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Форум » ЗАБОЛЕВАНИЯ ГЛАЗ У ДЕТЕЙ » ЗАБОЛЕВАНИЯ ГЛАЗ У ДЕТЕЙ » Диагностика миопии атропин или мидриацил
Диагностика миопии атропин или мидриацил
ТапочкаДата: Воскресенье, 31.01.2010, 18:06 | Сообщение # 1
Группа: Гости





Здравствуйте скажите пожалуйста достаточно ли капель мидриацил ( тропикамид) для диагностики миопии или нуно капать атропин. У нас участковый окулист всем назначает атропин и потом зрачки очень долго держатся широкими и у одной девочки было плохое самочувствие и вобщем мы не хотим.
Ребнок видит
0,1 по авторефрактометру -1.5 мы в частной клинике капали мидриацил - ничего не изменилось. Затем по нашей просьбе сделали цикломед - ничего не изменилось.
Стоит ли капать атропин? Наш врач в частной клинике говорит , что это пережитки прошлого и атропин сейчас при близорукости не капают.

 
vadimbondarДата: Понедельник, 01.02.2010, 08:04 | Сообщение # 2
Детский окулист
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Здравствуйте. Доктор из частной клиники прав. Атропин не нужен для проверки рефракции при миопии. Для этого достаточно тропикамида. Это общепринятая практика использовать тропикамид. Некоторые окулисты на постсоветском пространстве до сих пор убеждены в необходимости закапывания атропина. Многочисленные исследования их переубедить не могут


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vadimbondarДата: Понедельник, 01.02.2010, 08:05 | Сообщение # 3
Детский окулист
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Tropicamide (1%): an effective cycloplegic agent for myopic children.
Manny RE, Hussein M, Scheiman M, Kurtz D, Niemann K, Zinzer K; COMET Study Group.

College of Optometry, University of Houston, 505 J. Davis Armistead Bldg., Houston, TX 77204-2020, USA. rmanny@uh.edu
PURPOSE. To evaluate the cycloplegic effect of 1% tropicamide in myopic children and to determine whether its efficacy is associated with age, gender, iris color, ethnicity, magnitude of the refractive error, or latent error. METHODS. Four hundred sixty-nine children enrolled in the Correction of Myopia Evaluation Trial (COMET; a multicenter, randomized, double-masked clinical trial evaluating the rate of progression of juvenile-onset myopia in children wearing progressive-addition versus single-vision lenses) were given 1 drop of proparacaine in each eye followed 1 minute later by 1 drop of 1% tropicamide and then a second drop of 1% tropicamide 4 to 6 minutes later. Five accommodative responses to 20/100 letters located at 4 m and 33 cm were obtained in each eye with an autorefractor, 20 minutes after the second drop. Residual accommodation was calculated as the difference between the mean spherical equivalent responses obtained at the two distances. An examiner graded iris color, and ethnicity was reported by the children's parents or guardians. RESULTS. The mean residual accommodation was small: 0.38 +/- 0.41 diopters (D) in the right eye and 0.30 +/- 0.41 D in the left eye. Small but statistically significant differences in residual accommodation were associated with ethnicity, but not with any of the other factors. CONCLUSIONS. Tropicamide (1%) is an effective cycloplegic agent in myopic children.



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vadimbondarДата: Понедельник, 01.02.2010, 08:05 | Сообщение # 4
Детский окулист
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Comparison of tropicamide and cyclopentolate for cycloplegic refractions in myopic adult refractive surgery patients.

Author(s): Hofmeister EM, Kaupp SE, Schallhorn SC

Affiliation(s): Navy Refractive Surgery Center, Department of Ophthalmology, Naval Medical Center, San Diego, California 92134-1005, USA.

Publication date & source: 2005-04, J Cataract Refract Surg., 31(4):694-700.

Publication type: Clinical Trial; Randomized Controlled Trial

PURPOSE: To compare tropicamide 1%, a shorter-acting cycloplegic agent, with cyclopentolate 1% for cycloplegic refractions in adult refractive surgery patients. SETTING: Navy Refractive Surgery Center, Ophthalmology, Naval Medical Center, San Diego, California. METHODS: The study was prospective, single center, with randomized sequencing of cycloplegic agent; each patient received both agents. Thirty consecutive myopic adult refractive surgery patients (mean age 35.4 years) participated. A complete preoperative examination, including cycloplegic refraction, was obtained twice, 1 week apart. The patient and the examiner were masked to the medication. Main outcome measures included cycloplegic and manifest refractions, best corrected distance acuity, near-point accommodation, pupil diameters, and subjective appraisal of experience with cycloplegic agents. RESULTS: Twenty-eight of 30 patients completed both examinations. Both eyes were measured, but comparisons were limited to right and left eyes, independently. No statistically significant difference was found between the tropicamide and cyclopentolate cycloplegic refractions (mean difference in MSE +/- SD, OD=0.054 +/- 0.214 diopters (D), t=1.33, P=.10; OS=0.054 +/- 0.253 D, t=1.12, P=.14). Five eyes of 3 patients had a difference of 0.50 D or greater between the 2 agents; less myopia with cyclopentolate. Near-point testing revealed less residual accommodation with cyclopentolate (difference in MSE, OD=-0.27 +/- 0.51 D, t=2.68, P=.006; OS=-0.32 +/- 0.49 D, t=3.46, P=.001). Subjectively, 24 of 28 (86%) patients preferred tropicamide, 1 (4%) preferred cyclopentolate, and 3 (10%) had no preference. CONCLUSIONS: There was no statistically significant difference in mean cycloplegic refractions. Cyclopentolate was more effective than tropicamide in reducing accommodative amplitude in adult myopes (near-point testing). Patients strongly preferred tropicamide.



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vadimbondarДата: Понедельник, 01.02.2010, 08:06 | Сообщение # 5
Детский окулист
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The cycloplegic effects of cyclopentolate and tropicamide on myopic children.
Lin LL, Shih YF, Hsiao CH, Su TC, Chen CJ, Hung PT.

Department of Ophthalmology, National Taiwan University, Taipei, Republic of China.
Thirty-seven myopic children were given either 1-2 drops of 1% cyclopentolate or 1% tropicamide twice with 5 min intervals to evaluate the time course and maximal cycloplegic effect of both agents. The other fifteen subjects were given 1% tropicamide initially, then 1% cyclopentolate given after 30 min of maximal effect of tropicamide appeared to evaluate whether the effect of cyclopentolate was superior to tropicamide. Cycloplegic refraction was measured with an auto-refractometer (Topcon RK-3000) before drug delivery and every 15 min thereafter, for 90 min. The maximal cycloplegic effect of cyclopentolate was around 45 min, then it remained stable until 90 min after the last instillation. The effect of tropicamide was faster than that of cyclopentolate. It was around 30 min, then it stabilized until 75 min. The extra effect of cyclopentolate over tropicamide was minimal (only -0.1D). The power of cornea and astigmatism were not affected by either agent. However, a big variation in astigmatism was noted during the course, especially with cyclopentolate. This study suggests that 1% tropicamide should be a good agent for routine refractive status checking on myopic children.



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Форум » ЗАБОЛЕВАНИЯ ГЛАЗ У ДЕТЕЙ » ЗАБОЛЕВАНИЯ ГЛАЗ У ДЕТЕЙ » Диагностика миопии атропин или мидриацил
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