视知觉学习联合遮盖治疗屈光参差性弱视的初期临床观察  

Preliminary study of anisometropic amblyopia in juvenile treated with visual perceptual learning plus patching

作　　者：赵武校[1] 蓝方方[1] 刘洪婷[1] 李志超[1] 甘露[1] 刘伟民[1] 

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

出　　处：《眼科新进展》2014年第10期963-967,共5页Recent Advances in Ophthalmology

基　　金：广西卫生厅科研课题资助(编号:桂卫Z2011523;桂卫重2012099)~~

摘　　要：目的探讨视知觉学习联合遮盖治疗屈光参差性弱视的临床效果。方法回顾性病例系列研究。收集2006年7月至2011年6月在广西视光中心接受视知觉学习联合遮盖治疗达1 a的8岁以上31例屈光参差性弱视患者的临床资料,包括患者的性别、年龄、注视性质、眼位、治疗前后的最佳矫正视力、屈光度等数据。对患者治疗过程中的最佳矫正视力、屈光度等重复测量资料使用SPSS13.0统计软件一般线性模型(General linear model)的Repeated Measures过程进行方差分析,比较患者的最佳矫正视力和屈光度变化情况;同时对治疗效果的持久性进行评估。结果经过1 a的联合治疗,弱视眼视力平均提高了(3.9±1.8)行LogMAR视力(P<0.01),最佳矫正视力改善≥2行者达100.0%,基本治愈率达25.8%;联合治疗终止后1 a,87.0%的患者保持了治疗效果,平均最佳矫正视力下降0.03行LogMAR视力;对侧眼在联合治疗前后始终保持在正常视力水平。视知觉学习联合遮盖治疗前后,弱视眼和对侧眼的等效球镜值均缓慢降低:轻度弱视眼的等效球镜值在各时间点差异无统计学意义(P>0.05);中度、重度弱视眼的等效球镜在治疗中和治疗后均较治疗前降低(均为P<0.05);对侧眼的等效球镜在治疗后较治疗前和治疗中降低(均为P<0.05)。结论视知觉学习联合遮盖治疗可有效改善屈光参差性弱视患者弱视眼的最佳矫正视力,并能使治疗效果长期保持,但其基本治愈率有待提高。Objective To study the therapeutic effects of visual perceptual learning plus patching on juveniles with anisometropic amblyopia. Methods Retrospective case series. Medical records of patients with anisometropic amblyopia in Center for Optometry and Visual Science from July 2006 to June 2011 were documented prospectively,and patients whom aged 8 years or over and treated with visual perceptual learning plus patching for 12 consecutive months were recruited. Patients＇ age,gender,fixation character,ocular alignment,best corrected visual acuity（BCVA） and refraction status before and after treatment were checked and data were analyzed using the statistical package SPSS v. 13. 0 for Windows. A repeated measures ANOVA was used for analysis repeated-measures data such as visual acuity and refractive power. And a long term assessment of retention was performed. Results The mean BCVA of the amblyopic eyes improved by 0. 39 ± 0. 18 LogMAR（ P 0. 01）. Resolution of amblyopia was achieved in 8 of 31 patients（25.8%）. Amblyopia improved by two or more lines in all patients.87.0% of patients retained the treatment effect at 1 year after cessation of treatment,with a mean BCVA loss of 0. 03 LogMAR. By contrast,BCVA of the fellow eye was kept stable and normal during the whole stage.Spherical equivalent of the amblyopic eye showed a slowly descending trend,along with the fellow eye of the anisometropic amblyopia during visual perceptual learning. Among them,no significant differences was found at different check points in mild amblyopic eye（P 〉0. 05）,but significant differences were observed in moderate and severe amblyopic eye at pretreatment when compared with intratreatment and posttreatment,respectively（ all P〈 0. 05）. And significant differences were also found in fellow eye of the anisometropic amblyopia at post-treatment when compared with pre-treatment and intra-treatment,respectively（all P〈 0. 05）. Conclusion Amblyopic eye＇s BCVA can be improved with visual perceptual learning plus patch

关 键 词：视知觉学习 遮盖 屈光参差性弱视 最佳矫正视力 屈光度 

分 类 号：R777.44[医药卫生—眼科]