Development and surgical removal of an epiretinal membrane in infantile nystagmus syndrome: a new type of oscillopsia.

PURPOSE: To report and discuss a focal oscillopsia in a small area of the visual field produced by, and after the removal of, an epiretinal membrane (ERM) in an individual with infantile nystagmus syndrome (INS) since birth with no associated afferent visual deficits.

STUDY DESIGN: A retrospective case report.

METHODS: A chart review, including clinical and electrophysiological data. A 74 y/o man with INS and an epiretinal membrane was studied. Detailed studies of the retina post-removal of an epiretinal membrane, with consequent changes in best-corrected visual acuity (BCVA), and subjective oscillopsia compared to INS waveforms. OCT measurements and eye-movement data from digital video and scleral search-coil systems were used.

RESULTS: The monocular ERM produced an unexpected focal area of torsional/vertical oscillopsia (noted 1 year prior to the ERM surgery) in the portion of the visual field that corresponded with distortions from the ERM. The remainder of the visual field, corresponding with normal healthy retina was unaffected and stable in all planes. Post-removal, BCVA improved with redevelopment of the foveal pit and focal oscillopsia became less noticeable but remained due to the retinal distortion.

CONCLUSIONS: In patients with INS, complete oscillopsia suppression across the visual field requires undistorted vision. If a retinal area of visual distortion develops or results from retinal surgery, a symptomatic island of oscillopsia in one or more planes may result.