基本型间歇性外斜视患者的斜视控制能力与融合性辐辏和分开运动的关系  

Association of fusional convergence and divergence with control ability in children with intermittent exotropia

作　　者：傅涛[1] 王静[1] 苏庆[1] 郗平[1] 李育[1] 

机构地区：[1]首都医科大学附属北京同仁医院北京同仁眼科中心北京市眼科学与视觉科学重点实验室,北京100730

出　　处：《中华实验眼科杂志》2016年第5期456-459,共4页Chinese Journal Of Experimental Ophthalmology

基　　金：国家自然科学基金项目（30600688）;北京市自然科学基金项目（7132057）;北京市优秀人才培养项目（2010D003034000007）;北京市卫生系统高层次卫生技术人才培养计划

摘　　要：背景间歇性外斜视是介于外隐斜和恒定性外斜视之间的-种斜视类型。间歇性外斜视患者融合性辐辏和分开运动的评估对了解患者控制隐斜或间歇性偏斜的能力是非常重要的。目的分析基本型间歇性外斜视患儿融合性辐辏运动和分开运动与外斜视控制之间的关系。方法采用系列病例观察研究方法，纳入2013年7月至2014年2月在北京同仁医院就诊的基本型间歇性外斜视患儿63例。采用三棱镜加交替遮盖法测定患儿双眼偏斜角度；采用修正纽卡斯尔控制分数（RNCS）方法评估外斜视的控制能力并进行评分；采用1△～40△的水平三棱镜排镜及调节性视标检测融合性辐辏和分开运动的破裂点、恢复点和恢复易度检测。采用Spearman秩相关分析法评估融合性辐辏和分开运动的测量参数与间歇性外斜视控制分数之间的关系。结果患儿右眼和左眼的平均屈光度分别为（-1．95±1．63）D和（-2．01±1．73）D，受检眼视远和视近时斜视度分别为（36．67±15．69）△和（38．25±14．83）△，差异均无统计学意义（t=-0．13、-0．57，均P〉0．05）。患儿视远及视近时融合性辐辏运动的破裂点与外斜视控制分数之间均呈明显负相关（rs=-0．41，P=0．03；L=-0．56，P〈0．01）；而视远及视近融合性分开运动的破裂点与外斜视控制分数之间均无明显相关性（rs=0．05，P=0．78；rs=0．04，P=0．75）。无论辐辏融合还是分开融合，融合恢复易度与外斜视控制分数之间均无明显相关性（均P〉0．05）。结论融合性辐辏运动破裂点的检测能较好地提示间歇性外斜视的严重程度，有可能作为间歇性外斜视的手术治疗指征之-。Background Intermittent exotropia is a type of strabismus that between latent cxtropia and manifest extropia. The assessment of fusional convergence/divergence is important for understanding control ability of exodeviation in children with intermittent exotropia. Objective This study was to analyze the correlations between fusional convergence/divergence and control ability of exodeviation in children with intermittent exotropia. Methods Sixty-three children with intermittent exotropia were recruited in Beijing Tongren Eye Centre from July 2013 to February 2014 under the informed consent of children and their parents. Angle of deviation was measured by wearing prism and covering method alternately. The control ability of exodeviation was evaluated and scored by the Revised Newcastle Control Score （RNCS）, and fusional convergence and divergence were measured with 1 △ -40△ horizonal prisms and regulating targets. The correlations between the measured parameters of fusional convergence/divergence and control scores of exotropia were analyzed by Spearman rank correlation analysis. Results The mean diopter of the right and left eyes was （ - 1.95± 1.63 ） D and （ -2. 01 ± 1.73 ） D, respectively, and the mean deviation angle for distantly and near was （ 36.67 ± 15.69 ） △ and （ 38.25 ± 14.83 ） △ , respectively, without significant differences between them （ diopter： t = -0. 13, P〉 0. 05 ; deviation angle ： t = -0.57, P〉0.05 ）. Considerably negative correlations were found between the breakpoints of fusional convergence for distant or near and control scores of exodeviation （ rs = -0.41 ,P= 0. 03 ;r =-0.56 ,P〈0.01 ）. No significant correlations were found between the breakpoints of fusional divergence for distantly or near and control scores of exodeviation （ r = 0. 05, P = 0.78 ; r = 0.04, P 〈0. 75 ）. In addtion, there was nosignificant correlation between fusional recovery level and control scores （both at P 〉0. 05 ）. Conclusions Breakpoints of fusional conver

关 键 词：外斜视/生理病理 眼集合/生理病理 眼调节/生理 斜视/生理病理 儿童 

分 类 号：R777.41[医药卫生—眼科]