中国斜视与小儿眼科杂志
中國斜視與小兒眼科雜誌
중국사시여소인안과잡지
CHINESE JOURNAL OF STRABISMUS & PEDIATRIC OPHTHALMOLOGY
2014年
3期
26-31
,共6页
贾趁霞%胡俊喜%闫义涛%周予兰%王晓丽%刘向玲%王瑞虎
賈趁霞%鬍俊喜%閆義濤%週予蘭%王曉麗%劉嚮玲%王瑞虎
가진하%호준희%염의도%주여란%왕효려%류향령%왕서호
弱视%治疗%对比敏感度
弱視%治療%對比敏感度
약시%치료%대비민감도
amblyopia treatment%contrast%sensitivity
目的：分析弱视患者治疗前后的对比敏感度的变化。方法随机选取40例(80眼)健康体检儿童(视力≥1.0)为正常对照组，47(79眼)例弱视儿童为病人组。利用美国 STEREO 公司生产的 OPTEC 6500视功能测试仪分别测量正常对照组和病人组治疗前、综合治疗5个月时5种空间频率[1.5、3、6、12和18周/度(cycles/degree， c/d)]的对比敏感度(contrast sensitivity , CS)。所有检查对象在正常光线下，采用自然瞳孔测试，病人组先检查患者视力较好的眼，后检查视力较差的眼，将测试结果存储，通过相应软件处理，自动生成资料，即时呈现出对比敏感度函数(contrast sensitivity function, CSF)曲线图。用 SPSS17.0统计软件对比正常组、弱视组治疗前后不同空间频率对比敏感度数值有无差异。结果(1)正常儿童的 CSF 曲线其峰值位于空间频率6 c/d 附近,在较低、较高空间频率,CSF均降低,曲线呈一倒“ U“字形。曲线向高空间频率端外推,得截止率为25c/d。(2)轻度弱视组：治疗前 CS 在高空间频率时,振幅比正常对照组降低明显,,两组差异有统计学意义(P <0.05)。治疗后 CS 较治疗前升高，治疗前后差异有统计学意义(P<0.05)，治疗后 CS 与正常对照组差异无统计学意义。(3)中度弱视组：治疗前 CS 在中、高空间频率比正常对照组降低,和正常对照组之间差异有统计学意义(P <0.05)。治疗后 CS 较治疗前升高，差异有统计学意义(P<0.05)，治疗后 CS 与正常对照组差异无统计学意义。(4)重度弱视组：治疗前 CS 在低、中、高空间频率均比正常对照组降低,在中、高空间频率和正常对照组之间差异有统计学意义,但在低空间频率差异无统计学意义。治疗后CS 较治疗前升高，差异无统计学意义，和正常对照组差异亦无统计学意义。(5)弱视程度与疗效：弱视越重，疗效越差。轻度弱视基本痊愈18眼(90.0%),中度弱视基本痊愈32眼(86.5%)，重度弱视无基本痊愈者，三组间有极显著差异(P <0.05)。结论对比敏感度是一种较全面而敏感的视功能检查方法，是弱视早期诊断、监测疗效、指导治疗的一种可靠手段。
目的：分析弱視患者治療前後的對比敏感度的變化。方法隨機選取40例(80眼)健康體檢兒童(視力≥1.0)為正常對照組，47(79眼)例弱視兒童為病人組。利用美國 STEREO 公司生產的 OPTEC 6500視功能測試儀分彆測量正常對照組和病人組治療前、綜閤治療5箇月時5種空間頻率[1.5、3、6、12和18週/度(cycles/degree， c/d)]的對比敏感度(contrast sensitivity , CS)。所有檢查對象在正常光線下，採用自然瞳孔測試，病人組先檢查患者視力較好的眼，後檢查視力較差的眼，將測試結果存儲，通過相應軟件處理，自動生成資料，即時呈現齣對比敏感度函數(contrast sensitivity function, CSF)麯線圖。用 SPSS17.0統計軟件對比正常組、弱視組治療前後不同空間頻率對比敏感度數值有無差異。結果(1)正常兒童的 CSF 麯線其峰值位于空間頻率6 c/d 附近,在較低、較高空間頻率,CSF均降低,麯線呈一倒“ U“字形。麯線嚮高空間頻率耑外推,得截止率為25c/d。(2)輕度弱視組：治療前 CS 在高空間頻率時,振幅比正常對照組降低明顯,,兩組差異有統計學意義(P <0.05)。治療後 CS 較治療前升高，治療前後差異有統計學意義(P<0.05)，治療後 CS 與正常對照組差異無統計學意義。(3)中度弱視組：治療前 CS 在中、高空間頻率比正常對照組降低,和正常對照組之間差異有統計學意義(P <0.05)。治療後 CS 較治療前升高，差異有統計學意義(P<0.05)，治療後 CS 與正常對照組差異無統計學意義。(4)重度弱視組：治療前 CS 在低、中、高空間頻率均比正常對照組降低,在中、高空間頻率和正常對照組之間差異有統計學意義,但在低空間頻率差異無統計學意義。治療後CS 較治療前升高，差異無統計學意義，和正常對照組差異亦無統計學意義。(5)弱視程度與療效：弱視越重，療效越差。輕度弱視基本痊愈18眼(90.0%),中度弱視基本痊愈32眼(86.5%)，重度弱視無基本痊愈者，三組間有極顯著差異(P <0.05)。結論對比敏感度是一種較全麵而敏感的視功能檢查方法，是弱視早期診斷、鑑測療效、指導治療的一種可靠手段。
목적：분석약시환자치료전후적대비민감도적변화。방법수궤선취40례(80안)건강체검인동(시력≥1.0)위정상대조조，47(79안)례약시인동위병인조。이용미국 STEREO 공사생산적 OPTEC 6500시공능측시의분별측량정상대조조화병인조치료전、종합치료5개월시5충공간빈솔[1.5、3、6、12화18주/도(cycles/degree， c/d)]적대비민감도(contrast sensitivity , CS)。소유검사대상재정상광선하，채용자연동공측시，병인조선검사환자시력교호적안，후검사시력교차적안，장측시결과존저，통과상응연건처리，자동생성자료，즉시정현출대비민감도함수(contrast sensitivity function, CSF)곡선도。용 SPSS17.0통계연건대비정상조、약시조치료전후불동공간빈솔대비민감도수치유무차이。결과(1)정상인동적 CSF 곡선기봉치위우공간빈솔6 c/d 부근,재교저、교고공간빈솔,CSF균강저,곡선정일도“ U“자형。곡선향고공간빈솔단외추,득절지솔위25c/d。(2)경도약시조：치료전 CS 재고공간빈솔시,진폭비정상대조조강저명현,,량조차이유통계학의의(P <0.05)。치료후 CS 교치료전승고，치료전후차이유통계학의의(P<0.05)，치료후 CS 여정상대조조차이무통계학의의。(3)중도약시조：치료전 CS 재중、고공간빈솔비정상대조조강저,화정상대조조지간차이유통계학의의(P <0.05)。치료후 CS 교치료전승고，차이유통계학의의(P<0.05)，치료후 CS 여정상대조조차이무통계학의의。(4)중도약시조：치료전 CS 재저、중、고공간빈솔균비정상대조조강저,재중、고공간빈솔화정상대조조지간차이유통계학의의,단재저공간빈솔차이무통계학의의。치료후CS 교치료전승고，차이무통계학의의，화정상대조조차이역무통계학의의。(5)약시정도여료효：약시월중，료효월차。경도약시기본전유18안(90.0%),중도약시기본전유32안(86.5%)，중도약시무기본전유자，삼조간유겁현저차이(P <0.05)。결론대비민감도시일충교전면이민감적시공능검사방법，시약시조기진단、감측료효、지도치료적일충가고수단。
Objective Investigate contrast sensitivity (CS) on the eyes of amblyopic and treated amblyopic patients. Methods Contrast sensitivity at spatial frequencies (1.5, 3,6,12,18 cycles/degree) was measured in 47 ambly-opic children (79 eyes) and 40 normal children (80 eyes,visual acuity ≥1.0) which act as the control group on the Optec 6500 Functional Visual Analyzer (Stereo Optec Co. Inc,America) .For the amblyopic children,measurements were done before and after 5 months treatment.All subjects were tested with a natural pupil under normal lighting. The contrast sensitivity was tested monocularly on both eyes of amblyopic patients. The eyes with better visual acuity were firstly checked, and subsequent the worse ones. The saved measurement results were handled through the corre-sponding data processing software to obtain the CS curves. The changes in CS values in normal control eyes and am-blyopic eyes before and after treatment at different fre-quencies were analyzed by SPSS17.0 statistical software. Result ( 1) The peaks of contrast sensitivity function (CSF) curves for normal children were located at the spa-tial frequency of 6 c/d. The CSF decreased at the lower or higher spatial frequencies,therefore the CSF curve diagram showed an inverted“U”shape. The cut-off frequency was 25 c/d by extrapolating from the curve at high spatial fre-quency. (2) In mild amblyopia patients: The amplitude and CS obviously decreased at high spatial frequencies com-pared with the normal control group. The difference between the two groups is statistically significant (P<0.05) .Post treatment the CS obviously increased compared with that before treatment,and the difference is significant (amblyopi-a;treatment;contrast sensitivity<0.05) .There were no statistically significant differences between the normal control group and those amblyopic groups. (3) In moderate amblyopia patients: The CS decreased at medium and high spatial frequencies, which were statistically different (P <0.05) from the normal group. After treatment the CS increased. There were no statistically significant differences between the normal control group and those amblyopic patients. (4) In severe amblyopia patients The CS was lower in low, medium and high spatial frequencies than the control group. There was significant difference in the medium and high spatial frequencies,not in the low frequencies. After the treatment,CS is improved with no statistically significant differences. Comparison between the normal group and am-blyopic group demonstrated no statistically significant differences. (5) The extent and efficacy of amblyopia: The more severe the amblyopia degree is, the worse the curative effect is. The basic cure rates in mild and medium amblyopia were 90% (18 eyes) and 86.5% (32 eyes),respectively. Basically there were no cured patients in the severe ambly-opic groups. There were obvious difference among the three groups (P <0.05) .Conclusion CS is a comprehensive and sensitive detection method for visual function and provides a reliable methords in diagnosing early amblyopia,monitor-ing curative effect and guiding treatment.
