屈光参差性弱视和斜视性弱视患儿非弱视眼对比敏感度比较研究

Contrast Sensitivities of the Fellow Eyes in Children with Anisometropic and Strabismic Amblyopia

目的分析比较屈光参差性和斜视性弱视患儿非弱视眼对比敏感度测量值。方法回顾性病例资料研究,对107例屈光参差性弱视患儿(轻度28例、中度53例、重度26例)、110例斜视性弱视患儿(轻度41例、中度46例、重度23例)、30例正常儿童对比敏感度进行统计学分析。结果屈光参差性和斜视性弱视患儿,其非弱视眼对比敏感度均低于正常儿童;中、重度斜视性弱视患儿非弱视眼对比敏感度高于屈光参差性弱视患儿;斜视性弱视患儿中,随着弱视程度的加重,非弱视眼各空间频率的对比敏感度有增加的趋势;未进行过遮盖治疗和已行遮盖治疗的弱视患儿非弱视眼对比敏感度无差异。结论弱视患儿通过双眼间异常相互作用使非弱视眼对比敏感度下降。可能随着弱视程度的加重,斜视性弱视患儿的非弱视眼较屈光参差性弱视患儿在双眼竞争中表现出更强的竞争优势。遮盖治疗不会引起非弱视眼对比敏感度下降,也不是引起非弱视眼对比敏感度低于正常儿童的原因。

Objective To investigate the contrast sensitivities of the fellow eyes in children with anisometropic and strabismic amblyopia.Methods A retrospective study was undertaken.Medical records containing contrast sensitivity data of the fellow eyes in 107 children with anisometropic amblyopia,110 children with strabismic amblyopia,and 30 normal children were retrieved.The contrast sensitivities of the fellow eyes in those children were compared using independent t-test and one-way analysis of variance(ANOVA) with post hoc(modified LSD) multiple comparison test.Results Contrast sensitivity functions of the fellow eyes of children with anisometropic and strabismic amblyopia were weaker than those of the controls.The fellow eyes of children with moderate and severe strabismic amblyopia had better contrast sensitivities than those with anisometropic amblyopes.In strabismic amblyopic children,the contrast sensitivities of the fellow eyes grew with the degree of amblyopia.Occlusion therapy did not change contrast sensitivities of the fellow eyes.Conclusion The abnormal intraocular interactions between amblyopic and nonamblyopic 'normal' eyes decrease the contrast sensitivity functions of the fellow eyes.Compared with anisometropic amblyopic children,the fellow eyes of children with moderate and severe strabismic amblyopia show more superiority in the binocular competition.Occlusion therapy may not depress contrast sensitivities of the fellow eyes in children with amblyopia.