急性共同性内斜视临床特征观察

Clinical characteristics of acute acquired comitant esotropia

目的:探讨20例急性共同性内斜视(AACE)患者的临床特征。方法:回顾性病例研究。收集2018-06/2021-05在广东省江门市中心医院眼科确诊的AACE患者20例,所有患者均行头部影像学检查排除神经系统性疾病。分析患者的年龄、发病前近距离用眼时间、症状、屈光度、调节性集合与调节比值(AC/A)、斜视度、近立体视功能。结果:患者20例平均年龄为24.25±5.78岁,大部分患者在发病前每天近距离用眼6h以上。所有患者均因双眼复视来诊,眼部常规检查无异常,各诊断眼位的眼球运动无明显受限。全部患者的屈光状态均为近视,平均等效球镜为-5.73±5.09D。AC/A平均为2.65±1.16。患者远距离斜视度与近距离斜视度之间的无差异(P>0.05)。不同斜视度患者之间的近立体视功能有差异(P<0.05),不同病程的患者之间的近立体视功能无差异(P>0.05)。结论:大龄儿童及成人的ACCE多发生于长时间近距离用眼的中度近视人群中,主要症状为双眼复视,但各诊断眼位的眼球运动正常,没有神经系统性疾病,AC/A不高,远距离斜视度与近距离斜视度相近,近立体视功能可能与斜视度大小有关,可能与病程长短无关系。

AIM:To describe the clinical characteristics of 20 patients with acute acquired comitant esotropia(AACE).METHODS:This retrospective,observational case series study enrolled patients with AACE examined from June 2018 to May 2021 in Guangdong Jiangmen Central Hospital.The age when attacked,the duration of excessive near work before illness,symptom,refraction,AC/A,deviation and near stereopsis were analyzed.All 20 patients had unremarkable neurological finding by imageological test.RESULTS:Most patients whose mean age was 24.25±5.78 years immersed in near work for more than 6h a day before illness.All patients seeked for medical help because diplopia with normal ocular motility in all directions of gaze and meaningless finding in routine ophthalmologic examinations.They were all nearsightedness whose mean spherical equivalent was-5.73±5.09D,while mean AC/A was 2.65±1.16 within the upper limit.There was no different between the distant and near deviations(P>0.05).Deviations might be correlated with near stereopsis(P<0.05),however the duration from onset to treatment was irrelevant(P>0.05).CONCLUSION:The clinical features of AACE in older children and adults who immersed excessive near work are medium myopia,diplopia,normal ocular motility,no neurological finding and limited AC/A.Moreover,it is approximate between distant and near deviations.The deviations affect near stereopsisd more,while the influence of duration from onset to treatment may be less.