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创伤性脑损伤成人的调节与立体视觉

Accommodation and stereopsis in adults with traumatic brain injury.

作者信息

Chen Na, Liao Meng, Yang Chaohua, Liu Longqian

机构信息

Department of Optometry and Vision Science, West China Hospital, Sichuan University, Chengdu, China.

Department of Ophthalmology, West China Hospital, Sichuan University, Chengdu, China.

出版信息

Clin Exp Optom. 2020 Nov;103(6):877-884. doi: 10.1111/cxo.13056. Epub 2020 Mar 12.

Abstract

BACKGROUND

Traumatic brain injury has many adverse effects on visual functions. The aim of this study is to evaluate accommodation, stereopsis deficits and visual symptoms in Chinese patients with traumatic brain injury.

METHODS

This is a cross-sectional study that included 22 patients with traumatic brain injury and 22 controls; the refractive status, stereoacuity, and accommodative ability of each subject were measured.

RESULTS

Patients with traumatic brain injury were significantly more symptomatic than controls (p < 0.001). Near stereoacuity thresholds were significantly elevated in patients with traumatic brain injury compared to controls (p < 0.001). Accommodative amplitude (right eye: p = 0.007; left eye: p = 0.01; both eyes: p = 0.002) and accommodative facility rates (right eye: p < 0.001; left eye: p < 0.001; both eyes: p < 0.001) were significantly lower in patients with traumatic brain injury, for whom there were no significant differences between the accommodative facility rates of the pre- and post-three-minute binocular flipper sessions (p = 0.51). Patients with traumatic brain injury showed greater accommodative lag to 2.5 D (p = 0.03), 3 D (p = 0.03), 4 D (p = 0.004) and 5 D (p = 0.001) stimuli, but not to the 2 D (p = 0.10) stimulus. The regression equation of accommodative lag to stimuli was steeper for the traumatic brain injury group (slope: p = 0.01; y-intercept: p < 0.0001). There were also significant correlations between visual symptoms and clinical findings including binocular accommodative amplitude (r = -0.480, p = 0.001), binocular accommodative facility (r = -0.445, p = 0.004) and stereopsis (r = 0.457, p = 0.002).

CONCLUSION

Patients with traumatic brain injury have deficits in accommodation and stereopsis.

摘要

背景

创伤性脑损伤对视觉功能有诸多不利影响。本研究旨在评估中国创伤性脑损伤患者的调节功能、立体视功能缺陷及视觉症状。

方法

这是一项横断面研究,纳入了22例创伤性脑损伤患者和22例对照;测量了每位受试者的屈光状态、立体视锐度和调节能力。

结果

创伤性脑损伤患者的症状明显比对照组更严重(p < 0.001)。与对照组相比,创伤性脑损伤患者的近立体视锐度阈值显著升高(p < 0.001)。创伤性脑损伤患者的调节幅度(右眼:p = 0.007;左眼:p = 0.01;双眼:p = 0.002)和调节灵活度(右眼:p < 0.001;左眼:p < 0.001;双眼:p < 0.001)显著更低,且三分钟双眼翻转棱镜检查前后的调节灵活度对创伤性脑损伤患者而言无显著差异(p = 0.51)。创伤性脑损伤患者对2.5 D(p = 0.03)、3 D(p = 0.03)、4 D(p = 0.004)和5 D(p = 0.001)刺激表现出更大的调节滞后,但对2 D刺激(p = 0.10)无此表现。创伤性脑损伤组调节滞后与刺激的回归方程斜率更陡(斜率:p = 0.01;截距:p < 0.0001)。视觉症状与包括双眼调节幅度(r = -0.480,p = 0.001)、双眼调节灵活度(r = -0.445,p = 0.004)和立体视(r = 0.457,p = 0.002)在内的临床检查结果之间也存在显著相关性。

结论

创伤性脑损伤患者存在调节和立体视功能缺陷。

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