视感知觉训练系统在屈光参差性弱视治疗中的临床效果
Clinical efficacy of visual perception training system in the treatment of anisometropic amblyopia
马根方 1颜世传 1赵光辉 1王坤1
作者信息
- 1. 苏州大学理想眼科医斜视与小儿眼科,苏州 215000
- 折叠
摘要
目的 观察应用视感知觉训练系统治疗屈光参差性弱视的临床效果.方法 回顾性病例对照研究.纳入 2022 年 1 月至 2023 年 9 月就诊于苏州大学理想眼科医院的屈光参差性弱视患者 58 例(58 眼),年龄为 3～6 岁.根据治疗方法分为观察组 30 例(30 眼)和对照组 28 例(28 眼).所有患者首诊时均使用 1%阿托品凝胶散瞳验光并佩戴框架眼镜.对照组:给予遮盖优势眼联合精细训练;观察组:在对照组治疗基础上给予计算机虚拟现实的视感知觉训练.随访 1 年,观察所有患者最佳矫正视力(BCVA,logMAR)及三级视功能并进行统计学分析.结果 治疗前对照组BCVA为0.52±0.13,观察组BCVA为 0.56±0.18,两组间差异无统计学意义(t=-0.78,P=0.428).随访 1 年时,对照组BCVA为 0.23±0.07,观察组 BCVA为 0.18±0.05,均显著高于治疗前(t对照=9.20,P<0.001;t观察=12.27,P<0.001),观察组BCVA明显优于对照组(t=3.29,P=0.002).治疗后 6 个月时对照组患者同时视、融合功能及立体视重建率分别为 67.8%(19/28)、50.0%(14/28)、42.8%(12/28),观察组患者分别为80.0%(24/30)、76.7%(23/30)、70.0%(21/30);治疗后12 个月时,对照组患者同时视、融合功能及立体视重建率分别为 78.5%(22/28)、53.5%(15/28)、50.0%(14/28),观察组患者分别为 90.0%(27/30)、86.7%(26/30)、86.7%(26/30);两组患者三级视功能较治疗前均明显改善.治疗后 6 个月及 12 个月组间比较:观察组与治疗组患者在同时视改善上差异无统计学意义(均P>0.05),但观察组在融合功能及立体视改善方面显著优于对照组,差异有统计学意义(均P<0.05).结论 应用视感知觉训练系统治疗低龄屈光参差性弱视患者可以明显提高的视力、显著提高其双眼视功能,效果远高于单纯遮盖联合精细训练.
Abstract
Objective To observe the application efficacy of visual perception training system in the treatment of anisometropic amblyopia.Methods This was a retrospective case-control study.A total of 58 children(58 eyes)with anisometropic amblyopia who were admitted to the Lixiang Eye Hospital of Soochow University from Jan.2022 to Sep.2023 were included,and the age was 3-6 years.They were divided into an observation group with 30 cases(30 eyes)and a control group with 28 cases(28 eyes)based on therapeutic methods.All patients were given 1%atropine gel for mydriasis optometry and wore frame glasses at the first visit.The control group underwent fine training with the dominant eye covered-up.The observation group underwent computerised VR training for visual perception in addition to the treatment as the control group.All patients were followed up for 1 year.The best corrected visual acuity(BCVA,logMAR)and triple visual function of the two groups were collected and conducted,and statistical analysis was conducted.Results Before treatment,BCVA of the control group was 0.52±0.13,and BCVA of the observation group was 0.56±0.18.There was no significant difference between the two groups(t=-0.78,P=0.428).At 1 year after treatment,BCVA of the control group was 0.23±0.07,while BCVA of the observation group was 0.18±0.05,both of which were significantly higher than that before treatment(tcontrol=9.20,P<0.001,tobservation=12.27,P<0.001).BCVA of the observation group was significantly higher than that of the control group(t=3.29,P=0.002).At 6 months after treatment,the reconstruction rates of simultaneous vision,fusion and stereopsis in the control group were 67.8%(19/28),50.0%(14/28),and 42.8%(12/28),respectively.The reconstruction rates of simultaneous vision,fusion and stereopsis in the observation group were 80.0%(24/30),76.7%(23/30),and 70.0%(21/30),respectively.At 12 months after treatment,the reconstruction rates of simultaneous vision,fusion and stereopsis in the conrtol group were 78.5%(22/28),53.5%(15/28),and 50.0%(14/28),respectively.The reconstruction rates of simultaneous vision,fusion and stereopsis in the observation group were 90.0%(27/30),86.7%(26/30),and 86.7%(26/30),respectively.The triple visual function of the control group and the observation group both improved significantly compared to that before treatment.Inter-group comparison at 6 and 12 months after treatment showed that there was no significant difference in simultaneous perception improvement between the two groups(all P>0.05).But the observation group showed significant improvement in fusion function and stereoscopic vision compared with the control group,and the differences were statistically significant(all P<0.05).Conclusion The application of virtual reality visual perception training system can significantly improve the vision of young age patients with anisometropic amblyopia and greatly enhance their binocular visual function,and the effects are better than fine training with simple covering.
关键词
计算机/训练,知觉,视感/弱视,屈光参差/效果,临床Key words
Computer/Training,perception,visual perception/Amblyopia,anisometropia/Effect,clinical引用本文复制引用
出版年
2024
NETL
NSTL
万方数据