注视差异在分析双眼视功能中的应用研究

Application study of fixation disparity in the analysis of binocular visual function

目的研究注视差异在评价和分析双眼视功能中的作用，探寻更加准确合适的反映眼部功能的检查方法，同时为异常双眼视的临床诊断和治疗提供参考。方法横断面研究。对2013年3月至2013年9月，在天津医科大学眼科医院选取志愿参与研究的在校大学生80名，男34人，女46人，平均年龄（22．3±3．2）岁，使用电脑验光仪和综合验光仪分别进行客观及主观验光，在全矫基础上于40cm处，应用Wesson Fixation Disparity Card配合偏振片测量由不同棱镜诱导下的注视差异的大小和方向，并绘制注视差异曲线。应用随机点立体视觉检查图进行立体视锐度的检查。让被检者阅读纸质文本材料半小时，使用视疲劳评估表评估视疲劳程度。分析注视差异与双眼视功能各项参数的关系。结果不同注视差异曲线类型所占比例不同，Ⅰ型、Ⅱ型、Ⅲ型和Ⅳ型所占比例分别为46％（37／80）、9％（7／80）、26％（21／80）和19％（15／80）。注视差异的大小与立体视锐度具有相关性，差异有统计学意义（rs=-0．350，P=0．004）。注视差异曲线斜率与视疲劳程度具有相关性，差异有统计学意义（rs=0．857，P：0．000）。结论注视差异是评估某些双眼视功能的有效方法，注视差异的测量结果可以辅助诊断临床异常双眼视功能。

Objective To study the role of fixation disparity in analyzing binocular visual fimc- tion and find a better exam method to value visual function and to provide information in clinical diagnosis and treatment. Methods Eighty students aged 19-25 years old were randomly selected. Measure the prism-induced fixation disparity of students at distance of 40cm after routine optometric exams was performed. Stereo-acuity was measured by digital stereoscopic test charts. Eyestrain evalu- ation form asking about their level of ocular discomfort was taken after thirty minutes reading. The relationship between parameters of fixation disparity and binocular visual fimction were analyzed through cross-sectional study. Results Different type of fixation disparity curve had different percent- age. Type Ⅰ, type ⅠⅠ, typeⅢ and type Ⅳ were present in 46%（37/80）, 9%（7/80）, 26%（21/80） and 19% （15/80） of the population respectively. Fixation disparity was correlated with stereo-acuity （rs=-0.350, P =0.004）. Further, the slope of fixation disparity curve was found to be correlated with eyestrain （rs=0.857, P =0.000）. Conclusions Fixation disparity curve is a vital and effective way to value cer- tain binocular visual function. It can support the diagnosis of abnormal binocular visual function.