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1.
Arq. bras. oftalmol ; Arq. bras. oftalmol;84(2): 133-139, Mar,-Apr. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153127

ABSTRACT

ABSTRACT Purpose: This study was conducted to further define the specific clinical characteristics of patients with Brown syndrome and evaluate the outcomes of superior oblique tenotomy in its surgical management. Methods: A retrospective analysis of the medical charts of 45 patients with Brown syndrome was performed, which revealed that 11 patients underwent superior oblique tenotomy due to abnormal head posture and/or hypotropia and 1 patient underwent bilateral superior oblique tendon elongation with a silicone band due to abnormal head posture. In the last patient, silicone bands were removed at the postoperative 3rd month due to the lack of improvement in the abnormal head posture and the limitation of elevation in adduction. Simultaneous horizontal rectus muscle surgery was performed in four patients. Results: There was a predominance of female gender, right eye, congenital form, unilaterality, A-pattern, and an abnormal head posture type with a combination of chin up and head tilting. Bilateral form was observed only in female patients. Amblyopia was detected in two patients. Among patients aged >5 years, 40% had reduced stereopsis. Abnormal head posture was found in 60% of patients. More than half of them were diagnosed with a vertical and/or horizontal deviation. Tenotomy procedure eliminated the abnormal head posture in all patients and significantly improved the mean limitation of elevation in adduction and hypotropia (p=0.001, p=0.012). Two patients developed inferior oblique overaction in the operated eye. There was complete spontaneous resolution in two patients. Conclusions: The clinical features of patients with Brown syndrome in our study are considerably consistent with those of previous reports. The present study demonstrated the effectiveness of superior oblique tenotomy with less overcorrection in the surgical treatment of Brown syndrome.(AU)


RESUMO Objetivo: Definir mais detalhadamente as características clínicas específicas de pacientes com síndrome de Brown e avaliar os resultados da tenectomia do músculo oblíquo superior no manejo cirúrgico da síndrome de Brown. Métodos: Prontuários de 45 pacientes com síndrome de Brown foram analisados retrospectivamente. Onze pacientes submetidos à tenectomia do músculo oblíquo superior devido a postura anormal da cabeça ou a hipotropia e um paciente submetido ao alongamento bilateral do tendão do oblíquo superior com uma faixa de silicone devido a postura anormal da cabeça. Neste último paciente, a faixa de silicone foi removida no terceiro mês pós-operatório devido à ausência de melhora na postura anormal da cabeça e à limitação da elevação em adução. Quatro pacientes submeteram-se simultaneamente à cirurgia do músculo reto horizontal. Resultados: Houve predominância de sexo feminino, olho direito, forma congênita, acometimento unilateral, padrão em "A" e um tipo de postura anormal da cabeça combinando queixo elevado e inclinação da cabeça. A forma bilateral foi vista apenas em pacientes do sexo feminino. Foi constatada ambliopia em 2 pacientes. Dentre os pacientes acima de 5 anos de idade, 40% tinham estereopsia reduzida. Postura anormal da cabeça estava presente em 60% dos pacientes. Mais da metade dos pacientes foi diagnosticada com um desvio vertical, horizontal ou ambos. O procedimento de tenectomia eliminou a postura anormal da cabeça em todos os pacientes e melhorou significativamente a limitação média da elevação em adução e a hipotropia (p=0,001 e p=0,012). Dois pacientes desenvolveram hiperação do músculo oblíquo inferior no olho operado. Resolução completa ocorreu espontaneamente em 2 pacientes. Conclusões: O quadro clínico dos pacientes com síndrome de Brown no nosso estudo é bastante consistente com os relatos iniciais na literatura. Este estudo mostrou a eficácia da tenectomia do oblíquo superior, com menor hipercorreção no tratamento cirúrgico da síndrome de Brown.(AU)


Subject(s)
Humans , Tendons/physiopathology , Ocular Motility Disorders/physiopathology , Amblyopia/diagnosis , Retrospective Studies
2.
Rev. cuba. oftalmol ; 34(1): e850, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1289527

ABSTRACT

RESUMEN Objetivo: Valorar la efectividad del vídeojuego en educandos que padecen ambliopía funcional. Métodos: Se confeccionó la historia clínica de cada paciente, la cual incluyó la revisión oftalmológica completa, la evaluación de la agudeza visual con la prueba adecuada a cada edad, y se evaluó la presencia de supresión mediante la prueba de filtro rojo y las luces de Worth. Cada prueba se realizó de forma individual según el tipo y la severidad de la ambliopía, y se le indicó la refracción correspondiente. Los pacientes se dividieron en dos grupos: al grupo A se le aplicó la terapia tradicional de la ambliopía, y al grupo B se le siguió la misma pauta que un tratamiento tradicional de ambliopía, pero con la introducción de vídeojuegos. Resultados: Se observó en el grupo A un predominio de los pacientes con agudeza visual inicial entre 0,2 - 0,4 (50 %), la cual se incrementó en dos líneas o más en el (55 %); sin embargo, en el grupo B la agudeza inicial entre 0,2 - 0,4 fue de 56,5 %. Los resultados sensoriales seis meses posteriores al tratamiento, según cada grupo de estudio, mostraron en el grupo B una reducción de la supresión en el 91,3 %, y en el grupo A de un 75 %. Conclusión: La terapia visual combinada con vídeojuego es efectiva; mejora la agudeza visual; elimina y reduce la supresión, por lo que constituye una herramienta que complementa la terapia visual tradicional de la ambliopía.


ABSTRACT Objective: Assess the effectiveness of videogames for students suffering from functional amblyopia. Methods: A clinical record was developed for each patient, which included complete ophthalmological examination, visual acuity evaluation with the suitable test for each age, and determination of the presence of suppression by the red filter test and the Worth lights test. Each test was conducted individually according to the type and severity of amblyopia, and the corresponding refraction was indicated. The patients were divided into two groups: Group A received traditional amblyopia therapy, whereas Group B underwent traditional amblyopia treatment combined with the incorporation of videogames. Results: Group A showed a predominance of patients with initial visual acuity between 0.2 - 0.4 (50%), which increased two lines or more in 55%. However, in Group B initial visual acuity ranged between 0.2 - 0.4 in 56.5%. Six months after treatment, sensory results were 91.3% suppression reduction in Group B and 75% in Group A. Conclusion: Visual therapy proved effective when combined with videogames: visual acuity improved and suppression was reduced. It is thus a suitable tool to complement the traditional visual therapy for amblyopia.


Subject(s)
Humans , Child, Preschool , Child , Amblyopia/diagnosis , Medical Records , Video Games/adverse effects , Visual Acuity
3.
Arq. bras. oftalmol ; Arq. bras. oftalmol;83(1): 43-47, Jan.-Feb. 2020. tab, graf
Article in English | LILACS | ID: biblio-1088951

ABSTRACT

ABSTRACT Purpose: The aim of this study was to evaluate the effect of anterior chamber depth and axial length on clinical performance of the Spot Vision Screener in detecting amblyopia risk factors in children aged 3-10 years. Methods: A total of 300 eyes from 150 patients aged 3-10 years were prospectively tested with Spot Vision Screener (firmware version 3.0.02.32, software version 3.0.04.06) and a standard autorefractometer (Nidek ARK-1). The anterior chamber depth and axial length were measured with an optical biometer (Nidek AL-Scan). The sensitivity and specificity values for detecting significant refractive errors using the referral criteria of the American Association for Pediatric Ophthalmology and Strabismus were determined. Pearson's correlation analysis was employed to evaluate the relationship between the Spot Vision results and the anterior chamber depth and axial length. Results: Compared with the standard autorefractometer results, the Spot Vision Screener's sensitivity and specificity was 59% and 94%, respectively. The differences between the cycloplegic autorefractometer and the Spot Vision Screener spherical equivalents were negatively correlated with anterior chamber depth (r=-0.48; p<0.001) and axial length (r=-0.45; p<0.001). Conclusion: The Spot Vision Screener has moderate sensitivity and high specificity, using the criteria of the American Association for Pediatric Ophthalmology and Strabismus. The anterior chamber depth and axial length affect the Spot Vision results.


RESUMO Objetivo: O objetivo deste estudo foi avaliar o efeito da profundidade da câmara anterior e do comprimento axial sobre o desempenho clínico do Spot Vision Screener, na deteção de fatores de risco para a ambliopia em crianças de 3 a 10 anos de idade. Métodos: Um total de 300 olhos de 150 pacientes de 3-10 anos de idade foram prospectivamente testados com o Spot Vision Screener (firmware: 3.0.02.32, software: 3.0.04.06) e com autorefratómetro padrão (Nidek ARK-1). Todas as medições de profundidade e comprimento axial da câmara anterior dos pacientes foram realizadas através de Nidek AL Scan. A sensibilidade e especificidade para a deteção de erros refrativos significativos foram determinadas de acordo com os critérios de referência da Associação Americana de Oftalmologia e Estrabismo Pediátricos. A análise da Correlação de Pearson foi utilizada para avaliar a correlação entre os resultados do Spot Vision e a profundidade ou comprimento axial da câmara anterior dos pacientes. Resultados: Em comparação com os resultados do autorefratómetro padrão, a sensibilidade do Spot foi de 59% e a especificidade de 94%. As diferenças entre os equivalentes esféricos do autorefratómetro cicloplégico e o Spot Vision Screener foram correlacionados negativamente com a profundidade (r=-0,48; p<0,001) e o comprimento axial (r=-0,45; p<0,001) da câmara anterior dos casos. Conclusão: O Spot Vision Screener possui uma sensibilidade moderada e uma especificidade elevada utilizando os critérios da Associação Americana de Oftalmologia Pediátrica e Estrabismo; a profundidade da câmara anterior e o comprimento axial dos pacientes afetam os resultados do Spot Vision.


Subject(s)
Humans , Child, Preschool , Child , Vision Screening/instrumentation , Amblyopia/diagnosis , Refractive Errors/diagnosis , Amblyopia/etiology , Strabismus , Prospective Studies , Risk Factors , Sensitivity and Specificity , Retinoscopy , Axial Length, Eye , Anterior Chamber
4.
Rev. bras. oftalmol ; 79(1): 66-68, Jan.-Feb. 2020. graf
Article in English | LILACS | ID: biblio-1092650

ABSTRACT

Abstract The presence of retinal myelinated nerve fibers is not a rare finding during routine examinations, and it is usually a benign and isolated finding. However, in some rare cases, it can be associated with other ophthalmological conditions. We describe a case of a patient with the triad myelin nerve fibers, myopia and ambliopia, which configures the Straatsma Syndrome.


Resumo A presença de fibras de mielina é um achado comum durante exames oftalmológicos de rotina. Na maior parte das vezes, tem caráter beningno e é um achado isolado. No entanto, em alguns raros casos, a presença de mielinização pode estar associada a outras condições oftalmológicas. Descrevemos um caso de paciente com a tríade presença de fibras nervosas retinianas mielinizadas, miopia, e ambliopia, configurando a síndrome de Straatsma.


Subject(s)
Humans , Female , Middle Aged , Retinal Diseases/diagnosis , Amblyopia/diagnosis , Myopia/diagnosis , Nerve Fibers, Myelinated/pathology , Ophthalmoscopy , Optic Nerve/abnormalities , Visual Acuity , Anisometropia , Tomography, Optical Coherence , Fundus Oculi , Myelin Sheath
5.
Biomédica (Bogotá) ; Biomédica (Bogotá);39(3): 434-439, jul.-set. 2019. tab, graf
Article in English | LILACS | ID: biblio-1038804

ABSTRACT

ABSTRACT Fabry disease is a rare X-linked disorder caused by an alpha-galactosidase enzyme deficiency, which leads to a progressive lysosomal glycosphingolipids accumulation, mainly globotriaosylceramide, in multiple organism tissues including the eye. This case series describes the first ophthalmological Colombian report of Fabry disease highlighting the importance of ocular signs as markers of the disease, useful in diagnosis and treatment to avoid long-term complications that lead to a morbi-mortality increment. We describe five cases of Fabry disease from Bogotá, Colombia, including a complete clinical history, ophthalmologic, optometric examination, and photographs. We found that all patients had refractive defects and that in all cases corneal verticillata pattern was found. Four patients presented with posterior capsule lens brown-beige deposits and four patients had conjunctival and retinal tortuous vessels. A complete ophthalmologic examination is important for prompt diagnosis, which is key to starting a multidisciplinary treatment and reducing morbi-mortality.


RESUMEN La enfermedad de Fabry es un raro trastorno ligado al cromosoma X causado por deficiencia de la enzima alfa-galactosidasa y la consiguiente y progresiva acumulación lisosómica de glucoesfingolípidos, especialmente la globotriaosilceramida, en múltiples tejidos del organismo, incluido el ojo. En este reporte se presenta la primera serie de casos de manifestaciones oculares de la enfermedad de Fabry en Colombia, resaltando la importancia de los signos oculares como ayuda para el diagnóstico temprano. Se presentan cinco casos de la enfermedad en Bogotá y se da cuenta de las historias clínicas y los exámenes oftalmológicos y de optometría, y se incluyen fotografías. En todos los pacientes se hallaron errores de refracción y se evidenció el patrón de córnea verticillata. Cuatro pacientes presentaban depósitos de color café y castaño claro en la cápsula posterior del cristalino, y cuatro tenían tortuosidad vascular conjuntival y retiniana. El examen oftalmológico completo es importante para hacer un diagnóstico oportuno con el fin de iniciar el tratamiento multidisciplinario y reducir la morbimortalidad.


Subject(s)
Adolescent , Adult , Female , Humans , Male , Young Adult , Fabry Disease/complications , Eye Diseases/diagnosis , Refractive Errors/diagnosis , Retinal Vessels/abnormalities , Cataract/diagnosis , Amblyopia/diagnosis , Fabry Disease/genetics , Colombia , Conjunctiva/abnormalities , Conjunctiva/blood supply , Heterozygote , Lacrimal Apparatus/abnormalities
6.
Rev. bras. oftalmol ; 77(3): 133-136, May-June 2018. graf
Article in English | LILACS | ID: biblio-959079

ABSTRACT

Abstract Purpose: To present the design and implementation of an amblyopia risk factors screening project, in a large based Portuguese population. Methods: Two referral centers have been enrolled to assess all children aged 2 under their direct referral area. The photoscreener used was PlusOptix ® A09. At this age, the cut-off defined for referral was: ≥1 Diopter (D) of anisometropia, ≥1.5D of astigmatism, ≥2D of myopia and ≥1.5D of hyperopia. The results were reported to a reading platform that allowed the ophthalmologist to see all exams, and provide timely appointment with a complete ophthalmologic assessment for those who needed. Results: A total of 2867 photo screens were made to the population eligible to both referral centers, which comprises a coverage rate of 55%. Out of 2611 children under one of the referral area, 53% (n=1395) adhered to the screening. Within these children, 17.5% (n=245) were referred and 15.3 % (n=214) appointments were performed. The comparison of refraction between PlusOptix ® and cycloplegic refraction showed a strong correlation regarding the sphere and cylinder values. From the 214 children observed in consultation, glasses were prescribed in 25.7% (n=55), corresponding to 3.9% of all screened children under one of the referral area. This screening method showed a positive predictive value of 58.4%. Conclusion: This screening program may be highly relevant to eradicate untreated amblyopia from our population. The results may lead to the implementation of this project to the whole country.


Resumo Objetivo: Apresentação da implementação de um projeto de rastreio de fatores de risco de ambliopia, numa população alargada portuguesa. Métodos: dois centros de referência foram selecionados para avaliar todas as crianças de 2 anos, na sua área de referenciação direta. Para o foto rastreio foi utilizado o PlusOptix ® A09. Nesta idade, os valores definidos para referenciação foram: ≥1 Dioptria (D) de anosimetropia, ≥1.5 D de astigmatismo, ≥2 D de miopia e ≥1.5 D de hipermetropia. Os resultados foram reportados a uma plataforma de leitura que permitiu ao oftalmologista ver todos os exames e providenciar uma consulta oportuna com uma avaliação oftalmológica completa para aqueles que precisavam. Resultados: Foram realizados 2867 foto rastreios na população elegível para ambos os centros de referência, perfazendo uma taxa de cobertura de 55%. Das 2611 crianças sob uma área de referência, 53% (n = 1395) aderiram ao rastreio. Dentro desse grupo, 17,5% (n = 245) foram referenciadas e 15,3% (n = 214) consultas foram realizadas. Verificou-se uma forte correlação entre a refração do PlusOptix® e a refração cicloplégica. Das 214 crianças observadas em consulta, foram prescritos óculos em 25,7% (n = 55), correspondendo a 3,9% de todas as crianças sob uma área de referência. Este método de triagem mostrou um valor preditivo positivo de 58,4%. Conclusão: Este programa de rastreio pode ser altamente relevante para erradicar a ambliopia não tratada na nossa população. Os resultados podem levar à implementação deste projeto em todo o país.


Subject(s)
Humans , Male , Female , Child, Preschool , Refractive Errors/diagnosis , Vision Tests/instrumentation , Vision Screening/instrumentation , Amblyopia/diagnosis , Portugal , Visual Acuity , Amblyopia/epidemiology , Predictive Value of Tests , Risk Factors
7.
Rev. inf. cient ; 97(4): i: 700-f: 709, 2018. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1005442

ABSTRACT

Introducción: cuando la visión está disminuida o ausente ocasiona minusvalías para los niños, y provoca lentitud en el aprendizaje. Objetivo: determinar las afecciones oculares de pacientes pediátricos en consulta de Neuroftalmología, Hospital Oftalmológico Amistad Argelia-Cuba, El Oued, en el período enero a junio de 2016. Método: se realizó un estudio observacional, descriptivo, el universo quedó constituido por 825 niños. Se estudiaron las variables: edad, sexo, diagnóstico oftalmológico y tipo de tratamiento recibido. Resultados: el 65,5 por ciento de pacientes correspondió al sexo masculino, la edad más representada estuvo entre 11-14 años para un 48,5 por ciento. La ambliopía refractiva y el estrabismo fueron las afecciones oftalmológicas más frecuentes, en el 60,6 y 15,8 por ciento de los casos respectivamente. Conclusiones: el trabajo del neuroftalmólogo y su equipo de salud, contribuye al tratamiento de la ambliopía, recibiendo la mayoría de los niños corrección óptica en consulta(AU)


Introduction: when vision is diminished or absent it causes disabilities for children and slow learning. Objective: to determine the ocular affections of pediatric patients in Neurophthalmology consultation at the ophthalmological Hospital Amistad-Algeria-Cuba, El Oued, from January to June 2016. Method: an observational and descriptive study was carried out; also the universe was constituted by 825 children. The variables were studied: age, sex, ophthalmological diagnosis and type of treatment received by children. Results: 65.5 percent of patients were males; the most represented age was between 11-14 years for 48.5 percent. Refractive amblyopia and strabismus were the most frequent ophthalmological affections, in 60.6 and 15.8 percent of cases respectively. Conclusions: the work of the neurophthalmologist and his health team contributes to the treatment of amblyopia receiving most of the children optical correction in consultation(AU)


Introdução: quando a visão é diminuída ou ausente, causa incapacidades para as crianças e causa um aprendizado lento. Objetivo: determinar as condições oculares de pacientes pediátricos em um Neuro-Oftalmologia, Eye Hospital Amizade Argélia-Cuba, El Oued, no período de janeiro a junho de 2016. Método: um estudo observacional, descritivo, o universo era composto por 825 crianças. As variáveis estudadas foram: idade, sexo, diagnóstico oftalmológico e tipo de tratamento recebido. Resultados: 65,5 por cento dos pacientes corresponderam ao sexo masculino, a idade mais representada foi entre 11-14 anos para 48,5 por cento. A ambliopia refrativa e o estrabismo foram as afecções oftalmológicas mais frequentes, em 60,6 e 15,8 por cento dos casos, espectivamente. Conclusões: o trabalho do neuroftalmologista e sua equipe de saúde contribuem para o tratamento da ambliopia, sendo que a maioria das crianças recebe correção óptica em consulta(AU)


Subject(s)
Humans , Child , Eye Diseases/diagnosis , Eye Diseases/therapy , Amblyopia/diagnosis , Strabismus/diagnosis , Epidemiology, Descriptive , Algeria , Observational Study
8.
Rev. bras. oftalmol ; 76(5): 262-264, Sept.-Oct. 2017. graf
Article in English | LILACS | ID: biblio-899082

ABSTRACT

Abstract This article reports two cases of Straatsma Syndrome, a rare disease, emphasizing its clinical features that inclued myopia, strabismus and amblyopia associated with persistent myelinated fibers in the retina. Ophthalmic examination, color retinography and optical coherence tomography were performed.


Resumo Este artigo relata dois casos de síndrome de Straatsma, uma doença rara, enfatizando suas características clínicas que incluem miopia, estrabismo e ambliopia associada a persistência de fibras de mielina na retina. Foram realizados exame oftalmológico, retinografia e tomografia de coerência óptica.


Subject(s)
Humans , Female , Child, Preschool , Adult , Optic Nerve Diseases/diagnosis , Amblyopia/diagnosis , Strabismus/diagnosis , Myopia/diagnosis , Ophthalmoscopy , Refraction, Ocular , Retina/diagnostic imaging , Syndrome , Visual Acuity , Eyeglasses , Slit Lamp Microscopy , Fundus Oculi , Nerve Fibers, Myelinated/pathology
9.
Arq. bras. oftalmol ; Arq. bras. oftalmol;79(5): 346-351, Sept.-Oct. 2016. tab
Article in English | LILACS | ID: biblio-827971

ABSTRACT

ABSTRACT Abnormalities in visual processing caused by visual deprivation or abnormal binocular interaction may induce amblyopia, which is characterized by reduced visual acuity. Occlusion therapy, the conventional treatment, requires special attention as occlusion of the fellow normal eye may reduce its visual acuity and impair binocular vision. Besides recovering visual acuity, some researchers have recommended restoration of stereoacuity and motor fusion and reverse suppression in order to prevent diplopia. Recent studies have documented that the amblyopic visual cortex has a normal complement of cells but reduced spatial resolution and a disordered topographical map. Changes occurring in the late sensitive period selectively impact the parvocellular pathway. Distinct morphophysiologic and psychophysical deficits may demand individualization of therapy, which might provide greater and longer-lasting residual plasticity in some children.


RESUMO Anormalidades nos processamentos visuais causadas por privação visual ou interação binocular anormal podem gerar ambliopia, caracterizada por redução da acuidade visual. A terapia de oclusão (tratamento convencional) necessita de cuidados especiais, pois a oclusão do olho normal (não-amblíope) pode reduzir a acuidade visual do mesmo e prejudicar a visão binocular. Além de recuperar a acuidade visual, alguns pesquisadores alertam para a necessidade em potencial de se restaurar a estereoacuidade e a fusão motora, bem como reverter a supressão a fim de impedir diplopia. Estudos recentes revelam que nos córtices visuais de amblíopes há uma quantidade normal de células, mas com resolução espacial reduzida e mapa topográfico desorganizado. Alterações ocorridas durante o período crítico tardio do desenvolvimento visual humano impactam seletivamente a via parvocelular. Déficits morfofisiológicos e psicofísicos distintos podem exigir programas de tratamento potencialmente seletivos e poderiam explicar a plasticidade residual maior e mais duradoura em algumas crianças.


Subject(s)
Humans , Child , Amblyopia/etiology , Amblyopia/physiopathology , Amblyopia/therapy , Visual Acuity , Amblyopia/diagnosis , Age of Onset , Neuronal Plasticity
10.
Rev. cuba. oftalmol ; 29(1): 0-0, ene.-mar. 2016. tab
Article in Spanish | LILACS | ID: lil-781208

ABSTRACT

Objetivo: describir los resultados quirúrgicos y la obtención de fusión y estereopsia en operados de esotropía congénita, después de cuatro años de seguimiento y su relación con el ángulo de desviación preoperatorio y la edad al momento de la primera cirugía. Métodos: estudio descriptivo, longitudinal y prospectivo de una serie de casos, operados de esotropía congénita desde el año 2007 al 2010, seguidos durante cuatro años por consulta en el Instituto Cubano de Oftalmología Ramón Pando Ferrer. Se analizaron las variables edad al diagnóstico, ángulo de desviación preoperatorio y posoperatorio, edad al momento de la primera cirugía, presencia de fusión, estereopsia y desarrollo de ambliopía. Resultados: el ángulo de desviación preoperatorio promedio de los pacientes estudiados fue de 39,8 dioptrías y la media de la edad al momento de la primera cirugía fue 22,5 meses (DE 9,2). La media de supervivencia del alineamiento ocular fue de 39,3 meses, y fue superior en los pacientes con un ángulo de desviación preoperatorio menor de 40 dioptrías y con menos de 24 meses de edad al momento de la primera cirugía (p= 0,001). Presentaban fusión y estereopsia a los 4 años el 57,7 y el 26,9 por ciento de los pacientes. La media del número de cirugía fue de 1,42 (DE ± 0,504) a los 4 años. La causa más frecuente de segunda cirugía fue la hiperfunción del oblicuo inferior (19,2 por ciento). Conclusiones: la presencia de fusión y de estereopsia a los 4 años de evolución es mayor en aquellos pacientes con menor ángulo de desviación preoperatoria y con menos de 2 años de edad a la primera cirugía(AU)


Subject(s)
Humans , Infant , Child, Preschool , Depth Perception/genetics , Esotropia/congenital , Esotropia/surgery , Vision, Binocular/genetics , Amblyopia/diagnosis , Epidemiology, Descriptive , Longitudinal Studies , Prospective Studies , Strabismus/surgery
11.
Rev. méd. hondur ; 83(1/2): 29-32, ene.-jun. 2015. tab
Article in Spanish | LILACS | ID: biblio-938

ABSTRACT

Marco conceptual:El manejo y detección de ametropías en la niñez es multidisciplinario. Los programas de tamizaje incluyen maestros, pediatras, oftalmólogos y optometristas, con el fin de corregir y prevenir la ambliopía. Objetivo: Evaluar la efectividad del tamizaje realizado por maestros que fueron capacitados en la toma de agudeza visual. Metodología: Se realizó estudio de concordancia en donde el universo lo constituyeron 33 maestros de las Escuelas primarias República de Nicaragua, Reino de los Países Bajos y República de Paraguay del sector público del municipio del Distrito Central de Honduras.El estudio se llevó a cabo en el año lectivo 2015 entre los meses de mayo a julio. Se evaluaron 840 estudiantes matriculados de primero a sexto grado. La medición de la agudeza visual se realizó utilizando la Cartilla Snellen, tomando como punto de corte mediciones menores a 20/30 en el mejor ojo. Los estudiantes con dicha agudeza visual fueron examinados por los médicos residentes cuya evaluación fue considerada el gold estándar del estudio para determinar la sensibilidad y especificidad de las mediciones realizadas por los maestros. Resultados: La sensibilidad y especificidad del tamizaje ejecutado por los maestros fue de 100% y 74% respectivamente. El resultado de índice de Kappa de Cohen fue de 0.65. Conclusiones: los resultados del presente estudio indican que el tamizaje de agudeza visual realizado por los maestros presenta validez aceptable para identificar casos positivos de disminución de agudeza visual y que es mejor elegir una prueba muy sensible si se prefiere obtener falsos positivos en lugar de falsos negativos...(AU)


Subject(s)
Humans , Amblyopia/diagnosis , Faculty , Refractive Errors/diagnosis , Visual Acuity
13.
Rev. bras. oftalmol ; 73(6): 358-362, Nov-Dec/2014. tab, graf
Article in English | LILACS | ID: lil-741914

ABSTRACT

Objective: Some studies have hypothesized that an unfavourable higher order aberrometric profile could act as an amblyogenic mechanism and may be responsible for some amblyopic cases that are refractory to conventional treatment or cases of “idiopathic” amblyopia. This study compared the aberrometric profile in amblyopic children to that of children with normal visual development and compared the aberrometric profile in corrected amblyopic eyes and refractory amblyopic eyes with that of healthy eyes. Methods: Cross-sectional study with three groups of children – the CA group (22 eyes of 11 children with unilateral corrected amblyopia), the RA group (24 eyes of 13 children with unilateral refractory amblyopia) and the C group (28 eyes of 14 children with normal visual development). Higher order aberrations were evaluated using an OPD-Scan III (NIDEK). Comparisons of the aberrometric profile were made between these groups as well as between the amblyopic and healthy eyes within the CA and RA groups. Results: Higher order aberrations with greater impact in visual quality were not significantly higher in the CA and RA groups when compared with the C group. Moreover, there were no statistically significant differences in the higher order aberrometric profile between the amblyopic and healthy eyes within the CA and RA groups. Conclusions: Contrary to lower order aberrations (e.g., myopia, hyperopia, primary astigmatism), higher order aberrations do not seem to be involved in the etiopathogenesis of amblyopia. Therefore, these are likely not the cause of most cases of refractory amblyopia. .


Objetivo: Alguns estudos levantaram a hipótese de que um perfil aberrométrico de alta ordem desfavorável poderia ser um fator ambliogênico, responsável por certos casos de ambliopia “idiopática” ou refratária ao tratamento convencional. Este trabalho tem como objetivos: 1) comparar o perfil aberrométrico de crianças amblíopes com o de crianças com desenvolvimento visual normal; 2) comparar a aberrometria de olhos amblíopes tratados com sucesso/curados e olhos amblíopes refratários ao tratamento convencional com a aberrometria de olhos saudáveis. Métodos: Estudo transversal com três grupos de crianças: grupo CA (22 olhos de 11 crianças com ambliopia unilateral curada), grupo RA (24 olhos de 13 crianças com ambliopia unilateral refratária) e grupo C (28 olhos de 14 crianças com desenvolvimento visual normal). Avaliou-se a aberrometria ocular total utilizando o OPD Scan-III (NIDEK). Comparou-se o perfil aberrométrico dos três grupos de estudo bem como dentro dos grupos CA e RA, o olho amblíope com o saudável. Resultados: As aberrações de alta ordem com maior impacto na qualidade visual não foram significativamente superiores nos grupos CA e RA, comparativamente ao grupo C. Por outro lado, não se encontraram diferenças estatisticamente significativas entre o perfil aberrométrico de alta ordem dos olhos amblíopes e dos olhos sãos dentro dos grupos CA e RA. Conclusão: Contrariamente às aberrações de baixa ordem (miopia, hipermetropia, astigmatismo primário), as de alta ordem não parecem relacionar-se com a etiopatogênese da ambliopia. É também pouco provável que estas sejam a causa da maioria dos casos de ambliopia refratária. .


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Refraction, Ocular , Amblyopia/diagnosis , Corneal Wavefront Aberration/diagnosis , Aberrometry , Visual Acuity , Amblyopia/physiopathology , Amblyopia/therapy , Cross-Sectional Studies
14.
Yonsei med. j ; Yonsei med. j;: 1672-1677, 2014.
Article in English | WPRIM | ID: wpr-180227

ABSTRACT

PURPOSE: To investigate horizontal image disparity in three-dimensional (3-D) perception using 3-D animations in normal control patients and patients with intermittent exotropia, anisometropic amblyopia, and partially accommodative esotropia. MATERIALS AND METHODS: A total of 133 subjects were included. Stereopsis was measured using the Titmus Stereo test (Stereo Optical Inc., Chicago, IL, USA) and a 3-D stereopsis test with a 15 inch 3-D display laptop, adjusting 3-D parameters of 0 mm horizontal disparity to 15 mm horizontal disparity. RESULTS: When compared with normal controls, the average threshold of the 3-D stereopsis test was significantly reduced for esotropia patients (p<0.001) and for anisometric amblyopia patients (p<0.001), compared to normal controls. No significant difference was observed between normal controls and intermittent exotropia patients (p=0.082). The 3-D stereopsis test was correlated with the Titmus Stereo test (Spearman's rho=0.690, p<0.001). Mean difference in stereoacuity was 1.323 log seconds of arc (95% limits of agreement: 0.486 to 2.112), and 125 (92.5%) patients were within the limits of agreement. CONCLUSION: This study demonstrated that a 3-D stereopsis test with animation is highly correlated with the Titmus Stereo test; nevertheless, 3-D stereopsis with animations generates more image disparities than the conventional Titmus Stereo test. The 3-D stereopsis test is highly predictive for estimating real stereopsis in a 3-D movie theater.


Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Amblyopia/diagnosis , Anisometropia/diagnosis , Depth Perception , Esotropia/diagnosis , Imaging, Three-Dimensional/instrumentation , Perceptual Disorders , Software , Vision Disparity , Vision, Binocular , Visual Acuity/physiology
15.
Lima; s.n; 2013. 58 p. tab, graf.
Thesis in Spanish | LILACS, LIPECS | ID: biblio-1113177

ABSTRACT

La investigación tiene como objetivo determinar las características clínicas y epidemiológicas de Ambliopía en pacientes atendidos en el Servicio de Oftalmología del Hospital Nacional Arzobispo Loayza. El Estudio es retrospectivo, observacional, de corte transversal, la muestra estará conformada por 56 pacientes que ingresaron al Servicio de Oftalmología del Hospital Nacional Arzobispo Loayza que fueron diagnosticados clínicamente de Ambliopía en el periodo de enero a setiembre 2010. De los resultados tenemos que la Ambliopía en varones se presentaron 16 casos (28.6 por ciento) y en mujeres 40 casos (71.4 por ciento). Del total de pacientes varones con Ambliopía el 28,6 por ciento presentaron Hallazgos normales de Párpados, vías lagrimales y conjuntivas; el 28.6 por ciento presentaron motilidad ocular conservada y del total de pacientes mujeres con Ambliopía el 66 por ciento presentaron Hallazgos normales de Párpados, vías lagrimales, conjuntivas y el 5.4 por ciento patológico, los pacientes de 5 a 10 años con Ambliopía el 12.5 por ciento presentaron hallazgos normales de Párpados, vías lagrimales y conjuntivas; de 10 a 15 años el 23.2 por ciento presentaron hallazgos normales de Párpados, vías lagrimales y conjuntivas; los pacientes de 15 a mas años el 58.9 por ciento presentaron hallazgos normales de Párpados, vías lagrimales y conjuntivas. El 17.9 por ciento presentan Ambliopía Estrábica; el 35.7 por ciento Ambliopía Ametrópica; el 46.4 por ciento presentan Ambliopía Anisometrópica. El principal síntoma es la disminución de agudeza visual (100 por ciento). EI 62.5 por ciento presentan Ambliopía unilateral y el 37.5 por ciento Ambliopía bilateral. El 17.9 por ciento presentan déficit visual leve; el 37.5 por ciento presentan déficit visual moderado y el 44.6 por ciento presentan déficit visual severo.


The research aims to determine the clinical and epidemiological characteristics of Amblyopia in patients treated at the Department of Ophthalmology at the National Hospital Archbishop Loayza. The study is retrospective, observational, cross-sectional, the sample will consist of 56 patients admitted to the Department of Ophthalmology Arzobispo Loayza National Hospital who were clinically diagnosed with Amblyopia in the period January to September 2010. The results we have that Amblyopia in males are presented 16 cases (28.6 per cent) and female 40 cases (71.4 per cent). Of the male patients with Amblyopias in 28,6 per cent findings Normal eyelids, tear ducts and conjuntival, 28.6 per cent had ocular motility preserved and women of all patients with Amblyopia showed 66 per cent findings Normal eyelids, tear ducts, and conjuntival and 5.4 per cent pathological, the patients 5 to 10 years with Amblyopia showed 12.5 per cent findings Normal eyelids, tear duct and conjuntival, and patients 10 to 15 years with 23.2 per cent had Amblyopia findings Normal eyelids, tear duct and conjuntival, those patients with more than 15 years with Amblyopia showed 58.9 per cent findings Normal eyelids, tear ducts, conjuntival. Conclusions 17.9 per cent have strabismic Amblyopia, 35.7 per cent ametropic Amblyopia, 46.4 per cent have anisometric Amblyopia. The main symptom is decreased visual acuity (100 per cent). 62.5 per cent presented unilateral Amblyopia and 37.5 per cent bilateral Amblyopia, 17.9 per cent have level visual deficit, 37.5 per cent have moderate visual deficit and 44.6 per cent develop severe visual deficit.


Subject(s)
Male , Female , Humans , Child, Preschool , Child , Adolescent , Adult , Amblyopia/diagnosis , Amblyopia/epidemiology , Strabismus , Observational Study , Retrospective Studies , Cross-Sectional Studies
16.
Rev. cuba. oftalmol ; 26(supl.1): 668-678, 2013.
Article in Spanish | LILACS | ID: lil-706697

ABSTRACT

Las fibras de mielina intraoculares se presentan desde el nacimiento y suelen localizarse alrededor de la papila. El síndrome de mielinización de las fibras nerviosas retinales fue descrito por Virchow por primera vez en 1856. Este aparece como parches estriados, blanco o blanco grisáceos con los bordes imprecisos y plumosos siguiendo una configuración coincidente con la distribución de las fibras nerviosas retinales. Se presenta una paciente femenina de 4 años que es traída a consulta por desviación del ojo derecho. En el examen oftalmológico se detecta una agudeza visual con corrección de 0,1 y la oftalmoscopia confirma la mielinización de las fibras nerviosas retinales. En estos pacientes se asocia frecuentemente la miopía y ambliopía. A pesar de los pobres resultados visuales y ante la ausencia de otras terapias disponibles existe tendencia a tratamiento agresivo para la ambliopía, aunque en la literatura esto es aún controversial


The intraocular myelin fibers emerge since one's birth and it is usually located around the papilla. The syndrome of myelinated retinal nerve fibers was described for the first time by Virchow in 1856. This appears in the form of grooved patches, white or grayish white with imprecise and feathery borders following a coincident configuration with the distribution of the retinal nerve fibers. A four years-old girl who was taken to the doctor's office because she presented with right eye deviation. In the ophthalmologic exam, the best corrected visual acuity was 0.1 and the ophthalmoscopy confirmed myelinated retinal nerve fibers. Myopia and amblyopia were often associated in these patients. In spite of the poor visual results and the lack of other available therapies, specialists tend to apply aggressive treatment for amblyopia, although this procedure is still controversial in the medical literature


Subject(s)
Humans , Male , Child, Preschool , Amblyopia/diagnosis , Myopia/diagnosis , Nerve Fibers, Myelinated , Ophthalmoscopy/methods , Visual Acuity
17.
Indian J Ophthalmol ; 2012 Nov-Dec; 60(6): 541-543
Article in English | IMSEAR | ID: sea-144916

ABSTRACT

Aims: To create a normative data for lea grating (LG) in the Indian population and to compare LG with Cardiff Acuity Card (CAC). Settings and Design: Normative Data was acquired from normal children between 6 months-3 years coming to the ‘Immunisation Clinic’ and ‘Well-Baby Clinic’ at a Civil Hospital. To compare LG with CAC, normal and amblyopic children between 6 months-3 years were evaluated, Materials and Methods: Monocular and binocular visual acuity (VA) was measured using LG and then CAC. VA and time taken to perform the test were compared. Statistical Analysis Used: Pearson's Correlation Coefficient to compare VA and Student paired t-test (significance P<0.005) to compare time. Results: Two standard deviations of VA of 100 normal children overlapped with that published by Lea. Of the 30 amblyopic children aged 18.32 ± 10.5 months (2-36), 18 were females. VA was 0.95 ± 0.3 logMAR (0.7–1.2) and 1.0 ± 0.6 logMAR (0.5–2.1) binocularly and 1.32 ± 0.08 logMAR (0.2-0.6) and 1.15 ± 0.15 logMAR (0.88-1.48) monocularly on CAC and LG respectively. Pearson's correlation coefficient was 0.98 and 0.63 for binocular and monocular assessment respectively. Time taken to perform LG monocularly and binocularly was significantly less (P<0.001) than CAC. Conclusion: Normative data acquired in Indian pre-verbal children is similar to that published by Lea. Though VA by CAC is better than LG, the two tests are comparable.


Subject(s)
Amblyopia/diagnosis , Child, Preschool , Female , Humans , India , Language Development , Male , Vision Tests/methods , Visual Acuity/physiology
18.
Arq. bras. oftalmol ; Arq. bras. oftalmol;75(2): 87-88, mar.-abr. 2012. tab
Article in Portuguese | LILACS | ID: lil-640151

ABSTRACT

OBJETIVO: Comparar a acurácia do teste de fixação preferencial quando o paciente olha e toca o objeto alvo ao invés de apenas olhá-lo, como convencionalmente descrito. MÉTODOS: Estudo piloto transversal e prospectivo, incluindo 40 pacientes estrábicos, com desvios maiores que 10 dioptrias prismáticas entre 7 e 30 anos. RESULTADOS: O teste modificado mostrou sensibilidade de 93% (IC 95%=68,53 -98,73%) e especificidade de 77% (IC 95%=57,95 - 88,97%). O teste convencional apresentou sensibilidade de 93% (IC 95%=68,53 - 98,73%) e especificidade 46% (IC 95%= 28,76 - 64,54%). CONCLUSÕES: Estes resultados sugerem que a modificação no teste de fixação preferencial, solicitando que o paciente toque o objeto alvo, possa reduzir os resultados falsos positivos do teste.


PURPOSE: To compare the accuracy of the fixation preference test performed with the patient touching and looking at the fixation target, to the conventional method test done with the patient only looking at it. METHODS: A pilot transversal and prospective study was done with 40 strabismic patients with deviations greater than 10 prism diopters, from 7 to 30 years old. RESULTS: The modified test had a sensitivity of 93% (IC 95%=68.53 - 98.73%) and specificity of 77% (IC 95%=57.95 - 88.97%); while the conventional test had a sensitivity of 93% (IC 95%=68.53 - 98.73%) and a specificity of 46% (IC 95%=28.76 - 64.54%). CONCLUSIONS: Our results suggest that the modification of the fixation preference test by asking the patient to touch the fixation target might reduce the number of false positive results of the test.


Subject(s)
Adolescent , Adult , Child , Female , Humans , Young Adult , Fixation, Ocular , Strabismus/diagnosis , Vision Tests/methods , Amblyopia/diagnosis , Cross-Sectional Studies , Sensitivity and Specificity , Strabismus/physiopathology , Vision, Binocular , Visual Acuity
19.
Mediciego ; 17(Supl. 1)jul. 2011. tab, graf
Article in Spanish | LILACS | ID: lil-616719

ABSTRACT

La ambliopía se define como una disminución de la agudeza visual sin existir ninguna lesión orgánica que la justifique. Se identificó la prevalencia de la ambliopía en los estudiantes de la escuela primaria Augusto César Sandino del municipio de Ciego de Ávila, en el período comprendido desde marzo de 2008 a marzo de 2009. Se estudió el total de niños matriculados (557); se realizó un estudio observacional descriptivo de corte transversal en busca de ambliopía, se les realizó un examen físico ocular completo que fue la fuente de información. El 2.33 porciento de los escolares presentó ambliopía. El 46.15 porciento de los pacientes pertenecieron al grupo de edad de 6 a 4 años, predominó el sexo femenino 69.23 porciento. La ambliopía refractiva y la forma ligera fueron las más frecuentes (53.85 y 61.54 porciento). En el 76.92 porciento de los niños el desconocimiento de los padres fue la principal causa del diagnóstico tardío. El valor de ambliopes obtenido se encuentra dentro de la cifra promedio de prevalencia a nivel mundial, predominó el grupo de edad de 4 a 6 años, el sexo femenino, la ambliopía refractiva y la forma ligera; el desconocimiento de los padres o tutores fue la causa fundamental de diagnóstico tardío.


Amblyopia is defined as a decrease in visual acuity without existing any organic lesion to justify it. It was identified the prevalence of amblyopia in Primary School "Augusto Cesar Sandino” in Ciego de Avila municipality from March 2008 to March 2009. It was studied the total of children enrolled (557) where an observational descriptive cross-sectional study was carried out in search of amblyopia, they underwent a complete ocular physical examination that was the source of information. 2.33 percent of the students had amblyopia, 46.15 percent of patients were from 6 to 4 years old, females were the predominant sex (69.23 percent). Refractive and small amblyopia were the most frequent (53.85 and 61.54 percent). In 76.92 percent of children, their parents’ ignorance was the main cause of late diagnosis. The obtained value of amblyopes is in the average number of prevalence worldwide, dominated ages from 4 to 6 years, female sex, refractive and small amblyopia; the ignorance of parents or guardians was fundamental causes of late diagnosis.


Subject(s)
Humans , Male , Female , Child , Amblyopia/diagnosis , Amblyopia/epidemiology
20.
Rev. Méd. Clín. Condes ; 21(6): 972-977, nov. 2010. ilus, tab
Article in Spanish | LILACS | ID: biblio-999299

ABSTRACT

La ceguera infantil es menos frecuente que la adulta, pero el costo emocional y económico es comparativamente mayor en niños. Existen 1,4 millones de niños ciegos en el mundo, de causas diferentes, especialmente si se comparan países de ingresos económicos altos, medios y bajos. Detectar cada realidad permite hacer estrategias preventivas adecuadas. La ambliopía asociada a las patologías oftalmológicas y su período crítico de tratamiento hacen que su detección deba ser precoz. Se han establecido sugerencias de screening tanto en pacientes de riesgo como los prematuros, así como para la población general infantil


Children blindness is less frequent than in adults but the emotional and economic cost is comparatively high in children. There are 1,4 million blind children in the world from different causes specially if high, middle and low income countries are compared. Detecting each reality allows adequate prevention strategies. Amblyopic associated to ocular diseases and its critical treatment period need their detection to be early. Screening suggestions has been established for high risk patients as premature and for the general children population


Subject(s)
Humans , Amblyopia/diagnosis , Amblyopia/therapy , Blindness/prevention & control , Blindness/epidemiology
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