|Krystyna Orendorz-Frączkowska, Wojciech Gawron, Lucyna Pośpiech, Patrycja Krzyżanowska, Magdalena Koziorowska|
Introduction. It is assumed that impairment of the peripheral part of vision organ, except for the macula, does not significantly affect the visual-oculomotor reflexes. But there are papers reporting essential differences in optokinetic nystagmus as well as in changes of retinal sensitivity in response to the optokinetic stimulation in glaucoma patients compared to healthy subjects.
Aim. Evaluate effects of glaucoma impairment of retinal receptor on the visual-oculomotor reflexes.
Material and methods. The study group comprised 40 patients aged from 28 to 65 years with diagnosed primary open angle glaucoma (I group), and 40 healthy subject at similar age (control). Vestibular (ENG), eye tracking, saccadic tests, and optokinetic test with black and white stripes velocity of 20°/sec., 40°/sec., 60°/sec. to the right and left, as well as complex diagnostics of vision organ were performed.
Results. The visual field deficits with bilateral impairment of visual acuity were detected in 20 patients, and with unilateral impairment of visual acuity in 11 patients; 4 patients had unilateral blindness with extremely low perception of light and movement in the other eye. Eye tracking test was abnormal in 35%, saccadic tests was impaired in 37.5% of the cases. Increasing velocity of stimulation in both groups resulted in decreased optokinetic gain value, and this value was significantly lower in glaucoma patients in the test with stripe velocity of 60°/sec.
Conclusions. Asymptomatic, prolonged open-angle glaucoma may impair visual-oculomotor reflexes in a considerable proportion of patients, which may result in fallacious otoneurological evaluation. The ophtalmologic evaluation should not be omitted in the diagnosis of vertigo and dizziness.
keywords: odruchy wzrokowo-okoruchowe (optokinetyczne), jaskra, elektronystagmografia, układ równowagi, visual-oculomotor (optokinetic) reflexes, glaucoma, electronystagmography, equilibrium system
pages: from 187 to 191
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