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Changes in Dynamic and Kinematic Properties of Saccades in Ocular Myasthenia following Intravenous Immunoglobulin Treatment
Author(s) -
Serra Alessandro,
Thurtell Matthew J.,
Leigh R. John
Publication year - 2009
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2008.03712.x
Subject(s) - extraocular muscles , eye movement , palpebral fissure , kinematics , listing (finance) , medicine , myasthenia gravis , eye muscle , ophthalmology , anatomy , physics , finance , classical mechanics , economics
The dynamics and kinematics of saccades in a patient with severe ocular myasthenia were studied before and after treatment with intravenous immunoglobulin (IVIG). Before therapy, horizontal saccades were hypometric, but faster than similar‐sized saccades made by normal subjects. During a 5‐minute test period, saccades decreased in size (fatigue effect), but remained faster than those of controls. Listing's plane of the eye with greater ophthalmoplegia was increased in thickness. After IVIG treatment, the range of eye movements improved, but saccades remained faster than those of controls. Also, no fatigue was observed and the thickness of Listing's plane was reduced toward the normal range. Increased peak velocity, despite progressive hypometria due to fatigue, supports the hypothesis that the pale global extraocular muscle fibers are relatively spared in myasthenia. Involvement of other extraocular muscle‐fiber types leads to limited range of eye movements and an increase in the thickness of Listing's plane.