小児の弱視と視機能発達

出版社： 三輪書店
著者：
発行日： 2020-09-25
分野： 臨床医学：外科  >  眼科学
ISBN： 9784895906975
電子書籍版： 2020-09-25 （第1版第1刷）
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「弱視(amblyopia)」は、斜視・屈折異常・形態覚遮断などが原因となる小児で最も頻度の高い視力の発達障害であるが、弱視のみを単独で解説している書籍はこれまでほとんど存在しない。本書は、弱視の病態・検査・治療を深く多面的に学べるよう数多くの科学的根拠(エビデンス)を紹介し、基礎研究から最新の臨床まで幅広く取り上げている。弱視の病態に合わせてエビデンスに基づいた治療を選択する助けになり、小児眼科に携わる眼科医療者にとって必携の書籍である。

目次

  • Chapter1

    1　弱視の定義
    “弱視”とは何を指すのか?
    社会的・教育的弱視(ロービジョン:low vision)と機能的・医学的弱視(amblyopia)
    弱視(amblyopia)の定義
    弱視の定義の歴史的変遷
    弱視に関連した用語

    2　小児の正常視機能発達
    形態的発達
    視力の正常発達
    両眼視機能の正常発達
    視野の正常発達

    3　弱視の疫学と頻度
    弱視の有病率
    片眼弱視と両眼弱視の頻度

    4　弱視の分類
    弱視の原因別分類
    形態覚遮断弱視
    屈折異常弱視
    不同視弱視
    経線弱視
    斜視弱視
    微小斜視弱視

    5　眼振と弱視
    先天眼振
    先天眼振と弱視

    6　弱視と鑑別が必要な疾患
    弱視と間違われやすい網膜疾患
    弱視と間違われやすい視神経疾患
    弱視と間違われやすいその他の疾患

    7　弱視の研究
    A　動物モデル
    視覚神経経路
    大脳皮質でみられる両眼反応性とコラム構造
    動物モデルにおける弱視の誘導
    動物における視機能の評価
    片眼遮閉による生理学的な活動変化
    片眼遮閉による解剖学的な構造変化
    弱視が起こる時期
    弱視を引き起こす分子メカニズム
    弱視の治療に向けた基礎研究

    B　ヒト弱視
    心理物理
    機能画像
    電気生理(網膜電図・視覚誘発電位)
    対光反射
    OCT

    8　弱視の社会的影響
    弱視患者の意識調査
    両眼性視覚障害のリスク
    就労に視力の制限がある職業や資格

    Chapter2　弱視の検査

    1　医療面接
    医療面接とは
    医療面接の流れ

    2　屈折検査
    調節麻痺薬の種類と副作用
    他覚的屈折検査
    自覚的屈折検査

    3　視力検査
    固視反応
    嫌悪反射
    縞視力測定法
    ドットカード法(森実式ドットカード)
    ランドルト環を用いた視力検査

    4　固視検査
    両眼性固視検査
    単眼性固視検査

    5　4プリズム基底外方試験
    4プリズム基底外方試験

    6　両眼視機能検査
    立体視検査
    弱視と立体視

    7　眼位検査
    眼位検査

    8　眼底検査
    眼底検査
    弱視の眼底所見

    9　限界フリッカ値,色覚,視野
    限界フリッカ値
    色覚
    視野

    Chapter3 　弱視の治療

    1　弱視の治療時期
    弱視の治療開始時期
    何歳まで視力回復は可能か?
    弱視や顕性斜視のない中等度遠視に対する治療介入時期

    2　弱視の治療法
    屈折矯正
    健眼遮閉
    健眼アトロピン点眼
    眼間抑制の低減を目標とした新たな治療法
    薬物治療
    反復経頭蓋磁気刺激法

    3　弱視の分類別治療法
    偏心固視を伴う弱視
    形態覚遮断弱視
    斜視弱視
    不同視弱視
    屈折異常弱視

    4　治療中の近見作業
    近見作業による視的学習
    弱視訓練としての作業手法

    5　弱視治療のEBM
    根拠に基づく医療(evidence based medicine)
    PEDIGの弱視治療研究(ATS)
    屈折矯正のEBM
    完全遮閉(健眼遮閉)のEBM
    不完全遮閉(Bangerter遮閉膜,健眼アトロピン点眼)のEBM
    近見作業のEBM
    年齢と治療成績の関連
    弱視の予後と再発のリスク
    PEDIGの結果と諸外国の治療方針

    6　治癒基準と再発
    弱視の治癒基準
    弱視の再発

    7　健診による弱視の発見
    小児期の健康診査・健康診断に関する法令
    健康診査における視覚異常の判定
    健診による弱視の発見

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

Chapter 1 弱視の病態

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Chapter 2 弱視の検査

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Chapter 3 弱視の治療

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