Ophthalmic Technology Assessment: Surgical Treatments to Improve Visual Acuity in Infantile Nystagmus Syndrome

Ophthalmology Volume 130, Number 3, March 2023

中文摘要

本文回顧了有關治療幼年期眼震症候群 (Infantile Nystagmus Syndrome, INS) 的手術方式的文獻。研究共有23篇，其中包括1篇隨機試驗和22篇病例系列。目前沒有一種標準的手術治療INS以改善最佳矯正視力，但一些手術方法，如large recessions, anterior extirpation, myectomy with or without pulley fixation, and transposition of extraocular muscles，可以改善視力和減緩眼震症狀。研究顯示，幼年期手術的療效可能比成年期更佳。未來的研究需要探討新的手術技術和替代療法。此外，除了應該使用標準的光學字符進行雙眼視力測試外，還應包括客觀的眼震圖學(nystagmography)作為次要結果評估。最後，需要進行一項前瞻性、隨機、盲性研究，以確定手術治療是否有益。

English Abstract

The article provides a summary of various surgical procedures to improve visual acuity in patients with Infantile Nystagmus Syndrome (INS). The authors reviewed 23 studies, including one randomized trial and 22 case series, that evaluated surgical options for INS. The surgical procedures included large recessions, anterior extirpation, myectomy with or without pulley fixation, and transposition of extraocular muscles. The studies reported improvements in binocular visual acuity, ranging from 0.1 to 0.3 logMAR, or 1 to 3 Snellen lines, with statistical significance reported in some cases. However, the clinical significance of these improvements is debatable. There was no clear difference among the various procedures in terms of visual acuity outcomes. Objective nystagmography should be included as a secondary outcome measure along with visual acuity testing. Additional research is necessary to validate methods of VA testing in nonverbal children with INS.