婴幼儿眼球震颤的阅读表现。

Reading performance in infantile nystagmus.

机构信息

Ophthalmology Group, Faculty of Medicine & Biological Sciences, University of Leicester, Leicester Royal Infirmary, Leicester, United Kingdom.

出版信息

Ophthalmology. 2013 Jun;120(6):1232-8. doi: 10.1016/j.ophtha.2012.11.032. Epub 2013 Feb 22.

DOI:10.1016/j.ophtha.2012.11.032

PMID:23462273

Abstract

OBJECTIVE

To characterize reading deficits in infantile nystagmus (IN), to determine optimal font sizes for reading in IN, and to investigate whether visual acuity (VA) and severity of nystagmus are good indicators of reading performance in IN.

DESIGN

Prospective cross-sectional study.

PARTICIPANTS AND CONTROLS

Seventy-one participants with IN (37 idiopathic, 34 with albinism) and 20 age-matched controls.

METHODS

Reading performance was assessed using Radner reading charts and was compared with near logarithm of the minimum angle of resolution (logMAR) VA, nystagmus intensity, and foveation characteristics as quantified using eye movement recordings.

MAIN OUTCOME MEASURES

Reading acuity (smallest readable font size), maximum reading speed, critical print size (font size below which reading is suboptimal), near logMAR VA, nystagmus intensity, and foveation characteristics (using the eXpanded Nystagmus Acuity Function).

RESULTS

Using optimal reading conditions, maximum reading speeds were 18.8% slower in albinism and 14.7% slower in idiopathic IN patients compared with controls. Reading acuities were significantly worse (P<0.001) in IN patients compared with controls. Also, the range of font sizes over which reading speeds were less than the optimum were much larger in IN patients compared with controls (P<0.001). Reading acuity was correlated strongly to near VA (r(2) = 0.74 albinism, r(2) = 0.55 idiopathic), but was better than near VA in participants with poor VA. Near VA was a poor predictor of maximum reading speed. Nystagmus intensity and foveation were poor indicators of both reading acuity and maximum reading speed.

CONCLUSIONS

Maximum reading speeds can be near normal in IN when optimal font sizes are provided, even in individuals with poor VA or intense nystagmus. However, reading performance in IN is acutely sensitive to font size limitations. Font sizes for optimal reading speeds in IN may be as much as 6 logMAR lines worse than the near VA.

FINANCIAL DISCLOSURE(S): The author(s) have no proprietary or commercial interest in any materials discussed in this article.

摘要

目的

描述婴儿性眼球震颤（IN）的阅读障碍，确定 IN 阅读的最佳字体大小，并探讨视力（VA）和眼球震颤严重程度是否能很好地预测 IN 的阅读表现。

设计

前瞻性横断面研究。

参与者和对照

71 名 IN 患者（37 名特发性，34 名白化病）和 20 名年龄匹配的对照。

方法

使用 Radner 阅读图表评估阅读表现，并将其与近最小分辨角对数（logMAR）VA、眼球震颤强度以及使用眼动记录量化的注视特征进行比较。

主要观察指标

阅读视力（最小可读字体大小）、最大阅读速度、临界印刷字体大小（低于该字体大小阅读效果不佳）、近 logMAR VA、眼球震颤强度和注视特征（使用扩展眼球震颤视力函数）。

结果

在最佳阅读条件下，白化病患者的最大阅读速度比对照组慢 18.8%，特发性 IN 患者的最大阅读速度比对照组慢 14.7%。与对照组相比，IN 患者的阅读视力明显更差（P<0.001）。此外，与对照组相比，IN 患者的阅读速度低于最佳的字体大小范围要大得多（P<0.001）。阅读视力与近 VA 密切相关（白化病 r(2) = 0.74，特发性 r(2) = 0.55），但在 VA 较差的患者中，阅读视力优于近 VA。近 VA 是最大阅读速度的不良预测指标。眼球震颤强度和注视是阅读视力和最大阅读速度的不良指标。