中华眼视光学与视觉科学杂志
中華眼視光學與視覺科學雜誌
중화안시광학여시각과학잡지
CHINESE JOURNAL OF OPTOMETRY OPHTHALMOLOGY AND VISUAL SCIENCE
2012年
10期
609-613
,共5页
杨磊%燕振国%马强华%叶建军
楊磊%燕振國%馬彊華%葉建軍
양뢰%연진국%마강화%협건군
儿童%屈光参差%弱视%立体视觉%磁共振成像
兒童%屈光參差%弱視%立體視覺%磁共振成像
인동%굴광삼차%약시%입체시각%자공진성상
Children%Anisometropia%Amblyopia%Stereopsis%Magnetic resonance imaging
目的 利用血氧水平依赖性功能性磁共振成像(BOLD-fMRI)技术评价屈光参差性弱视儿童在规范弱视训练后,立体觉映射的脑皮层功能区的恢复情况.方法 自身前后对照研究.选择11例屈光参差性弱视初诊患儿,行任务态组块式(Blocks)设计的fMRI实验,在弱视治疗后1周、2周及4周时复查BOLD-fMRI.采用基于Matlab 7.12.0.635的SPM8软件包进行图像后处理,采用随机效应法分别获得各组脑皮层激活的矩阵数据,利用假设驱动法对各治疗阶段结果进行自身前后配对t 检验,获得治疗前后各组视皮层激活的差异数据.立体图像为计算机生成的随机点立体视觉检查图,通过配戴红蓝眼镜观察立体视图像,当识别立体视图像后迅速点按反馈键.结果 弱视训练至4周时,左侧枕叶(BA18)、枕中回(BA19)、边缘叶(BA19)及右侧枕叶舌回(BA17)和双侧顶上小叶(BA7)激活范围不同程度扩大,与治疗前的平均激活强度差异t值分别是1.636、1.902、1.727、1.350与1.777(P＜0.01),但增进幅度偏小,且与随机点立体视图的恢复不平行.结论 儿童屈光参差性弱视对立体觉映射的脑皮层功能损害严重、短期恢复困难.
目的 利用血氧水平依賴性功能性磁共振成像(BOLD-fMRI)技術評價屈光參差性弱視兒童在規範弱視訓練後,立體覺映射的腦皮層功能區的恢複情況.方法 自身前後對照研究.選擇11例屈光參差性弱視初診患兒,行任務態組塊式(Blocks)設計的fMRI實驗,在弱視治療後1週、2週及4週時複查BOLD-fMRI.採用基于Matlab 7.12.0.635的SPM8軟件包進行圖像後處理,採用隨機效應法分彆穫得各組腦皮層激活的矩陣數據,利用假設驅動法對各治療階段結果進行自身前後配對t 檢驗,穫得治療前後各組視皮層激活的差異數據.立體圖像為計算機生成的隨機點立體視覺檢查圖,通過配戴紅藍眼鏡觀察立體視圖像,噹識彆立體視圖像後迅速點按反饋鍵.結果 弱視訓練至4週時,左側枕葉(BA18)、枕中迴(BA19)、邊緣葉(BA19)及右側枕葉舌迴(BA17)和雙側頂上小葉(BA7)激活範圍不同程度擴大,與治療前的平均激活彊度差異t值分彆是1.636、1.902、1.727、1.350與1.777(P＜0.01),但增進幅度偏小,且與隨機點立體視圖的恢複不平行.結論 兒童屈光參差性弱視對立體覺映射的腦皮層功能損害嚴重、短期恢複睏難.
목적 이용혈양수평의뢰성공능성자공진성상(BOLD-fMRI)기술평개굴광삼차성약시인동재규범약시훈련후,입체각영사적뇌피층공능구적회복정황.방법 자신전후대조연구.선택11례굴광삼차성약시초진환인,행임무태조괴식(Blocks)설계적fMRI실험,재약시치료후1주、2주급4주시복사BOLD-fMRI.채용기우Matlab 7.12.0.635적SPM8연건포진행도상후처리,채용수궤효응법분별획득각조뇌피층격활적구진수거,이용가설구동법대각치료계단결과진행자신전후배대t 검험,획득치료전후각조시피층격활적차이수거.입체도상위계산궤생성적수궤점입체시각검사도,통과배대홍람안경관찰입체시도상,당식별입체시도상후신속점안반궤건.결과 약시훈련지4주시,좌측침협(BA18)、침중회(BA19)、변연협(BA19)급우측침협설회(BA17)화쌍측정상소협(BA7)격활범위불동정도확대,여치료전적평균격활강도차이t치분별시1.636、1.902、1.727、1.350여1.777(P＜0.01),단증진폭도편소,차여수궤점입체시도적회복불평행.결론 인동굴광삼차성약시대입체각영사적뇌피층공능손해엄중、단기회복곤난.
Objective The aim of this study was to evaluate the recovery about the visual cortex function of stereopsis in anisometropic amblyopia after regular amblyopia treatment with blood oxygenation level dependent functional MRI techniques (BOLD-fMRI).Methods In this study,selfcontrolled study before and after treatment was used,and blocks-designed fMRI was performed on 11 children with first amblyopic treatment,and review BOLD-fMRI inspection after regular amblyopia treatment 1 week,2 weeks and 1 month.Functional MRI data were processed by using SPM8 which based on the MATLAB7.12.0.635.Random effect group analysis was performed in each group to acquire average cerebral cortex activated functional images data.Through the hypothesis drive method,the differences range of activated area in each group were compared by before and after amblyopia treatment matched t-test.During the study,the patients were asked to view stimuli through red-blue filtered stereo glasses.The visual stimuli were computer-generated random-dot stereograms (R.D.S),click feedback key immediately after the R.D.S were recognized.Results The functional area that was left occipital lobe (BA18),middle occipital gyrus (BA19),limbic lobe (BA19),lingualis gyrus of the right occipital lobe (BA17) and the bilateral parietal lobe (BA7) expanded in different levels after 4 weeks (compared the fourth weeks with without treatment,mean t value was 1.636,1.902,1.727,1.350 and 1.777 respectively,P＜0.01).However,those data showed activation on the small area,and with the R.D.S on the recovery is not parallel.Conclusion In children anisometropic amblyopia,the visual cortical functional mediating stereopsis is damaged seriously and not easy to treat in the short time.
