IntroductionThe vestibulo-ocular reflex (VOR) stabilizes vision during head movements. VOR disorders lead to symptoms such as imbalance, dizziness, and oscillopsia. Despite similar VOR dysfunction, patients display diverse complaints. This study analyses saccades, balance, and spatial orientation in chronic peripheral and central VOR disorders, specifically examining the impact of oscillopsia.MethodsParticipants involved 15 patients with peripheral bilateral vestibular loss (pBVL), 21 patients with clinically and genetically confirmed Machado–Joseph disease (MJD) who also have bilateral vestibular deficit, and 22 healthy controls. All pBVL and MJD participants were tested at least 9 months after the onset of symptoms and underwent a detailed clinical neuro-otological evaluation at the Dizziness and Eye Movements Clinic of the Meir Medical Center.ResultsAmong the 15 patients with pBVL and 21 patients with MJD, only 5 patients with pBVL complained of chronic oscillopsia while none of the patients with MJD reported this complaint. Comparison between groups exhibited significant differences in vestibular, eye movements, balance, and spatial orientation. When comparing oscillopsia with no-oscillopsia subjects, significant differences were found in the dynamic visual acuity test, the saccade latency of eye movements, and the triangle completion test.DiscussionEven though there is a significant VOR gain impairment in MJD with some subjects having less VOR gain than pBVL with reported oscillopsia, no individuals with MJD reported experiencing oscillopsia. This study further supports that subjects experiencing oscillopsia present a real impairment to stabilize the image on the retina, whereas those without oscillopsia may utilize saccade strategies to cope with it and may also rely on visual information for spatial orientation. Finding objective differences will help to understand the causes of the oscillopsia experience and develop coping strategies to overcome it.

中文翻译：

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双侧前庭丧失和无法解释的振荡症状的功能影响

简介前庭眼反射 (VOR) 可稳定头部运动期间的视力。 VOR 障碍会导致失衡、头晕和振荡等症状。尽管有类似的 VOR 功能障碍，但患者表现出不同的主诉。本研究分析了慢性外周和中枢 VOR 疾病的眼跳、平衡和空间定向，特别检查了颤动的影响。方法参与者包括 15 名外周双侧前庭丧失 (pBVL) 患者、21 名临床和基因证实的马查多-约瑟夫病患者 ( MJD），也有双侧前庭缺陷，以及 22 名健康对照。所有 pBVL 和 MJD 参与者在症状出现至少 9 个月后接受测试，并在梅尔医疗中心的头晕和眼动诊所接受详细的临床神经耳科评估。 结果 在 15 名 pBVL 患者和 21 名 MJD 患者中，只有 5 名 pBVL 患者主诉有慢性振荡，而 MJD 患者中没有一人报告有这种主诉。各组之间的比较在前庭、眼球运动、平衡和空间定向方面表现出显着差异。当比较振动视和无振动视受试者时，在动态视力测试、眼球运动的扫视潜伏期和三角完成测试中发现显着差异。讨论尽管MJD存在显着的VOR增益损害，但某些受试者的VOR较少与 pBVL 相比，报告出现振荡，但没有 MJD 患者报告出现振荡。这项研究进一步支持，经历振动视的受试者在稳定视网膜上的图像方面存在真正的障碍，而没有振动视的受试者可能会利用扫视策略来应对它，也可能依赖视觉信息来进行空间定向。找到客观差异将有助于了解振荡体验的原因并制定应对策略来克服它。