OÊı·ÏÌÔÏÔÁ›· - Πανελλήνια Οφθαλμολογική Εταιρεία

OÊı·ÏÌÔÏÔÁ›·, 14, 2 (2002) 185ÙȘ appleÚÒÙ˜ ‚‰oÌ¿‰Â˜ Ù˘ ˙ˆ‹˜, Ì ÂÎÎÚ›ÛÂȘ ‚ÏÂÓ-ÓÒ‰ÂȘ ‹ ‚ÏÂÓÓoapple˘Ò‰ÂȘ. ∏ ‰È¿ÁÓˆÛË Â›Ó·È Â‡ÎoÏË,‚·ÛÈṲ̂ÓË ÛÙo ÈÛÙoÚÈÎfi Î·È ÙËÓ ÎÏÈÓÈ΋ ÂͤٷÛË. ∏‰È·ÊoÚÈ΋ ‰È¿ÁÓˆÛË ı· Á›ÓÂÈ ·applefi ÙËÓ ÂappleÈappleÂÊ˘Î›ÙÈ-‰·, ÙËÓ ·appleo˘Û›· ‹ ·ÙÚËÛ›· ÙˆÓ ‰·ÎÚ˘˚ÎÒÓ ÛËÌ›-ˆÓ, Ùo Û˘Ú›ÁÁÈo Ùo˘ ÚÈÓo‰·ÎÚ˘˚Îo‡ applefiÚo˘, Ùo Û˘Á-ÁÂÓ¤˜ ÁÏ·‡ÎˆÌ· Î·È ÙË ‰·ÎÚ˘o΢ÛÙ›Ùȉ·3.∏ Û˘¯Ó‹ ·˘ÙfiÌ·ÙË ‰È¿ÓoÈÍË Ùo˘ ÚÈÓo‰·ÎÚ˘˚Îo‡applefiÚo˘, ÂappleÈ‚¿ÏÏÂÈ ÙËÓ ·Ó·ÌoÓ‹ ηٿ Ùo˘˜ appleÚÒÙo˘˜Ì‹Ó˜ Ù˘ ˙ˆ‹˜ (̤¯ÚÈ ÙoÓ 8o-12o Ì‹Ó·) Ì ÙoappleÈ΋·ÓÙÈ‚ÈoÙÈ΋ ·ÁˆÁ‹ Î·È ˘‰ÚoÛÙ·ÙÈÎfi Ì·Û¿˙ Ùo˘ÚÈÓo‰·ÎÚ˘˚Îo‡ applefiÚo˘. ªÂ ÙËÓ Ù·ÎÙÈ΋ ·˘Ù‹ ·appleoη-ı›ÛÙ·Ù·È Ë ‚·ÙfiÙËÙ· Ùo˘ applefiÚo˘ ηٿ ÙoÓ appleÚÒÙo¯ÚfiÓo Ù˘ ˙ˆ‹˜ ÛÙo 88-96% ÙˆÓ apple·È‰ÈÒÓ. ∞ÏÏ¿ ηÈÙ· ÌÈÛ¿ apple·È‰È¿ ·applefi ÂΛӷ appleo˘ Û˘Ó¯›˙o˘Ó Ó· ‰·-ÎÚ‡˙o˘Ó ÌÂÙ¿ ÙoÓ appleÚÒÙo ¯ÚfiÓo, ‚ÂÏÙÈÒÓoÓÙ·È ÛËÌ·-ÓÙÈο ̤¯ÚÈ ÙoÓ 18o Ì‹Ó·4. °È· Ù· ˘applefiÏoÈapple· apple·È‰È¿Ë ÎÏ·ÛÛÈ΋ ·ÓÙÈÌÂÙÒappleÈÛË Â›Ó·È o ηıÂÙËÚÈ·ÛÌfi˜Ù˘ ÚÈÓo‰·ÎÚ˘˚΋˜ o‰o‡ Î·È Ë appleχÛË Ì oÚfi ‹Î˘·Óo‡Ó Ùo˘ ÌÂı˘ÏÂÓ›o˘ ÁÈ· ÙËÓ ÂappleȂ‚·›ˆÛË Ù˘‰È¿ÓoÈ͢ Ùo˘ applefiÚo˘ ˘applefi ÁÂÓÈ΋ ·Ó·ÈÛıËÛ›· ‹ ̤ıË.∞ÛıÂÓ›˜ Î·È Ì¤ıo‰o˜∞applefi Ùo 1982 ̤¯ÚÈ Ùo 2001, 214 ‚Ú¤ÊË ˘appleo‚Ï‹ıË-Î·Ó Û ηıÂÙËÚÈ·ÛÌfi Ù˘ ÚÈÓo‰·ÎÚ˘˚΋˜ o‰o‡ ˘applefi ̤ıË.∏ ËÏÈΛ· ÙˆÓ apple·È‰ÈÒÓ ÂÎ˘Ì·›ÓÂÙo ·applefi 8 ÌËÓÒÓ Ì¤-¯ÚÈ 2,5 ¯ÚoÓÒÓ, Ì ̤Ûo fiÚo Ùo˘˜ 11 Ì‹Ó˜. 61 apple·È‰È¿ ›-¯·Ó ·ÌÊoÙÂÚfiappleÏ¢ÚË ·applefiÊÚ·ÍË Î·È ¤ÙÛÈ o Û˘ÓoÏÈÎfi˜·ÚÈıÌfi˜ ÙˆÓ oÊı·ÏÌÒÓ ‹Ù·Ó 275. Ù· 215 Ì¿ÙÈ· ÌÂÙ¿ÙoÓ Î·ıÂÙËÚÈ·ÛÌfi ¤ÁÈÓ appleχÛË Ù˘ ÚÈÓo‰·ÎÚ˘˚΋˜ o‰o‡Ì oÚfi ‹ ΢·Óo‡Ó Ùo˘ ÌÂı˘ÏÂÓ›o˘, Û ÌÂÁ¿ÏË ·Ú·›ˆÛË.Ù· 60 Ì¿ÙÈ· Ë appleχÛË ‰ÂÓ ÂÊ·ÚÌfiÛıËÎÂ. fiÏ· Ù· appleÂÚÈÛÙ·ÙÈο ÁÈ· 4-5 Ë̤Ú˜ appleÚÈÓ ·applefi ÙoÓηıÂÙËÚÈ·ÛÌfi ‰ÈÓfiÙ·Ó ÙoappleÈ΋ ·ÓÙÈ‚ÈoÙÈ΋ ·ÁˆÁ‹ ηÈÁÈ· 5 Ë̤Ú˜ ÌÂÙ¿ ÙoÓ Î·ıÂÙËÚÈ·ÛÌfi ‰ÈÓfiÙ·Ó ÌÈÎÙfiÎoÏχÚÈo (·ÓÙÈ‚ÈoÙÈÎfi Î·È ÎoÚÙÈ˙fiÓË).∞appleoÙÂϤÛÌ·Ù·∏ ‰È¿ÓoÈÍË Ùo˘ ÚÈÓo‰·ÎÚ˘˚Îo‡ applefiÚo˘ Î·È Ë·apple·ÏÏ·Á‹ Ùo˘ ÌÈÎÚo‡ ·ÛıÂÓ‹ ·applefi ÙËÓ ÂappleÈÊoÚ¿Î·È ÙȘ ‚ÏÂÓÓoapple˘Ò‰ÂȘ ÂÎÎÚ›ÛÂȘ appleÚ·ÁÌ·ÙoappleoÈ‹-ıËΠ۠appleoÛoÛÙfi 88-90% Î·È ÛÙȘ ‰‡o oÌ¿‰Â˜ (189Ì¿ÙÈ· ·applefi Ù· 215 Ì appleχÛË ÌÂÙ¿ ÙoÓ Î·ıÂÙËÚÈ·ÛÌfiÎ·È 55 Ì¿ÙÈ· ·applefi Ù· 61 ¯ˆÚ›˜ appleχÛË ÌÂÙ¿ ÙoÓ Î·-ıÂÙËÚÈ·ÛÌfi).Δ· ˘applefiÏoÈapple· apple·È‰È¿ ›¯·Ó ·appleoηٿÛÙ·ÛË Ù˘·applefiÊڷ͢ ‹ ‚ÂÏÙ›ˆÛË ÙˆÓ Û˘ÌappleÙˆÌ¿ÙˆÓ ÌÂÙ¿·applefi ıÂÙÈÎfi ηıÂÙËÚÈ·ÛÌfi appleo˘ appleÚ·ÁÌ·ÙoappleoÈ‹ıËÎÂ3-5 Ì‹Ó˜ ÌÂÙ¿ ·applefi ÙoÓ appleÚÒÙo.˘˙‹ÙËÛËO ηıÂÙËÚÈ·ÛÌfi˜ Ù˘ ÚÈÓo‰·ÎÚ˘˚΋˜ o‰o‡ ›-Ó·È ·appleoÙÂÏÂÛÌ·ÙÈ΋ ̤ıo‰o˜ ‰È¿ÓoÈ͢ Ù˘ Û˘Á-ÁÂÓo‡˜ ·applefiÊڷ͢ Ùo˘ ÚÈÓo‰·ÎÚ˘˚Îo‡ applefiÚo˘, ÁÈ·Ùo˘˜ ·ÛıÂÓ›˜ ÂΛÓo˘˜ appleo˘ Ë ‰È¿ÓoÈÍË ‰ÂÓ ¤ÁÈÓ·˘ÙfiÌ·Ù· ̤¯ÚÈ ÙoÓ 8o-12o Ì‹Ó· Ù˘ ˙ˆ‹˜. ∏ ·Ó·-ÌoÓ‹ ÁÈ· Ù˘¯fiÓ ·˘ÙfiÌ·ÙË ‰È¿ÓoÈÍË Ùo˘ applefiÚo˘ ÎÚ›-ÓÂÙ·È ·apple·Ú·›ÙËÙË, ‰Â‰o̤Óo˘ Ùo˘ ˘„ËÏo‡ appleoÛo-ÛÙo‡ ÙˆÓ apple·È‰ÈÒÓ appleo˘ ·apple·ÏÏ¿ÛÛoÓÙ·È ÙˆÓ Û˘-ÌappleÙˆÌ¿ÙˆÓ Ù˘ ·applefiÊڷ͢ ̤۷ ÛÙoÓ appleÚÒÙo ¯Úfi-Óo Ù˘ ˙ˆ‹˜ Ùo˘˜, Ì ÙËÓ ‚o‹ıÂÈ· Ù˘ Û˘ÓÙËÚËÙÈ΋˜·ÁˆÁ‹˜5. ∏ Û˘ÓÙËÚËÙÈ΋ ·ÁˆÁ‹ Û˘Ó›ÛÙ·Ù·È ·Ê’ÂÓfi˜ ÛÙËÓ ÙoappleÈ΋ ·ÓÙÈ‚ÈoÙÈ΋ ·ÁˆÁ‹, ·Ê’ ÂÙ¤Úo˘ÛÙo ηıËÌÂÚÈÓfi Ì·Û¿˙ Ùo˘ applefiÚo˘. ∂ÎÙfi˜ Ù˘ Û˘-¯Ó‹˜ ÂÓÛÙ¿Ï·Í˘ ÙˆÓ ·ÓÙÈ‚ÈoÙÈÎÒÓ ÛÙ·ÁfiÓˆÓ Î·Ù¿ÙȘ appleÂÚÈfi‰o˘˜ ‚ÏÂÓÓoapple˘ˆ‰ÒÓ ÂÎÎÚ›ÛÂˆÓ (ÊÏÂÁÌo-Ó‹˜), Â›Ó·È ÛÎfiappleÈÌo Ó· ÂÓÛÙ·Ï¿ÛÛoÓÙ·È Î·È ÌÈ·ÊoÚ¿ ÙËÓ Ë̤ڷ ηٿ ÙȘ appleÂÚÈfi‰o˘˜ ËÚÂÌ›·˜, ÁÈ·Ó· ·appleoÙÚ¤appleÂÙ·È Ë appleÈı·ÓfiÙËÙ· Ó¤·˜ appleÚoÛ‚oÏ‹˜.Δo Ì·Û¿˙ appleÚ¤appleÂÈ Ó· ÂÊ·ÚÌfi˙ÂÙ·È Î·ıËÌÂÚÈ-Ó¿ Ì apple›ÂÛË Ùo˘ ‰·ÎÚ˘˚Îo‡ ·ÛÎo‡ Î·È Û˘Ó¤¯ÈÛËÙ˘ apple›ÂÛ˘ appleÚo˜ Ù· οو Û‡Ìʈӷ Ì ÙËÓ appleoÚ›·Ùo˘ ÚÈÓo‰·ÎÚ˘˚Îo‡ applefiÚo˘, fiappleˆ˜ appleÚÒÙo˜ appleÂÚȤ-ÁÚ·„ o Creiger (1923) 3 . ª’ ·˘ÙfiÓ ÙoÓ ÙÚfiappleo ·-ÛÎÂ›Ù·È ˘‰ÚoÛÙ·ÙÈ΋ apple›ÂÛË appleÚo˜ Ùo ÛËÌ›o ·applefi-Êڷ͢ Î·È ÌappleoÚ› Ó· ‰ËÌÈo˘ÚÁËı› ¿ÓoÈÁÌ· ÛÙËÓÌÂÌ‚Ú¿ÓË appleo˘ ÊÚ¿ÛÛÂÈ ÙoÓ applefiÚo. ∏ Ù·ÎÙÈ΋ ·˘Ù‹o‰ËÁ› ÛÂ Â˘Ù˘¯¤˜ ·appleoÙ¤ÏÂÛÌ· ÛÙo 90% ÙˆÓ appleÂÚÈappleÙÒÛˆÓ̤۷ ÛÙoÓ appleÚÒÙo ¯ÚfiÓo Ù˘ ˙ˆ‹˜. ÙȘ˘applefiÏoÈapple˜ appleÂÚÈappleÙÒÛÂȘ ÂӉ›ÎÓ˘Ù·È o ηıÂÙËÚÈ·-ÛÌfi˜ Ù˘ ÚÈÓo‰·ÎÚ˘˚΋˜ o‰o‡ 6,7 . Àapple¿Ú¯o˘Ó Û˘Á-ÁÚ·Ê›˜ appleo˘ ·Ó·Ê¤Úo˘Ó ÙËÓ ‰ÈÂÓ¤ÚÁÂÈ· Ùo˘ ηıÂ-ÙËÚÈ·ÛÌo‡ ÛÙo Â͈ÙÂÚÈÎfi È·ÙÚ›o, ÂÓÒ oÈ appleÂÚÈÛÛfi-ÙÂÚoÈ appleÚoÙÈÌo‡Ó ÙËÓ ¯ÂÈÚo˘ÚÁÈ΋ ·›ıo˘Û· Ì ÙËÓÛ˘ÓÂÚÁ·Û›· Ùo˘ ·Ó·ÈÛıËÛÈoÏfiÁo˘8-10 .ŸÏ· Ù· appleÂÚÈÛÙ·ÙÈο Ì·˜ ¤ÁÈÓ·Ó ÛÙo ¯ÂÈÚo˘Ú-Á›o Ì Ùo˘˜ ÌÈÎÚo‡˜ ·ÛıÂÓ›˜ ˘applefi ̤ıË. Ùo ÌÂ-Á·Ï‡ÙÂÚo ·ÚÈıÌfi ÙˆÓ appleÂÚÈÛÙ·ÙÈÎÒÓ ÌÂÙ¿ ÙoÓ Î·-ıÂÙËÚÈ·ÛÌfi ¤ÁÈÓ appleχÛË Ù˘ ÚÈÓo‰·ÎÚ˘˚΋˜ o‰o‡Î·È ÂappleȂ‚·›ˆÛË Ù˘ ‰È¿ÓoÈ͢ Ùo˘ applefiÚo˘.Δ· ÙÂÏÂ˘Ù·›· ¯ÚfiÓÈ· ‰oÎÈÌ¿Û·ÌÂ Î·È ‰È·appleÈ-ÛÙÒÛ·Ì Ùo ›‰Èo ηϿ ·appleoÙÂϤÛÌ·Ù· ¯ˆÚ›˜ ÙËÓappleχÛË, ÛÙȘ appleÂÚÈappleÙÒÛÂȘ appleo˘ Ë ·›ÛıËÛË Ù˘ ‰È¿ÓoÈ-͢ Ùo˘ applefiÚo˘ ηٿ ÙËÓ ÒÚ· Ùo˘ ηıÂÙËÚÈ·ÛÌo‡‹Ù·Ó ‚¤‚·ÈË.˘Ìapple¤Ú·ÛÌ·∏ appleχÛË Ù˘ ÚÈÓo‰·ÎÚ˘˚΋˜ o‰o‡ ÌÂÙ¿ ÙoÓηıÂÙËÚÈ·ÛÌfi ÁÈ· ÙËÓ Û˘ÁÁÂÓ‹ ·applefiÊÚ·Í‹ Ù˘ ‰ÂÓ