Guclu Hande, Gurlu Vuslat Pelitli, Ozal Sadik Altan, Ozkurt Zeynep Gursel
Hande Guclu, MD Ophthalmologist, Trakya University of Medicine, Ophthalmology Department, Edirne, 22030, Turkey.
Vuslat Pelitli Gurlu, MD Associate Professor, Trakya University of Medicine, Ophthalmology Department, Edirne, 22030, Turkey.
Pak J Med Sci. 2015 Jul-Aug;31(4):807-11. doi: 10.12669/pjms.314.7465.
To determine the prognostic factors affecting stereoacuity in patients with refractive accommodative esotropia (RAE) according to the results of long follow- up period.
We reviewed the charts of 70 patients with RAE between the years 1985-2014. Patients were classified into three groups. G-1: Stereoacuity score 40 second/arc. G-2: Stereoacuity score >40 second/arc (50-3000). G-3: No binocular vision. Initiation age of RAE, duration of deviation, refractive error, amblyopia, amblyopia treatment, anisometropia, visual acuity, family history, angle of deviation for distance and near at each group and the prognostic factors affecting stereoacuity were analyzed.
The mean initiation age of RAE was 2.7±1.5 years, the mean age at first visit was 6.4±4.2 years. The mean follow up time was 7.3±4.4 years. Seven patients had 40 second/arc, 48 patients had 50 to 3000 second/arc stereoacuity, 15 patients had no binocular vision. Mean deviation for near was statistically higher in group 2 and 3. Visual acuity levels were higher in group 1 and 2 and was statistically significant. Low visual acuity (p=0.001, 0.008), higher angle of deviation at near (p=0.01), increased duration of deviation (p=0.01), presence of amblyopia (p=0.001) and irregularity of amblyopia treatment (p=0.01) were significantly related with poor stereoacuity.
According to the prognostic factors low stereoacuity was mostly related with amblyopia as a result the late presentation of the patients in seeking care. Appropriate treatment as full refractive correction and amblyopia treatment during the RAE is important for development of good stereopsis. Also angle of deviation at near and duration of deviation can be a useful predictor for poor stereoacuity levels.
根据长期随访结果,确定影响屈光性调节性内斜视(RAE)患者立体视锐度的预后因素。
我们回顾了1985年至2014年间70例RAE患者的病历。患者分为三组。G-1组:立体视锐度评分为40秒/弧度。G-2组:立体视锐度评分>40秒/弧度(50-3000)。G-3组:无双眼视觉。分析每组患者的RAE起始年龄、斜视持续时间、屈光不正、弱视、弱视治疗、屈光参差、视力、家族史、远近斜视角度以及影响立体视锐度的预后因素。
RAE的平均起始年龄为2.7±1.5岁,首次就诊的平均年龄为6.4±4.2岁。平均随访时间为7.3±4.4年。7例患者立体视锐度为40秒/弧度,48例患者立体视锐度为50至3000秒/弧度,15例患者无双眼视觉。第2组和第3组的近斜视平均度数在统计学上更高。第1组和第2组的视力水平更高,且具有统计学意义。低视力(p=0.001,0.008)、较高的近斜视角度(p=0.01)、斜视持续时间增加(p=0.01)、弱视的存在(p=0.001)以及弱视治疗的不规范(p=0.01)与较差的立体视锐度显著相关。
根据预后因素,低立体视锐度主要与弱视有关,这是由于患者寻求治疗较晚。在RAE期间进行充分的屈光矫正和弱视治疗等适当治疗对于良好立体视觉的发展很重要。此外,近斜视角度和斜视持续时间可能是低立体视锐度水平的有用预测指标。