屈光性调节性内斜视的远期双眼视功能  

BINOCULAR VISION IN REFRACTIVE ACCOMMODATIVE ESOTROPIA IN A LONG TERM

作　　者：郑荣昌[1] 孙春华[1] 赵堪兴[1] 

机构地区：[1]天津医科大学

出　　处：《牡丹江医学院学报》2007年第4期19-21,共3页Journal of Mudanjiang Medical University

摘　　要：目的:分析屈光性调节性内斜视对双眼视功能远期恢复的影响。方法:屈光性调节性内斜视(Refractive Accommoda-tive Esotropia,RAET)患者39人;及同期就诊远视性屈光不正(Hypermetropic Refraction Error,HRE)对照组(水平及垂直斜视度各≤5△和≤1△)43人。两组初诊平均年龄分别为:4.89±1.00岁、4.96±0.88岁,平均随访时间分别为:5.03±0.83年、4.86±0.70年。所有病人初诊时均1%阿托品眼膏散瞳(一日2次,连用5天)检影验光后配全矫眼镜,屈光度均在+2D^+6D范围内。此后每半到一年睫状肌麻痹验光一次,依此调整眼镜度数;并运用遮盖去遮盖、遮盖加三棱镜试验检查眼位。末次就诊时所有受试者矫正视力≥0.8,并记录此时双眼视功能:同时视、融合功能;Titmus、颜少明同视机随机点立体视图及TNO立体视功能。结果:所有受试者均有同时视功能,二组间双眼融合功能无显著差异(P=0.1621)。RAET组矫正眼位正位(水平及垂直斜视度各≤5△和≤1△)12人,仅1人完全无立体视;残留<+10△的小度数斜视27人,仅6人具有粗略立体视功能。RAET组三种立体视图检查结果均显著差于HRE组(P均=0.0000)。RAET组Titmus与TNO检查结果间亦具有显著差异性(P=0.0040)。结论:RAET患者即使经治疗眼位得以恢复,且具有同时视和融合双眼视功能,但对残留小度数内斜视者,远期易遗留不良的立体视功能。随机点立体视图能更好地反应其立体视功能。To identify the effect of refractive accommodative esotropia（RAET） on binocular vision in a long term. Motheds The participants were 39 children with RAET and 43 children （HRE）. The patients with RAET were diagnosed at the age of 4.89±1.00 years with hypermetropic refraction error and were observed for 4.96 ± 0.88 years. The patients with HRE were diagnosed at the age of 4.89 ± 1.00 years and were observed for 4.86 ± 0.70 years. Refractive errors were determined after instillation of atropine 1% two times per day for 5 days. The cycloplegic refraction was repeated at intervals of 6months to 1 year and the glasses were adjusted when necessary. All partici pants were with refractive errors of ＋2D - ＋6D at first,and without amplyopia at the last visit. Ocular deviation were determinated with coveruncover,prism and cover test. Binocular vision was tested for every participant at the last visit, including simultaneous perception, fusion and stereopsis （Titmus, TNO and Yan Shaoming random-dot stereogram with synoptophore）. Results All patients have simultaneous perception, and there is no significant difference for fusion between RAET and HRE （ P = 0. 1621 ）. In RAET group, 1 patient had no stereopSis among 12 orthophoric patients; but only 6 patients had rough stereopsis among 27 patients with small angle esotropia（ 〈 ＋ 10△ ）. But there were significant difference for Titmus, TNO and Yan Shaoming random - dot stereogram between RAET and HRE（ P = 0.0000）. In addition, RAET had different results with Titmus and TNO （P = 0.0040）. Conclusion Even if with orthotropia, good visions, simultaneous perception and fusion, the prognosis of patients with RAET is not satisfactory for restoration of normal stereopsis because of microtropia. Random - dot stereogram can react stereopsis better than contour stereogram.

关 键 词：屈光性调节性内斜视 双眼视觉 同时视 融合 立体视 

分 类 号：R77[医药卫生—眼科]