眼位正常、外隐斜及间歇性外斜视儿童的近视患病率比较

Comparison of myopia prevalence among normal,exophoria and intermittent exotropia children

目的通过观察眼位正常、外隐斜视及间歇性外斜视儿童的近视患病率和等效球镜屈光度,探讨三组儿童的近视患病率及程度的差异。方法临床回顾性研究。收集6~14岁眼位正常儿童151人、外隐斜视儿童180例及间歇性外斜视儿童168例的验光结果,均使用睫状肌麻痹剂(托吡卡胺滴眼液)使睫状肌充分麻痹放松调节后客观验光3次,取平均值为客观验光结果。并将间歇性外斜视组分为基本型、集合不足型和分开过强型,观察三种类型间歇性外斜视患者等效球镜屈光度的差异。结果不同年龄的间歇性外斜视组近视患病率均显著高于眼位正常组和外隐斜视组,差异均有统计学意义(均为P<0.05)。不同年龄的眼位正常组近视患病率和外隐斜视组差异均无统计学意义(均为P>0.05)。间歇性外斜视组总体近视患病率与眼位正常组和外隐斜视组差异均有统计学意义(均为P=0.000);眼位正常组总体近视患病率与外隐斜视组差异有统计学意义(P=0.034)。眼位正常组、外隐斜视组、间歇性外斜视组等效球镜屈光度分别为(0.08±0.99)D、(-0.16±1.16)D、(-1.23±1.57)D,三组间差异有统计学意义(P=0.000)。眼位正常组与外隐斜视组(P=0.015)、眼位正常组与间歇性外斜视组(P=0.000)及外隐斜视组与间歇性外斜视组(P=0.000)的等效球镜屈光度差异均有统计学意义。间歇性外斜视组中,集合不足型等效球镜屈光度(-1.68±1.61)D、基本型(-1.14±1.44)D、分开过强型(-0.85±1.50)D,三种类型组间差异有统计学意义(P=0.000)。集合不足型等效球镜屈光度明显低于基本型(P=0.000)和分开过强型(P=0.041)。结论间歇性外斜视儿童近视患病率及近视程度均高于眼位正常组及外隐斜视组儿童。

Objective To discuss the difference of myopia prevalence and spherical equivalent among normal, exophoria and intermittent exotropia children. Methods The children aged between 6 years old to14 years old were divided into 3 groups of orthophoria （n = 151 ） ,exophoria （n = 180） and intermittent exotropia （n = 168 ） based on the result of cover-tmcover test. Intermittent exotropia group was divided into three types of basic, convergence insufficiency and divergence excess. Diopter values were retrospectively reviewed, and results were recorded with the average data after the objective optometry of cycloplegia. Results Myopia prevalence of intermittent exotropia of different ages was higher than normal and exophoria （ all P 〈 0.05 ）, but no difference between exophoria and normal （ all P 〉 0.05 ）. There were statistical significant differences in overall prevalence among three groups （intermittent exotropia and orthophoria ：P = 0. 000, intermittent exotropia and exophoria ：P = 0. 000, orthophoria and exophoria：P =0.034）. Average spherical equivalent was （0.08 ± 0.99）D in orthophoric group, （ -0.16 ± 1.16）D in exophoric group and （ - 1.23 ± 1.57）D in intermittent exotropie group, there was statistical difference among three groups （P = 0. 000）. The differences were also statistical significant between orthophoria group and exophoria group （P = 0. 015） ,intermittent exotropia group and orthophoria group （ P = 0. 000 ）, exophoria group and intermittent exotropia group （P =0.000）. In the group of intermittent exotro- pia,average spherical equivalent was （ - 1.68 ± 1.61 ） D in convergence insufficient group, （ - 1.14 ± 1.44） D in basic group and （ -0.85 ± 1.50 ） D in divergence excessive group, there was statistical difference among three groups （ P = 0.000 ）. The spherical equivalent in convergence insufficient group was lower than the basic group （P = 0. 000 ） and divergence excessive group （P = 0.041 ）. Conclusion The myopia prevalence and degree of intermittent exotropia are all higher than normal and exophoria in children.