共同性斜视患者立体视损害的影响因素分析

Analysis of the influencing factors of stereopsis damage in concomitant strabismus patients

目的研究共同性斜视患者立体视损害的影响因素。方法回顾性病例分析。收集2018年12月1日~2019年11月30日于我院行斜视矫正术的186例住院患者的病例资料。纳入患者均为共同性斜视,其中男性103例、女性83例,均使用维视顿视功能检查治疗仪检测立体视。采用SPSS 17.0统计学软件进行统计学分析,采用χ^(2)检验分析性别、年龄、斜视类型、斜视程度、主导眼对患者立体视缺失率的影响,采用二项logistic回归方法分析立体视损害的影响因素。结果①性别差异对斜视患者立体视无影响,男性患者立体视缺失率为81.55%,女性患者立体视缺失率为85.54%,差异无统计学意义(χ^(2)=0.527,P=0.468)。②不同年龄段斜视患者的立体视缺失率不同,<12岁的患者立体视缺失率为78.00%,≥12岁的患者立体视缺失率为89.53%,差异有统计学意义(χ^(2)=4.429,P=0.035)。③斜视类型不同,患者立体视缺失率不同,内斜视患者立体视缺失率为96.86%,间歇性外斜视患者立体视缺失率为58.14%,恒定性外斜视患者立体视缺失率为86.08%,差异有统计学意义(χ^(2)=28.529,P<0.001)。④斜视程度对立体视的损害无明显影响,斜视度<60 PD的患者立体视缺失率为81.08%,斜视度≥60 PD的患者立体视缺失率为84.82%,差异无统计学意义(χ^(2)=0.449,P=0.503)。⑤主导眼差异对立体视无明显影响,主导眼为右眼的患者立体视缺失率为80.85%,主导眼为左眼的立体视缺失率为85.87%,差异无统计学意义(χ^(2)=0.843,P=0.359)。⑥二项logistic回归分析显示斜视类型是立体视缺失的影响因素(P=0.001),间歇性外斜视、恒定性外斜视和共同性内斜视三者的立体视损害风险依次增高。共同性内斜视相对于间歇性外斜视的OR值为39.597(P=0.001),共同性内斜视相对于恒定性外斜视的OR值为9.119(P=0.040)。结论斜视类型是共同性斜视患者立体视缺失的影响因素。共同性内斜视对立体视的损害大于恒定性外斜视与间歇性外斜视,间歇性外斜视对立体视的损害在这三类斜视中最小。

Objective To study the influencing factors of stereopsis damage in patients with concomitant strabismus.Methods Retrospective case analysis.Data of 186 hospitalized patients treated with strabismus surgery in our hospital on December 1 in 2018 to November 30 in 2019 were collected.All the included patients were concomitant strabismus,including 103 males and 83 females,whose stereoacuity have been checked by the VISTON system.In this study,SPSS 17.0 statistical software was used for statistical analysis,and Chi-square test was used to analyze the influence of gender,age,type of strabismus,degree of strabismus and dominant eye on the rate of stereoscopic damage.Binomial logistic regression model was used to analyze the correlation between stereoscopic damage and related factors.Results①The gender had no effect on stereopsis in patients with strabismus.The rate of stereoscopic damage in male patients was 81.55%,while in female patients was 85.54%,without significant difference(χ^(2)=0.527,P=0.468).②The age had a significant impact on patients'stereopsis,with a stereoscopic loss rate of 78.00%in patients under 12 years old and 89.53%in those above or equal to 12 years old(χ^(2)=4.429,P=0.035).③The rate of stereopsis damage differed significantly among different types of strabismus,with a stereoscopic loss rate of 96.86%for patients with esotropia,58.14%for patients with intermittent exotropia,and 86.08%for patients with constant exotropia(χ^(2)=28.529,P<0.001).④The degree of strabismus had no significant effect on the damage of stereopsis.The rate of stereoscopic loss in patients with strabismus less than 60 PD was 81.08%,and in that greater than or equal to 60 PD was 84.82%,with no statistically significant difference(χ^(2)=0.449,P=0.503).⑤The difference in the dominant eye showed no significant effect on stereopsis.The rate of stereoscopic loss in patients with right-and left-dominant eye was 80.85%and 85.87%,respectively(χ^(2)=0.843,P=0.359).⑥Binomial logistic regression analysis showed that the type of strabismus was the influencing factor of stereoscopic damage(P=0.001),and the risk of stereoscopic damage in intermittent exotropia,constant exotropia and concomitant esotropia increased sequentially.The OR value of concomitant esotropia relative to intermittent exotropia was 39.597(P=0.001),and that relative to constant exotropia was 9.119(P=0.040).Conclusions The type of strabismus is an influencing factor of stereoscopic damage in patients with concomitant strabismus,among which esotropia showed the strongest damage while intermittent exotropia the least.