摘要
目的研究间歇性外斜视的双眼调节功能。方法前瞻性病例对照研究。人选年龄在18～40岁的间歇性外斜视组76例，正常对照组40例，用MEM动态检影的方法测量双眼注视40cm处调节视标时主导眼与非主导眼的调节反应、正／负相对调节（PRA／NRA）、斜视度。对数据进行t检验、秩和检验和相关分析。结果间歇性外斜视组48只（63％）主导眼表现为调节超前，调节反应平均为（-0-32±0．57）D；62只（81％）非主导眼表现为调节滞后，非主导眼调节反应平均为（＋0．36±0．44）D；主导眼与非主导眼之间的调节反应差异有统计学意义（Z=-7．01，P〈0．01）。正常对照组主导眼调节反应为（＋0．34±0．28）D，间歇性外斜视组主导眼的调节反应与对照组主导眼间差异有统计学意义（Z=-6．36．P〈0．01）。主导眼调节反应量与斜视度之间呈负相关（r=-0．67，P〈0．01）。间歇性外斜视组PRA平均为（-4．03±0．82）D，对照组为（-3．09±0．74）D，差异有统计学意义（t=6．05，P〈0．01）；间歇性外斜视组NRA平均为（＋1．96±0．56）D，对照组为（＋2．23±0．34）D，差异有统计学意义（t=-2．82，P〈0．01）。结论间歇性外斜视者在双眼注视近距离视标时主导眼与非主导眼调节反应不一致；在集合保持同定的情况下间歇性外斜视者处于调节紧张难以放松的状态。
Objective To investigate the binocular accommodative function of patients with intermittent exotropia. Methods Seventy-six patients aged 18 to 40 years with intermittent exotropia and 40 normal controls were recruited for a prospective case control study. Accommodative responses in dominant and nondominant eyes were tested using MEM （monocular estimate method） dynamic rctinoscopy. The testing measured positive relative accommodation/negative relative accommodation （PRA/NRA） and deviation to a 40 cm target with binocular viewing. The data were analyzed by a nonparametric test, t-test and correlation analysis. Results During binocular viewing at the 40 cm target, the accommodative response was asymetric between the two eyes in patients with intermittent exotropia. Forty-eight of the dominant eyes （63%） showed an accommodative lead. Sixty-two of the nondominant eyes （81%） showed an accommodative lag. The mean accommodative response in the dominant and nondominant eyes in patients and normal control dominant eyes were -0.32±0.57 D, ＋0.36±0.44 D and ＋0.34±0.28 D, respectively. The accommodative response was asymetric in patients between dominant and nondominant eyes （Z=-7.01, P〈0.01）. There was significant difference between the dominant eyes in patients and normal controls （Z=-6.36, P〈0.01）. The accommodative responses in the dominant eyes were significantly correlated with the angle of exotropia （r=-0.67, P〈0.01 ）. The mean PRA was -4.03±0.82 D in patients and -3.09±0.74 D in normal controls （t=6.05, P〈0.01）. The mean NRA was ＋1.96±0.56 D in patients and ＋2.23±0.34 D in normal controls （t=-2.82, P〈0.01）. Conclusion During binocular viewing at the near target, the accommodative response in patients with intermittent exotropia was asymetric between dominant and nondominant eyes with a hyperactive response in the dominant eve.
出处
《中华眼视光学与视觉科学杂志》
CAS
2013年第8期471-474,共4页
Chinese Journal Of Optometry Ophthalmology And Visual Science
关键词
间歇性外斜视
调节
主导眼
Intermittent exotropia
Accommodation
Dominant eye
