眼底门诊中非弱视儿童低常视力的病因分析

目的通过眼底检查和视觉电生理检查，研究眼底内科门诊中学龄儿童非弱视性视力低于正常的病因。方法对2006年7月～2006年10月期间．单眼或双眼矫正视力低于4．9．排除弱视的86例（156眼）儿童病例进行前瞻性病因分析，其中男55例，女31例，平均年龄（11±3．1）岁。全部病例均接受了眼前节和眼底检查，48例行视网膜电图（ERG）检查。30例行视觉诱发电位（VEP）检查。结果86例中，视力异常病因按解剖部位分类依次为：视网膜脉络膜疾病40例（46．51％），视神经病变23例（26．74％），青光眼5例（5．81％），原因不明的低常视力有18例（20．93％）。以上病例通过眼底检查确诊26例（30．23％），结合眼底检查和电生理检查确诊29例（33．72％）。本组病例中有16例（18．60％）曾被诊断为弱视。结论非弱视性儿童矫正视力低于正常的病例中．以脉络膜视网膜疾病和视神经疾病为主．原因不明的低常视力仍有一定比例．常规眼底检查必要时需结合视觉电生理检查对于正确的诊断非常重要。

Etiological analysis of nonamblyoptic subnormal vision in retinal center

Objective To assess the aetiology of children with nonamblyoptic subnormal visual acuity using fundus examination and electrophysiologic testing. Methods Eighty-six children with nonamblyoptic subnormal corrected visual acuity were enrolled. Fiftyfive children were male and 31 were female. The mean age of the children was （11±3.1）years old. All children were given routine examination for their anterior segments and fundus. In addition, 48 children underwent electroretinography （ERG） record and 30 children underwent visually evoked potential （VEP） record. Results Of the 86 cases, chorioido-retinal disorders （n=40,46.51%）, optic neuropathy （n=23,26.74%）, glaucoma （n=5,5.81%）, unexplained subnormal visual acuity （n=18,20.93%）. Twenty-six cases （30.23%） were definitely diagnosed only through fundus examination. Combined with electrophysiologic testing another 29 cases （33.72%） were made final diagnosis. Sixteen cases （18.60%） were given a new diagnosis. Conclusion This short research indicated congenital/hereditary chorioido-retinal and optic nerve diseases accounted for the main part of children among nonamblyoptic subnormal visual acuity. Therefore, careful fundus examination combined with visual electrophysiology testing, is important for establishing the correct clinical diagnosis if necessary.