共同性斜视立体视觉临床检测及分析.docVIP

共同性斜视立体视觉临床检测及分析 　 作者：范丽英　张芳　候立杰　徐肃仲 【摘要】 　　目的：研究不同检查方法检测斜视患者立体视锐度的一致性，以及不同类型斜视立体视损害的差异。方法：对4～25岁双眼视正常组76例及共同性斜视组89例（间歇性外斜39例，恒定性外斜22例，非调节性内斜28例），采用TNO 及Randot 立体图于40 cm处检查近距离立体视，采用Optec3500 视觉检查仪检查远距离立体视，比较3种方法测定的立体视锐度的一致性及不同类型斜视的立体视差异。 结果：随机点立体图（TNO）的立体视锐度高于非随机点立体图（Randot 与Optec3500）的立体视锐度（P lt;0.01）；恒定性外斜及内斜TNO 近立体视丧失达90%以上，3种方法检查的立体视分布无显著性差异；间歇性外斜的远、近立体视均存在，但其分布有显著性差异（P lt;0.05），远立体视的中心凹立体视比例明显降低。 结论：立体视损害与斜视偏斜性质无关；随机点及图形立体图对斜视者的检查结果在中心凹立体视一致性好，在黄斑及周边立体视差异较大，故不能仅凭一种检查方法来判断斜视者是否存在立体视。 【关键词】 斜视　立体视锐度　随机点立体图　图形立体图 　　Clinical study on stereoscopic vision of comitant strabismus Abstract AIM: To evaluate the agreement among different stereotests and the effect of comitant strabismus on stereoscopic vision. METHODS: Seventy-six normal subjects and 89 strabismus patients participated in the research (aged 4-25 years). Strabismus patients were divided into three groups: 39 intermittent exotropia, 22 constant exotropia and 28 constant non-accommodative esotropia. In each participant, stereoacuity was measured using the TNO stereoacuity test, the Randot circles and the Optec3500 circles tests. RESULTS: In normal subjects and strabismus patients, better stereoacuity scores were acquired using the circles tests than the random dot-based TNO test (P lt;0.01). Stereoblind in constant strabismus was 90%. There were no significant differences of stereoacuity score between constant exotropia and constant esotropia. There were significant difference of stereoacuity score between distant and near stereoacuity in intermittent exotropia (Plt;0.05). CONCLUSION: Constant exotropia and constant esotropia produced the same effect on stereoscopic vision. Significant differences of stereoacuity scores were found in the moderate and coarse range of stereoacuity between the different tests. Overall, the results of this study indicate reliance on a single test to determine the presence versus absence of stereoscopic vision is generally not supported. · KEYWORDS:strabismus; stereoacuity; c