Macropsia
Macropsia | |
---|---|
Other names | Megalopia |
Specialty | Ophthalmology ![]() |
Macropsia is a neurological condition affecting human visual perception, in which objects within an affected section of the visual field appear larger than normal, causing the person to feel smaller than they actually are. Macropsia, along with its opposite condition,
Signs and symptoms
The most obvious
Psychological effects
There are a broad range of psychological and emotional effects that a person with macropsia may experience. One competing theory has radically stated that macropsia may be an entirely
Causes
Structural defects
In cases where macropsia affects one
There is evidence that a lesion appearing in the posterior area of the ventral occipitotemporal visual pathway can cause macropsia. This lesion can be due to an ischemic cell death after an acute posterior cerebral infarction.[12]
Medications
The most prevalent research on prescription drugs with side effects of macropsia deals with zolpidem and citalopram. Zolpidem is a drug prescribed for insomnia, and although it has proven beneficial effects, there have been numerous reported cases of adverse perceptual reactions.[13] One of these cases discusses an anorexic woman's episode of macropsia, which occurred twenty minutes after taking 10 mg zolpidem. The same woman later had two more episodes of zolpidem-induced macropsia, after taking 5 mg and 2.5 mg zolpidem, respective to each episode. The intensity of the macropsia episodes decreased with the decreasing amount of zolpidem administered; it is implied in the article that the level of intensity was based on the patients accounts of her macropsia episodes, and that no external diagnosis was used.[14] Hoyler points out notable similarities among the different reported cases of zolpidem-induced disorganization. The similarities were that all the cases were reported by women, the disorganization and agitation followed the first administration of zolpidem, and once zolpidem was discontinued, there were no lasting residual effects. It is believed that zolpidem-related macropsia is more prevalent in women because plasma zolpidem concentration is 40% higher in women, a concentration that further increases in anorexic women.[14]
Citalopram-induced macropsia is similar to zolpidem-induced macropsia since both types have been observed in relatively few cases, and neither of the drugs' side effects can be supported by experimental evidence. Citalopram is an antidepressant that inhibits serotonin reuptake.[15] The first case of macropsia thought to be induced by citalopram involves a woman who experienced macropsia after her first administration of 10 mg citalopram. Just as with zolpidem, after the immediate discontinuation of citalopram, there were no further episodes of macropsia.[16]
Illicit drugs
There are suggestions that visual distortions, such as macropsia, can be associated with cocaine use.[17] Episodes of temporary drug-induced macropsia subside as the chemicals leave the body.[citation needed]
Migraine
Past research has linked macropsia to
Epilepsy
Macropsia may present itself as a symptom of both
Hypoglycaemia
Endogenous
Viruses
Patients with both
Pathophysiology
Macropsia may be a result of optical
Diagnosis
Macropsia is generally diagnosed once a patient complains of the characteristic symptoms, such as disproportionally large objects in their visual field. The
Treatment
The most common way to treat forms of aniseikonia, including macropsia, is through the use of auxiliary optics to correct for the
With regard to drug-induced or virus-induced macropsia, once the underlying problem, either drug abuse or viral infection, is treated, the induced macropsia ceases.[citation needed]
Research
Future research may focus on ways to limit the occurrence of retinally-induced macropsia due to surgery.[citation needed] In terms of treatment, the most effective optical correction is still being researched with respect to visual field angles and direction to a target.[3] The susceptibility of certain age demographics to macropsia is a subject that requires further validation.[18] Overall, there have not been very many reports of macropsia induced by certain drugs, specifically zolpidem and citalopram. Once a larger effort is made to compile such reports, there will inevitably be more research on the subject of macropsia.[citation needed]
References
- ^ a b c de Wit GC, Muraki CS. Field-dependent aniseikonia associated with an epiretinal membrane a case study. Ophthalmology 2006; 113:58-62.
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- ^ a b c d e f g h i de Wit G.C. Retinally-induced aniseikonia. Binocul Vis Strabismus Q. 2007; 22:96-101.
- ^ a b c d e Ugarte M, Williamson TH. Horizontal and vertical micropsia following macula-off rhegmatogenous retinal-detachment surgical repair. Graefes Arch Clin Exp Ophthalmol. 2006; 244:1545-1548.
- ^ a b Raphael, C.M. Macropsia. 122 (1): 110 Am J Psychiatry
- ^ a b c Golden, Gerald S. The Alice in Wonderland Syndrome in Juvenile Migraine. Pediatrics 1979;63;517-519
- ^ a b Benegas NM, Egbert J, Engel WK, Kushner BJ. Diplopia secondary to aniseikonia associated with macular disease. Arch Ophthalmol. 1999; 117:896-899.
- ^ Enoch JM, Schwartz A, Chang D, Hirose H. Aniseikonia, metamorphopsia and perceived entoptic pattern: some effects of a macular epiretinal membrane, and the subsequent spontaneous separation of the membrane. Ophthalmic Physiol Opt. 1995; 15:339-343.
- ^ Kroyer K, Jensen OM, Larsen M. Objective signs of photoreceptor displacement by binocular correspondence perimetry: a study of epiretinal membranes. Invest Ophthalmol Vis Sci. 2005; 46:1017-1022.
- ^ Ugarte M, Williamson TH. Aniseikonia associated with epiretinal membranes. Br J Ophthalmol. 2005; 89:1576-80.
- ^ Sjostrand J, Anderson C. Micropsia and metamorphopsia in the re-attached macula following retinal detachment. Acta Ophthalmol (Copenh). 1986: 64:425-32.
- ^ Park, M. G., Joo, H., Park, K. P., & Kim, D. S. (2005). Macropsia caused by acute posterior cerebral artery infarction. J Korean Neurol Assoc., 23(5), 655-658.
- ^ Hoyler CL, Tekell JL, Silva JA. Zolpidem-induced agitation and disorganization. Gen Hosp Psychiatry 1996; 18:452–453.
- ^ a b Iruela LM, Ibanez-Rojo V, Baca E. Zolpidem-induced macropsia in anorexic woman. Lancet 1993; 342(8868): 443-444.
- ^ Milne RJ, Goa KL. Citalopram. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic potential in depressive illness. Drugs 1991; 41:450-477.
- ^ Ghanizadeh, A. Citalopram-induced macropsia. Clin Neuropharamcol 2007; 30(4): 246-247.
- ^ Unnithan SB, Cutting JC. The cocaine experience: Refuting the concept of a model psychosis? Psychopathol 1992; 25: 71-78.
- ^ a b c d e K. Abe, N. Oda, R. Araki, et al. Macropsia, micropsia, and episodic illusions in Japanese adolescents. Journal of the American Academy of Childhood and Adolescent Psychiatry 1989; 28:493–496.
- ^ Swash M. Visual perseveration in temporal lobe epilepsy J Neurol Neurosurg Psychiatry 1979;42:569–71.
- ^ a b Zwijnenburg PJ, Wennink JM, Laman DM, Linssen WH. Alice in Wonderland syndrome: a clinical presentation of frontal lobe epilepsy. Neuropediatrics, 2002 33: 53-5.
- ^ Moorhouse D. Some Neurological manifestations of endogenous hypoglycemia. Br Med J 1956; 2: 1512-1514.
- ^ Kalinowsky LB, Hoch PH. Shock treatments, psychosurgery and other somatic treatments in psychiatry. Grune and Stratton; 1952.
- ^ Cinbis M, Aysun S: Alice in Wonderland syndrome as an initial manifestation of Epstein-Barr virus infection (case report). Br J Ophthalmol 1992; 76:316
- ^ Atsushi Kamei, Makoto Sasaki, Manami Akasaka, Shoichi Chida. Abnormal magnetic resonance imaging in a child with Alice in Wonderland syndrome following Epstein-Barr virus infection No to hattatsu. Brain and development. 2002 Jul;34(4): 348-52
- ^ a b Lahat E, et al. Alice in Wonderland syndrome and infectious mononucleosis in children. J Neur Neurosur Psych 1990; 53:1104
- ^ Lancaster WB. Aniseikonia. Trans Am Ophthalmol Soc. 1938; 36:227-234.
- ^ Riley, H. D. (2005). Amsler grid testing. Indiana University School of Optometry. "Amsler Grid Testing". Archived from the original on 2009-12-07. Retrieved 2009-12-05.