Povezanost položaja očiju u budnom stanju I vestibulookularnog refleksa Kod zdrave novorođenčadi

Abstract

Posmatranje položaja očiju i njihove usklađenosti na najranijem uz- rastu je od izuzetne važnosti. Bitan preduslov za normalan razvoj vidne funkcije je paralelan položaj očiju. Razne devijacije ili skretanje oka, koje se mogu evidentirati već kod novorođenčadi i ukazivati na nedozrelost struktura centralnog nervnog sistema, istovremeno mogu biti i predik- tor pojave strabizma odnosno razrokosti. Učestalost ovog poremećaja kod dece je do 5%. S obzirom da se strabizam često susreće kod dece koja pokazuju poteškoće u savladavanju veština čitanja i pisanja, neophodno ga je što ranije otkriti kako bi se preduzele mere za pravovremenu korekciju. Inter- val između početka razrokosti i tretmana je ključni faktor za postizanje boljeg kvaliteta binokularnog vida. Cilj ovog rada je bio da utvrdi da li postoji povezanost između položa- ja očiju u budnom stanju i vestibulookularnog refleksa kod beba ispitanih neposredno po rođenju. Posmatranje položaja očiju u budnom stanju (POB) i testiranje vesti- bulo-okularnog refleksa (VOR), sprovedeno je u Institutu za ginekologiju i akušerstvo Kliničkog centra Srbije (IGA KCS), na uzorku od N=100 no- vorođenčadi. Kriterijumi za odabir ispitivanog uzorka su bili sledeći: uredne trudnoće, zdrava terminska novorođenčad, najviše vrednosti Apgar scor-a 9 ili 10, starosna dob novorođenčeta u vreme ispitivanja – 3. dan po rođenju, približno jednak broj novorođenčadi muškog i ženskog pola. U test situaciji, ispitivana beba je morala biti naspavana, u stanju optimalne relaksiranosti i kooperabilnosti. Kod sve novorođenčadi uzeti su podaci o polu, telesnoj težini (TT), telesnoj dužini (TD) i obimu glave (OG). Dobi- jeni podaci su dokumentovani uz pomoć digitalne kamere, zatim bodovani, statistički i deskriptivno obrađeni. Rezultati istraživanja su pokazali da ne postoji statistički zna- čajna povezanost između prisutnosti VOR s jedne strane, i položaja očiju kod novorođenčadi u budnom stanju, s druge strane. Dakle, stepen prisutno- sti pomenutog refleksa nije povezan sa time da li oči bebe imaju normalnu poziciju (kada su u srednjoj liniji) ili njihova pozicija odstupa od normale (kada nisu u srednjoj liniji).

Observing the position of the eyes in the awake state and their alignment at the earliest age is of great importance. An essential prerequisite for normal visual development is parallel position of the eyes. Various deviations or deflections of the eye, that may already be recorded in newborns and indicate immaturity of the structure of the central nervous system, at the same time can be a predictor of occurrence of strabismus. The incidence of this disorder in children is up to 5%. Since the strabismus is frequently found in children who show difficulties in mastering the skills of reading and writing, it is necessary to detect it as early as possible in order to undertake certain exercises for timely correction. The interval between the onset of strabismus and the treatment is the key factor for achieving a better quality of binocular vision. The aim of this study was to determine whether there is a correlation between ocular alignment in the awake state and vestibulo-ocular reflex in healthy babies immediately after birth. Observation of ocular alignment in the awake state (OAA) and testing vestibulo-ocular reflex (VOR), were conducted at the Institute of Gynecology and Obstetrics, Clinical Center of Serbia, on a sample of N = 100 newborns. Criteria for the selection of tested sample were as follows: regular pregnancies and childbirth, healthy newborns, full-term newborns, maximum value of Apgar scores (9 or 10), infant age at the time of testing – the third day upon birth and approximately the same number of male and female babies. In the test situation, a baby who is tested should be rested and relaxed. Besides that, data on body mass on birth, body weight (BW), body length (BL) and head circumference (HC) were recorded for all newborns. The obtained results were recorded by means of a digital camera, then scored and statistically and descriptively processed.The research results showed that there was no statistically significant correlation between the presence of a VOR on the one hand, and the ocular alignment in newborns in the awake state, on the other hand. Thus, the degree of presence of the aforementioned reflex is not associated with the fact that baby‘s eyes have the normal position (when they are in the midline), or their position deviates from the norm (when they are not in the midline).