Zihinsel Engelli Çocuklarda Oküler Patolojiler: Prospektif Bir Çalışma

Amaç: Bu çalışmanın amacı Down sendromu veya herhangi bir kromozomal-genetik anomalisi olmayan zihinsel engelli pediatrik hastalarda oküler patolojilerin araştırılmasıdır. Gereç ve Yöntemler: Bu çalışmaya 2010 ve 2011 yılları arasında 79 zeka geriliği olan ve 110 sağlıklı çocuk olmak üzere toplam 189 hasta dahil edildi. Hastaların demografik faktörleri (yaş, cinsiyet) ile etkilenen taraf, görme keskinliği, ezotropya, ekzotropya, ön segment patolojileri ve arka segment patolojileri değerlendirildi. Çalışma grubundaki tüm pediatrik hastalar Wechsler Çocuklar için Zeka Ölçeği-Yenilenmiş Formu’na göre IQ düzeyi 70 olarak ayrıldı. Bulgular: Zeka geriliği olan çocukların yaş ortalaması 11,85±6,19 (3-17) yıl iken sağlıklı çocukların yaş ortalaması 10,73±3,35 (3-15) yıl idi. Görmesi değerlendirilen 74 hastanın 8'inde görme bozukluğu varken, sağlıklı grupta ise hiç görme bozukluğu yoktu (sağ ve sol için sırasıyla p=0,001 ve p=0,004). Düşük IQ'lu çocuklarda, 2 (%2,5) olguda ön segment patolojisi ve 3 (%3,8) olguda ise arka segment patolojisi saptandı. Düşük IQ'lu hastaların 7 (%8,9)'sinde şaşılık saptanırken sağlıklı çocuklarda ise hiç şaşılık saptanmadı. Zeka geriliği olan olguların 5 (%6,3)'inde ekzotropya, 2 (%2,5)'sinde ise ezotropya vardı. Ekzotropya zeka geriliği olan çocuklarda kontrol grubuna göre anlamlı derecede daha yüksek olarak bulundu (p=0,012). Sonuç: Zihinsel engelli çocuklarda görme bozukluğu, ön-arka segment patolojisi, ekzotropya yüksek prevalansa sahipti ve tüm oküler patolojiler düşük zihinsel engelle ilişkiliydi.

Anahtar Kelimeler:

Çocuk, zihinsel özürlü, görme bozuklukları

Ocular Pathologies in Children with Mental Retardation: A Prospective Study

Aim: The aim of this study is to investigate the ocular pathologies in mentally retarded pediatric patients without Down syndrome or any certain chromosomal-genetic anomaly. Material and Methods: A total of 189 patients, including 79 mental retarded and 110 healthy children, were included in this study between 2010 and 2011. Demographic factors (age, gender) of the patients, and affected side, visual acuity, esotropia, exotropia, anterior segment pathologies and posterior segment pathologies were evaluated. All pediatric patients in study group were divided as IQ level 70 according to Wechsler Intelligence Scale for Children-Revised Form. Results: The mean age of the children with mental retardation was 11.85±6.19 (3-17) years, while the mean age of healthy children was 10.73±3.35 (3-15) years. While visual impairment was present in 8 of the 74 patients whose vision was evaluated, there was no impairment in the healthy group (p=0.001 and p=0.004 for right and left, respectively). Anterior segment pathology was detected in 2 (2.5%) cases, and posterior segment pathology in 3 (3.8%) cases in children with low IQ. While strabismus was detected in 7 (8.9%) patients with low IQ, no strabismus was found in healthy children. Five (6.3%) of the cases with mental retardation had exotropia and 2 (2.5%) had esotropia. Exotropia was found significantly higher in children with mental retardation compared to the control group (p=0.012). Conclusion: Visual impairment, anterior-posterior segment pathology, exotropia had a high prevalence in children with mental retardation, and all ocular pathologies were related to low intellectual disability.

Keywords:

Children, mentally retarded, vision disorders,

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