CAJ | 학술논문

目的研究同量治疗下双眼屈光不正性弱视主视眼与非主视眼疗效是否存在差异.方法临床病例系列研究.对2011年1月至2012年12月在汕头市中心医院眼科治疗的双眼矫正视力相等或差一行的100例双眼屈光不正性弱视儿童,采用卡洞法检查分成主视眼组与非主视眼组.应用阿托品散瞳检查屈光度及矫正视力,进行双眼同量综合弱视治疗,包括戴镜、精细目力训练、视刺激疗法.于治疗后第1、3、6、12个月检查主视眼与非主视眼矫正视力的进步行数和基本治愈率.结果治疗前后主视眼眼别未见转换,在治疗的第1、3、6、12个月,主视眼视力进步行数分别为(2.23±1.11)、(3.00±1.33)、(3.48±1.40)、(3.72±1.42),非主视眼视力分别为(1.93±1.27)、(2.98±1.35)、(3.49±1.42)、(3.73±1.38);主视眼基本治愈率分別为51.0％ (51/100)、78.0％ (78/100)、82.0％ (82/100)、87.0％(87/100),非主视眼分别为36.0％ (36/100)、74.0％ (74/100)、82.0％ (82/100)、86.0％ (86/100).主视眼矫正视力进步行数和基本治愈率在治疗的第1个月均高于非主视眼,差异比较有统计学意义(t =4.18,P ＜0.01,x2=4.58,P=0.03),而在第3、6、12个月则均相近,差异比较无统计学意义(P＞0.05).结论同量治疗下双眼屈光不正性弱视儿童主视眼眼别未发生改变,短期内主视眼的疗效优于非主视眼,而中、长期疗效则差异比较无统计学意义.
목적 연구동량치료하쌍안굴광불정성약시주시안여비주시안료효시부존재차이.방법 림상병례계렬연구.대2011년1월지2012년12월재산두시중심의원안과치료적쌍안교정시력상등혹차일행적100례쌍안굴광불정성약시인동,채용잡동법검사분성주시안조여비주시안조.응용아탁품산동검사굴광도급교정시력,진행쌍안동량종합약시치료,포괄대경、정세목력훈련、시자격요법.우치료후제1、3、6、12개월검사주시안여비주시안교정시력적진보행수화기본치유솔.결과 치료전후주시안안별미견전환,재치료적제1、3、6、12개월,주시안시력진보행수분별위(2.23±1.11)、(3.00±1.33)、(3.48±1.40)、(3.72±1.42),비주시안시력분별위(1.93±1.27)、(2.98±1.35)、(3.49±1.42)、(3.73±1.38);주시안기본치유솔분별위51.0％ (51/100)、78.0％ (78/100)、82.0％ (82/100)、87.0％(87/100),비주시안분별위36.0％ (36/100)、74.0％ (74/100)、82.0％ (82/100)、86.0％ (86/100).주시안교정시력진보행수화기본치유솔재치료적제1개월균고우비주시안,차이비교유통계학의의(t =4.18,P ＜0.01,x2=4.58,P=0.03),이재제3、6、12개월칙균상근,차이비교무통계학의의(P＞0.05).결론 동량치료하쌍안굴광불정성약시인동주시안안별미발생개변,단기내주시안적료효우우비주시안,이중、장기료효칙차이비교무통계학의의.
Objective To compare the therapeutic efficacy between dominant and non-dominant eyes under the same level of treatment intensity for bilateral ametropic amblyopia.Methods From January 2011 to December 2012,200 eyes of 100 children with bilateral ametropic amblyopia (visual acuity ≤ 1 line difference between the two eyes) who treated in Shantou Center Hospital were classified as dominant eye or non-dominant eye groups based on Card-Hole measurement.After atropine mydrisis,retinoscopy optometry measurement and vision correction,all the eyes were treated with the same combination of trainings,including glasses,fine eyesight training,and CAM stimulator to two eyes.The improvement in visual acuity and elementary cure rate were examined at 1,3,6,and 12 months.Results Dominant eyes remained the dominant trait after training.At 1,3,6,and 12 months after training,the improvement in visual acuity was (2.23±1.11),(3.00±1.33),(3.48± 1.40) and (3.72±1.42) lines,respectively,in the dominant eyes; and they were (1.93±1.27),(2.98± 1.35),(3.49±1.42) and (3.73±1.38) lines in the non-dominant eyes respectively.The elementary cure rate was 51.0％ (51/100),78.0％ (78/100) and 82.0％ (82/100) in the dominant eyes and 36.0％ (36/100),74.0％ (74/100),82.0％ (82/100) and 86.0％ (86/100) in the non-dominant eyes respectively.The dominant eyes showed greater improvement in both visual acuity and elementary cure rate at 1month compared with the non-dominant eyes (t =4.18,P ＜0.01,x2=4.58,P=0.03),but the differences were no longer statistically significant at 3,6 and 12months (P ＞0.05).Conclusions Dominant eyes remain dominant after receiving therapy for bilateral ametropic amblyopia in children.Dominant eyes appear to have greater therapeutic efficacy compared with non-dominant eyes in short term.