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Year : 1979  |  Volume : 27  |  Issue : 4  |  Page : 214-215

Heterotopia of maculae in A.V. patterns

S.D. Eye Hospital, Hyderabad, India

Correspondence Address:
P Siva Reddy
S.D. Eye Hospital, Hyderabad
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How to cite this article:
Reddy P S, Reddy R H, Reddy H P, Reddy GG. Heterotopia of maculae in A.V. patterns. Indian J Ophthalmol 1979;27:214-5

How to cite this URL:
Reddy P S, Reddy R H, Reddy H P, Reddy GG. Heterotopia of maculae in A.V. patterns. Indian J Ophthalmol [serial online] 1979 [cited 2021 Jul 30];27:214-5. Available from: https://www.ijo.in/text.asp?1979/27/4/214/32635

Table 1

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Table 1

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The incidence of A.V. phenomena in horizontal squint has not been recognised as late as 1951. The mechanisms[4] of these patients is still not settled. Different schools have the­orised incriminating horizontal muscles, vertical recti or obliques.

Campimetry and fixation photography have been used in the study of mechanism of A.V. patterns.

  Materials and methods Top

The material in this study comprised 50 patients with A.V. patterns associated with horizontal deviations.

For Photography-Kowa RC. 2 fundus camera was used.

Pictures were taken with Agfa colour and Agfa Gavert 50 A.S.A. film.

First an ophthalmoscopic examination was done both direct and indirect to note the heterotopia of the maculae. Fundus pictures are taken in.

1. straight ahead position.

2. Eyes rotated 25° to the right and 25° to the left.

3. Eyes rotated 15° up and 15° down-The last two positions were made not possible due to poor cooperation of the patients and when taken the optic disc and macu-a vent out of the fields due to lack of device for controlled movement of the eyes.


In our study of 50 patients we found the relative frequency of A.V. Pattern as follows:

ESO 'V'=20 cases (40%); ESO 'A'=7 cases (14%);

EXO 'V'=22 cases (44%) and EXO 'A'=l case (2%)

The placement of macula in both eyes were as follows: Infraplaced-11, Supraplaced-6 and normally placed-33. Five case sheets with 12 fundus photographs were projected to illustrate the position of the fovea which remained infraplaced in V. Pattern and supra. placed in A. Pattern with no change in varying position of the eyes as against incyclo and excyclo vertical muscle paresis the position shifts and helps identify the muscle. It was also demonstrated that normalisation of macular position occured following suitable surgery in A.V. Patterns. The suggested surgical measures have been summarised in [Table - 1].

  Summary and Conclusions Top

The unvarying position of intra-placed and supraplaced macula in different directions of gaze raises the question whether the anamolous insertion of oblique muscle or the hetero­topia of maculae is primary cause for the role of these muscles in causing horizontal incomit­ance in upward and downward gaze. The central mechanism cannot explain the primary underaction of inferior oblique with no other component of III nerve nuclei involved. A hypothetical underaction of superior oblique on the basis of a hypoplasia of IV N. Nuclei may be considered.

  References Top

Alder, F.H., Physiology of the Eye-clinical application St. Louis, Mosby, 1965.  Back to cited text no. 1
Hermann, M. Burian, Gunter Von Noorden, Binocular vision Ocular motility St. Louis Mosby, 1974.  Back to cited text no. 2
John C. Locke, 1968, Amer. Med. J., 65, 362.   Back to cited text no. 3
Stansworth: A.V. Patterns, B.J.O. 25: 12, 1968.  Back to cited text no. 4


  [Table - 1]


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