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[青少年及成人弱视患者视觉可塑性的临床研究]

[Clinical study of visual plasticity in teenage and adults with amblyopia].

作者信息

Chen Jun-ping, Song Wen-xi, Wu Qi-hui

机构信息

Department of Ophthalmology, The Fourth People's Hospital of Chongqing, Chongqing 400014, China.

出版信息

Zhonghua Yan Ke Za Zhi. 2003 Dec;39(12):710-3.

Abstract

OBJECTIVE

Human visual plasticity was studied by the observation of the effects of treatment in teenage and adult amblyopia.

METHODS

One hundred and two cases (125 eyes) were diagnosed as amblyopia according to the national criteria of amblyopia. These patients were divided into teenage group (15 - 17 years old, 47 cases and 57 eyes) and adult group (18 - 45 years old, 55 cases and 68 eyes). Eye examination, including best correct visual acuity, laser interference fringes visual acuity (IVA), degree and patterns of amblyopia, and nature of fixation were performed in these two groups before amblyopic treatment. Patients were treated with correct spectacle, optical and drug penalization (including far and near penalization, as well as light penalization), combined with occlusion and assisted with red light pleoption. All patients were followed up for 1 - 5 years, with an average of 2.9 years.

RESULTS

Fifty five eyes (44%) were cured (23 eyes recovered, 32 eyes basically cured), 37 eyes (29.6%) were improved, 33 eyes (26.4%) were nullified and the total improvement rate was 73.6%. Different ages did not influence the results of treatment significantly (P > 0.05). Outcome of foveal fixation and parafoveal fixation was much better than that of paramacular fixation and peripheral fixation (P < 0.005). The curative efficiency of amblyopia was also dependent on the degree of amblyopia (P < 0.005). Curative effects of ametropic and anisometropic amblyopia were better than that of strabismic and deprivable amblyopia (P < 0.01). Visual acuity predicted by IVA before the treatment was the same as real results after the treatment in 112 eyes among 125 eyes (92.8%). The correlation efficient between the predicted and real vision was statistically significant (r = 0.886 2, P < 0.000 1).

CONCLUSIONS

Vision in most teenage and adult amblyopia can be improved by amblyopic therapy. Therefore, it seems that human visual plasticity exists permanently during the whole life. Visual acuity after the treatment can be predicted by pre-treatment IVA. Results of amblyopia treatment are closely related with the degree and patterns of amblyopia and are also dependent on the cooperation of the patients.

摘要

目的

通过观察青少年及成人弱视治疗效果来研究人类视觉可塑性。

方法

依据国家弱视标准,102例(125只眼)患者被诊断为弱视。这些患者被分为青少年组(15 - 17岁,47例57只眼)和成人组(18 - 45岁,55例68只眼)。在弱视治疗前,对这两组患者进行眼部检查,包括最佳矫正视力、激光干涉条纹视力(IVA)、弱视程度和类型以及注视性质。患者接受正确配镜、光学及药物压抑(包括远、近压抑以及光压抑),联合遮盖并辅以红光闪烁。所有患者随访1 - 5年,平均2.9年。

结果

55只眼(44%)治愈(23只眼视力恢复,32只眼基本治愈),37只眼(29.6%)好转,33只眼(26.4%)无效,总有效率为73.6%。不同年龄对治疗结果影响不显著(P > 0.05)。中心凹注视和旁中心凹注视的治疗效果远优于黄斑旁注视和周边注视(P < 0.005)。弱视治疗效果还取决于弱视程度(P < 0.005)。屈光不正性和屈光参差性弱视的治疗效果优于斜视性和形觉剥夺性弱视(P <

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