先天性单侧上斜肌麻痹患者眼底旋转与立体视觉的关系研究  

Relationships between the torsion and the stereopsis of congenital unilateral superior oblique palsy

作　　者：刘佩佩 付晶[1] 孙阿莉[1] 董芳[1] Liu Pei-pei;Fu Jing;Sun A-li(Bejing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Bejing Key Laboratory of Ophthalmology&Visual Science,Beijing 100730,China)

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,100730

出　　处：《中国斜视与小儿眼科杂志》2022年第4期6-10,I0011,共6页Chinese Journal of Strabismus & Pediatric Ophthalmology

摘　　要：目的采用眼底照相为客观检查方法,探讨先天性单侧上斜肌麻痹(USOP)患者眼底旋转情况与立体视觉的相关性。方法收集2018年1月至2021年12月在我院行手术治疗的先天性USOP患者,对其病历资料进行回顾性分析,测量眼底照片中黄斑中心凹-视盘中心夹角(fovea-disc angle FDA),分析眼底旋转状况及FDA大小与患者立体视觉之间的关系。结果研究共纳入43例USOP患者,35%(15例)眼底正常(双眼均无旋转),65%(28例)眼底外旋。眼底正常组的双眼总FDA为12.62°±3.24°,外旋组为22.74°±8.60°,正常组双眼总FDA明显小于外旋组,P<0.05。眼底正常组和外旋组远近立体视均存在者分别为33%(5例)和7%(2例),差异显著,P<0.05。所有患者双眼总FDA与远、近立体视均存在相关性(r=-0.307,P=0.046,r=-0.326,P=0.033);正常组双眼总FDA与远近立体视无相关性,外旋组双眼总FDA与近立体视存在相关性(r=-0.521,P=0.004);外旋组中单眼外旋患者,其外旋眼FDA与远近立体视相关程度最高(r=-0.627,P=0.002,r=-0.587,P=0.004),而非外旋眼FDA与远近立体视无相关性。结论先天性USOP患者眼底正常者,立体视保存率高,眼底外旋者立体视功能差。双眼FDA(尤其是外旋眼FDA)与远近立体视负相关,FDA越小,远近立体视越好。Objective Fundus photography was used to investigate the correlation between the torsion and the stereopsis in patients with congenital unilateral superior oblique palsy(USOP).Methods The patients with congenital USOP who underwent surgery in our hospital from January 2018 to December 2021 were collected and their case data were retrospectively analyzed.Fovea-disc angle(FDA)was measured to evaluate the relationship between fundus torsional states,FDA and the stereopsis.Results A total of 43 patients with USOP were included in the study,of the USOP patients,35%(15)had normal fundus(no torsion in both eyes)and 65%(28)showed extorsion of the fundus.In the patients without torsion in either eye,the total FDA value of both eyes was 12.62±3.24 degrees,which was significantly smaller than that of extorsion group(22.74±8.60 degrees).In the non-extorsion group,33%(5 cases)of the patients had both near and far stereopsis,while only 7%(2 cases)of the patients with extorsion had both near and far stereopsis.The preservation rate of stereopsis in extorsion group is lower than that in non-extorsion group.The total FDA of all patients’eyes was correlated with far and near stereopsis(r=-0.307,P=0.046,r=-0.326,P=0.033).There was no correlation between binocular total FDA and near and far stereopsis in the normal group,and there was a correlation between binocular total FDA and near stereopsis in extorsion group(r=-0.521,P=0.004);In the patients with torsion in one eye,there is a significant correlation between the FDA of extorsion eyes and far and near stereopsis(r=-0.627,P=0.002,r=-0.587,P=0.004),while the FDA of non-extorsion eyes has no correlation with far and near stereopsis.Conclusions Patients with congenital USOP have a high rate of stereopsis preservation in those with normal fundus,and those with extorsion of the fundus have worse stereopsis function.Binocular FDA(especially the FDA of extorsion eye)is negatively correlated with far and near stereopsis.The smaller FDA is,the better stereopsis is.

关 键 词：眼底照相 旋转 上斜肌麻痹 立体视 

分 类 号：R779.6[医药卫生—眼科]