图像视觉诱发电位自律空间频率刺激疗法联合左旋多巴对儿童屈光性弱视近立体视和视网膜黄斑厚度的影响

Effects of PVEP-CD combined with levodopa on the improvement of near stereoscopic vision and macular thickness in children with refractive amblyopia

目的探讨图像视觉诱发电位自律空间频率刺激疗法(PVEP-CD)联合左旋多巴对儿童屈光性弱视近立体视改善情况和视网膜黄斑厚度的影响。方法选择2019年5月至2023年5月于宁海县第一医院进行诊治的屈光性弱视儿童124例,按治疗方法将其分为对照组(62例)和研究组(62例)。2组弱视儿童均接受PVEP-CD综合疗法治疗,研究组在此基础上联合左旋多巴治疗。将2组患儿性别、年龄、近立体视锐度等级、最佳矫正视力(BCVA)等进行对比,对比2组患儿近立体视改善情况,不同年龄、弱视程度患儿近立体视改善情况,以及治疗前、治疗半年后黄斑中心凹各层厚度。结果治疗半年后,2组患儿近立体视均好转,其中研究组患儿的临床总有效率为85%(53/62),比对照组患儿的52%(32/62)高(χ^(2)=16.496,P<0.01);且研究组患儿近立体视锐度提高等级为(2.2±1.1),比对照组的(1.5±0.6)高(t=4.704,P<0.05)。<6周岁、≥6周岁患儿近立体视锐度改善有效率、近立体视锐度提高等级对比,均差异无统计学意义(均P>0.05);轻度弱视患儿中,研究组患儿近立体视锐度改善有效率比对照组高,近立体视锐度提高等级比对照组高;治疗半年后2组患儿中心凹厚度均比治疗前下降,且研究组比对照组低,而副中心凹内层厚度、副中心凹外层厚度则比治疗前上升,且研究组比对照组高(均P<0.05)。结论PVEP-CD综合疗法联合左旋多巴应用于儿童屈光性弱视的治疗中,有效提高近立体视锐度等级,改善视网膜黄斑厚度,促进患儿视觉功能快速恢复,疗效显著。

Objective To investigate the effects of image visual evoked potential autonomous spatial fre-quency stimulation therapy(PVEP-CD)combined with levodopa on the improvement of near stereoscopic vision and macular thickness in children with refractive amblyopia.Methods A total of 124 children with refractive amblyopia who were treated in Ninghai County First Hospital from May 2019 to May 2023 were selected and ran-domly divided into a control group(62 cases)and a study group(62 cases)according to different treatment.Both groups of amblyopia children were treated with PVEP-CD comprehensive therapy,and the study group were treated with levodopa on this basis.The gender,age,near stereoscopic acuity level,and best corrected visual acuity(BC-VA)of the two groups of children were compared.The improvement of near stereoscopic vision in children of dif-ferent ages,the improvement of near stereoscopic vision in children with different degrees of amblyopia,and the thickness of each layer of the macular fovea before and after six months of treatment in two groups were compared.Results After half a year of treatment,the near stereoscopic vision was significantly improved in both groups.The total clinical effective rate of the study group was 85%(53/62),which was higher than that of the control group 52%(32/62)(χ^(2)=16.496,P<0.01).Moreover,the improvement grade of near-stereoscopic acuity in the study group was(2.2±1.1),which was higher than that in the control group(1.5±0.6)(t=4.704,P<0.05).There was no signifi-cant difference in the effective rate and level of improvement in near stereoscopic acuity between children aged 6 and≥6 years old(all P>0.05);Among children with mild amblyopia,the effective rate of improving near stereo-scopic acuity in the study group was higher than that in the control group,and the level of improving near stereo-scopic acuity was higher than that in the control group;After six months of treatment,the thickness of the central fovea in both groups of children decreased compared to before treatment,and the study group was lower than the control group.However,the thickness of the inner layer of parafovea and the outer layer of parafovea were higher than before treatment,and the study group was higher than the control group(both P<0.05).Conclusion PVEP-CD combined with levodopa in the treatment of children with refractive amblyopia can effectively improve the near stereoscopic acuity level,the retinal macular thickness,and promote the rapid recovery of visual function in chil-dren,with remarkable curative effects.