视觉虚拟现实训练与传统训练方法治疗儿童弱视的比较

doi:10.3760/cma.j.cn115909-20200306-00068

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摘要目的：比较视觉虚拟现实训练与传统训练方法治疗儿童弱视的疗效。方法：前瞻性随机对照试验。选取2018年6月至2019年12月于武汉大学中南医院确诊的并首次接受治疗的3～12岁弱视患儿90例（146眼），虚拟组45例（74眼），传统组45例（72眼）。在屈光矫正及定量遮盖的基础上，虚拟组采用视觉虚拟现实训练方法治疗，传统组采用传统训练方法治疗，时间为3个月，比较2组患儿治疗前后视力及立体视的变化。采用t检验或秩和检验、χ2 检验及Fisher确切概率对数据进行分析。结果：虚拟组总有效率87%，传统组总有效率68%，2组比较差异有统计学意义（χ2 =7.086，P=0.008）。3～6岁，虚拟组有效率91%，优于传统组74%（χ2 =4.652，P=0.031）；7～9岁和10～12岁患儿，虚拟组和传统组之间差异无统计学意义；轻度弱视患儿，虚拟组有效率为92%，优于传统组的75%（χ2 =2.908，P=0.018）；中度、重度弱视患儿，虚拟组和传统组之间差异无统计学意义；屈光不正性弱视患儿，虚拟组有效率为89%，传统组为74%，差异无统计学意义；屈光参差性弱视患儿，虚拟组有效率为85%，传统组为57%，差异有统计学意义（χ2 =3.840，P=0.045）。在治疗后1、2、3个月后虚拟组有效率为43%、 54%和87%，持续高于传统组的24%、40%和68%，差异有统计学意义（χ2 =6.308，P=0.012；χ2 =2.779， P=0.016；χ2 =7.086，P=0.008）；3个月后，虚拟组立体视觉正常者比例为72%，高于传统组61%（χ2 =8.214， P=0.004）。结论：视觉虚拟现实训练较传统方法治疗儿童弱视疗效更显著，特别是对3～6岁轻度的屈光参差性弱视；该方法不仅可以较快提高患儿视力，还有助于双眼立体视觉的改善。

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关键词 ： , 弱视, 视觉虚拟现实训练, 传统训练方法, 视力, 立体视

Abstract： Objective: To compare the clinical effects of a visual virtual reality training system and a traditional method for amblyopia in children. Methods: This was a prospective, randomized, controlled study. A total of 90 children (146 eyes) from 3 years to 12 years of age underwent treatment for amblyopia for the first time. They were divided into an experimental group (45 cases, 74 eyes) and control group (45 cases, 72 eyes). Children in the experimental group had treatment with a visual virtual reality training system, and the control group had conventional integrated therapy. Visual tests were conducted every month, and a stereopsis examination was conducted after 3 months. The efficacy and safety of the visual virtual reality training method was evaluated by comparing the effects for the two groups. Data were analyzed using t test, rank sum test, Chi-square test and Fisher exact test. Results: The total effective rate for the experimental group was 87%, and was 68% for the control, and the difference was significant (χ2 =7.086, P=0.008). The results were significantly different for the patients in the 3 to 6 age group (91% vs. 74%, χ2 =4.652, P=0.031). For mild amblyopia, the effective rate was 92% in experimental group, which was significantly better than the 75% in control group (χ2 =2.908, P=0.018). For anisometropic children the effective rate in the experimental group was significantly better than the rate in the control group (85% vs. 57%, χ2 =3.840, P=0.045). When the effective rates for the two treatments were compared at 1, 2 and 3 months, the effective rates in the experimental group (43%, 54% and 87%) were significantly better than the rates in the control group (24%, 40% and 68%) (χ2 =6.308, P=0.012; χ2 =2.779, P=0.016; χ2 =7.086, P=0.008). When stereopsis was compared after 3 months, stereopsis in the experimental group (72%) was better than that in the control group (61%)(χ2 =8.214, P=0.004). Conclusions: The efficacy of visual virtual reality training is better than traditional treatment, especially for children 3 to 6 years of age and for anisometropia amblyopia. Visual virtual reality training cannot only improve visual acuity, it helps to improve stereopsis as well.

Key words： amblyopia visual virtual reality training traditional treatment visual acuity stereopsis

收稿日期: 2020-03-06

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通讯作者: 蔡小军（ORCID：0000-0001-5955-3820），Email：xiaojuncai168@163.com

引用本文:

张威余爱华蔡小军. 视觉虚拟现实训练与传统训练方法治疗儿童弱视的比较[J]. 中华眼视光学与视觉科学杂志, 2020, 22(11): 842-846. Wei Zhang, Aihua Yu, Xiaojun Cai. Comparison of Visual Virtual Reality Training and Traditional Treatment for Childhood Amblyopia. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(11): 842-846. DOI: 10.3760/cma.j.cn115909-20200306-00068

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20200306-00068 或 https://www.cjoovs.com/CN/Y2020/V22/I11/842

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