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Eileen E. Birch, Sherry Fawcett, David Stager; Co-Development of VEP Motion Response and Binocular Vision in Normal Infants and Infantile Esotropes. Invest. Ophthalmol. Vis. Sci. 2000;41(7):1719-1723.
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purpose. To determine the maturational course of nasotemporal asymmetry in
infantile esotropia and to define the relationships among the symmetry
of the motion visual evoked potential (MVEP), eye alignment, fusion,
methods. Sixty healthy term infants and 34 infants with esotropia participated.
Nasotemporal MVEP asymmetry was assessed by the presence of a
significant F1 response component with an inter-ocular
phase difference of approximately 180° and by an amplitude“
asymmetry index.” Fusion was evaluated using the 4 p.d.
base out prism test. Random dot stereoacuity was assessed in infants
with forced-choice preferential looking (FPL) using the Infant Random
Dot Stereocards. Eye alignment was assessed by the alternate prism and
cover or the modified Krimsky test.
results. Normal infants 2 to 3 months of age exhibited marked nasotemporal MVEP
asymmetry, which rapidly diminished by 6 to 8 months. Neonates did not
exhibit MVEP asymmetry. There was good concordance between fusion and
MVEP symmetry and between stereopsis and MVEP symmetry; the concordance
between MVEP symmetry and orthoposition of the visual axes was
significantly poorer. The same proportion of normal and young esotropic
infants showed symmetrical MVEPs. Regardless of the age at surgery,
most patients with infantile esotropia had asymmetrical MVEPs after
conclusions. These data support a strong link between fusion and MVEP symmetry
during both normal maturation and in infantile esotropia. Furthermore,
the finding that the youngest infants with esotropia do not differ
significantly from normal suggests that the nasotemporal asymmetry
found in older patients with infantile esotropia does not represent an
arrest of maturation but, rather, a pathologic change of the motion
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