Original article
Disc-foveal angle and ocular counterrolling as a key in its interpretation
El ángulo papila-fóvea y la torsión ocular compensatoria, clave en su interpretación
L. Vélez Escolàa,
, A. Galán Terrazab, W.A. Lagrèzec, N. Martín Beguéd, J. Puig Galyd, D. Velázquez Villoriae, G. Arcos Algabaf, D. Mora Ramírezg, J. García-Arumíd
Corresponding author
a Departamento de Oftalmología, Hospital Universitario de Innsbruck, Austria
b Clínica Dyto, Barcelona, Spain
c Departamento de Oftalmología, Hospital Universitario de Freiburg, Alemania
d Departamento de Oftalmología, Hospital Universitari Vall d’Hebron, Barcelona, Spain
e Clínica Villoria, Pontevedra, Spain
f Centro médico Amedics, Barcelona, Spain
g Departamento de Oftalmología, Hospital Sant Joan Despí Moisés Broggi-Consorci Sanitari Integral, Barcelona, Spain
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"apellidos" => "García-Arumí" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">d</span>" "identificador" => "aff0020" ] ] ] ] "afiliaciones" => array:7 [ 0 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Universitario de Innsbruck, Austria" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Clínica Dyto, Barcelona, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] 2 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Universitario de Freiburg, Alemania" "etiqueta" => "c" "identificador" => "aff0015" ] 3 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Universitari Vall d’Hebron, Barcelona, Spain" "etiqueta" => "d" "identificador" => "aff0020" ] 4 => array:3 [ "entidad" => "Clínica Villoria, Pontevedra, Spain" "etiqueta" => "e" "identificador" => "aff0025" ] 5 => array:3 [ "entidad" => "Centro médico Amedics, Barcelona, Spain" "etiqueta" => "f" "identificador" => "aff0030" ] 6 => array:3 [ "entidad" => "Departamento de Oftalmología, Hospital Sant Joan Despí Moisés Broggi-Consorci Sanitari Integral, Barcelona, Spain" "etiqueta" => "g" "identificador" => "aff0035" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "El ángulo papila-fóvea y la torsión ocular compensatoria, clave en su interpretación" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1257 "Ancho" => 1674 "Tamanyo" => 195006 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The participant’s head is placed in different positions on the camera headrest, based on readings from the CROM inclinometers. The internal fixation target remained always visible.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">The term torsion can be defined as the act of twisting or the state of being twisted, which may be confusing because the word can refer to a movement or to a static position. We use the term disc-foveal angle (DFA) to refer to a torsional position. Ocular counterrolling (OCR) is considered to be the torsion movement (roll) that the eyes make in the opposite direction of a head tilt in order to compensate for the tilt, through a reflex mainly governed by the otolithic organs. Some authors have questioned the existence of this compensatory ocular torsion.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">DFA can be objectively measured by several methods: indirect ophthalmoscopy lens,<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> identifying anatomic features of the eye,<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a> anterior segment photography,<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> confocal scanning laser ophthalmoscopy,<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a> perimetry,<a class="elsevierStyleCrossRefs" href="#bib0030"><span class="elsevierStyleSup">6,7</span></a> autorrefractometry {Fesharaki, 2014 #105}<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> and fundus photography.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,9–16</span></a> Many authors who study OCR do so in laboratories with a complex infrastructure and specialized devices (motorized chairs with bite-bars associated with video-oculography<a class="elsevierStyleCrossRefs" href="#bib0085"><span class="elsevierStyleSup">17,18</span></a> or a search coil.<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> We sought a reproducible, time-sparing method for determining DFA that could be used in our everyday consulting rooms. It consisted in measuring the disc-foveal angle on fundus photography using a single software program (Keynote, iWork, Apple Inc.). By precisely controlling the head position with a cervical range of motion device (CROM, Performance Attainments Associates) and measuring DFA in the different head positions we were able to calculate the OCR. Our objectives were to describe normal DFA and OCR values in various head positions defined in the yaw, pitch and roll plane in order to help in the interpretation of paired fundus photographs on normal subjects. With the OCR values we were able to analyze how the patients’ head position affects DFA when they are sitting in front of the fundus camera.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material and methods</span><p id="par0015" class="elsevierStylePara elsevierViewall">This is an analytical, cross-sectional study, including 40 eyes from 20 volunteers (11 men and 9 women), aged 27 to 60 years. In each individual, 22 fundus photographs were obtained (11 of the right eye (RE) and 11 of the left eye (LE)). A total of 440 wide-field (45°) fundus photographs were taken, using a 3D OCT-2000 (Topcon Corporation, Tokyo, Japan) after mydriasis with 1% tropicamide had been achieved.</p><p id="par0020" class="elsevierStylePara elsevierViewall">Volunteers were prospectively recruited between 2015 and 2016 and underwent a full ocular examination at the Dyto Clinic, Barcelona. The volunteers were briefed about the procedure and gave their consent to participate in the study. The study and data collection conformed to all local laws and were compliant with the principles of the Declaration of Helsinki. The research was approved by the institutional review board.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Participants with orbital or strabismus disorders, those with previous surgeries for these conditions, those with hazy media or retinal disease that hindered localization of the fovea and posterior pole vascularization, and those with optic nerve pathology were excluded. We also excluded individuals with neurological, musculoskeletal, auditory, or vestibular disease.</p><p id="par0030" class="elsevierStylePara elsevierViewall">The participant’s eyes were dilated with 1% tropicamide, he or she was sat on a stool and the CROM device was adjusted to the head. The investigator placed the participant’s head in several different positions on the camera headrest, based on readings from the CROM inclinometers. The body was held still. The measurement protocol was developed using the manual from the CROM device and recommendations from published studies and reviews of measurement reliability and reproducibility.<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20,21</span></a></p><p id="par0035" class="elsevierStylePara elsevierViewall">Participants were asked to look at the internal fixation target. The range of head movements was limited by two conditions: participants had to be able to see the internal fixation target and the OCT joystick had to allow to track the eye and clearly focus the retina (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Paired fundus photographs, first of the RE and then of the LE were taken in each position by a second investigator. Head movement velocity was 2°/s and the head was held in each position less than 5 s. We controlled velocity with the aid of the measurement scale of the inclinometers of the CROM and with a metronome set up at 60 beats per minute. The head had to be maintained completely immobile during the two fundus photographs. If this was not the case, both photographs had to be repeated.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0040" class="elsevierStylePara elsevierViewall">Head positioning always followed the same order: head upright, head tilt to the right 20° and 40°, head tilt to the left 20° and 40°, head yaw to the right 20° and 40°, head yaw to the left 20° and 40°, head pitch-up 20° and head pitch-down 20°.</p><p id="par0045" class="elsevierStylePara elsevierViewall">The images obtained were processed and analyzed using the Keynote (V. 6.2.2) software program (iWork, Apple Inc.), which allowed measurement of the disc-foveal angle. We created a new method to make this process systematic and reproducible. A photographic enlargement of 200% or 300% was used to increase accuracy, and each line inserted had a thickness of 0.25 pt. A rectangle was inserted tangential to the optic disc matching its size and shape, with two diagonals crossing at its geometrical center. With this strategy we avoided any potential bias caused by the differing physiological shapes and configurations of the optic disc. The fovea was anatomically localized. In some cases, exposure, saturation, contrast, and sharpness were adjusted until the fovea was clearly identifiable. A circle (8<span class="elsevierStyleHsp" style=""></span>×<span class="elsevierStyleHsp" style=""></span>8<span class="elsevierStyleHsp" style=""></span>pt) was then placed on the fovea. A line was drawn from the center of the optic disc to the center of the circle (fovea). The angle formed by the line and the horizontal was automatically calculated by the software program. If the line drawn fell above the horizontal, the angle was considered positive and the eye was then excyclotorted. If the line drawn fell below the horizontal, the angle was considered negative and the eye was then incyclotorted (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0050" class="elsevierStylePara elsevierViewall">Eleven fundus photographs of the same eye had to be measured and compared. In order to place the fovea at exactly the same location, we drew two lines taking arteriovenous crossing points as anatomical references. The two lines crossed at the fovea.</p><p id="par0055" class="elsevierStylePara elsevierViewall">To perform the reproducibility and correlation tests between two different fundus cameras, the OCT 3D-2000 (Topcon Corporation, Tokyo, Japan) and the TRC-50EX (Topcon Corporation, Tokyo, Japan), 160 fundus photographs were taken in 20 individuals. Two paired fundus photographs (right and left eye) were taken with the head in upright position. After a short break, the head was repositioned and the procedure was repeated with the same fundus camera, obtaining a total of 4 fundus photographs. The same procedure was then carried out with the other fundus camera. Descriptive and inferential statistics were performed using STATA 11.2 for Windows (StataCorp LP, College Station, TX). In each head position, we calculated RE and LE DFA and OCR if present, the absolute difference between RE and LE DFA (|RE – LE|), and the sum of RE and LE DFA (RE<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LE). OCR was calculated as follows: OCR<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>DFA in the wished head position – DFA in upright head position. For example: OCR at 20° head tilt to the left would mean DFA in 20° head tilt to the left – DFA in upright head position. The sample did not follow a normal distribution, but was very close to it.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0060" class="elsevierStylePara elsevierViewall">The sample included 20 participants, 55% men and 45% women, with an age range of 27–60 years (mean, 34.8 years).</p><p id="par0065" class="elsevierStylePara elsevierViewall">In upright head position and primary gaze position, mean RE DFA was 5.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.4° and mean LE DFA was 8.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9°. The difference in DFA between the two eyes was 3.1° (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001, Wilcoxon signed-rank test).</p><p id="par0070" class="elsevierStylePara elsevierViewall">We calculated as well the mean absolute difference between RE and LE DFA. This value gives a very precise information about the difference of DFA between both eyes, but does not show which eye has a higher DFA. For example: if DFA RE was 5° and DFA LE was 1°, the difference in DFA (LE – RE) would be −4° but the absolute difference would be 4°. If DFA RE was 1° and DFA LE was 5°, the difference in DFA (LE – RE) would be +4° and the absolute difference would still be 4°.</p><p id="par0075" class="elsevierStylePara elsevierViewall">The mean absolute difference between RE and LE DFA (|RE – LE|) in upright head position was 3.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.6°. Variations in the absolute difference were statistically significant in the roll plane (p=0.000 Wilcoxon signed-rank test) (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>), but not in the yaw or pitch planes. At head tilts of 20° and 40° to the right shoulder, the absolute differences were 22.0° and 52.5°, respectively. At head tilts of 20° and 40° to the left shoulder, absolute differences were 34.6° and 66.5°, respectively (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.000 Wilcoxon signed-rank test).</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0080" class="elsevierStylePara elsevierViewall">The mean sum of DFA in both eyes (RE + LE) in upright head position was 14.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.4°. There were no significant differences in this value in any of the head positions analyzed (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">Concerning OCR we found that at a head tilt of 20° to the right shoulder, the compensatory OCR was 7.1° in the RE (<a class="elsevierStyleCrossRef" href="#fig0025">Fig. 5</a>) and 7.7° in the LE (<a class="elsevierStyleCrossRef" href="#fig0030">Fig. 6</a>), which represents 35.6% and 38.7% of the head movement, respectively. At a head tilt of 40° to the right shoulder, OCR was 12.2° in the RE and 12.1° in the LE, representing 30.6% and 30.3% of the movement, respectively. At a head tilt of 20° to the left shoulder, OCR was 4.4° in the RE and 4.2° in the LE, representing 22% and 20.8% of the movement, respectively. At a head tilt of 40° to the left shoulder, OCR was 8° in the RE and 8.7° in the LE, which represented 19.9% and 21.7% of the head movement, respectively. OCR was always statistically significant (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.000 Wilcoxon signed-rank test), indicating that it is not a chance event. In the remaining head planes (yaw and pitch) OCR showed no significant changes.</p><elsevierMultimedia ident="fig0025"></elsevierMultimedia><elsevierMultimedia ident="fig0030"></elsevierMultimedia><p id="par0090" class="elsevierStylePara elsevierViewall">The intraclass correlation coefficient (ICC) in the reproducibility study of the 3D OCT 2000 (Topcon Corporation, Tokyo, Japan) was 0.96 (RE) and 0.90 (LE). The ICC for the TRC-50EX (Topcon Corporation, Tokyo, Japan) was 0.96 (RE) and 0.98 (LE). The ICC of the correlation study between the two systems was 0.91 (RE) and 0.75 (LE).</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discussion</span><p id="par0095" class="elsevierStylePara elsevierViewall">Our results based on DFA measurements in different head positions support the existence of OCR and indicate that its magnitude varies with head tilt. The OCR values obtained in our participants are slightly higher than those reported in the literature. Schworm et al.<a class="elsevierStyleCrossRef" href="#bib0085"><span class="elsevierStyleSup">17</span></a> found an OCR of 27% with a head tilt of 15°, Averbuch-Heller et al.<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a> 24% with a head tilt of 20°, Kingma et al.<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a> 22% with a head tilt of 180°, and Collewijn et al.<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a> 10% with a 20° head tilt. These data were obtained using different methods, which makes comparisons difficult.</p><p id="par0100" class="elsevierStylePara elsevierViewall">We found an asymmetry related to the OCR, which showed higher values in both eyes when the head was tilted to the right side than to the left. There is some reported evidence that equal degrees of tilt to the right and left do not produce equal degrees of counterrolling. Miller<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a> and Fesharaki<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> (among other authors) found greater OCR when the head was tilted to the right than to the left, which supports Bárány’s assertion (1906) that “the right labyrinth in rotatory stimulation preponderates over the left, physiologically”. Another possible mechanism for our larger OCR values to the right side is that we always started with rightward head tilts. Again, there is controversy about this point because other authors (Nelson and Cope)<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a> have found greater OCR with head tilting to the left.</p><p id="par0105" class="elsevierStylePara elsevierViewall">Regarding DFA in upright head position, wide variations have been noted in the results obtained by different authors using the fundus photography measuring technique.<a class="elsevierStyleCrossRefs" href="#bib0035"><span class="elsevierStyleSup">7,9–16</span></a> The lowest reported DFA are 3.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2° for the RE<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> and 5.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9° for the LE,<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a> and the highest are 7.25<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.35°<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a> for the RE and 6.8<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.4° for the LE.<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a> Some authors have found that the difference in DFA between the two eyes was non-significant, whereas others have reported significant differences, ranging from 0.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.23°(15) to 2.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.3°<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> with the LE showing a higher DFA. We found that the LE a showed significantly larger DFA (8.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9°) than the RE (5.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.4°), with a difference of 3.1° and an absolute difference of 3.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.6°. These findings are supported by our additional data obtained in 1036 children, where mean DFA was 7.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.5° in the LE and 5.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.6° in the RE, with a difference of 2.2° and an absolute difference of 4.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.1°.<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a></p><p id="par0110" class="elsevierStylePara elsevierViewall">As we already mentioned, normal DFA values show high dispersion in the population. If absolute difference and sum of DFA are considered in addition to the normal intervals of DFA, the range of normal values is reduced (the range of normal DFA, absolute difference and sum of DFA in 50% and 90% of the sample studied are shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">The existence of OCR influences DFA in different head positions on the roll plane. We noticed that absolute difference in DFA between eyes increases with head tilt but the sum of DFA in both eyes does not change in any head position. This fact gives the observer an important tool for analyzing paired fundus photographs yielding values outside the normal range: (1) An absolute difference between eyes outside of normal, with the sum of both eyes within normal, could indicate that the head may have been tilted during the study; (2) An absolute difference between eyes considerably outside the normal range and a sum value also outside normal could indicate that the head position may have moved between the two photographs or that the individual may have some type of disease or previous surgery affecting torsion. In the circumstances described above, the paired fundus photographs should be repeated with the head held immobile in upright position.</p><p id="par0120" class="elsevierStylePara elsevierViewall">It is important to be aware that some healthy persons have extreme DFA values that are exceptions to normality. In persons with disease, the situation is more complex. The values obtained in conditions affecting torsion (eg ocular movement disorders, neurological disease, and vestibular disease) may overlap the normal values, and vice versa. Hence, DFA values should be viewed with caution and always be evaluated together with the ocular movement examination.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conclusions</span><p id="par0125" class="elsevierStylePara elsevierViewall">The technique presented here to measure the disc-foveal angle is a simple, time-sparing method for acquiring this data that can be easily used by physicians in their consulting room. The fact that the left eye shows greater DFA than the right eye is a reference to keep in mind when analyzing fundus photographs, and ocular rolling, which only occurs in the roll plane, is a key factor to consider in the evaluation.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Conflict of interest</span><p id="par0130" class="elsevierStylePara elsevierViewall">The authors declare no conflict of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1275444" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Purpose" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1179864" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1275443" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1179865" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Material and methods" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0025" "titulo" => "Conclusions" ] 9 => array:2 [ "identificador" => "sec0030" "titulo" => "Conflict of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-03-22" "fechaAceptado" => "2019-05-18" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1179864" "palabras" => array:6 [ 0 => "Eye movements/physiology" 1 => "Head movements/physiology" 2 => "Rotation" 3 => "Photography" 4 => "Fundus oculi" 5 => "Fovea centralis" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1179865" "palabras" => array:6 [ 0 => "Movimientos oculares/fisiología" 1 => "Movimientos cefálicos/fisiología" 2 => "Rotación" 3 => "Fondo de ojo" 4 => "Fotografía" 5 => "Fóvea central" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Purpose</span><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Describe a time-sparing technique to measure disc-foveal angle (DFA), determine normal values and its role when analyzing paired fundus photographs.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Methods</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">DFA was analysed using the software program Keynote V 6.2.2 on 440 fundus photographs (3D OCT 2000, Topcon) of 20 individuals. The 11 different head positions were determined with the cervical range of motion device (CROM, Performance Attainment Associates). A reproducibility and correlation study between two fundus cameras (OCT 3D-2000 and TRC-50EX, Topcon) was performed.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Mean DFA of the right and left eye was 5.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.4° and 8.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9°, with a difference of 3.1° (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001 Wilcoxon signed-rank test) in the upright head position. Mean absolute difference in DFA between eyes was 3.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.6°; an increase was seen with increasing head tilt (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.000 Wilcoxon signed-rank test). Mean sum of DFA in both eyes was 14.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.4°. On head-tilt of 20° and 40° to the right, mean ocular counterrolling (OCR) was 7.1° and 12.2° in right eye and 7.7° and 12.1° in left eye. On head-tilt of 20° and 40° to the left, OCR was 4.4° and 8° in right eye and 4.2° and 8.7° in left eye (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.000 Wilcoxon signed-rank test). The two cameras showed strong correlation and high reproducibility.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Our DFA measurement technique is time-sparing and reproducible. Left eye shows higher disc-foveal angle than right eye. OCR occurs only in the roll plane. Absolute difference in disc-foveal angle between eyes changes according to head tilt, this information is of value when analyzing paired fundus photographs.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Purpose" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Objetivo</span><p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Describir una técnica rápida para medir el ángulo papila-fóvea (APF), determinar sus valores normales y su relevancia a la hora de analizar retinografías apareadas.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Métodos</span><p id="spar0070" class="elsevierStyleSimplePara elsevierViewall">en 20 sujetos se realizaron 440 retinografías (3D OCT 2000, Topcon) en 11 posiciones diferentes de la cabeza (CROM, Performance Attainment Associates). Se analizó el APF mediante el software Keynote V 6.2.2 y se estudió la reproducibilidad y correlación entre los retinógrafos OCT 3D-2000 y TRC-50EX (Topcon).</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">La media del APF en el ojo derecho (OD) y en el izquierdo (OI) fue de 5.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>3.4° y de 8.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.9°, con una diferencia de 3.1° (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.001 test del signo-rango de Wilcoxon). La media de la diferencia absoluta del APF entre ambos ojos fue 3.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>2.6°; aumentando con la inclinación cefálica en el plano frontal (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.000 test del signo-rango de Wilcoxon). La media de la suma del APF de ambos ojos fue 14.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>5.4°. La media de la torsión ocular compensatoria (TOC) con la cabeza inclinada 20° y 40° a la derecha fue 7.1° y 12.2° en OD y 7.7° y 12.1° en OI. Con la cabeza inclinada 20° y 40° a la izquierda, la media fue 4.4° y 8° en OD y 4.2° y 8.7° en OI (p<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.000 test del signo-rango de Wilcoxon). Los retinógrafos mostraron alta correlación y reproducibilidad.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusión</span><p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Nuestra técnica es rápida y reproducible. El OI muestra mayor APF. La TOC sólo ocurre en el plano frontal. La diferencia absoluta de APF varía con la inclinación de la cabeza, aspecto relevante al analizar retinografías apareadas.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusión" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Vélez Escolà L, Galán Terraza A, Lagrèze WA, Martín Begué N, Puig Galy J, Velázquez Villoria D, et al. El ángulo papila-fóvea y la torsión ocular compensatoria, clave en su interpretación. Arch Soc Esp Oftalmol. 2019;94:585–591.</p>" ] ] "multimedia" => array:7 [ 0 => array:8 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1257 "Ancho" => 1674 "Tamanyo" => 195006 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0015" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">The participant’s head is placed in different positions on the camera headrest, based on readings from the CROM inclinometers. The internal fixation target remained always visible.</p>" ] ] 1 => array:8 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 591 "Ancho" => 1255 "Tamanyo" => 61553 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0020" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Image processing. The DFA is determined by a line drawn from the center of the disc to the fovea relative to the horizontal. When the line is above the horizontal, the angle is positive (excyclotorsion) and when the line is below the horizontal, the angle is negative (incyclotorsion).</p>" ] ] 2 => array:8 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 929 "Ancho" => 1506 "Tamanyo" => 60307 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0025" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Absolute difference in DFA between the 2 eyes (RE – LE) distribution (°) by head position. NHP, neutral head position; HRR, head roll to the right; HRL, head roll to the left; HYR, head yaw to the right; HYL, head yaw to the left; HPU, head pitch-up; HPD, head pitch-down.</p>" ] ] 3 => array:8 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 940 "Ancho" => 1510 "Tamanyo" => 78848 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0030" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Sum of DFA in the 2 eyes (RE<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LE) distribution (°) by head position. NHP, neutral head position; HRR, head roll to the right; HRL, head roll to the left; HYR, head yaw to the right; HYL, head yaw to the left; HPU, head pitch-up; HPD, head pitch-down.</p>" ] ] 4 => array:8 [ "identificador" => "fig0025" "etiqueta" => "Fig. 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 811 "Ancho" => 1511 "Tamanyo" => 43058 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0035" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">RE OCR (°) in different head positions. HRR, head roll to the right; HRL, head roll to the left.</p>" ] ] 5 => array:8 [ "identificador" => "fig0030" "etiqueta" => "Fig. 6" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr6.jpeg" "Alto" => 810 "Ancho" => 1508 "Tamanyo" => 42086 ] ] "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0040" "detalle" => "Fig. " "rol" => "short" ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">LE OCR (°) in different head positions. HRR, head roll to the right; HRL, head roll to the left.</p>" ] ] 6 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at0045" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:2 [ "leyenda" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">RE, right eye; LE, left eye.</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Concept \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P25-P75 (50% Population) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col" style="border-bottom: 2px solid black">P5-P95 (90% Population) \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">RE DFA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.20°–7.35° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">−1.62°–10.95° \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LE DFA \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.20°–9,90° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.75°–13.70° \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Absolute difference in DFA (RE – LE) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.30°–5.50° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.35°–8.15° \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">Sum of DFA (RE<span class="elsevierStyleHsp" style=""></span>+<span class="elsevierStyleHsp" style=""></span>LE) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">10.40°–17.45° \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.00°–23.60° \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2181925.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Distribution of DFA in Healthy Individuals.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:26 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The absence of so-called compensatory ocular countertorsion: the response of the eyes to head tilt" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "R.S. Jampel" 1 => "D.X. Shi" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archopht.120.10.1331" "Revista" => array:7 [ "tituloSerie" => "Arch Ophthalmol" "fecha" => "2002" "volumen" => "120" "numero" => "10" "paginaInicial" => "1331" "paginaFinal" => "1340" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12365912" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Compensatory ocular torsion" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B.J. Kushner" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1001/archopht.121.12.1806-a" "Revista" => array:6 [ "tituloSerie" => "Arch Ophthalmol" "fecha" => "2003" "volumen" => "121" "numero" => "12" "paginaInicial" => "1806" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/14662615" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[An objective measure of ocular torsion: a new indirect ophthalmoscopy lens]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "E. de Ancos" 1 => "G. Klainguti" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Klin Monbl Augenheilkd" "fecha" => "1994" "volumen" => "204" "numero" => "5" "paginaInicial" => "360" "paginaFinal" => "362" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Photographic assessment of changes in torsional strabismus" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J. Felius" 1 => "K.G. Locke" 2 => "M.A. Hussein" 3 => "D.R. Stager Jr" 4 => "D.R. Stager Sr" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.jaapos.2009.09.008" "Revista" => array:7 [ "tituloSerie" => "J AAPOS" "fecha" => "2009" "volumen" => "13" "numero" => "6" "paginaInicial" => "593" "paginaFinal" => "595" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20006824" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The otoliths and the ocular countertorsion reflex" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "J.R. Nelson" 1 => "D. Cope" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Otolaryngol" "fecha" => "1971" "volumen" => "94" "numero" => "1" "paginaInicial" => "40" "paginaFinal" => "50" ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[Comparison of 2 techniques for evaluating static monocular cyclotorsion with central visual field and scanning laser ophthalmoscope]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J.P. Woillez" 1 => "J. Honore" 2 => "S. Defoort" 3 => "J.C. Hache" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0181-5512(07)89663-x" "Revista" => array:7 [ "tituloSerie" => "J Fr Ophtalmol" "fecha" => "2007" "volumen" => "30" "numero" => "6" "paginaInicial" => "593" "paginaFinal" => "597" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/17646748" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "[A simple and precise measurement of ocular torsion]" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "X. Martin" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1055/s-2008-1050976" "Revista" => array:7 [ "tituloSerie" => "Klin Monbl Augenheilkd." "fecha" => "1985" "volumen" => "186" "numero" => "6" "paginaInicial" => "515" "paginaFinal" => "519" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/4046462" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The effects of lateral head tilt on ocular astigmatic axis" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Fesharaki" 1 => "A. Azizzadeh" 2 => "S.M. Ghoreishi" 3 => "M. Fasihi" 4 => "S. Badiei" 5 => "L. Rezaei" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/2277-9175.124638" "Revista" => array:5 [ "tituloSerie" => "Adv Biomed Res" "fecha" => "2014" "volumen" => "3" "paginaInicial" => "10" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24592363" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cyclorotation of the eyes and subjective visual vertical in vestibular brain stem lesions" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T. Brandt" 1 => "M. Dieterich" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1111/j.1749-6632.1992.tb25234.x" "Revista" => array:6 [ "tituloSerie" => "Ann N Y Acad Sci" "fecha" => "1992" "volumen" => "656" "paginaInicial" => "537" "paginaFinal" => "549" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1599168" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cyclorotation of the eyes and the subjective visual vertical" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Dieterich" 1 => "T. Brandt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Bailliere’s Clin Neurol" "fecha" => "1992" "volumen" => "1" "numero" => "2" "paginaInicial" => "301" "paginaFinal" => "316" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Étude des rapports papille-fovéa par rétinophotographie chez le patient sain" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "F. Lefèvre" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Fr Ophthalmol" "fecha" => "2007" "volumen" => "30" "numero" => "6" "paginaInicial" => "598" "paginaFinal" => "606" ] ] ] ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Measuring normal ocular torsion and its variation by fundus photography in children between 5-15 years of age" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "J. Jethani" 1 => "G. Seethapathy" 2 => "J. Purohit" 3 => "D. Shah" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.4103/0301-4738.67060" "Revista" => array:7 [ "tituloSerie" => "Indian J Ophthalmol" "fecha" => "2010" "volumen" => "58" "numero" => "5" "paginaInicial" => "417" "paginaFinal" => "419" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/20689198" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Apparent foveal displacement in normal subjects and in cyclotropia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "W.W. Bixenman" 1 => "G.K. von Noorden" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Ophthalmology" "fecha" => "1982" "volumen" => "89" "numero" => "1" "paginaInicial" => "58" "paginaFinal" => "62" ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Adaptation to tilting of the visual environment in cyclotropia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "M. Ruttum" 1 => "G.K. von Noorden" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/s0002-9394(14)77791-8" "Revista" => array:7 [ "tituloSerie" => "Am J Ophthalmol" "fecha" => "1983" "volumen" => "96" "numero" => "2" "paginaInicial" => "229" "paginaFinal" => "237" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/6881246" "web" => "Medline" ] ] ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Mesure de la torsion monocularie: comparaison méthode objective et méthode subjective" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "M. Dadi" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "J Fr Ophtalmol" "fecha" => "1992" "volumen" => "24" "paginaInicial" => "113" "paginaFinal" => "119" ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Position of the fovea centralis with respect to the optic nerve head" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "T.D. Williams" 1 => "J.M. Wilkinson" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/00006324-199205000-00006" "Revista" => array:8 [ "tituloSerie" => "Optom Vis Sci" "fecha" => "1992" "volumen" => "69" "numero" => "5" "paginaInicial" => "369" "paginaFinal" => "377" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1594198" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0211699516300339" "estado" => "S300" "issn" => "02116995" ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Assessment of ocular counterroll during head tilt using binocular video oculography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H.D. Schworm" 1 => "J. Ygge" 2 => "T. Pansell" 3 => "G. Lennerstrand" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Invest Ophthalmol Vis Sci" "fecha" => "2002" "volumen" => "43" "numero" => "3" "paginaInicial" => "662" "paginaFinal" => "667" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11867581" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ocular counterrolling in response to static and dynamic tilting: implications for human otolith function" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "C.H. Markham" 1 => "S.G. Diamond" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Vestib Res" "fecha" => "2002" "volumen" => "12" "numero" => "2-3" "paginaInicial" => "127" "paginaFinal" => "134" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12867670" "web" => "Medline" ] ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ocular torsion during voluntary blinks in humans" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "O. Bergamin" 1 => "S. Bizzarri" 2 => "D. Straumann" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Invest Ophthalmol Vis Sci" "fecha" => "2002" "volumen" => "43" "numero" => "11" "paginaInicial" => "3438" "paginaFinal" => "3443" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12407154" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The usefulness of the cervical range of motion device in the ocular motility examination" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B.J. Kushner" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Arch Ophthalmol" "fecha" => "2000" "volumen" => "118" "numero" => "7" "paginaInicial" => "946" "paginaFinal" => "950" ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reproducibility of the cervical range of motion (CROM) device for individuals with sub-acute whiplash associated disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "M.A. Williams" 1 => "E. Williamson" 2 => "S. Gates" 3 => "M.W. Cooke" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00586-011-2096-8" "Revista" => array:7 [ "tituloSerie" => "Eur Spine J" "fecha" => "2012" "volumen" => "21" "numero" => "5" "paginaInicial" => "872" "paginaFinal" => "878" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/22139052" "web" => "Medline" ] ] ] ] ] ] ] ] 21 => array:3 [ "identificador" => "bib0110" "etiqueta" => "22" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Torsional eye movements in patients with skew deviation and spasmodic torticollis: responses to static and dynamic head roll" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "L. Averbuch-Heller" 1 => "K.G. Rottach" 2 => "A.Z. Zivotofsky" 3 => "J.I. Suarez" 4 => "A.D. Pettee" 5 => "B.F. Remler" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1212/wnl.48.2.506" "Revista" => array:7 [ "tituloSerie" => "Neurology" "fecha" => "1997" "volumen" => "48" "numero" => "2" "paginaInicial" => "506" "paginaFinal" => "514" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9040747" "web" => "Medline" ] ] ] ] ] ] ] ] 22 => array:3 [ "identificador" => "bib0115" "etiqueta" => "23" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Ocular torsion induced by static and dynamic visual stimulation and static whole body roll" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "H. Kingma" 1 => "P. Stegeman" 2 => "R. Vogels" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Eur Arch Otorhinolaryngol" "fecha" => "1997" "volumen" => "254" "numero" => "Suppl 1" "paginaInicial" => "S61" "paginaFinal" => "3" ] ] ] ] ] ] 23 => array:3 [ "identificador" => "bib0120" "etiqueta" => "24" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Human ocular counterroll: assessment of static and dynamic properties from electromagnetic scleral coil recordings" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "H. Collewijn" 1 => "J. Van der Steen" 2 => "L. Ferman" 3 => "T.C. Jansen" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Exper Brain Res" "fecha" => "1985" "volumen" => "59" "numero" => "1" "paginaInicial" => "185" "paginaFinal" => "196" ] ] ] ] ] ] 24 => array:3 [ "identificador" => "bib0125" "etiqueta" => "25" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Counterrolling of the human eyes produced by head tilt with respect to gravity" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "E.F. Miller 2nd" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Acta Otolaryngol" "fecha" => "1962" "volumen" => "54" "paginaInicial" => "479" "paginaFinal" => "501" ] ] ] ] ] ] 25 => array:3 [ "identificador" => "bib0130" "etiqueta" => "26" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estudio sobre la torsión ocular: posición cefálica, edad y síndrome de Down" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "L. Vélez Escolà" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Libro" => array:2 [ "titulo" => "Tesis de Doctorado. Universidad Autónoma de Barcelona, Facultad de Medicina, España" "fecha" => "2015" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000009400000012/v1_201912161902/S2173579419301598/v1_201912161902/en/main.assets" "Apartado" => array:4 [ "identificador" => "5816" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Original articles" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000009400000012/v1_201912161902/S2173579419301598/v1_201912161902/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579419301598?idApp=UINPBA00004N" ]
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