单眼弱视患者空间视觉缺损特点及其机制

发布时间：2018-11-24 14:39

【摘要】：目的:评价单眼弱视者的空间视觉缺损及其与弱视程度的相关性,并基于M-P视觉通道理论分析单眼弱视空间视觉缺损的机制。方法:采用ETDRS数字视力表和OptecR6500视功能检测仪检测111例7~34岁单眼弱视者弱视眼和非弱视眼的视锐度和对比敏感度函数,通过视锐度和对比敏感度函数衍生计算对比敏感度函数曲线下面积(AULCSF)、峰值对比敏感度(S max)、S max所对应的空间频率(Fr max)以及截止空间频率(CutSF),分析单眼弱视者的空间视觉缺损特点及其与弱视程度的相关性。结果:单眼弱视者的弱视程度与双眼对比敏感度AULCSF差值呈负相关(r=-0.83,P0.01),弱视眼视锐度与AULCSF、CutSF、S max、Fr max呈负相关(r值分别为-0.68、-0.80、-0.73和-0.56,P0.01)。不同程度弱视患者视锐度、AULCSF、S max、Fr max及CutSF间差异均有统计学意义(P0.01)。不同程度弱视者非弱视眼视锐度、AULCSF、S max、Fr max及CutSF差异均无统计学意义(P0.05)。轻度弱视者的弱视眼与非弱视眼AULCSF和Fr max差异也无统计学意义(P0.05),S max和CutSF差异有统计学意义(P0.05);而中重度弱视者弱视眼与非弱视眼AULCSF、S max、Fr max及CutSF差异均有统计学意义(P0.01)。不同程度弱视者弱视眼在各空间频率下对比敏感度差异均有统计学意义(P0.01),而非弱视眼间差异无统计学意义(P0.05)。结论:视锐度与AULCSF、CutSF、S max、Fr max在弱视者空间视觉评价时呈现趋势一致性。随着弱视程度的加重,弱视眼的整体空间视觉功能逐渐下降,视觉系统的高频端分辨率逐渐减弱和最佳对比度识别能力降低,最适空间频率向低空间频率偏移。在轻度弱视者中,M细胞通道无明显异常,P细胞各亚型的敏感性下降;而中高度弱视者中,M和P细胞通道均受到不同程度的损伤,且以P细胞通道受损为主。
[Abstract]:Objective: to evaluate the spatial visual defect of monocular amblyopia and its correlation with amblyopia, and to analyze the mechanism of monocular amblyopia based on M-P visual channel theory. Methods: the visual acuity and contrast sensitivity function of amblyopia and non-amblyopic eyes were measured by ETDRS digital visual acuity meter and OptecR6500 visual function tester. The spatial frequency (Fr max) and cutoff frequency (CutSF), corresponding to the peak contrast sensitivity (S max), S max of area (AULCSF), under the contrast sensitivity function curve are calculated by derivation of acuity and contrast sensitivity function. To analyze the characteristics of spatial visual defect in monocular amblyopia and its correlation with amblyopia. Results: the degree of amblyopia in monocular amblyopia was negatively correlated with the contrast sensitivity (AULCSF) (r = -0.83, P0.01), and the acuity of amblyopia was negatively correlated with AULCSF,CutSF,S max,Fr max (r = -0.68) -0.80, respectively. -0.73 and -0.56p 0.01). There were significant differences in acuity, AULCSF,S max,Fr max and CutSF in amblyopic patients with different degrees of amblyopia (P0.01). There was no significant difference in acuity, AULCSF,S max,Fr max and CutSF in non-amblyopic eyes with different degrees of amblyopia (P0.05). There was no significant difference in AULCSF and Fr max between amblyopia and non-amblyopia in mild amblyopia (P0.05), S max and CutSF (P0.05). The AULCSF,S max,Fr max and CutSF of amblyopia and non amblyopia in moderate and severe amblyopia were significantly different (P0.01). The contrast sensitivity of amblyopia eyes with different degrees of amblyopia had statistical significance at each spatial frequency (P0.01), but there was no significant difference between non-amblyopic eyes (P0.05). Conclusion: acuity and AULCSF,CutSF,S max,Fr max are consistent in spatial visual evaluation of amblyopia. With the aggravation of amblyopia, the overall spatial visual function of amblyopia drops gradually, the high frequency end resolution of the visual system weakens and the recognition ability of the best contrast decreases, and the optimum spatial frequency shifts to the low spatial frequency. In the patients with mild amblyopia, the M cell channel was not abnormal, but the sensitivity of P cell subtypes was decreased, while in the middle and high degree amblyopia group, M and P cell channels were damaged to varying degrees, and P cell channel was mainly damaged.
【作者单位】：湖州师范学院附属第一医院眼科;浙江大学附属第二医院眼科中心;浙江工业大学信息智能与决策优化研究所;
【基金】：浙江省科技计划项目(2009C33133) 浙江省医药卫生科技计划(2012KYA102) 浙江省重点实验室基金(2011E10006) 浙江省眼科创新团队基金(2009R50039)
【分类号】：R777.44

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