Kromeier M, Schmitt C, Bach M, Kommerell G
Abteilung Neuroophthalmologie und Schielbehandlung, Universitäts-Augenklinik Freiburg, Killianstrasse 5, 79106 Freiburg.
Ophthalmologe. 2002 Jul;99(7):549-54. doi: 10.1007/s003470100550.
Since Ogle (1949) dissociated heterophoria is distinguished from associated heterophoria. Dissociated heterophoria is defined as a deviation from the orthovergence position that occurs when no fusional contours are provided. Associated heterophoria is a deviation that occurs under prism correction of fixation disparity, i.e. under a viewing condition in which fusional contours are absent only in the centre of the visual field. Both dissociated and associated heterophoria have been used as indications for prismatic correction. It has been controversially discussed to what extent dissociated and associated heterophoria are comparable.
A total of 43 subjects were investigated using the white Maddox rod test for horizontal dissociated heterophoria and the cross test of Hans-Joachim Haase (a test similar to the fixation disparity test described by Ogle 1949) for horizontal associated heterophoria. In both tests subjects were asked to continually correct any deviation using Herschel prisms. Readings were taken after 1 min.
The correlation between the results obtained with the white Maddox rod test and the cross test was r = 0.89 (p < 0.0001) and the slope of the regression line was 0.92 (95% confidence interval from 0.77 to 1.07). One subject was unable to reach a match in the cross test because she had an "obligate" fixation disparity due to a staphyloma posticum.
Our study revealed a high correlation between dissociated and associated heterophoria. This result appears plausible since the feedback loop for fusion is disconnected in both cases, although in a different manner: When dissociated heterophoria is measured, fusionable contours are absent. When associated heterophoria is measured, any disparity of peripheral contours that could serve as an error signal is nullified by instantaneous prism correction. The high concordance of dissociated and associated heterophoria suggests that both measures are of equal value as an indication for prismatic spectacle correction. In rare cases of an "obligate" fixation disparity, however, associated heterophoria cannot be determined so that dissociated heterophoria remains as the only indication.
自奥格尔（1949年）以来，分离性隐斜与共同性隐斜有所区别。分离性隐斜被定义为在没有融合性轮廓时出现的与正位视位置的偏差。共同性隐斜是在注视差异的棱镜矫正下出现的偏差，即在仅视野中心没有融合性轮廓的观察条件下。分离性和共同性隐斜都被用作棱镜矫正的指征。关于分离性和共同性隐斜在多大程度上具有可比性一直存在争议。
共对43名受试者进行了研究，使用白色马多克斯杆试验检测水平分离性隐斜，使用汉斯 - 约阿希姆·哈泽的交叉试验（一种类似于奥格尔1949年描述的注视差异试验的试验）检测水平共同性隐斜。在两项试验中，均要求受试者使用赫歇尔棱镜持续矫正任何偏差。1分钟后进行读数。
白色马多克斯杆试验和交叉试验所得结果之间的相关性为r = 0.89（p < 0.0001），回归线斜率为0.92（95%置信区间为0.77至1.07）。一名受试者在交叉试验中无法达到匹配，因为她因后巩膜葡萄肿存在“强制性”注视差异。
我们的研究揭示了分离性隐斜和共同性隐斜之间存在高度相关性。这一结果似乎合理，因为在这两种情况下融合的反馈回路均被断开，尽管方式不同：测量分离性隐斜时，不存在可融合的轮廓。测量共同性隐斜时，任何可作为误差信号的周边轮廓差异都通过即时棱镜矫正而消除。分离性和共同性隐斜的高度一致性表明，这两种测量方法作为棱镜眼镜矫正的指征具有同等价值。然而，在罕见的“强制性”注视差异情况下，无法确定共同性隐斜，因此分离性隐斜仍然是唯一的指征。
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