Shiraishi Yukari, Wakayama Akemi, Matsumoto Fumiko, Tanabe Fumi, Kusaka Shunji
Department of Ophthalmology, Kindai University Faculty of Medicine, Osaka-sayama City, Osaka, Japan.
Clin Ophthalmol. 2023 Jun 1;17:1545-1553. doi: 10.2147/OPTH.S412194. eCollection 2023.
To investigate the association between stereoacuity and suppression during occlusion therapy for patients with anisometropic amblyopia.
Retrospective study.
This study included 19 patients with hyperopic anisometropic amblyopia who underwent occlusion therapy. The mean age of the patients was 5.5 ± 1.4 years. The participants were evaluated for improvement in stereoacuity and suppression before beginning occlusion therapy, when the highest amblyopic visual acuity (VA) was achieved, during tapering, at the end of occlusion therapy, and at the final visit. Stereoacuity was evaluated using the TNO test or JACO stereo test. The presence of suppression was evaluated using circle No. 1 of the Stereo Fly Test or JACO results as the optotype.
Of the 19 patients, 13 (68.4%) had suppression before occlusion, eight (42.1%) when the highest VA was achieved, five (26.3%) during tapering, and none at the final visit. Of the 13 patients with suppression before occlusion, 10 (76.9%) showed further improvement in stereoacuity when suppression disappeared, and nine had foveal stereopsis of 60 arcseconds. A significant association was confirmed between foveal stereopsis and suppression when the highest VA was achieved and during the tapering period (<0.05, Fisher's exact test).
Suppression was observed even when the VA in amblyopic eyes reached the highest score. By gradually decreasing the duration of occlusion, suppression was eliminated, leading to the acquisition of foveal stereopsis.
探讨屈光参差性弱视患者在遮盖治疗期间立体视锐度与抑制之间的关联。
回顾性研究。
本研究纳入了19例接受遮盖治疗的远视性屈光参差性弱视患者。患者的平均年龄为5.5±1.4岁。在开始遮盖治疗前、弱视视力（VA）达到最高时、逐渐减量期、遮盖治疗结束时以及最后一次随访时，对参与者的立体视锐度改善情况和抑制情况进行评估。使用TNO测试或JACO立体视测试评估立体视锐度。使用立体视蝇试验的1号圈或JACO结果作为视标评估抑制的存在情况。
19例患者中，13例（68.4%）在遮盖前存在抑制，8例（42.1%）在视力达到最高时存在抑制，5例（26.3%）在逐渐减量期存在抑制，而在最后一次随访时均无抑制。在遮盖前存在抑制的13例患者中，10例（76.9%）在抑制消失时立体视锐度进一步改善，其中9例具有60角秒的中央凹立体视。在视力达到最高时和逐渐减量期，中央凹立体视与抑制之间存在显著关联（<0.05，Fisher精确检验）。
即使弱视眼的视力达到最高分，仍可观察到抑制现象。通过逐渐缩短遮盖时间，抑制现象得以消除，从而获得中央凹立体视。
