中华眼科医学杂志(电子版)
中華眼科醫學雜誌(電子版)
중화안과의학잡지(전자판)
CHINESE JOURNAL OF OPHTHALMOLOGIC MEDICINE(ELECTRONIC EDITION)
2013年
1期
18-21
,共4页
白大勇%吴倩%胡守龙%王媛%崔燕辉%于刚
白大勇%吳倩%鬍守龍%王媛%崔燕輝%于剛
백대용%오천%호수룡%왕원%최연휘%우강
儿童%婴儿型眼球震颤%眼震图%波形
兒童%嬰兒型眼毬震顫%眼震圖%波形
인동%영인형안구진전%안진도%파형
Child%Nystagmus%Videonystagmography%Wavelet
目的:探讨红外视频眼震仪对儿童眼球震颤综合征( INS)患者眼震波形的分析能力及眼震波形与立体视功能的关系。方法回顾性分析北京儿童医院眼科使用MG6B-5型LED光源放大镜检查的142例(284只眼) INS患儿的临床资料,其中77例(154只眼)患儿行Y-II眼震仪检查,15例(30只眼)患儿行EYELINK眼震仪检查,40例(80只眼)患儿使用Inami同视机及Titmus立体图对进行立体视功能检查。对无代偿头位患儿视力与有代偿头位患儿的视力比较采用独立t检验,对40例(80只眼)同视机立体视、Titmus立体视、眼震频率、振幅及震强检查资料齐全的患儿进行检测指标间的Spearman相关性分析。结果使用Y-II眼震仪检查的INS患儿81例,行EYELINK眼震仪检查的患儿共15例。发现水平冲动眼震型72例(144只眼);水平钟摆样眼震54例(108只眼);T型眼震3例(6只眼);复合眼震13例(26只眼)。其中隐性水平冲动眼震3例(6只眼),隐性+显性水平冲动眼震1例(2只眼),垂直眼震7例(14只眼)。具有代偿头位的患儿86例(172只眼),其中单纯面向右转者17例(34只眼),单纯面向左转者22例(44只眼),单纯下颌上抬者3例(6只眼),单纯下颌内收者4例(8只眼),单纯头向右肩倾斜者4例(8只眼),单纯头向左肩倾斜者4例(8只眼),集合抑制者8例(16只眼)。有代偿头位的患儿86例(172只眼),行过矫正视力检查的患儿62例(124只眼);无代偿头位的患儿62例(124只眼),进行矫正视力检查的患儿49例(98只眼)。代偿头位的患儿矫正视力均值为(0.36±0.24),无代偿头位的患儿矫正视力均值为(0.25±0.16)。具有代偿头位患儿的矫正视力优于无代偿头位患儿,差异有统计学意义(t=3.04,P<0.01)。复合头位的患儿32例(21.6%)。使用Y-II眼震仪检查的患儿81例(162只眼),眼震平均频率为(2.83±1.37)Hz,平均振幅为(7.91±5.32)°,平均震强为(22.43±16.93)°×Hz。对40例(80只眼)婴儿型眼震患儿的眼震频率、震幅、震强与立体视分别做Spearman相关性分析,表明频率、震强、振幅与立体视(同视机立体视、Titmus立体圈、Titmus立体动物)无明显相关性(r=0.54,-0.134,0.017;P >0.05)、(r=0.24,0.095,0.137;P >0.05)、(r=0.155,0.136,0.312;P≥0.05)。结论婴儿型眼球震颤可以使用眼震图精确检测振幅、震频、震强及眼震波形,多数患儿具有代偿头位,代偿头位下矫正视力优于无代偿头位患儿,因而对治疗具有指导意义。
目的:探討紅外視頻眼震儀對兒童眼毬震顫綜閤徵( INS)患者眼震波形的分析能力及眼震波形與立體視功能的關繫。方法迴顧性分析北京兒童醫院眼科使用MG6B-5型LED光源放大鏡檢查的142例(284隻眼) INS患兒的臨床資料,其中77例(154隻眼)患兒行Y-II眼震儀檢查,15例(30隻眼)患兒行EYELINK眼震儀檢查,40例(80隻眼)患兒使用Inami同視機及Titmus立體圖對進行立體視功能檢查。對無代償頭位患兒視力與有代償頭位患兒的視力比較採用獨立t檢驗,對40例(80隻眼)同視機立體視、Titmus立體視、眼震頻率、振幅及震彊檢查資料齊全的患兒進行檢測指標間的Spearman相關性分析。結果使用Y-II眼震儀檢查的INS患兒81例,行EYELINK眼震儀檢查的患兒共15例。髮現水平遲動眼震型72例(144隻眼);水平鐘襬樣眼震54例(108隻眼);T型眼震3例(6隻眼);複閤眼震13例(26隻眼)。其中隱性水平遲動眼震3例(6隻眼),隱性+顯性水平遲動眼震1例(2隻眼),垂直眼震7例(14隻眼)。具有代償頭位的患兒86例(172隻眼),其中單純麵嚮右轉者17例(34隻眼),單純麵嚮左轉者22例(44隻眼),單純下頜上抬者3例(6隻眼),單純下頜內收者4例(8隻眼),單純頭嚮右肩傾斜者4例(8隻眼),單純頭嚮左肩傾斜者4例(8隻眼),集閤抑製者8例(16隻眼)。有代償頭位的患兒86例(172隻眼),行過矯正視力檢查的患兒62例(124隻眼);無代償頭位的患兒62例(124隻眼),進行矯正視力檢查的患兒49例(98隻眼)。代償頭位的患兒矯正視力均值為(0.36±0.24),無代償頭位的患兒矯正視力均值為(0.25±0.16)。具有代償頭位患兒的矯正視力優于無代償頭位患兒,差異有統計學意義(t=3.04,P<0.01)。複閤頭位的患兒32例(21.6%)。使用Y-II眼震儀檢查的患兒81例(162隻眼),眼震平均頻率為(2.83±1.37)Hz,平均振幅為(7.91±5.32)°,平均震彊為(22.43±16.93)°×Hz。對40例(80隻眼)嬰兒型眼震患兒的眼震頻率、震幅、震彊與立體視分彆做Spearman相關性分析,錶明頻率、震彊、振幅與立體視(同視機立體視、Titmus立體圈、Titmus立體動物)無明顯相關性(r=0.54,-0.134,0.017;P >0.05)、(r=0.24,0.095,0.137;P >0.05)、(r=0.155,0.136,0.312;P≥0.05)。結論嬰兒型眼毬震顫可以使用眼震圖精確檢測振幅、震頻、震彊及眼震波形,多數患兒具有代償頭位,代償頭位下矯正視力優于無代償頭位患兒,因而對治療具有指導意義。
목적:탐토홍외시빈안진의대인동안구진전종합정( INS)환자안진파형적분석능력급안진파형여입체시공능적관계。방법회고성분석북경인동의원안과사용MG6B-5형LED광원방대경검사적142례(284지안) INS환인적림상자료,기중77례(154지안)환인행Y-II안진의검사,15례(30지안)환인행EYELINK안진의검사,40례(80지안)환인사용Inami동시궤급Titmus입체도대진행입체시공능검사。대무대상두위환인시력여유대상두위환인적시력비교채용독립t검험,대40례(80지안)동시궤입체시、Titmus입체시、안진빈솔、진폭급진강검사자료제전적환인진행검측지표간적Spearman상관성분석。결과사용Y-II안진의검사적INS환인81례,행EYELINK안진의검사적환인공15례。발현수평충동안진형72례(144지안);수평종파양안진54례(108지안);T형안진3례(6지안);복합안진13례(26지안)。기중은성수평충동안진3례(6지안),은성+현성수평충동안진1례(2지안),수직안진7례(14지안)。구유대상두위적환인86례(172지안),기중단순면향우전자17례(34지안),단순면향좌전자22례(44지안),단순하합상태자3례(6지안),단순하합내수자4례(8지안),단순두향우견경사자4례(8지안),단순두향좌견경사자4례(8지안),집합억제자8례(16지안)。유대상두위적환인86례(172지안),행과교정시력검사적환인62례(124지안);무대상두위적환인62례(124지안),진행교정시력검사적환인49례(98지안)。대상두위적환인교정시력균치위(0.36±0.24),무대상두위적환인교정시력균치위(0.25±0.16)。구유대상두위환인적교정시력우우무대상두위환인,차이유통계학의의(t=3.04,P<0.01)。복합두위적환인32례(21.6%)。사용Y-II안진의검사적환인81례(162지안),안진평균빈솔위(2.83±1.37)Hz,평균진폭위(7.91±5.32)°,평균진강위(22.43±16.93)°×Hz。대40례(80지안)영인형안진환인적안진빈솔、진폭、진강여입체시분별주Spearman상관성분석,표명빈솔、진강、진폭여입체시(동시궤입체시、Titmus입체권、Titmus입체동물)무명현상관성(r=0.54,-0.134,0.017;P >0.05)、(r=0.24,0.095,0.137;P >0.05)、(r=0.155,0.136,0.312;P≥0.05)。결론영인형안구진전가이사용안진도정학검측진폭、진빈、진강급안진파형,다수환인구유대상두위,대상두위하교정시력우우무대상두위환인,인이대치료구유지도의의。
Objective To evaluate the examination methods of infant nystagmus syndrome(INS), the waveform analysis ability of videonystagmography and the relationship of stereoscopic vision and nystagmus wavelet.Methods It was a retrospective study.One handred and forty-two INS cases (284 eyes) in Department of Ophthalmology,Beijing Children Hospital of the Capital University of Medical Sciences from June 2009 to July 2012 were included.All cases were examined by LED magnifier of MG6B-5 type among which 77 cases (154 eyes) were examined by Y-II videonystagmography,15 cases (30 eyes) were examined by EYELINK videonystagmography,40 cases (80 eyes) were examined by Inami synoptophore and Titmus chart.Independent sample t test and spearman correlation test were used in this study.Resuluts Among 77 cases examined by Y-II videonystagmography and 15 cases examined by EYELINK videonystagmography, we observed 72 cases (144 eyes) of horizontal jerk nystagmus,54 cases (108 eyes) of horizontal pendular nystagmus pendular, 3 cases (6 eyes) of T type and 13 cases (26 eyes) of complex nystagmus.Eighty-six cases (172 eyes) had compensatory head posture,62 cases (124 eyes) had vision corrected;62 cases (124 eyes) did not have compensatory head posture,49 cases (98 eyes) had vision corrected.The corrected vision of patients with compensatory head posture was (0.36±0.24) while the corrected vision of those without compensatory head posture was (0.25±0.16).Difference was statistically significant(t=3.04,P<0.01). Thirty-two cases (21.6%) had complex head posture.Seventy-seven cases (154 eyes) were examined by Y-II videonystagmography,and the frequency of nystagmus of them was (2.83 ±1.37) Hz,the amplitude of nystagmus was (7.91±5.32)°,the intensity of nystagmus was (22.43±16.93)°×Hz.The spearman correlation test among 40 INS patients showed that the stereoscopic vison had no obvious correlation with frequency,amplitude and intensity of nystagmus waveform(r=0.54,-0.134,0.017;P >0.05)、(r=0.24, 0.095,0.137;P >0.05)、(r=0.155,0.136,0.312;P ≥0.05).Conclusions Videonystagmography can record the frequency, amplitude intensity and wavelet accurately.Most cases of INS patients have compensatory head posture and better corrected vision with compensatory head posture.