Binocular Diplopia Associated With Subretinal Neovascular Membranes

Burgess, Dean B.; Roper-Hall, Gill; Burde, Ronald M.

doi:10.1001/archopht.1980.01020030307014

Cited by 44 publications

(29 citation statements)

References 6 publications

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“…Previously, binocular diplopia has been reported with preretinal 1 as well as subretinal lesions. 2 To our knowledge, this is the first combined series of patients with pathology at different levels of the fundus and the only report of a successful therapy in this challenging group of patients.…”

Section: Commentmentioning

confidence: 43%

“…2 When retinal wrinkling or macular derangement causes a mechanical displacement of the affected fovea, both foveas are no longer corresponding retinal points, and diplopia ensues.…”

mentioning

confidence: 42%

“…INOCULAR DIPLOPIA secondary to macular pathology has been described previously, [1][2][3] and when diagnosed is often left untreated. These patients classically have comitant, small-angle hyperdeviations and no cyclovertical muscle dysfunction.…”

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confidence: 43%

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Nonsurgical Management of Binocular Diplopia Induced by Macular Pathology

et al. 1999

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Objective: To treat binocular diplopia secondary to macular pathology.Methods: Seven patients underwent evaluation and treatment. All had constant vertical diplopia caused by various maculopathies, including subretinal neovascularization, epiretinal membrane, and central serous retinopathy. Visual acuity ranged from 20/20 to 20/30 in the affected eye. All except 1 patient had a small-angle, comitant hyperdeviation with no muscle paresis. Sensory evaluation demonstrated peripheral fusion and reduced stereoacuity. Neither prism correction nor manipulation of the refractive errors corrected the diplopia. A partially occlusive foil (Bangerter) of density ranging from 0.4 to 1.0 was placed in front of the affected eye to restore stable, single vision. Results:The Bangerter foil eliminated the diplopia in all patients. Two patients elected not to wear the foil; 1 patient was afraid of becoming dependent, and the other was bothered by the visual blur. Visual acuity in the affected eye was reduced on average by 3 lines. All patients maintained the same level of sensory fusion, with only 2 having reduced stereoacuity. Symptoms returned when the foil was removed or its density was reduced. Conclusion:Low-density Bangerter foils provide an effective, inexpensive, and aesthetically acceptable management for refractory binocular diplopia induced by macular pathology, allowing peripheral fusion to be maintained.

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Section: Commentmentioning

confidence: 43%

“…2 When retinal wrinkling or macular derangement causes a mechanical displacement of the affected fovea, both foveas are no longer corresponding retinal points, and diplopia ensues.…”

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confidence: 42%

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Nonsurgical Management of Binocular Diplopia Induced by Macular Pathology

et al. 1999

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“…1999;117:896-899 B INOCULAR DIPLOPIA associated with epiretinal membrane formation and subretinal neovascular membranes has been described. 1,2 The mechanism is postulated to be a mechanical distortion of the macula causing rivalry between central and peripheral fusional mechanisms. Patients with these conditions are unable to fuse when their deviation is offset with prisms owing to the continuing rivalry.…”

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confidence: 42%

Diplopia Secondary to Aniseikonia Associated With Macular Disease

Benegas

Egbert²,

Engel³

et al. 1999

Arch Ophthalmol

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To provide an explanation for diplopia and the inability to fuse in some patients with macular disease. Methods: We identified 7 patients from our practices who had binocular diplopia concurrent with epiretinal membranes or vitreomacular traction. A review of the medical records of all patients was performed. In addition to complete ophthalmologic and orthoptic examinations, evaluation of aniseikonia using the Awaya New Aniseikonia Tests (Handaya Co Ltd, Tokyo, Japan) was performed on all patients.Results: All patients were referred for troublesome diplopia. Six of the patients had epiretinal membranes and 1 had vitreomacular traction. All 7 patients had aniseikonia, ranging from 5% to 18%. In 5 of the patients the image in the involved eye was larger, and in the other 2 patients it was smaller than in the fellow eye. All patients had concomitant small-angle strabismus and at least initially did not fuse when the deviation was offset with a prism. Response to optical management and retinal surgery was variable.Conclusions: Aniseikonia caused by separation or compression of photoreceptors can be a contributing factor to the existence of diplopia and the inability to fuse in patients with macular disease. Concomitant smallangle strabismus and the inability to fuse with prisms may lead the clinician to the incorrect diagnosis of central disruption of fusion. Surgical intervention does not necessarily improve the aniseikonia.

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“…For example, DraggedFovea diplopia syndrome was described as central binocular diplopia secondary to displacement of one or both foveas by epiretinal membranes or other maculopathies. [15][16][17][18][19][20] De Pool et al 20 described 83 patients with Dragged-Fovea diplopia syndrome. These patients presented with diplopia (vertical, horizontal, both vertical and horizontal, and torsional), although not all of them had strabismus.…”

Section: Discussionmentioning

confidence: 41%