间歇性外斜视的调节灵活度和调节反应

Accommodative Facility and Accommodative response of Intermittent Exotropia

目的 比较间歇性外斜视和正常眼位人群之间,间歇性外斜视注视眼和非注视眼之间的调节灵活度和调节反应.方法： 病例对照研究.选取2016年10月至2017年1月在温州医科大学附属眼视光医院门诊就诊的35例间歇性外斜视患者作为间歇性外斜视组,另选取24例正位眼或外隐斜斜视度≤6△的门诊患者作为对照组.采用±2.00 D的反转拍和开放视野式自动验光仪分别测量受试者在单眼和双眼注视近距视标时的调节灵活度和调节反应.采用t检验对数据进行分析.结果： 间歇性外斜视组的双眼调节灵活度为（8.8±4.1）cpm,显著低于对照组[（10.9±3.1）cpm],两者差异有统计学意义（t=-2.165,P=0.035）.间歇性外斜视组的非注视眼调节灵活度显著低于注视眼（t=4.657,P〈0.001）.双眼注视40 cm处视标时,间歇性外斜视组的注视眼调节反应高于对照组的主导眼 （t=-2.163,P=0.035）.双眼注视状态下,间歇性外斜视组注视眼的调节反应为（1.89±0.30）D,高于其在单眼注视状态下的调节反应[ （1.64±0.34） D],两者差异有统计学意义（t=3.801, P=0.001）.结论：间歇性外斜视患者的双眼调节灵活度低于对照人群,其注视眼和非注视眼的调节灵活度和调节反应均不一致,且双眼注视时调节反应高于单眼注视状态.

Objective： To evaluate the accommodative facility and accommodative response in patients with intermittent exotropia. Methods： Thirty-five patients with basic intermittent exotropia and 24 normal controls were recruited for a case control study at Eye Hospital, Wenzhou Medical University from October 2016 to January 2017. Binocular and monocular accommodative facility were tested using a ± 2.00 diopter （D） fip. Accommodative responses under binocular and monocular viewing conditions at 40 cm were tested by an open-feld autorefractor WAM-5500. Data were analyzed using t-tests. results： The binocular accommodative facility of intermittent exotropia was 8.8 ± 4.1 cycles per minute （cpm）, which was signifcantly lower than the normal control, 10.9 ± 3.1 cpm （t=-2.165, P=0.035）. The fxating eye of intermittent exotropia had higher monocular accommodative facility than the non-fxating eye （t=4.657, P〈0.001）. Under binocular viewing conditions, the fxating eye of the intermittent exotropia had a higher accommodative response than the fxating eye of the normal control （t=-2.163, P=0.035）. The binocular accommodative response was also higher than the accommodative response under monocular viewing conditions （t=3.801, P=0.001）. conclusions： Patients with intermittent exotropia have low binocular accommodative facility. They also have asymmetric monocular accommodative facility and asymmetric accommodative responses between the fixating eye and the deviating eye. Patients with intermittent exotropia have a higher accommodative response under binocular viewing conditions than under monocular viewing conditions.