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Article: Perception of tilt following counter-rotation surgery

TitlePerception of tilt following counter-rotation surgery
Authors
KeywordsAdaptation
Age-related macular degeneration
Counter-rotation surgery
Tilt
Issue Date2010
PublisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CEO
Citation
Clinical And Experimental Ophthalmology, 2010, v. 38 n. 3, p. 284-291 How to Cite?
AbstractBackground: Macular translocation surgery (MTS) is one of the treatment options for age-related macular degeneration (AMD) followed by counter-rotation surgery (CRS) to correct the resulting tilt. The objective of this paper is to determine the perception of tilt following CRS and identify factors that influence the perception of tilt in the presence of residual cyclorotation following CRS. Methods: Thirty-four AMD patients treated with MTS and CRS were investigated; and all measurements were made preoperatively, and after each surgical procedure. Fundus photographs were analysed with computer software to determine the degree of retinal rotation and reliability was assessed by two independent assessors. The degree of perceptual rotation was measured with Maddox rod and the subjective appreciation of tilt was established by direct questioning. Fixation preference was determined by cover test and convergence. Bagolini glasses were used to determine binocular outcome. Results: Post CRS, 20 of the 34 patients had adapted to tilt. There was a significant difference of 5° ± 7° (95% confidence intervals: 1-8°, t = 2.9, degree of freedom = 19, P = 0.008) between the degree of rotation measured from the fundus photographs and the Maddox rod measurement following CRS. Patients with residual retinal rotation less than or equal to 15° did not appreciate tilt in free space. More importantly, fixation with the operated eye and ignoring the image from the non-operated eye was significantly associated with being free of tilt in natural viewing conditions (P < 0.05). Conclusion: Despite the presence of residual cyclorotation of the macula following CRS of up to 27°, a significant proportion (59%) of patients did not perceive the world as tilted in natural viewing conditions. Differences between retinal rotation and perceptual tilt provide evidence of sensory adaptation. It was patients who fixed with their operated eye and ignored the image from the non-operated eye who did not perceive tilt post CRS. © 2010 The Authors. Journal compilation © 2010 Royal Australian and New Zealand College of Ophthalmologists.
Persistent Identifierhttp://hdl.handle.net/10722/127677
ISSN
2015 Impact Factor: 2.546
2015 SCImago Journal Rankings: 1.335
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorMehta, Jen_HK
dc.contributor.authorFarnell, DJJen_HK
dc.contributor.authorStappler, Ten_HK
dc.contributor.authorLiazos, Een_HK
dc.contributor.authorWong, Den_HK
dc.date.accessioned2010-10-31T13:39:38Z-
dc.date.available2010-10-31T13:39:38Z-
dc.date.issued2010en_HK
dc.identifier.citationClinical And Experimental Ophthalmology, 2010, v. 38 n. 3, p. 284-291en_HK
dc.identifier.issn1442-6404en_HK
dc.identifier.urihttp://hdl.handle.net/10722/127677-
dc.description.abstractBackground: Macular translocation surgery (MTS) is one of the treatment options for age-related macular degeneration (AMD) followed by counter-rotation surgery (CRS) to correct the resulting tilt. The objective of this paper is to determine the perception of tilt following CRS and identify factors that influence the perception of tilt in the presence of residual cyclorotation following CRS. Methods: Thirty-four AMD patients treated with MTS and CRS were investigated; and all measurements were made preoperatively, and after each surgical procedure. Fundus photographs were analysed with computer software to determine the degree of retinal rotation and reliability was assessed by two independent assessors. The degree of perceptual rotation was measured with Maddox rod and the subjective appreciation of tilt was established by direct questioning. Fixation preference was determined by cover test and convergence. Bagolini glasses were used to determine binocular outcome. Results: Post CRS, 20 of the 34 patients had adapted to tilt. There was a significant difference of 5° ± 7° (95% confidence intervals: 1-8°, t = 2.9, degree of freedom = 19, P = 0.008) between the degree of rotation measured from the fundus photographs and the Maddox rod measurement following CRS. Patients with residual retinal rotation less than or equal to 15° did not appreciate tilt in free space. More importantly, fixation with the operated eye and ignoring the image from the non-operated eye was significantly associated with being free of tilt in natural viewing conditions (P < 0.05). Conclusion: Despite the presence of residual cyclorotation of the macula following CRS of up to 27°, a significant proportion (59%) of patients did not perceive the world as tilted in natural viewing conditions. Differences between retinal rotation and perceptual tilt provide evidence of sensory adaptation. It was patients who fixed with their operated eye and ignored the image from the non-operated eye who did not perceive tilt post CRS. © 2010 The Authors. Journal compilation © 2010 Royal Australian and New Zealand College of Ophthalmologists.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing Asia. The Journal's web site is located at http://www.blackwellpublishing.com/journals/CEOen_HK
dc.relation.ispartofClinical and Experimental Ophthalmologyen_HK
dc.rightsThe definitive version is available at www.blackwell-synergy.com-
dc.subjectAdaptationen_HK
dc.subjectAge-related macular degenerationen_HK
dc.subjectCounter-rotation surgeryen_HK
dc.subjectTilten_HK
dc.subject.meshMacula Lutea - surgery-
dc.subject.meshMacular Degeneration - surgery-
dc.subject.meshRetina - surgery-
dc.subject.meshTilt-Table Test - methods-
dc.subject.meshVisual Perception - physiology-
dc.titlePerception of tilt following counter-rotation surgeryen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1442-6404&volume=38&issue=3&spage=284&epage=291&date=2010&atitle=Perception+of+tilt+following+counter-rotation+surgery-
dc.identifier.emailWong, D: shdwong@hku.hken_HK
dc.identifier.authorityWong, D=rp00516en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1442-9071.2010.02235.xen_HK
dc.identifier.pmid20447125-
dc.identifier.scopuseid_2-s2.0-77953222911en_HK
dc.identifier.hkuros181864en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77953222911&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume38en_HK
dc.identifier.issue3en_HK
dc.identifier.spage284en_HK
dc.identifier.epage291en_HK
dc.identifier.isiWOS:000276949000011-
dc.publisher.placeAustraliaen_HK
dc.identifier.scopusauthoridMehta, J=23501882700en_HK
dc.identifier.scopusauthoridFarnell, DJJ=7004457484en_HK
dc.identifier.scopusauthoridStappler, T=8563727800en_HK
dc.identifier.scopusauthoridLiazos, E=24577500600en_HK
dc.identifier.scopusauthoridWong, D=7401536078en_HK
dc.identifier.citeulike7079467-

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