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NR 7-9/2007
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Trudności w
diagnostyce i leczeniu zdysocjowanego odchylenia pionowego (DVD).
Część I.
Difficulties in diagnosis
and treatment of dissociated vertical deviation (DVD). Part I.
Piotr Loba2, Anna
Broniarczyk-Loba1
1Z Przyklinicznej Poradni Leczenia Zeza przy
Uniwersyteckim Szpitalu Klinicznym nr 1 im. N. Barlickiego w
Łodzi
Z Kliniki Chorób Oczu Uniwersytetu Medycznego w Łodzi
Kierownik: prof. dr hab. n. med. Wojciech Omulecki
2Z Koła Naukowego przy Klinice Chorób Oczu
Uniwersytetu Medycznego w Łodzi
Kierownik: prof. dr hab. n. med. Wojciech Omulecki |
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| Summary: |
Dissociated vertical
deviation (DVD) is a poorly understood eye motility
disorder of unexplained etiology. It occurs as a common
hyperdeviation present in most cases of congenital
esotropia, but also appears in patients with normal
binocular vision and exotropia. DVD is a bilateral
condition, often with distinct asymmetry. Its clinical
characteristics includes elevation, extorsion and
abduction of the nonfixating eye, with fixating eye
incyclotorting concomitantly. Commonly it is associated
with a compensatory head tilt.
Main problem of DVD diagnostics of DVD is quantification
of its magnitude due to large variability of various
measurements during one eye examination, and usually one
fails trying to obtain reproducible measurements in one
patient. Therefore, establishing of a proper treatment
plan is often unfeasible. Differential diagnosis is
occasionally difficult in individuals with inferior and
superior oblique overaction with or without co-existing
DVD.
Primary goal of DVD management is to improve
patients’physical looks so that the upward turning of
the eye is hardly noticeable. Both conservative as well
as surgical treatment should be considered. Planning and
performing the effective surgery is extremely difficult
in DVD; and various surgical approaches to DVD are used
worldwide. |
| Słowa kluczowe: |
zdysocjowane odchylenie
pionowe (DVD), trudności diagnostyczne, leczenie
chirurgiczne. |
| Key words: |
dissociated vertical
deviation (DVD), diagnostic difficulties, surgical
treatment. |
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