Comparison of Double Maddox Rod Test and Bagolini Striated Lens Test for Superior Oblique Palsy

PURPOSE: We compared the results of the double Maddox rod test (DMRT), which is commonly performed in clinics as a subjective torsion test for superior oblique muscle palsy, with those of the Bagolini striated lenses test (BSLT) in a least dissociating condition to predict the cyclofusional capacity. METHODS: Twenty-five patients with acquired superior oblique muscle palsy were tested for degree of subjective torsion with DMRT and BSLT in primary position and down-gaze in Daegu Catholic University Hospital from May 2014 to March 2015. DMRT was performed in a dark room and BSLT in a lighted room. RESULTS: Mean extorsional degree in primary position was 3.40 ± 2.58° on DMRT and 1.88 ± 2.92° on BSLT, a significant difference (p = 0.000). In down-gaze, mean extorsional degree was 4.16 ± 2.90° with DMRT and 2.40 ± 2.90° with BSLT (p < 0.001). CONCLUSIONS: The subjective torsional measurement with BSLT was significantly smaller than with DMRT, and the cyclofusional capacity in patients with acquired superior oblique palsy was 1.5° in primary position and 1.8° in down-gaze. BSLT is helpful in addition to DMRT and fundus photograph for the evaluation of cyclotropia in patients with superior oblique muscle palsy, and this test may yield clinically important information for predicting the cyclofusional capacity of patients with superior oblique muscle palsy.

Surgical Results of Modified Harada-Ito Operation for Excyclotorsion

PURPOSE: We evaluated the efficacy of the modified Harada-Ito operation for excyclotorsion in acquired superior oblique palsy patients after trauma. METHODS: This study represents a retrospective review of 10 eyes in 9 patients who were surgically treated for excyclotorsion. Cyclotorsion was measured with the double maddox-rod test and fundus photographies preoperatively and postoperatively. RESULTS: The median measured change in excyclotorsion before and after the surgery in the primary gaze was reduced from 15.67 +/- 6.00 to 4.78 +/- 3.42 according to fundus photographies and from 12.30 +/- 6.27 to 2.45 +/- 3.73 according to the double maddox-rod test. Subjective and objective changes in excyclotorsion werer not significantly different. CONCLUSIONS: The Modified Harada-Ito operation is an effective treatment for correcting excyclotorsion. Although not statistically significant, the amount of excyclotorsion on fundus photography is exaggerated. This point should be considered to achieve effective surgery.