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感觉性A-V型外斜视的患病率、危险因素及临床特征

Prevalence, risk factors and clinical features of sensory A-V pattern exotropia.

作者信息

Zhu Bin-Bin, Tang Shi-Yu, Wang Xiang-Jun, Fu Li-Cheng, Yan Jian-Hua

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou 510060, Guangdong Province, China.

Ophthalmology, Department of Surgery, the Second People's Hospital of Foshan, Foshan 528000, Guangdong Province, China.

出版信息

Int J Ophthalmol. 2025 Feb 18;18(2):323-329. doi: 10.18240/ijo.2025.02.17. eCollection 2025.

Abstract

AIM

To investigate the potential mechanisms of A-V pattern and evaluate the surgical outcomes used in the treatment of sensory exotropia.

METHODS

The medical records of patients with sensory A-V pattern exotropia who underwent strabismus surgery between May 2014 to June 2019 was retrospectively reviewed. The control group included sensory exotropia patients without A-V pattern and concomitant A-V pattern exotropia patients with normal vision who undergone strabismus surgery over this same time period. Ocular alignment, best corrected visual acuity, oblique muscle function, and stereopsis records were collected.

RESULTS

Among the 843 eligible patients, 91 (10.79%; 39 males and 52 females) had A-pattern (54, 6.4%) or V-pattern (37, 4.4%). Age at onset of vision impairment was 4±5y and at the time of surgery was 25±9y. Statistically significant negative correlations were present between impaired visual acuity and the pre-operative exodeviation (=-0.198, =0.016) and patterns (=-0.207, =0.015). Age at surgery and exodeviation in patients with concomitant A-V pattern exotropia was significantly earlier as compared with that of sensory A-V pattern exotropia and sensory exotropia (both <0.0001). There were no significant differences in these clinical variables between sensory exotropia with or without A-V pattern. Deviation and pattern were significantly reduced in patients receiving horizontal rectus surgery with or without oblique muscle surgery (both <0.0001).

CONCLUSION

The prevalence of sensory A-V pattern exotropia in our study is 10.79%. Visual acuity represents an important factor contributing to the occurrence and development of A-V pattern. Isolated horizontal rectus surgery can provide a good option for the correction of sensory A-V pattern exotropia.

摘要

目的

探讨A-V型斜视的潜在机制,并评估用于治疗感觉性外斜视的手术效果。

方法

回顾性分析2014年5月至2019年6月间接受斜视手术的感觉性A-V型外斜视患者的病历。对照组包括同期接受斜视手术的无A-V型的感觉性外斜视患者和视力正常的合并A-V型外斜视患者。收集眼位、最佳矫正视力、斜肌功能和立体视记录。

结果

在843例符合条件的患者中,91例(10.79%;男性39例,女性52例)有A-型(54例,6.4%)或V-型(37例,4.4%)。视力障碍发病年龄为4±5岁,手术时年龄为25±9岁。视力损害与术前外斜视(r=-0.198,P=0.016)和类型(r=-0.207,P=0.015)之间存在统计学显著的负相关。合并A-V型外斜视患者的手术年龄和外斜视明显早于感觉性A-V型外斜视和感觉性外斜视患者(均P<0.0001)。有无A-V型的感觉性外斜视患者在这些临床变量上无显著差异。接受水平直肌手术(无论是否联合斜肌手术)的患者斜视度和类型均显著降低(均P<0.0001)。

结论

本研究中感觉性A-V型外斜视的患病率为10.79%。视力是导致A-V型发生和发展的重要因素。单纯水平直肌手术可为矫正感觉性A-V型外斜视提供良好选择。

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