Gusek-Schneider G C, Martus P
Department of Ophthalmology, University Erlangen-Nuremberg, Erlangen, Germany.
Strabismus. 2000 Sep;8(3):169-77.
To investigate the frequency of hyperopia and suspected stimulus deprivation myopia in human congenital ptosis.
Ametropia was evaluated in both eyes of 50 patients with congenital ptosis. The age at investigation was one year and older, average 6 years and 10 months. The amount of refraction was documented as the spherical equivalent (100% cycloplegia). Differences between the paired eyes of 1.0 dpt or more were defined as anisometropia. Statistical analysis was performed using the chi-square and sign tests.
The frequency of myopia was lower (7/50: 14%) than that of hyperopia (43/50: 86%) in the ptotic eye (p<0.001). However, myopia occurred more often in the ptotic eye (7/50: 14%) than in the fellow eye (3/50: 6%, p>0.3). Myopic anisometropia was found only in the ptotic eye (5/50 vs. 0/50, p = 0.06), but was not more frequent than hyperopic anisometropia: (5/50 vs. 9/50, p>0.4). A covered center of the pupil in 27 out of 50 eyes was not associated significantly with myopia (2 of 27 versus 5 of 23, p>0.2). Altogether, we found a significantly higher rate of myopia <-1 dpt and hyperopia > 2 dpt: 10% vs. 1.4% and 40% vs. 10.2% (p<0.001) in comparison with normal school children.
In summary, the following three findings were noted, of which the first two were expected and the third was not. 1. Compared with the normal population, there was an overall higher frequency of myopia in unilateral congenital ptosis. 2. There was a higher frequency of myopia in the ptotic than in the fellow eye. 3. Compared with the normal population, there was also a higher frequency of hyperopia. The clinical presentation of human congenital ptosis may be influenced by compensating head posture, strabismus, accommodation and biochemical effects, and the condition may therefore differ from the classical well-defined animal model of stimulus deprivation myopia.
研究人类先天性上睑下垂患者中远视及疑似形觉剥夺性近视的发生率。
对50例先天性上睑下垂患者的双眼进行屈光不正评估。受调查者年龄在1岁及以上，平均为6岁10个月。屈光度数记录为等效球镜度（100%睫状肌麻痹）。双眼差值达1.0屈光度或更高定义为屈光参差。采用卡方检验和符号检验进行统计学分析。
上睑下垂眼的近视发生率（7/50：14%）低于远视发生率（43/50：86%）（p<0.001）。然而，上睑下垂眼的近视发生率（7/50：14%）高于对侧眼（3/50：6%，p>0.3）。仅在上睑下垂眼发现近视性屈光参差（5/50比0/50，p = 0.06），但不比远视性屈光参差更常见：（5/50比9/50，p>0.4）。50只眼中有27只眼瞳孔中心被遮盖与近视无显著相关性（27只眼中2只比23只眼中5只，p>0.2）。总体而言，与正常学童相比，我们发现近视<-1屈光度和远视>2屈光度的发生率显著更高：分别为10%比1.4%和40%比10.2%（p<0.001）。
总之，注意到以下三个发现，其中前两个在意料之中，第三个则不然。1. 与正常人群相比，单侧先天性上睑下垂患者总体近视发生率更高。2. 上睑下垂眼的近视发生率高于对侧眼。3. 与正常人群相比，远视发生率也更高。人类先天性上睑下垂的临床表现可能受代偿性头位、斜视、调节及生化效应影响，因此该病症可能与经典的明确形觉剥夺性近视动物模型有所不同。
