散光对儿童眼球正视化及弱视治疗效果的影响
산광대인동안구정시화급약시치료효과적영향
Effect of astigmatism on emmetropization and treatment of amblyopia in young children
  • 万方数据
    中华眼视光学与视觉科学杂志 중화안시광학여시각과학잡지
    CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
    2010年 5期 371-374 ,共4页

    付景珂%胡聪%李霞%何峰丽

    부경가%호총%리하%하봉려

    散光%正视化%弱视%儿童 散光%正視化%弱視%兒童
    산광%정시화%약시%인동
    Astigmatism%Emmetropization%Amblyopia%Child
    目的 探讨不同程度的散光对远视儿童眼球正视化进程及视力变化的影响,从而为临床上此类患儿的屈光矫正、弱视治疗提供参考.方法 回顾性病例系列研究.收集1999年10月至2008年2月期间连续就诊时间长达5年及以上且病例资料完整的4～11岁远视患儿138例(258眼),按散光程度分为对照组(散光≤0.5 D,107眼)、散光1组(0.5 D＜散光＜1.0 D,85眼)和散光2组(散光≥1.0 D,66眼).比较5年中各组内相邻两年间及组间的球镜度数、视力差异,比较首次与第5年末散光度数的差异.年间、组间球性屈光度数及视力的比较采用方差分析,首次检查与末次检查时的散光度数的差异采用配对t检验进行分析.结果 对照组与散光1组的首次检查及第1、2、3年末的屈光度数相邻两年间球镜度数差异均有统计学意义(P＜0.05);第3与第4年、第4与第5年末球镜度数差异均无统计学意义.散光2组的6次检查相邻两年间差异均有统计学意义(P＜0.05).对照组与散光1组对应时间点两组间球镜度数差异均无统计学意义.3组患儿的球镜度数在首次及第1、2、3年末差异无统计学意义;第4、5年末,3组间的差异有统计学意义(F值分别为5.06、7.58,P＜0.05).对照组与散光1组首次与第1、2年末的矫正视力差异有统计学意义(P＜0.05);其他相邻两年间差异无统计学意义.散光2组首次与第1年末矫正视力差异有统计学意义(P＜0.05);其他相邻两年间的矫正视力差异无统计学意义.对照组与散光1组对应时间点两组间矫正视力的差异无统计学意义.散光2组与其他两组患儿的矫正视力在首次及第1年末差异无统计学意义,在第2、3、4、5年末时差异有统计学意义(P＜0.05).散光2组5年后的散光度数明显下降,差异有统计学意义(t=3.1440,P=0.021).结论 ≥1.0 D的散光可促进远视眼的正视化进程,但不利于弱视的治疗.轻度的散光(＜1.0 D)对眼球正视化进程影响作用不明显,也不影响视力的发育.故在远视性屈光不正眼球正视化过程中,＜1.0 D的散光对眼球正视化进程无明显影响.
    목적 탐토불동정도적산광대원시인동안구정시화진정급시력변화적영향,종이위림상상차류환인적굴광교정、약시치료제공삼고.방법 회고성병례계렬연구.수집1999년10월지2008년2월기간련속취진시간장체5년급이상차병례자료완정적4～11세원시환인138례(258안),안산광정도분위대조조(산광≤0.5 D,107안)、산광1조(0.5 D＜산광＜1.0 D,85안)화산광2조(산광≥1.0 D,66안).비교5년중각조내상린량년간급조간적구경도수、시력차이,비교수차여제5년말산광도수적차이.년간、조간구성굴광도수급시력적비교채용방차분석,수차검사여말차검사시적산광도수적차이채용배대t검험진행분석.결과 대조조여산광1조적수차검사급제1、2、3년말적굴광도수상린량년간구경도수차이균유통계학의의(P＜0.05);제3여제4년、제4여제5년말구경도수차이균무통계학의의.산광2조적6차검사상린량년간차이균유통계학의의(P＜0.05).대조조여산광1조대응시간점량조간구경도수차이균무통계학의의.3조환인적구경도수재수차급제1、2、3년말차이무통계학의의;제4、5년말,3조간적차이유통계학의의(F치분별위5.06、7.58,P＜0.05).대조조여산광1조수차여제1、2년말적교정시력차이유통계학의의(P＜0.05);기타상린량년간차이무통계학의의.산광2조수차여제1년말교정시력차이유통계학의의(P＜0.05);기타상린량년간적교정시력차이무통계학의의.대조조여산광1조대응시간점량조간교정시력적차이무통계학의의.산광2조여기타량조환인적교정시력재수차급제1년말차이무통계학의의,재제2、3、4、5년말시차이유통계학의의(P＜0.05).산광2조5년후적산광도수명현하강,차이유통계학의의(t=3.1440,P=0.021).결론 ≥1.0 D적산광가촉진원시안적정시화진정,단불리우약시적치료.경도적산광(＜1.0 D)대안구정시화진정영향작용불명현,야불영향시력적발육.고재원시성굴광불정안구정시화과정중,＜1.0 D적산광대안구정시화진정무명현영향.
    Objective To investigate the effect of different astigmatisms on emmetropization and amblyopia. Methods Retrospective case series study. Two hundred and fifty-eight eyes of 138 children were divided into 3 groups: a normal control group (107 eyes) and an astigmatism group 1 (85 eyes) and group 2 (66 eyes) according to their degree of astigmatism.Refractive status and visual acuity (VA) were measured and compared at the beginning and at 1,2, 3, 4 and 5 years. Astigmatism was measured and compared at the beginning and end. Results Refractive status: the normal control group and the astigmatism group 1 had a significant decrease in refractive status at 1, 2 and 3 years (P＜0.05 for both). Astigmatism group 2 had a significant decrease in refractive status every year (F=24.65, P＜0.05). No significant differences were found in refractive status when the normal control and the astigmatism group 1 were compared at corresponding times. Significant differences were found in years 4 and 5 between the astigmatism group 2 and the other two groups. Visual acuity: the normal control and astigmatism group 1 had a significant improvement in visual acuity in years 1 and 2; there was a significant improvement in year 1 in the astigmatism group 2. The intergroup results for corresponding times were not statistically significant for the normal control and astigmatism group 1. There was a statistically significant difference between astigmatism groups 2 and 1, and between group 2 and the normal group in years 2, 3, 4 and 5.The amount of astigmatism decreased significantly in the astigmatism group 2 between the first and last check-ups (t=3.1440, P=0.021). Conclusion Astigmatism≥ 1.0 D is found to accelerate emmetropization. But amblyopia could not be completely cured. Astigmatism＜1.0 D has no influence on emmetropization and amblyopia.
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