Tomaç Sühan, Sener E Cumhur, Sanaç A Sefik
Zonguldak Karaelmas University Faculty of Medicine, Department of Ophthalmology, Zonguldak, Turkey.
Jpn J Ophthalmol. 2002 Jan-Feb;46(1):52-8. doi: 10.1016/s0021-5155(01)00470-1.
To investigate the clinical characteristics and sensory mechanism of microtropia.
Twenty patients with primary microtropia were studied. The patients were evaluated by the visuscope, Irvine prism test, Bagolini striated glasses test, Worth 4-dot test (W4D), TNO, and stereo-fly plate of the Titmus test.
The patients who had positive cover test and eccentric fixation showed wandering eccentric fixation. The Irvine prism test was positive in all the patients by using prisms of different strengths and positions. All the patients had abnormal fusion at near. At distance, 15 patients had abnormal fusion by the Bagolini glasses and 8 patients had abnormal fusion by the Worth test. Ten patients had gross stereopsis and the remaining 10 had no measurable stereopsis.
The type of microtropia with eccentric fixation without identity is mainly due to the wandering eccentric fixation. All patients with microtropia have abnormal fusion without fixation point scotoma because positive prism test response does not change to normal by using prisms of different strengths and positions. Differences in fusion results are mainly due to the weakness of abnormal fusion rather than fixation point scotoma. With occlusion treatment, amblyopia can be improved, whereas binocular defects of microtropia cannot be improved.
研究微小斜视的临床特征及感觉机制。
对20例原发性微小斜视患者进行研究。通过视野镜、欧文棱镜试验、巴戈利尼条纹眼镜试验、沃思四点试验(W4D)、TNO以及蒂特马斯试验的立体视标盘对患者进行评估。
遮盖试验阳性且有偏心注视的患者表现为游动性偏心注视。使用不同强度和位置的棱镜时,所有患者的欧文棱镜试验均为阳性。所有患者近距融合均异常。远距离时,15例患者通过巴戈利尼眼镜检查融合异常,8例患者通过沃思试验融合异常。10例患者有明显立体视,其余10例无可测量的立体视。
无等同性的偏心注视型微小斜视主要是由于游动性偏心注视所致。所有微小斜视患者均有融合异常且无注视点暗点,因为使用不同强度和位置的棱镜时,阳性棱镜试验反应不会恢复正常。融合结果的差异主要是由于异常融合减弱而非注视点暗点。通过遮盖治疗,弱视可得到改善,而微小斜视的双眼缺陷无法改善。