Russian Pediatric OphthalmologyRussian Pediatric OphthalmologyРоссийская педиатрическая офтальмология1993-18592412-432XEco-Vector8446110.17816/rpoj84461ReviewsНаучные обзорыReview ArticleClinical pathology and diagnostics of nystagmusНистагм: клиника, диагностикаhttps://orcid.org/0000-0001-7669-1256ApaevAleksander V.АпаевАлександр Вячеславович
Russian Federation

researcher

научный сотрудник

doc229@mail.ruHelmholtz National Medical Research Center of Eye DiseasesНМИЦ глазных болезней им. Гельмгольца2512202116437460111202117012022Copyright ©; 2021, Eco-VectorCopyright ©; 2021, ООО "Эко-Вектор"2021Eco-VectorООО "Эко-Вектор"https://ruspoj.com/1993-1859/article/view/84461

Optical nystagmus is an involuntary oscillatory movement. Nystagmus can occur as an isolated nosology and lead to decreased visual functions in combination with other pathologies. A decreased visual function, including visual acuity, is observed in many patients with optic nystagmus. Patients with optical nystagmus were noted by ophthalmologists with a significant difference in the acuity of monocular and binocular vision, which is much higher in the second case. As a rule, a difference is observed in visual acuity in the straight and forced position of the head. Frequently, nystagmus is combined with refractive errors. Some authors consider astigmatism the most common form of ametropia in nystagmus, and nystagmus itself, a predisposing factor for the presence of astigmatism. An important task in diagnostics is the quantitative eye movement assessments since the tactics of treatment and the prognosis of the course of the disease depend on this. One of the problems in the examination of patients with nystagmus is the assessment of the fundal condition. Modern optical coherence tomographs are helpful in the objective diagnostics of retinal structures of the posterior pole of the eye, as well as improved software, such as the “Eye Tracking” system, and an increased scanning speed allowed reliable studies even with spontaneous oscillatory eye movements and a significantly decreased visual acuity. With nystagmic relative amblyopia, both photosensitivity and fixation were violated, which may indicate the presence of organic changes in the central parts of the retina and a primary fixation violation.

Оптический нистагм — это непроизвольные колебательные движения глаз высокой частоты. Нистагм может встречаться как изолированная нозология, так и в сочетании с другой патологией, приводящей к снижению зрительных функций. У многих пациентов с оптическим нистагмом отмечается снижение зрительных функций, в том числе остроты зрения. У пациентов с оптическим нистагмом офтальмологи отмечают значительную разницу в остроте монокулярного и бинокулярного зрения, во втором случае она значительно выше. Как правило, существует разница в остроте зрения в прямом и вынужденном положении головы. Нередко нистагм сочетается с аномалиями рефракции. Некоторые авторы считают астигматизм наиболее частой формой аметропии при нистагме, а сам нистагм, предрасполагающим фактором к наличию астигматизма. Важной задачей в диагностике является количественная оценка движений глаз, так как от этого зависят тактика лечения и прогноз течения заболевания. Одной из проблем в обследовании пациентов с нистагмом является оценка состояния глазного дна. Благодаря современным оптическим когерентным томографам стала доступна объективная диагностика ретинальных структур заднего полюса глаза, а усовершенствованное программное обеспечение, система «Eye Tracking» и повышение скорости сканирования позволяют проводить достоверные исследования даже при самопроизвольных колебательных движениях глаз и значительном снижении остроты зрения. При нистагмической относительной амблиопии имеется нарушение и светочувствительности, и фиксации, что может указывать на наличие органических изменений в центральных отделах сетчатки и первичное нарушение фиксации.

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