垂直肌麻痹性斜视双眼视觉的临床观察

Clinical observation on binocular vision in patients with vertical muscle paralysis

采用同视机及立体视觉检查图，检测50例垂直肌麻痹患者同视机三级功能及近立体视锐度的变化。结果示，45例（90％）保存有立体视觉；50例均具有融合功能，垂直肌麻痹患者的水平融合范围均小于正常融合范围，水平融合范围平均值与正常融合范围的差异均有统计学意义（P〈0．05），其垂直融合范围均大于正常的融合范围，垂直融合范围平均值与正常融合范围的差异均有统计学意义（P〈0．05）；垂直运动眼外肌麻痹的患者，代偿头位与头正位时的同视机定量立体视、近立体视锐度差异无统计学意义（P〉0．05）；垂直斜视度≤10^△者与〉10^△者近立体视锐度的保有例数差异有统计学意义（P〈0．05）；垂直斜视度≤10^△与〉10^△者定量与定性立体视锐度的保有例数差异无统计学意义（P〉0．05）。

A retrospective clinical study was conducted to observe the changes of the binocular vision in patients with vertical muscle paralysis . All patients were examined by using synotophore and stereoscopic vision chart. The results were analyzed by SPSS （statistical product and service solutions） and the variations of synotophore and stereoacuity were mainly observed. Our study revealed that out of 50 patients, 45 （90%） maintained the stereocauity, and all the 50 had fusion function, but with horizontal fusion range smaller than the normal, and their vertical fusion ranges were greater than the normal, showing there was statistically significant difference （P 〈 0. 05）, however, no significant difference in quantitative stereopsis and near stereoacuity whether in tilt head posture or in primary position （ P 〉 0. 05 ）. Among those with vertical deviation ≤ 10^△ , as comparing with those 〉 10^△ （ chi-square test P 〈 0. 05 ） more patients maintained near stereopsis. There was no difference in quantitative and qualitative stereoacuity between these two case groups （ chi-square test P 〉 0. 05）. It suggested that all cases with vertical muscle paralysis might maintain the fusion function, while 90% cases keep the stereoscopic vision. The angle of vertical deviation might affect the near stereopsis, showing that increasing vertical fusion range shouled be a compensation for maintaining the binocular vision caused by vertical deviation.