Lempert Philip
Cornell Medical Center, Ithaca, NY, USA.
Semin Ophthalmol. 2008 Sep-Oct;23(5):302-6. doi: 10.1080/08820530802505997.
To compare retinal area to optic disc rim area ratios of hyperopic normal, strabismic eyes with equal acuity, amblyopic, and fellow eyes.
Neuroretinal rim areas of 293 amblyopic and fellow eyes, and 77 non-amblyopic hyperopic right eyes, and 84 non-amblyopic strabismic right eyes were measured by magnification corrected retinal photography and planimetry. Retinal area estimates were based on axial lengths.
All subjects had bilateral hyperopia. Patients with glaucoma or known optic nerve atrophy were excluded. The normal and strabismic groups had equal visual acuity in each eye better than 20/40. The amblyopic group had acuity worse than 20/40 in one eye uncorrectable with lenses and without gross anatomic defects.
The amblyopic group included 137 with strabismus and 89 with anisometropia exceeding 1.5 diopters. There were highly significant differences between the ratio of retinal area to optic disc rim area of the amblyopic and of normal eyes (unpaired t-test, p = 8.6 x 10(-6)), the amblyopic and strabismic right eyes (unpaired t-test, p = 4.22 x 10(-8)) as well between the fellow and amblyopic eyes (paired t-test, p = 2.13 x 10(-5)). The difference between the normal and strabismic eyes without amblyopia was not significant (p = 0.82). There was a 20 percent increase in the retinal receptor areas of hyperopic amblyopic eyes as compared to hyperopic eyes without amblyopia despite reduced retinal areas in the amblyopic eyes. Dysplastic and/or asymmetric optic discs were present in 163 of 293 (56 percent) amblyopic patients, 47 of 84 (56 percent) strabismic, and 10 of 77 (13 percent) normal patients.
The increase in the receptor area may be an explanation for diminished acuity and impaired visual function in amblyopic eyes.
比较远视正常眼、视力相等的斜视眼、弱视眼及其对侧眼的视网膜面积与视盘边缘面积之比。
通过放大校正视网膜摄影和平面测量法，测量了293只弱视眼及其对侧眼、77只非弱视远视右眼和84只非弱视斜视右眼的神经视网膜边缘面积。视网膜面积估计基于眼轴长度。
所有受试者均为双侧远视。排除青光眼或已知视神经萎缩患者。正常组和斜视组每只眼的视力均优于20/40。弱视组中一只眼的视力低于20/40，无法通过镜片矫正且无明显解剖缺陷。
弱视组包括137例斜视患者和89例屈光参差超过1.5屈光度的患者。弱视眼与正常眼的视网膜面积与视盘边缘面积之比（未配对t检验，p = 8.6×10⁻⁶）、弱视眼与斜视右眼之比（未配对t检验，p = 4.22×10⁻⁸）以及对侧眼与弱视眼之比（配对t检验，p = 2.13×10⁻⁵）之间存在高度显著差异。无弱视的正常眼与斜视眼之间的差异不显著（p = 0.82）。与无弱视的远视眼相比，远视弱视眼的视网膜感受器面积增加了20%，尽管弱视眼的视网膜面积减小。293例（56%）弱视患者中有163例存在发育异常和/或不对称视盘，84例（56%）斜视患者中有47例，77例（13%）正常患者中有10例。
感受器面积增加可能是弱视眼视力下降和视觉功能受损的一个原因。
