全天遮盖与部分遮盖对弱视患儿视力恢复的影响  

Effects of full-time and part-time occlusion on visual acuity recovery in amblyopic children

作　　者：吴荒[1] 池云峰[1] 

机构地区：[1]吉林大学第二医院眼科医院视光学科,吉林省长春市130041

出　　处：《眼科新进展》2012年第8期746-749,共4页Recent Advances in Ophthalmology

基　　金：吉林省卫生厅科研基金资助(编号:2010Z079)~~

摘　　要：目的探讨全天遮盖和每天遮盖4h的部分遮盖对弱视患儿视力恢复的影响。方法选择3～11岁屈光参差性弱视或斜视性弱视患者200例,双眼最佳矫正视力相差≥2行。按年龄分为学龄前组(3～5岁,66例)、低年级组(6～8岁,93例)和高年级组(9～11岁,41例)。初始治疗仅予屈光矫正,3个月后每组内按遮盖方式随机分为全天遮盖组和部分遮盖组(每天持续遮盖4h),分别于遮盖3个月、6个月和9个月观察弱视眼视力情况。结果经过3个月的屈光矫正,3个年龄组的弱视眼视力均有明显进步(学龄前组平均提高2.3行,t=10.898,P<0.001;低年级组平均提高1.6行,t=11.563,P<0.001;高年级组平均提高1.6行,t=9.823,P<0.001)。在此后的遮盖治疗过程中,弱视眼视力继续提高,完全遮盖组与部分遮盖组的弱视眼视力在遮盖治疗后3个月(学龄前组:t=-0.136,P=0.892;低年级组:t=0.755,P=0.452;高年级组:t=-0.039,P=0.969)、6个月(学龄前组:t=0.737,P=0.465;低年级组:t=-0.838,P=0.405;高年级组:t=-0.326,P=0.747)、9个月(学龄前组:t=-1.618,P=0.116;低年级组:t=-1.816,P=0.075;高年级组:t=1.313,P=0.207)差异均无统计学意义。结论在屈光矫正基础上,采用每天4h的部分遮盖与传统的全天遮盖均可明显提升弱视眼视力,且两者疗效并无显著差异。Objective To discuss the effects of full-time and part-time occlusion（4 hours every day） on visual acuity recovery in amblyopic children.Methods Two hundreds children with anisometropic or strabismic amblyopia from 3 years old to 11 years old were chosen,the difference of best corrected visual acuity between two eyes was no less than two lines.All the cases were divided into preschool group（3-5 years old,n=66）,junior group（6-8 years old,n=93） and senior group（9-11 years old,n=41）.Optical correction alone was used at first three months.All the patients in each group were divided into part-time occlusion group and full-time occlusion group randomly after optical correction for three months.The visual acuity was measured at 3 months,6 months and 9 months during occlusion period.Results Amblyopia was improved significantly with optical correction alone in all groups at initial three months（average increasing 2.3 lines in preschool group,t=10.898,P〈0.001;average increasing 1.6 lines in junior group,t=11.563,P〈0.001;average increasing 1.6 lines in senior group,t= 9.823,P〈0.001）.Improvements in visual acuity of the amblyopic eyes were continued during occlusion period.No significant difference was found between full-time and part-time occlusion group at 3 months（preschool group：t=-0.136,P=0.892;junior group：t=0.755,P=0.452;senior group：t=-0.039,P=0.969）,6 months（preschool group：t=0.737,P=0.465;junior group：t=-0.838,P=0.405;senior group：t=-0.326,P=0.747） and 9 months（preschool group：t=-1.618,P=0.116;junior group：t=-1.816,P=0.075;senior group：t=1.313,P=0.207）,respectively.Conclusion Based on optical correction,prescribing 4 hours of daily occlusion can improve visual acuity as effective as full-time occlusion,the effect has no difference.

关 键 词：弱视 遮盖治疗 视力 

分 类 号：R777.44[医药卫生—眼科]