屈光参差性弱视儿童视力与立体视的关系

The relationships between visual acuity and stereopsis in children with anisometropic amblyopia

目的 探究相同屈光参差范围内不同类型屈光参差性弱视儿童的视力与立体视情况,以及视力、屈光参差类型对拥有立体视与否的影响.方法 回顾性研究.收集56例屈光参差性弱视儿童和52例伴有斜视的屈光参差性弱视儿童以及20例正常儿童相应检查数据,检查包括矫正视力、屈光程度、随机点动态2阶粗糙立体视.采用多元方差分析3类儿童的视力差异,统计立体视分布情况,运用非条件logistic回归分析视力与屈光参差类型对拥有立体视与否的影响.结果 单纯屈光参差性弱视儿童与伴有斜视的屈光参差性弱视儿童的视力差异无统计学意义（F=3.58,P=0.0314,校正α=0.016）.单纯及伴有斜视的屈光参差性弱视儿童粗糙立体视拥有率分别为96％,71％.在双眼视力一致的条件下,伴有斜视的屈光参差性弱视与单纯屈光参差性弱视儿童相比,拥有2阶立体视的OR估计值为0.132（95％CI：0.034～0.503）.在屈光参差类型一致的条件下,高、中双眼视力平衡度与低双眼视力平衡度相比,拥有2阶立体视的OR估计值分别为5.161 （95％ CI： 0.868～30.675）和3.939 （95％CI：0.920～16.858）.结论 相同屈光参差程度范围中不同类型屈光参差性弱视儿童的视力差异不明显;伴有斜视的屈光参差性弱视儿童立体视缺损的可能性更高,并且双眼不平衡度越高引起的立体视下降越明显.

Objective To explore visual acuity and stereopsis in children with different types of anisometropic amblyopia, and the effect of visual acuity and anisometropia types on the existence of stereopsis.Methods In this retrospective study, the database of 56 children with anisometropic amblyopia, 52 children with strabismic anisometropic amblyopia and 20 normal children as control were collected in current study by detecting their corrected visual acuity, the severity of anisometropia and 2-order （coarse） stereopsis.Multivariate analysis of variance and logistic regression analysis were used as statistical methods and stereopsis distribution is calculated.Results There is no statistically significant difference in visual acuity between simple anisometropic amblyopia and strabismicanisometropic amblyopia （F=3.58, P=0.0314, corrective α=0.016）.96% simple anisometropic amblyopes and 71% strabismic anisometropic amblyopes have 2-order stereopsis.With no changes in binocular visual acuity, compared strabismic auisometropic amblyopia with simple anisometropic amblyopia, the 2-order stereopsis OR（odds ratio） estimates was 0.132（95%CI： 0.034～0.503）.Within the same type of anisometropia, compared the binocular visual balance of high and medium level with low level, the 2-order stereopsis OR estimates were 5.161（95%CI： 0.868～30.675） and 3.939（95%CI： 0.920～16.858） respectively.Conclusion Within the same anisometropia level, there was no significant difference in visual acuity across different types of anisometropic children with strabismic ansiometropic anmblyopia retain a fewer range of coarse stereopsis than simple anisometropia.Stereopsis degraded by monocular vision is more significant than by binocular vision in children with anisometropia, and the more severe the binocular imbalance becomes the more significant the stereopsis degrades.