric optokinetic response. Br Orthoptic J 1983; 40: 1–4.
Kommerrell G . Ocular phenomenon in infantile strabismus. In: Lennerstrand G, von Noorden GK, Campos EC, editors. Strabismus and amblyopia. Werner-Gren International Symposium Series. Macmillan Press, 1988: 99–109.
Demer JL, von Noorden GK . Optokinetic asymmetry in estotropia. J Pediatr Ophthalmol Strabmismus 1988; 25: 286–92.
Reed MJ, Steinbach MJ, Anstis SM, Gallie B, Smith D, Kraft S . The development of optokinetic nystagmus in strabismic and monocularly enucleated subjects. Behav Brain Res 1991; 46: 31–42.
Westall CA, Shute RH . OKN asymmetries in orthoptic patients: contributing factors and effects of treatment. Behav Brain Res 1992; 49: 77–84.
Tychsen LR, Hurtig R, Scott WE . Pursuit is impaired but the vestibulo-ocular reflex is normal in infantile esotropia. Arch Ophthalmol 1985; 103: 536–9.
Ing M, Costenbader FD, Parks MM, Albert DG . Early surgery for congenital esotropia. Am J Ophthalmol 1966; 61: 1419–27.
Parks MM . Congenital esotropia with a bifixation result: report of a case. Doc Ophthalmol 1984; 58: 109–14.
Archer S, Helveston EM, Miller K, Ellis FD . Stereopsis in normal infants and infants with congenital esotropia. Am J Ophthalmol 1986; 101: 591–6.
Rogers GL, Bremer DL, Leguire LE, Fellows RR . Clinical assessment of visual function in the young child: a prospective study of binocular vision. J Pediatric Ophthalmol Strabismus 1986; 23: 233–5.
Mohindra I, Zwaan J, Held R, Brill S, Zwaan F . Development of acuity and stereopsis in infants with esotropia. Ophthalmology 1985; 92: 691–7.
Birch EE, Stager DR, Berry P, Everett ME . Prospective assessment of acuity and stereopsis in amblyopic infantile esotropes following early surgery. Invest Ophthalmol Vis Sci 1990; 31: 758–65.
Stager DR, Birch EE . Preferential looking acuity and stereopsis in infantile esotropia. J Pediatric Ophthalmol Strabismus 1986; 26: 160–5.
Schor CM, Wilson N, Fusaro R, McKee SP . Prediction of early onset esotropia from components of the infantile squint syndrome. Invest Ophthalmol Vis Sci (Suppl) 1995; 36: 645.
Hague S, Shallo-Hoffman J, Fells P, Gresty M . Abnormal motion perception in early onset esotropia. In: Lennerstrand G, editor. Update on strabismus and pediatric ophthalmology. Boca Raton: CRC Press, 1994: 106–9.
Hartmann EE, Succop A, Buck SL, Weiss AH, Teller DY . Quantification of monocular optokinetic nystagmus asymmetries and motion perception with motion-nulling techniques. J Opt Soc Am A 1993; 10: 1835–40.
Wang A-H, Norcia AM, Jampolsky A . Reversing grating as a simple clinical method to test the symmetry of motion perception and potential binocularity. Invest Ophthalmol Vis Sci (Suppl) 1992; 33: 1340.
Norcia AM, Garcia H, Humphry R, Holmes A, Hamer RD, Orel-Bixler D . Anomalous motion VEPs in infants and in infantile esotropia. Invest Ophthalmol Vis Sci 1991; 32: 436–9.
Kommerrell G, Ulrich D, Gilles G, Bach M . Asymmetry of motion VEP in infantile strabismus and in central vestibular nystagmus. In: Fuchs AF, Brandt T, Buttner U, Zee DS, editors. Contemporary ocular motor and vestibular research: a tribute to David A. Robinson. Thieme: Stuttgart, 1994: 394–7.
Norcia AM, Hamer RD, Orel-Bixler D . Temporal tuning of the motion VEP in infants. Invest Ophthalmol Vis Sci (Suppl) 1990; 31: 10.
Jampolsky A, Norcia AM, Hamer RD . Preoperative alternate occlusion decreases motion processing abnormalities in infantile esotropia. J Pediatr Ophthalmol Strabismus 1994; 31: 6–17.
Atkinson J . Development of optokinetic nystagmus in the human infant and monkey infant. In: Freeman RD, editor. Developmental neurobiology of vision. New York: Plenum, 1979: 277–87.
Naegele JR, Held R . The postnatal development of monocular optokinetic nystagmus in infants. Vision Res 1982; 22: 341–6.
Teller DY, Succop A, Mar C . Infant eye movement asymmetries: stationary gratings elicit temporal-to-nasal optokinetic nystagmus in 2-month-old infants. Vision Res 1994; 34: 1859–64.
Hubel DH, Wiesel TN . The period of susceptibility to the physiological effects of unilateral eye closure in kittens. J Physiol (Lond) 1970; 206: 419–36.
Sherman SM, Spear PD . Organization of visual pathways in normal and visually deprived cats. Physiol Rev 1982; 62: 738–855.
Norcia AM, Hamer RD, Jampolsky A, Orel-Bixler D . Plasticity of motion processing mechanisms following surgery for infantile esotropia. Vision Res 1995; 35: 3279–96.
Hamer RD, Norcia AM, Orel-Bixler D, Hoyt CS . Motion VEPs in late-onset esotropia. Clin Vision Sci 1993; 8: 55–62.
Sokol S, Pelli E, Moskowitz A, Reese D . Pursuit eye movements in late onset esotropia. J Pediatr Ophthalmol Strabismus 1991; 28: 82–6.
Chandna A, Norcia AM, Peterzell DH . VEP correlates of direction-specific binocular mechanisms. Invest Ophthalmol Vis Sci (Suppl) 1993; 34: 1054.
Poggio GF, Talbot WH . Mechanisms of static and dynamic stereopsis in foveal cortex of the rhesus monkey. J Physiol (Lond) 1981; 315: 469–92.
Burkhalter A, Van Essen DC . Processing of color, form and disparity information in areas VP and V2 of ventral extrastriate cortex in the macaque monkey. J Neurosci 1986; 6: 2327–51.
Poggio GF, Gonzalez F, Krause F . Stereoscopic mechanisms in monkey visual cortex: binocular correlation and disparity selectivity. J Neurosci 1988; 8: 4531–50.
Felleman DF, Van Essen DC . Receptive field properties of neurons in area V3 of macaque extrastriate cortex. J Neurophysiol 1987; 57: 889–920.
Maunsell JHR, Van Essen DC . Functional properties of neurons in middle temporal visual area of the macaque monkey. I. Selectivity for stimulus direction, speed and orientation. J Neurophysiol 1983; 49: 1127–47.
Maunsell JHR, Van Essen DC . Functional properties of neurons in middle temporal visual area of the macaque monkey. II. Binocular interactions and sensitivity to disparity. J Neurophysiol 1983; 49: 1148–66.
Roy J-P, Komatsu H, Wurtz RH . Disparity sensitive neurons in monkey extrastriate area MST. J Neurosci 1992; 17: 2478–92.
Hawken MJ, Parker AJ, Lund JS . Laminar organization and contrast sensitivity of direction-selective cells in the striate cortex of the Old World monkey. J Neurosci 1988; 8: 3541–8.
Lund JS . Anatomical organization of macaque monkey striate visual cortex. Annu Rev Neurosci 1988; 11: 253–88.
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Norcia, A. Abnormal motion processing and binocularity: Infantile esotropia as a model system for effects of early interruptions of binocularity. Eye 10, 259–265 (1996). https://doi.org/10.1038/eye.1996.55
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DOI: https://doi.org/10.1038/eye.1996.55
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