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屈光性调节性内斜视患儿屈光不正部分矫正和完全矫正对感觉和运动预后的影响。

The effects of partial and full correction of refractive errors on sensorial and motor outcomes in children with refractive accommodative esotropia.

作者信息

Sefi-Yurdakul Nazife, Kaykısız Hüseyin, Koç Feray

机构信息

Department of Ophthalmology, Başkent University Hospital, Çiğli, İzmir, Turkey.

Bitlis State Hospital, Bitlis, Turkey.

出版信息

Int Ophthalmol. 2019 Apr;39(4):883-890. doi: 10.1007/s10792-018-0889-z. Epub 2018 Mar 17.

DOI:10.1007/s10792-018-0889-z
PMID:29549487
Abstract

PURPOSE

To investigate the effects of partial and full correction of refractive errors on sensorial and motor outcomes in children with refractive accommodative esotropia (RAE).

METHODS

The records of pediatric cases with full RAE were reviewed; their first and last sensorial and motor findings were evaluated in two groups, classified as partial (Group 1) and full correction (Group 2) of refractive errors.

RESULTS

The mean age at first admission was 5.84 ± 3.62 years in Group 1 (n = 35) and 6.35 ± 3.26 years in Group 2 (n = 46) (p = 0.335). Mean change in best corrected visual acuity (BCVA) was 0.24 ± 0.17 logarithm of the minimum angle of resolution (logMAR) in Group 1 and 0.13 ± 0.16 logMAR in Group 2 (p = 0.001). Duration of deviation, baseline refraction and amount of reduced refraction showed significant effects on change in BCVA (p < 0.05). Significant correlation was determined between binocular vision (BOV), duration of deviation and uncorrected baseline amount of deviation (p < 0.05). The baseline BOV rates were significantly high in fully corrected Group 2, and also were found to have increased in Group 1 (p < 0.05). Change in refraction was - 0.09 ± 1.08 and + 0.35 ± 0.76 diopters in Groups 1 and 2, respectively (p = 0.005). Duration of deviation, baseline refraction and the amount of reduced refraction had significant effects on change in refraction (p < 0.05). Change in deviation without refractive correction was - 0.74 ± 7.22 prism diopters in Group 1 and - 3.24 ± 10.41 prism diopters in Group 2 (p = 0.472). Duration of follow-up and uncorrected baseline deviation showed significant effects on change in deviation (p < 0.05).

CONCLUSIONS

Although the BOV rates and BCVA were initially high in fully corrected patients, they finally improved significantly in both the fully and partially corrected patients. Full hypermetropic correction may also cause an increase in the refractive error with a possible negative effect on emmetropization. The negative effect of the duration of deviation on BOV and BCVA demonstrates the significance of early treatment in RAE cases.

摘要

目的

探讨屈光性调节性内斜视(RAE)患儿屈光不正部分矫正和完全矫正对感觉和运动结果的影响。

方法

回顾了完全性RAE患儿的病例记录;在两组中评估他们的首次和末次感觉及运动检查结果,两组分别分类为屈光不正部分矫正组(第1组)和完全矫正组(第2组)。

结果

第1组(n = 35)首次入院时的平均年龄为5.84±3.62岁,第2组(n = 46)为6.35±3.26岁(p = 0.335)。第1组最佳矫正视力(BCVA)的平均变化为0.24±0.17最小分辨角对数(logMAR),第2组为0.13±0.16 logMAR(p = 0.001)。斜视持续时间、基线屈光不正和屈光不正减少量对BCVA变化有显著影响(p<0.05)。双眼视觉(BOV)、斜视持续时间和未矫正的基线斜视角之间存在显著相关性(p<0.05)。完全矫正的第2组基线BOV率显著较高,第1组也有升高(p<0.05)。第1组和第2组的屈光不正变化分别为-0.09±1.08和+0.35±0.76屈光度(p = 0.005)。斜视持续时间、基线屈光不正和屈光不正减少量对屈光不正变化有显著影响(p<0.05)。未进行屈光矫正时,第1组斜视变化为-0.74±7.22棱镜度,第2组为-3.24±10.41棱镜度(p = 0.472)。随访时间和未矫正的基线斜视对斜视变化有显著影响(p<0.05)。

结论

虽然完全矫正患者的BOV率和BCVA最初较高,但完全矫正和部分矫正患者最终均有显著改善。完全远视矫正也可能导致屈光不正增加,对正视化可能产生负面影响。斜视持续时间对BOV和BCVA的负面影响表明RAE病例早期治疗的重要性。

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