间歇性外斜视儿童眼位控制力与融像性集合参数相关性研究

The relationship between the control level and fusional convergences in children with intermittent exotropia

目的探讨间歇性外斜视儿童眼位控制力与融像性集合各参数的相关性。方法临床病例对照研究。对2013年12月至2014年6月在青岛大学附属医院眼科被确诊为基本型间歇性外斜视患者96例，年龄6～12岁，按纽卡斯尔控制评分（newcastle control score，NCS）分三组：控制力良好组（0-3分）、控制力中等组（4—6分）和控制力不良组（7～9分），采用三棱镜交替遮盖试验测量斜视角，水平棱镜检查融像性集合功能，并将检查结果与眼位控制力进行相关性统计学分析。结果不同控制组之间，总集合幅度相似差异无统计学意义（视近P=0．279、视远P=0．618）。良好控制组的集合储备视近、视远差异均有统计学意义（P〈0．01），均高于中等和不良控制组，差异均具有统计学意义（P〈0．05）。在所有融像性集合参数中，融像储备率与控制力的相关性最强，差异具有统计学意义（视近比率：r=-0．63，P〈0．01；视远比率：r=-0．58，P〈0．01）。视远时融像储备率≥2的所有患者中，表现出良好的控制力（NCS≤3）。结论眼位控制力级别不同的儿童基本型间歇性外斜视患者的总集合幅度相似，不良控制组的集合储备明显较低。融像储备率≥2是判断患者眼位控制力良好的指标之一。

Objective To investigate the relationship between the Newcastle Control Score （NCS） and different fusional convergences in children with intermittent exotropia. Methods Firstly, the 96 patients （6 to 12 years old） with intermittent exotropia were divided into three groups, the good, moderate ＇and poor control groups by the NCS. Then, the patients underwent two examinations respectively, one was measurement of the angle of deviation, the other was the measurement of fu- sional convergence of distance and near. Lastly, the statistical correlation of the examinations results and the level of control of children with intermittent were compared and analyzed. Results In dif- ferent Commanded groups, the total convergence amplitude was similar （P =0.279, near; P =0.618, distance）. The fusional reserve of groups with good control （P 〈0.001, near; P 〈0.001, distance） were all higher than groups with moderate and poor control. Among overall parameters of fusional convergence, the correlation between fusional reserve ratio and control as the strongest one were de- fined, （near ratio： r = -0.63, P 〈0.001; distant ratio： r = -0.58, P 〈0.001）. Of all the patients with fusional reserve ratio ≥2, 100% of them （five patients all） demonstrated good control （NCS ≤3）. Conclusions The total convergence amplitude of children who suffered intermittent exotropia and in different levels of control are similar; the fusional reserve ratio of the group with poor control is sig- nificantly low; In this study, the statistics demonstrate that fusional reserve ratio ≥2 is one of the indexes to testify the patient is in good control.