屈光不正性弱视类型及初始治疗的年龄对儿童近立体视功能的影响

The type of refractive amblyopic and the initial treatment age of children for the influence of near stereopsis

目的探讨屈光不正性弱视类型及初始治疗的年龄对近立体视功能的影响。方法采用颜氏立体图对门诊的121例3~9岁屈光不正性弱视儿童的立体视功能进行治疗前后(6月)的对比分析,观察弱视程度的不同及屈光类型的不同对患儿立体视治疗前后的影响及不同开始治疗年龄对近立体视发育的影响。结果屈光不正性弱视儿童有不同程度的近立体视,具有正常近立体视锐度比例为22.92%。以散光性屈光不正为主,高度远视者近立体视较差,开始治疗的年龄越小,近立体视功能发育越好,疗效越好,不同年龄组治疗效果间有统计学意义;不同程度的屈光不正性弱视患者治愈后近立体视锐度也存在差异,轻度、中度弱视较重度弱视立体视功能发育较好,治疗后预后好,重度弱视的立体视功能预后较差,差异有统计学意义。结论屈光不正性弱视中高度远视对视功能影响较大,开始治疗年龄越小,立体视发育预后较好。开始治疗年龄较晚的立体视发育相对较差。散光型弱视儿童立体视功能明显好于高度远视组儿童(屈光参差除外),重度弱视有一部分视力提高后立体视仍未发育,在弱视治疗的后期要注意双眼视觉的恢复。

Objective To investigate the effect of type of amblyopia and initial treatment of the age on near stereopsis.Methods Overall 121 cases with ametropic amblyopia of age 3to 9children（after 6months treatment of amblyopia）were observed.The Yan stereogram was used to evaluate near stereopsis function.We observed the effects of different degree of amblyopia and different types of ametropia on near stereopsis functions before and after the operations and the effects of different treatment age on the development of stereopsis.Results Children with ametropic amblyopia had different degrees of near stereopsis,with normal stereopsis 22.92%.Mostly was childen with astigmatic refractive error,and the near stereopsis functions of high hyperopia groups were poor.The earlier the treatment age,the better recovery effects of near stereoscopic functions.The therapeutic effects between different age groups had statistical significance.Six months after the treatment,there also were differences in near stereopsis functions of different degrees of amblyopia groups.Mild and moderate amblyopia groups had better stereopsis functions,and the stereopsis functions were poor in severe amblyopia groups.The difference between the three groups was statistically significant.Conclusion hyperopia has larger influence in visual functions.The earlier the treatment started,the better the stereopsis developed.The latter age of treatment,the poorer recovery the stereopsis and the visual functions.The near stereopsis functions in Astigmatism types were significantly better than those in the hyperopia groups（excluding anisometropia cases）,and severe amblyopia has not yet developed in stereopsis later in the treatment although the visual acuity improved.The recovery of binocular vision should be paid more attention during the treatment of amblyopia.