遮盖疗法联合综合训练治疗屈光参差性弱视儿童的疗效及对视觉敏感度的影响

Study on efficacy and visual sensitivity of long - term masking therapy for children with ametropic amblyopia

摘要:

目的：探究遮盖疗法联合综合训练治疗屈光参差性弱视儿童的疗效及对视觉敏感度的影响。

方法：选取2013-01/2015-01入我院就诊的屈光参差性弱视儿童85例85眼，所有患儿入院后均予以传统遮盖疗法联合综合训练，统计分析临床疗效及视觉敏感度变化，并分析治疗前后视力、AULCSF、S_max和Fr_max变化。

结果：传统遮盖疗法配合综合训练后，患儿视力明显较治疗前改善(1.12±0.29 vs 0.45±0.25)，差异均有统计学意义(P<0.01)； 且AULCSF、S_max和Fr_max指标均升高，差异均有统计学意义(P<0.05)； 同一空间频率敏感度比较，治疗后明显较治疗前高，差异均有统计学意义(P<0.05)，且随空间频率的增加对比敏感度逐渐降低。不同屈光程度治疗后总有效率差异有统计学意义(P=0.001)。轻度组和中度组临床总有效率比较差异无统计学意义(χ²=3.091，P=0.079)； 轻度组和重度组总有效率比较差异有统计学意义(χ²=11.471，P=0.001)； 中度组和重度组临床总有效率比较差异无统计学意义(χ²=3.359，P=0.067)。此外，就配戴眼镜年龄而言，6岁及以下开始配戴总有效率明显高于6岁以后(95% vs 77%)，差异有统计学意义(P<0.05)。

结论：屈光参差性弱视儿童采用非弱视眼每天4h遮盖疗法，并佩戴矫正镜，结合综合训练，可取得确切疗效，尤其是对于7岁以下儿童。

Abstract:

AIM: To investigate the efficacy and visual sensitivity of occlusion therapy combined training for children with ametropic amblyopia.

METHODS: Totally 85 children(85 eyes)with anisometropic amblyopia treated in our hospital from January 2013 to January 2015 were selected. All patients were given occlusion therapy combined training. Statistical analysis of clinical efficacy and visual sensitivity changes were taken, and the changes of visual acuity, AULCSF, S_max, Fr_max were analyzed.

RESULTS: The visual acuity after therapy was significantly better than that before treatment(1.12±0.29 vs 0.45±0.25, P<0.01); AULCSF, S_max and Fr_max all increased, the difference between the two groups was statistically significant(P<0.05). The sensitivity of the same spatial frequency was significantly higher than that before treatment, the difference was statistically significant(P<0.05), and the contrast sensitivity decreased gradually with the increase of spatial frequency. There were statistical differences in the total effective rate of different refractive degrees after treatment(P=0.001). Mild group and moderate group had no significant difference on the total clinical efficiency difference(χ²=3.091, P=0.079); between mild group and severe group total effective rate was significantly different(χ²=11.471, P=0.001); the moderate and severe groups total clinical efficiency were no significantly different(χ²=3.359, P=0.067). In addition, the total efficiency rate of wearing glasses under the age of 6 was significantly higher than that after 6 years old(95% vs 77%), statistical difference between the two groups was significant(P<0.05).

CONCLUSION: Masking therapy combined with comprehensive training, in the treatment of children with ametropic amblyopia, and wearing a corrective spectacles, is desirable, especially for children under 7 years of age.