间歇性外斜视患儿的阅读能力及其与双眼视觉功能和视觉信息处理能力的关系。

Reading ability in children with intermittent exotropia and its association with binocular visual function and visual information processing capability.

作者信息

Yang Yan, Hou Jinen, Huang Hailu, Wei Cong, Chen Jingsen, Wu Tong, Liu Junyi, Deng Daming, Ling Shihui, Yang Wenhan, Yan Jianhua, Chang Shuai, Yu Xinping

机构信息

State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China.

Guangdong Provincial Key Laboratory of Ophthalmology and Visual Science, Guangdong Provincial Clinical Research Center for Ocular Diseases, Guangzhou, China.

出版信息

BMC Ophthalmol. 2025 Sep 1;25(1):497. doi: 10.1186/s12886-025-04326-y.

DOI:10.1186/s12886-025-04326-y

PMID:40890623

Abstract

PURPOSE

To evaluate children's reading performance with intermittent exotropia (IXT) and investigate possible associations among reading abnormalities, binocular visual function, and visual information processing.

METHODS

This cross-sectional, case-control study involved 61 children with basic-type IXT and 40 healthy controls aged 7 to 13. Reading performance was assessed objectively using the Development Eye Movement (DEM) test and subjectively with the Dyslexia Checklist for Chinese Children (DCCC). Binocular visual function assessments included fusion, stereopsis, and contrast sensitivity. Visual information processing was evaluated using the Test of Visual Perceptual Skills (TVPS-4) and Beery Visual Motor Integration (VMI-6).

RESULTS

Children with IXT exhibited significantly poorer performance on both the horizontal (p = 0.04) and vertical subtests (p = 0.048, p = 0.023, p = 0.037 under different viewing conditions) of the DEM test compared to controls. DCCC questionnaire responses indicated greater difficulties among children with IXT in reading, oral language, written expression, reading habits, attention, and vocabulary comprehension (all p < 0.05). Additionally, children with IXT demonstrated significantly reduced stereopsis, fusion, and contrast sensitivity (all p < 0.05). Scores for visual perception (assessed with TVPS-4) and visual-motor integration (assessed with VMI-6) were also lower in the IXT group (p = 0.003 and p = 0.008, respectively). Stepwise multivariate analysis identified visual-motor integration as an independent predictor of DEM reading performance (p = 0.005), accounting for 11% of the variance in reading ability among children with IXT.

CONCLUSION

Children with intermittent exotropia exhibit reduced reading performance, with visual-motor integration possibly as a key factor. Clinical interventions may benefit from focusing on enhancing visual-motor integration.

摘要

目的

评估患有间歇性外斜视（IXT）儿童的阅读表现，并研究阅读异常、双眼视觉功能和视觉信息处理之间可能存在的关联。

方法

这项横断面病例对照研究纳入了61名患有基本型IXT的儿童和40名年龄在7至13岁的健康对照者。使用发育性眼动（DEM）测试客观评估阅读表现，并使用《中国儿童阅读障碍检查表》（DCCC）进行主观评估。双眼视觉功能评估包括融合、立体视和对比敏感度。使用视觉感知技能测试（TVPS-4）和贝里视觉运动整合测试（VMI-6）评估视觉信息处理能力。

结果

与对照组相比，患有IXT的儿童在DEM测试的水平子测试（p = 0.04）和垂直子测试（在不同观看条件下p = 0.048、p = 0.023、p = 0.037）中表现明显更差。DCCC问卷回答表明，患有IXT的儿童在阅读、口语、书面表达、阅读习惯、注意力和词汇理解方面存在更大困难（所有p < 0.05）。此外，患有IXT的儿童的立体视、融合和对比敏感度明显降低（所有p < 0.05）。IXT组的视觉感知（用TVPS-4评估）和视觉运动整合（用VMI-6评估）得分也较低（分别为p = 0.003和p = 0.008）。逐步多变量分析确定视觉运动整合是DEM阅读表现的独立预测因素（p = 0.005），占患有IXT儿童阅读能力方差的11%。