102例眼球震颤儿童屈光状态分析

Analysis of refractive errors in 102 children with nystagmus

目的对儿童眼球震颤患者视功能、屈光状态分布进行分析，探讨儿童眼球震颤的屈光矫正时机与方式，从而促进患儿的视觉发育，提高视功能。方法回顾性病例研究。收集2002年1月至2013年2月在北京儿童医院就诊的102例眼球震颤患儿的视力、双眼视功能、屈光状态、眼球震颤相关检查资料，将患儿分为3组：特发性组81例，白化病组10例，其他原因组11例。对患儿等效球镜度、散光的类型以及散光度进行分析。结果眼球震颤的患儿平均裸眼视力为4．20±0．34，最佳矫正视力为4．45±0．27，最佳矫正视力大多在4．3至4．7之间。特发性组等效球镜度为（一0．25±3．36）D，白化病组为（＋0．24±3．25）D，其他原因组为（＋1．03±3．12）D。白化病组患儿主要表现为远视性屈光不正。眼球震颤患儿有着较大比例的散光．其中特发性眼球震颤组比例为86％．白化病及其他类型眼球震颤患儿为100％。其中顺规散光是其主要散光形式，顺规散光比例分别为55％、70％、64％。结论眼球震颤患儿常伴发屈光不正，应早期通过屈光矫正进行干预，促进视觉发育，提高视功能。

Objective To determine the distribution of refractive errors and the degree and type of astigmatism in children with nystagmus. Methods This was a retrospective study of a larger sample of 102 children with nystagmus. They ranged in age from 11 months to 17 years old （average, 51.9±41.5 months）. The children were divided into 3 subtypes： idiopathic nystagmus group （81 patients）, albino group （10 patients）, and the remaining nystagmus group （11 patients）. Refractive errors were evaluated objectively by eycloplegic refraction. Uncorrected visual acuity and best corrected visual acuity were assessed. An analysis of the amplitude and intensity of the nystagmus was done with a computer analysis of the digitized data from an eye movement instrument （eye-link）. Results Spherical equivalent refractive errors of the idiopathic nystagmus group, albino group,and the remaining nystagmus group were -0.25±3.36 D, ＋0.24±3.25 D and ＋1.03±3.12 D. With-the-rule astigmatism was prevalent among children with nystagmus. The specific ratios were 55%, 70% and 64%. On average, the refractive errors were more widely distributed and slightly myopic in children with idiopathic congenital nystagmus （CN）. There was more astigmatism in the albino group （primarily with-the-rule）. Conclusion The incidence of refractive errors in children with nystagmus is relatively high. Therefore, refractive correction should be encouraged in children with nystagmus. Improvement in visual function is likely to occur.