成人散瞳前后的斜视测量

Strabismus Measurements in Adults Before and After Pupil Dilation.

作者信息

Rivera Sean S, Lee Michael S, Lunos Scott, Anderson Jill S, Bothun Erick D

机构信息

Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota; Ophthalmology Department, DaVita Medical Group, Albuquerque, New Mexico.

Department of Ophthalmology and Visual Neurosciences, University of Minnesota, Minneapolis, Minnesota; Department of Neurology, University of Minnesota, Minneapolis, Minnesota; Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota.

出版信息

Am J Ophthalmol. 2017 Jun;178:1-8. doi: 10.1016/j.ajo.2017.03.004. Epub 2017 Mar 14.

DOI:10.1016/j.ajo.2017.03.004

PMID:28302533

Abstract

PURPOSE

To determine the effect of dilating drops on strabismus measurements in adults.

DESIGN

Prospective cohort study.

METHODS

Patients aged 18 and older with strabismus underwent a standard evaluation of ocular motility, stereopsis, and ocular alignment with alternate prism cover test by a certified orthoptist. After pupil dilation with 2.5% phenylephrine and 1% tropicamide, ocular alignment was remeasured in primary gaze at 6 meters, at 1/3 meter, and at 1/3 meter with a +3.00 by a second certified orthoptist, masked to the previous measurements. The primary outcome was the mean difference in the angle of horizontal and vertical deviations after dilation in prism diopters.

RESULTS

A total of 55 patients were enrolled with a variety of diagnoses. For horizontal measurements the mean change was 0.54 prism diopters at 6 meters (95% confidence interval [CI] -0.36 to 1.43, P = .24), 1.67 prism diopters at 1/3 meter (95% CI -0.19 to 3.54, P = .08), and -0.05 prism diopters at 1/3 meter with a +3.00 add (95% CI -1.65 to 1.56, P = .95). The mean change in vertical deviation was 0.18 prism diopters at 6 meters (95% CI -0.19 to 0.56, P = .34), 0.57 prism diopters at 1/3 meter (95% CI 0-1.15, P = .05), and 0.47 prism diopters at 1/3 meter with a +3.00 add (95% CI -0.23 to 1.17, P = .18).

CONCLUSIONS

Pupil dilation does not meaningfully affect vertical or horizontal strabismus measurements in adults. Mild variability at near in younger patients is eliminated with the use of a +3.00 add.

摘要

目的

确定散瞳滴眼液对成人斜视测量的影响。

设计

前瞻性队列研究。

方法

年龄在18岁及以上的斜视患者由一名认证的视光师进行标准的眼球运动、立体视和交替棱镜遮盖试验眼位检查。在用2.5%苯肾上腺素和1%托吡卡胺散瞳后，由第二名认证视光师在6米、1/3米处以及1/3米处加+3.00镜片的情况下重新测量原在位眼位，该视光师对之前的测量结果不知情。主要结局是散瞳后水平和垂直偏斜角度以棱镜度计的平均差异。

结果

共纳入55例患有各种诊断的患者。对于水平测量，6米处平均变化为0.54棱镜度（95%置信区间[CI] -0.36至1.43，P = 0.24），1/3米处为1.67棱镜度（95% CI -0.19至3.54，P = 0.08），1/3米处加+3.00镜片时为-0.05棱镜度（95% CI -1.65至1.56，P = 0.95）。垂直偏斜的平均变化在6米处为0.18棱镜度（95% CI -0.19至0.56，P = 0.34），1/3米处为0.57棱镜度（95% CI 0至1.15，P = 0.05），1/3米处加+3.00镜片时为0.47棱镜度（95% CI -0.23至1.17，P = 0.18）。