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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/10 19:22:04」(JST)

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Oscillopsia is a visual disturbance in which objects in the visual field appear to oscillate. The severity of the effect may range from a mild blurring to rapid and periodic jumping. Oscillopsia is an incapacitating condition experienced by many patients with neurological disorders.^[1] It may be the result of ocular instability occurring after the ocular motor system is affected, no longer holding images steady on the retina. A change in the magnitude of the vestibulo-ocular reflex due to vestibular disease can also lead to oscillopsia during rapid head movements.^[2] Oscillopsia may also be caused by involuntary eye movements such as nystagmus, or impaired coordination in the visual cortex (especially due to toxins) and is one of the symptoms of superior canal dehiscence syndrome. Sufferers may experience dizziness and nausea. Oscillopsia can also be used as a quantitative test to document aminoglycoside toxicity. Permanent oscillopsia can arise from an impairment of the ocular system that serves to maintain ocular stability.^[3] Paroxysmal oscillopsia can be due to an abnormal hyperactivity in the peripheral ocular or vestibular system.^[3]

Permanent oscillopsia due to impairment of the ocular stabilizing systems

Ocular stability is maintained by three different ocular motor systems

The fixation system^[3]
The visuo-vestibular stabilizing system^[3]
Neural integrator^[3]

1. The fixation system and its deficit

In the fixation system, the ocular motor noise that comes from microsaccades, microtremors and slow drifts (all necessary for important perceptual functions) are limited by the visual and cerebellar ocular motor feedback loops. The frontal basal ganglia and cerebellar network also helps to provide correct saccades and inhibit unwanted saccades for fixation.^[3]
A deficit in this fixation system results in ocular instability that mainly leads to acquired pendular nystagmus and saccadic intrusions. Acquired pendular nystagmus is seen in a variety of conditions with the two most frequent being multiple sclerosis and oculopalatal tremor.^[3]

2. The visuo-vestibular stabilizing systems and their deficits

The vestibular and visual ocular stabilizing systems interact together in order to maintain the image of the visual scene steady on the retina during a head and body displacement situation.^[3]
A deficit in these vestibular or visual ocular stabilizing systems may result in ocular instability due to pathological jerk nystagmus. The vestibulo-ocular reflex deficit (especially when bilateral) and a deficit of vestibulo-ocular reflex inhibition can result in oscillopsia and impaired visual acuity during head and body displacement.^[3]

3. The neural integrator and its deficit

The neural integrator helps to maintain a constant innervation of extra-ocular eye muscles to avoid backward drift of the eyes.^[3]
A deficit in the neural integrator can result in gaze-evoked nystagmus and oscillopsia in the eccentric eye position.^[3]

References

^ Tilikete, Caroline; Vighetto, Alain (February 2011). "Oscillopsia". Current Opinion in Neurology 24 (1): 38–43. doi:10.1097/WCO.0b013e328341e3b5. PMID 21102332. Retrieved 6 May 2012.
^ Straube, A.; Leigh, R. J.; Bronstein, A.; Heide, W.; Riordan-Eva, P.; Tijssen, C. C.; Dehaene, I.; Straumann, D. (2004). "EFNS task force - therapy of nystagmus and oscillopsia" (PDF). European Journal of Neurology 11: 83–89. doi:10.1046/j.1468-1331.2003.00754.x. Retrieved 6 May 2012.
^ ^a ^b ^c ^d ^e ^f ^g ^h ⁱ ^j ^k Tilikete, Caroline; Vighetto, Alain (February 2011). "Oscillopsia : Causes and Management". Current Opinion in Neurology 24 (1): 38–43. doi:10.1097/WCO.0b013e328341e3b5. PMID 21102332.

External links

Fuzzy Vision
Oscillopsia Video : First person experience of Oscillopsia

UpToDate Contents

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1. 回転性めまい患者の評価 evaluation of the patient with vertigo
2. 眼振の概要 overview of nystagmus
3. キアリ奇形 chiari malformations
4. 振子様眼振 pendular nystagmus
5. 成人における小脳性運動失調の概要 overview of cerebellar ataxia in adults

English Journal

Effect of chlorzoxazone in patients with downbeat nystagmus: A pilot trial.

Feil K, Claaßen J, Bardins S, Teufel J, Krafczyk S, Schneider E, Schniepp R, Jahn K, Kalla R, Strupp M.SourceFrom the Department of Neurology and German Center for Vertigo and Balance Disorders, University Hospital Munich, Campus Grosshadern, Munich, Germany.
Neurology.Neurology.2013 Sep 24;81(13):1152-8. doi: 10.1212/WNL.0b013e3182a55f6d. Epub 2013 Aug 23.
OBJECTIVE: Downbeat nystagmus (DBN) is the most frequent form of acquired persisting fixation nystagmus with different symptoms such as unsteadiness of gait, postural instability, and blurred vision with reduced visual acuity (VA) and oscillopsia. However, different symptomatic therapeutic principle
PMID 23975871

Upbeat nystagmus in anti-Ma2 encephalitis.

Garcia-Reitboeck P, Thompson G, Johns P, Al Wahab Y, Omer S, Griffin C.SourceAtkinson Morley Neuroscience Unit, St George's Hospital, , London, UK.
Practical neurology.Pract Neurol.2013 Sep 16. doi: 10.1136/practneurol-2013-000524. [Epub ahead of print]
Anti-Ma2 encephalitis is a paraneoplastic disorder characterised by brainstem and/or limbic involvement. Eye movement abnormalities can occur in this condition, often with confusion or somnolence. We describe a patient with progressive oscillopsia (with upbeat nystagmus) and unsteadiness, followed b
PMID 24043843

Neuro-ophthalmological emergencies: which ocular signs or symptoms for which diseases?

Cordonnier M, Van Nechel C.SourceNeuro-ophthalmology unit, Ophthalmology Department, Hôpital Erasme, Cliniques Universitaires de Bruxelles, 808, Route de Lennik, 1070, Brussels, Belgium, monique.cordonnier@erasme.ulb.ac.be.
Acta neurologica Belgica.Acta Neurol Belg.2013 Sep;113(3):215-24. doi: 10.1007/s13760-013-0188-4. Epub 2013 Mar 9.
There are five possible ocular signs or complaints of a life or sight threatening neuro-ophthalmological condition: diplopia, isolated anisocoria, transient visual loss, severe pain in head or neck (with or without photophobia) and oscillopsia/nystagmus. In this review, the ocular signs and symptoms
PMID 23475430

Japanese Journal

A Case of Superior Canal Dehiscence Syndrome

藤森貴世子,坂直樹,瀬尾徹,大田重人,阪上雅史
耳鼻咽喉科臨床 106(2), 105-108, 2013
… A 27-year-old man presented with dizziness and oscillopsia induced by loud sounds. …
NAID 130003374008

リン酸カルシウムセメントによる裂隙閉鎖を行った上半規管裂隙症候群の1例

林寿光,青木光広,山田南星 [他],久世文也,水田啓介,伊藤八次
日本耳鼻咽喉科學會會報 114(6), 568-572, 2011-06-20
右耳に上半規管裂隙を有し, 裂隙を閉鎖し治療した33歳男性症例を提示する. 3年前から騒音環境下にいるとめまいが起き, その後咳をする間もめまいと右耳閉感に悩まされ続けてきた. 標準純音聴力検査にて右耳低周波数域における気骨導差を認め, Tullio現象は陽性, Valsalva法にて垂直回旋混合性の眼振を認めた. 側頭骨CT検査にて右上半規管頂部の骨欠損が同定され, 上半規管裂隙症候群と診断され …
NAID 10029380887

上半規管裂隙症候群の1例

瀧正勝,長谷川達央,坂口博史,山本聡,鈴木敏弘,久育男
Equilibrium research 68(3), 143-148, 2009-06-01
… They reported that patients with SSCD typically exhibit symptoms of oscillopsia and pressure-/sound-induced vertigo due to the absence of the bony layer covering the superior semicircular canal. …
NAID 10026088207