弱视治疗过程中视差和立体视觉恢复的初步观察

目的分析屈光不正性弱视和屈光参差性弱视患儿视觉康复过程中远立体视觉、近零视差、非交叉视差和交叉视差的恢复情况。方法前瞻性连续病例研究。收集4—12岁屈光参差性弱视和屈光不正性弱视患儿58例，分别于初诊、治疗1、3、6个月时进行检影验光检测患儿最佳矫正视力．同时采用颜少明《立体视觉检查图》检查近零视差立体视锐度、交叉视差和非交叉视差立体感知度，采用同视机Ⅲ级功能定性图片检测患儿远立体视觉。应用单因素线性回归分析对数据进行处理。结果在弱视患儿视力提高的过程中，对于具有较好的基础视力和治疗过程中视力恢复较好的患者，立体视锐度恢复较好[近零视差与基础视力的回归方程是Y=-0．92X＋3．13（F=9．203，P〈0．01）；近零视差与终末视力的回归方程是Y=-0．81X＋3．23（F=9．886，P〈0．01）；同视机远立体视觉的恢复早于随机点近立体视觉：近立体视觉中，近零视差首先恢复，交叉视差随之，非交叉视差最后恢复。并且这种恢复规律在屈光参差性弱视患儿中更为明显。结论在弱视患儿视觉康复过程中，随着患儿视力的提高，远立体视觉、近零视差、交叉视差和非交叉视差顺次恢复。

Preliminary observations on the recovery of different types of stereoscopic vision during treatment for amblyopia

Objective To investigate the recovery of distance stereopsis, zero disparity, crossed disparity and uncrossed disparity in ametropic amblyopic and anisometropic amblyopic children. Methods In this prospective consecutive case study, the best distance corrected visual acuity of 58 amblyopic children was tested during treatment. Zero disparity, crossed disparity and uncrossed disparity were measured by Yan＇s random dot stereogram; distance stereopsis was detected by synoptophore. Data were analyzed with linear regression. Results Patients who had better visual acuity before treatment or those whose visual acuity increased quickly during treatment had better recovery of stereoscopic vision [regression equation for zero disparity and visual acuity before treatment was Y=-0.92X＋3.13 （F=9.203, P〈0.01）; regression equation for zero disparity and visual acuity at the completion of treatment was Y=-0.81X＋3.23 （F=9.886, P〈0.01）]. With the improvement in visual acuity, distance stereopsis recovered earlier than near stereopsis, and zero disparity, crossed disparity and uncrossed disparity recovered in order. Conclusion Distance stereopsis, near zero disparity, crossed disparity and uncrossed disparity recovered in order with the improvement of visual acuity in amblyopic children.