Zusammenfassung
Zweck: Darstellung der Visusprognose bei hochgradiger Amblopie unter Therapie. Methoden: Literaturreview nach Recherche in PubMed. Ergebnisse: Übereinstimmend kommen die Studien für hohe Amblyopie durch Anisometropie und/oder Strabismus zu besseren Visusergebnissen bei frühem Therapiebeginn. Es wird bei Kindern unter 7 Jahren ein Visus bei Therapieende von mindestens 0,4 (logMAR 0,4), d. h. Lesefähigkeit, erreicht. Bei Therapiebeginn führt auch eine Partialokklusion mit niedrigen Stundenzahlen bereits zu einem Visusanstieg. Ein schlechterer Visus bei Therapieende verschlechtert die Langzeitprognose. Anisomyopie hat eine schlechtere Visusprognose als Anisohyperopie. Neuere Studien über langfristige Okklusionstherapie mit dadurch eventuell noch besserem Endvisus und damit weniger Amblyopierezidiven und besserer Langzeitprognose fehlen. Schlussfolgerungen: Screening und frühe und langfristige Therapie ist zur Reduktion der Prävalenz hoher Amblyopien erforderlich.
Abstract
Purpose: The aim of this study was to characterise the visual acuity prognosis in the therapy for severe amblyopia. Methods: Literature review on the basis of studies in PubMed was undertaken. Results: The studies investigating severe amblyopia due to anisometropia and/or strabismus are unanimous in their finding that the early onset of therapy leads to better results for visual acuity. In children under the age of seven years a visual acuity of at least 0.4 (logMAR 0.4); that is, the ability to read, is achieved. At the beginning of therapy, even a partial occlusion with a limited number of hours already shows an improvement in visual acuity. Poor visual acuity at the end of therapy worsens the long-term prognosis. Anisometropia has a poorer visual acuity prognosis than anisohyperopia. Recent studies investigating the possibility of still better visual acuity, and therefore less recurrence of amblyopia and better long-term prognosis, following long-term occlusion therapy are lacking. Conclusions: Screening and early and long-term therapy are necessary in order to reduce the prevalence of severe amblyopia.
Schlüsselwörter
Amblyopie - Strabismus - Anisometropie - Ametropie - Astigmatismus
Key words
amblyopia - strabismus - anisometropia - ametropia - astigmatism
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Prof. Dr. Gabriele-Charlotte Gusek-Schneider
Augenklinik, Universitätsklinikum Erlangen
Schwabachanlage 6
91054 Erlangen
Phone: ++ 49/91 31/8 53 44 89
Fax: ++ 49/91 31/8 53 46 49
Email: gabriele.gusek-schneider@uk-erlangen.de
