L. Averbuchheller et Rj. Leigh, MEDICAL TREATMENTS FOR ABNORMAL EYE-MOVEMENTS - PHARMACOLOGICAL, OPTICAL AND IMMUNOLOGICAL STRATEGIES, Australian and New Zealand journal of ophthalmology, 25(1), 1997, pp. 7-13
Purpose: To review current medical treatments for nystagmus and saccad
ic intrusions, and their visual consequences. Methods: Evaluation of s
tudies that have used reliable measurement of eye movements and visual
acuity before and after treatment. Interpretation of results in light
oi physiological and pharmacological studies in animals, and recent i
mmunological advances. Results: There are many case reports of patient
s with abnormal eye movements being improved by a variety of drugs, bu
t few double-blind, controlled studies have been carried out. Most pro
mising are agents that mediate their effects through the neurotransmit
ter gamma-aminobutyric acid: such drugs include baclofen and gabapenti
n. Botulinum toxin, injected into selected extraocular muscles or the
retrobulbar space, can abolish nystagmus for several months, but often
produces troublesome side-effects, such as diplopia and ptosis, which
limit its value. Optical measures to either reduce nystagmus by manip
ulating vergence angle, or reduce retinal image motion, help some pati
ents. Opsoclonus occurring in association with cancer may be successfu
lly treated with an immune-adsorption technique using a protein A colu
mn. Conclusions: There is need for controlled, blinded studies to eval
uate the many agents reported to improve visual symptoms in individual
patients with abnormal eye movements.