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弱视的视觉功能作为治疗反应的决定因素

Visual functions in amblyopia as determinants of response to treatment.

作者信息

Singh Vinita, Agrawal Siddharth

出版信息

J Pediatr Ophthalmol Strabismus. 2013 Nov-Dec;50(6):348-54. doi: 10.3928/01913913-20131001-01. Epub 2013 Oct 8.

Abstract

PURPOSE

To describe the visual functions in amblyopia as determinants of response to treatment.

METHODS

Sixty-nine patients with unilateral and bilateral amblyopia (114 amblyopic eyes) 3 to 15 years old (mean age: 8.80 ± 2.9 years), 40 males (58%) and 29 females (42%), were included in this study. All patients were treated by conventional occlusion 6 hours per day for mild to moderate amblyopia (visual acuity 0.70 or better) and full-time for 4 weeks followed by 6 hours per day for severe amblyopia (visual acuity 0.8 or worse). During occlusion, near activities requiring hand-eye coordination were advised. The follow-up examination was done at 3 and 6 months. Improvement in visual acuity was evaluated on the logMAR chart and correlated with the visual functions. Statistical analysis was done using Wilcoxon rank sum test (Mann-Whitney U test) and Kruskal-Wallis analysis.

RESULTS

There was a statistically significant association of poor contrast sensitivity with the grade of amblyopia (P < .001). The grade of amblyopia (P < .01), accommodation (P < .01), stereopsis (P = .01), and mesopic visual acuity (P < .03) were found to have a correlation with response to amblyopia therapy.

CONCLUSIONS

The grade of amblyopia (initial visual acuity) and accommodation are strong determinants of response to amblyopia therapy, whereas stereopsis and mesopic visual acuity have some value as determinants.

摘要

目的

描述弱视患者的视觉功能作为治疗反应的决定因素。

方法

本研究纳入了69例3至15岁(平均年龄:8.80±2.9岁)的单侧和双侧弱视患者(114只弱视眼),其中男性40例(58%),女性29例(42%)。所有患者对于轻度至中度弱视(视力0.70或更好)采用每天6小时的传统遮盖治疗,对于重度弱视(视力0.8或更差)则先进行4周的全天遮盖,之后每天6小时。在遮盖期间,建议进行需要手眼协调的近距活动。在3个月和6个月时进行随访检查。使用对数最小分辨角视力表评估视力改善情况,并将其与视觉功能相关联。采用Wilcoxon秩和检验(Mann-Whitney U检验)和Kruskal-Wallis分析进行统计分析。

结果

对比敏感度差与弱视程度之间存在统计学显著关联(P <.001)。发现弱视程度(P <.01)、调节功能(P <.01)、立体视(P =.01)和中视视力(P <.03)与弱视治疗反应相关。

结论

弱视程度(初始视力)和调节功能是弱视治疗反应的重要决定因素,而立体视和中视视力作为决定因素具有一定价值。

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