分离性垂直偏斜临床特征分析

Clinical feature analysis of dissociated vertical deviation

目的探讨分离性垂直偏斜(dissociated vertical deviation,DVD)的临床特征。方法对我科自2003年1月至2006年6月住院患者的临床资料进行回顾分析。结果共统计DVD患者191例(332眼),双眼诊断为DVD者141例(73.8%),单眼DVD者50例(26.2%),双眼视力均≥0.8者120例(62.8%),150例(78.5%)Titmus立体视检查呈阴性,182例合并其他眼部疾病,如隐性眼球震颤(13.6%)、共同性外斜视(16.8%)、间歇性外斜视(19.9%)、共同性内斜视(14.7%)、麻痹性斜视(18.8%)等,仅诊断为DVD者只有9例(4.7%)。79例(41.4%)未行手术治疗,83例(43.5%)行上直肌后退术,29例(15.2%)行下斜肌截除+转位术。结论DVD患者多为青少年,多为双眼,对立体视功能的影响较大,多合并其他眼部疾病。

Objective To summarize and analyze the clinical features of dissociated vertical deviation （DVD）. Methods The clinical data from January 2003 to June 2006 in Tianjin Eye Hospital were retrospectively analyzed. Resuits One hundred and ninty-one cases （332 eyes） with DVD were collected, in which 141 cases（73.8% ） were diagnosed as bilateral DVD and 50 cases （26.2%） as unilateral DVD. Binocular visual acuities of 120 cases were ≥0.8 （62.8%）. Titmus test of 150 cases （78.5%） were negative. One hundred and eighty-two cases were accompanied by other ocular diseases, such as latent nystagmus （ 13. 6% ）, constant exotropia （ 16. 8% ）, intermittent exotropia （ 19.9% ） , infantile esotropia （ 14.7% ） and paralytic strabismus （ 18.8% ）. The other 9 cases were diagnosed only as DVD （4.7%）. Seventy-nine cases （41.4%） did not accept surgery, while 83 cases （43.5%） were treated by recession of superior rectus and 29 cases （ 15.2% ） by anterior transposition of the inferior oblique muscle. Conclusions DVD commonly occurs bilaterally in young people, which has a great impact on stereovision and is usually accompanied by other ocular diseases. （Chin J Ophthalmol and Otorhinolaryngo1,2008 ,8 ：38-39）