间歇性外斜视患者的眼球旋转情况研究  

Assessment of ocular torsion in patients with intermittent exotropia

作　　者：刘佩佩 戴薇 付晶[1] Liu Peipei;Dai Wei;Fu Jing(Beijing Tongren Eye Center,Beijing Tongren Hospital,Capital Medical University,Beijing 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、北京同仁眼科中心眼科学与视觉科学北京市重点实验室,北京100730

出　　处：《眼科》2023年第5期425-429,共5页Ophthalmology in China

基　　金：国家自然科学基金面上项目(82070998);首都卫生发展科研专项重点攻关(首发2022-1-2053);北京市医院管理中心临床技术创新项目(XMLX202103)。

摘　　要：目的研究间歇性外斜视患者眼球旋转情况。设计回顾性病例系列。研究对象2021年10月至2022年7月北京同仁医院5~16岁间歇性外斜视患者108例及正常对照108例。方法免散瞳眼底照相检查,使用Image J软件测量视盘-黄斑中心凹夹角(DFA),外旋为黄斑中心位于视盘下缘水平线以下,内旋为黄斑中心居于视盘中心水平线以上,位于两者之间则认为无旋转。分析间歇性外斜视组患者眼球旋转与修正纽卡斯尔控制力评分、斜视角度、立体视的相关性。主要指标DFA、眼球旋转情况及与修正纽卡斯尔控制力评分、斜视角度、立体视的相关性。结果间歇性外斜视组患者平均DFA为(6.17±3.18)°,明显大于正常对照组的(5.36±2.50)°(t=2.939,P=0.003)。间歇性外斜视组患者眼球旋转(内旋及外旋)者33眼(15.28%),明显高于对照组的14眼(6.48%)(χ^(2)=8.843,P=0.003)。间歇性外斜视患者的DFA大小与修正纽卡斯尔控制力评分及斜视角度、远近立体视均具有显著正相关性(r=0.634,P<0.001;r=0.353,P<0.001;r=0.370,P<0.001;r=0.271,P=0.005)。结论间歇性外斜视患者在控制力越差、斜视角度越大、立体视越差时,眼球旋转情况越明显。(眼科,2023,32:425-429)Objective To evaluate the distribution of ocular torsion in intermittently exotropic patients.Design Retrospective case series.Participants 108 patients with intermittent exotropia aged 5~16 years presented from October 2021 to July 2022,and 108 patients without strabismus were collected as the control group in Beijing Tongren Hospital.Method All subjects underwent non-mydriatic fundus photography.The disc-foveal angle(DFA)was measured using Image J software.Photographs of the fundus were classified as normal(no torsion)when the fovea lay between the center and the inferior margin of the optic disc.There was an intorsion when the fovea was above the disc center.Extorsion when the fovea was situated below its inferior margin.The correlation between DFA and the Revised Newcastle Control Score(RNCS)and strabismus angle,stereoacuity was analyzed.Main Outcome Measures DFA,ocular torsion and correlation with RNCS,strabismus angle,and stereopsis.Results The mean DFA in the intermittent exotropia group was significantly greater than that in the normal control group(6.17°±3.18°;5.36°±2.50°,respectively,P=0.003),and the incidence of ocular torsion(extorsion or intorsion)in the intermittent exotropia group was significantly higher than that in the control group(33 eyes,15.28%;14 eyes,6.48%,P=0.003).DFA size has significant positive correlation with RNCS,strabismus angle and stereoacuity in patients with intermittent exotropia(r=0.634,P<0.001;r=0.353,P<0.001;r=0.370,P<0.001;r=0.271,P=0.005).Conclusion Intermittent exotropia patients exist more obvious the ocular torsion when their control scores were poor,their strabismus angles were larger,and their stereoacuities were poorer.(Ophthalmol CHN,2023,32:425-429)

关 键 词：间歇性外斜视 旋转 视盘-黄斑中心凹夹角 

分 类 号：R777.41[医药卫生—眼科]