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双眼视觉和间歇性斜视中调节与集合的视差驱动模型与模糊驱动模型

Disparity-driven vs blur-driven models of accommodation and convergence in binocular vision and intermittent strabismus.

作者信息

Horwood Anna M, Riddell Patricia M

机构信息

Infant Vision Laboratory, School of Psychology & Clinical Language Sciences, University of Reading, United Kingdom; Orthoptic Department, Royal Berkshire Hospital, Reading, United Kingdom.

Infant Vision Laboratory, School of Psychology & Clinical Language Sciences, University of Reading, United Kingdom.

出版信息

J AAPOS. 2014 Dec;18(6):576-83. doi: 10.1016/j.jaapos.2014.08.009.

Abstract

PURPOSE

To propose an alternative and practical model to conceptualize clinical patterns of concomitant intermittent strabismus, heterophoria, and convergence and accommodation anomalies.

METHODS

Despite identical ratios, there can be a disparity- or blur-biased "style" in three hypothetical scenarios: normal; high ratio of accommodative convergence to accommodation (AC/A) and low ratio of convergence accommodation to convergence (CA/C); low AC/A and high CA/C. We calculated disparity bias indices (DBI) to reflect these biases and provide early objective data from small illustrative clinical groups that fit these styles.

RESULTS

Normal adults (n = 56) and children (n = 24) showed disparity bias (adult DBI 0.43 [95% CI, 0.50-0.36], child DBI 0.20 [95% CI, 0.31-0.07]; P = 0.001). Accommodative esotropia (n = 3) showed less disparity-bias (DBI 0.03). In the high AC/A-low CA/C scenario, early presbyopia (n = 22) showed mean DBI of 0.17 (95% CI, 0.28-0.06), compared to DBI of -0.31 in convergence excess esotropia (n=8). In the low AC/A-high CA/C scenario near exotropia (n = 17) showed mean DBI of 0.27. DBI ranged between 1.25 and -1.67.

CONCLUSIONS

Establishing disparity or blur bias adds to AC/A and CA/C ratios to explain clinical patterns. Excessive bias or inflexibility in near-cue use increases risk of clinical problems.

摘要

目的

提出一种替代性的实用模型,用以概念化间歇性共同性斜视、隐斜视以及集合与调节异常的临床模式。

方法

尽管比率相同,但在三种假设情况下可能存在偏向差异或模糊的“风格”:正常;调节性集合与调节的比率(AC/A)高且集合性调节与集合的比率(CA/C)低;AC/A低且CA/C高。我们计算了差异偏向指数(DBI)以反映这些偏向,并从小规模说明性临床组中提供符合这些风格的早期客观数据。

结果

正常成年人(n = 56)和儿童(n = 24)表现出差异偏向(成人DBI为0.43 [95%可信区间,0.50 - 0.36],儿童DBI为0.20 [95%可信区间,0.31 - 0.07];P = 0.001)。调节性内斜视(n = 3)表现出的差异偏向较小(DBI为0.03)。在AC/A高 - CA/C低的情况下,早期老花眼(n = 22)的平均DBI为0.17(95%可信区间,0.28 - 0.06),相比之下,集合过强性内斜视(n = 8)的DBI为 - 0.31。在AC/A低 - CA/C高的情况下,外斜视(n = 17)的平均DBI为0.27。DBI范围在1.25至 - 1.67之间。

结论

确定差异或模糊偏向可补充AC/A和CA/C比率,以解释临床模式。近距离线索使用中的过度偏向或不灵活性会增加临床问题的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/626c/4270963/91c4042d2e8f/gr2.jpg

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