儿童屈光参差性弱视立体视觉中枢区激活的fMRI研究  

Visual cortical functional mediating stereopsis in children anisometropic amblyopia： evidence from fMRI

作　　者：杨磊[1] 燕振国[2] 马强华 叶建军 

机构地区：[1]兰州大学第二临床医学院,730030 [2]兰州军区兰州总医院眼科中心 [3]核磁诊断中心

出　　处：《中华眼视光学与视觉科学杂志》2012年第10期609-613,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

摘　　要：目的利用血氧水平依赖性功能性磁共振成像（BOLD-fMRI）技术评价屈光参差性弱视儿童在规范弱视训练后，立体觉映射的脑皮层功能区的恢复情况。方法自身前后对照研究。选择11例屈光参差性弱视初诊患儿，行任务态组块式（Blocks）设计的fMRI实验，在弱视治疗后1周、2周及4周时复查BOLD-fMRI。采用基于Matlab7．12．0．635的SPM8软件包进行图像后处理，采用随机效应法分别获得各组脑皮层激活的矩阵数据，利用假设驱动法对各治疗阶段结果进行自身前后配对t检验．获得治疗前后各组视皮层激活的差异数据。立体图像为计算机生成的随机点立体视觉检查图，通过配戴红蓝眼镜观察立体视图像，当识别立体视图像后迅速点按反馈键。结果弱视训练至4周时，左侧枕叶（BA18）、枕中回（BA19）、边缘叶（BA19）及右侧枕叶舌回（BA17）和双侧顶上小叶（BA7）激活范围不同程度扩大，与治疗前的平均激活强度差异t值分别是1．636、1．902、1．727、1．350与1．777（P〈0．01），但增进幅度偏小．且与随机点立体视图的恢复不平行。结论儿童屈光参差性弱视对立体觉映射的脑皮层功能损害严重、短期恢复困难。Objective The aim of this study was to evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment with blood oxygenation level dependent functional MRI techniques （BOLD-fMRI）. Methods In this study, self-controlled study before and after treatment was used, and blocks-designed fMRI was performed on 11 children with first amblyopic treatment, and review BOLD-flVIRI inspection after regular amblyopia treatment 1 week, 2 weeks and 1 month. Functional MRI data were processed by using SPM8 which based on the MATLAB7.12.0.635. Random effect group analysis was performed in each group to acquire average cerebral cortex activated functional images data. Through the hypothesis drive method, the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test. During the study, the patients were asked to view stimuli through red-blue filtered stereo glasses. The visual stimuli were computer-generated random-dot stereograms （R.D.S）, click feedback key immediately after the R.D.S were recognized. Results The functional area that was left occipital lobe （BA18）, middle occipital gyrus （BA19）, limbic lobe （BA19）, lingualis gyrus of the right occipital lobe （BA17） and the bilateral parietal lobe （BA7） expanded in different levels after 4 weeks （compared the fourth weeks with without treatment, mean t value was 1.636, 1.902, 1.727, 1.350 and 1.777 respectively, P〈0.01）. However, those data showed activation on the small area, and with the R.D.S on the recovery is not parallel. Conclusion In children anisometropic amblyopia, the visual cortical functional mediatiug stereopsis is damaged seriously and not easy to treat in the short time.

关 键 词：儿童 屈光参差 弱视 立体视觉 磁共振成像 

分 类 号：R777.44[医药卫生—眼科]