屈光参差性弱视治疗前后双眼视觉的临床观察  

A clinical observation on binocular vision in anisometropic amblyopia before and after treatment

作　　者：林楠[1] 卢炜[1] 成娟娟[1] 孙省利[1] 

机构地区：[1]首都医科大学附属北京同仁医院眼科中心,100730

出　　处：《眼科》2008年第3期204-206,214,共4页Ophthalmology in China

摘　　要：目的了解屈光参差性弱视儿童治疗前及矫止视力正常后双眼视觉的状况。设计回顾性病例系列。研究对象屈光参差性弱视儿童53例。方法对53例屈光参差性弱视儿童分别在治疗前及矫正视力≥0.9后采用颜少明《立体视觉检查图》和同视机检测其双眼视觉功能。主要指标立体视锐度、交叉视差、非交叉视差立体视觉,同时知觉、远融合范围,定性远立体视。结果屈光参差与弱视(r=0.613)、弱视与立体视(r=0.422)及屈光参差与立体视均具有相关性(r=0.354)。弱视患儿矫正视力正常后其近立体视锐度、交叉视差、非交叉视差立体视觉均较治疗前有显著改善,差异有统计学意义(P<0.01)。弱视患儿矫正视力正常后其同时机功能较治疗前无明显差异(P=0.37);远融合范围及远立体视均较治疗前有显著改善,差异有统计学意义(远融合范围P=0.03,远立体视P<0.01)。结论屈光参差、弱视、立体视觉三者之间具有相关性。屈光参差性弱视影响融合和立体视觉的发育。随着视力的提高,双眼视觉有显著改善。Objective To investigate the binocular vision change in anisometropic amblyopic children having normal corrected acuity before and ＇after treatment. Design Retrospective case series. Participants Fifty-three children with anisometropic amblyopia. Methods Binocular vision of 53 anisometropic amblyopic children was tested with synoptophore and stereogram designed by Yan Shao-ming before treatment and after their best distance corrected acuity≥0.9. Main Outcome Measures Near zero disparity, crossed disparity, uncrossed disparity, simultaneous perception, distance fusion range and distance qualitative stereopsis. Results The correlations between anisometropia and amblyopia （r=0.613） was significant, as well as amblyopia and stereoaeuity （r=0.422）, anisometropia and stereoacuity （r=0.354）. Near zero disparity, crossed disparity and uncrossed disparity in anisometropic amblyopic children were improved significantly after who had normal corrected acuity （P〈0.01）. The comparison of simultaneous perception was not prominent before and after treatment （P=0.37）, distance fusion range and distance qualitative stereopsis were improved significantly after treatment （distance fusion range P=0.03, distance qualitative stereopsis P〈0.01）. Conclusions There is significant association among anisometropia, amblyopia and stereoacuity. Anisometropic amblyopia may affect the development of fusion and stereopsis in children. The binocular vision may improve significantly when the visual acuity increases.

关 键 词：弱视 屈光参差 立体视锐度 交叉视差 非交叉视差 

分 类 号：R777.44[医药卫生—眼科] R749.3[医药卫生—临床医学]