Farklı şaşılıklarda optokinetik nistagmus ve duyusal testler
Optokinetic nystagmus and sensorial tests in different strabismus
Yazar: ALPAY DEMİREL
Danışman: DOÇ.DR. FATİH MEHMET MUTLU
GATA / Tıp Fakültesi / Göz Hastalıkları Ana Bilim Dalı
Derece: Tıpta Uzmanlık, 2007
Konu: Göz Hastalıkları = Eye Diseases
Dizin: Şaşılık = Strabismus

Özet:
Bu calışmanın amaci, farkli tip sasihk olgularmdaki binokulariteyi veduyusal ozellikleri saptamak ve monokuler optokinetik nistagmus (MOKN)asimetrisi ile arasmdaki iliskiyi arastirmaktir. Bes yasindan once sasihk tanisialmis 42 ezotropya, 37 ekzotropya, 10 tek tarafh Duane Tip 1 ile 11dogumsal ust oblik felci (UOF) olgusu cahsmaya ahndi. Onbes kisiden olusankontrol grubu olusturuldu. Olgulann Titmus, Randot ve Mentor testleri ileyakin ve uzak stereo keskinlik duzeyi, Bagolini test ve sinoptofor ile fuzyondurumu degerlendirildi. Olgulann ambliyopi ve disosiye vertikal deviasyon(DVD) olma durumlan belirlendi. MOKN asimetrisinin degerlendirilmesindeBarany tamburu ve videonistagmografi gibi kalitatif ve kantitatif iki yontemkullanildi, sonuclan kantitatif yontemle karsilastinrken, Barany ve VNGtestleri arasmdaki iliski arastinldi. MOKN asimetrisinin binokularitesi olmayansasihk olgulannda yuksek sikhkta oldugu goruldu. Asimetri daha 50kbinokularitesi dusuk olan ezotropyah olgularda saptandi. Ekzotropyaholgularda genellikle iyi derece binokularite saptanirken binokularitesi olmayanaz sayida ekzotrop olguda asimetri vardi. Duane tip 1'li olgularda iyiderecede binokularite ve hasta gozde OKN kazanclann dusuk olmasiylabirlikte simetrik MOKN saptandi. UOF'li olgularda mukemmel binokularite vesimetrik MOKN bulundu. Ambliyopi ve DVD ile seyreden sasihk olgulanndaMOKN asimetrisi daha fazla sikliktaydi. Barany asimetri duzeyi ile VNGasimetri indeksi arasmda anlamh ve orta-iyi duzeyde iliski saptandi. Sonucolarak, binokularite ile MOKN asimetrisi arasmda iliski mevcuttu. §asihkhastalarmda binokulariteyi veya potansiyel binokuler fonksiyonlan teshisetmede OKN degerlendirmesi yararh bir test olabilir.Anahtar kelimeler : Binokularite, MOKN,Şaşılık

Abstract:
The purpose of this study is to determine the binocularity and sensorialfeatures in different strabismus cases, and to evaluate correlation withmonocular optokinetic nystagmus (MOKN) asymmetry. Fortytwo esotropicand 37 exotropic patients diagnosed with strabismus before 5 years of age,and 10 unilateral Duane Type 1,11 congenital superior oblique palsy (SOP)cases were included. A control group consisting of 15 healty volenteers wasalso studied. The near and distance stereoacuity levels were evaluated byTitmus, Randot and Mentor tests, fusional condition was evaluated by usingBagolini test and synoptophor. Presence of amblyopia and dissociatedvertical deviation (DVD) were determined. MOKN asymmetry was evaluatedqualitatively and quantitatively by using Barany drum andvideonystagmography (VNG). While comparing the results with quantitativetechnique, the correlation between Barany and VNG tests was assesed. Highfrequency of MOKN asymmetry was detected in patients with no binocularity.Asymmetry was detected more frequently in esotropic patients with low gradeof binocularity. Although a good grade of binocularity was generally detectedin patients with exotropia, there was asymmetry in few exotropic patients withno binocularity. A good grade of binocularity in patients with Duane Type 1and symmetryc MOKN along with low OKN gain in diseased eye weredetected. Excellent binocularity and symmetryc MOKN were found in patientswith SOP. MOKN asymmetry was more frequent in amplyopic and strabismiccases with DVD. There was a significant and moderate-high gradecorrelation for asymmetry level and index between Barany and VNG tests. Inconclusion, there was a relationship between binocularity and MOKNasymmetry. OKN evaluation may be a useful test for detecting potentialbinocular functions and binocularity in patients with strabismus.Keywords : Binocularity, MOKN, strabismus