知觉学习改善屈光参差性弱视视功能的临床观察  

Visual function enhancement by perceptual learning for anisometropic amblyopia

作　　者：丁坤[1] 王优[2] 丁玉珑[2] 刘俐[3] 黄(王乐) 闫晓河[1] 林小铭[1] 

机构地区：[1]中山大学中山眼科中心,广州510060 [2]南方医科大学,广州510515 [3]佛山市顺德区第一人民医院,528300 [4]中山大学中山眼科中心,广州510060

出　　处：《中华眼视光学与视觉科学杂志》2013年第10期601-605,共5页Chinese Journal Of Optometry Ophthalmology And Visual Science

基　　金：广东省科技计划项目（2011B061300067）;国家自然科学基金（81200962）

摘　　要：目的 探讨知觉学习训练在改善青少年及成人屈光参差性弱视患者视功能方面的效果.方法 前瞻性自身对照研究.共纳入18例青少年和成年单眼屈光参差性弱视患者,弱视眼在截止空间频率下进行对比度检测任务的训练,对侧相对健眼作为对照.患者随访3～6个月.分别观察患者训练前后的最佳矫正视力和对比度阈值改变,立体视改变以及试验组训练前后视觉诱发电位改变.数据进行t检验、相关性分析.结果 弱视眼与相对健眼相比,其在训练前后的视力改变,截止空间频率下的对比度阈值改变,以及所有空间频率下的对比度阈值改变差异均有统计学意义（t=2.731,P＜0.05；t=5.108,P＜0.01；t=3.700,P＜0.01）,弱视眼及对侧眼在训练前后潜伏期变化,振幅变化差异均无统计学意义,并且18例中有8例立体视得到改善.12例患者随访3个月,弱视眼视力平均保持了99.3％,对侧眼视力改善平均保持了50％.结论 知觉学习能改善青少年及成年屈光参差性弱视患者的视功能,可用于治疗大龄弱视.Objective To evaluate the effects of perceptual learning on visual acuity and contrast sensitivity function in juveniles and adults with amblyopia. Methods In this prospective self-control study, 18 anisometropic amblyopes were recruited,the amblyopic eyes were trained in contrast detection near the pre-training cut-off spatial frequency. Patients were followed up for 3-6 months. Changes in the best corrected visual acuity and contrast sensitivity function and pattern visual evoked potentials and stereoacuity were measured. Data were analyzed using t test and correlation analysis. Results The amblyopic eyes had more profound changes in the visual acuity and contrast threshold （at all spatial frequencies） than the non-amblyopic fellow eyes （t=2.731, P〈O.05; t=5.108, P〈0.01; t=3.700, P〈0.01）. No difference was found in the mean 60＂, 30＂, 15＂ P100 latency and amplitude in both eyes after the treatment. Eight patients showed improvement in steroacuity （average 420＂）. The improved visual acuity was retained at 6 months in some patients. Conclusion Perceptual learning can improve the visual function of juvenile and adult amblyopia.

关 键 词：屈光参差性弱视 知觉学习 对比敏感度 

分 类 号：R777.44[医药卫生—眼科]