Wallace D K
Department of Ophthalmology and Pediatrics, University of North Carolina at Chapel Hill, 27599-7040, USA.
J AAPOS. 1999 Aug;3(4):241-4. doi: 10.1016/s1091-8531(99)70009-1.
Atropinization of the sound eye is an alternative to patching in the treatment of amblyopia. Whether atropine treatment can induce a switch in fixation depends on the refractive error of the sound eye, visual acuity of the amblyopic eye, distance from the fixation target, and presence of any optical correction or penalization. General guidelines are needed on the basis of refractive error and visual acuity in the amblyopic eye to predict which patients may potentially benefit from atropine penalization.
Refractive error and visual acuity at distance (6 m) and/or at near (33 cm) were recorded in a normal eye of 126 consecutive children (mean age, 8.2 years), 30 to 60 minutes after receiving cyclopentolate 1%. Visual acuity was plotted versus refractive error at distance and at near, and best-fit curves were calculated.
There was a consistent, reproducible relationship between refractive error and visual acuity after cycloplegia at both distance and near in healthy children.
The results of this study can be used to quickly determine whether atropine penalization has the potential for success on the basis of a patient's visual acuity in the amblyopic eye and refractive error in the sound eye. When adequate hyperopia is present in the sound eye, one should consider testing for fixation preference or initiating a therapeutic trial of atropine. Those children with insufficient hyperopia in the sound eye relative to visual acuity in the amblyopic eye can be spared the time, expense, and potential side effects of atropine penalization.
对健眼进行阿托品化是治疗弱视时替代遮盖疗法的一种方法。阿托品治疗是否能引起注视转换取决于健眼的屈光不正、弱视眼的视力、与注视目标的距离以及是否存在任何光学矫正或抑制。需要根据弱视眼的屈光不正和视力制定通用指南，以预测哪些患者可能从阿托品抑制中潜在获益。
连续126名儿童（平均年龄8.2岁）在滴用1%环喷托酯后30至60分钟，记录其健眼的远距（6米）和/或近距（33厘米）屈光不正及视力。绘制远距和近距视力与屈光不正的关系图，并计算最佳拟合曲线。
在健康儿童中，睫状肌麻痹后远距和近距的屈光不正与视力之间存在一致、可重复的关系。
本研究结果可用于根据患者弱视眼的视力和健眼的屈光不正快速确定阿托品抑制是否有可能成功。当健眼中存在足够的远视时，应考虑检测注视偏好或开始阿托品治疗试验。相对于弱视眼的视力，健眼中远视不足的儿童可以避免阿托品抑制带来的时间、费用和潜在副作用。
