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有和没有神经发育障碍的儿童临床群体中视觉和动眼神经改变的分布情况。

Distribution of Visual and Oculomotor Alterations in a Clinical Population of Children with and without Neurodevelopmental Disorders.

作者信息

Bilbao Carmen, Piñero David Pablo

机构信息

Department of Optometry, Policlínica Alto Aragón, 22003 Huesca, Spain.

Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, 03690 Alicante, Spain.

出版信息

Brain Sci. 2021 Mar 10;11(3):351. doi: 10.3390/brainsci11030351.

Abstract

A prospective, non-randomized comparative study was conducted to compare the distribution of oculomotor and visual alterations in children with neurodevelopmental disorders and healthy children without such disorders. Sixty-nine children (aged 6-13 years) were enrolled and divided into three groups: a control group (CG) of 23 healthy children; a group of 18 healthy children with oculomotor abnormalities (OAG); and a group of 28 children with a neurodevelopmental disorder (NDDG), with 15 cases of dyslexia, 7 cases of developmental coordination disorder (DCD) and 6 cases of attention deficit/hyperactivity disorder (ADHD). Significantly worse near stereopsis was found in NDDG compared with CG ( < 0.001) and OAG ( = 0.001). Likewise, a significantly lower amplitude of accommodation was found in NDDG compared with CG in both the right ( = 0.001) and left eyes ( < 0.001). No statistically significant differences between groups were found in the measurement of near and distance phoria ( ≥ 0.557), near point of convergence ( = 0.700) and fusional vergences ( ≥ 0.059). Significantly impaired oculomotor test scores were found in NDDG compared with CG ( < 0.001), with no significant differences between OAG and NDDG ( ≥ 0.063). The comparison between the three types of neurodevelopmental disorders included revealed the presence of a significantly lower amplitude of accommodation in children with DCD compared with dyslexics. Furthermore, less exophoria at near was present in children with dyslexia compared with children with ADHD ( = 0.018) and DCD ( = 0.054). In conclusion, children with dyslexia, ADHD and DCD show an altered oculomotor pattern and a more reduced amplitude of accommodation, not always compatible with the diagnostic criteria of an accommodative insufficiency. Accommodative and binocular vision problems are not always present in these children and cannot be considered an etiologic factor.

摘要

进行了一项前瞻性、非随机对照研究,以比较神经发育障碍儿童与无此类障碍的健康儿童的眼球运动和视觉改变的分布情况。纳入了69名儿童(年龄6 - 13岁),并将其分为三组:23名健康儿童组成的对照组(CG);18名有眼球运动异常的健康儿童组成的组(OAG);以及28名患有神经发育障碍的儿童组成的组(NDDG),其中包括15例诵读困难、7例发育性协调障碍(DCD)和6例注意力缺陷多动障碍(ADHD)。与CG(<0.001)和OAG(=0.001)相比,NDDG组的近立体视明显更差。同样,与CG相比,NDDG组右眼(=0.001)和左眼(<0.001)的调节幅度均显著降低。在近距和远距隐斜测量(≥0.557)、近点集合(=0.700)和融合性聚散(≥0.059)方面,各组之间未发现统计学上的显著差异。与CG相比,NDDG组的眼球运动测试分数显著受损(<0.001),OAG组和NDDG组之间无显著差异(≥0.063)。对所纳入的三种神经发育障碍类型的比较显示,与诵读困难儿童相比,DCD儿童的调节幅度明显更低。此外,与ADHD儿童(=0.018)和DCD儿童(=0.054)相比,诵读困难儿童的近距外隐斜更少。总之,患有诵读困难、ADHD和DCD的儿童表现出眼球运动模式改变和调节幅度降低,这并不总是符合调节不足的诊断标准。这些儿童并不总是存在调节和双眼视觉问题,也不能将其视为病因。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f6be/7999547/4bc5eeca5ae6/brainsci-11-00351-g001.jpg

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