Yue Yi-ying, Zhao Kan-xing, Ma Hui-zhi, Hua Ning, Wang Le-jin
Tianjin Medical University, Tianjin Eye Hospital, Tianjin 300020, China.
Zhonghua Yan Ke Za Zhi. 2003 Dec;39(12):724-6.
To investigate the results of using shifting fixation eye to manage monocular or asymmetrical binocular dissociated vertical deviation (DVD).
Twenty-three DVD children whose corrected vision was better than 0.5 in the amblyopic eye were studied. The goal of the shifting fixation eye was gained by decreasing the vision of the primary fixation eye to 2 or 3 lines (Snellen Visual Acuity) lower than that of the fellow fixation eye by occlusion or optical methods. The vision, alignment and retinal correspondence were evaluated before and after the treatment.
After the treatment, in 10 patients, the vision of the primary fixation eye did not decrease significantly and the vision of the fellow eye increased 2 lines. In 19 patients, a cosmetic result was achieved; the primary fixation eye was shifted in 4 patients that had similar hepertropia in two eyes (<or= 10(Delta)). Normal retinal correspondence was restored in 3 patients who had normal retinal correspondence at near while depressed at distance.
Shifting fixation eye is an effective treatment for DVD hepertropia, especially in patients with monocular or asymmetrical binocular DVD with hepertropia in one eye and latent hepertropia in the fellow eye. This method is suitable to DVD children who do not accept the surgical treatment and have slight to moderate amblyopia and ametropia.
探讨采用交替注视眼法治疗单眼或不对称双眼分离性垂直偏斜（DVD）的效果。
研究23例弱视眼矫正视力优于0.5的DVD患儿。通过遮盖或光学方法将主注视眼视力降低2或3行（斯内伦视力表），使其低于对侧注视眼，以达到交替注视眼的目的。治疗前后评估视力、眼位及视网膜对应情况。
治疗后，10例患儿主注视眼视力无明显下降，对侧眼视力提高2行。19例患儿获得了美容效果；4例双眼上斜视程度相似（≤10Δ）的患儿主注视眼发生了转移。3例近距视网膜对应正常而远距时降低的患儿恢复了正常视网膜对应。
交替注视眼法是治疗DVD上斜视的有效方法，尤其适用于单眼或不对称双眼DVD、一眼有上斜视而对侧眼有潜在上斜视的患儿。该方法适用于不接受手术治疗且有轻度至中度弱视和屈光不正的DVD患儿。
