先天性上睑下垂弱视的原因分析

Analysis of the causes of amblyopia in congenital ptosis

目的分析先天性上睑下垂(congenital ptosis,CP)导致弱视的原因。方法回顾性分析山西省眼科医院2017年1月至2019年1月收治的349例(471眼)CP的临床资料,分为3组:轻度组88眼、中度组113眼和重度组270眼,另以单侧先天性上睑下垂者的对侧眼作为对照组227眼。所有患者均行上睑下垂矫正术。探讨散光、遮盖、弱视及年龄之间的关系。结果轻、中、重三组的散光率、弱视率均高于对照组(χ2=29.230,61.010;P均<0.05);轻、中、重三组患者散光度与对照组相比差异有统计学意义(P<0.05);遮盖者发生弱视可能性是未遮盖者的5.89倍;散光者发生弱视可能性是无散光者的3.24倍;≤14岁组与>14岁组的散光率、弱视率的差异均无统计学意义(χ2=0.010,0.279;P=0.919,0.597)。结论CP患者弱视及散光的发生率和散光的数值均高于一般人群。相比散光性弱视而言,遮盖引起的形觉剥夺性弱视对CP患者弱视的影响更大。14岁后散光与弱视并不随着年龄的增长而加重。

Objective To analyze the cause of amblyopia caused by congenital ptosis.Methods The clinical data of 471 eyes of 349 cases with congenital ptosis from Jan.2017 to Jan.2019 in Shanxi Eye Hospital were analyzed retrospectively.All patients were divided into 3 groups,88 eyes in mild group,113 eyes in moderate group,270 eyes in severe group.And 227 contralateral eyes of unilateral ptosis in the control group.All patients received correction of congenital ptosis.The relationship among astigmatism,cover,amblyopia and age were investigated.Results The incidence of astigmatism and amblyopia in all congenital ptosis groups were higher than those of the control group(χ2=29.230,61.010;all P<0.05).The astigmatism of all congenital ptosis groups were significantly higher than that of the control group(P<0.05).The possibility of amblyopia in patients with eye covered was 5.89 times higher than that of uncovered patients.The possibility of amblyopia in astigmatism patients was 3.24 times higher than that of non-astigmatism patients.The difference in astigmatism rate and amblyopia rate were not statistically significant between the group under 14 years old and the group over 14 years old(χ2=0.010,0.279;P=0.919,0.597).Conclusion The incidence of astigmatism and amblyopia in patients with congenital ptosis is higher than that of normal population.Compared with astigmatism amblyopia,visual deprivation amblyopia caused by cover has a greater impact on amblypia in patients with congenital ptosis.Astigmatism and amblyopia do not progress with the growth of the age after 14 years.