Department of Ophthalmology, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China.
Department of Neurosurgery, Shanghai Children's Hospital, Shanghai Jiao Tong University, Shanghai, 200062, China.
BMC Ophthalmol. 2022 Sep 8;22(1):364. doi: 10.1186/s12886-022-02581-x.
Cortical visual impairment (CVI) is the common cause of pediatric visual impairment in cerebral palsy (CP) while exotropia is the most common strabismus associated with CP. We aim to observe the strabismic surgery outcomes in pediatric patients with CP and CVI.
Our medical records were collected from pediatric patients treated in our hospital from May 1, 2017 to Jan 1, 2022. With normal intelligence assessment and diagnosis of exotropia in children with CP and CVI, microsurgeries were performed under intravenous combined inhalation anesthesia. The strabismus was examined by the prism test under best vision correction and the contrast sensitivity testing (CST) was measured at five levels of spatial frequencies.
A total of 38 exotropia patients with CP and CVI were identified and included for analysis during the study period with age ranged from 5 to 12 years (mean 8.45 years) and mean follow up duration was 8.7 months (6-42 months). After bilateral lateral rectus recession (with/without medial rectus resection or inferior oblique transposition), the exotropia amount of participants were obviously revealed from - 30 ~ - 140 (median, IQR: - 50, 40) prism diopters (PD) preoperatively to 0 ~ - 15 (0, 5) PD postoperatively. Statistically significantly improvements were observed at all levels of spatial frequency on CST postoperatively, especially at high spatial frequency areas (p < 0.05).
Our results demonstrated that the effect of strabismus surgery on exotropia in children with CP and CVI were stable and monocular contrast sensitivity post- operation increased significantly at all spatial frequencies levels.
皮质视觉障碍（CVI）是脑瘫（CP）儿童视力障碍的常见原因，而外斜视是与 CP 相关的最常见斜视。我们旨在观察 CP 和 CVI 儿童斜视手术的结果。
我们的病历资料来源于 2017 年 5 月 1 日至 2022 年 1 月 1 日在我院接受治疗的儿科患者。对 CP 和 CVI 合并外斜视的儿童进行智力评估和诊断正常后，在静脉复合吸入麻醉下进行微创手术。在最佳视力矫正下用棱镜检查斜视，并在 5 个空间频率水平测量对比敏感度测试（CST）。
研究期间共纳入 38 例外斜视 CP 和 CVI 患者，年龄 5 至 12 岁（平均 8.45 岁），平均随访时间 8.7 个月（6-42 个月）。双侧外直肌后退（伴/不伴内直肌切除或下斜肌转位）后，患者术前外斜视量从-30-140（中位数，IQR：-50，40）棱镜度明显减少至术后 0-15（0，5）棱镜度。术后 CST 在所有空间频率水平均有显著改善，尤其是在高空间频率区域（p<0.05）。
我们的研究结果表明，斜视手术对 CP 和 CVI 儿童外斜视的疗效稳定，术后单眼对比敏感度在所有空间频率水平均显著提高。
