Tsitsiashvili E
Georgian National Center of Ophthalmology and Neurology, Tbilisi.
Georgian Med News. 2007 Sep(150):7-10.
Under amblyopia one ought to understand a variety by origin forms of reduction of vision the reason for which are functional disorders of the visual analyzer with no changes in the fundus of the eye and without any organic affections of the visual pathways and centers. At the present time, the pathophysiological mechanisms of amblyopia remain a puzzle. Diagnostics and adequate treatment of amblyopia remains so far a topical problem in clinical ophthalmology. The objective of our investigation was to estimate functional state of the visual system and efficiency of treatment of amblyopia of varying degree by means of special computer programs. Clinical researches were based on the analysis of results of 317 patients (410 eyes) with anisometropic (120 patients-120 eyes), disbinocular (127 patients-150 eyes) and refractive (70 patients-140 eyes) amblyopias of different degrees at the age from 5 to 17 with visual acuity from 0.05 up to 0.5 on the amblyopic eye, with the symptoms of functional disturbance: decrease in achromatic and color spatial contrast sensitivity in the domain of high and middle frequencies; decrease in contrast sensitivity of on-off channels of the retinal cone system; normal sensitivity to saturated colors; decrease in color sensitivity to unsaturated, red and green colors; dramatic changes in color (red and green) sensitivity in the paracentral zone (5 degrees -10 degrees ) of the retina and 20 healthy children-40 eyes. In addition to routine ophthalmologic methods we also used the special computer programs for diagnostics and adequate treatment of amblyopia: "ZEBRA"; "OFF-ON"; "eYe" ("Shooting-gallery", "Chase", "Crosses","Spiders"); "Contour"; "MEKO" ("KONSTR", "UFO", "SHOW"). Statistical analysis of results was performed with statistical method "ANOVA". Diagnostical computer methods enable quantitative estimation of the functional state of different channels of the visual system (based on the data of spatial contrast, light, color and contrast sensitivity); pathophysiologically substantiated computer methods for the treatment of amblyopia and restoration of binocular function are characterized by a high efficiency according to all accepted criteria for the evaluation of the functional state of the visual system; the patients thanks to the game character and diversity of exercises show interest in the treatment; the methods mentioned above may be actively applied in clinical practice.
弱视是指各种起源形式的视力减退,其原因是视觉分析器的功能障碍,眼底无变化,视觉通路和中枢无任何器质性病变。目前,弱视的病理生理机制仍是一个谜。弱视的诊断和适当治疗至今仍是临床眼科的一个热门问题。我们研究的目的是通过特殊的计算机程序评估视觉系统的功能状态以及不同程度弱视的治疗效果。临床研究基于对317例患者(410只眼)的结果分析,这些患者年龄在5至17岁,患有不同程度的屈光参差性弱视(120例患者 - 120只眼)、双眼视异常性弱视(127例患者 - 150只眼)和屈光不正性弱视(70例患者 - 140只眼),弱视眼视力从0.05至0.5,伴有功能障碍症状:高中频区域的消色差和颜色空间对比敏感度降低;视网膜锥系统开 - 关通道的对比敏感度降低;对饱和颜色的敏感度正常;对不饱和、红色和绿色颜色的颜色敏感度降低;视网膜旁中心区(5度 - 10度)颜色(红色和绿色)敏感度的显著变化,以及20名健康儿童 - 40只眼。除了常规眼科方法外,我们还使用了用于弱视诊断和适当治疗的特殊计算机程序:“ZEBRA”;“OFF - ON”;“eYe”(“射击场”、“追逐”、“十字”、“蜘蛛”);“轮廓”;“MEKO”(“KONSTR”、“UFO”、“SHOW”)。结果采用“方差分析”统计方法进行统计分析。诊断性计算机方法能够对视觉系统不同通道的功能状态进行定量评估(基于空间对比、光、颜色和对比敏感度的数据);根据所有公认的视觉系统功能状态评估标准,用于弱视治疗和双眼功能恢复的病理生理学依据充分的计算机方法具有很高的效率;由于游戏性质和练习的多样性,患者对治疗表现出兴趣;上述方法可积极应用于临床实践。