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Session: Poster session C

Torsion and Quality of Life study in patients with Sagging Eye Syndrome

Elena HERNANDEZ-GARCIA1, Elena PIEDRAHITA-ALONSO2, Alicia RUIZ-POMEDA2, Maria Rosario GOMEZ DE LIAÑO-SANCHEZ1

1Hospital Clinico San Carlos, Madrid, Spain
2Universidad Complutense, Madrid, Spain

Objective: To evaluate the concordance and repeatability of objective and subjective methods to measure ocular torsion in patients with sagging eye syndrome, as well as to to analyze the impact of diplopia on quality of life.

Methods: cross-sectional descriptive study in a sample of 62 patients. Binocular vision, ocular motility and different eyelid measurements were examined. Subjective ocular torsion was measured using Maddox's double rod method, and objective torsion was measured using the Fovea Disc Angle method (Eidon retinograph) and the FoDi method (SD-OCT Spectralis tomograph). The presence of diplopia in the different gaze positions was evaluated with the diplopia questionnaire and the impact of diplopia on quality of life with the AS-20 questionnaire. A descriptive analysis of all variables was performed and the repeatability and concordance of each method was studied.

Results: The mean age of the sample was 82.63±5.77 years and 68.8% were women. Repeatability was better with the FDA method (ICC OD=0.92; ICC OI=0.87) than with the FoDi method (ICC OD=0.90; ICC OI=0.77). Much higher excyclotorsion values were obtained in the LE in both methods (p-value<0.001). A good concordance between methods was obtained in the case of the RE (ICC=0.85) and acceptable in the case of the LE (ICC=0.75), with a mean difference between methods of 0.38±2.19º in the RE and 2.34±2.11º in the LE. The impact on quality of life was minimal in the psychosocial part (97.98/100) and important in the functional part (70/100), and the presence of diplopia was moderate in the different gaze positions (40.09/100).

Conclusions: the objective methods used show good repeatability (better with the FDA method) and good agreement between them (better with the RE). The FoDi method underestimates the excycloposition values obtained compared to the FDA method. A significant impact of diplopia has been found in the functional part of the quality of life of patients with SES.