การศึกษาวิเคราะห์ลักษณะตากระตุก การวินิจฉัยและการรักษาของภาวะตากระตุกในเด็ก
คำสำคัญ:
eye movement disorders, congenital nystagmus, idiopathic infantile nystagmus, electroretinogram, infantile nystagmus, pediatric ophthalmologyบทคัดย่อ
Objective: To report the clinical characteristics, types, causes, and management of pediatric nystagmus diagnosed over a 15-year period.
Patients and Methods: A retrospective study was conducted on pediatric patients under the age of 18 years old who were diagnosed with nystagmus at Siriraj Hospital from 2005 to 2019. The patients’ demographic data, characteristics, causes, and treatments of nystagmus were collected.
Results: A total of 328 patients were enrolled. The median age at diagnosis was 1.8 years, with 180 male patients (54.9%). The most prevalent cause was nystagmus associated with retinal and optic nerve abnormalities (42.4%), followed by idiopathic infantile nystagmus syndrome (INS, 17.7%), and nystagmus associated with anterior segment abnormalities (11.6%). Idiopathic INS was more common in Down’s syndrome (37.5%) than in non-Down’s syndrome patients (14.3%). Among the electroretinogram (ERG) results for nystagmus associated with retinal or optic nerve abnormalities, 83.7% were abnormal. Treatments varied by cause, with refractive correction being the most common (40.5%). Nystagmus from central nervous system (CNS) tumors had the highest rate of surgical treatments (42.9%), while nystagmus associated with anterior segment abnormalities often required multimodal treatments (34.2%).
Conclusion: This study offers insights into the characteristics, prevalence, and treatment of pediatric nystagmus within a tertiary care hospital in Thailand. The primary cause identified was nystagmus associated with retinal/optic nerve abnormalities. ERG is recommended in uncertain diagnosis cases or when retinal function is questionable. Treatment modalities are determined by the underlying cause of nystagmus, with refractive correction being the most commonly employed approach across all causes.
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The Thai Journal of Ophthalmology (TJO) is a peer-reviewed, scientific journal published biannually for the Royal College of Ophthalmologists of Thailand. The objectives of the journal is to provide up to date scientific knowledge in the field of ophthalmology, provide ophthalmologists with continuing education, promote cooperation, and sharing of opinion among readers.
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