中华眼科杂志
中華眼科雜誌
중화안과잡지
Chinese Journal of Ophthalmology
2014年
7期
494-499
,共6页
宋峰伟%孙朝晖%杨羿%王丽萍%于晓宁%汤霞靖
宋峰偉%孫朝暉%楊羿%王麗萍%于曉寧%湯霞靖
송봉위%손조휘%양예%왕려평%우효저%탕하정
弱视%暗适应%视敏度%对比敏感度%治疗结果
弱視%暗適應%視敏度%對比敏感度%治療結果
약시%암괄응%시민도%대비민감도%치료결과
Amblyopia%Dark adaptation%Visual acuity%Contrast sensitivity%Treatment outcome
目的 研究连续全遮盖治疗8 ~14岁学龄期屈光参差性弱视儿童的有效性及安全性.方法 前瞻性系列病例研究.收集8 ~14岁的单纯屈光参差弱视儿童43例,采用连续全遮盖治疗3个月(遮盖日与非遮盖日比例为29∶1).运用ETDRS视力表和Optec 6500视功能检测仪测量治疗前、治疗1个月后及治疗3个月后的视力和对比敏感度函数,通过视力和对比敏感度所衍生的对比敏感度函数曲线下面积(AULCSF)、峰值对比敏感度(Smax)、Smax所对应的空间频率(Fmax)以及截至空间频率(CutSF)进行空间视功能评价.对治疗前后数据进行方差齐性检验和单因素方差分析,进一步采用Bonferroni法进行两两比较.结果 连续全遮盖治疗前、治疗后1和3个月的双眼视力分别为-0.70 ±0.30,-0.57±0.29,-0.47±0.28,AULCSF的差值分别为0.78±0.48,0.63 ±0.43、0.53 ±0.42,各组间差异均有统计学意义(F=6.406,P<0.01;F =3.517,P=0.028).进一步进行两两比较显示,治疗3个月后双眼视力差值和双眼AULCSF差值与治疗前相比差异均有统计学意义(P <0.01;P =0.02).连续全遮盖治疗前、治疗后1和3个月的弱视眼视力、AULCSF和CutSF各组间差异均有统计学意义(F =6.906,4.016,5.717;P <0.05).进一步两两比较显示,治疗后3个月弱视眼视力、AULCSF和CutSF与治疗前相比差异均有统计学意义(P<0.05).连续全遮盖治疗前、治疗后1和3个月的非弱视眼视力和AULCSF、弱视眼Smax和Fmax,各组间差异均无统计学意义(F=0.243,0.265,0.949,2.934;P>0.05);分别进行两两比较显示治疗前后各阶段间差异均无统计学意义(P>0.05).结论 针对8~ 14岁的屈光参差性弱视学龄期儿童进行连续全遮盖治疗是可行的,疗效显著,能够改善视觉高频端分辨率,同时非弱视眼在连续全遮盖(29:1)治疗3个月后未出现视功能减退.
目的 研究連續全遮蓋治療8 ~14歲學齡期屈光參差性弱視兒童的有效性及安全性.方法 前瞻性繫列病例研究.收集8 ~14歲的單純屈光參差弱視兒童43例,採用連續全遮蓋治療3箇月(遮蓋日與非遮蓋日比例為29∶1).運用ETDRS視力錶和Optec 6500視功能檢測儀測量治療前、治療1箇月後及治療3箇月後的視力和對比敏感度函數,通過視力和對比敏感度所衍生的對比敏感度函數麯線下麵積(AULCSF)、峰值對比敏感度(Smax)、Smax所對應的空間頻率(Fmax)以及截至空間頻率(CutSF)進行空間視功能評價.對治療前後數據進行方差齊性檢驗和單因素方差分析,進一步採用Bonferroni法進行兩兩比較.結果 連續全遮蓋治療前、治療後1和3箇月的雙眼視力分彆為-0.70 ±0.30,-0.57±0.29,-0.47±0.28,AULCSF的差值分彆為0.78±0.48,0.63 ±0.43、0.53 ±0.42,各組間差異均有統計學意義(F=6.406,P<0.01;F =3.517,P=0.028).進一步進行兩兩比較顯示,治療3箇月後雙眼視力差值和雙眼AULCSF差值與治療前相比差異均有統計學意義(P <0.01;P =0.02).連續全遮蓋治療前、治療後1和3箇月的弱視眼視力、AULCSF和CutSF各組間差異均有統計學意義(F =6.906,4.016,5.717;P <0.05).進一步兩兩比較顯示,治療後3箇月弱視眼視力、AULCSF和CutSF與治療前相比差異均有統計學意義(P<0.05).連續全遮蓋治療前、治療後1和3箇月的非弱視眼視力和AULCSF、弱視眼Smax和Fmax,各組間差異均無統計學意義(F=0.243,0.265,0.949,2.934;P>0.05);分彆進行兩兩比較顯示治療前後各階段間差異均無統計學意義(P>0.05).結論 針對8~ 14歲的屈光參差性弱視學齡期兒童進行連續全遮蓋治療是可行的,療效顯著,能夠改善視覺高頻耑分辨率,同時非弱視眼在連續全遮蓋(29:1)治療3箇月後未齣現視功能減退.
목적 연구련속전차개치료8 ~14세학령기굴광삼차성약시인동적유효성급안전성.방법 전첨성계렬병례연구.수집8 ~14세적단순굴광삼차약시인동43례,채용련속전차개치료3개월(차개일여비차개일비례위29∶1).운용ETDRS시력표화Optec 6500시공능검측의측량치료전、치료1개월후급치료3개월후적시력화대비민감도함수,통과시력화대비민감도소연생적대비민감도함수곡선하면적(AULCSF)、봉치대비민감도(Smax)、Smax소대응적공간빈솔(Fmax)이급절지공간빈솔(CutSF)진행공간시공능평개.대치료전후수거진행방차제성검험화단인소방차분석,진일보채용Bonferroni법진행량량비교.결과 련속전차개치료전、치료후1화3개월적쌍안시력분별위-0.70 ±0.30,-0.57±0.29,-0.47±0.28,AULCSF적차치분별위0.78±0.48,0.63 ±0.43、0.53 ±0.42,각조간차이균유통계학의의(F=6.406,P<0.01;F =3.517,P=0.028).진일보진행량량비교현시,치료3개월후쌍안시력차치화쌍안AULCSF차치여치료전상비차이균유통계학의의(P <0.01;P =0.02).련속전차개치료전、치료후1화3개월적약시안시력、AULCSF화CutSF각조간차이균유통계학의의(F =6.906,4.016,5.717;P <0.05).진일보량량비교현시,치료후3개월약시안시력、AULCSF화CutSF여치료전상비차이균유통계학의의(P<0.05).련속전차개치료전、치료후1화3개월적비약시안시력화AULCSF、약시안Smax화Fmax,각조간차이균무통계학의의(F=0.243,0.265,0.949,2.934;P>0.05);분별진행량량비교현시치료전후각계단간차이균무통계학의의(P>0.05).결론 침대8~ 14세적굴광삼차성약시학령기인동진행련속전차개치료시가행적,료효현저,능구개선시각고빈단분변솔,동시비약시안재련속전차개(29:1)치료3개월후미출현시공능감퇴.
Objective To investigate the efficacy and safety of full-time patching therapy of anisometropic amblyopia in children aged 8-14 years.Methods It was a prospective case series study.Forty-three patients with anisometropic amblyopia without strabismus (ranged from 8-14 years,mean 10.8 years) were included in this study.All of the patients received eye patching for the entire day,29 days a month,during the first 3 months.Distance best corrected visual acuity in LogMAR units; cycloplegic refraction and contrast sensitivity function were performed on all the patients before treatment,at a month later of full-time patching therapy,and all recorded at 3 months later,and evaluation the spatial function with visual acuity,the area under the log contrast sensitivity function (AULCSF),the co-ordinates of the peak of the CSF (maximum sensitivity,Smax,and the spatial frequency at which it occurs,Fmax) and the cut-off spatial frequency.Difference amoug groups was evaluated by analysis of variance (One-Way ANOVA),and the Bonferroni test investigated the pairwise comparison of the groups.Results The degree of amblyopia and the D-value of binocular AULCSF of before full-cover treatment,after one month's and three months' full-cover treatment were-0.70 ± 0.30,-0.57 ± 0.29,-0.47 ± 0.28 and 0.78 ± 0.48,0.63 ±0.43,0.53 ±0.42,respectively,which showed statistically significant differences (F =6.406,P < 0.01 ; F =3.517,P =0.028).The degree of amblyopia,the D-value of binocular AULCSF after three months' full-cover treatment had significant difference compared with those before full-cover treatment (P < 0.01 ; P =0.02).There were statistically significant differences along with time in the best corrected visual acuity (BCVA) of the amblyopic eye,AULCSF and CutSF (F =6.906,P < 0.01 ; F =4.016,P =0.02 ; F =5.717,P <0.01).The BCVA of the amblyopic eye,AULCSF and CutSF after three months' full-cover treatment had significant difference compared with those before full-cover treatment (P < 0.01 ; P =0.028; P <0.01).However,the BCVA,AULCSF of the normal eye,and Smax,Frmax of amblyopic eye showed no statistically significant differences among groups along with time (F =0.243,P =0.785 ; F =0.265,P =0.768; F=0.949,P =0.390; F =2.934,P =0.057).Conclusions The present results show that continuous full-time patching in older children with anisometropic amblyopia improves visual acuity,and cut off spatial sensitivity with no serious complications.The use of continuous full-time patching in after-school children to improve amblyopia seems promising.