视觉训练对非弱视性视力低下56例患者疗效观察

Therapeutic effect of visual training on low vision of no arnblyopia

目的 观察视觉训练对治疗非弱视性视力低下患者的效果.方法 前瞻性研究.选取2015年2月至2016年5月期间在濮阳市眼科医院就诊的阿托品散瞳后屈光度数为-1.00 ＋3.00 D、无屈光参差、无固定性斜视、两眼矫正视力相差＜2行、矫正视力低于同龄儿童正常视力、5～12岁的56名儿童,进行为期四周的视觉训练,比较视觉训练前后双眼矫正视力、裸眼视力、Flipper周期、调节幅度（AMP）.结果 56名儿童双眼平均裸眼视力训练前后分别为0.53±0.13和0.91±0.14（t=3.2657,P＜0.05）,差异有统计学意义;训练前后双眼平均矫正视力分别为0.59±0.12和0.98±0.05（t=3.3724,P＜0.05）,差异有统计学意义;训练前后单眼±2.00 D翻转拍40 cm处,右眼分别为5.8±2.6周期和18.2±1.7周期（t=13.6285,P＜0.05）,差异有统计意义;左眼分别为6.3±1.9周期和18.5±1.3周期（t=12.8354,P＜0.05）,差异有统计意义;训练前后调节幅度右眼分别为8.9±2.5 D和15.1±1.2 D（t=20.1624,P＜0.05）,差异有统计学意义;训练前后左眼分别为8.6±2.2 D和15.3±1.1 D（t=21.6218,P ＜0.05）.结论 视觉训练对于非弱视性视力低下患者,可明显改善调节灵敏度和调节幅度,裸眼视力和矫正视力随之可明显提高,提示此类患者的视力低下是由调节功能紊乱导致.

Objective To investigate the therapeutic effect of visual training on low vision of no amblyopia.Methods A prospective study.A total of 56 children with low vision of no amblyopia were selected which came to Puyang Eye Hospital during a period from February 2015 to May 2016 to accept an visual training lasted for 4 weeks.All of the children met the following criteria：the degree of refractive power was-1.00 D～＋3.00 D,without anisometropia,the discrepancy of corrected visual acuity of two eyes was less than two rows on standard visual acuity chart,the corrected visual acuity was below normal children,aged from 5 to 12 years old.The monocular corrected visual acuity,uncorrected visual acuity,monocular Flipper cycle and amplitude of monocular accommodation before and after the visual training were measured.Results The average binocular uncorrected visual acuity of the 56 children was 0.53±0.13 before training and was 0.91±0.14 after training,with statistical difference （t =3.2657,P 〈0.05）.The average binocular corrected visual acuity was 0.59±0.12 before training and was 0.98±0.05 after training,with statistical difference （t =3.3724,P 〈0.05）.The Flipper cycle of right eye before and after training respectively was 5.8±2.6 and 18.2±1.7,with statistical difference （t =13.6285,P 〈0.05）.The Flipper cycle of left eye before and after training respectively was 6.3±1.9 and 18.5±1.3,with statistical difference （t =12.8354,P 〈0.05）.The amplitude of accommodation of right eye was 8.9±2.5 D before training and was 15.1±1.2 D after training,with statistical difference （t =20.1624,P 〈0.05）.The amplitude of accommodation of left eye was 8.6±2.2 D before training and was 15.3±1.1 D after training,with statistical difference （t =21.6218,P 〈0.05）.Conclusions Visual training can effectively improve the adjust sensitivity and the amplitude of accommodation,uncorrected visual acuity and corrected visual acuity of low vision of no amblyopia.This suggests that the low vision of these patients is caused by dysfunction of accommodation.