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dell'ambioplia analysis and treatment methods
450 years BC Hippocrates said, "If the doctor does not find any alteration in the eye of the patient, and if the patient does not see the diagnosis was amblyopia. About 2450 years have passed and this is what, with a hint of irony, writes Von Graefe "amblyopia is a condition in which the observer sees nothing and the patient very little."
E 'implied then, that during this period is not changed a lot in the behavior of this disease, have changed the course of study methods and tools to investigate the causes but, in essence, the approach and outcomes of therapy have not changed crabs. Dell'ambliopia onset is usually responsible for abnormal binocular interaction: Amblyopia is often associated with strabismus or anisometropia in infancy (video IN). The presence of conflicting signals or different from the two eyes to the cerebral cortex involves active suppression, el ' amblyopia non-dominant eye. These forms of amblyopia are unilateral. Amblyopia can also result the sense of deprivation due to cataract or complete ptosis. Sometimes a marked hyperopia or astigmatism may cause amblyopia high in both eyes, which have a deficit in visual acuity despite the correction of refractive defects. In these cases, the retina appears normal. Sometimes retinal lesions or visual pathways can cause amblyopia organic. There are clues that suggest that the mechanisms of various types of amblyopia are fundamentally different. Fortunately, treatment is the same. Nell'ambliopia Knapp and Capobianco proposed atropinizzazione healthy eye and miosis eye amblyopia. In reality, miotics are not without side effects. Recall that the PHOSPHOLIN iodide abbassa la colinesterasi nei globuli rossi, e prima che i valori si ristabiliscono devono passare diverse settimane. Inoltre ciò può costituire un rischio se il paziente deve subire una narcosi. Altri effetti sistemici secondari dei miotici sono: sudorazione, nausea, vomito, salivazione eccessiva, diarrea e crampi addominali. A livello locale, si può verificare un transitorio offuscamento della visione, un oscuramento generalizzato del campo di visione, e lo sviluppo di cisti iridee ( nella misura che va da 20% al 50%). Generalmente tali cisti scompaiono dopo la sospensione della terapia.
La penalizzazione farmacologica dell’occhio non ambliopico è un’alternativa raramente usata nel trattamento dell’ambliopia. Studies have shown that the penalty consulted with atropine is equally effective than with occlusion, whereas the data that has boosted drug treatment was the rating of the patient. In fact, all groups treated with atropine showed strong preference for the latter to the occlusion. The study + full it seemed to me that in which they evaluated three types of therapy: full time atropine, intermittent atropine and optical penalization as a primary treatment dell'ambliopia moderate and in some cases of deep amblyopia. Here again the penalty with atropine, especially intermittent, and has achieved excellent results, especially considerable, high grade both patients and parents, to suggest a re-evaluation of standard treatment for amblyopia.
AMBLYOPIA AND DRUGS
The quality of vision is closely linked to the performance of nerve cell structures related to visual function. E 'therefore important to provide the body with a system capable of maintaining physiological levels neuroprotection of phospholipids in the cell membrane. Choline is a molecule in the body and is used for the synthesis of cytidine - 5? Difosfocolina endogenous-that is also involved in the process of maturation of visual function. The citicolina a drug is safe and well tolerated as evidenced by the toxicological tests conducted. E 'indicated for the treatment of vascular diseases - brain, head trauma, cognitive disorders of different causes. Once absorbed, it is widely distributed throughout the body, crosses the blood-brain barrier, reaching the CNS. It 'been shown that the substance improves visual acuity of adults with amblyopia . Several studies have shown that AV, contrast sensitivity, and ENP change after treatment with CPD - choline (1000 mg im / day). Results: AV increases of 1.4 - 1.5 lines in the ordinance O 0.4 in normal and partially sighted. SC improves OO about 3DB ENP increase the amplitude (30%) and progresses in phase. General improvement of the factors considered. Were also observed the effects of CDP - choline associated with part-time occlusion and the results confirmed that the CDP-choline greatly enhances the effects of occlusion shortening the treatment time.
Levodopa-Carbidopa is a combination used to treat Parkinson's disease. Research has shown the effects of this combination on the visual system (1.5 mg / kg). The conclusions all lead back to a net improvement A / V and SC, the drug was well tolerated and produces significant relevant data.
Neuroimaging NELL'AMBLIOPIA
The tools used to determine the location and nature of cortical deficits are human nell'ambliopia: Functional MRI (fMRI), positron emission tomography (PET) and magnetoencephalography (MEG ). A number of cortical areas show reduced levels of activation nell'ambliope, including primary and secondary visual areas and regions within the parieto-occipital cortex and ventral temporal cortex. In the second study, the imaging results showed that adults and children with amblyopia have a decrease in gray matter in the visual cortical regions, including the calcarine division, known to contain the primary visual cortex. These results were confirmed by separate analysis of the affected areas. In children, was found a greater reduction of gray matter in the occipital and parietal areas in ventral temporal cortex, this projection is consistent with the latest report on which the cause amblyopia deficit localization and object recognition. These are the first data to provide possible neuro-anatomical basis for the loss of binocularity and visual sensitivity in children and adults with amblyopia.
acuity 'VISUAL 20/20: IL DIRITTO ALLA VISIONE
Il Direttore Generale WHO nel 1999 ha lanciato il programma Visus 20/20, “diritto alla visione”. L’iniziativa è supportata da 18 associazioni internazionali, provenienti da 11 paesi, per la prevenzione della cecità, che insieme all’Associazione Internazionale per la Prevenzione alla Cecità hanno accolto la causa di liberare il mondo dalle cause prevedibili di cecità entro il 2020. Si stima che un milione e mezzo di bambini in tutto il mondo è affetto da cecità e che il 90% di essi vive nei paesi in via di sviluppo. E’ essenziale che i bambini affetti da patologie quali cataratta, opacità corneali, strabismo, errori rifrattivi non corretti, that are potential causes of amblyopia are treated as soon as possible, in order to recover a good visual acuity. Many hospitals in developing countries are in possession of a computer. Currently you can follow a squint or amblyopia via computer by simply using Microsoft Windows 95 or its equivalent, and internet access. Also the use of a digital camera will allow the hospital to be in touch and make a consultation at a distance. DR. Eugene M. Helveston, in collaboration with Orbis International, Orbis has developed the E-Consultation Program. His experience of Cuba links - Indiana has helped to get connected with the ophthalmologists Orbis Nepal from home in Canada.
Notes about
Emilia Gallo Orthoptist - Assistant in Ophthalmology Ophthalmology UOC ARNAS Garibaldi - Catania
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