CAJ | 학술논문

目的：了解脑瘫患儿常见的视觉障碍情况，为临床早期行眼部筛查、诊断及治疗提供依据，促进脑瘫患儿的视觉康复。 　　方法：对223例确诊为脑瘫的患儿行眼部常规检查，包括眼位及眼球运动检查，间接检眼镜或Retcam Ⅱ检查眼底，散瞳验光检查了解屈光状态，闪光视觉诱发电位（F-VEP）检查了解视觉通路传导，记录并分析常见的视觉障碍。 　　结果：脑瘫患儿223例中，主要的视觉障碍表现为斜视、屈光不正及闪光视觉诱发电位的改变，部分患儿还同时伴有不同类型的眼底病变。其中有174例伴有不同类型的斜视，内斜最常见为121例，外斜次之为36例，垂直性斜视者15例，眼球震颤者2例。129例247眼存在屈光不正，复性远视散光118眼，单纯远视51眼，混合散光33眼，复性近视散光19眼，单纯远视散光21眼，单纯近视散光4眼，单纯近视1眼。194例381眼存在闪光视觉诱发电位的异常，主要表现为P2波的潜伏期延长，振幅降低。51例伴有不同类型的眼底改变，视神经萎缩及眼底出血最为常见。 　　结论：脑瘫患儿常常伴发不同类型的视觉功能障碍，严重影响了患儿的视觉质量及全身康复，重视眼部常规检查及视觉训练，对患儿视觉系统的正常发育及脑瘫的全面康复具有重要的意义。
목적：료해뇌탄환인상견적시각장애정황，위림상조기행안부사사、진단급치료제공의거，촉진뇌탄환인적시각강복。 　　방법：대223례학진위뇌탄적환인행안부상규검사，포괄안위급안구운동검사，간접검안경혹Retcam Ⅱ검사안저，산동험광검사료해굴광상태，섬광시각유발전위（F-VEP）검사료해시각통로전도，기록병분석상견적시각장애。 　　결과：뇌탄환인223례중，주요적시각장애표현위사시、굴광불정급섬광시각유발전위적개변，부분환인환동시반유불동류형적안저병변。기중유174례반유불동류형적사시，내사최상견위121례，외사차지위36례，수직성사시자15례，안구진전자2례。129례247안존재굴광불정，복성원시산광118안，단순원시51안，혼합산광33안，복성근시산광19안，단순원시산광21안，단순근시산광4안，단순근시1안。194례381안존재섬광시각유발전위적이상，주요표현위P2파적잠복기연장，진폭강저。51례반유불동류형적안저개변，시신경위축급안저출혈최위상견。 　　결론：뇌탄환인상상반발불동류형적시각공능장애，엄중영향료환인적시각질량급전신강복，중시안부상규검사급시각훈련，대환인시각계통적정상발육급뇌탄적전면강복구유중요적의의。
AIM: To understand the common conditions of visual impairment in cerebral palsy children, and to provide the basis for early screening of eyes, early diagnosis and treatment, and promote the visual rehabilitation for children with cerebral palsy. METHODS:Two hundred and twenty-three children with cerebral palsy underwent routine ophthalmologic examination, including the position of eye and eyeball movement, indirect ophthalmoscopy or Retcam II fundus examination, mydriasis optometry check and flash-visual evoked potential ( F-VEP ) examination, and the results were recorded and analyzed. RESULTS: Strabismus, ametropia and changes of F-VEP were the mainly impairments in 223 children with cerebral palsy, and some children also were associated with ocular fundus disease.There were 174 children with different types of strabismus, including 121 children with esotropia, 36 children with exotropia, 15 children with vertical strabismus, and 2 children with nystagmus.There were 129 children ( 247 eyes ) with refractive errors, including 118 eyes with compound hyperopic astigmatism, 51 eyes with simple hyperopia, 33 eyes with mixed astigmatism, 19 eyes with compound myopic astigmatism, 21 eyes with simple hyperopia astigmatism, 4 eyes with simple myopia astigmatism, only 1 eye with simple myopia.The F-VEP of 194 children ( 381 eyes ) were abnormal, and performed as delayed latency and reduced amplitude of P2 wave.In addition, there were 51 children with different types of ocular fundus changes, in which optic nerve atrophy and retinal hemorrhage were the most common. CONCLUSION: Children with cerebral palsy often are associated with different types of visual dysfunction, which seriously affect the visual quality and systemic rehabilitation. Routine eye examination and visual training should be paid attention, which play an important role in the normal development of the visual system and comprehensive rehabilitation of children with cerebral palsy.