摘要
目的比较间歇性外斜视患者行1h诊断性遮盖试验（1h-DOT）前、后斜视角及斜视分型的变化。方法回顾性系列病例研究。收集2008年1月至2011年10月期间均行1h-DOT前、后斜视角测量的住院间歇性外斜视患者207例。所有患者术前均采用三棱镜加交替遮盖法进行注视6m及33cm调节性视标的第一眼位斜视角测量，然后遮盖患者一眼1h后再次进行斜视角测量。采用配对设计的t检验对遮盖前、后看远及看近斜视角的均值进行比较；遮盖前、后看远及看近斜视角一致性的评价采用Bland-Altman法；采用Pearson卡方检验对lh-DOT前、后间歇性外斜视分型的变化进行比较。结果看远斜视角遮盖前为（28．00±9．38）PD，遮盖后为（29．85±9．59）PD，差异有统计学意义（t=6．24，P=0．000）；看近斜视角遮盖前为（28．17±9．92）PD，遮盖后为（34．38±10．57）PD，差异有统计学意义（t=12．23，P=0．000）。Bland-Ahman图显示，遮盖前、后测量的看远斜视角一致性较好；遮盖前、后测量的看近斜视角一致性较差。遮盖前、后间歇性外斜视分型的差异有统计学意义（χ^2=20．11P=0．000）。结论1h-DOT主要影响间歇性外斜视患者的看近斜视角，而对看远斜视角影响较小。1h-DOT对于间歇性外斜视的分型具有重要意义。
Objective To compare the angle of deviation and types of intermittent exotropia be- fore and after 1-hour diagnostic occlusion test （lh-DOT） in patients with intermittent exotropia. Methods Retrospective case series study. Two hundreds and seven cases of inpatients with intermit- tent exotropia whose exodeviations were measured before and after lh-DOT were recruited from Jan- uary 2008 to October 2011 in the Eye Center of Provincial Hospital affiliated to Shandong Universi- ty. Prism and alternative cover test was used to evaluate the exodeviation fixating at indoor distance accommodative target of 6m and near accommodative target of 33cm before and after lh-DOT. Dif- ference in measurements of mean angle of deviation at distance and at near before and after lh-DOT was assessed using paired t test. Bland-Altmann method was used to evaluate the agree- ment of mean angle of deviation at distance and at near before and after lh-DOT. A Chi-square test was applied to compare the distribution of types of in-termittent exotropia before and after Ih-DOT. Results The mean exodeviations fixat-ing at the distance target of 6m before and after lh-DOT were 28.00±9.38 PD and 29.85±9.59 PD, respectively, and the difference was significant （t =6.24, P =0.000）. The mean exodeviations fixating at the near target of 33cm before and after lh-DOT were 28.17±9.92 PD and 34.38±10.57 PD respectively, and the difference was significant （t =12.23,P =0.000）. The Bland-Altmann figure demonstrated that the angles of deviation fixating at distance target of 6m before and after lh-DOT showed comparable results, and that the angles of deviation fixating at near target of 33cm before and after lh-DOT showed incomparable results. The differ- ence of types of intermittent exotropia before and after lh-DOT was significant （χ^2=20.11, P = 0.000）. Conclusions lh-DOT has a strongly effect on the angle of deviation at near and has a weak effect on that at distance in patients with intermittent exotropia, lh-DOT is important for distin- gnishing different types of intermittent exotropia.
出处
《中国实用眼科杂志》
CSCD
北大核心
2013年第6期724-727,共4页
Chinese Journal of Practical Ophthalmology
关键词
外斜视
间歇性
测量
斜视角
Exotropia
Intermittent
Measurements
Exodeviation
