压抑疗法与遮盖法治疗大龄儿童远视性屈光参差性轻中度弱视的疗效及依从性  

Clinical efficacy and patient compliance of penalization in older children with anisometropic amblyopia

作　　者：董凤 崔莎[2] 颜世传 牛兰俊 赵光辉 DONG Feng;CUI Sha;YAN Shichuan(Lixiang Eye Hospital of Soochow University,Suzhou 215000,China)

机构地区：[1]苏州理想眼科医院,苏州215021 [2]湖北省襄阳市中心医院北区眼科,襄阳441058

出　　处：《中国中医眼科杂志》2019年第5期380-383,共4页China Journal of Chinese Ophthalmology

摘　　要：目的比较压抑疗法与遮盖法治疗大龄儿童远视性屈光参差性弱视的临床疗效及依从性。方法选取2013年5月—2018年3月在苏州理想眼科医院小儿眼科及襄阳中心医院北区眼科就诊的10~16岁轻中度远视性屈光参差性弱视儿童76例(76只眼),行屈光矫正后随机分为2组,压抑组39例(39只眼),遮盖组37例(37只眼)。压抑组的优势眼予1%阿托品点眼,遮盖组的优势眼予全天遮盖(除睡觉及洗脸以外的其余时间全部遮盖)。2组分别于治疗前和治疗6个月行视功能评估,记录治疗前后的最佳矫正视力、近立体视锐度,同时比较2种方法的依从性。结果压抑组总有效率为79.49%,遮盖组总有效率为81.08%,2组差异无统计学意义(c2=0.03,P>0.05)。治疗前,2组患儿近立体视功能比较,差异无统计学意义(c2=0.17,P>0.05),治疗6个月,压抑组有近立体视功能者为30例(76.92%),遮盖组为12例(32.43%),2组差异有统计学意义(c2=15.20,P<0.01)。采用评分法比较2组的依从性,压抑组依从性平均分为(2.28±0.61)分,遮盖组依从性平均分为(2.00±0.67)分,2组差异无统计学意义(P>0.05)。结论压抑疗法与遮盖法在治疗大龄儿童远视性屈光参差性弱视同样有效;在促进患儿近立体视重建方面,压抑疗法优于后者。OBJECTIVE To compare the clinical efficacy and compliance of penalization and masking therapy in older children with anisometropic amblyopia.METHODS Seventy-six children(76 eyes)aged from 10~16 years old with mild-to-moderate anisometropic amblyopia treated in Lixiang Eye Hospital of Soochow University and north department of Xiangyang Central Hospital between May 2013 and March 2018 were included.All were given refractive correction first,and then divided into 2 groups randomly.The penalization group(PG)consisted of 39 patients,were given 1%atropine ophthalmic gel in the dominant eyes for penalization.The other 37 cases consisted of the masking therapy group(OG),and their dominant eyes were covered all day long.The best corrected visual ability(BCVA),stereoacuity and the compliance before intervention and 6 months after it were evaluated and recorded.RESULTS The effective rate was 79.49%in the penalization group,while 81.08%in the cover group and they were of no statistical difference(c2=0.03,P>0.05).The two groups showed no significant difference in stereovision before treatment(c2=0.17,P=0.05),But there were 30 cases regained their stereopsis in the penalization group(76.92%)while 12 cases(32.43%)made it in the masking treatment group;The difference was statistically significant(c2=15.20,P=0.01).The average compliance score in the penalization group was 2.28±0.61,while it was 2.00±0.67 in the covering group.CONCLUSION The penalization and the masking therapy were equally effective in treating the anisometropic amblyopia of older children.But the former was better than the later for the recovery of stereopsis.And the penalization therapy yielded a better compliance.

关 键 词：压抑疗法 遮盖法 弱视 阿托品 

分 类 号：R777.44[医药卫生—眼科]