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Augenheilkunde up2date 2018; 8(02): 127-136
DOI: 10.1055/a-0584-9264
Kinder- und Neuroophthalmologie, Strabismus
Georg Thieme Verlag KG Stuttgart · New York

Update Augenheilkunde – Amblyopie und Refraktionsfehler

Amblyopia and refractive error
Lutz Joachimsen
,
Nikolai J. Gross
,
Wolf A. Lagrèze
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Publikationsverlauf

Publikationsdatum:
17. Mai 2018 (online)

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Zusammenfassung

Der folgende Beitrag stellt zwei aktuelle Themen der Kinderophthalmologie in den Fokus, die vermutlich auch immer wieder in der kinder- und jugendärztlichen Praxis relevant sein werden: die Amblyopie und ihre Früherkennung inklusive Videorefraktometrie und Refraktionsfehler im Schulkindalter mit Fokus auf Myopie, deren Häufigkeit weltweit zunimmt

Abstract

Myopia is on the increase worldwide and will become a major challenge over the next decades in terms of secondary ophthalmologic complications. There are effective therapeutic options available to slow or prevent the progression of myopia. So far, it has not been investigated whether there are possible additive effects of these interventions. Further investigations – especially in Caucasian populations – are necessary to verify the study results available from Asia. There is limited data on how long further progression of myopia is preventable. A therapy appears reasonable as long as a progression of myopia is detectable.

Consistent childhood amblyopia screening provides a cost-effective measure for the prevention of visual disturbances over the course of life. How this can be best integrated into the existing system of “U-investigations”, must be clarified by the cost-bearers and professional associations. This discourse should be supported by close interdisciplinary exchange and further studies on the prevalence of different degrees of amblyopia. In addition, sensitive and specific or even multi-stage tests should be developed in order to implement an early detection that is cost-effective and saves resources.

Kernaussagen

  • Die Myopie nimmt weltweit zu und wird in den nächsten Jahrzehnten zu einer großen Herausforderung hinsichtlich ihrer sekundären ophthalmologischen Komplikationen.

  • Es sind effektive therapeutische Möglichkeiten verfügbar, um das Fortschreiten einer Myopie zu verlangsamen bzw. ihr Auftreten zu verhindern.

  • Bislang wurde noch nicht untersucht, ob es mögliche additive Effekte dieser Interventionen gibt.

  • Weiterführende Untersuchungen – gerade an kaukasischen Populationen – sind notwendig, um die Übertragbarkeit der aus Asien vorliegenden Studienergebnisse zu überprüfen.

  • Es liegen nur wenige Daten vor, wie lange gegen ein weiteres Fortschreiten einer Myopie behandelt werden soll. Eine Therapie erscheint so lange sinnvoll, wie eine Progression der Kurzsichtigkeit nachweisbar ist.

  • Ein konsequentes Amblyopie-Screening im Kindesalter bietet eine kosteneffektive Maßnahme zur Prävention von Sehstörungen im Verlauf des weiteren Lebens. Wie dieses am besten in das bestehende System der U-Untersuchungen integriert werden kann, muss durch die Kostenträger und Berufsverbände geklärt werden.

  • Unterstützt werden soll dieser Diskurs durch engen interdisziplinären Austausch und weiterführende Studien zur Prävalenz verschiedener Schweregrade von Amblyopie. Zudem sollen sensitive und spezifische oder sogar mehrstufige Tests erarbeitet werden, um eine kosteneffektive und ressourcensparende Früherkennung umzusetzen.

Schlüsselwörter

Amblyopie - Refraktionsfehler - Myopie - Brückner-Test

Key words

ambyopia - refractive error - myopia - Bruckner testing
 

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