间歇性外斜视儿童的融合功能研究

The fusional function in children with intermittent exotropia

目的探讨间歇性外斜视儿童融合功能的状况。设计回顾性病例系列。研究对象间歇性外斜视儿童48例。方法采用同视机检测48例间歇性外斜视儿童的三级视功能,采用颜少明随机点《立体视觉检查图》检查视近立体视锐度,并以正常相同年龄儿童20例做对照。主要指标同时视、融合范围及立体视锐度。结果 48例患者中,8例无重合点,余40例中34例患者的重合点均落在外融合范围内。11例患者无Ⅱ级融合功能,余37例患者的内、外融合范围分别是(12.74±5.57)度和(4.97±2.11)度;正常对照组的内、外融合范围分别为(24.05±6.67)度和(3.52±0.96)度,两组比较差异有统计学意义(P均<0.05)。以同视机检测,23例(47.92%)患者无立体视,而以颜氏随机点立体视觉图检测,仅2例(4.17%)近立体视丧失。结论间歇性外斜视儿童的融合功能异常,外融合范围扩大、内融合范围缩小;远立体视觉的丧失早于近立体视觉的丧失。

Objective To evaluate the fusional function of the children with intermittent extropia. Design Retrospective case se- ries. Participants Forty-eighty cases with intermittent extropia. Methods The binocular vision of 48 children with intermittent extropia was evaluated by synoptophore and the near stereopsis was examined with stereogram designed by YAN Shao-ming. The values mea- sured from normal children were used as control. Main Outcome Measures Simultaneous perception, fusional amplitude and stereop- sis. Results Eight out of the 48 patients had no simultaneous perception, and 34 had the point of simultaneous perception in the nega- tive field of fusion. Eleven patients had no fusion function, and 37 patients had a negative fusional amplitude of 4.97°±2.11° and a positive fusional amplitude of 12.74°±5.57°, which were significantly different from the normal control （3.52°±0.96° and 24.05°±6.67° respectively, all P〈0.05）. Twenty-three of the patients had no distant stereopsis and only 2 had the near stereopsis disrupted. Conclusion In the children with intermittent extropia, the negative fusional amplitude is enlarged and the positive fusional amplitude is shrinked, and the distant stereopsis is damaged earlier than near stereopsis.