Transitory disorders of visual function: diagnostic procedure

Transient disorders of visual function are a phenomenon commonly encountered in neuro-ophthalmological practice. Differential diagnosis is discussed on the basis of the general appearance of these functional changes.     

Assessment of visual function in autistic children.

Children with autism demonstrate "atypical" gaze or social "looking" and frequently manifest such sterotypies as eye pressing, hand flicking, and light gazing. This study's purpose was to evaluate autistic children for visual dysfunction that may be related to the manifested visual signs and symptoms. Thirty-four autistic children, ages 2 to 11 years (median age = 7 years, 6 months) were evaluated for ocular alignment, refractive error, visual acuity, oculomotility skills, and stereopsis. None of the children manifested ocular disease, known seizure disorders, or dysmorphic features. Their developmental levels ranged from average intelligence to severely retarded. Binocular visual acuity was measured with the acuity card procedure. Monocular visual acuity was not obtained. Refractive errors ranged from -4.25 to +3.25 D; the median was plano with the near retinoscopy technique. Of the 34 children, 21% were strabismic at far and 18% were strabismic at near. Lang stereo testing was attempted on all children and completed on 17. Of the 17, all but 3 exhibited 550 sec arc. Only 14.7% of the children exhibited voluntary pursuit movements, and all the children demonstrated saccadic fixations. Thirty-one children had atypical optokinetic nystagmus (OKN) responses such as delayed onset, short duration, gaze avoidance, or stereotypic behavior. Repeated testing revealed consistent visual responses on OKN and visual acuity. Given these findings, research with this population should be pursued further.     

应用闪光视觉诱发电位监护眼眶术中的视觉功能

目的　评价闪光视觉诱发电位 (flashvisualevokedpotential,FVEP)在眼眶手术中视觉功能监护的可行性和可靠性。方法　对 82例临床眼眶手术患者术中行FVEP视觉功能监测 ,以期观察术中视觉功能状况 ,并与术后视觉功能进行分析比较。结果　 82例中 ,监护成功 6 9例 ;术中监护与术后视觉功能一致 6 7例 ,一致率 97% ;假阳性 1例 ;假阴性 1例。结论　FVEP应用于眼眶手术中的视觉功能监护 ,能及时发现视神经损伤和手术操作不当 ,可降低手术致盲率。     

Visual function and visual perception in cerebral palsied children

PURPOSE: To investigate visual function and perception in cerebral palsied (CP) children. METHODS: A total of 105 congenitally CP children (aged 6-15 years), without severe mental retardation, were classified into three groups: those with spastic quadriplegia, spastic diplegia and spastic hemiplegia. Data collected included patient history, IQ, refraction, far and near visual acuity, position of the eyes and eye movements, visual fields, colour perception, stereoacuity, slit lamp and fundoscopic examinations, and evaluation of visual perception. The results were compared with a control group from the general paediatric population. RESULTS: The IQ of the CP children ranged between 70 and 100. A total of 59% of them had best corrected distance visual acuity <6/6, with 25.5% <6/9. Near visual acuity was also reduced (70.1% scored <6/6 and 38.4% scored <6/9). Incidence of refractive errors was higher than in the control group (hypermetropia in 43.8% of the eyes, myopia 16.19% and astigmatism 40.9%) as was the incidence of strabismus (26.7% esotropic and 27.6% exotropic). In visual field testing, 80.95% of CP children were normal. A total of 94.28% had normal colour perception and 89.52% were free of ocular pathology. Stereopsis was abnormal or absent in 85.71% of the cases. Visual perception was markedly reduced: in 57.14% of the cases it was less than or equal to that of 6-year-old children; in 26.66% equal to that of 6- to 7.5-year-old children, and in 16.2% of the cases greater than or equal to that of 7.5-year-old children. CONCLUSIONS: In the absence of severe mental retardation, CP children have deficient visual skills. It is suggested that the poor visual skills of CP children are a separate, identifiable factor compounding the adverse effects of mental retardation.     

间歇性外斜视儿童术后视觉训练对视功能的重建效果分析

目的:探讨视觉训练用于间歇性外斜视术后患儿对其视功能重建的效果。方法:选取2016-08/2019-01于我院确诊且行眼位矫正手术治疗的间歇性外斜视患儿94例94眼,根据术后是否行视觉训练分两组,术后未予以视觉训练的患儿47例纳入对照组,术后2wk开始予双眼视觉训练的患儿47例纳入观察组。随访6mo,观察两组患儿视功能恢复及眼位回退情况。结果:术后6mo,观察组双眼同时视功能(89%)、融合功能(85%)及立体视功能(40%)恢复患儿所占比例显著高于对照组(53%、47%、19%),且观察组患儿眼位正位率明显高于对照组(91%vs 66%)。结论:儿童间歇性外斜视术后进行双眼视功能训练可促进双眼视功能恢复,同时还可降低术后眼位回退风险。     

The prevalence of visual disorders in a school for emotionally disturbed children

Data on the prevalence of visual disorders in special populations as well as in normal populations is sparse. Fifty-five students in a special education school were given a comprehensive screening for pathology, acuity, refractive error, fusion, oculomotor, and perceptual motor skills. This group had a very high prevalence of visual disorders especially perceptual motor, oculomotor and fusion disorders.     

视知觉训练治疗对弱视儿童视觉表征和双眼视功能的影响

目的：评价视知觉训练治疗对弱视儿童视觉表征和双眼视功能的影响。

方法：选取2014-01/2015-12我院眼科门诊收治的94例94眼弱视儿童为研究对象,并按弱视程度进行分组,采用视知觉训练治疗3mo。比较各组临床疗效及治疗前后的知觉水平眼位和差眼视力,并采用Pearson相关系数分析弱视儿童治疗前后差眼视力差值与知觉眼位差值的关系。

结果：轻度弱视儿童临床总有效率高于中、重度弱视儿童(P<0.05),中度弱视儿童与重度弱视儿童临床总有效率比较无差异(P>0.05)。弱视儿童治疗后知觉水平眼位明显低于治疗前(P<0.05); 轻、中、重度弱视患儿治疗后知觉水平眼位均明显降低(P<0.05),轻、中度弱视儿童知觉水平眼位改善幅度较重度弱视患儿明显(P<0.05)。弱视儿童治疗后差眼视力较治疗前明显提升(P<0.05); 轻、中、重度弱视患儿治疗后差眼视力均明显提高(P<0.05),轻、中度弱视儿童差眼视力改善幅度较重度弱视患儿明显(P<0.05)。弱视儿童治疗前后差眼视力差值与知觉眼位差值呈正相关(r=0.371,P<0.001)。

结论：视知觉训练治疗能有效改善弱视儿童视觉表征、双眼视功能,适用于弱视儿童的临床治疗。     

Improving the function of the visual system in children with aphakia

Systematic reeducation by pleoptic-orthoptic exercises was performed in children with posttraumatic and congenital aphakia for the improvement of the visual acuity, normal retinal fixation and binocular vision. The treatment comprised 244 children aged 1-16 years who were formerly given a correcting contact lens on the aphakic eye. In the result of rehabilitation a visual acuity of over 5/16 was attained in 79.5 per cent of cases, a normal retinal fixation in 73.77 per cent and the binocular vision in 46.31 p.c. Better results were obtained after treatment of a posttraumatic cataract, poorer results after extraction of a congenital cataract.     

双眼视觉训练对间歇性外斜视儿童术后双眼视功能重建的观察

目的：分析双眼视觉训练对间歇性外斜视儿童术后双眼视功能重建效果的影响。

方法：回顾性分析2013-04/2016-04我院收治的间歇性外斜视患儿108例,其中45例术后未予以双眼视觉功能训练作为对照组,63例术后采用TSJ-IV型同视机训练软件进行双眼视觉训练作为观察组。观察两组术后双眼视觉功能重建及眼位回退情况。

结果：术前两组患儿双眼视功能、斜视度数等基线资料差异均无统计学意义(P>0.05)。术后3mo,观察组三级视功能显著较术前改善,且观察组同时视、视觉融合及立体视患儿所占比例均显著高于对照组,差异均有统计学意义(P<0.05); 观察组黄斑立体视及黄斑中心凹立体视患儿所占比例显著高于对照组,且观察组无立体视患儿所占比例明显低于对照组,差异均有统计学意义(P<0.05)。术后3mo,观察组斜视度数≤30^△患儿所占比例显著高于对照组,差异有统计学意义(P<0.05)。术后1a回访,观察组眼位回退率明显较对照组低,差异有统计学意义(P<0.05)。

结论：间歇性外斜视术后配合同视机双眼视觉训练可促进双眼视觉功能重建,改善斜视度数,同时还可避免术后眼位回退情况。     

双眼视觉训练对间歇性外斜视儿童术后双眼视功能重建的疗效观察

目的:观察双眼视觉训练对间歇性外斜视儿童术后双眼视功能重建的疗效。方法:将2010-01/2011-10收治的112例间歇性外斜视患儿,术后分为3组,第1组采用同视机进行双眼视觉训练,第2组采用视知觉学习训练软件进行双眼视觉训练,第3组为对照组,未进行双眼视觉训练。对三组患儿术后视远、视近立体视锐度及术后1a眼位正位率进行观察比较。结果:两组视觉训练患儿视远、视近立体视锐度显著高于对照组,差异有显著性。在术后1a随访时,对照组眼位正位率显著低于其他两组。结论:间歇性外斜视患儿术后进行双眼视觉训练,可显著促进患儿双眼视功能的重建,降低眼位回退率,提高手术成功率。     

Detection of abnormal visual cortex in children with amblyopia by voxel-based morphometry

PURPOSE: To detect the abnormalities of gray matter in children with amblyopia by voxel-based morphometry (VBM). DESIGN: Prospective, nonrandomized clinical trial. METHODS: Thirteen children with amblyopia and 14 normally sighted children underwent magnetic resonance (MR) examination. The two groups were age-matched with a mean age of 5.8 years. In the amblyopia group, five children had strabismus amblyopia, and eight had anisometropic amblyopia. We analyzed the original 3-dimensional T1 brain images using the VBM module within the widely used analysis software package SPM2 (Welcome Department of Cognitive Neurology, London, United Kingdom). After normalization, segmentation, and smoothing of the images, comparison between amblyopic and control groups was derived for the gray matter of the entire brain using parametric statistics. RESULTS: The results of VBM analysis indicated that the amblyopic group had decreased gray matter density in the middle frontal gyrus, parahippocampal gyrus, fusiform gyrus, inferior temporal gyrus of the left hemisphere, and the bilateral calcarine cortices. The radii of these regions ranged from 12 to 36 voxels. These abnormalities were consistent with morphologic changes in brain regions related to visual function. CONCLUSIONS: Using MR and VBM analysis, we detected morphologic changes in the visual cortex of children with amblyopia, which may indicate developmental abnormalities of visual cortex during the critical growth period.