单眼或双眼：多发性硬化症中双眼和单眼低对比度视力测试的比较。
One eye or two: a comparison of binocular and monocular low-contrast acuity testing in multiple sclerosis.
机构信息
Department of Neurology, University of Pennsylvania School of Medicine, Philadelphia, USA.
出版信息
Am J Ophthalmol. 2011 Jul;152(1):133-40. doi: 10.1016/j.ajo.2011.01.023. Epub 2011 May 12.
PURPOSE
To determine the magnitudes of binocular summation for low- and high-contrast letter acuity in a multiple sclerosis (MS) cohort, and to characterize the roles that MS disease, age, interocular difference in acuity, and a history of optic neuritis have on binocular summation. The relation between binocular summation and monocular acuities and vision-specific quality of life (QoL) was also examined.
DESIGN
Cross-sectional observational study.
METHODS
Low-contrast acuity (2.5% and 1.25% contrast) and high-contrast visual acuity (VA) were assessed binocularly and monocularly in patients and disease-free controls at 3 academic centers. Binocular summation was calculated as the difference between the binocular and better eye scores. QoL was measured using the 25-item National Eye Institute Visual Functioning Questionnaire (NEI VFQ-25) and the 10-item neuro-ophthalmic supplement. The relation of the degree of binocular summation to monocular acuity, clinical history of acute optic neuritis, age, interocular acuity difference, and QoL was determined.
RESULTS
Binocular summation was demonstrated at all contrast levels, and was greatest at the lowest level (1.25%). Increasing age (P < .0001), greater interocular differences in acuity (P < .0001), and prior history of optic neuritis (P = .015) were associated with lower magnitudes of binocular summation; binocular inhibition was seen in some of these patients. Higher magnitudes of summation for 2.5% low-contrast acuity were associated with better scores for the NEI VFQ-25 (P = .02) and neuro-ophthalmic supplement (P = .03).
CONCLUSION
Binocular summation of acuity occurs in MS but is reduced by optic neuritis, which may lead to binocular inhibition. Binocular summation and inhibition are important factors in the QoL and visual experience of MS patients, and may explain why some prefer to patch or close 1 eye in the absence of diplopia or ocular misalignment.
目的
在多发性硬化症 (MS) 队列中确定低对比度和高对比度字母视力的双眼总和幅度，并确定 MS 疾病、年龄、视力差异和视神经炎病史对双眼总和的作用。还检查了双眼总和与单眼视力和特定于视觉的生活质量 (QoL) 的关系。
设计
横断面观察性研究。
方法
在 3 个学术中心，对患者和无疾病对照者的低对比度视力 (2.5%和 1.25%对比度) 和高对比度视力进行双眼和单眼评估。双眼总和通过双眼和较好眼评分之间的差异来计算。使用 25 项国家眼科研究所视觉功能问卷 (NEI VFQ-25) 和 10 项神经眼科补充问卷来测量 QoL。确定双眼总和与单眼视力、急性视神经炎的临床病史、年龄、眼间视力差异和 QoL 的关系。
结果
在所有对比度水平都显示出双眼总和，在最低水平（1.25%）最大。年龄增加（P <.0001）、视力差异较大（P <.0001）和既往视神经炎病史（P =.015）与双眼总和幅度降低有关；在这些患者中，一些人出现双眼抑制。2.5%低对比度视力的总和幅度较高与 NEI VFQ-25（P =.02）和神经眼科补充问卷（P =.03）的较高分数相关。
结论
MS 中存在视力的双眼总和，但视神经炎会降低总和，这可能导致双眼抑制。双眼总和和抑制是 MS 患者 QoL 和视觉体验的重要因素，这可能解释了为什么有些人在没有复视或眼位不正的情况下更喜欢遮盖或闭上一只眼睛。
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