单眼弱视的临床分析

目的　探讨单眼弱视的临床特点。方法　对 96例单眼弱视进行追踪观察 ,对弱视类型、程度、注视性质与疗效的关系进行统计分析 ,并观察其立体视变化。结果　单眼弱视中屈光参差性弱视占 66 67% ,斜视性弱视占 33 33%。斜视合并屈光参差性弱视患者基本治愈率仅 50 % ,单眼弱视中重度弱视较多 ,占 33 33% ,立体视恢复正常者 55 2 1 % ,均为屈光参差性弱视。结论　单眼弱视患者中常见斜视性弱视和屈光参差性弱视两种临床类型 ,其中以斜视伴有屈光参差的弱视治疗效果最差 ,而斜视对患者的立体视损害最严重     

大龄儿童单眼弱视的疗效观察

目的探讨大龄儿童单眼弱视的疗效及其相关影响因素。方法10~15岁大龄儿童单眼弱视患儿67例(67眼),经综合疗法治疗弱视,观察其治疗效果,并对弱视类型、弱视程度、注视性质等相关影响因素进行分析。结果大龄儿童单眼弱视67例(67眼)治愈率(包括基本治愈+治愈率)为58.21%(39/67),进步26.87%(18/67),无效14.92%(10/67),总有效率为85.07%(57/67)。屈光参差性弱视、斜视性弱视和形觉剥夺性弱视的治愈率分别为71.74%、33.33%和0%,不同类型弱视之间的疗效差异有统计学意义(P<0.01)。轻度弱视、中度弱视和重度弱视的治愈率分别为85.71%、57.14%和27.27%,不同程度弱视之间的疗效差异有统计学意义(P<0.01)。结论大龄儿童单眼弱视疗效较好,应予积极治疗,其疗效与弱视类型、弱视程度、注视性质密切相关,屈光参差性弱视、弱视程度轻及中心注视者疗效好。     

学龄儿童单眼弱视的疗效分析

目的:探讨学龄期儿童单眼弱视的治疗效果。方法:我院门诊治疗的6～18岁单眼弱视患者71例,采用综合疗法,观察其治疗效果,并对患者的年龄、弱视类型、弱视程度及注视性质与疗效的相关性进行分析。结果:学龄期儿童单眼弱视71例71眼的治愈率为63%(45/71),进步24%(17/71),无效13%(9/71)。结论:学龄期儿童单眼弱视治疗效果较好,应予积极治疗,疗效与患儿年龄、弱视类型、弱视程度及注视性质关系密切,6～12岁患儿,屈光参差性弱视、轻度弱视、中心注视者疗效好。     

综合疗法治疗儿童弱视100例远期疗效观察

目的:探讨综合疗法治疗不同类型儿童弱视的远期临床疗效。 方法：对100例190眼儿童按弱视类型、弱视程度、注视性质和年龄进行分类,并采用矫正屈光不正、遮盖疗法、家庭精细目力训练及红光治疗、综合治疗仪对其进行治疗,随访观察达5a以上。 结果：屈光不正性弱视治愈率最高,明显高于屈光参差性、斜视性弱视和遮盖性弱视,轻度弱视的治愈率明显高于中度和重度弱视。中心注视高于旁中心注视,弱视治疗的年龄越小,疗效越好,3~6岁组明显高于其他年龄组。 结论：弱视治疗的疗效与弱视类型、弱视程度、注视性质及开始治疗的年龄、家长及患儿的依从性有密切关系,用综合疗法治疗弱视可以提高其治愈率,并缩短疗程。     

大龄儿童及青少年单眼弱视的疗效分析

目的探讨大龄儿童及青少年单眼弱视的疗效及其相关影响因素。方法 9~18岁大龄儿童及青少年单眼弱视患儿126例(126只眼),经综合疗法治疗弱视,观察其治疗效果,并对弱视类型、弱视程度、注视性质、依从性及年龄等相关影响因素进行分析。结果大龄儿童及青少年单眼弱视126例(126只眼)基本治愈率56.35%(71/126),有效率30.95%(39/126),无效12.70%(16/126),治疗总有效率为87.30%(110/126)。其中屈光参差性弱视疗效最好,与斜视性弱视和形觉剥夺性弱视之间的疗效差异有统计学意义(P<0.01)。弱视程度越轻,疗效越好,不同程度弱视之间的疗效差异有统计学意义(P<0.01)。中心注视者疗效高于旁中心注视者,两者间有显著性差异(P<0.01)。结论大龄儿童及青少年单眼弱视疗效较好,应予积极治疗,其疗效与弱视类型、弱视程度、注视性质、依从性等密切相关。     

弱视综合治疗的临床疗效观察

目的探讨弱视的综合治疗并评价其临床效果。方法对286例儿童504眼弱视进行弱视的综合治疗,并对其疗效进行随访达3年以上。结果屈光不正性弱视治愈率最高为91.07%,明显高于屈光参差性、斜视性弱视和形觉剥夺性弱视。轻度弱视的治愈率(94.32%)明显高于中度和重度弱视。弱视治疗的年龄越小,疗效越好,3～5岁组(91.71%)明显高于其他年龄组。中心注视者(89.13%)的疗效明显高于旁中心注视者。结论弱视治疗的疗效与弱视类型、弱视程度、注视性质及开始治疗的年龄有密切关系,用综合疗法治疗弱视可以提高其治愈率。     

综合疗法治疗儿童弱视1045眼疗效分析

本文选用综合疗法治疗儿童弱视共５７０例１０４５眼,总治愈率为７３．１１％。轻度弱视治愈率为８７．０７％,中度弱视治愈率为８１．１４％,重度弱视治愈率为４７．２２％,中心注视治愈率为７８．６５％,旁中心注视为１７．０２％。屈光不正性弱视治愈率为８２．７６％,屈光参差性为４３．０８％,斜视性为４６．１％,形觉剥夺性为２５％。本组治疗效果与弱视的类型、程度、注视性质及年龄均有着密切关系,弱视程度越轻效果越好。中心注视者疗效远高于旁中心者,各类型的弱视中以屈光不正性疗效最佳。并认为综合性治疗法优于其他单一方法     

综合疗法治疗儿童弱视410例分析

目的探讨应用综合治疗法治疗儿童弱视的疗效。方法对410例(750只眼)弱视眼,行配镜遮盖及精细目力训练等。结果年龄越小,弱视程度越轻,坚持治疗时间越长,疗效越好。屈光不正弱视治疗率明显高于屈光参差和斜视性弱视,中心注视性弱视疗效优于旁中心注视性弱视。结论综合疗法的疗效与弱视的类型、程度、年龄、坚持治疗时间和注视性质密切相关,综合治疗法疗效好。     

儿童弱视68例传统治疗疗效分析

目的:探讨应用眼睫状肌麻痹验光配镜,遮盖,精细目力训练,黑白光栅等视觉刺激治疗,斜视手术矫正等传统治疗方法,对儿童弱视治疗的疗效。方法:分析68例108眼弱视儿童,分别按年龄、弱视程度、弱视类型、注视性质分组,经过传统的方法治疗后,视力提高情况。结果:年龄越小治愈率越高:3～5岁组高于6～8岁组和9～12岁组;弱视程度越轻治愈率越高:轻度弱视组高于中度弱视组和重度弱视组;中心注视高于偏中心注视;屈光不正性弱视高于屈光参差性弱视和斜视性弱视。结论:儿童弱视矫治的疗效与患儿的年龄、弱视的程度、弱视类型、注视性质有关。传统治疗对弱视儿童视力的提高,效果切实有效,因其操作简单、方便经济值得基层医院学习推广。     

80例儿童弱视复发原因分析

目的探讨儿童弱视复发的相关因素。方法对80例（143只眼）临床基本治愈的弱视患儿进行3年以上的随访观察,经散瞳验光矫正视力下降至〈0.9者为弱视复发。结果弱视复发率为26.6%,屈光参差性和斜视性弱视复发率明显高于屈光不正性弱视,并显示弱视程度越重,复发率越高,旁中心注视弱视复发率高于中心注视性弱视。结论儿童弱视复发与弱视的类型、程度及注视性质有关。     

屈光参差性弱视与斜视性弱视临床疗效的比较

目的:分析比较屈光参差性与斜视性弱视的治疗效果。方法:前瞻性研究。2018-07/2020-01在我院门诊确诊的并首次接受治疗的单眼弱视患者46例,平均年龄9±3岁,其中男26例,女20例,按照临床诊断分为斜视性弱视组(无屈光不正),共23例,平均年龄9±3岁,其中男12例,女11例。以及屈光参差性弱视组,共23例,平均年龄9±3岁,其中男14例,女9例。对两组患者采用遮盖及精细训练治疗弱视,于治疗前及治疗后采用国际标准视力表检测视力、用Titmus图谱行立体视锐度的检测。比较两组患者经弱视治疗前后最佳矫正视力及立体视恢复的差异。结果:治疗前两组患者弱视眼的最佳矫正视力无差异(t=-0.475,P>0.05),但斜视性弱视患者的立体视功能明显低于屈光参差性弱视患者(t=-3.919,P<0.001);通过2mo的治疗,两组患者最佳矫正视力提高值有明显差异(t=-2.946,P<0.01),而两组患者立体视提高值无差异(t=1.305,P>0.05);通过6mo的治疗,两组患者最佳矫正视力提高差值有明显差异(t=-2.353,P<0.05),两组患者立体视提...     

Increased drift in amblyopic eyes.

Reports are conflicting on the presence of increased drift in amblyopic eyes. Furthermore, the individual effects of either amblyopia or strabismus alone on ocular drift have not been systematically investigated. We therefore used a photoelectric method to record horizontal eye position during monocular and binocular fixation in patients having amblyopia without strabismus, intermittent strabismus, or constant strabismus amblyopia. Our principal finding was increased drift amplitude (up to 3.5 degree) and velocity (up to 3.0 degrees per second) in amblyopic eyes during monocular fixation. While increased drift was found 75% of the time in amblyopia without strabismus and 50% of the time in constant strabismus amblyopia, it was found only 20% of the time in intermittent strabismus. Amblyopic drift could be either error-producing or error-correcting in nature. Increased drift was not present during monocular fixation with the dominant eye or during binocular fixation in any of our 16 patients. We therefore conclude that amblyopia and not strabismus is a necessary condition for the presence of markedly increased fixational drift. Increased drift amplitude but not velocity may adversely affect visual acuity in the amblyopic eye.     

光学药物压抑疗法对儿童单眼弱视的疗效

目的对比分析光学药物压抑疗法与遮盖疗法对儿童斜视性或屈光参差性弱视的疗效。方法前瞻性临床研究。收集2013年1月至2015年3月在我院诊断为斜视性或屈光参差性弱视的儿童患者,根据采用的弱视治疗方法不同分为遮盖疗法组（遮盖组）与光学药物压抑疗法组（压抑组）。根据弱视程度不同又分为轻度、中度、重度弱视进行分析。对随访12个月以上患者的弱视治疗效果进行分析比较。2组弱视程度比较采用Wilcoxon秩和检验,组间的有效率和治愈率比较采用χ²检验。结果共纳入斜视性或屈光参差性弱视患者85例（85眼）,其中遮盖组52例（52眼）,压抑组33例（33眼）。遮盖组治愈率60%,压抑组治愈率64%,2组治愈率差异无统计学意义（χ²=0.137,P=0.711）。遮盖组有效率88%,压抑组有效率85%,2组有效率差异无统计学意义（χ²=0.234,P=0.629）。轻度、中度、重度弱视患者中,遮盖组与压抑组有效率差异均无统计学意义。遮盖组52只弱视眼均转为注视眼,压抑组进行药物压抑治疗3~6个月后,29只弱视眼转为注视眼,4只未转为注视眼,后改为遮盖疗法。结论与传统遮盖疗法相比,光学药物压抑疗法对于儿童斜视性或屈光参差性弱视的治疗效果相近。     

Monocular near-point accommodation and the blood supply to the ciliary body of the amblyopic eye in schoolchildren with concomitant strabismus

Visual acuity, the character of fixation, the angle of deviation, refraction, monocular determination of accommodation and blood supply of the ciliary body have been studied in 50 schoolchildren (100 eyes) with convergent strabismus and amblyopia of various degree. Children with amblyopia of high and moderate degrees have shown a sharp fall or absolute absence of the positive part of relative accommodation and reduced blood supply of the ciliary body. Between the mentioned indices and degree of amblyopia there exists a positive connexion.     

Rapid, high-accuracy detection of strabismus and amblyopia using the pediatric vision scanner

Purpose. The Pediatric Vision Scanner (PVS) detects strabismus by identifying ocular fixation in both eyes simultaneously. This study was undertaken to assess the ability of the PVS to identify patients with amblyopia or strabismus, particularly anisometropic amblyopia with no measurable strabismus. Methods. The PVS test, administered from 40 cm and requiring 2.5 seconds of attention, generated a binocularity score (BIN, 0%-100%). We tested 154 patients and 48 controls between the ages of 2 and 18 years. BIN scores of amblyopic children and controls were measured, and 21 children received sequential PVS measurements to detect any changes in BIN resulting from amblyopia treatment. Results. With the pass/refer threshold set at BIN 60%, sensitivity and specificity were 96% for the detection of amblyopia or strabismus. Assuming a 5% prevalence of amblyopia or strabismus, the inferred positive and negative predictive values of the PVS were 56% and 100%, respectively. Fixation accuracy was significantly reduced in amblyopic eyes. In anisometropic amblyopia patients treated successfully, the BIN improved to 100%. Conclusions. The PVS identified children with amblyopia or strabismus with high sensitivity and specificity, while successful treatment restored normal BIN scores in amblyopic patients without strabismus. The results support the hypothesis that the PVS detects strabismus and amblyopia directly. Future strategies for screening by nonspecialists may thus be based on diagnostic detection of amblyopia and strabismus rather than the estimation of risk factors, allowing for rapid, accurate identification of children with amblyopia early in life when it is most amenable to treatment.     

Amblyopia in myopia in patients with strabismus and without strabismus

PURPOSE: To determine factors, which have influence on presence of strabismus among myopic patients with amblyopia. MATERIAL AND METHODS: Material covers 21 myopic patients with amblyopia, aged 6-15. All children presented have a different amount of anisometropia, 12 of them had strabismus. Authors, compared the group of patients with amblyopia and strabismus (12) with the group of patients with pure anisometropic amblyopia (9), according to the following criteria: age of presentation, best corrected visual acuity, mean refraction error of amblyopic eye, mean amount of anisometropia, percentage of patients with central fixation and binocular vision. RESULTS: Patients with strabismus presented oneself earlier than patients without squint. Best corrected visual acuity was better in patients without strabismus. Refraction error in both groups has similar value. Amount of anisometropia was slightly smaller in the group with squint. Central fixation and binocular vision were better preserved among patients without strabismus. Authors didn't find the following correlations too: correlation between amount of anisometropia and amount of amblyopia in both groups, correlation between amount of anisometropia and the amount of the deviation of squinting eye, correlation between depth of amblyopia and the amount of deviation of the squinting eye. CONCLUSION: It seems, that primary factor leading to presence of strabismus among patients with anisometropic myopia, is motor dysfunction of extraocular muscles.     

Orienting of covert attention by neutral and emotional gaze cues appears to be unaffected by mild to moderate amblyopia

Amblyopia is a developmental disorder of vision associated with higher-order visual attention deficits. We explored whether amblyopia affects the orienting of covert spatial attention by measuring the magnitude of the gaze cueing effect from emotional faces. Gaze and emotion cues are key components of social attention. Participants with normal vision (n = 30), anisometropic (n = 7) or strabismic/mixed (n = 5) amblyopia performed a cued peripheral target detection task under monocular and binocular viewing conditions. The cue consisted of a centrally presented face with left or right gaze (50% validity to target location) and a fearful, happy, or neutral expression. The magnitude of spatial cueing was computed as the reaction time difference between congruent and incongruent trials for each expression. Fearful facial expressions oriented spatial attention significantly more than happy or neutral expressions. The magnitude of the gaze cueing effect in our cohort of mild-to-moderate amblyopia was comparable to that in normal vision and was not correlated with the severity of amblyopia. There were no statistical group or amblyopia subtype differences for reaction time in any viewing condition. These results place constraints on the range of attentional mechanisms affected by amblyopia and possibly suggest normal covert processing of emotional face stimuli in mild and moderate amblyopia.     

儿童弱视715眼治疗效果的临床分析

目的：探讨儿童弱视临床特点和综合治疗效果。

方法：选取2015-07/2017-07我院确诊收治的弱视儿童393例715眼,建立弱视治疗档案,给予弱视综合疗法治疗,观察其治疗效果,并对其年龄、弱视类型、弱视程度、弱视注视性质和治疗依从性等影响疗效的临床特点进行分析。

结果：患儿393例715眼中,基本治愈者520眼(72.7%),进步者117眼(16.4%),无效者 78眼(10.9%),总有效率为89.1%。年龄、弱视类型、弱视程度、注视性质、治疗依从性等临床特点影响弱视治疗效果。

结论：儿童弱视的总体治疗效果较好。与患儿年龄、弱视类型、弱视程度、弱视注视性质和治疗依从性等临床特点关系密切。年龄偏大,弱视类型为屈光参差性弱视、斜视性弱视,弱视程度重、旁中心注视及依从性差的患儿治疗效果差。     

单眼弱视患儿黄斑区微血管结构和血流密度改变及视觉质量分析

目的　观察黄斑区视网膜微血管结构、血流密度、视觉质量及黄斑区视网膜厚度在单眼弱视儿童中的特点,并评价其在单眼弱视儿童中的作用。方法　选取2019年10月至2021年3月于西南医科大学附属医院眼科就诊的单眼弱视患儿81例。使用光学相关断层扫描（OCT）测量黄斑区视网膜厚度;通过光学相干断层扫描血管造影术（OCTA）测量黄斑区视网膜浅层毛细管丛的微血管结构和血流密度;使用双通道视觉质量分析系统（OQASⅡ）对患者视觉质量进行客观评估。结果　在81例单眼弱视儿童中,屈光参差性弱视47例,斜视性弱视34例。弱视眼黄斑区视网膜在外环上、外环下和外环平均值均较对侧眼厚,差异均有统计学意义（均为P<0.05）;在3 mm×3 mm范围黄斑扫描中,弱视眼的血管线性密度（VD）_{1 mm ×1 mm}、VD_{1 mm ×3 mm}、VD_{3 mm ×3 mm}均小于对侧眼（P<0.05）,其中屈光参差性弱视眼的VD_{1 mm ×1 mm}小于斜视性弱视眼（均为P<0.05）,差异均有统计学意义;弱视眼的血流灌注密度（PD）_{1 mm ×1 mm}、PD_{1 mm ×3 mm}、PD_{3 mm ×3 mm}均小于对侧眼（均为P<0.05）,差异均有统计学意义,其中屈光参差性弱视眼的PD_{1 mm ×1 mm}小于斜视性弱视眼,差异均有统计学意义（均为P<0.05）;在6 mm×6 mm范围黄斑扫描中,弱视眼的VD_{1 mm ×1 mm}、VD_{1 mm ×3 mm}均小于对侧眼（均为P<0.05）,差异均有统计学意义,其中屈光参差性弱视眼的VD_{1 mm ×1 mm}小于斜视性弱视眼,差异均有统计学意义（均为P<0.05）;弱视眼的PD_{1 mm ×1 mm}、PD_{1 mm ×3 mm}均小于对侧眼（均为P<0.05）,差异均有统计学意义,其中屈光参差性弱视眼的PD_{1 mm ×1 mm}小于斜视性弱视眼,差异均有统计学意义（均为P<0.05）;弱视眼的截止空间频率(MTF cutoff)、斯特列尔比值(SR)及对比度为100%、20%、9%时的OV值(OV100%、OV20%和 OV9%)低于对侧眼,弱视眼的客观散射指数(OSI)高于对侧眼,其中屈光参差性弱视眼的MTF cutoff、OV100%低于斜视性弱视眼,OSI高于斜视性弱视眼,差异均具有统计学意义（均为P<0.05）。结论　黄斑区OCT和OCTA对评估单眼弱视患儿视网膜的结构和血流变化有一定意义,其中屈光参差性弱视较斜视性弱视变化更大;弱视眼的视觉质量较正常对侧眼降低,屈光参差性弱视较斜视性弱视的视觉质量稍差,OQASⅡ能客观全面获取单眼弱视儿童视网膜成像质量的信息。     

儿童屈光参差性弱视复发原因探讨

目的探讨屈光参差性弱视远期疗效的相关影响因素．．方法随访观察了123例217眼屈光参差性弱视，基本治愈后3a以上的病例，经再次扩瞳验光后证实矫正视力低于0.8以下。结果本组屈光参差性弱视的复发因其类型和程度不同存在着明显的差异，总复发率为25．2％，其中近视性屈光参差性弱视的复发率最高，依次为单眼性屈光参差性弱视，远视性屈光参差性弱视，和双眼性屈光参差性弱视。结论屈光参差性弱视治愈后的巩固是预防复发的根本。对弱视中易复发的病例应进行重点观察，早期发现、了解视力下降的原因，及时治疗是非常重要的。