Methods for Testing the Subjective Visual Vertical during the Chronic Phase of Menière's Disease.

Samira Ira Zabaneh,Heidi Olze,Linda Josephine Voss,Katharina Stölzel,Agnieszka J Szczepek

doi:10.3390/diagnostics11020249

Abstract

The subjective visual vertical (SVV) evaluates the function of the utricle, which, in patients with Menière’s disease (MD), can be affected by endolymphatic hydrops. This study aimed to determine the SVV in MD patients during the chronic phase of illness compared to healthy participants. The second aim was to compare the SVV measurement tools: the analog bucket test, digital bucket test, and C-SVV© goggles. The SVV scores differed significantly between MD patients and the control group for the analog bucket test (p < 0.001) and the C-SVV® goggles (p = 0.028), but no significance was shown when using the digital bucket test (p = 0.062). When comparing the analog bucket test and the C-SVV® goggles applying the calculated threshold (1.125° in analog bucket test, 2.5° in C-SVV® goggles), the bucket test showed higher accuracy (bucket test 73.84%, C-SVV® goggles 69.23%). When examining the influence of betahistine on SVV scores, there were no statistically significant differences in both the analog bucket test and C-SVV© goggles. We conclude that SVV test can be used as an additional tool to evaluate utricle function during the chronic phase of MD and that the analog bucket test produces the most reliable results. The intake of betahistine does not influence the perception of SVV.

Highlights

We evaluated the deviation of subjective visual vertical (SVV) in Menière’s disease (MD) patients in correlation to the affected side
There was a statistically significant difference in age between the groups (p < 0.001), with the control subjects being younger than the MD patients (Table 1)
Our results suggest that SVV can be determined during the chronic phase of MD and that the bucket test and the C-SVV®

Summary

Introduction

Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. The subjective visual vertical (SVV) reflects the deviation of individual perception of the Earth-vertical line. Healthy participants estimate the SVV within 2◦ of a real vertical line, depending on the testing laboratory or laboratory conditions [1]. The determined SVV angle allows a measure of utricular function [2,3]

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Conclusion