Koç F, Sefi-Yurdakul N
Izmir Ataturk Education and Research Hospital, Izmir, Turkey.
Eye (Lond). 2016 Feb;30(2):264-9. doi: 10.1038/eye.2015.241. Epub 2015 Nov 20.
The purpose of this study was to determine the predictors of stereoacuity outcome in visually mature subjects with exotropia following surgical correction. Visually mature subjects who were surgically aligned and had been tested for stereoacuity in the postoperative period were studied retrospectively. Subjects were grouped with respect to their responses to Titmus or TNO stereotests. Characteristics such as amblyopia, anisometropia, and characteristics of the exodeviation such as time of onset, duration, intermittency, presence of an A or V pattern, distance-near disparity, coexisting vertical deviation, and inferior oblique overaction, were compared between the groups. One hundred and four visually mature subjects with exotropia met the inclusion criteria. Stereoacuity was achieved in 77% of the study group and only 9% of these could achieve fine stereoacuity. Negative stereoacuity was more frequently associated with larger deviation angles, higher anisometropia, inferior oblique overaction, pattern strabismus, coexisting vertical strabismus, and distance-near disparity, but not at a statistically significant level. The optimal cutoff for strabismus duration was 20 years for a positive stereoacuity outcome. Any-level visual acuity difference was found to decrease the chance for positive stereoacuity significantly. The odds ratios for the stereoacuity positivity were 4.05 for strabismus duration <20 years, 7.9 for strabismus onset >1 year of age, 3.79 for weaker eye visual acuity >20/25 and 9.85 for intermittency of strabismus. Intermittence of exotropia was the strongest predictor for positive stereoacuity. Exotropia onset after 1 year of age, absence of any-level visual acuity difference, and strabismus duration <20 years were the other predictors with decreasing power.
本研究的目的是确定手术矫正后患有外斜视的视觉成熟受试者立体视锐度结果的预测因素。对接受手术矫正并在术后进行立体视锐度测试的视觉成熟受试者进行回顾性研究。根据受试者对Titmus或TNO立体视测试的反应进行分组。比较了两组之间的特征,如弱视、屈光参差,以及外斜视的特征,如发病时间、持续时间、间歇性、A或V型模式的存在、远近差异、共存的垂直偏差和下斜肌亢进。104名患有外斜视的视觉成熟受试者符合纳入标准。研究组中77%的受试者获得了立体视锐度,其中只有9%的受试者能够获得精细立体视锐度。负立体视锐度更常与较大的斜视角度、较高的屈光参差、下斜肌亢进、模式性斜视、共存的垂直斜视和远近差异相关,但无统计学意义。对于阳性立体视锐度结果,斜视持续时间的最佳临界值为20年。发现任何程度的视力差异都会显著降低获得阳性立体视锐度的机会。斜视持续时间<20年时,立体视锐度阳性的优势比为4.05;斜视发病年龄>1岁时为7.9;较弱眼视力>20/25时为3.79;斜视间歇性时为9.85。外斜视的间歇性是阳性立体视锐度的最强预测因素。1岁以后发病的外斜视、不存在任何程度的视力差异以及斜视持续时间<20年是其他预测因素,其预测能力依次降低。