Roberts C J, Adams G G W
Strabismus Service, Moorfields Eye Hospital, City Road, London, UK.
Eye (Lond). 2002 Sep;16(5):577-9. doi: 10.1038/sj.eye.6700159.
Poster at College Congress, Birmingham 2001. Oral presentation at European Strabismus Association, Florence 2001.
Anisometropia of more than one dioptre during the sensitive visual period may cause amblyopia. Its management requires refractive correction, and occlusion. Compliance with treatment is critical if visual improvement is to obtained. High anisometropia, poor initial acuity and mixed strabismic/anisometropia amblyopia are predictive factors for a poor outcome. We evaluated contact lens use in the management of high anisometropic amblyopia.
Retrospective analysis of anisometropic amblyopia managed in a paediatric contact lens clinic (July 1996-July 2000), after standard amblyopia therapy of spectacles and occlusion therapy had been tried. Presenting age, acuity and refraction, duration of lens wear and occlusion, and final visual outcomes were noted.
Seven children (four male, three female) presented at age 3.5-6 years (mean 4.5). Six had myopic anisometropia 6.0-18.4 dioptres (mean 10.4 dioptres) and one 6.75 dioptres hypermetropic anisometropia. The initial corrected acuities of the amblyopic eyes were 6/18 to 1/60. Five patients used contact lenses with a range from 5 months to 4 years. Final acuities were 6/12-1/60. Two myopes with 6 dioptres anisometropia improved three to four Snellen lines, one with 8.8 dioptres improved one line. Three with >10 dioptres anisometropia did not improve. The hypermetropic patient improved part of one Snellen line.
High anisometropic amblyopia is challenging to treat. In our study contact lenses improved visual acuity in myopic anisometropia of up to 9 dioptres.
2001年在伯明翰学院大会上展示的海报。2001年在佛罗伦萨欧洲斜视协会上的口头报告。
在视觉敏感期，超过1屈光度的屈光参差可能导致弱视。其治疗需要屈光矫正和遮盖。若要获得视力改善，治疗依从性至关重要。高度屈光参差、初始视力差以及混合性斜视/屈光参差性弱视是预后不良的预测因素。我们评估了隐形眼镜在高度屈光参差性弱视治疗中的应用。
对一家儿科隐形眼镜诊所（1996年7月至2000年7月）治疗的屈光参差性弱视进行回顾性分析，此前已尝试了标准的弱视治疗方法，即眼镜和遮盖疗法。记录就诊年龄、视力和屈光情况、戴镜和遮盖时间以及最终视力结果。
7名儿童（4名男性，3名女性）就诊年龄为3.5至6岁（平均4.5岁）。6名患有近视性屈光参差，度数为6.0至18.4屈光度（平均10.4屈光度），1名患有6.75屈光度的远视性屈光参差。弱视眼的初始矫正视力为6/18至1/60。5名患者使用隐形眼镜，时间为5个月至4年。最终视力为6/12至1/60。两名近视性屈光参差6屈光度的患者视力提高了三到四行，一名8.8屈光度的患者提高了一行。三名屈光参差大于10屈光度的患者视力未改善。远视性患者视力提高了部分一行。
高度屈光参差性弱视治疗具有挑战性。在我们的研究中，隐形眼镜改善了高达9屈光度的近视性屈光参差患者的视力。
