Mesut COŞKUN, Ali AKAL, Ayşe Ö. ÖNER, Hakkı DOĞAN

Anizometropik ambliyopisi olan hastalara uygulanan kapama tedavisinin binoküler görme üzerine etkisi

Anizometropik ambliyopisi olan hastalara uygulanan kapama tedavisinin binoküler görme üzerine olan etkisi incelenmiştir. Yaşları 4-11 yıl arasında değişen (ort:6,9±1,1 yıl) anizometropik ambliyopi tanısı almış 34 hastaya kapama tedavisi uygulandı. Kapama süresi hastanın uyanık dur-duğu saatlerde minimum 6 saat olmak üzere ambliyo-pinin derinliği ve hasta uyumu dikkate alınarak yarım gün veya tam gün olarak belirlendi. Hastaların başlangıç, 1.ay, 3.ay ve 6.ay’da düzeltilmiş en iyi görme keskinlik-leri ölçüldü. Hastaların tedavi öncesi ve sonrası binoküler görme düzeyleri Bagolini çizgili camları ve Worth’ün dört nokta testi kullanılarak ölçüldü. Sonuçlar aynı yaş grubu kontrollerle karşılaştırılarak istatistiksel yönden analiz edildi. Ambliyop hastaların tedavi sonrası 6. ay’daki görme dü-zeyleri, tedavi öncesi görme düzeylerine göre istatistiksel olarak anlamlı derecede yüksekti (sırasıyla, 0,72±0,02 ve 0,47±0,24, p

Anahtar Kelimeler:

Göz tembelliği, Şaşılık, Görme keskinliği, Görme, binoküler

The effect of occlusion therapy on binocular vision in anisometropic ambliopia

To investigate the effect of occlusion therapy on binocular vision in patients with anisometropic ambliopia. Occlusion therapy applied to a total of 34 patients with anisometropic ambliopia aged between 4 and 11 years (mean, 6.9±1.1 years). Occlusion therapy period was minimum 6 hours during patient’s awakening hours, and duration was determined according to the depth of ambliopia and patient’s compliance as half or a whole day. Best corrected visual acuities of patients were measured at 1st, 3rd , and 6th months. Pre- and posttreatment binocular vision levels of patients were measured using Bagolini’s lineated glasses and Worth’s four points test. Results were compared with those of matched control subjects. Visual levels of amblyopic patients at 6th month were significantly higher than those of their pre-treatment levels (0.72±0.02 vs. 0.47±0.24, respectively, p<0.05). Binocular visual levels were also found to be significantly increased using by occlusion therapy (p<0.05). Occlusion therapy resulted in significant increases in both visual acuity and binocular vision in anisometropic ambliopia.

Keywords:

Amblyopia, Strabismus, Visual Acuity, Vision, Binocular,

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1. Arden GB, Wooding SL. Patterns of ERG in amblyopia. Invest Ophthalmol Vis Sci 1985;26: 88-91.
2. Simons K, Reinecke RD. Amblyopia screening and stereopsis. In: Symposium on Strabismus: Transaction o the New Orleans 1978. Acad Ophthalmol, St Louis The CV Mosby Co, 15.
3. Vital-Durand F, Ayzac L. Tackling amblyopia in human infants. Eye 1996;10: 239-42.
4. Townshed AM, Holmes JM, Evans LS. Depth of anisometropic amblyopia and difference in refraction. Am J Ophthalmol 1993;116: 431-6.
5. Noorden GK, Crawford MLJ. The sensitive period. Trans Ophthalmol Soc UK 1979;99: 442-6.
6. Sanaç AŞ, şener C. şaşılık ve Tedavisi Pelin Ofset ve Matbaacılık san. Ankara 2001; 83-93.
7. The 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. Am Acad Ophthalmol 2003;110: 1632-8.
8. Ikade H. Is ambliyopia a peripheral defect? Trans Ophthalmol Soc UK 1979;99: 347-51.
9. Crawford MLJ, Smith III E, Harwerth RS, Von Noorden GK. Stereoblind monkeys have few binocular neurons. Invest Ophthalmol Vis Sci 1984;25: 779-81.
10. Ikeda H, Tremain KE. Ambliyopia occurs in retinal ganglion cells in cats reared with convergent squint without alternating fixation. Exp Brain Res 1979;35: 559-82.
11. Koç F, Özal H, Kargı Ş, Fırat E. Ambliyopide kapama tedavisi MN Oftalmoloji 2002; 9: 161-8.
12. Von Noorden GK, Leffler MB.Visual acuity in strabismic amblyopia under monocular and binocular conditions. Arch Ophthalmol 1966;76: 172-7.
13. Flynn JT, McKenny SG, Dannheim E. Brightness matching in strabismic amblyopia. Am Orthoptic J 1971;21: 38-49.
14. Von Noorden GK. Idiopathic ambliyopia. Am J Ophthalmol 1985;100: 214-7.
15. Dorey SE, Adams GGW, Lee JP, Sloper JJ. Intensive occlusion therapy for amblyopia. Br J Ophthalmol 2001;85: 310-3
16. Watson PG, Sanaç AŞ, Pickering MS. A comparison of various methods of treatment of ambliyopia. Trans Ophthalmol Soc UK 1985;104:319-28.
17. Lee SY, Isenberg SJ. The Relationship between Streopsis and Visual Acuity after Occlusion Therapy for Amblyopia. Am Acad Ophthalmol 2003;110:2088-92.
18. Burian HM. Stereopsis. Doc Ophthalmol 1951;169: 5-6.
19. Levy NS, Glick EB. Stereoscopic reception and Snellen visual acuity. Am J Ophthalmol 1974;78: 722-4.
20. Goodwin RT, Romano PE. Stereoacuity degradation by experimental and real monocular and binocular amblyopia. Invest Ophtalmol Vis Sci 1985;26: 917-23.
21. Donzis PB, Rppazzo JA, Burde RM, Gordon M. Effect of binocular variations of Snellen’s visual acuity on Titmus stereoacuity. Arch Ophthalmol 1983;101: 30-2.
22. Lövasik JV, Szymkiw M. Effects of aniseikonia, anisometropia, accommodation, retinal illuminance, and pupil size on stereopsis. Invest Ophthalmol Vis Sci 1985;26: 741-50.
23. Sen DK. Results of treatment of anisohypermetropic amblyopia without strabismus. Br J Ophthalmol 1982;66: 680-4.
24. Mitchel DE, Howell ER, Keith CG. The effect of minimal occlusion therapy on binocular vision functions in amblyopia. Invest Ophthalmol Vis Sci 1983;24: 778-81.