AMBLİYOPİ VE GÜNCEL TEDAVİ YAKLAŞIMLARI
Ambliyopi, çocukluğun erken dönemlerinde sağlıklı görme gelişiminin sağlanamaması sonucu ortaya çıkan görme keskinliğinde azalma durumudur. Refraksiyon kusuru, şaşılık, anatomik ya da konjenital engeller gibi ambliyopiye neden olan risk faktörlerinin ortadan kaldırılması görme gelişiminin arttırılmasını sağlar. Günümüzde erişkinlerde de tedavinin mümkün olduğunu savunan çalışmalar olsa da genel kabul gören görüş ambliyopinin erken tedavi edilmediği takdirde, geri döndürülemez ve yaşam boyu etkisini gösteren bir görme azlığına sebep olmasıdır . Bu derlemede, aileler ve klinisyenler açısından son derece önemli bir durum olan ambliyopinin nedenleri ve günümüzdeki tanı ve tedavi yaklaşımları ele alınmaya çalışılmıştır. AbstractAmbliyopia is reduction of visual acuity due to the inhibition of healthy visual development during early childhood. The visual development may increase by recovery of the risk factors such as refractive errors, strabismus, anatomic and congenital disorders. Today, there are many studies that defend the possibility of ambliyopia treatment in adults. However, the main accepted view is if ambliyopia is not treated in early period, it will cause irreversible and life-time visual loss. In this review, we have tried to discuss the causes, diagnosis and treatment approaches of ambliyopia which is an important disease for families and clinicians.
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- 1. Holmes JM, Clarke MP. Amblyopia. Lancet. 2006;367:1343-51.
- 2. Birch EE. Amblyopia and binocular vision. Prog Retin Eye Res. 2013;33:67-84.
- 3. Webber AL, Wood J. Amblyopia: prevalence, natural history, functional effects and treatment. Clin Exp Optom. 2005;88:365-75.
- 4. Epelbaum M, Milleret C, Buisseret P, Dufier JL. The sensitive period for strabismic amblyopia in humans. Ophthalmology. 1993;100:323–7.
- 5. Wong AM. New concepts concerning the neural mechanisms of amblyopia and their clinical implications. Can J Ophthalmol. 2012;47:399-409.
- 6. Stewart CE, Moseley MJ, Fielder AR. Amblyopia therapy: an update. Strabismus. 2011;19:91-8.
- 7. Taylor K, Elliott S. Interventions for strabismic amblyopia. Cochrane Database Syst Rev. 2014;7:CD006461.
- 8. Barrett BT, Bradley A, Candy TR. The relationship between anisometropia and amblyopia.
Prog Retin Eye Res. 2013;36:120-58.
- 8. Ziylan S, Yabas O, Zorlutuna N, Serin D. Isoametropic amblyopia in highly hyperopic children. Acta Ophthalmol Scand. 2007;85:111-3.
- 9. Mansouri B, Stacy RC, Kruger J, Cestari DM. Deprivation amblyopia and congenital hereditary cataract. Semin Ophthalmol. 2013;28:321-6.
- 10. Williams C, Northstone K, Harrad RA, Sparrow JM, Harvey I. for the ALSPAC Study Team. Amblyopia treatment outcomes after screening before or at age 3 years: follow up from randomised trial. BMJ. 2002;324:1549.
- 11. Eibschitz-Tsimhoni M, Friedman T, Naor J, Eibschitz N, Friedman Z. Early screening for amblyogenic risk factors lowers the prevalence and severity of amblyopia. J AAPOS. 2000;4:194–9.
- 12. Powell C, Wedner S, Richardson S. Screening for correctable visual acuity deficits in school-age children and adolescents. Cochrane Database Syst Rev. 2005;1:CD005023.
- 13. Committee on Practice and Ambulatory Medicine, Section on Ophthalmology. American Association of Certified Orthoptists, American Association for Pediatric Ophthalmology and Strabismus, American Academy of Ophthalmology. Eye examination in infants, children, and young adults by pediatricians. Pediatrics. 2003;111:902–7.
- 14. Hartmann EE, Dobson V, Hainline L, Marsh-Tootle W, Quinn GE, Ruttum MS, Schmidt PP et al; Maternal and Child Health Bureau and national Eye Institute Task Force on Vision Screening inthe Preschool Child. Preschool vision screening: summary of a task force report. Ophthalmology. 2001;108:479-86.
- 1 16. Committee on Practice and Ambulatory Medicine and Section on Ophthalmology, American Academy of Pediatrics. Use of photoscreening for children's vision screening. Pediatrics. 2002;109:524–5.
- 17. Bell AL, Rodes ME, Collier Kellar L. Childhood eye examination. Am Fam Physician. 2013;88(4):241-8. Erratum in: Am Fam Physician. 2014;89:76.
- 18. DeSantis D. Amblyopia. Pediatr Clin North Am. 2014;61:505-18.
- 19. Newsham D. A randomised controlled trial of written information: the effect on parental non-concordance with occlusion therapy. Br J Ophthalmol. 2002;86:787–91.
- 20. Pediatric Eye Disease Investigator Group, Repka MX, Kraker RT, Dean TW, Beck RW, Siatkowski RM, Holmes JM, Beauchamp CL et al. A randomized trial of levodopa as treatment for residual amblyopia in older children. Ophthalmology. 2015;122:874-81.
- 21. Kishimoto F, Fujii C, Shira Y, Hasebe K, Hamasaki I, Ohtsuki H. Outcome of conventional treatment for adult amblyopia. Jpn J Ophthalmol. 2014;58:26-32.
- 22. Campana G, Maniglia M. Editorial: Improving visual deficits with perceptual learning.
Front Psychol. 2015;6:491.
- 23. Bonaccorsi J, Berardi N, Sale A. Treatment of amblyopia in the adult: insights from a new rodent model of visual perceptual learning. Front Neural Circuits. 2014;8:82.
- 24. Zhang JY, Cong LJ, Klein SA, Levi DM, Yu C. Perceptual learning improves adult amblyopic vision through rule-based cognitive compensation. Invest Ophthalmol Vis Sci. 2014;55:2020-30.
- 25. Pediatric Eye Disease Investigator Group. The course of moderate amblyopia treated with patching in children: experience of the amblyopia treatment study. Am J Ophthalmol. 2003;136:620–9.
- 26. Pediatric Eye Disease Investigator Group. A randomized trial of atropine vs. patching for treatment of moderate amblyopia in children. Arch Ophthalmol. 2002;120:268–78.
- 27. Pediatric Eye Disease Investigator Group. A comparison of atropine and patching treatments for moderate amblyopia by patient age, cause of amblyopia, depth of amblyopia, and other factors. Ophthalmology. 2003;110:1632–8.
- 28. Sachdeva V, Mittal V, Gupta V, Gunturu R, Kekunnaya R, Chandrasekharan A, et al.
Combined Occlusion and Atropine Therapy" Versus "Augmented Part-Time Patching" in Children with Refractory/Residual Amblyopia: A Pilot Study. Middle East Afr J Ophthalmol. 2016;23:201-7.
- 29. Bacal DA. Amblyopia treatment studies. Curr Opin Ophthalmol. 2004;15:432–6.
- 30. Alotaibi AG, Fawazi SM, Alenazy BR, Abu-Amero KK. Outcomes of 3 hours part-time occlusion treatment combined with near activities among children with unilateral amblyopia. Saudi Med J. 2012;33:395-8.
- 31. Holmes JM, Beck RW, Kraker RT, Astle WF, Birch EE, Cole SR, Cotter SA, et al.The Pediatric Eye Disease Investigator Group. Risk of amblyopia recurrence after cessation of treatment. J AAPOS. 2004;8:420–8.
- 32. Rahi J, Logan S, Timms C, Russell-Eggitt I, Taylor D. Risk, causes, and outcomes of visual impairment after loss of vision in the non-amblyopic eye: a population-based study. Lancet. 2002;360:597–602.
- 33. Leguire LE, Walson PD, Rogers GL, Bremer DL, McGregor ML. Longitudinal study of levodopa/carbidopa for childhood amblyopia. J Pediatr Ophthalmol Strabismus 1993;30:354-60.
- 34. Sofi IA, Gupta SK, Bharti A, Tantry TG. Efficiency of the occlusion therapy with and without levodopa-carbidopa in amblyopic children-A tertiary care centre experience. . Int J Health Sci (Qassim) 2016;10:249-57.
- 35. Kothari M. Occlusion-amblyopia following high dose oral levodopa combined with part time patching. Indian J Ophthalmol. 2014;62:1163-5.
- 36. Hess RF, Babu RJ, Clavagnier S, Black J, Bobier W, Thompson B. The iPod binocular home-based treatment for amblyopia in adults: efficacy and compliance. Clin Exp Optom. 2014;97:389-98.
- 37. Yalcin E, Balci O. Efficacy of pereptual vision therapy in enhancing visual acuity and contrast sensitivity function in adult hypermetropic anisometropic amblyopia. Gh. Clin Ophthalmol. 2014;8:49-53.
- 38. Vedamurthy I, Nahum M, Huang SJ, Zheng F, Bayliss J, Bavelier D, Levi DM. A dichoptic custom-made action video game as a treatment for adult amblyopia. Vision Res. 2015 Apr 24. doi: 10.1016/j.visres.2015.04.008.