Department of Ophthalmology, Yeungnam University Medical Center, Daegu, Korea.
Korean J Ophthalmol. 2020 Dec;34(6):485-490. doi: 10.3341/kjo.2020.0079. Epub 2020 Dec 3.
We investigated the changes in ocular deviation after the monocular occlusion test in adults with intermittent exotropia and evaluated its association with the level of control.
We retrospectively enrolled adults (aged ≥18 years) with intermittent exotropia who visited our clinic between September 2015 and May 2019. Patients with basic intermittent exotropia with a distant deviation within 10 prism diopters (PD) of the near deviation were included. The largest ocular deviations obtained before and after 1 hour of monocular occlusion were compared. The level of control was measured using the LACTOSE (Look and Cover, then Ten seconds of Observation Scale for Exotropia) control scoring system.
Forty-six consecutive adult patients (28 males, 18 females; mean age, 34.3 years) were enrolled. The mean ocular deviation was 36.3 PD (range, 18 to 5 PD) at distant fixation and 38.5 PD (range, 18 to 80 PD) at near fixation, which increased significantly to 38.5 PD (p = 0.043) and 41.1 PD (p = 0.011), respectively, after monocular occlusion. The mean ocular deviation increased ≥5 PD in 14 (30.4%) and 15 (32.6%) patients at distant and near fixation, respectively. The level of control was measured in 30 patients. A higher degree of near control was significantly associated with an increase of ≥5 PD in near fixation after the test (p = 0.009 for a near control score ≤2).
The monocular occlusion test may help to determine the largest ocular deviation in adults with intermittent exotropia. Approximately one-third of patients exhibited an increase in ocular deviation ≥5 PD. Patients exhibiting good control were more likely to manifest an increase in the ocular deviation.
我们研究了间歇性外斜视成人单眼遮盖试验后眼位的变化，并评估其与控制水平的关系。
我们回顾性纳入了 2015 年 9 月至 2019 年 5 月间在我院就诊的间歇性外斜视成人患者（年龄≥18 岁）。纳入标准为存在基本间歇性外斜视，远距斜视度与近距斜视度相差 10 棱镜度（PD）以内。比较单眼遮盖 1 小时前后的最大眼位偏差。采用 LACTOSE（观察和遮盖，然后观察外斜视 10 秒量表）控制评分系统测量控制水平。
共纳入 46 例连续成年患者（男 28 例，女 18 例；平均年龄 34.3 岁）。远距注视时平均眼位偏差为 36.3 PD（范围 185 PD），近距注视时平均眼位偏差为 38.5 PD（范围 1880 PD），单眼遮盖后眼位偏差显著增加至 38.5 PD（p = 0.043）和 41.1 PD（p = 0.011）。远距和近距注视时，分别有 14 例（30.4%）和 15 例（32.6%）患者的眼位偏差增加≥5 PD。30 例患者测量了控制水平。试验后近距控制力较好的患者，其近距眼位偏差增加≥5 PD 的可能性显著更高（近距控制力评分≤2 时，p = 0.009）。
单眼遮盖试验有助于确定间歇性外斜视成人的最大眼位偏差。约有三分之一的患者表现出≥5 PD 的眼位偏差增加。控制力较好的患者更有可能出现眼位偏差增加。
