逆规散光对弱视治疗效果的影响

目的 :探讨顺规散光和逆规散光是否影响屈光参差性弱视的治疗效果。方法 :对 6 2例屈光参差引起的单眼弱视患者进行分析。按照散光类型将患者分为 7组 ,分别是 :单纯 /复性远视顺规散光组 (Ⅰ )、单纯 /复性远视逆规散光组 (Ⅱ )、单纯 /复性近视顺规散光组 (Ⅲ )、单纯 /复性近视逆规散光组 (Ⅳ )、混合性顺规散光组 (Ⅴ )、混合性逆规散光组 (Ⅵ )、斜轴散光组 (Ⅶ ) ,比较各组弱视治疗的所需时间及治疗前后的视力情况。结果 :远视顺规散光 (Ⅰ )与远视逆规散光 (Ⅱ )比较 ,后者需要弱视治疗时间较长 ,获得的矫正视力较低 ,差异均有较显著性 (t分别为 5 .3和 14 .5 ,P <0 .0 1)。近视顺规散光 (Ⅲ )与近视逆规散光 (Ⅳ )比较 ,同样也是顺规散光组弱视治疗时间较长 ,获得的矫正视力较低 ,差异也有显著性 (t分别为 10 .4 6和 10 ,P <0 .0 1)。结论 :逆规散光是弱视治疗效果的重要影响因素 ,弱视治疗对于存在近视或远视性逆规散光的病例作用甚微 ,且在视力发展时期 ,近视力损害可能比远视力损害更具有导致弱视的危害性。

Influence of against-the-rule astigmatism on the outcome of treatment for amblyopia

Objective : To evaluate whether with-the-rule (WTR) or against-the-rule(ATR) ast igmatism influences the treatment outcome of anisometropic amblyopia. Methods: 62 patients with unilateral anisometropic amblyopia without strabismus were reviewed retrospectively. Patients with simple,compound,mixed,and obliqu e myopia,and hyperopic astigmatism were divided into seven groups according to the type of astigmatism. The duration of occlusion and best corrected visual acu ity(BCVA) were compared before and after treatment. Results: There was a statistically significant longer duration of occlusion and fewer lines gained for BCVA among patients with hyperopic ATR astigmatism compar ed to those patients with hyperopic WTR astigmatism(t=5.3 and t=14.5,respectively,P<0.01). Results were the sam e for myopic ATR patients compared to myopic WTR patients(t=10.4 6 and t=10,respectively,P<0.01). Conclusion:ATR astigmatism is an important factor influencing the outcome of tr eatment for amblyopia. Current treatment for amblyopia treatment seems to have l ittle effective on patients with either hyperopic or myopic ATR astigmatism. Dur ing visual development,near vision impairment may pose a greater risk for the d evelopment of amblyopia than distance vision impairment.