Prognostic value of visual evoked responses in childhood amblyopia.

We assessed the possible clinical utility of pattern reversal visual evoked potentials in predicting the success of pleoptic treatment. Thirty amblyopic children--16 strabismic, 11 anisometropic and three of refractive type (in all cases the amblyopia was monocular)--and ten children without amblyopia (control group) were examined by conventional psychometric methods. Visual evoked potentials (VEP) to pattern reversal stimulation were also recorded. The amblyopic group was treated with occlusion of the preferred eye for three to six months. Psychometric and VEP tests were repeated in 15 amblyopic children after the treatment. The pre-treatment VEP amplitude side-differences (between amblyopic and better fellow eye) were significant, with first positive wave, P1, being invariably lower on the amblyopic side. We correlated the side-differences in visual acuity with the corresponding side-differences in amplitude and latency of the P1 wave. In the former the correlation coefficient was r = 0.47 (p < 0.01), and in the latter r = 0.65 (p < 0.01). Latency was prolonged in the eyes with significantly reduced visual acuity in which the wave form was also typical for amblyopia. We then correlated the difference between pre- and post-treatment visual acuity of the amblyopic eye with the pre- and post-treatment difference in amplitude (correlation coeff. r-0.51 (p = 0.05)) and latency of the P1 wave (correlation coeff. r = 0.40 (p > 0.05)).(ABSTRACT TRUNCATED AT 250 WORDS)

Risks of retrobulbar application of anesthetics and drugs.

In spite of hundreds of harmless retrobulbar applications of anesthetics and drugs, a certain risk still exists. In the past ten years in our Department with 7200 retrobulbar procedures performed in local anesthesia and 12500 retrobulbar applications of the drugs (corticosteroids, antibiotics, vasodilatators) 14 incidents were registered. Palpebral chemosis and retrobulbar hematoma or eyeball protrusion were transient in 11 patients. Acute disturbance of the chorioretinal circulation occurred in three patients. In one of them vascular occlusion was total with permanent loss of vision, while in the other two recuperation of vision was the sign that vascular spasm was transient.