Stewart C E, Moseley M J, Fielder A R, Stephens D A
Department of Visual Neuroscience, Imperial College London, Charing Cross Campus, Margravine Road, London W6 8RP, UK.
Br J Ophthalmol. 2004 Dec;88(12):1552-6. doi: 10.1136/bjo.2004.044214.
To describe the visual response to spectacle correction ("refractive adaptation") for children with unilateral amblyopia as a function of age, type of amblyopia, and category of refractive error.
Measurement of corrected amblyopic and fellow eye logMAR visual acuity in newly diagnosed children. Measurements repeated at 6 weekly intervals for a total 18 weeks.
Data were collected from 65 children of mean (SD) age 5.1 (1.4) years with previously untreated amblyopia and significant refractive error. Amblyopia was associated with anisometropia in 18 (5.5 (1.4) years), strabismus in 16 (4.2 (0.98) years), and mixed in 31 (5.2 (1.5) years) of the study participants. Mean (SD) corrected visual acuity of amblyopic eyes improved significantly (p<0.001) from 0.67 (0.38) to 0.43 (0.37) logMAR: a mean improvement of 0.24 (0.18), range 0.0-0.6 log units. Change in logMAR visual acuity did not significantly differ as a function of amblyopia type (p = 0.29) (anisometropia 0.22 (0.13); mixed 0.18 (0.14); strabismic 0.30 (0.24)) or for age (p = 0.38) ("under 4 years" 0.23 (0.18); "4-6 years" 0.24 (0.20); "over 6 years" 0.16 (0.23)).
Refractive adaptation is a distinct component of amblyopia treatment. To appropriately evaluate mainstream therapies such as occlusion and penalisation, the beneficial effects of refractive adaptation need to be fully differentiated. A consequence for clinical practice is that children may start occlusion with improved visual acuity, possibly enhancing compliance, and in some cases unnecessary patching will be avoided.
描述单侧弱视儿童对框架眼镜矫正（“屈光适应”）的视觉反应，该反应是年龄、弱视类型和屈光不正类别的函数。
测量新诊断儿童矫正后的弱视眼和对侧眼的最小分辨角对数视力（logMAR）。每6周测量一次，共测量18周。
收集了65名平均（标准差）年龄为5.1（1.4）岁、此前未治疗过弱视且有明显屈光不正的儿童的数据。研究参与者中，18名（5.5（1.4）岁）弱视与屈光参差有关，16名（4.2（0.98）岁）与斜视有关，31名（5.2（1.5）岁）与混合性因素有关。弱视眼的平均（标准差）矫正视力从0.67（0.38）显著提高到0.43（0.37）logMAR（p<0.001）：平均提高0.24（0.18），范围为0.0至0.6对数单位。logMAR视力变化在弱视类型方面（p = 0.29）（屈光参差0.22（0.13）；混合性0.18（0.14）；斜视性0.30（0.24））或年龄方面（p = 0.38）（“4岁以下”0.23（0.18）；“4至6岁”0.24（0.20）；“6岁以上”0.16（0.23））无显著差异。
屈光适应是弱视治疗的一个独特组成部分。为了适当地评估诸如遮盖和压抑疗法等主流治疗方法，需要充分区分屈光适应的有益效果。临床实践的一个结果是，儿童可能以提高的视力开始遮盖治疗，这可能会增强依从性，并且在某些情况下可以避免不必要的遮盖。
