Kasaee Abolfazl, Yazdani-Abyaneh Alireza, Tabatabaie Syed Ziaeddin, Jafari Alireza K, Ameri Ahmad, Eshraghi Bahram, Samarai Vafa, Mireshghi Meysam, Rajabi Mohammad Taher
Department of Ophthalmology, Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Int J Ophthalmol. 2010;3(4):328-30. doi: 10.3980/j.issn.2222-3959.2010.04.12. Epub 2010 Dec 18.
To study the frequency of amblyogenic factors in patients with congenital ptosis.
In this cross-sectional study, 114 eyes of 100 patients with congenital ptosis more than 1 year old were included. Amblyopia was defined as best-corrected visual acuity (BCVA) less than 10/10 or a difference between the two eyes of at least 2/10. In patients too young to be measured by the linear Snellen E test, fixation behavior was observed. Different types of amblyopia were assessed for each patient as: 1) anisometropic amblyopia: astigmatic anisometropia ≥1 dpt, hyperopic spherical anisometropia ≥1 dpt, myopic spherical anisometropia ≥-3 dpt (with cycloplegia); 2) strabismic amblyopia, and 3) stimulus deprivation amblyopia (SDA). Then the total incidence of amblyopia and each type of it were obtained. Patients with uni- and bi-lateral ptosis were also compared.
The incidence of amblyopia in ptotic eyes was 39/114 (34.2 %), and for each specific cause was: refractive amblyopia in 29.8%, SDA in 10.5%, strabismic amblyopia in 4.3%. Amblyopia was more frequent in severe ptosis, 76% in patients with covered optical axes (OA), compared to non-covered OA (22.5%). In unilateral ptosis with covered OA, astigmatic anisometropic amblyopia was more frequent, and in bilateral ptosis with at least one eye covered OA, spherical anisometropic amblyopia was more frequent. In both unilateral and bilateral ptosis, SDA was more common if the OA was covered.
As refractive anisometropic amblyopia is more prevalent than SDA, paying attention to all causes of amblyopia may be important in preventing amblyopia in a child with a ptotic eye.
研究先天性上睑下垂患者中致弱视因素的发生率。
在这项横断面研究中，纳入了100例年龄超过1岁的先天性上睑下垂患者的114只眼。弱视定义为最佳矫正视力（BCVA）低于10/10或两眼视力相差至少2/10。对于因年龄太小而无法通过线性斯内伦E字视力表测试的患者，观察其注视行为。为每位患者评估不同类型的弱视：1）屈光参差性弱视：散光性屈光参差≥1屈光度、远视性球镜屈光参差≥1屈光度、近视性球镜屈光参差≥-3屈光度（散瞳后）；2）斜视性弱视；3）形觉剥夺性弱视（SDA）。然后得出弱视的总发生率及其各类型的发生率。还对单侧和双侧上睑下垂的患者进行了比较。
上睑下垂眼的弱视发生率为39/114（34.2%），各具体病因的发生率为：屈光性弱视29.8%，形觉剥夺性弱视10.5%，斜视性弱视4.3%。重度上睑下垂患者的弱视更为常见，遮盖光轴（OA）的患者中弱视发生率为76%，未遮盖OA的患者中为22.5%。在遮盖OA的单侧上睑下垂中，散光性屈光参差性弱视更为常见，在至少一只眼遮盖OA的双侧上睑下垂中，球镜屈光参差性弱视更为常见。在单侧和双侧上睑下垂中，如果OA被遮盖，形觉剥夺性弱视都更常见。
由于屈光参差性弱视比形觉剥夺性弱视更普遍，关注所有弱视病因对于预防上睑下垂患儿的弱视可能很重要。
