Comparison of Double Maddox Rod Test and Bagolini Striated Lens Test for Superior Oblique Palsy

Purpose: We compared the results of the double Maddox rod test (DMRT), which is commonly performed in clinics as a subjective torsion test for superior oblique muscle palsy, with those of the Bagolini striated lenses test (BSLT) in a least dissociating condition to predict the cyclofusional capacity. Methods: Twenty-five patients with acquired superior oblique muscle palsy were tested for degree of subjective torsion with DMRT and BSLT in primary position and down-gaze in Daegu Catholic University Hospital from May 2014 to March 2015. DMRT was performed in a dark room and BSLT in a lighted room. Results: Mean extorsional degree in primary position was 3.40 +/- 2.58 degrees on DMRT and 1.88 +/- 2.92 degrees on BSLT, a significant difference (p = 0.000). In down-gaze, mean extorsional degree was 4.16 +/- 2.90 degrees with DMRT and 2.40 +/- 2.90 degrees with BSLT (p < 0.001). Conclusions: The subjective torsional measurement with BSLT was significantly smaller than with DMRT, and the cyclofusional capacity in patients with acquired superior oblique palsy was 1.5 degrees in primary position and 1.8 degrees in down-gaze. BSLT is helpful in addition to DMRT and fundus photograph for the evaluation of cyclotropia in patients with superior oblique muscle palsy, and this test may yield clinically important information for predicting the cyclofusional capacity of patients with superior oblique muscle palsy.