[1]赵武校,甘露,蓝方方,等.已治愈与未治愈屈光参差性弱视患者双眼间的波前像差特点[J].眼科新进展,2019,39(2):153-157.[doi:10.13389/j.cnki.rao.2019.0035]
　ZHAO Wu-Xiao,GAN Lu,LAN Fang-Fang,et al.Interocular evaluation of wavefront aberration in anisometropic amblyopia：A case-control study[J].Recent Advances in Ophthalmology,2019,39(2):153-157.[doi:10.13389/j.cnki.rao.2019.0035]
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《眼科新进展》[ISSN:1003-5141/CN:41-1105/R]

卷:
39卷
期数:
2019年2期
页码:
153-157
栏目:
应用研究
出版日期:
2019-02-05

文章信息/Info

Title:
Interocular evaluation of wavefront aberration in anisometropic amblyopia：A case-control study
作者:
赵武校; 甘露; 蓝方方; 李志超; 罗妍
530021　广西壮族自治区南宁市，广西壮族自治区人民医院视光科 广西视光中心
Author(s):
ZHAO Wu-Xiao; GAN Lu; LAN Fang-Fang; LI Zhi-Chao; LUO Yan
Center for Optometry and Visual Science，Department of Optometry，People’s Hospital of Guangxi Zhuang Autonomous Region，Nanning 530021，Guangxi Zhuang Autonomous Region，China
关键词:
屈光参差性弱视; 远视性屈光参差; 等效离焦度; 高阶像差; 均方根值
Keywords:
anisometropic amblyopia; hyperopic anisometropia; defocus equivalent; higher order aberrations; root mean square
分类号:
R778.2
DOI:
10.13389/j.cnki.rao.2019.0035
文献标志码:
A
摘要:
目的　探讨已治愈与未治愈屈光参差性弱视患者双眼间的波前像差特点。方法　收集在广西视光中心就诊并自愿参加本研究的屈光参差患者共91例，根据病史和矫正视力将所有患者分成两组：对照组（已治愈的屈光参差性弱视）31例、弱视组（未治愈的屈光参差性弱视）60例。对照组按照等效离焦度的高低，将每例患者双眼的数据分别归入原弱视眼组和原对侧眼组；弱视组按照矫正视力是否正常，将每例患者双眼的数据分别列入弱视眼组和对侧眼组。弱视组患者按年龄分为成年弱视22例、未成年弱视38例。所有患者均接受iDesign?波前像差仪（美国AMO公司）检测，以均方根值（root mean square，RMS）形式表示总像差和各项高阶像差（RMS3~6）。配对t检验用于分析各组内双眼间的参数差异；独立样本t检验比较两组间的参数差异；Spearman相关分析和线性回归分析各亚组内变量间的相互关系。结果　对照组原弱视眼等效离焦度高于原对侧眼，差异有统计学意义（P<0.01）；弱视组弱视眼等效离焦度、总像差RMS均高于对侧眼，差异均有统计学意义（均为P<0.01）；其余参数如总高阶像差、三阶像差、四阶像差、五阶像差、六阶像差RMS，在两组内双眼间的差异均无统计学意义（均为P>0.05）。散瞳状态下成年弱视组、未成年弱视组双眼间等效离焦度、总像差RMS差异均有统计学意义（均为P<0.01），弱视眼均大于对侧眼。波前像差图像显示：对照组和弱视组双眼间总像差均呈非对称性、总高阶像差均呈相似性与对称性。将对照组、弱视组双眼间波前像差各参数差值进行组间比较，独立样本t检验结果提示：△等效离焦度以及△总像差RMS在两组之间的差异均有统计学意义（均为P<0.01），弱视组均大于对照组；其余参数在两组间的差异均无统计学意义（均为P>0.05）。对照组、弱视组内双眼的等效离焦度均与其自身总像差RMS呈正相关；等效离焦度与其他波前像差参数之间无相关性。线性回归分析结果显示：对照组内原弱视眼的等效离焦度与总像差RMS的回归方程为Y=0.16+0.798X(R2=0.633，F=50.031，P=0.000)，原对侧眼的等效离焦度与总像差RMS的回归方程为Y=1.278+0.611X(R2=0.522，F=31.613，P=0.000)；弱视组内弱视眼的等效离焦度与总像差RMS的回归方程为Y=-1.466+1.149X(R2=0.825，F=272.675，P=0.000)，对侧眼的等效离焦度与总像差RMS的回归方程为Y=1.101+0.832X(R2=0.632，F=99.561，P=0.000)。结论　散瞳状态下已治愈和未治愈的屈光参差性弱视患者等效离焦度和总像差形态在双眼间存在明显差异，但高阶像差在双眼间具有相似性和对称性。
Abstract:
Objective　To investigate the characteristic of interocular wavefront aberration in resolved and persistent anisometropic amblyopia.Methods　Ninety-one hyperopic anisometropes without strabismus from the Center for Optometry and Visual Science of Guangxi were recruited and divided into two groups:resolved anisometropic amblyopia (control group,n=31) and persistent anisometropic amblyopia (amblyopic group,n=60) according to their medical records and best corrected visual acuity (BCVA).Then control group was divided into previous amblyopic eye (pAE) and previous fellow eye (pFE) subgroups according to the history and refraction of each subject,and amblyopic group was divided into amblyopic eye (AE) and fellow eye (FE) subgroups according to BCVA of each subject.Besides,the amblyopic group was divided into adults (n=22) and adolescents (n=38) subgroups according to their age.All patients underwent wavefront aberration examination on iDesign? System (AMO,USA).Total aberrations (TAs) and higher-order aberrations (HOAs) were analyzed in terms of root mean square (RMS).Paired t-test and independent sample t-test was used to compare interocular differences within and between groups,separately.Spearman correlation analysis and linear regression analysis were applied to explore the interrelations between refraction and wavefront aberrations within groups.Results　Defocus equivalent (DE) of pAE was significantly higher than the pFE in the control group (P<0.01).DE and TAs of AE were significantly higher than the FE in amblyopic group (P<0.01).But there were no significant interocular differences of HOAs,RMS 3 to RMS 6 within groups (all P>0.05).Furthermore,significant interocular differences in DE and TAs of adolescents and adults amblyopia were also noticed within subgroups in mydriasis condition (all P<0.01),in which the DE and TA of AE were higher than those of FE.Pattern analysis indicated that both groups showed interocular asymmetric pattern in TAs,and interocular similarity and symmetry in HOAs.Independent sample t-test indicated that significant interocular differences between groups were noticed only in △DE and △TAs (all P<0.01),in which the △DE and △TAs of amblyopic group were higher than those of control group.Spearman’s correlation coefficient demonstrated that significant correlations between DE and TAs were noted in both groups (all P<0.01),but no other relationship was observed.In control group,the linear regression equation between DE and TAs in pAE was Y=0.16+0.798X(R2=0.633,F=50.031,P=0.000),in pFE was Y=1.278+0.611X(R2=0.522,F=31.613,P=0.000).In amblyopic group,the linear regression equation between DE and TAs in AE was Y=-1.466+1.149X(R2=0.825,F=272.675,P=0.000),in FE was Y=1.101+0.832X(R2=0.632,F=99.561,P=0.000).Conclusion　In addition to significant interocular differences in DE and TA pattern,both resolved and persistent anisometropic amblyopia manifested interocular similarity and symmetric pattern in HOAs in mydriasis condition.

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备注/Memo

备注/Memo:
广西壮族自治区卫生和计划生育委员会资助项目（编号：桂卫S201639、Z2016600、Z2013336）；广西壮族自治区人民医院青年基金项目
更新日期/Last Update: 2019-02-18