CASE REPORT article

Front. Virtual Real.

Sec. Virtual Reality in Medicine

Volume 6 - 2025 | doi: 10.3389/frvir.2025.1595694

Case report: Improvement of diplopia due to severe internuclear ophthalmoplegia by 4-aminopyridine documented using a novel virtual reality based oculography headset

Provisionally accepted
Emilie Sophie ReuterEmilie Sophie Reuter1,2*Justus LuerwegJustus Luerweg1,2Ruth SchneiderRuth Schneider1,2Rafael KlimasRafael Klimas1,2Jeremias MotteJeremias Motte1,2Ralf Karl GoldRalf Karl Gold1,2Anke SalmenAnke Salmen1,2*
  • 1Ruhr University Bochum, Bochum, Germany
  • 2St Josef Hospital, Bochum, North Rhine-Westphalia, Germany

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Internuclear ophthalmoplegia (INO) is an eye movement disorder that occurs in about one third of people with multiple sclerosis (MS). We used a novel, head-mounted, virtual reality (VR) based oculography device (PRET TM , machineMD AG, Switzerland), to objectively measure oculomotor symptoms reported by a patient with MS to aid in clinical diagnosis confirmation of INO. The patient's symptoms, primarily diplopia, were managed successfully with 4-aminopyridine. The VRbased eye-tracking tool documented the subjective improvement in oculomotor function tracking treatment effects.

Keywords: Internuclear ophthalmoplegia, Multiple Sclerosis, VR-based oculography, 4aminopyridine, Diplopia

Received: 18 Mar 2025; Accepted: 12 Jun 2025.

Copyright: © 2025 Reuter, Luerweg, Schneider, Klimas, Motte, Gold and Salmen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Emilie Sophie Reuter, Ruhr University Bochum, Bochum, Germany
Anke Salmen, Ruhr University Bochum, Bochum, Germany

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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