Anatomic Features and Function of the Macula and Outcome of Surgical Tenotomy and Reattachment in Achiasma – Corrected Proof
Objective:
To examine the anatomic features and function of the macula in achiasma and to compare visual acuity, eye movements, foveation, and eye velocity before and after tenotomy and reattachment (T&R) surgery.
Design:
Case series.
Participants:
Two children with isolated achiasma.
Methods:
Ophthalmologic examinations, brain magnetic resonance imaging, full-field and multifocal electroretinography (ERG), visual evoked potentials (VEPs), spectral-domain optical coherence tomography (OCT), eye-movement recordings, and unilateral T&R in 1 patient.
Main Outcome Measures:
Visual acuity before and after surgery, macular anatomic features and function, and eye velocity before and after T&R surgery in 1 patient.
Results:
Magnetic resonance imaging and VEP confirmed absence of decussation of retinofugal fibers in both patients. Visual acuity was 20/100 and 20/200. The anatomic features and function of the fovea and macula were normal by OCT and multifocal ERG. After T&R, there was a marked reduction in horizontal eye velocity and monocular visual acuity improved to 20/80.
Conclusions:
The finding that the macula is normal in achiasma suggests that reduced acuity is the result of retinal image motion from nystagmus. Two-muscle T&R reduces horizontal retinal image motion and can improve visual acuity in achiasma or patients with infantile nystagmus.
Financial Disclosure(s):
The author(s) have no proprietary or commercial interest in any materials discussed in this article.