CAJ | 학술논문

背景人类具备不同阶度的空间感知觉,但目前临床所用的立体视检查多采用图像移位的零阶刺激模式,临床上应根据不同阶度空间感知的神经地形图建立新的空间感知觉筛查系统. 目的检查弱视和斜视患儿零阶、一阶、二阶多维空间感知觉的缺损状态,以研究弱视和斜视患儿在多维空间感知觉立体视功能方面的缺损情况,并探讨零阶、一阶、二阶空间感知觉缺损的内在关联.方法对北京儿童医院眼科门诊就诊的4～14岁儿童79例进行空间感知觉检查,受检者根据临床症状的不同分为正常组19名、屈光不正性弱视组19例、屈光参差性弱视组12例、斜视组18例、斜视合并弱视组11例.依次用一套新的多维空间感知觉筛查系统检查各组患儿零阶、一阶、二阶随机点及线条空间感知觉,并进行差异比较. 结果在所有研究对象中,存在零阶、一阶、二阶随机点感知通道缺失者分别为24例(占30.4％)、1 8例(占22.8％)、24例(占30.4％),平均为27.9％；零阶、一阶、二阶线条空间感知通道缺失分别为37例(占46.8％)、37例(占46.8％)、32例(占40.5％),平均为44.7％.零阶空间感知有缺失的患儿中,仍残留有一阶、二阶空间感知的随机点占41.6％,线条占43.2％；零阶随机点或线条空间感知觉均无缺损的患儿中,存在一阶或/和二阶空间感知觉缺损的患儿占37.5％.患有弱视或斜视的患儿与正常组相比各阶空间感知的差异均有统计学意义(P＜0.05). 结论弱视或斜视患儿空间感知通道存在缺失,零阶空间感知觉存在缺失的患儿仍部分残留有一阶或二阶空间感知觉,而零阶空间感知觉正常的患儿可能一阶或二阶空间感知觉有缺损.视觉信息加工的多维空间感知觉模型能够指导弱视或斜视等视觉信息加工障碍患儿的检查,并能开展一系列的感知觉学习治疗.
배경 인류구비불동계도적공간감지각,단목전림상소용적입체시검사다채용도상이위적령계자격모식,림상상응근거불동계도공간감지적신경지형도건립신적공간감지각사사계통. 목적 검사약시화사시환인령계、일계、이계다유공간감지각적결손상태,이연구약시화사시환인재다유공간감지각입체시공능방면적결손정황,병탐토령계、일계、이계공간감지각결손적내재관련.방법 대북경인동의원안과문진취진적4～14세인동79례진행공간감지각검사,수검자근거림상증상적불동분위정상조19명、굴광불정성약시조19례、굴광삼차성약시조12례、사시조18례、사시합병약시조11례.의차용일투신적다유공간감지각사사계통검사각조환인령계、일계、이계수궤점급선조공간감지각,병진행차이비교. 결과 재소유연구대상중,존재령계、일계、이계수궤점감지통도결실자분별위24례(점30.4％)、1 8례(점22.8％)、24례(점30.4％),평균위27.9％；령계、일계、이계선조공간감지통도결실분별위37례(점46.8％)、37례(점46.8％)、32례(점40.5％),평균위44.7％.령계공간감지유결실적환인중,잉잔류유일계、이계공간감지적수궤점점41.6％,선조점43.2％；령계수궤점혹선조공간감지각균무결손적환인중,존재일계혹/화이계공간감지각결손적환인점37.5％.환유약시혹사시적환인여정상조상비각계공간감지적차이균유통계학의의(P＜0.05). 결론 약시혹사시환인공간감지통도존재결실,령계공간감지각존재결실적환인잉부분잔류유일계혹이계공간감지각,이령계공간감지각정상적환인가능일계혹이계공간감지각유결손.시각신식가공적다유공간감지각모형능구지도약시혹사시등시각신식가공장애환인적검사,병능개전일계렬적감지각학습치료.
Background There is multi-dimensional order of spatial stereopsis perception in human,however,current stereopsis examination is zero-order of position disparity.A multi-dimensional space perception model is very important for the detection of stereoacuity.Objective This study was to screen the deficit of zero-order,first-order,second-order multi-dimensional spatial stereopsis perception in amblyopia and strabismus children and to explore the association of zero-order,first-order,second-order spatial perception deficit.Methods Multidimensional spacial perception was examined in 79 children aged 4-14 years in Beijing Children' s Hospital.Nineteen normal children,19 children with ametropia amblyopia,12 children with anisometropic amblyopia,18 children with strabismus and 11 children with strabismus combined amblyopia were included this study.The random-dot and line spatial stereopsis perception in zero-order,first-order and second-order were examined with a new system of multidimensional space perception screening.Written informed consent was obtained from each subject or custodian before any ocular examination associated with this study.Results Absence of zero-order,first-order,second-order random-dot channel was found in 24 children (24/79,30.4％),18 children (18/79,22.8％) and 24 children (24/79,30.4％) respectively,with an average percentage of 27.9％.Absence of zero-order,first-order,second-order line channel was examined in 37 children (37/79,46.8％),37 children (37/79,46.8％),32 children (32/79,40.5％),with an average percentage of 44.7％.In the children with a deficiency of the zero-order spatial perception,the children who still remained the first-order or/and second-order spatial perception of random-dot accounted for 41.6％ and that of lines accounted for 43.2％.In children without deficiency of zero-order random-dot or lines spatial space perception,deficiency of first-order and/or second-order spatial perception was in 37.5％ children.Various order spatial perception deficiency was seen in children suffering from amblyopia or strabismus compared with normal group(P ＜ 0.05).Conclusions There exists spatial perception deficiency in children with amblyopia or strabismus.The patients with zero-order spatial perception absence partially remain a first-order or/and second-order spatial perception;while the patients with normal zero-order spatial perception might have first-order or second-order spatial perception deficiency.The multi-dimensional space perception model has a directive role for the training of visual information process and the treatment of spatial perceptual learning in children with amblyopia or strabismus.