Department of Ophthalmology, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
Am J Ophthalmol. 2012 Dec;154(6):981-986.e3. doi: 10.1016/j.ajo.2012.05.026. Epub 2012 Sep 5.
To investigate binocular interaction of visual acuity (VA) in patients with intermittent exotropia and its relationship with accommodative responses during binocular vision.
Prospective pilot study.
setting: Institutional. patient: Sixty-three patients with intermittent exotropia between 8 and 15 years of age. observation: Binocular VA and monocular VA were measured in sequence. Accommodative responses of both eyes were measured using the WAM-5500 autorefractor/keratometer (GrandSeiko) during binocular and monocular viewing conditions at 6 m. Accommodative responses during binocular vision were calculated using the difference between the refractive errors of binocular and monocular vision. main outcome measures: Binocular interactions of VA were categorized as binocular summation, equivalency, or inhibition. The prevalence of the 3 patterns of binocular interaction was investigated. Accommodative responses were correlated with differences between binocular VA and better monocular VA.
Most patients (38 patients; 60.3%) showed binocular equivalency. Binocular summation and inhibition were noted in 19 (30.2%) and 6 (9.5%) patients, respectively. Linear regression analysis revealed a significant correlation between binocular interaction and accommodative responses during binocular vision (P < .001). Accommodative responses significantly correlated with the size of exodeviation at distance (P = .010).
In patients with intermittent exotropia, binocular interaction is associated with accommodative response during binocular vision and the size of exodeviation, suggesting that accommodative convergence is a mechanism that maintains ocular alignment. Therefore, binocular interaction, especially binocular inhibition, can be a good indicator of diminishing fusional control in intermittent exotropia.
研究间歇性外斜视患者双眼视力（VA）的相互作用及其与双眼视觉时调节反应的关系。
前瞻性初步研究。
设置：机构内。患者：63 例 8 至 15 岁间歇性外斜视患者。观察：依次测量双眼和单眼视力。使用 WAM-5500 自动屈光/角膜曲率计（GrandSeiko）在 6 m 处的双眼和单眼视条件下测量双眼的调节反应。通过双眼和单眼视觉之间的屈光误差差异计算双眼视觉时的调节反应。主要观察指标：VA 的双眼相互作用分为双眼总和、等效或抑制。研究了 3 种双眼相互作用模式的流行率。调节反应与双眼视力与较好单眼视力之间的差异相关。
大多数患者（38 例；60.3%）表现为双眼等效。19 例（30.2%）和 6 例（9.5%）患者分别出现双眼总和和抑制。线性回归分析显示，双眼相互作用与双眼视觉时的调节反应之间存在显著相关性（P <.001）。调节反应与远距外斜视量显著相关（P =.010）。
在间歇性外斜视患者中，双眼相互作用与双眼视觉时的调节反应以及外斜视量有关，提示调节性集合是维持眼球对准的一种机制。因此，双眼相互作用，尤其是双眼抑制，可能是间歇性外斜视融合控制减弱的一个良好指标。
