! ! "#$%& ! ! "#$%& $ ’ ! $ ’ ! "%& $ "%& $! !! ! ! "#$%& ! "#$%& !"# ( ( $% $% & & ’( ’( $ $ )* +* ,,! )* +* ,,! & - & - && && . . . . . . & & / / $ $ & & $0 $0 1# $& 1# $& 23 23 ##4 ##4 ’ ’ . ’( . ’( / / 5 5 . . 6 . 6 . && && 2 2 / / 6 6 & & - - && && 5 5 /& /& . . - - & & & . ’( & . ’( Methods Thirty one patients, aged from 14 to 50 years old, presenting USOP (14 right eye,17 left eye) had an oculomotor test : covert test, deviometry, 9 postions photographies, Lancaster test if normal Binocular Vision(VB). A congenital or acquired USOP was notified. An eye fundus photography with a Scanning Laser Ophthalmoscope (SLO) was taken in standard condition. CT was measured in calculating the angle between horizontal line and the line relating fovea and the center of the optic disk (Fig 1). Results Patients CT average is higher and more variable than Healthy Controls (HC). Inter ocular différence, is more important in the left eye palsy group than HC and reach nearly zero in the right eye group. Variance analysis between patients data and HC data is performed considering eye factor. CT average varies between the three groups (F (2.78) = 7.76 ; p = 0.001). Post hoc comparisons show that CT is higher in every USOP group than healthy group (p < ou = 0.011). Eye difference (RE – LE) depends of the group. Difference is signficant in LSOP group (p < 0.001) but not in RSOP group (p = 0. 872). Planified comparisons show that eye CT différence is greater in LSOP group than healthy group (F (1.78) = 5.55 ; p = 0.021) or RSOP group (F (1.78) = 8.87 ; p = 0.004). Discussion SLO is a simply method to measure eye CT. Previously we mesured a CT asymmetry (Woillez et al. 2007). Left eye CT is measured with an average of 1.68°+/- 4.06°more (Table 1). These results were somet imes measured by differents authors but never really noticeable (Table 2). In case of USOP we measure a greater CT average than HC. We think that a cyclo fusion deficiency is a good reason to explain this difference about healthy eyes. About the paralysed eye we can think that there is an incyclotorsion deficit. Other authors had already mesured same results about USOP or bilateral SOP (Kraft et al. 1993).They found a greater CT in there SOP group. But they used Maddox test and add together RE and LE. Left higher physiological CT associated with a higher paralytic CT is probably the cause of a greater difference between eyes in case of LSOP. Conversely, right smaler physiological CT associated with a higher right paralytic CT is probably the cause of absence of difference between eyes in case of RSOP. 7#" 7#" 18 18 1" 1" 1, 1, " "°& #)* #)* 18 18 """ """ 7,8 7,8 "°& + + , , , , + + -. ’/ -. ’/ !,7 !,7 "8 "8 4" 4" 18 18 " "°& 0)1 0)1 ,# ,# 7 7 "48 "48 "°& #2 , #2 , "1 "1 1!4 1!4 4!# 4!# 78 78 " "°& .#) .#) ,7 ,7 ,!! ,!! ,7, ,7, "°& + + , , , , + + #0 + #0 + 0 2 4 6 8 10 12 POS D POS G Sujets sains CT (degrees) OD OG #)#°± #%% 941°± 14 7 :( + 3 4 "#5*1& .0°± 1%1 9""#°± " # :( ! ’ "#55%& #°± 1# "8°± !7 18°± ! 1# ,3 "%..2& .*°± %55 !4°± !1 ,°± 87 1# ’ + "#555& .)-°± %) ""#°± ,7 41°± !1 :( "#5*-& %0°± %1 18°± " !7°± # :( 6 ! "#55%& .*°± % 14°± , 7,°± , 8# :( ! 6 "#551& :;: : : + 7& 8 RSOP LSOP HC RE LE Conclusion Cyclotorsion is modified by USOP. CT asymmetry in HC is an important data to notice before testing CT of USOP patients. It’s maybe a reason to explain some normal paralysed eye CT in case of USOP. Fig 1: CT evaluated with SLO Table 1: SLO Cyclotorsion measured in Right Superior Oblique Palsy( RSOP ) group and Left Superior Oblique Palsy( LSOP) group versus Healthy Controls (HC) Graph 1: CT measured in Right and Left SOP patients versus Healthy Subjects. Table 2: CT measured in HC by differents Authors. EFP:Eye Fundus Photography, SLO:Scanning Laser Opthalmoscopy, NMR:Non Mydriatic Retinography. Referencies: Brandt, T., Dieterich, M., (1992). Cyclorotation of the eyes and subjective visual vertical in vestibular brainstem lesions. Ann N Y Acad Sci, 656, 537-549. Dadi, M., Hernandez, M., (1992). Mesure de la torsion monoculaire : comparaison de méthodes objectives et méthodes subjectives. J Fr Ophtalmol, 24, 113-119. Dieterich, M., Brandt, T. (1993). Ocular torsion and perceived vertical in oculomotor, trochlear and abducens nerve palsies. Brain, 116, 1095-1104. Kraft, S., Oreilly, C., Quigley, P., Allan, K., Sprague, H. (1993). Cyclotorsion in Unilateral and Bilateral Superior Oblique Paresis. J Pediatr Ophthalmol Strabismus, 30, 361-367. Lefevre, F., Leroy, K., Delrieu, B., Lassale, D., Pechereau, A., (2007). Study of the optic nerve head-fovea angle with retinophotography in healthy patients . J Fr Ophtalmol, 30, (6), 598-606. Martin, X., (1985). Mesure simple et précise de la torsion oculaire. Klin. Mbl Augenheilk, 186, 515-519. Rousie- Baudry, D., (1999). Asymétries cranio faciales et système oculo labyrinthique. Thèse de Doctorat Lille II. Ruttum, M., Von Noorden, G., (1983). Adaptation to tilting of the visual environment in cyclotropia. Am J Ophthalmol , 96, 229-237. Woillez, J.P., Honoré, J., Defoort, S., Hache, J.C. (2007) Evaluating static monocular cyclotorsion with central visual field and scanning laser ophthalmoscope J Fr Ophtalmol Vol 30, N°6 - pp. 593-597 <’ ## -’ <=>’<