正常及弱视儿童瞳孔对光反射的动力学特征

发布时间：2018-06-29 03:45

本文选题：弱视 + 瞳孔对光反射　；参考：《昆明医科大学》2012年硕士论文

【摘要】：目的：探讨6-10岁正常及弱视儿童瞳孔对光反射的特征,为视觉敏感期儿童弱视的早期筛查及诊断治疗,以及弱视治疗疗效分析提供相关参考依据。方法：应用中国科学院昆明动物研究所所研制的瞳孔测试仪检测6-10岁60例非弱视儿童,60例屈光参差性弱视儿童和60例屈光不正性弱视儿童的瞳孔对光反射参数。通过对5个参数(暗适应后期既给光刺激时瞳孔像素值ASC,给光后瞳孔面积收缩至最小时的像素值AN；从开始给光到瞳孔收缩面积最小时的像素值的时间TC,瞳孔最大收缩率S；瞳孔收缩平均速度CV)的测量,在非弱视儿童与屈光不正性弱视儿童之间,屈光参差性儿童的弱视眼与非弱视眼之间,屈光参差性弱视以及屈光不正性弱视儿童轻中重度之间,以及部分屈光不正性弱视儿童在经过治疗训练后视力提高前后,屈光参差性弱视儿童非弱视眼与正常非弱视儿童双眼之间,屈光参差性儿童弱视眼与屈光不正性弱视儿童双眼之间,以及在总体180只非弱视眼和180只弱视眼之间的两组数据进行统计学分析。结果： 1.屈光不正性弱视儿童与正常(非弱视)儿童相比较,弱视儿童的瞳孔面积较非弱视儿童大,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率较小,收缩时间延长,差异均具有统计学意义(P0.05)。 2.屈光参差性弱视儿童弱视眼与非弱视眼相比较,弱视眼的瞳孔面积较非弱视儿童大,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率较小,收缩时间延长,差异均具有统计学意义(P0.05)。 3.屈光不正性弱视儿童轻中重度3组的对比,随着弱视程度的加深,瞳孔面积变大,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率变小,收缩时间延长,差异均具有统计学意义(P0.05)。 4.屈光参差性弱视儿童轻中重度3组的对比,随着弱视程度的加深,瞳孔面积变大,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率变小,收缩时间延长,差异均具有统计学意义(P0.05)。 5.屈光不正性弱视儿童治疗训练前后的对比,治疗后矫正视力提高,瞳孔面积变小,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率变大,收缩时间缩短,差异均具有统计学意义(P0.05)。 6.屈光参差性弱视儿童非弱视眼与正常非弱视儿童双眼的对比,瞳孔面积偏大,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率偏小,收缩时间延长,差异均具有统计学意义(P0.05)。 7.屈光参差性弱视儿童弱视眼与屈光不正性弱视儿童双眼的对比,瞳孔面积偏小,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率偏大,收缩时间缩短,差异均具有统计学意义(P0.05)。 8.180只弱视眼与180只非弱视眼的对比,前者瞳孔面积较大,无论是在暗适应末期还是光刺激后瞳孔缩小到最小值；瞳孔从暗适应末期到收缩到最小值时的平均收缩速度和瞳孔最大收缩率较小,收缩时间延长,差异均具有统计学意义(P0.05)。结论： 1、弱视儿童(眼)与正常非弱视儿童(眼)相比,瞳孔面积较大,瞳孔对光反射的灵敏度及收缩幅度较小,且与弱视程度直接相关,说明了瞳孔测试仪在弱视的临床诊断具有一定的应用价值。 2、弱视儿童(眼)经过训练治疗,矫正视力提高后,瞳孔面积变小,瞳孔对光反射的灵敏度及收缩幅度增加。因此,瞳孔测试仪也可以作为弱视疗效评估的检测手段。
[Abstract]:Purpose :

Objective To investigate the characteristics of pupil ' s reflex in children aged 6 - 10 years and children with amblyopia , and provide relevant reference for the early screening and diagnosis of amblyopia in children with visual acuity and the analysis of amblyopia treatment efficacy .

Method :

The pupil of 60 non - amblyopia children aged 6 - 10 , 60 cases of anisometropic amblyopia and 60 cases of ametropic amblyopia were measured by pupil tester developed by Kunming Institute of Animal Research , Chinese Academy of Sciences .
the maximum pupil shrinkage rate S from the time TC of the pixel value that starts to give the light to the pupil contraction area ;
The measurement of pupil contraction mean velocity ( CV ) was statistically analyzed between the non - amblyopia children and the ametropic amblyopia children , the anisometropic amblyopia and the anisometropic amblyopia children , the anisometropic amblyopia children and the normal non - amblyopia children ' s eyes , the anisometropic amblyopia children ' s amblyopia and the anisotropism amblyopia children ' s eyes , and the two groups of data between the total 180 non - amblyopia and 180 amblyopia eyes .

Results :

1 . Compared with normal ( non - amblyopia ) children in children with ametropic amblyopia , the pupil area of amblyopia children is larger than that of non - amblyopia children , whether at the end of dark adaptation or after light stimulation , the pupil is reduced to the minimum value ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

2 . Compared with the non - amblyopia children , the pupil area of the amblyopia eyes was larger than that of the non - amblyopia children , whether at the end of the dark adaptation or after the light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

3 . Compared with the mild - moderate - severe group , the pupil area became larger as the degree of amblyopia deepened , whether the pupil was reduced to the minimum at the end of dark adaptation or after light stimulation ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

4 . Compared with the mild moderate and severe group , the pupil area became larger as the degree of amblyopia deepened , whether at the end of dark adaptation or after light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

5 . Before and after the treatment of ametropic amblyopia children , the corrected visual acuity improved and the pupil area became smaller , whether at the end of dark adaptation or after light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were significant , and the contraction time was shortened and the difference was statistically significant ( P0.05 ) .

6 . Compared with the normal non - amblyopia children ' s eyes , the pupil area of anisometropic amblyopia children was larger than that of normal non - amblyopia children .
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were small , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

7 . Compared with the children with amblyopia of anisometropic amblyopia and ametropic amblyopia , the pupil area is small , whether at the end of dark adaptation or after light stimulation , the pupil is reduced to the minimum value ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were significant , the contraction time was shortened , and the difference was statistically significant ( P0.05 ) .

8.180 eyes were compared with 180 non - amblyopia eyes , the pupil area of the former was larger , whether at the end of dark adaptation or after light stimulation , the pupil was reduced to the minimum ;
The average systolic velocity and the maximum pupil contraction rate of the pupil from the end of darkness to the minimum were smaller , the contraction time was prolonged , and the difference was statistically significant ( P0.05 ) .

Conclusion :

1 . Compared with the normal non - amblyopia children ( eyes ) , the pupil area is larger , the sensitivity of the pupil to light reflection and the contraction amplitude are small , and it is directly related to the degree of amblyopia , which shows that the pupil tester has certain application value in the clinical diagnosis of amblyopia .

2 . The pupil area becomes smaller and the pupil ' s sensitivity and contraction amplitude of the pupil are increased . Therefore , the pupil tester can also be used as the detection means for the evaluation of amblyopia curative effect .
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R777.44

【参考文献】