屈光参差性弱视儿童双眼视觉状态

目的：分析屈光参差性弱视儿童的屈光状态、矫正视力情况及其与双眼视觉功能的关系。方法：横断面研究。收集2015年11月至2016年9月就诊于北京9家医院（分布于8个区县）的屈光参差性弱视儿童患者106例（106眼），年龄（6.2±5.4）岁。根据屈光参差危险因素将所有患者分为远视性屈光参差组（67例）、近视性屈光参差组（5例）、散光性屈光参差组（12例）、远视合并散光性屈光参差组（20例）及近视合并散光性屈光参差组（2例）。对所有患者行裸眼视力（UCVA）、矫正视力（BCVA）、屈光状态、远近立体视等检查。采用Pearson相关性分析双眼屈光参差的差值程度与高度屈光不正眼UCVA、BCVA及双眼视觉间的相关性，并分析双眼矫正视力差值程度与双眼视觉的相关性。采用单因素方差分析比较5组高度屈光不正眼BCVA及远近立体视情况。结果：屈光参差的差值程度与高度屈光不正眼UCVA和BCVA、远立体视、近立体视（即随机点立体视，包括立体视锐度、交叉立体视、非交叉立体视）均呈负相关（均P<0.05）；双眼矫正视力差值与远立体视、近立体视均呈负相关（均P<0.05）。5组间在高度屈光不正眼BCVA、远立体视、近立体视方面总体差异均有统计学意义（F=6.221、5.271、3.622、3.647、3.464，P<0.05），进一步两两比较显示高度屈光不正眼BCVA在近视性屈光参差组最好，然后依次为远视性屈光参差组、散光性屈光参差组、近视合并散光性屈光参差组以及远视合并散光性屈光参差组，组间差异均有统计学意义（均P<0.05）；远立体视在远视性屈光参差组最好，然后依次为近视性屈光参差组、散光性屈光参差组，组间差异均有统计学意义（均P<0.05），但远视合并散光性屈光参差组与近视合并散光性屈光参差组的远立体视差异无统计学意义；近立体视在近视性屈光参差组最好，然后依次为远视性屈光参差组、散光性屈光参差组、远视合并散光性屈光参差组以及近视合并散光性屈光参差组，组间差异均有统计学意义（均P<0.05）。结论：屈光参差性弱视儿童的屈光参差程度与视力、立体视功能相关，且立体视功能和双眼矫正视力差值也有相关性。不同类型屈光参差儿童立体视损害有所差异。

binocular Vision Function in Children with Anisometropic Amblyopia

Objective: To analyze refractive status and visual acuity and its relationship to binocular visual function in children with anisometropic amblyopia. Methods: A total of 106 children (106 eyes) with anisometropic amblyopia were recruited from November 2015 to September 2016 in nine hospitals in Beijing. All children were divided into the following groups based on risk factors for anisometropia: hyperopia anisometropia(67 cases), myopia anisometropia (5 cases), astigmatism anisometropia (12 cases), hyperopia combined astigmatism anisometropia (20 cases) and myopia combined astigmatism anisometropia (2 cases). Visual acuity, uncorrected and best corrected visual acuity, refractive status, and distant/near stereoscopic vision were tested. Pearson's correlation was used to analyze the correlation between dioptric differences and UCVA/BCVA in high refractive errors eye and distant/near stereoscopic vision. The correlation between BCVA difference of the two eyes and distant/near stereoscopic vision were also calculated. One-way ANOVA compared BCVA in high myopic eye and distant/near stereoscopic vision between groups.Results: There was a correlation for the dioptric difference between UCVA and BCVA, distant stereoscopic vision, and random dot stereograms (RDS) stereoscopic vision in high refractive errors (all P<0.05).There was a significant correlation between the difference in BCVA and distant stereoscopic vision and RDS stereoscopic vision (all P<0.05). There was a statistically significant difference between the five groups for BCVA, distant stereoscopic vision and RDS stereoscopic vision (F=6.221, 5.271, 3.622, 3.647,3.464, P<0.05). Visual acuity for high refractive error eye in the myopia anisometropia group was best compared to the other four groups. The differences were statistically significant between each group (all P<0.05). Distant stereoscopic vision in the hyperopia anisometropia group was best compared to the other four groups. The differences were statistically significant between each group, except hyperopia combined astigmatism anisometropia and myopia combined astigmatism anisometropia groups (all P<0.05). RDS stereopsis in the myopia anisometropia group was best compared to the other four groups. The differences were statistically significant between each group (all P<0.05). Conclusions: Visual acuity and stereoscopic vision are correlated to the dioptric difference. Stereoscopic vision is significantly correlated with the difference in BCVA. Stereoscopic damage is different in patients based on the type of anisometropia.