Hatt Sarah R, Mohney Brian G, Leske David A, Holmes Jonathan M
Department of Ophthalmology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA.
Am J Ophthalmol. 2008 Mar;145(3):556-561. doi: 10.1016/j.ajo.2007.10.028. Epub 2008 Jan 16.
Distance stereoacuity is used to monitor deterioration of intermittent exotropia (IXT), but variability of stereoacuity has not been studied rigorously. The purpose of this study was to assess the variability of stereoacuity over one day in children with IXT.
Prospective cohort study.
Twelve children with IXT were recruited. Stereoacuity was assessed using the Frisby Davis Distance test and the Distance Randot test at distance, and the Frisby and Preschool Randot tests at near. Tests were repeated three or four times over the day, with at least two hours between assessments. The main outcome measure was variable stereoacuity defined as a change by two or more log levels between any two time points over the day.
Variable stereoacuity at distance was found in five (42%) of 12 patients. Four (33%) of 12 patients demonstrated variable results using the Distance Randot test, three of whom also showed variable results using the Frisby Davis Distance test. One patient had variable results using the Frisby Davis Distance test only. Nine (75%) of 12 patients completed near stereoacuity testing; two (22%) of nine showed variable near stereoacuity. Two (22%) of nine showed variable results using the Preschool Randot test, one (11%) of whom also had variable results using the Frisby test. In some cases, stereoacuity changed from measurable stereoacuity on one assessment to nil on another.
Nearly half of children with IXT show marked changes in stereoacuity over the course of a single day. When based on isolated measures, an apparent change in distance stereoacuity between visits should be interpreted with caution.
远距离立体视锐度用于监测间歇性外斜视(IXT)的恶化情况,但立体视锐度的变异性尚未得到严格研究。本研究的目的是评估IXT患儿一天内立体视锐度的变异性。
前瞻性队列研究。
招募了12名IXT患儿。使用弗里斯比·戴维斯远距离测试和远距离兰多测试评估远距离立体视锐度,使用弗里斯比测试和学龄前兰多测试评估近距离立体视锐度。一天内测试重复三到四次,两次评估之间至少间隔两小时。主要观察指标是变异性立体视锐度,定义为一天内任意两个时间点之间变化两个或更多对数级别。
12例患者中有5例(42%)远距离立体视锐度存在变异性。12例患者中有4例(33%)使用远距离兰多测试结果存在变异性,其中3例使用弗里斯比·戴维斯远距离测试结果也存在变异性。1例患者仅使用弗里斯比·戴维斯远距离测试结果存在变异性。12例患者中有9例(75%)完成了近距离立体视锐度测试;9例中有2例(22%)近距离立体视锐度存在变异性。9例中有2例(22%)使用学龄前兰多测试结果存在变异性,其中1例(11%)使用弗里斯比测试结果也存在变异性。在某些情况下,立体视锐度在一次评估中为可测量,而在另一次评估中变为零。
近一半的IXT患儿在一天内立体视锐度有明显变化。基于单次测量时,就诊之间远距离立体视锐度的明显变化应谨慎解读。