Rohr Juliana Tessari Dias, Isaac Cassiano Rodrigues, de Lima Adriano de Almeida, Garcia Ana, Dos Santos Procópio Miguel, Tavares Maria Clotilde Henriques
Department of Ophthalmology, Hospital de Base do Distrito Federal, Brasília, Brazil.
Department of Physiological Sciences, Institute of Biological Sciences, University of Brasília - UnB, Brasília, Brazil.
Front Hum Neurosci. 2022 Apr 13;16:769412. doi: 10.3389/fnhum.2022.769412. eCollection 2022.
Despite the various perceptual-motor deficits documented in strabismus, there is a paucity of studies evaluating visual illusions in patients with strabismus. The aim of this study was to examine how the illusionary perception occurs in children/adolescents (10-15 years old) with strabismus with referral for surgery to correct ocular deviations. A controlled cross-sectional study was carried out in which 45 participants with strabismus and 62 healthy volunteers aged 10-15 years were evaluated. The behavioral response to three geometric illusions [Vertical-Horizontal illusion, Müller-Lyer illusion (Bretano version) and Ponzo illusion] and respective neutral stimuli (non-illusory images) regarding the estimation of image size and response time were measured using the Method of Adjustment. To analyze the influence of secondary factors: type of ocular deviation (convergent, divergent or associated with vertical deviation); amount of eye deviation; presence of amblyopia and stereopsis, a one-way ANOVA was performed. Among the tested illusions, children with strabismus showed greater susceptibility ( = 0.006) and response time ( = 0.004) to Ponzo's illusory images. Children with strabismus and preserved stereopsis, on the other hand, showed similar susceptibility and response time to control group patients to the Ponzo illusion ( < 0.005). Patients with amblyopia showed overcorrection in the estimate of non-illusory Ponzo images ( = 0.046). Children with horizontal ocular deviation (esotropia or exotropia) associated with vertical deviation (hypertropia, DVD and/or alphabetical anisotropy) showed higher susceptibility to vertical adjustment images for the Müller-Lyer illusion (Brentano version) ( = 0.017). Individuals with strabismus tended to overcorrect the length of the straight-line segment adjusted for non-illusory images when testing non-illusory images in the Müller-Lyer test (Brentano version) ( = 0.009), as well as for the neutral images in the Vertical-Horizontal test ( = 0.000). The findings indicated impairment in the perception of geometric illusions and neutral figures, especially for the Ponzo illusion test by children with strabismus. As the behavioral response to illusory images may indirectly reflect the visual and morphofunctional alterations present in these individuals, we suggest that the investigation of visual illusory perception can be used as a new research strategy in the field of investigating the visual function in strabismus.
尽管斜视患者存在各种感知运动缺陷，但评估斜视患者视觉错觉的研究却很少。本研究的目的是探讨10至15岁因斜视需手术矫正眼位偏斜的儿童/青少年中错觉感知是如何发生的。开展了一项对照横断面研究，评估了45名斜视参与者和62名10至15岁的健康志愿者。使用调整法测量了对三种几何错觉[垂直-水平错觉、缪勒-莱尔错觉（布雷塔诺版本）和庞佐错觉]以及关于图像大小估计和反应时间的相应中性刺激（非错觉图像）的行为反应。为了分析次要因素的影响：眼位偏斜类型（内斜、外斜或伴有垂直偏斜）；眼位偏斜量；弱视和立体视的存在情况，进行了单因素方差分析。在测试的错觉中，斜视儿童对庞佐错觉图像表现出更高的易感性（P = 0.006）和反应时间（P = 0.004）。另一方面，有立体视的斜视儿童在庞佐错觉测试中表现出与对照组患者相似的易感性和反应时间（P < 0.005）。弱视患者在非错觉庞佐图像的估计中表现出过矫正（P = 0.046）。伴有垂直偏斜（上斜肌亢进、DVD和/或字母性斜视）的水平眼位偏斜（内斜视或外斜视）儿童在缪勒-莱尔错觉（布雷塔诺版本）的垂直调整图像测试中表现出更高的易感性（P = 0.017）。在缪勒-莱尔测试（布雷塔诺版本）中测试非错觉图像时，斜视个体在调整非错觉图像的直线段长度时往往表现出过矫正（P = 0.009），在垂直-水平测试中的中性图像测试中也是如此（P = 0.000）。研究结果表明斜视儿童在几何错觉和中性图形感知方面存在损害，尤其是在庞佐错觉测试中。由于对错觉图像的行为反应可能间接反映这些个体存在的视觉和形态功能改变，我们建议视觉错觉感知的研究可作为斜视视觉功能研究领域的一种新的研究策略。
