Treatment of spontaneous dissociated vertical deviation with the pharmacological penali-zation of the  fixing eye

María Estela Arroyo-Yllanes; Blanca Adriana Galicia-Castillo; José Fernando Pérez-Pérez

2005, Number 6

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Cir Cir 2005; 73 (6)

Treatment of spontaneous dissociated vertical deviation with the pharmacological penali-zation of the fixing eye

Arroyo-Yllanes ME, Galicia-Castillo BA, Pérez-Pérez JF

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Language: Spanish
References: 22
Page: 425-429
PDF size: 85.00 Kb.

ABSTRACT

Background: Dissociated vertical deviation (DVD) is a common innervational entity frequently found in patients with congenital endotropia. It is characterized as being bilateral, asymmetric, and to a greater extent, in the non-fixating eye. It can be compensatory or non-compensatory. In the majority of cases, surgery is the treatment of choice, but spontaneous appearance of DVD is a common occurrence after surgery, sometimes to a degree similar to that prior to surgery.
Objective: Our aim was to evaluate the behavior of dissociated vertical deviation with penalization of the fixating eye.
Material and methods: An experimental and longitudinal study was conducted in which patients with spontaneous DVD were included, whether or not associated with horizontal deviation, with or without previous surgery. Atropine (1%) was applied every 24 h in the fixating eye for 3 months and DVD presence, magnitude, and spontaneity were evaluated at 15 days, 1 month, 3 months and 1 month after penalization suspension.
Results: Eight patients were included. DVD magnitude decreased with penalization (p = 0.02) and remained unchanged when atropine was suspended (p = 0.6). With regard to decompensatory phases, DVD shifted from spontaneous to non-spontaneous during penalization (p = 0.01); when this was eliminated, deviation showed decompensation again (p = 0.03).
Conclusions: Fixating eye penalization with 1% atropine reduces DVD magnitude and decompensatory phases during follow-up.

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