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Reika Kono, Satoshi Hasebe, Hiroshi Ohtsuki, Kennichi Kashihara, Yoshihiko Shiro; Impaired Vertical Phoria Adaptation in Patients with Cerebellar Dysfunction. Invest. Ophthalmol. Vis. Sci. 2002;43(3):673-678.
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purpose. To determine whether phoria adaptation to a vertical prism disparity is
altered in patients with cerebellar dysfunction.
methods. With a computer-aided haploscope, adaptive responses of fusion-free eye
position to a 10- or 30-minute period was measured in subjects wearing
a 3-prism diopter vertical prism over one eye. Thirteen patients with
well-documented cerebellar diseases who did not have manifest ocular
misalignment or limited versional eye movement and age-matched healthy
results. The mean ± SD percentage of vertical phoria adaptation was 13%±
22% and 20% ± 16% for the 10- and 30-minute adaptations,
respectively. These levels were significantly smaller than the
respective ones in the age-matched control group (P < 0.001, repeated measures MANOVA). Seven (54%) of 13 patients,
including two with genetically confirmed pure cerebellar lesions
(spinocerebellar ataxia type 6), showed markedly reduced responses to
both the 10- and 30-minute adaptations. In all three patients with
acute cerebellar ataxia, the adaptive response was improved at the same
time as remission of cerebellum-associated neurologic deficits.
conclusions. Phoria adaptation to vertical binocular disparity is frequently
impaired in patients with cerebellar dysfunction. These results bolster
the hypothesis that phoria adaptation is a cerebellar-dependent
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