视知觉学习联合调节灵敏度训练治疗屈光参差性弱视患者的临床疗效

目的　探讨视知觉学习联合调节灵敏度训练治疗屈光参差性弱视患者的临床疗效。方法　收集２０１３年至２０１５年在我院就诊的屈光参差性弱视患者８６例（８６眼），随机分为对照组（４２眼）与观察组（４４眼）。对照组进行视知觉学习训练，观察组进行视知觉学习联合调节灵敏度训练，比较两组患者治疗３个月后的最佳矫正视力，对比敏感度，正、负相对调节以及调节灵敏度、Ｔｉｔｍｕｓ立体视的变化。结果　对照组弱视眼经过３个月的训练后，最佳矫正视力提高２行及２行以上的患者为２４眼。观察组则为３６眼，两组比较差异有统计学意义（χ２＝５．６０２，Ｐ＜０．０１）。训练后两组患者对比敏感度均有所提高。观察组对比敏感度的升高以低、中空间频率升高表现突出，两组比较差异有统计学意义（均为Ｐ＜０．０５），高频区对比敏感度升高不明显（Ｐ＞０．０５）。与对照组相比训练后观察组患者正、负相对调节以及调节灵敏度均有所改善，差异均有统计学意义（均为Ｐ＜０．０５）。观察组训练３个月后，拥有＞８０″～２００″黄斑立体视１２眼，＞４００″～８００″周边立体视１８眼，与对照组相比差异均有统计学意义（均为Ｐ＜０．０１）。恢复≤６０″正常立体视６眼，对照组为４眼，两组比较差异无统计学意义（Ｐ＞０．０５）。结论　视知觉学习联合调节灵敏度训练在提高屈光参差性弱视患者的视力、对比敏感度、调节力以及立体视方面具有显著的疗效。

Visual perceptual learning combined with accommodative facility training for anisometropic amblyopia

Objective To evaluate the clinical effects of visual perceptual learning combined with accommodative facility training on anisometropia amblyopia. Methods Eighty-six patients (86 eyes) were recruited in our hospital from 2013 t0 2015. They were randomly divided into control group ( 42 eyes) who performed visual perceptual learning and trial group ( 44 eyes) who performed visual perceptual learning combined with accommodative facility training. The best corrected visual acuity, contrast sensitivity , Titmus stereopsis , positive and negative relative accommodation and accommodative facility after training 3 months between two groups were compared. Results In control group and trial group , the best corrected visual acuity increased 2 lines or above in 24 eyes and 36 eyes , respectively, there was statistical difference (X2 = 5. 602 , P <0. 05). The contrast sensitivity in two groups after training 3 months were all increased. In trail group ,the contrast sensitivity were increased mainly in low and moderate spatial frequency, there were statistical differences between two groups ( all P < 0. 05 ) , but there was no statistical difference in high spatial frequency (P > 0. 05 ) . Compared with the control group , there were statistical differences in positive and negative relative accommodation , accommodative facility between two groups ( all P < 0. 05 ) . After training 3 months in the trail group ,Titmus stereopsis more than 80" - 200" were in 12 eyes ,more than 400" - 800" were in 18 eyes,there were sigruficant differences compared with the control group ( all P < 0. 01 ) . Titmus stereopsis returned to normal were 6 eyes and 4 eyes in the trail group and control group , respectively there was no statistical difference (P > 0. 05 ) . Conclusion Visual perceptual learning combined with accommodative facility trairung on arusometropia amblyopia has obvious treatment effects on vision.contrast sensitivity , stereopsis and accommodative facility improvement.