RU2206297C2 - Method for treating the cases of deep refraction amblyopia in hypermetropic patients - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves selecting contact lens of minimum diopter tolerable by given patient. Pleoptic treatment course is administered with magnetic stimulation, laser stimulation and video computer autotraining one session of each method per day until vision acuity improvement is achieved. The contact lens diopter is increased with minimum increment improving vision acuity and healthy eye occlusion is applied in combination with functional psychological training exercises. The functional psychological training exercises with partial healthy eye occlusion is administered on the background of contact correction between pleoptic treatment courses until vision acuity improvement is achieved. EFFECT: enhanced effectiveness of treatment. 2 cl, 3 dwg

Description

 The invention relates to medicine, and more particularly to ophthalmology, and can be used to treat deep refractive amblyopia in patients with hyperopia.

 A known method of treating refractive amblyopia in patients with hyperopia. including full spectacle vision correction taking into account the astigmatic component in combination with the course of pleoptic treatment (ML Mitronina. The dissertation of the candidate of medical sciences "Comprehensive treatment of refractive amblyopia in children with hyperopia". Moscow, 1996, p. 38-45).

 However, when using spectacle correction in patients with anisometropia, it is not always possible to select the maximum spectacle correction tolerated by the patient.

 The objective of the invention is to provide an effective method for the treatment of deep refractive amblyopia in patients with hyperopia with intolerable maximum spectacle correction in order to increase visual function.

 The technical result is achieved by the fact that in the method of treating deep refractive amblyopia in patients with hyperopia, including complete optical vision correction in combination with a course of pleoptic treatment and partial occlusion of a healthy eye in combination with a set of functional psychological exercises aimed at developing associative connections in the cortex the brain, initially make the selection of a contact lens with minimal dioptric tolerated by this patient, conduct a pleoptic course about treatment to improve visual acuity, then the contact lens dioptricity is minimized to increase visual acuity and occlusion of a healthy eye is performed in combination with a set of functional psychological exercises, while a set of functional psychological exercises with partial occlusion of a healthy eye is performed against contact correction between courses pleoptic treatment to achieve maximum visual acuity, while the course of pleoptic treatment includes magnetostimulation, laser stimulation and computer-assisted auto-training for 1 sense of each method per day.

 Using the method of treating deep refractive amblyopia in patients with hypermetropia according to the invention allows to achieve the maximum possible visual functions due to the fact that the visual analyzer and the accommodation system of the eye are gradually adapting, which leads to the most complete and portable optical correction. Further, against the background of the most selected optical correction, using a set of pleoptic techniques and functional-psychological exercises, we develop connections between the central and peripheral parts of the visual analyzer. Complex pleoptic treatment increases associative interanalyzer interhemispheric cortical connections.

 The method is as follows. Initially, a contact lens is selected with the minimum dioptric tolerated by this patient, a course of pleoptic treatment is carried out to improve visual acuity, then the contact lens dioptricity is minimized to improve visual acuity and occlusion of a healthy eye is combined with a set of functional psychological exercises, and the complex is functionally -psychological exercises with partial occlusion of a healthy eye is carried out against the background of contact correction between courses of pleoptic le reading to achieve maximum visual acuity.

 The course of pleoptic treatment includes magnetostimulation, laser stimulation and video-computer auto-training for 1 session of each method per day.

Functional psychological exercises:
“Double drawings” - simultaneously draw two similar geometric figures with both hands. After the patient has mastered this drawing, the exercise becomes more complicated - at the same time draw inappropriate geometric shapes (circle and square, circle and triangle, etc.). The duration of the exercise is 5-10 minutes daily.

 “Alphabet” - touch the fingertips with one fingertip to the navel area, touch the points under the collarbone with the fingers of the other hand, and then massage the dots simultaneously for 15 seconds. At this time, start with two eyes to draw a circle clockwise, loudly pronouncing aloud the letters of the alphabet. Next, draw a figuratively two-eyed circle counterclockwise and pronounce the alphabet loudly. The duration of the task is 15 minutes daily (ML Mitronina. The dissertation of the candidate of medical sciences "Comprehensive treatment of refractive amblyopia in children with hyperopia". Moscow, 1996, p. 44-45).

 The course of pleoptoptic treatment contains magnetostimulation, laser stimulation, video-computer autotraining.

 Magnetostimulation.

 To conduct a course of magnetostimulation (RU, patent 2103961, A 61 9/00, 1998), two “BIO MPG” stimulants (Switzerland) are used simultaneously, forming a rotational pulsed magnetic field with a maximum induction of 0.25 T. The frequency of the turn pulses should be close to the patient's heart rate.

 Before each magnetostimulation session, the patient determines the pulse of the blood by finger. Devices with pulsed magnetic fields synchronize with the pulsation of blood flow. The impact is carried out simultaneously by two stimulants on the following and flies (1, 2, 3).

- to the orbit area (position 1);
- on the temporal region in the area of the outer edge of the orbit of both eyes (position 2);
- on the auricotemporal regions at the projection level of the chiasm from both sides (position 3);
- on the occipital region at the level of the projection of the cortical sections of the visual analyzer (position 4) (figure 1).

 Laser stimulation.

For laser stimulation, a helium-neon ophthalmic portable laser device "STUDIO KRUTOV" with optics made in the form of glasses is used as a source of laser radiation. The power density of the flow is 50-100 μW / cm ² . Radiation in the red region of the spectrum (wavelength 630 μm). The diameter of the laser spectrum is 6-8 mm. Stimulation was performed on both eyes, every other day, exposure time 3 minutes.

 Video-computer autotraining is carried out by watching a video with turning the screen on or off depending on the current state of biopotentials of the patient’s brain characteristic of amblyopia, thereby reinforcing the preferred, clearer perception of the subject image, i.e. increase the activity of the visual cortex. A hardware complex is used to conduct video-computer auto-training (patent RU 2061508, 1995). The complex includes an audio-video system combined with a portable electroencellograph. Before the treatment session, which consists in watching a video, sensors are applied to take an electroencephalogram from the frontal and occipital region of the brain (projection of the visual zone of the cerebral cortex). The electroencephalogram is analyzed by a computer, processed, video viewing is shown in accordance with the periods of activity of the visual zone of the cerebral cortex. The duration of the session is 20 minutes.

 Treatment of deep refractive amblyopia in patients with hyperopia is carried out for 4-6 weeks.

 Example 1. Patient C., 21 years old. Diagnosis: High degree hypermetropia of the right eye. Complex hyperopic astigmatism. Deep refractive amblyopia. Refractive anisometropia.

Visual acuity: right eye 0.08 sph ± n / a
Retinal visual acuity (ROS) 0.4
Left eye 1.0.

 A contact lens with a minimum diopter of + 3.5D was selected for tolerance in the right eye. Visual acuity in a contact lens 0.16.

 A two-week course of treatment was carried out, including magnetostimulation, laser stimulation, video-computer auto-training. Between courses of pleoptic treatment, a partial occlusion of a healthy eye is carried out in combination with functional psychological exercises. Against the background of the treatment, the visual acuity of the right eye was 0.2 sph + 1.5D sul + 1.5 ax 60 = 0.2. The nature of vision is simultaneous. ROSE OD = 0.6.

 The dioptricity of the contact lens was increased to + 5.0 D and pleoptic treatment was continued for another two weeks. Visual acuity of the right eye after treatment 0.2 spd-0.5D = 0.3.

 Then a contact lens + 7.0D is put on the right eye. After adaptation for three weeks, the visual acuity of the right eye of 0.3 sul-1.0 ax 150 = 0.4, ROS = 0.9. Six months later, the maximum visual acuity of the right eye is 0.3-0.4, ROS = 0.9-0.1.

Claims (2)

 1. A method for the treatment of deep refractive amblyopia in patients with hyperopia, including complete optical vision correction in combination with a course of pleoptic treatment and partial occlusion of a healthy eye in combination with a set of functional psychological exercises aimed at developing associative connections in the cerebral cortex, characterized in that initially they select a contact lens with the minimum diopter tolerated by this patient, conduct a course of pleoptic treatment to improve visual acuity, then minimally increase the dioptricity of the contact lens to improve visual acuity and carry out occlusion of a healthy eye in combination with a set of functional psychological exercises, while a complex of functional psychological exercises with partial occlusion of a healthy eye are performed against contact correction between courses of pleoptic treatment until maximum visual acuity.  2. The method according to p. 1, characterized in that the course of pleoptic treatment includes magnetostimulation, laser stimulation and video-computer auto-training for 1 session of each method per day.

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