间歇性外斜视斜视度测量方法比较研究  

Comparative study on the methods of measuring exodeviations in intermittent exotropia

作　　者：金涵[1] 李岚[1] 田军[1] 舒秀梅[1] 徐洁[1] 周水莲[1] 

机构地区：[1]江西省人民医院眼科中心,南昌330006

出　　处：《中国实用眼科杂志》2015年第5期507-510,共4页Chinese Journal of Practical Ophthalmology

基　　金：江西省科技厅社发支撑项目（20132BBG70094）

摘　　要：目的为了能测出间歇性外斜视患者更大的潜在斜视度数，探讨间歇性外斜患者1h诊断性遮盖试验（1h—DOT）与三棱镜适应试验（PAT）两种方法测量斜视度数的效果。方法前瞻性研究。对2013年6月至2014年3月在江西省人民医院眼科中心住院的间歇性外斜视患者50例，男性22例，女性28例；年龄5～22岁。应用三棱镜加交替遮盖对受试者进行初始6m与33cm、1h—DOT6m与33cm、PAT6m与33em三种方法的第一眼位斜视度数测量。与初始测量结果比较，受试者在1h-DOT及PAT后，视远或视近斜视度增加≥10PD为阳性。三种测量方法的斜视度数均值采用方差分析q检验，进行两两比较；阳性率的比较采用卡方检验。结果初始6m、1h—DOT6m、PAT6m三种方法测量视远斜视度分别为（26．3±6．4）、（28．5±7．6）、（34．1±8．6）PD；与初始6m比较，1h—DOTer]量的视远斜视度均值差异无统计学意义（q=2．06，P〉0．05），PAT差异有统计学意义（q=5．21，P〈O．01）。与初始6m比较，1h—DOT、PAT两种方法测量视远斜视度增加的例数为（4／50，阳性率8％）和（20／50，阳性率40％），两者比较差异有统计学意义（x^2=14．03，P〈0．005）。初始33cm、1h—DOT、PAT三种方法测量的视近斜视度数分别为（27．5±6．1）、（33．2±7．8）、（38．3±9．5）PD。与初始33cm比较，1h—DOT（q=5．36，P〈0．01）、PAT（q=6．32，P〈0．01），两种方法测量的视近斜视度数均值的差异均有统计学意义。与初始33cm比较，1h—DOT和PAT测量的视近斜视度数增加的例数分别为（17／50，阳性率34％）和（31／50，阳性率62％）；两者比较差异有统计学意义（r=12．98，P〈0．05）。结论PAT可以测出间歇性外斜视患者最大的视远及视近斜视度数。而1h—DOT只可测出间歇性外斜视患者更大的视近斜视度数。Objective To study the effect of the 1-hour diagnostic occlusion test （lh-DOT） and the prism adaption test （PAT） on measuring the angle of exodeviation for patients with intermittent exotropia, in order to measure the potential angle of extrodeviation for them. Methods Prospective case series study. The data was collected during June 2013 to March 2014 on 50 inpatients with in- termittent exotropia in the Eye Center of Jiangxi Province of People＇s Hospital, among them were 22 males and 28 females, with age between 5 and 22. Prism and alternative cover test was per- formed on the objects to evaluate the exodeviaiton on the primary position. All objects were tested on three methods： fixating at indoor distance target of 6m and near target of 33cm, lh-DOT 6m and 33cm, PAT 6m and 33cm. Compared to the first method, objects showing no less than 10 prism diopter （PD） when tested under the latter two methods were called positive increased angle of exodeviation. The angles of exodeviation from these three methods were compared pairwise after av- eraging over the results from these 50 objects and carrying out the q-test for each method, respec-tively. A Chi-square test was performed on the rate of positive increased angle of exodevia- tion before comparing each method. Results The exodeviations tested under the fixating at 6m, lh-DOT6m, and PAT6m were （26.3±6.4）, （28.5±7.6）, and （34.1±8.6） PD, respectively. The difference of the exodeviations on fixating at distance target from fixating at 6m and lh-DOT6m was insignificant （q=2.06, P 〉0.05）, and the fixating at 6m and PAT6m was sig- nificant （q=5.21, P 〈0.01）. Compared to fixating at 6m, the number of cases of positive in- creased angle of exodeviation for fixating at distance targets were （4/50, positive rate 8%） and （20/50, positive rate 40%） for lh-DOT6m, and PAT6m, respectively; the comparison of lh-DOT6m and PAT6m was significant （X^2=14.03, P 〈0.005）. The exodeviations tested under fixating at 33cm, 1h-DOT, an

关 键 词：间歇性外斜 遮盖试验 三棱镜适应 斜视度 

分 类 号：R777.41[医药卫生—眼科]