Vergence-mediated changes in Listing's plane do not occur in an eye with superior oblique palsy.
OBJECTIVE
As a normal subject looks from far to near, Listing's plane rotates temporally in each eye. Since Listing's plane relates to the control of torsional eye position, mostly by the oblique eye muscles, the current study was conducted to test the hypothesis that a patient with isolated superior oblique palsy would have a problem controlling Listing's plane.


METHODS
Using the three-dimensional scleral search coil technique, binocular Listing's plane was measured in four patients with congenital and in four patients with acquired unilateral superior oblique palsy during far- (94 cm) and near- (15 cm) viewing. The results were compared to previously published Listing's plane data collected under exactly the same conditions from 10 normal subjects.


RESULTS
In patients with unilateral superior oblique palsy, either congenital or acquired, Listing's plane in the normal eye rotated temporally on near-viewing, as in normal subjects, while in the paretic eye it failed to do so. In patients with acquired superior oblique palsy, Listing's plane was already rotated temporally during far-viewing and failed to rotate any farther on near-viewing, whereas in patients with congenital superior oblique palsy Listing's plane in the paretic eye was oriented normally during far-viewing and failed to rotate any farther on near-viewing.


CONCLUSIONS
These results suggest that the superior oblique muscle, at least in part, is responsible for the temporal rotation of Listing's plane that occurs in normal subjects on convergence.
Neurology Department, Royal Prince Alfred Hospital, Sydney, Australia.
Americo A
AA
Migliaccio
Phillip D
PD
Cremer
Swee T
ST
Aw
G Michael
GM
Halmagyi
D000293:Adolescent; D000328:Adult; D000368:Aged; D003290:Convergence, Ocular; D005403:Fixation, Ocular; D006801:Humans; D008280:Magnetics; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000503:physiopathology*; D009886:Ophthalmoplegia / Q000503:physiopathology*