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   Table of Contents      
ORIGINAL ARTICLE
Year : 1991  |  Volume : 39  |  Issue : 3  |  Page : 127-128

Audiometric and vestibular abnormalities in macular degeneration


1 Department of Ophthalmology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India
2 Department of Oto-rhino-laryngology, Institute of Medical Sciences, Banaras Hindu University, Varanasi - 221005, India

Correspondence Address:
R Singh
C-7, New Medical Enclave, Banaras Hindu University, Varanasi - 221 005
India
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Source of Support: None, Conflict of Interest: None


PMID: 1841887

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  Abstract 

Audiometric (pure tone audiometry and tone decay) and vestibular examinations (bilateral caloric test and electronystagmography) were carried out in 10 cases of macular degeneration of different types and 10 normal individuals as control. Out of 10 cases of macular degeneration of various types, 3 (30%) showed hearing impairment, while on vestibular examination 3 (30%) also had vestibular abnormalities. Only one case was associated with both audiometric as well as vestibular abnormalities. In the control group none of the individual showed either audiometric or vestibular changes.


How to cite this article:
Singh R, Maurya O, Yadav V S, Samant H C. Audiometric and vestibular abnormalities in macular degeneration. Indian J Ophthalmol 1991;39:127-8

How to cite this URL:
Singh R, Maurya O, Yadav V S, Samant H C. Audiometric and vestibular abnormalities in macular degeneration. Indian J Ophthalmol [serial online] 1991 [cited 2019 Oct 14];39:127-8. Available from: http://www.ijo.in/text.asp?1991/39/3/127/24453



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  Introduction Top


Dillinas (1959) and Amalric (1960) described patients with hearing impairment and granular macular pigment epitheliopathy. Woltez (1927), Cornea, Teodorsure (1965). Charmis and associates (1968) reported a total of 47 patients of similar maculopathy with normal visual acuity and hearing loss. Grimaud and as­sociates (1962) described 22 cases with profound hearing impairment associated with chorioretinopathy.

Retinal pigment epitheliopathy associated with hearing impairment is known to occur as the result of prenatal rubella infection (Krill, 1967).

Thus, from the above observations, it is quite evident that maculopathies are associated with hearing loss but there has not been much mention in literature about audiometric and vestibular abnormalities in different types of macular degeneration.

Keeping this in mind we wanted to see whether audiometry and vestibular examination can be of any use in detection of macular degeneration in earlier stages before it goes to pigmentary disturbances and central visual loss.

In the present study we carried out the audiometric and vestibular examination in different types of macular degeneration cases.


  Material and methods Top


In the present study audiometric examination (pure tone audiometry and tone decay) and vestibular examination (bithermal caloric test and electronys­tagmography were carried out in 10 cases of different types of macular degeneration and in 10 normal cases as control. Cases of both sex were included varying in age from 7 to 52 years.

From the study point of view cases in this series were divided into two groups:

Group A : Normal cases (Control group)

Group B : Macular degeneration.

Before proceeding further with the evaluation of the audiometric and vestibular changes, all the patients were subjected to thorough examinations such as oblique illumination, visual acuity with and without glasses, intraocular tension (by Schiotz tonometer), colour vision (Ishiara chart) - visual fields (central and peripheral), biomicroscopic examination, ophthal­moscopic examination !under full mydriasis (direct and indirect) and otolaryngological examination. Laboratory investigations included total leucoyte count, differential leucocyte count, erythrocyte sedimentation rate and V.D.R.L.

All the cases were subjected to their state of audiometric (pure tone audiometry and tone decay) and vestibular functions (bithermal caloric test and electronystagmography) in neurootological section of the oto-rhino-laryngology department of Banares Hindu University.


  Observations Top


In our series in 10 cases of different types of macular degeneration, 3 (30%) showed hearing impairment, of which 2 (20%) had mild sensorineural hearing impairment, 1(10%) had mild conductive hearing im­pairment and on vestibular examination 3 (30%) also had vestibular abnormalities, of which only one case was associated with both audiometric and vestibular abnormalities. In our study, none of the 10 individuals of the control group showed either audiometric or vestibular abnormalities.


  Discussion Top


Hearing loss and vestibular changes in pigmentary retinopathy can be due to the genetic disorders as a result of environmental factors, prenatal rubella infection and intrauterine environmental insult as mentioned by Krill (1967), Walff (1972) and J. Brownyn Bateman (1980).

But in our study, there was no evidence of rubella infection, neither congenital nor prenatal intrauterine insult, although, family history was positive in 30% of cases. In our cases audiometric abnormalities (SNHL) were seen in 2 (20%) cases and vestibular abnormalities were seen in 3 (30%) cases, the cause might be due to degenerative changes in organ of corti and labyrinths along with the degeneration of macula, having the same analogous, anatomical ec­todermal origin.

Among these, one case showed all three parameters (canal paresis, direc~onal preponderance and minor butterfly pattern)[7].

 
  References Top

1.
Amallic. N.P : Bull. Soc. Ophthal. Jr., 73 : 196, 1960.  Back to cited text no. 1
    
2.
Cornea P, Banu T and Teodoresco L. : Alternatives Chorioretiniennes chez. les sourds - muets. Anal. Oculist., 198 : 130, 105.  Back to cited text no. 2
    
3.
Charamis J., Tsamparlakis J., Palimaris G., Koliopoulos J. : Deaf mutism and ophthalmic lesions, Pediat. Ophthalmol., 5 : 230, 1968.  Back to cited text no. 3
    
4.
Ghamaud R.: Cordier J., Durnex J.B., Perrin C. and Colson R. : Les Alternatives Chorioretiniennes Chez. Sovrds. Whests. Rev. Otoneuro­ophthalmol, 34 : 59. 1962.  Back to cited text no. 4
    
5.
Krill A.E. : The retinal diseases of rubella. Arch. Ophthal., 77 : 445, 1967.  Back to cited text no. 5
    
6.
Walff S.M. : The ocular manifestations of congenital rubella. Trans. Amer. Ophthal. Soc. 70 : 577, 1972.  Back to cited text no. 6
    
7.
Brownwys Bateman J., Erwin D. Riedner. Stefan Levin L. et al. Heterogenecity of retinal degeneration and hearing impairment syndromes. Amer.J. Ophthal. 90 : December, 1980.  Back to cited text no. 7
    



 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3]



 

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Abstract
Introduction
Material and methods
Observations
Discussion
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