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患有RP的儿童是否适合采用光刺激疗法?

作者:冰琴
来自:
人气:1279
2012-09-24

以下回复来自美国著名眼科医生,CCRP顾问委员郭兆源医师,特此感谢!

译文
首先,据我所知,光刺激法是80多年前在欧洲被开发出来用以治疗弱视的。在中国目前人们仍在使用它,但在美国已没有人使用它,因为遮盖法是治疗的首选方法。其次,一些人认为光线会加速视网膜的营养不良。在视紫红质基因突变引起的视网膜变性过程中,光毒性(光线)可能起到了不良作用。然而,现在并没有直接证据证明光线对RP的不良影响,但患者仍应尽量避免强光的刺激。因此,如果患儿仍处在治疗弱视的关键时期(通常在7岁之前,也可延伸到十一二岁),我建议最好的治疗办法是遮挡视力好的眼睛,而不是使用光刺激疗法。

 

如上所述,现在治疗弱视最好的选择是遮盖视力好的眼睛,从而强迫患儿在一段时间内使用视力差的眼睛。另外,如有必要,可以给患儿佩戴矫正眼镜,或进行斜视手术或其他必要的手术以提高其弱视眼的视力。

英文原文:
 First, as I understand it, photostimulation was developed more than 80 years ago in Europe to treat certain amblyopia. People are still doing it in China. But in the US, no one is doing it, because occlusion/patching is the treatment of choice. Second, light is considered by some to be accelerator of retinal dystrophy. Phototoxicity likely plays a role in retinal degeneration caused by rhodopsin mutations. However there is no direct evidence demonstrating that light is a modifier of RP. It is still prudent to protect from high level of light exposure. Therefore, I would advise patching the good eye rather than using photostimulation to treat amblyopia if the patient is still within the critical time for treatment, usually before age 7 ( it can be extended to early teens.)

 

To correct amblyopia, the treatment of choice is to cover the good eye to force the use of the weak eye for a period of time. If necessary, the child should also be fitted with the correct glasses or to have strabismus or other surgery to help improve the condition of the weak eye.
 

(译者:木星)

 

录入:伊然 添加:2012-09-24
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