Treatment for Central-Peripheral Rivalry-Type Diplopia (“Dragged-Fovea Diplopia Syndrome”)

Hatt, Sarah R.; Klaehn, Lindsay D.; Kramer, Andrea; Iezzi, Raymond; Holmes, Jonathan M.

doi:10.1016/j.ajo.2019.06.030

Cited by 15 publications

(8 citation statements)

References 22 publications

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“…[ 2 ] Typically these patients have good visual acuity but with metamorphopsia, and small-angle comitant or incomitant hyperdeviation without any cyclovertical muscle dysfunction. [ 1 ] ERM peeling has been shown to help in resolution of diplopia in some patients,[ 3 ] but in our patient it did not work. This could be due to permanent minute macular displacement, persisting even after surgical relief of the forces causing macular traction.…”

Section: Discussionmentioning

confidence: 64%

“…Patients can be trained to actively ignore the blurred image in the affected eye and many actually succeed in doing that over time. [ 3 ] Our patient did try the same for more than a year, but it did not help. He also attempted partial occlusion of one eye, but could not adjust to it as his profession involved significant public interaction and working with computers for long hours.…”

Section: Discussionmentioning

confidence: 93%

“…He also attempted partial occlusion of one eye, but could not adjust to it as his profession involved significant public interaction and working with computers for long hours. Successful use of Fresnel prisms and Bangerter’s filters[ 3 ] has been described but cost and limited availability is an issue, especially in a resource-limited setting like sub-Saharan Africa. Extraocular muscle surgery can bring images closer, facilitating fusion.…”

Section: Discussionmentioning

confidence: 99%

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Central mini-tenotomy and environmental modifications to correct “macular diplopia” due to sickle cell retinopathy in a resource-limited setting

Pehere¹,

Bornguoi²,

Fahn³

2020

J West Afr Coll Surg

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Section: Discussionmentioning

confidence: 64%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

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Central mini-tenotomy and environmental modifications to correct “macular diplopia” due to sickle cell retinopathy in a resource-limited setting

Pehere¹,

Bornguoi²,

Fahn³

2020

J West Afr Coll Surg

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“…Reduced diplopia awareness has been reported with the use of prism correction or fogging in some patients. 348 Fogging the vision in one eye, which eliminates the foveal conflict by producing a central scotoma, 349 has been the most successful.…”

Section: P403mentioning

confidence: 99%

“…It is important to remember that some patients with retinal misregistration have treatable causes of diplopia as well 347 . There is emerging evidence that peeling of the epiretinal membrane may be effective in addressing binocular retinal diplopia in a proportion of patients, 348 but retinal surgery for epiretinal membrane appears to be a double-edged sword because some nondiplopic patients become diplopic following this retinal procedure. 351…”

Section: P403mentioning

confidence: 99%

Adult Strabismus Preferred Practice Pattern®

Dagi

Velez²,

Archer

et al. 2020

Ophthalmology

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The Adult Strabismus PPP was then sent for review to additional internal and external groups and individuals in August 2019. All those returning comments were required to provide disclosure of relevant relationships with industry to have their comments considered. Members of the Pediatric Ophthalmology/Strabismus Preferred Practice Pattern Panel reviewed and discussed these comments and determined revisions to the document. The following organizations and individuals returned comments.

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Binocular Interference vs Diplopia in Patients With Epiretinal Membrane

2020

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ymptoms of epiretinal membrane (ERM) include reduced visual acuity, metamorphopsia, 1-3 aniseikonia, 4 and/or central-peripheral rivalry (CPR)-type diplopia 5 (also known as dragged-fovea diplopia 3 ). Over the years, [5][6][7][8] we have noted that some patients with ERM describe another apparently distinct symptom; needing to close 1 eye to improve their overall visual experience but in the absence of diplopia or strabismus. We term this phenomenon binocular interference, where a patient has reduced binocular visual quality vs monocular visual quality, manifesting as the need to close 1 eye in the absence of diplopia or strabismus. The aim of this study was to report the frequency of binocular interference associated with monocular eye closure in patients with ERM and also to evaluate its association with clinical parameters and quality of life domain scores. MethodsApproval was obtained from the institutional review board at Mayo Clinic, Rochester, Minnesota, for data collection and analysis, and written informed consent was obtained. No compensation or incentives were offered for participation. All procedures and data collection were conducted in a manner IMPORTANCE Patients with epiretinal membrane (ERM) sometimes close 1 eye for improved vision, but associations have not been rigorously studied.OBJECTIVE To evaluate associations with monocular eye closure in patients with ERM, and to report binocular interference (closing 1 eye to improve visual quality). DESIGN, SETTING, AND PARTICIPANTSRetrospective medical record review of an adult strabismus clinic at a tertiary referral center. Patients with ERM referred from retina clinicians between June 2010 and October 2019 who completed the Adult Strabismus (AS)-20 questionnaire, including the question: "I cover or close one eye to see things better." Two groups were identified: (1) patients reporting eye closure sometimes or more, and (2) patients reporting no eye closure (as control patients). MAIN OUTCOMES AND MEASURESFrequencies of (1) central-peripheral rivalry (CPR)-type diplopia (dragged fovea diplopia); (2) binocular interference (monocular eye closure but no diplopia or strabismus); and (3) other, associated with monocular eye closure. Visual acuity, metamorphopsia, aniseikonia, and AS-20 quality of life domain scores (self-perception, interactions, reading function, and general function) compared between binocular interference, CPR-type diplopia, and control patients.RESULTS A total of 124 patients with ERM (58 of 124 were women [47%]; mean [SD] age, 70 [9] years) reported monocular eye closure. Associations were binocular interference in 36 (29%; 95% CI, 21%-38%), CPR-type diplopia in 34 (27%; 95% CI, 20%-36%), and other (primarily strabismus) in 54 (44%). Compared with control patients with ERM (n = 11), patients with ERM and binocular interference had worse quality of life on AS-20 reading function (95 vs 62; mean difference, 22 points; 95% CI, 7-27 points; P = .007) and general function (89 vs 68; mean difference, 23 points; 95% CI, 13-34 points; P =...

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Treatment for Central-Peripheral Rivalry-Type Diplopia (“Dragged-Fovea Diplopia Syndrome”)

Cited by 15 publications

References 22 publications

Central mini-tenotomy and environmental modifications to correct “macular diplopia” due to sickle cell retinopathy in a resource-limited setting

Central mini-tenotomy and environmental modifications to correct “macular diplopia” due to sickle cell retinopathy in a resource-limited setting

Adult Strabismus Preferred Practice Pattern®

Binocular Interference vs Diplopia in Patients With Epiretinal Membrane

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