近视性屈光参差对双眼协动参数的影响

发布时间：2018-04-20 18:25

本文选题：屈光参差 + 双眼视　；参考：《天津医科大学》2010年硕士论文

【摘要】： 研究目的：通过测量近视性屈光参差患者日常戴镜状态下的各项双眼协动参数,了解其视功能状况,探讨屈光参差对双眼视觉的影响。研究对象： 1、近视性屈光参差组：随机选取自2008年8月至2009年6月间于天津市眼科医院就诊的近视性屈光参差患者以及天津医科大学在校学生共49人。纳入标准：(1)屈光参差为双眼球镜差值≥1.50D和/或柱镜差值≥1.00D且柱镜少于1/2球镜度数。(2)均为近视性屈光参差者。(3)日常所戴眼镜单眼矫正视力≥0.8,且戴镜时间超过半年。(4)无眼部器质性病变。(5)经遮盖法检查无显斜视。(6)无老视等生理性调节功能减退。 2、对照组：选取同期就诊的非屈光参差者44人作为对照组。纳入标准：(1)正视、近视及近视散光患者(双眼球镜差值1.50D和/或柱镜差值1.00D,且柱镜少于1/2球镜度数)。(2)无斜视、弱视及其他眼部器质性病变。(3)无老视等生理性调节功能减退。研究方法：分别对两组研究对象进行视网膜检影(他觉验光),使用综合验光仪进行主觉验光,测量其矫正视力。使用顶焦度计测量所戴眼镜后顶点焦度,检查镜片光学中心水平距离,确认患者戴镜的矫正视力。以所戴眼镜度数和光学中心水平距离为基础,测量患者远(5m)、近距离(40cm)的分离性水平隐斜视,计算AC/A比率；测量远、近距离水平聚散力,集合近点,测量调节功能,包括调节幅度、调节滞后、相对调节及调节灵敏度。根据所得数据绘制双眼视分析图表,并利用Sheard准则分析双眼视状况。结果： 1、屈光参差组与对照组分离性水平隐斜视的比较两组研究对象远、近距离分离性水平隐斜视均以外隐斜居多,屈光参差组的分离性水平隐斜程度大于对照组,差异有统计学意义(P0.05)。 2、屈光参差组与对照组的AC/A比率比较两组AC/A比率均接近正常值,差异无统计学意义(P0.05)。 3、屈光参差组与对照组水平聚散力的比较(1)远距离水平聚散力的比较屈光参差组远距离水平聚散力的BI破裂点、恢复点值和BO模糊点、破裂点、恢复点值均小于对照组,差异均无统计学意义(P0.05)。 (2)近距离水平聚散力的比较屈光参差组近距离水平聚散力的BI和BO模糊点、破裂点、恢复点值均小于对照组,除BO恢复点值(P0.05)以外,其他差异均无统计学意义(P0.05)。 4、屈光参差组与对照组调节功能的比较 (1)屈光参差组双眼调节幅度差大于对照组双眼调节幅度差,调节灵敏度小于对照组,两组相比差异均有统计学意义(P0.05)。 (2)屈光参差组与对照组相对调节值、调节滞后量接近,差异均无统计学意义(P0.05)。 5、屈光参差组集合近点与对照组的比较屈光参差组集合近点较远,两组相比差异无统计学意义(P0.05)。结论： 1、屈光参差影响水平眼位,特别是近距离分离性水平眼位呈现较大程度的外隐斜。 2、屈光参差者远、近距离水平聚散力均减小,融合储备的下降对维持正常双眼视造成影响。患者远距离可以拥有正常双眼单视功能,但注视近距离时,部分患者可能存在单眼视状态。 3、屈光参差者双眼的调节幅度差别大,可能是由于矫正过程中高度屈光不正眼的低矫正,以及矫正视力差别造成。 4、屈光参差者双眼的调节灵敏度小,直接提示融合功能受到影响。 5、屈光参差者长期坚持戴镜,可以使AC/A比率、集合近点和调节滞后恢复到正常范围,提示正确、及时地矫正对于维持正常双眼单视功能的必要性。 6、Sheard准则对于评价双眼视功能有重要作用,屈光参差者的准则符合率低。
[Abstract]:Objective : To investigate the effect of anisometropic anisometropic anisometropic anisometropic anisometropic anisometropic anisometropic amblyopia on binocular vision in patients with myopia .

Study Object :

1 . myopic anisometropic group : randomly selected from August 2008 to June 2009 in Tianjin Eye Hospital and 49 people in Tianjin Medical University .

2 . The control group : 44 non - anisometropic patients who visited the same period as the control group were selected as the control group . The criteria were as follows : ( 1 ) emmetropic , myopia and myopic astigmatism patients ( the difference of binocular spherical mirror is 1.50D and / or the difference of the column mirror is 1.00D , and the column lens is less than 1 / 2 sphere degrees ) . ( 2 ) There is no visual , amblyopia and other ocular organic lesions . ( 3 ) There is no aging and other physiological regulation functions .

Study method :

retinoscopy was performed on two groups of subjects , and the corrected visual acuity was measured by using a comprehensive optometry instrument . The focal length of the lens was measured by using the top power meter , the horizontal distance of the optical center of the lens was examined , and the corrected visual acuity of the lens was confirmed .
Measure the distance , near - distance horizontal gathering force , set near - point , measure and adjust function , including adjusting amplitude , adjusting lag , relative regulation and adjusting sensitivity . Draw binocular vision analysis chart according to the obtained data , and analyze binocular vision condition by using Smyth criterion .

Results :

1 . Compared with the control group , the difference was statistically significant ( P0.05 ) .

2 . The AC / A ratio of the anisodine group and the control group was close to the normal value , and the difference was not statistically significant ( P0.05 ) .

3 . Comparison of astigmatism between anisometropic group and control group ( 1 ) Compared with the control group ( 1 ) , the comparison between the two groups

The BI rupture point , the recovery point value and the BO fuzzy point , the fracture point and the recovery point value of the long - distance horizontal dispersion force of the anisometropic group were smaller than those of the control group , and the difference was not statistically significant ( P0.05 ) .

( 2 ) Comparison of near - distance horizontal forces

There was no statistical difference between the BI and BO fuzzy points , the rupture points and the recovery point values of the near - level scatter force of the anisometropic group , except for the BO recovery point value ( P0.05 ) .

4 . Comparison of adjustment function between anisometropic group and control group

( 1 ) The difference of binocular accommodation amplitude in anisometropic group was larger than that of control group , and the sensitivity was lower than that of control group , and the difference was statistically significant ( P0.05 ) .

( 2 ) There was no statistical significance ( P0.05 ) .

5 . Comparison of near - point and control group in anisometropic group

There was no significant difference between the two groups ( P0.05 ) .

Conclusion :

1 . anisometropic anisotroscopy affects the horizontal eye level , especially the near - close separation horizontal eye position presents a large degree of external oblique .

2 . The level of astigmatism decreased and the decrease of fusion reserve had an effect on maintaining normal binocular vision . The patient had normal binocular single - view function , but at close distance , some patients might have single - eye vision .

3 . The difference of the adjustment range between the refractive index and the refractive error is large , which may be caused by the low correction of the high refractive error in the correction process and the difference of corrected visual acuity .

4 . The adjustment sensitivity of the binocular is small , which directly suggests that the fusion function is affected .

5 . Long - term persistent wearing of the lens by refractive index can restore the AC / A ratio , the set near - point and the regulation lag to the normal range , and prompt the correct and timely correction of the necessity of maintaining the single - view function of the normal binocular .

6 . The criterion of Smyth is important for evaluating binocular visual function , and the criterion of refractive index is low .

【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2010
【分类号】：R777.44

【参考文献】