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Eye movement recordings to investigate a supranuclear component in chronic progressive external ophthalmoplegia: a cross-sectional study
  1. A E Ritchie1,
  2. P G Griffiths2,
  3. P F Chinnery3,
  4. A W Davidson4
  1. 1Department of Ophthalmology, The Royal Free Hospital, London, UK
  2. 2Department of Ophthalmology, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK
  3. 3Mitochondrial Research Group, Institute of Ageing and Health, Newcastle University, UK
  4. 4Regional Medical Physics Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK
  1. Correspondence to Adrian W Davidson, Regional Medical Physics Department, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK; Adrian.davidson{at}


Background It has been postulated that eye movement disorders in chronic progressive external ophthalmoplegia (CPEO) have a neurological as well as a myopathic component to them.

Aim To investigate whether there is a supranuclear component to eye movement disorders in CPEO using eye movement recordings.

Methods Saccade and smooth pursuit (SP) characteristics together with vestibulo-ocular reflex (VOR) gain and VOR suppression (VORS) gain in 18 patients with CPEO and 34 normal patients were measured using Eyelink II video-oculography.

Results The asymptotic values of the peak velocity main sequence curves were reduced in the CPEO group compared to those of normal patients, with a mean of 161°/s (95% CI 126°/s to 197°/s) compared with 453°/s (95% CI 430 to 475°/s), respectively. Saccadic latency was longer in CPEO (263 ms; 95% CI 250 to 278), compared to controls (185 ms; 95% CI 181 to 189). Smooth pursuit and VOR gains were impaired in CPEO, although this could be explained by non-supranuclear causes. VORS gain was identical in the two groups.

Conclusions This study does not support a supranuclear component to the ophthalmoplegia of CPEO, although the increased latencies observed may warrant further investigation.

  • Vestibuloocular reflex
  • chronic progressive external ophthalmoplegia
  • supranuclear
  • muscles
  • physiology
  • experimental & laboratory

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  • Funding Newcastle upon Tyne Hospitals Special Trustees.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Newcastle upon Tyne Ethics Committee.

  • Provenance and peer review Not commissioned; externally peer reviewed.