视知觉学习治疗儿童屈光不正性弱视4年随访研究  

Visual perceptual learning in treatment of children ametropic amblyopia:4 years follow-up outcomes

作　　者：李志超[1,2] 赵武校[1,2] 蓝方方[1,2] 王贻东[1,2] 甘露[1,2] 刘伟民[1,2] 

机构地区：[1]广西壮族自治区人民医院视光科 [2]广西视光中心,广西壮族自治区南宁市530021

出　　处：《眼科新进展》2012年第7期645-647,共3页Recent Advances in Ophthalmology

基　　金：广西壮族自治区卫生厅科研课题基金资助(编号Z2011523;Z2011434)~~

摘　　要：目的探讨视知觉学习治疗儿童屈光不正性弱视的远期疗效。方法回顾性研究。选取2006年在广西视光中心接受"视知觉学习"治疗且达到"基本治愈"标准的4～8岁屈光不正性弱视患者65例(117眼),所有病例均随访4a以上。随访期间收集患者的矫正视力和屈光度。所有患者按起始弱视程度分为轻度、中度和重度弱视后,使用Two-wayANOVA比较3组患者间视力的稳定性;按屈光性质分为近视性、远视性和混合散光性弱视后,使用One-wayANOVA比较3组患者的屈光度变化情况。结果矫正视力:整体而言,终止视知觉学习后1a、2a、3a、4a时的矫正视力分别为0LogMAR、(0.006±0.024)Log-MAR、(-0.001±0.055)LogMAR、(-0.011±0.060)LogMAR,各随访时间点间差异均无统计学意义(均为P>0.05),均高于治疗前视力(0.344±0.171)LogMAR(均为P=0.000);但重度弱视儿童的矫正视力在随访期间差异有统计学意义(P<0.05),表现为在随访的第3年和第4年时出现了小幅视力回退。屈光度:视知觉治疗前、后球镜的变化量近视性、远视性、混合散光性弱视患者之间差异有统计学意义(P<0.01),且3组之间两两比较差异均有统计学意义(均为P<0.05);但视知觉治疗前、后柱镜与等效离焦度的变化量在3组患者之间差异均无统计学意义(均为P>0.05)。结论视知觉学习治疗儿童屈光不正性弱视的远期疗效稳定、可靠。Objective To investigate the long-term effects of visual perceptual learning for children ametropic amblyopia. Methods In retrospective study,sixty-five patients （ 117 eyes） with ametropic amblyopia aged from 4 years old to 8 years old,who had accepted visual perceptual learning at Visual Science and Optometry of Guangxi, were enrolled. All subjects had been followed up of more than 4 years,the corrected vis- ual acuity and refractive error diopter were obtained during the follow-up times. All pa- tients were divided into mild, moderate and severe amblyopic group by amblyopic de- gree,respectively,then Two-way ANOVA was used to compare the stability of visual a- cuity among the groups;All patients were divided into myopic, hyperopic, and mixed amblyopic group by refraction,and One-way ANOVA to compare the changes in refrac- tive error diopter among the groups. Results In whole,the corrected visual acuity of all subjects at 1 years,2 years,3 years and 4 years after perceptual learning were 0 Log- MAR, （0.006 ±0. 024） LogMAR, （ -0. 001 ±0. 055） LogMAR and （ -0. 011 ±0. 060） Log- MAR,there was no statistical difference between each time point（both P 〉 0.05） ,but all were higher than that before learning （ 0. 344± 0. 171 ） LogMAR, there were significant differences（both P = 0. 000）. But significant differences were notified in severe ambly- opic groups during the follow-up time points （P 〈 0.05 ）, which demonstrated that cor- rected visual acuity was slightly declined sInce the third and forth year after termination of perceptual learning. Significant differences were found in spherical diopter before and after perceptual learning among the myopic, hyperopic, and mixed amblyopic groups （P 〈 0.01 ）. and also showed between anv of the two groups （ both P 〈 0.05 ）. But there was no statistical difference in cylindrical diopters and defocus equivalent among three groups （ both P 〉 O. 05 ）. Conclusion Long-term outcomes are stable and reliable in children ametropic

关 键 词：视知觉学习 屈光不正性弱视 儿童 屈光回退 

分 类 号：R777.44[医药卫生—眼科]