Biglan A W
Department of Ophthalmology, University of Pittsburgh School of Medicine, Pa, USA.
J Pediatr Ophthalmol Strabismus. 1995 Sep-Oct;32(5):309-14. doi: 10.3928/0191-3913-19950901-10.
Strabismus occurs frequently in patients with spina bifida or meningomyelocele.
I performed 1544 eye examinations in 298 patients with spina bifida over a period of 15 years. The patient records were retrospectively reviewed for visual acuity, binocular function, and strabismus. Select patients with A-pattern strabismus were recalled for neuroimaging.
Visual acuity was correctable to 20/40 in 85% of the patients. One hundred and eighty-three patients (61%) had strabismus at some time over the study period. Sixty-three percent had an esodeviation; 37% an exodeviation. A-pattern strabismus was more common in patients with exotropia (39%) than in those with esotropia (27%). Defects on neuroimaging in the region of the vertical gaze pathways in the brain stem were correlated with A-pattern strabismus.
With increased longevity of the patient with spina bifida, quality-of-life issues become increasingly important. Amblyopia, strabismus, and other acquired defects in the visual system related to hydrocephalus should be closely monitored and treated when indicated.
脊柱裂或脊髓脊膜膨出患者中斜视很常见。
在15年的时间里，我对298例脊柱裂患者进行了1544次眼部检查。对患者记录进行回顾性分析，以了解视力、双眼视功能和斜视情况。挑选出有A-型斜视的患者进行神经影像学检查。
85%的患者视力可矫正至20/40。在研究期间，183例患者（61%）曾出现过斜视。63%为内斜视；37%为外斜视。外斜视患者中A-型斜视（39%）比内斜视患者（27%）更常见。脑干垂直注视通路区域的神经影像学缺陷与A-型斜视相关。
随着脊柱裂患者寿命的延长，生活质量问题变得越来越重要。弱视、斜视以及其他与脑积水相关的视觉系统后天缺陷应密切监测，并在有指征时进行治疗。
