低视力对数视力表评价严重弱视儿童视力的研究

目的应用低视力对数视力表评价严重弱视患儿的疗效。方法研究对象是初诊时矫正视力低于或等于0．1的12例患儿，年龄3—5岁，其中远视性屈光参差性弱视11例，斜视性弱视1例。采用的视力表，是刘晓玲等设计的低视力对数视力表，进行的矫正远视力评价。治疗采用以遮盖和矫正为主的综合治疗。结果12例患儿治疗前矫正视力为0．04～0．08，视功能训练后视力提高2行或2行以上的有10例，其中有3例3眼超过0．1的视力，医师、患儿及家长得到较大的鼓舞，积极参加进一步训练。结论虽然严重弱视的儿童的视力预后比较差，但是使用低视力对数视力表评价以后，使得低于0．1的视力也能够精细测量，短时间的治疗已经证明多数儿童视力有2行的提高，其结果，得到家长理解和儿童的合作。     

阿托品抑制法与遮盖法治疗儿童弱视的比较

临床治疗弱视常用遮盖法 ,如患儿不配合可用压抑疗法。我们对 1 0 0例患儿行阿托品治疗或遮盖治疗 ,现将两组结果报告如下 :资料与方法1 一般资料　患儿 1 0 0人 ,按就诊顺序编号 ,分A、B两组 ,双号为A组 ,单号为B组 ,每组各 50人 ,年龄 2 5～ 7岁 ,两组平均年龄均为 4 5岁。A组斜视性弱视 1 2眼 ,屈光参差性弱视 3 8眼 ;B组斜视性弱视 1 1眼 ,屈光参差性弱视 3 9眼。均符合以下标准 :(1 ) 7岁以下 ,单眼弱视 ,为中心注视。(2 )矫正视力 ,弱视眼视力为 0 2～ 0 5,健眼视力≥ 0 8(对数视力表换算成小数记录法 ,以下同 )。(3 )无视力…     

学龄前儿童人工晶状体植入术后的弱视矫治

目的探讨学龄前儿童白内障摘出及人工晶状体植入术后的弱视训练，寻求解决术后低视力的最佳方法。方法3～6岁学龄前儿童白内障患者100例180眼人工晶状体植入术后，及时治疗后发性白内障、矫正屈光不正、综合治疗并坚持弱视训练，观察视力及视功能的变化。结果随访1-4a，全部病例视力均在0．1以上，0．5以上者144眼，78例患儿建立了立体视功能。结论学龄前儿童白内障摘出及人工晶状体植入术后，及时治疗并发症、重视屈光矫正、综合治疗并坚持弱视训练可获得良好的视功能。[眼科新进展2005；25（5）：449—450]     

厦门市10585名儿童弱视调查及防治

目的　了解我市儿童弱视患病情况 ,为制定群体防治措施提供科学依据。方法　用国际标准视力表检查视力 ,并行眼科常规检查 ,排除器质性病变。视力≤ 0 8及斜视者用 0 5 %阿托品眼药水散瞳验光 ,矫正视力≤ 0 8者为弱视。结果　普查 1 0 5 85人 ,弱视患病率为 4 3 2 % ,弱视首次检出率为 74 84% ,男女之间、各年龄组之间患病率差别无统计学意义。结论　定期对幼儿进行斜视弱视普查及给家长上眼保健课 ,督促患儿及早治疗 ,按时复诊 ,是防治弱视的关键 ,应纳入幼儿园《儿童眼保健常规》。     

不同方法治疗中度弱视儿童的临床研究

目的 通过用不同方法治疗儿童中度弱视疗效的观察,探讨其成功治疗有关的因素及治疗的成功率.方法 以随机方式收集我院门诊中度弱视儿童340例,包括斜视性或屈光参差性弱视,随机分为两组(遮盖组及阿托品组)进行弱视治疗,在治疗过程中,进行弱视知识的教育,并做好跟踪记录,随访6个月、2年.结果 两组资料特征(年龄、性别、弱视类型、治疗前矫正视力、治疗前立体视)在统计学上无显著性差异(P＞0.05);前6个月,340例患儿视力有不同程度的提高,遮盖组明显好于阿托品组,2年后阿托品组平均提高3.4行,平均视力20/32+1 (Snellen视力表),＞ 20/32或提高＞3行为84.6％;遮盖组平均提高3.5行,平均视力20/32+3(Snellen视力表),＞20/32或提高＞3行为86.6％.P＞0.05,两组比较统计学上差异无显著性.其中屈光参差性弱视患儿2年随访时有一种倾向,遮盖组立体视觉好于阿托品组.而斜视性弱视组没有发现双眼视的差异.结论 健眼滴用阿托品及遮盖法均可矫治弱视,治疗6个月时,两种方法治疗中度弱视在视力提高速度和程度遮盖组好于阿托品组,而2年后视力提高的幅度滴用阿托品的方法与遮盖法相似.     

常用远用视力表的临床价值对照研究

目的:分析《标准对数视力表》与《低视力视力表》对远用视力检查的临床意义及临床价值。方法:随机抽取本院验光部验光患者59例(118眼),每位患者分别进行两种视力表的远用视力检查,然后记录裸眼视力以及矫正视力检查结果,再进行配对设计资料检验。结果:裸眼视力检查t=2.9944,矫正视力检查t=3.5564,P<0.05,两种视力表无论是裸眼视力还是矫正视力在统计学上均有显著性差异。结论:两种视力表的视力检查结果有所差异,裸眼视力相差19.953′视角,矫正视力相差15.849′视角,且低视力专用视力表的均值均小于标准对数视力表。     

低视力儿童的眼底病变

根据我国儿童盲与低视力的流行病学调查 ,儿童低视力患病率为 0 0 43 % ,全国有视力残疾儿童 2 0多万[1] 。儿童低视力问题越来越受到眼科界的重视。现将我院诊治的 2 1 7例低视力儿童的眼底病变情况报告如下。临床资料1 观察对象和方法患者来自 1 994～ 1 999年因视力不良在我科检查并诊断为低视力的儿童 2 1 7例。低视力诊断参照世界卫生组织 1 973年制定的低视力与盲的标准 ,即好眼最佳矫正视力优于 0 0 5 ,低于 0 3者为低视力[2 ] 。患者年龄 4～ 1 4岁 ,平均 7 2岁 ,其中男 1 1 3例 ,女1 0 4例。所有病例均用国际标准视力表检查视…     

Psychometric视力表对弱视儿童视力的评估作用

目的评价Psychometric视力表在弱视儿童诊治中的应用价值．拥挤现象对正常视力儿童和弱视儿童的影响是否相同。方法我院门诊5～15岁儿童113人，男65人，女48人，平均年龄（7.42±2．03）岁，用标准对数视力表和包含拥挤现象的Psychometric视力表分别检查左右眼的两种视力，比较正常眼和弱视眼两种视力的差别。结果正常视力儿童和弱视儿童的两种视力差异都有显著性（P〈0．05）。对数视力比P视力高。弱视儿童的两种视力差别比正常儿童大。不同弱视类型之间视力差别不大．不同弱视程度之间两种视力有差别。结论儿童都受拥挤现象的影响，但是弱视儿童的拥挤现象更明显。拥挤现象影响程度与弱视程度有关。与弱视类型关系不大。Psychometric视力表适合弱视患者的视力检查。     

红光闪烁治疗仪联合红色视力表远距离视功能训练对儿童近视性弱视的影响

目的：探讨红光闪烁治疗仪联合红色视力表远距离视功能训练对儿童近视性弱视的影响。

方法：将我院收治的112例近视性弱视患儿分组,对照组予短小遮盖+近距离功能性视力训练,观察组在此基础上予红光闪烁治疗仪联合红色视力表远距离视功能训练。比较两组患儿临床疗效和治疗前后屈光动态变化、BCVA、弱视复发率。

结果：观察组的临床总有效率高于对照组(P<0.05)。治疗后,观察组近视性屈光度与治疗前对比无差异(P>0.05),而对照组随时间延长逐渐升高(P<0.05); 观察组治疗1a后的近视性屈光度、年均屈光度变化值和弱视复发率低于对照组(P<0.05)。两组患儿治疗后BCVA优于治疗前,治疗1a时优于治疗6mo(P<0.05)。

结论：红光闪烁治疗仪联合红色视力表远距离视功能训练治疗儿童近视性弱视可有效降低年平均屈光度变化值,矫正最佳视力,降低弱视复发率。     

联合个体化训练治疗大龄儿童屈光参差性弱视

目的探讨联合个体化训练治疗大龄儿童屈光参差性弱视的临床疗效。方法对45例9～14岁弱视患儿散瞳验光足矫配镜,每日遮盖健眼2～4h,周六和周日各遮6～10h。用DV-100视觉诱发电位分析系统检测患儿最佳的空间频率,以此为标准,制取相应的自律空间频率刺激和三级功能训练光盘进行训练,每眼10min/d。当矫正视力低于0.6时,用自律空间频率刺激光盘训练以提高视力。当矫正视力提到0.6时,用三级功能训练光盘训练以提高并巩固视力,直至视力提高到1.0。结果随访1年,视力提高到0.9及以上者33例,视力提高2行或2行以上者7例,无效5例。结论通过联合个体化训练既可增进视力,巩固疗效,又可促使双眼视功能的建立。     

儿童弱视治疗中遮盖疗法的合理应用

目的探讨遮盖疗法治疗儿童弱视的适应证。设计前瞻性队列研究。研究对象从儿童视光专家门诊中选择年龄在3-10岁,双眼最佳矫正视力相差大于一行（国际标准视力表）的90例弱视儿童（147眼）。方法将弱视儿童分为4组：具有3级视功能的56例（112眼）,均为屈光不正性弱视,通过简单随机方法分为A、B两组,每组各28例;无同视功能的34例（35眼）,其中屈光参差性弱视27例（27眼）,屈光不正性弱视7例（8眼）,通过简单随机方法分为c、D两组,每组各17例。A组、c组采用常规弱视治疗加遮盖疗法;B组、D组采用常规弱视治疗,不予遮盖。分别于治疗后2、4、6个月随访观察最佳矫正视力恢复情况。主要指标弱视眼治疗前后的最佳矫正视力（国际标准视力表）。结果治疗后4组儿童的最佳矫正视力均有提高。具有3级视功能的A、B两组间比较,治疗后2,4、6个月差异均无统计学意义（P均〉0．05）;无同视功能的C、D两组间比较,给予遮盖疗法的C组各时间段最佳矫正视力较不予遮盖疗法的D组提高明显（P均〈0．01）。结论对于具有3级视功能的弱视儿童,治疗时不必采用遮盖疗法,而无同视功能的弱视儿童,则需要对优势眼采用适当的遮盖疗法。     

Improvement of visual acuity in children with anisometropic amblyopia treated with rotated prisms combined with near activity

AIM: To evaluate the efficacy of a new modality for improving visual acuity (VA) in pediatric patients with anisometropic amblyopia.METHODS: Retrospective and interventional case series. Medical records of 360 children with anisometropic amblyopia treated with a modality that included rotated prisms, lenses, and near activities from January 2008 to January 2012 were analyzed. Characteristics such as improvement of VA and contrast sensitivity in amblyopic eyes and resolution of amblyopia (VA≤0.1logMAR or a difference of ≤2 lines in logMAR between the eyes) were assessed.RESULTS: Among the patients, the mean VA of the amblyopic eyes improved from 0.48logMAR (SD=0.16) to 0.12logMAR (SD=0.16) and the mean VA improvement was 0.36logMAR (SD=0.10, P<0.001). Resolution of amblyopia was achieved in 233 of 360 patients (64.72%). The mean time for resolution of amblyopia was 8.05 weeks (SD=4.83) or 14.14 sessions (SD=8.76). Among the study group, refraction error did not change significantly after treatment (P=0.437). We found that better baseline VA may be related to success and shorten the time to amblyopic resolution.CONCLUSION: VA and contrast sensitivity improved with rotated prisms, correcting lenses, and near activities in children with anisometropic amblyopia. The VA improvement by this modality was comparable to other methods. However, the time to resolution of amblyopia was shorter with this method than with other modalities. Rotated prisms combined with near acuity could provide an alternative treatment in children with anisometropic amblyopia who can’t tolerant traditional therapy method like patching.     

Does compliance with amblyopia management improve following supervised occlusion treatment?

PURPOSE: To demonstrate improvement in compliance following supervised occlusion therapy for amblyopia in children who had failed to respond to outpatient treatment. METHODS: Retrospective review of the visual outcome of 30 children who were admitted to an ophthalmology ward for 1-day intensive supervised occlusion. These children had documented poor compliance and previously failed to respond to the outpatient occlusion treatment. During their stay a trained ophthalmology nurse educated parents regarding amblyopia and the benefits of occlusion therapy. Visual acuity (VA) of the amblyopic and fellow eyes was recorded on admission, discharge, and at each subsequent visit. The compliance was recorded from parent's history and also indirectly by noticing improvement in vision. RESULTS: The mean supervised occlusion was 7.4 hours (range 4-12 hours). The compliance with occlusion therapy improved in 23 children (77%) after discharge. The mean duration of occlusion after discharge improved to 4 hours (range 1-12 hours). The mean follow-up was 18 months (range 4-24 months). Though there was no dramatic improvement in VA at discharge there was a statistically significant improvement in VA between admission and last recorded VA (p<0.0001). Of the 23 children who were compliant with occlusion following discharge, 21 (91%) gained at least one line of acuity in their amblyopic eye on the last assessment of their VA and five of them achieved 6/12. Of the seven children who did not comply with occlusion following discharge, only one patient gained one line improvement in his amblyopic eye. CONCLUSIONS: This study shows that supervised occlusion treatment and parental education was effective in children who had initially failed traditional outpatient treatment.     

左旋多巴对屈光参差性弱视患儿视力的影响

目的：观察息宁（左旋多巴／卡比多巴）对难治性屈光参差性弱视患儿视力的影响，探讨左旋多巴用药时间和治疗机理。方法：给３２例（５￣１５岁）经传统疗法治疗至少６个月无效的屈光参差性弱视患儿口服息宁１ｍｇ／０．２５ｍｇ／ｋｇ，一日三次，连续６０天。观察服药前及服药后第３、６、９、３０、６０天单字Ｅ视力的变化。结果：弱视眼和优势眼的单字视力服药后第３天提高，差异有极显著性（Ｐ〈０．０１），继续服药无进一步改     

Anisometropic amblyopia treated with spectacle correction alone: possible factors predicting success and time to start patching

PURPOSE: To evaluate factors predicting resolution of amblyopia and the time course of improvement in VA in children 3 to 7 years old with anisometropic amblyopia treated with spectacles alone. DESIGN: Prospective, noncomparative intervention. METHODS: Measurement of corrected amblyopic logMAR visual acuity (VA) in newly diagnosed children at four-weekly intervals until VA stabilized or amblyopia resolved. The time course of improvement in VA and the factors related to amblyopia resolution were assessed. RESULTS: Sixty children with a mean age of 5.3 years and mean anisometropia of 2.95 diopters (D) were included. Amblyopia improved by 2 or more logMAR lines in 56 patients (93%) and resolved in 27 patients (45%), with a mean improvement in VA of 0.38 logMAR. The improvement in VA in the amblyopic eye was considerable at four to 12 weeks then reached a plateau, after which it improved only slowly. Resolution of amblyopia was related to better initial VA (0.2 to 0.6 logMAR) and lesser amounts of anisometropia (<4 D). The time to resolution ranged from four to 40 weeks, but no patient with residual amblyopia showed an improvement in VA of more than 0.1 logMAR over four consecutive visits. CONCLUSIONS: With spectacle correction alone, 3- to 7-year-old children with previously untreated anisometropic amblyopia achieved approximately four-line improvement and resolved nearly in half. The nearly two-month plateau periods during improvement of VA should be noticed. After four months with no improvement in VA, occlusion therapy or atropine penalization may be considered.     

Visual acuity tests using chart, line, and single optotype in healthy and amblyopic children.

PURPOSE: The purpose of this study was to evaluate the difference between full chart, single line, and single optotypes visual acuity (VA) test results in healthy and amblyopic children. METHODS: Thirty-five children with amblyopia (20 with strabismus and 15 with anisometropia) and 40 ophthalmologically normal age-matched children were examined. The mean age of the patients in the study and control groups did not differ significantly (P= .9). A commercial projector that projected tumbling-E randomly placed optotypes was used. The VA of the amblyopic eye of the patients in the study group and the right eye of the patients in the control group was examined first using a full chart of optotypes, then using a single line of optotypes, and finally with individual symbols. The procedure was repeated with the other eye. RESULTS: LogMAR VA improved when the full chart was substituted with a single line, and improved by a similar increment further with single optotypes, in both the study and control groups. VA improved significantly more in eyes with amblyopia than in control subjects. Results were not influenced by age. CONCLUSION: VA testing using a single line gives better, sometimes misleading results, than tests with a full chart because it reduces but does not eliminate the crowding effect. When using a device that can employ more than 1 mode, the exacttest mode should be specified and maintained throughout the follow-up.     

弱视儿童瞬态图形视觉诱发电位视力与国际标准视力的比较

目的研究弱视儿童瞬态图形视觉诱发电位（pattern visual evoked potential．PVEP）视力与国际标准视力表视力之间的相关性．探讨用视觉诱发电位技术检测弱视儿童客观视力的可行性及临床实用性。方法检测32例（64眼）3-11岁的弱视患儿的瞬态图形视觉诱发电位视力（PVEP视力）及国际标准视力表视力并进行相关分析。PVEP检测使用美国LKC公司生产的UTAS—E3000电生理诊断系统。使用5个不同空间频率的水平条栅作为刺激,时间频率为2Hz,将能够观察到典型PVEP波形的最高空间频率作为患儿的PVEP视力。结果瞬态图形视觉诱发电位视力与国际标准视力表视力之间有良好的相关性（r=0．712,P〈0．05）;弱视程度不同．瞬态图形视觉诱发电位视力的分布亦有显著差异：国际标准视力表视力与瞬态图形视觉诱发电位视力存在一定数值对应规律。重度弱视组,PVEP视力100％在0．85cpd（最低空间频率）;中度弱视组,PVEP视力分布相对较分散,集中分布在3．40cpd和6．80cpd,无1眼达13．60cpd;轻度弱视组．PVEP视力集中分布在3．40cpd和6．80cpd两个空间频率．其中达6．80cpd者占71．2％;视力≥0．9组．全部PVEP视力≥6．80cpd。四组PVEP视力呈相对集中分布。随国际标准视力提高．PVEP视力也相应提高。结论在无法使用国际标准视力表检查弱视儿童视力时,可以运用瞬态图形视觉诱发电位技术进行客观视力评估．尤其是低龄弱视儿童。     

视力低常儿童的屈光状态与弱视分析

目的 分析矫正视力正常眼和弱视眼的屈光状态差异,评价不同屈光状态对儿童视力的影响.方法 回顾分析540名(1080只眼)裸眼视力低常儿童的屈光状态.结果 矫正视力正常眼和弱视眼的屈光不正均以复性远视散光为主,弱视眼中的散光眼构成比和程度均高于正常眼,弱视眼的远视程度明显高于正常眼(P<0.01).结论 复性远视散光、中...