Vergence and Strabismus in Neurodegenerative Disorders
Maintaining proper eye alignment is necessary to generate a cohesive visual image. This involves the coordination of complex neural networks, which can become impaired by various neurodegenerative diseases. When the vergence system is affected, this can result in strabismus and disorienting diplopia...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2018-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | http://journal.frontiersin.org/article/10.3389/fneur.2018.00299/full |
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| author | Sarah L. Kang Aasef G. Shaikh Aasef G. Shaikh Fatema F. Ghasia Fatema F. Ghasia |
| author_facet | Sarah L. Kang Aasef G. Shaikh Aasef G. Shaikh Fatema F. Ghasia Fatema F. Ghasia |
| author_sort | Sarah L. Kang |
| collection | DOAJ |
| description | Maintaining proper eye alignment is necessary to generate a cohesive visual image. This involves the coordination of complex neural networks, which can become impaired by various neurodegenerative diseases. When the vergence system is affected, this can result in strabismus and disorienting diplopia. While previous studies have detailed the effect of these disorders on other eye movements, such as saccades, relatively little is known about strabismus. Here, we focus on the prevalence, clinical characteristics, and treatment of strabismus and disorders of vergence in Parkinson’s disease, spinocerebellar ataxia, Huntington disease, and multiple system atrophy. We find that vergence abnormalities may be more common in these disorders than previously thought. In Parkinson’s disease, the evidence suggests that strabismus is related to convergence insufficiency; however, it is responsive to dopamine replacement therapy and can, therefore, fluctuate with medication “on” and “off” periods throughout the day. Diplopia is also established as a side effect of deep brain stimulation and is thought to be related to stimulation of the subthalamic nucleus and extraocular motor nucleus among other structures. In regards to the spinocerebellar ataxias, oculomotor symptoms are common in many subtypes, but diplopia is most common in SCA3 also known as Machado–Joseph disease. Ophthalmoplegia and vergence insufficiency have both been implicated in strabismus in these patients, but cannot fully explain the properties of the strabismus, suggesting the involvement of other structures as well. Strabismus has not been reported as a common finding in Huntington disease or atypical parkinsonian syndromes and more studies are needed to determine how these disorders affect binocular alignment. |
| first_indexed | 2024-12-23T11:57:05Z |
| format | Article |
| id | doaj.art-aa35aef8724b4129bfdf59436a00b863 |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-12-23T11:57:05Z |
| publishDate | 2018-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-aa35aef8724b4129bfdf59436a00b8632022-12-21T17:48:03ZengFrontiers Media S.A.Frontiers in Neurology1664-22952018-05-01910.3389/fneur.2018.00299344056Vergence and Strabismus in Neurodegenerative DisordersSarah L. Kang0Aasef G. Shaikh1Aasef G. Shaikh2Fatema F. Ghasia3Fatema F. Ghasia4Case Western Reserve University School of Medicine, Cleveland, OH, United StatesCase Western Reserve University School of Medicine, Cleveland, OH, United StatesDaroff-Dell’Osso Ocular Motility Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United StatesDaroff-Dell’Osso Ocular Motility Laboratory, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, United StatesCole Eye Institute, Cleveland Clinic, Cleveland, OH, United StatesMaintaining proper eye alignment is necessary to generate a cohesive visual image. This involves the coordination of complex neural networks, which can become impaired by various neurodegenerative diseases. When the vergence system is affected, this can result in strabismus and disorienting diplopia. While previous studies have detailed the effect of these disorders on other eye movements, such as saccades, relatively little is known about strabismus. Here, we focus on the prevalence, clinical characteristics, and treatment of strabismus and disorders of vergence in Parkinson’s disease, spinocerebellar ataxia, Huntington disease, and multiple system atrophy. We find that vergence abnormalities may be more common in these disorders than previously thought. In Parkinson’s disease, the evidence suggests that strabismus is related to convergence insufficiency; however, it is responsive to dopamine replacement therapy and can, therefore, fluctuate with medication “on” and “off” periods throughout the day. Diplopia is also established as a side effect of deep brain stimulation and is thought to be related to stimulation of the subthalamic nucleus and extraocular motor nucleus among other structures. In regards to the spinocerebellar ataxias, oculomotor symptoms are common in many subtypes, but diplopia is most common in SCA3 also known as Machado–Joseph disease. Ophthalmoplegia and vergence insufficiency have both been implicated in strabismus in these patients, but cannot fully explain the properties of the strabismus, suggesting the involvement of other structures as well. Strabismus has not been reported as a common finding in Huntington disease or atypical parkinsonian syndromes and more studies are needed to determine how these disorders affect binocular alignment.http://journal.frontiersin.org/article/10.3389/fneur.2018.00299/fullstrabismusdiplopianeurodegenerativeParkinson’s diseasespinocerebellar ataxiaMachado–Joseph disease |
| spellingShingle | Sarah L. Kang Aasef G. Shaikh Aasef G. Shaikh Fatema F. Ghasia Fatema F. Ghasia Vergence and Strabismus in Neurodegenerative Disorders Frontiers in Neurology strabismus diplopia neurodegenerative Parkinson’s disease spinocerebellar ataxia Machado–Joseph disease |
| title | Vergence and Strabismus in Neurodegenerative Disorders |
| title_full | Vergence and Strabismus in Neurodegenerative Disorders |
| title_fullStr | Vergence and Strabismus in Neurodegenerative Disorders |
| title_full_unstemmed | Vergence and Strabismus in Neurodegenerative Disorders |
| title_short | Vergence and Strabismus in Neurodegenerative Disorders |
| title_sort | vergence and strabismus in neurodegenerative disorders |
| topic | strabismus diplopia neurodegenerative Parkinson’s disease spinocerebellar ataxia Machado–Joseph disease |
| url | http://journal.frontiersin.org/article/10.3389/fneur.2018.00299/full |
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