自发性续发性外斜视临床特点分析

Clinical characteristics and analysis of spontaneous consecutive exotropia

目的通过观察和归纳自发性续发性外斜视的临床特点，探讨外斜视漂移的发病机制和临床意义。方法收集斜视弱视专科门诊就诊的8例自发性续发性外斜视患者的临床资料进行了回顾分析和总结，包括患者的出生史、视力、屈光状态、斜视度、双眼视功能、治疗措施等。结果患者均原为调节性内斜视，具有弱视、运动性融合功能低下甚至丧失，以及在早年接受足度或近足度远视镜矫正治疗等临床特点。结论外斜视漂移并不少见，具有一定的临床指导意义，其发病可能是融合机制、神经动力因素和解剖因素的合力结果。

Purposes To investigate the pathogenesis and clinical significance of exotropic drift by studying the clinical charactenstics of spontaneous consecutive extropia. Methods To review the case reportsof eight children with spontaneous consecutive exotropia who attended the Strabismic and Amblyopic clinic of Zhongshan Ophthalmic Center, Sun Yat-sen University in recent 10 years. Clinical data were analyzed includ- ing birth history, visual acuity, refraction, binocular vision and therapeutic means. Results All cases of spontaneous consecutive exotropia in the study had an early onset of accommodative esotropia associated with amblyopia, poor or loss of fusion and full or near full correction to the hypermetropic refractive error. Conclusions Exotropic drift is not uncommon and has clinical significance in the treatment of strabismus. It is suggested that exotropic drift may be caused by a combination of fusion, innervational and anatomical factors.