Lesueur L, Chapotot E, Arne J L, Perron-Buscail A, Deneuville S
Service d'Ophtalmologie, Hôpital Purpan, Toulouse.
J Fr Ophtalmol. 1998 Jun-Jul;21(6):415-24.
The aim of this cross-sectional retrospective study was to analyze the predictability of amblyopia in children with myopic and hyperopic unilateral and bilateral ametropia.
One hundred and sixty two eyes of 96 children, (mean age: 8.6 years), were included in this work. Mean visual acuities and significant refractive errors were estimated for all the cases. The frequency of amblyopia and strabismus was studied in cases without amblyopia and in cases with medium and high grade amblyopia.
Mean visual acuities were significantly higher in cases of bilateral myopia (p < 0.001) and hyperopia (p < 0.05) compared with unilateral ametropia. The frequency of myopic eyes (p < 0.01), eyes with high grade of myopia (p < 0.002) and anisomyopic eyes (p < 0.001) was significantly higher in cases of high amblyopia compared with cases without amblyopia. Strabismus (p < 0.05) were also significantly more frequent in cases of high amblyopia as well as in cases of myopic eyes (p < 0.01). Moreover, in the group of high amblyopia, 6 cases (6/7) had developed an intolerance for contact lenses.
The risk of developing high grade amblyopia appeared significantly associated with unilateral medium and high level myopia. Strabismus and difficulties with good correction of anisometropia by contact lenses or spectacle appeared to be predisposing factors. This observation would suggest the indication of refractive surgery might be useful in these particular cases. To conclude, this study emphasizes the importance of early treatment of ametropia to reduce the incidence of amblyopia in children.
本横断面回顾性研究旨在分析近视和远视性单眼及双眼屈光不正患儿弱视的可预测性。
本研究纳入了96名儿童的162只眼（平均年龄：8.6岁）。评估了所有病例的平均视力和显著屈光不正情况。研究了无弱视病例以及中度和高度弱视病例中弱视和斜视的发生率。
与单眼屈光不正相比，双眼近视（p < 0.001）和远视（p < 0.05）病例的平均视力显著更高。与无弱视病例相比，高度弱视病例中近视性眼（p < 0.01）、高度近视性眼（p < 0.002）和屈光参差性眼（p < 0.001）的发生率显著更高。高度弱视病例以及近视性眼病例中斜视（p < 0.05）的发生率也显著更高（p < 0.01）。此外，在高度弱视组中，有6例（6/7）出现了对隐形眼镜不耐受的情况。
发生高度弱视的风险似乎与单眼中度和高度近视显著相关。斜视以及隐形眼镜或眼镜对屈光参差的良好矫正困难似乎是诱发因素。这一观察结果表明屈光手术在这些特殊病例中可能有用。总之，本研究强调了早期治疗屈光不正对降低儿童弱视发生率的重要性。
