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中华眼科医学杂志(电子版) ›› 2019, Vol. 09 ›› Issue (06) : 342 -347. doi: 10.3877/cma.j.issn.2095-2007.2019.06.004

论著

部分调节性内斜视屈光状态与双眼单视功能的相关性研究
苏学刚1, 管征1, 李强1, 冷非2, 白大勇2,†()   
  1. 1. 101300　北京市顺义区妇幼保健院，北京儿童医院顺义妇儿医院眼科
    2. 100045　首都医科大学附属北京儿童医院眼科
  • 收稿日期:2019-05-15 出版日期:2019-12-28
  • 通信作者: 白大勇
  • 基金资助:
    爱佑慈善基金会"儿科专项"基金(AYEK201803)

Correlation between the refractive status of partial accommodative esotropia and binocular single vision

Xuegang Su1, Zheng Guan1, Qiang Li1, Fei Leng2, Dayong Bai2,†()   

  1. 1. Department of Ophthalmology, Shunyi Maternal and Children′s Hospital of Beijing Children′s Hospital, Beijing 101300, China
    2. Department of Ophthalmology, Beijing Children′s Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China
  • Received:2019-05-15 Published:2019-12-28
  • Corresponding author: Dayong Bai
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引用本文：

苏学刚, 管征, 李强, 冷非, 白大勇. 部分调节性内斜视屈光状态与双眼单视功能的相关性研究[J]. 中华眼科医学杂志(电子版), 2019, 09(06): 342-347.

Xuegang Su, Zheng Guan, Qiang Li, Fei Leng, Dayong Bai. Correlation between the refractive status of partial accommodative esotropia and binocular single vision[J]. Chinese Journal of Ophthalmologic Medicine(Electronic Edition), 2019, 09(06): 342-347.

目的

研究部分调节性内斜视患儿的屈光状态与双眼单视功能的相关性。

方法

回顾性分析36例部分调节性内斜视患儿，对患儿裸眼视力、矫正视力、阿托品散瞳后的屈光度数、戴镜半年的远近残余斜视度及双眼单视功能等进行记录和统计学分析。左右眼等效球镜用配对秩和检验比较，右眼等效球镜与视力、斜视度和视功能的相关性采用Spearman分析。

结果

36例部分调节性内斜视患儿年龄3~14岁，平均(79.39±31.21)个月，右眼等效球镜(+4.45±1.73)D，左眼等效球镜(+4.75±1.68)D；33 cm裸眼斜视度(+53.19±18.05)△，6 m裸眼斜视度(+47.50±19.00)△；33 cm残余斜视度(+30.36±12.03)△，6 m残余斜视度(+25.53±9.59)△。右眼等效球镜与同视机Ⅰ级、Ⅱ级和Ⅲ级视功能无相关性(r＝-0.012，-0.058，-0.016；P>0.05)。右眼等效球镜与33 cm裸眼斜视度呈正相关(r＝0.344，P<0.05)，与裸眼视力呈负相关(r＝-0.456，P<0.05)。33 cm裸眼斜视度与同视机Ⅰ级、Ⅱ级和Ⅲ级功能均呈负相关(r＝-0.378，-0.678，-0.482；P<0.05)，与Titmus立体图亦呈负相关(r＝-0.477，P<0.05)。6 m裸眼斜视度与同视机Ⅰ级、Ⅱ级和Ⅲ级功能均呈负相关(r＝-0.453，-0.610，-0.430；P<0.05)。33 cm残余斜视度与同视机Ⅱ和Ⅲ级功能均呈负相关(r＝-0.651，-0.600；P<0.05)，与Titmus立体图、立体动物和立体圆圈亦呈负相关(r＝-0.688，-0.625，-0.462；P<0.05)。6 m残余斜视度与同视机Ⅱ和Ⅲ级功能均呈负相关(r＝-0.587，-0.543；P<0.05)，与Titmus立体图、立体动物和立体圆圈亦呈负相关(r＝-0.644，-0.514，-0.492；P<0.05)。

结论

部分调节性内斜视患儿的屈光状态与双眼单视功能不相关，与裸眼视力负相关。影响双眼单视功能的是残余斜视度。

关键词: 部分调节性内斜视, 屈光状态, 双眼单视功能
Objective

To study the relationship between the refractive status of children with partial accommodative esotropia and binocular single vision.

Methods

36 children with partial accommodative esotropia were retrospectively analyzed. The naked visual acuity, corrected visual acuity, diopter after atropine dilation, near and distant residual strabismus after wearing glasses for half a year, and binocular monocular function were recorded and statistically analyzed.

Results

36 children with partial accommodative esotropia were aged range from 3 to 14 years, with an average of (79.39±31.21) months. Equivalent spherical of right eyeball was (+ 4.45±1.73) D, and left eyeball was (+ 4.75±1.68) D. 33 cm naked strabismus was (+ 53.19±18.05) △, while, 6 m was (+ 47.50±19.00) △. 33 cm residual strabismus was (+ 30.36±12.03) △, while, 6 m was (+ 25.53±9.59) △. There is no correlation between equivalent spherical and Ⅰ, Ⅱ, and Ⅲ visual functions (r=-0.012, -0.058, -0.016; P>0.05). Equivalent spherical was positively correlated with 33 cm naked strabismus (r=0.344, P<0.05), and negatively correlated with naked visual (r=-0.456, P<0.05). 33 cm naked strabismus was negatively correlated withⅠ, Ⅱ and Ⅲ visual functions (r=-0.378, -0.678, -0.482; P<0.05), also with Titmus stereogram (r=-0.477, P<0.05). 6 m naked strabismus was negatively correlated with Ⅰ, Ⅱ, and Ⅲ visual functions (r=-0.453, -0.610, -0.430; P<0.05). 33 cm residual strabismus was negatively correlated with Ⅱ and Ⅲ visual functions (r=-0.651, -0.600; P<0.05), also with Titmus stereogram, stereofauna, and stereo circle (r=-0.688, -0.625, -0.462; P<0.05). 6 m residual strabismus was negatively correlated with Ⅱ and Ⅲ visual functions (r=-0.587, -0.543; P<0.05), also with Titmus stereogram, stereofauna, and stereo circle (r=-0.644, -0.514, -0.492; P<0.05).

Conclusions

The refractive status of children with partial accommodative esotropia is not related to binocular monocular function, but negatively related to naked visual acuity. The residual strabismus affects binocular monocular function.

Key words: Partial accommodative esotropia, Refractive state, Binocular single vision
图5 患者戴镜前后的比较　图5A示患者，女，9岁；裸眼视力右0.8，左0.5；裸眼斜视度33 cm，右注视+40△，左注视+40△；裸眼斜视度6 m，右注视+30△，左注视+30△。图5B示矫正视力右1.0，左0.8；眼镜度数，右+6.00 D＝+0.50 D×80，左+6.75 D＝+1.50 D×110。患者戴镜3个月后右眼斜视度33 cm降低+22△，6 m降低28△；左眼戴镜斜视度33 cm降低+12△，6 m降低18△
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