方法：前瞻性研究。选取2018-02/2020-09本院收治的屈光参差弱视儿童患者158例，采用随机数字表法将弱视儿童分为两组：阿托品压抑疗法组优势眼治疗给予1%阿托品凝胶，临睡前滴一滴至结膜囊内，每周治疗2次者78例； 遮盖疗法组弱视儿童每日遮盖优势眼大于2h 治疗者80例。比较两组弱视儿童治疗6mo后立体视功能、对比敏感度、行图形视觉诱发电位检测，评估治疗效果及依从性。

结果：阿托品压抑疗法组和遮盖疗法组总体依从性比较有差异(96.2% vs 73.8%，P<0.05)，有效率比较无差异(79.5% vs 73.8%，P>0.05)，立体视功能重建有效率比较有差异(74.4% vs 56.3%，P<0.05)。两组治疗6mo后在1、4、8、10、12c/d频率下对比敏感度较治疗前明显升高(均P<0.001)，阿托品压抑疗法组在8、10、12c/d频率下对比敏感度高于遮盖疗法组(均P<0.05)，P100波幅高于遮盖疗法组，P100潜伏期低于遮盖疗法组(P100波幅：12.96±2.10 vs 11.42±2.53μV ； P100潜伏期：105.26±12.41 vs 111.40±11.74ms，均P<0.05)。

结论：阿托品压抑疗法治疗儿童屈光参差性弱视较遮盖疗法有更高的治疗依从度，对弱视儿童的立体视功能有更好的效果，且有较高的安全性。

METHODS:This prospective study included 158 children with anisometropic amblyopia who were admitted to the hospital between February 2018 and September 2020. Children enrolled were divided into penalization therapy group(78 cases)and occlusion therapy group(80 cases)by random number table method. Dominant eyes of the penalization therapy group were treated with 1% atropine gel for twice a week, while dominant eyes of the occlusion therapy group were covered for 2h or longer every day. Treatment effect, stereoscopic function and contrast sensitivity were measured after 6mo of treatment. The pattern visual evoked potentials were detected, treatment compliance,and treatment effect were evaluated.

RESULTS:The overall compliance rates of the penalization therapy group and the occlusion therapy group were 96.2% and 73.8%(P<0.05). The overall response rates of the two groups were 79.5% and 73.8%(P>0.05). The overall effective rates of stereoscopic visual function reconstruction in the two groups were 74.4% and 56.3%(P<0.05). After treatment, the contrast sensitivities under 1, 4, 8, 10 and 12c/d were significantly increased in the two groups(all P<0.001). Besides, the contrast sensitivities under 8, 10 and 12c/d in the penalization therapy group were higher than those in the occlusion therapy group(all P<0.05). After treatment, P100 amplitude(μV)of the penalization therapy group was higher than that of the occlusion therapy group(12.96±2.10 vs 11.42±2.53μV,P<0.05), while P100 latency(ms)was lower than that of the occlusion therapy group(105.26±12.41 vs 111.40±11.74ms, P<0.05).

CONCLUSION:For patients with amblyopia, atropine penalization therapy can improve treatment compliance and stereoscopic visual function of patients with amblyopia, and have higher safety.