Vision Science Research Group, School of Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland, United Kingdom.
Invest Ophthalmol Vis Sci. 2010 Jun;51(6):2885-90. doi: 10.1167/iovs.09-4670. Epub 2010 Jan 27.
To describe refractive status in children and young adults with cerebral palsy (CP) and relate refractive error to standardized measures of type and severity of CP impairment and to ocular dimensions.
A population-based sample of 118 participants aged 4 to 23 years with CP (mean 11.64 +/- 4.06) and an age-appropriate control group (n = 128; age, 4-16 years; mean, 9.33 +/- 3.52) were recruited. Motor impairment was described with the Gross Motor Function Classification Scale (GMFCS), and subtype was allocated with the Surveillance of Cerebral Palsy in Europe (SCPE). Measures of refractive error were obtained from all participants and ocular biometry from a subgroup with CP.
A significantly higher prevalence and magnitude of refractive error was found in the CP group compared to the control group. Axial length and spherical refractive error were strongly related. This relation did not improve with inclusion of corneal data. There was no relation between the presence or magnitude of spherical refractive errors in CP and the level of motor impairment, intellectual impairment, or the presence of communication difficulties. Higher spherical refractive errors were significantly associated with the nonspastic CP subtype. The presence and magnitude of astigmatism were greater when intellectual impairment was more severe, and astigmatic errors were explained by corneal dimensions. Conclusions. High refractive errors are common in CP, pointing to impairment of the emmetropization process. Biometric data support this
In contrast to other functional vision measures, spherical refractive error is unrelated to CP severity, but those with nonspastic CP tend to demonstrate the most extreme errors in refraction.
描述脑瘫（CP）患儿和年轻成人的屈光状态，并将屈光不正与 CP 损伤的类型和严重程度的标准化测量以及眼轴长度相关联。
本研究采用基于人群的样本，纳入了 118 名年龄在 4 至 23 岁的 CP 患儿（平均年龄 11.64 ± 4.06 岁）和年龄匹配的对照组（n = 128；年龄 4-16 岁；平均年龄 9.33 ± 3.52 岁）。采用粗大运动功能分类量表（GMFCS）描述运动障碍程度，采用欧洲脑瘫监测（SCPE）对亚型进行分类。所有参与者均进行屈光不正测量，CP 组的一部分参与者进行眼轴长度和角膜曲率测量。
与对照组相比，CP 组的屈光不正患病率和程度均显著更高。眼轴长度与球镜屈光不正呈强相关。这种相关性在纳入角膜数据后并未改善。CP 患者的球镜屈光不正的存在或程度与运动障碍程度、智力障碍程度或存在沟通困难之间无相关性。非痉挛型 CP 亚型的患者存在更高的球镜屈光不正。当智力障碍程度更严重时，球镜屈光不正和散光的程度更大，而散光可以用角膜参数来解释。
CP 患者中常见高度屈光不正，提示其正视化过程受损。生物测量数据支持这一观点。
与其他功能性视力测量指标不同，球镜屈光不正与 CP 严重程度无关，但非痉挛型 CP 患者的屈光不正最严重。
