大龄儿童及青少年屈光参差性弱视的预后及相关因素分析

Chunyan C Cai, Wei-ming Xu, Hongbin Dai
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摘要

目的探讨7 ~ 17岁儿童屈光参差性弱视的治疗效果,探讨影响治疗效果的因素。方法对72例7 ~ 17岁参差性弱视患者进行回顾性研究。所有患者均接受屈光矫正、健全眼闭塞和红色闪烁。偏心固定患者行海丁格刷和后像治疗。视敏度提高≥2线视为矫正视力改善。结果治疗前、治疗3个月、6个月、1年的最佳矫正视力分别为0.28±0.18、0.49±0.28、0.60±0.32、0.70±0.35。72例患者中,55例患者治疗1年后视力改善(76.4%)。偏心固定21例,仅有8例视力改善(38.1%),中心固定51例,47例视力改善(92.2%)。重度26例、中度37例、轻度参差弱视9例,视力改善13例、33例、9例。没有依从性,没有人能提高视力。结论大龄儿童屈光参差性弱视综合治疗效果良好。结果与弱视的初始严重程度、弱视眼的固定和依从性有关。轻中度弱视,中心固定,依从性好,效果较好。关键词:屈光参差性弱视;年长的孩子;弱视的治疗
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The outcome and related factors in anisometropic amblyopia in elder children and teenagers
Objective To investigate the outcome of anisometropic amblyopia therapy in children aged 7-17 years old and to identify factors which influence the outcome of treatment. Methods A retrospective study of 72 patients with anisometropic amblyopia aged 7-17 years old were included in this study. All the patients received refractive correction, occlusion of the sound eye and red scintillation. In addition, patients with eccentric fixation received Haidinger brush and afterimage therapy. Corrected visual acuity was considered improved as visual acuity was elevated by ≥2 lines. Results The best corrected visual acuity of the amblyopic eye was 0.28±0.18, 0.49±0.28, 0.60±0.32, 0.70±0.35 before treatment, after 3 months’, 6 months’ and 1year treatment. Among all the 72 patients, 55 patients’ visual acuity improved after 1-year treatment (76.4%). Only 8 patients’ visual acuity improved in 21 patients with eccentric fixation (38.1%), while 47 patients’ visual acuity improved in 51 patients with centric fixation (92.2%). 13, 33, 9 patients’ visual acuity improved in 26 severe, 37 moderate, 9 mild anisometropic amblyopia patients respectively. No one could get improved visual acuity without compliance. Conclusions Good results can be attained through combined therapy in older children with anisometropic amblyopia. The results are related to the initial severity of amblyopia, fixation of the amblyopic eye and compliance. Better outcome can be obtained in patients with mild to moderate amblyopia, centric fixation and good compliance. Key words: Anisometropic amblyopia; Older children; Therapy of amblyopia
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