Factors influencing stereoacuity outcomes in adults with acquired strabismus

PURPOSE: Functional improvements of binocular vision after strabismus surgery in adults are common but not well understood. In a prospective study, factors associated with stereoacuity outcome in patients with strabismus acquired following binocular vision maturation were investigated. DESIGN: Prospective data collection. METHODS: Twenty-three patients aged 14 to 85 years with acquired strabismus were enrolled. Random dot stereoacuity was quantified using a battery of tests including the Randot Preschool Stereoacuity test, the Randot (version 2) shapes test, and the Randot Butterfly test. RESULTS: Ninety-six percent of patients achieved measurable stereoacuity following successful eye realignment. Better median stereoacuity is achieved in patients with the following characteristics: < or =12 months of constant strabismus (60 vs 400 seconds of arc with >12 months' strabismus, P < .001); a presurgical capacity for fine to moderate stereopsis (60 vs 400 seconds of arc with coarse or no measurable stereopsis, P < .005); a presurgical capacity for macular fusion (60 vs 400 seconds of arc with no measurable macular fusion capacity, P < .001); and postsurgical orthotropia (100 seconds of arc) or intermittent orthotropia (100 seconds of arc vs 2000 seconds of arc with 5 to 8 prism diopters (PD) of postsurgical residual strabismus, P < .05). CONCLUSION: Surgical correction of acquired strabismus is associated with recovery of stereopsis. Factors associated with stereoacuity outcomes include duration of strabismus and presurgical binocular vision capacity. A postsurgical correction of orthotropia or intermittent orthotropia supports better stereoacuity than a larger residual angle of strabismus subtending up to 8 PD of deviation.     

A-V综合征术后立体视的变化

目的观察A．V综合征患者斜视术后立体视的变化。方法前瞻性系列病例研究。4-8岁A．V综合征患者83例,矫正视力在0．6-1．0之间,双眼视力平衡。其中V征48例（外斜V征35例,内斜V征13例）,平均年龄（5．3±0．8）岁;A征35例（外斜A征26例,内斜A征9例）,平均年龄（5．5±1．1）岁。术后随访时间12-18周。采用同视机和Titmus立体视图本分别判断是否存在远、近立体视觉。数据采用×：检验进行分析。结果72例患者获得完全眼正位。V征组患者术前及术后存在远立体视者分别为5例（10％）和13例（27％）,差异有统计学意义（X^2=4．376,P=0．036）;存在近立体视者分别为8例（17％）和17例（35％）,差异有统计学意义（X^2=4．381,P=0．036）。A征组患者术前及术后存在远立体视者分别为4例（11％）和8例（23％）,差异无统计学意义;存在近立体视者术前和术后分别为5例（14％）和11例（31％）,差异无统计学意义。A征组与V征组患者术前和术后立体视变化比较差异无统计学意义。结论A-V型斜视破坏立体视明显,手术矫正眼位有助于双眼单视的恢复。     

Preoperative Factors Affecting Stereopsis after Surgical Alignment of Acquired Partially Accommodative Esotropia

Abstract

Background/Aim: Despite successful ocular realignment, many strabismus patients never develop high levels of stereopsis. The purpose of this study was to determine preoperative factors that affect postoperative stereopsis in patients with acquired partially accommodative esotropia (APAET).

Methods: This was a retrospective chart review of patients who underwent successful surgery for APAET. We compared preoperative factors between patients achieving postoperative stereopsis of 100 seconds of arc or better versus those with worse than 100 seconds of arc.

Results: Fifty-seven patients met our inclusion criteria. Twenty-four (42%) had a final stereopsis of 100 seconds of arc or better. The mean age of onset of esodeviation for patients attaining stereopsis of 100 seconds of arc or better was 31.8?±?12.9 months, versus 23.9?±?10.0 months (p?=?0.012) for patients with worse than 100 seconds of arc. Duration of constant misalignment was not significantly different between the two groups (30.1?±?18.5 for patients attaining 100 seconds of arc versus 27.3?±?18.6 months; p?=?0.57). A multivariate regression analysis found older age of onset to be the only predictive factor for achieving better postoperative stereopsis (odds ratio 1.065, 95% CI: 1.014–1.118).

Conclusion: Age of onset appears to be the most important factor affecting postoperative stereopsis in patients with APAET. Patients with an age of onset after 36 months tended to have better outcomes regardless of the duration of misalignment. Duration of misalignment and age at surgery did not have a significant impact on postoperative stereopsis in our patient population.     

随机点立体图与图形立体图检测立体视的一致性分析

目的:研究随机点立体图与图形立体图检测立体视锐度的一致性,评估偏差仅限于周边立体视或无立体视范围,还是包括黄斑中心凹立体视的整个立体视谱。方法:对4~25岁双眼视正常组76例及共同性斜视组89例,采用TNO及Randot立体图于40cm处检查近距离立体视,比较两种方法测得的立体视锐度的一致性。结果:双眼视正常组两种方法测得的立体视锐度分布无统计学差异;斜视组两种方法检测的立体视锐度分布有显著统计学差异(χ2=19.27,P<0.01),且差异存在于整个立体视谱。结论:随机点及图形立体图检查结果的不一致反应了两类方法的机制不同,图形立体图检查混杂了单眼信息导致的假阳性结果,随机点立体图检查无立体视可能并非大脑皮质立体视觉真正丧失。     

Gains beyond cosmesis: Recovery of fusion and stereopsis in adults with longstanding strabismus following successful surgical realignment

We evaluated recovery of binocularity in 15 chronically strabismic, non-fusing (with neutralizing prisms) adults following successful surgical alignment. We included ≥12-year-olds, with best corrected visual acuity (BCVA) ≥20/60, and excluded those with: anisoacuity >2 lines-Snellen; failed realignment judged by >10 prism diopters (PD) horizontal and >4 PD vertical. Six-week outcomes were: fusion by Worth Four-Dots (WFDT) and Bagolini striated glasses (BSG) and stereopsis by Titmus test and the Netherlands organisation for applied scientific research (TNO) test. Baseline data in medians (range): age 18 (12-40) years, strabismus 45 (19-95) PD, duration 14 (0.5-24) years, 12 females; 12 exotropes, three esotropes; visual acuity was 20/20 in 10, while none had BCVA <20/60. Postoperative strabismus measured 6 PD (range:0-10). By six weeks none suppressed: WFDT findings showed eight fused at distance and 13 at near; and on BSG figures were 10 and 13 respectively. Stereopsis was demonstrated by 13 on Titmus and by 10 on TNO tests. It is concluded that longstanding strabismic adults with good vision can recover fusion and stereopsis following successful squint surgery.     

Comparative analysis of the Lang Stereopad in a non-clinic population

ABSTRACT

Aim: New methods of measurement require testing to evaluate test validity. This study compares stereoacuity results of the Lang Stereopad to other common clinical stereoacuity assessments in a normal vision population.

Methods: A prospective cross-sectional study was conducted comparing the Lang Stereopad stereoacuity results to results from the Lang II, Frisby, and TNO stereo tests. Mean stereoacuity values and their correlation with inter-ocular visual acuity difference were compared for each stereo test.

Results: 98 subjects (mean age of 33.5 years, SD 14.1; 39 males and 59 females) with normal parameters of visual function underwent multiple stereotest assessments. Median stereoacuity values were the lowest (i.e. more detailed stereoacuity) when using the Frisby stereotest (median 40”; 20–170” [minimum-maximum]) and TNO stereotest (median 60”; 15–480”). In comparison, medians were about double at 100” (50–800”) for the Lang Stereopad and greater at 200” (200–200”) for the Lang II stereotest. There was no correlation for each stereotest with interocular visual acuity differences.

Conclusions: The Lang Stereopad test is easy to administer and it has certain advantages such as no requirement for additional test glasses. It is a useful assessment to add to the clinical armamentarium for binocular assessment of stereopsis. The Lang Stereopad does not agree well with other stereo tests such as the TNO and Frisby but provides a greater stereoacuity test range than the Lang II. The Lang Stereopad now requires testing in a clinical population in which stereoacuity is a pre-requisite part of the assessment.     

Development of Manifest Strabismus and Reduced Visual Acuity Following Initial Normal Orthoptic Examination/Pseudo-strabismus Under the Age of 30 Months

Aim: To evaluate the incidence of manifest strabismus and the visual acuity found at 5-year vision screening in those who were referred with concerns of strabismus under the age of 30 months and were initially diagnosed by an orthoptist with either pseudo-strabismus or “no abnormality detected” (NAD).

Method: Data were collected for children who were seen between April 2007 and March 2008 and diagnosed as above. Notes were retrieved and the database of visual acuity at screening was examined.

Results: 248 children were diagnosed as NAD or pseudo-squint on their first visit. 82 were discharged at their first appointment and 166 were offered follow-up. Notes were retrieved for 208 (84%). Of those followed up, 4 (1.9%) were later found to have a heterotropia (2 esotropes, 2 exotropes). Vision screening results were available for 207 (83.5%). Of these, 172 (83%) passed and 35 (17%) failed vision screening. 2 were found to have microtropia and 1 was esotropic. There was no statistically significant difference in the rate of referral from visual screening between the general population and those who were seen and discharged on their first visit (x^2?=?1.76, p?=?0.67 risk ratio?=?0.98 [95% CI 0.89 to 1.08]).

Conclusion: The incidence of undiagnosed esotropia in this group is between 2.4% and 3.4%. The risk of failing visual screening is the same as the general population.     

Effect of Bilateral Age-Related Cataract on Stereoacuity

Abstract

Aim of the study: The objective of this study is to determine the effect of bilateral age-related cataract on stereoacuity. The outcome of cataract surgery is usually measured against the gold standard of visual acuity but stereoacuity necessary for fine motor tasks is often ignored.

Methodology: Stereoacuity threshold was measured in 142 participants with bilateral age-related cataracts using Frisby stereo test prior to any cataract surgery and 6 weeks after cataract surgery in the second eye with bilateral monofocal PMMA PC-IOL implantation.

Outcome: Significant improvement in postoperative stereoacuity was found after extraction of bilateral age-related cataracts and PMMA PC-IOL implantation (p?<?0.0001). Reduced stereoacuity was associated with increased age. There was no significant correlation of postoperative stereoacuity with duration of symptoms (p?=?0.883).     

Correlation between Depth Perception by Three-Rods Test and Stereoacuity by Distance Randot Stereotest

Background: The examination of depth perception with three-rods test, in addition to visual acuity testing, is required to obtain motor vehicle license to drive taxies and trucks, according to the Road Traffic Act in Japan. The aim of this study was to examine whether the results of the three-rods test would correlate with the results of static stereopsis tests, used in ophthalmic practice.

Methods: This study involved 54 normal subjects, 9 women and 45 men, with ages ranging from 18 to 25 (mean, 20.8) years. All had visual acuity of 0.8 or better with or without glasses or contact lenses correction and had no strabismus at the distant (5?m) or near (0.3?m) fixation. TNO Stereotest and Titmus Stereotest were examined at 40?cm while Distance Randot Stereotest was at 3?m. At three-rods test, a central rod was moved at the speed of 50?mm/sec forward and backward automatically against two laterally located fixed rods, placed inside the illuminated box. An examinee at the distance of 2.5?m observed the rods inside the box from a small viewing window and pushed a button to stop the central rod in alignment with the fixed rods. Erred distance (mm) of the central rod from the fixed rods as a mean of 4 measurements was correlated with stereoacuity in second of arc, measured by three kinds of the stereopsis tests.

Results: The erred distance of three-rods test was positively correlated with static stereoacuity at distance measured with Distance Randot Stereotest (ρ?=?0.418, p?=?0.0023, Spearman rank correlation test) and also with the other stereopsis tests at near fixation. The stereoacuity at near fixation, measured by TNO Stereotest and Titmus Stereotest, was positively correlated with each other (ρ?=?0.431, p?=?0.0017).

Conclusion: Three-rods test, examining depth perception, together with the response by eye-hand coordination, gave consistent results with distant static stereoacuity when measured with Distance Randot Stereotest.     

正常和间歇性外斜视儿童立体视的研究

目的 研究正常和分开过强型间歇性外斜视儿童手术前,后不同距离立体视的变化。方法 对4－12岁正常组儿童844例和患儿组因分开过强型间歇性外斜视行手术治疗的患儿35例,采用TNO立体视检查法和新立体视检查法（new stereo tests,NST)检测近距离立体视,采用自制的中,远距离立体视检查法检查1－5m立体视;比较不同年龄和间歇性外斜视手术前,后不同距离平均立体视锐度的差异。结果 （1）正常组：4－8岁儿童约98％TNO检查近距离立体视锐度≤60“,立体视锐度与年龄的增长呈直线相关性;10－11岁时立体视锐度最小;4－8岁儿童与9－12岁儿童比较,立体视锐度分布差异有非常显著意义（P＜0．01）;约97％儿童NST检查近距离立体视锐度≥40“,各年龄段平均立体视锐度为40“-42“。中,远距离立体视锐度4岁时最大,随年龄的增长逐渐减小,9－10岁时最小;（2）患儿组;TNO和NST检查,手术前,后近距离立体视锐度接近,差异均无显著意义（P＞0．05）;术前中,远距离立体视锐度大于正常组,差异有显著意义（P＜0．05）;术后中距离立体视锐度较术前明显改善并接近政党,远距离立体视锐度有轻微改善。结论 （1）正常组4岁儿童不同距离立体视开始发育,随年龄的增长继续发育,8岁后明显提高,9－11岁完善。（2）分开过强型间歇性外斜视儿童术前近距离立体视良好,中,远距离立体视不良,术后中距离立体视改善明显,间歇性外斜视手术应以中距离立体视的恢复程度作为疗效指标。     

婴幼儿期外斜视术后眼位及双眼视功能的影响因素

目的:研究影响婴幼儿期外斜视术后眼位及双眼视功能的相关因素.方法:选取于我院眼科住院诊治行外斜视矫正术的患儿90例,收集其相关临床资料并术后回访1a,分析其影响术后眼位及双眼视功能的相关因素,包括发病年龄、斜视类型、手术年龄、就诊年龄、手术前远立体视功能、手术前近立体视功能、手术后眼位等.结果:单因素及Logistic回归多因素分析结果提示:斜视类型、远期眼位、术前同视机立体视功能是婴幼儿期外斜视术后眼位及双眼视功能的影响因素(P＜0.05),而性别、发病年龄、手术年龄、术前Timus立体视功能、斜视临床分型不是婴幼儿期外斜视术后眼位及双眼视功能的影响因素(P＞0.05).结论:婴幼儿期行外斜视术的斜视类型、远期眼位、术前同视机立体视功能是影响术后眼位及双眼功能的主要影响因素,为术后恢复的患儿眼位及双眼视功能提供一定的治疗依据.     

To evaluate stereoacuity in patients with acquired esotropia and to determine factors associated with favourable outcomes

Aim:

To evaluate stereoacuity in patients with acquired esotropia and determine the factors associated with favorable outcomes.

Materials and Methods:

A total of 68 subjects aged 6 years and above were included in the study. Thorough clinical evaluation including binocular status examination using the Bagolini-striated glass test, The Netherland Organization (TNO), and Randot stereo test were done. The subjects were divided into two groups 1 and 2, based on the amount of deviation. Statistical analysis of the result was performed.

Result:

The duration of misalignment in the group with deviation less than or equal to 8 prism diopters (PD) was 1.49 ± 0.86 years, whereas in the group with deviation more than or equal to 10 PD was 4.64 ± 2.99 years (P = 0.000). Among the subjects in group 1, 89.5% achieved fusion and 52.6% had stereoacuity on both TNO and Randot, whereas in group 2 40% achieved fusion and 3.3% stereopsis on both TNO and Randot (one case with only coarse stereopsis). A subanalysis within group 1 revealed a statistically significant difference for the duration of misalignment (P = 0.02), but a marginal difference for the amount of deviation (P = 0.3).

Conclusion:

A horizontal deviation up to 8 PD was compatible with stereopsis. Also, the duration of constant misalignment affects the attainment of stereopsis despite successful realignment.     

不同类型斜视手术前后远近立体视的变化

目的：探讨斜视类型对术后远、近立体视恢复的影响。

方法：选取72例不同类型斜视患者,按斜视类型分为四组：组1为非调节性内斜视,组2为间歇性外斜视,组3为恒定性外斜视,组4为外斜V征伴下斜肌亢进。手术前后分别应用同视机检查远立体视。采用颜少明编绘的《立体视觉检查图》检查近立体视锐度。记录并分析术前、术后第7d,1、3、6mo的各项检查数据。

结果：斜视患者72例术后远、近立体视的恢复较术前有明显改善,其差异有统计学意义(P<0.05)。间歇性外斜视组术后远、近立体视的恢复优于非调节性内斜视组、恒定性外斜视组及外斜V征伴下斜肌亢进组,其差异有统计学意义(P<0.05)。非调节性内斜视组、恒定性外斜视组和外斜V征伴下斜肌亢进组术后不同时期远、近立体视的恢复差异无统计学意义(P>0.05)。远立体视(0例)比近立体视(19例,26%)的损害更严重,术后近立体视(51例,71%)的恢复明显优于远立体视(17例,24%),术后1mo远、近立体视恢复效果明显。

结论：不同斜视类型对术后远、近立体视恢复的影响存在差异,间歇性外斜视术后远、近立体视的恢复效果最佳。非调节性内斜视、恒定性外斜视和外斜V征伴下斜肌亢进对术后远、近立体视的恢复影响一致。斜视患者远立体视损害较重,术后近立体视恢复明显优于远立体视。     

Stereopsis after successful surgery for rhegmatogenous retinal detachment

Background

To evaluate stereopsis after successful surgery for unilateral rhegmatogenous retinal detachment (RD), and to investigate the relationship between stereopsis and clinical factors.

Methods

In 75 patients after RD surgery and 28 age-matched normal subjects, stereopsis was measured using the Titmus Stereo Test (TST) and TNO stereotest. Clinical data were collected, including age, gender, circumferential dimension of retinal tears, area and duration of RD, macular status, surgical procedures, postoperative spherical equivalent, and logarithm of the minimum angle of resolution best-corrected visual acuity (logMAR BCVA), low-contrast visual acuity, postoperative lens status (phakia/pseudophakia), and presence of postoperative epiretinal membrane (ERM), to determine the factors related to stereopsis.

Results

Stereopsis in patients after surgery was significantly worse than normal subjects (p?<?0.0001). Stereopsis in TST was significantly correlated with the area of RD (p?<?0.005), difference of postoperative spherical equivalent between two eyes (p?<?0.05), postoperative logMAR BCVA (p?<?0.005), difference of postoperative logMAR BCVA between two eyes (p?<?0.01), and low-contrast visual acuity (p?<?0.05). Stereopsis in TNO stereotest showed significant association with postoperative logMAR BCVA (p?<?0.05). Stereopsis in both stereotests were significantly worse in patients with macula-off RD than macula-on RD (p?<?0.005, p?<?0.01 respectively). No significant relationship was found between stereopsis and other factors. Multiple regression analysis revealed that macular status (on/off) had a significant correlation with both stereopsis in TST and TNO stereotest (p?=?0.028, p?=?0.019 respectively), whereas other clinical parameters were not relevant.

Conclusions

Stereopsis is significantly deteriorated in patients after RD surgery than in normal subjects. Stereopsis was associated with the difference in refraction between two eyes, postoperative visual acuity and contrast sensitivity, and preoperative macular status.     

计算机随机点立体视图和TNO对白内障术后立体视检查的比较

目的:本文旨在通过对比白内障患者术后进行的计算机随机点立体视图和TNO立体视觉检查图的检查结果,评价计算机随机点立体视图的实用性及可行性.方法:选择2011-01/06于我院行双眼白内障超声乳化摘除术,双眼间隔1d,并且联合行折叠式人工晶状体植入术的受试者78例作为研究对象,手术均由同一熟练的超声乳化手术医师完成.患者术后定期随访,于术后3mo由同一医师分别使用计算机随机点立体图和TNO立体视检查图检查立体视觉并比较其结果差异.结果:所有受试者均具有不同程度的立体视,由计算机随机点立体图测得黄斑部位立体视患者14例,黄斑中心凹部位立体视患者26例,眼底周边部位立体视38例;TNO立体视觉检查图分别为11例,24例和43例,黄斑立体视、黄斑中心凹立体视随机点检出率较TNO图高,但是两者差异无统计学意义.使用计算机随机点立体图测得的正常与异常立体视结果为32例、46例,使用TNO立体视检查图测得的正常与异常立体视结果为35例、43例,差异无统计学意义.结论:新型计算机随机点立体视图对白内障术后立体视检查的结果与TNO立体图具有较高的一致性,是一种可靠的测量立体视功能的方法,可以用于白内障患者术后立体视觉功能的检测.     

The relationship between stereopsis and visual acuity after occlusion therapy for amblyopia

PURPOSE: To investigate the relationship between visual acuity (VA) and stereoacuity after occlusion therapy in patients with various types of amblyopia. DESIGN: Retrospective noncomparative case series. PARTICIPANTS: Sixty-one children with amblyopia caused by anisometropia with no strabismus (26 children), small angle (相似文献   

两种方法测定间歇性外斜视远随机点立体视的差异

目的 比较同视机随机点立体视检测和单屏显示计算机随机点立体视检测系统对间歇性外斜视远方随机点立体视测定的异同.方法 对30名正常人和94名间歇性外斜视患者用同视机随机点立体视和单屏显示计算机随机点立体视检测系统(single monitor distance stereopsis test SMDST)检测远方随机点立体视.检查结果记录有或无.将94例间歇性外斜视患者从年龄,近方立体视和远近方斜视度分别进行分组后,对两种不同检测方法的结果给予比较.结果 30例正常人,两种检查方法检出率为100％,94例间歇性外斜视同视机随机点立体视(14/94) 14.89％,SMDST(58/94) 61.7％.两种检查方法检出率的差异明显(P＜0.001),有统计学意义.≤8岁和＞8岁两组的同视机随机点立体视没有差别(P=0.635),SMDST有差异(P=0.005).近方立体视＜200″和≥200″两组的同视机随机点立体视有差异(P=0.038),SMDST有明显差异(P=0.001).近方斜视度＜40△和≥40△两组的同视机随机点立体视有差别(P=0.049),SMDST没有差别(P=0.822).远方斜视度＜40△和≥40△两组的同视机随机点立体视有差别(P=0.001),SMDST没有差别(P=0.083).结论 评价间歇性外斜视远方立体视要考虑检测的方法,SMDST是间歇性外斜视远方立体视检出率较高的方法.间歇性外斜视年龄≤8有远方立体视的可能性要大;有＜200″近方立体视的间歇性外斜视远方立体视存在的可能性大.     

成人共同性斜视术后双眼视觉功能重建的临床研究

目的:探讨成人共同性斜视术后双眼视觉功能的重建。方法:观察21例成人共同性斜视患者,用同视机测定三级视功能,用《颜少明立体视检查图》检查近立体视锐度、交叉视锐度及非交叉视锐度,分析比较患者术前,术后3d;6wk;6mo双眼视觉功能的变化。结果:术前16例患者存在单眼抑制,术后6wk有6例患者消除单眼抑制,双眼视觉功能得到重建,差别具有统计学意义(P<0.05);术前具有同视机双眼视觉功能者5例,术后6wk增加至11例,其中7例得到改善,改善率36.8%,差别具有统计学意义(P<0.05);术前存在近立体视者3例,术后6wk增加至7例,其中4例得到改善,改善率22.2%,差别具有显著统计学意义(P<0.01);术前存在正常交叉视锐度者3例,术后6wk增加至7例,其中4例得到改善,改善率22.2%,差别具有显著统计学意义(P<0.01);术前存在正常非交叉视锐度者4例,术后6wk增加至7例,其中3例得到改善,改善率17.6%,差别具有显著统计学意义(P<0.01)。结论:成人共同性斜视术后双眼视觉功能得到不同程度的改善,主要体现在同时视和融合功能,但立体视难以重建,尤其是远立体视;对错过双眼视觉发育敏感期的成人共同性斜视手术,也不应忽视重建患者的双眼视觉功能。     

共同性斜视立体视觉的临床检测与分析

目的:研究不同检查方法检测斜视患者立体视锐度的一致性,以及不同类犁斜视立体视损害的差异.方法:对4-25岁双眼视正常组76例及共同性斜视组89例(间歇性外斜39例,恒定性外斜22例,非调节性内斜28例),采用TNO及Randot立体图于40 cm处检查近距离立体视,采用Optec3500视觉检查仪检查远距离立体视,比较3种方法测定的立体视锐度的一致性及不同类型斜视的立体视差异.结果:随机点立体图(TNO)的立体视锐度高于非随机点立体图(Randot与Optec3500)的立体视锐度(P＜0.01);恒定性外斜及内斜TNO近立体视丧失达90%以上,3种方法检查的立体视分布无显著性差异;间歇性外斜的远、近立体视均存在,但其分布有显著性差异(P＜0.05),远立体视的中心凹立体视比例明显降低.结论:立体视损害与斜视偏斜性质无关;随机点及图形立体图对斜视者的检查结果在中心凹立体视一致性好,在黄斑及周边立体视差异较大,故不能仅凭一种检查方法来判断斜视者是否存在立体视.     

儿童先天性上斜肌麻痹术后双眼视功能的变化

目的:通过对儿童先天性上斜肌麻痹手术前后双眼视功能的观察,探讨其术后成功重建双眼视觉的影响因素。方法:对30例34眼接受手术治疗的儿童先天性上斜肌麻痹患者进行回顾性分析,所有患者手术前后均用同视机检查双眼视功能,Titmus(立体视检查图)检查近立体视觉。结果:手术后同时知觉、融合功能、远立体视、近立体视较术前均有明显改善,有统计学差异(P<0.05);比较不同视力手术后立体视的变化情况,发现好视力组术后立体视恢复较差视力组好,两者比较有统计学差异(P<0.05);不同斜视度数术后立体视改善情况不同,大度数组术后立体视恢复较小度数组差,两者比较有统计学差异(P<0.05)。比较有无代偿头位,发现有代偿头位组术后立体视好于无代偿头位组,两者有统计学差异(P<0.05)。结论:儿童先天性上斜肌麻痹术后双眼视功能明显改善,视力、斜视度、代偿头位对术后双眼视觉重建均有影响。