传统遮盖疗法治疗12～16岁屈光参差性弱视

Effectiveness of occlusion therapy in ametropic amblyopia aged 12-16 years old

目的 探讨传统遮盖疗法对12～16岁屈光参差性弱视的治疗效果.方法 41例12～16岁屈光参差性弱视儿童,男23例女18例,在适宜的屈光矫正基础上,传统的完全遮盖与精细作业相结合,每月随访视力变化,弱视眼视力不再继续提高后3月改为每天遮盖4～6 h.结果 全部41例患儿视力均有明显提高,治疗前弱视眼视力平均0.21,治疗后平均0.62,差异具有统计学意义（P＜0.01）,平均提高4.1行,提高最明显的2例从0.2提高至1.0,提高了8行,平均遮盖时间9.1月,其中遮盖开始后的前5个月视力提高最为明显,随后进入平台期,遮盖至12月部分患儿的视力仍有提高.12岁组视力提高程度与15～16岁组差异具有统计学意义（P＜0.05）,与13岁组和14岁组差异无统计学意义（P＞0.05）.治疗结束后,健眼视力无1例下降,无1例因遮盖发生外伤,2例遮盖开始后,发生遮盖区皮肤轻度瘙痒,此后自行缓解.全部患儿在家长和学校老师帮助下能完成课业任务,无1例退学.结论 年长儿童屈光参差性弱视仍有治愈的可能,传统遮盖疗法效果较好.

Objective To examine occlusion therapy effects on children aged 12-16 years with ametropic amblyopia. Methods The 41 subjects were provided with spectacle correction and occlusion therapy combined with fine exercise,and underwent visual acuity （VA） follow up by 4 weeks,when visual improvement discontinued,occlusion for 4-6 hours per day one day. Results Improvement in VA of the amblyopic eye during 9.1 months averaged 4.1 lines,and visual performance improved significantly on the first 5.0 months after treatment.The improvement in children aged 12years was statistically significant thani5-16 years （P 〈0.05） and was no longer statistically significant than 13 and 14 years. Conclusions Visual acuity in most teenage amblyopia can be improved by conventional occlusion therapy.