To Continuously Observe The Change Of The Null Zone Of Patients With Infantile Nystagmus Syndrome After Operation

Purpose: The purpose of this report is to characterize the change of eyes-related parameters after the operation of patients with infantile nystagmus syndrome(INS).To provide a reference for the clinical evaluation of postoperative effect and the rational arrangement of patients' follow-up time after operation Methods: A retrospective study,from June.2014 to December.2016,all patients with INS after surgery to shift the null zone were operated by one surgeon in Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine.Ophthalmological examination and eye movement recording were recorded before surgery and 1-3 months,4-6 months and final follow-up after surgeries respectively.Visual acuity?stereopsis?refractive error?degree of anomalous head posture(AHP)?Expanded nystagmus acuity function(NAFX)?foveation time and the position of the null zone were evaluated.SPSS 19.0 software was used for the statistical analysis.MATLAB software was used to explore the trend of the NAFX.Results: A total of 17 patients with INS who met Inclusion criteria were brought into our study.Male: female=11:6,age at surgery was 7.24±1.89 years(5-11 y),the final follow-up visit was 15 months(6-27m).BCBVA with straight head and stereopsis significantly improved.For those operated on for an AHP with or without associated strabismus the AHP improved meaningfully.The NAFX,position of the null zone measured from eye movement recordings showed significant increases in all patients.Six(35%)patients appeared the loss of operative effect which was related to the NAFX.The lower the NAFX value,the more likely it was to have a reduction in the effect of the operation.The mean time for the reduced effect of surgery was 10±4.9 months.Four patients had a second AHP after operation that was associated with the complex AHP they had before operation.The mean time for the appearance of second AHP was 9.6± 5.37 months.Postoperative NAFX value had risen over time,but there was a slight drop after the peak.BCBVA,stereopsis,refractive error and NAFX had no significant correlation of the time of second AHP and reduced effect of surgery.Conclusions: Surgery to shift the null zone is an effective way to treat INS.35% patients appeared the reduced effect of surgery.The lower the NAFX value and early postoperative stereopsis,the more likely it was to have a reduction in the effect of the operation.A patient with a complex abnormal head position would appear a second anomalous head position head after surgery,if the operation just solves one plane of deviation.Only one patient appeared the overcorrection after operation.