视感知觉检查系统对共同性外斜视术后立体视功能重建的相关预测因素

doi:10.3760/cma.j.cn115909-20200408-00141

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摘要目的：引入视感知觉可塑性评分检查训练系统，评价该检测方法在临床应用中预测共同性外斜视术后立体视恢复状况的准确度以及灵敏度和特异度。方法：前瞻性临床研究。连续收集2017年1─9月在北京同仁医院诊断为共同性外斜视且进行手术治疗的患者136例，在术后1周接受视感知觉可塑性评分检查。采用秩相关分析手术年龄、病程时长、术前斜视角度、术后1周斜视角度等因素与可塑性评分相关性。所有患者均从术后1周开始进行视感知觉训练，分别于术后1、3、6个月进行远、近立体视功能检测，制作ROC曲线，评价可塑性评分对术后不同时间点远、近立体视功能恢复预测的准确度及灵敏度和特异度。采用Delong test将可塑性评分以及传统临床指标对半年立体视功能的恢复状况的预测效能进行比较。结果：间歇性外斜视患者109例（80.2%），恒定性外斜视27例（19.9%）。可塑性评分分别与年龄、术前斜视度、斜视病程、外斜视类型、术后1周斜视度相关（r=-0.3、-0.2、 -0.3、0.4、-0.3，均P<0.05）。可塑性评分在术后半年内不同时间点对立体视功能均具有预测能力，其中对术后6个月远、近立体视功能恢复正常均具有中等程度的预测意义，曲线下面积（AUC）均 >0.7，P<0.001。传统临床指标中，术前近立体视功能对术后半年近立体视功能有较低的预测能力（AUC=0.63<0.7，P=0.009）；术前看远斜视角度对术后6个月远、近立体视功能能否完全恢复正常具有较低的预测能力（AUC=0.66<0.7，P=0.02），但这些指标与可塑性评分的预测能力相比，差异无统计学意义（Z=1.2、1.4，P>0.05）。结论：视感知觉检查训练系统中，可塑性评分可以有效地预测共同性外斜视患者术后远、近立体视功能的恢复状况，为术后患者制定进一步的诊疗策略提供依据。

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关键词 ： , 共同性外斜视, 立体视, 视感知觉检查训练系统, 可塑性评分

Abstract： Objective: To evaluate the accuracy, sensitivity and specificity of the plasticity score in examinations of visual perception and training systems in the clinical application for predicting the recovery of stereopsis in patients with concomitant exotropia. Methods: This was a prospective clinical study. A total of 136 patients with concomitant exotropia were continuously recruited and underwent surgery in Beijing Tongren Hospital from January 2017 to September 2017. Of these, there were 109(80.2%) cases of intermittent exotropia and 27(19.9%) cases of constant exotropia. One week after the surgery, all patients underwent visual perception plasticity testing. Spearman correlation was used to analyze the correlation between the type of exotropia, age at surgery, duration of strabismus, deviation angle of preoperative strabismus, deviation angle of strabismus one week after surgery, and plasticity score. All patients underwent visual perception training one week after surgery for 6 months. The far stereopsis and near stereopsis acuity tests were performed 1 month, 3 months, and 6 months after surgery, and the ROC curve was plotted to evaluate the accuracy, sensitivity and specificity of the plasticity score in predicting stereopsis after concomitant exotropia surgery. The Delong test was used to compare the predictive efficacy of the plasticity score and traditional clinical indicators on the recovery of stereopsis function 6 months after surgery. Results: The plasticity score was correlated with age preoperative deviation angle, the course of strabismus, strabismus type and deviation angle one week after surgery (r was -0.3, -0.2, -0.3, 0.4, -0.3, P<0.05, respectively). The plasticity score can predict far and near stereopsis at different time points during the 6 month interval after surgery. There was a moderate predictive significance for both far and near stereopsis six months after surgery (AUC>0.7, P<0.001). For the traditional clinical indicators, preoperative near stereopsis had a low degree of predictive significance for near stereopsis 6 months after surgery (AUC=0.63<0.7, P=0.009), but there was no significant difference when compared with the plasticity score (Z=1.2, P=0.06). The preoperative far deviation angle had a low predictive significance for the complete recovery of both near and far stereopsis 6 months after surgery (AUC=0.66<0.7, P=0.02), but there was no significant difference of degree of predictive significance between the deviation angle and plasticity score (Z=1.4, P=0.15). Conclusions: The plasticity score can effectively predict the recovery of far and near stereopsis in patients with concomitant exotropia after surgery, and provide the basis for further diagnosis and treatment strategies for patients after surgery.

Key words： concomitant exotropia stereopsis visual perceptual checking and training system plasticity score

收稿日期: 2020-04-08

PACS:

基金资助: 首都临床特色应用研究专项课题（Z171100001017066）；北京同仁医院院内骨干基金（TRYY-KYJJ-2016-012）；北京市卫生系统高层次卫生技术人才-学科骨干（2015-3-023）；北京市属医院科研培育计划（PX2017045）

通讯作者: 付晶（ORCID：0000-0002-2939-9479），Email：fu_jing@126.com

引用本文:

张容菡1，3 付晶1 赵博文1 孟昭君1 马楠1 阎丽4 王京辉1 成娟娟1 曹凯2. 视感知觉检查系统对共同性外斜视术后立体视功能重建的相关预测因素[J]. 中华眼视光学与视觉科学杂志, 2020, 22(12): 895-901. Ronghan Zhang1, 3, Jing Fu1,Bowen Zhao1,Zhaojun Meng1,Nan Ma1,Li Yan4,Jinghui Wang1,Juanjuan Cheng1,Kai Cao2. Effect of a Visual Perceptual Evaluation System on Predicting Stereopsis Function Rehabilitation after Concomitant Exotropia Surgery. Chinese Journal of Optometry Ophthalmology and Visual science, 2020, 22(12): 895-901. DOI: 10.3760/cma.j.cn115909-20200408-00141

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https://www.cjoovs.com/CN/10.3760/cma.j.cn115909-20200408-00141 或 https://www.cjoovs.com/CN/Y2020/V22/I12/895

[1]	Schuster AK, Elflein HM, Pokora R, et al. Health-related quality of life and mental health in children and adolescents with strabismus-results of the representative population-based survey KiGGS. Health Qual Life Outcomes, 2019, 17(1): 81. DOI: 10.1186/s12955-019-1144-7.
[2]	Mojon-Azzi SM, Kunz A, Mojon DS. Strabismus and discrimination in children: Are children with strabismus invited to fewer birthday parties? Br J Ophthalmol, 2011, 95(4): 473- 476. DOI: 10.1136/bjo.2010.185793.
[3]	Chen YW, Lin SA, Lin PW, et al. The difference of surgical outcomes between manifest exotropia and esotropia. Int Ophthalmol, 2019, 39(7): 1427-1436. DOI: 10.1007/s10792- 018-0956-5.
[4]	Yu CB, Fan DS, Wong VW, et al. Changing patterns of strabismus: A decade of experience in HongKong. Br J Ophthalmol, 2002, 86(8): 854-856. DOI: 10.1136/bjo.86.8.854.
[5]	Birch EE, Stager DR, Berry P, et al. Prospective assessment of acuity and stereopsis in amblyopic infantile esotropes following early surgery. Invest Ophthalmol Vis Sci, 1990, 31(4): 758-765.
[6]	Fawcett S, Leffler J, Birch EE. Factors influencing stereoacuity in accommodative esotropia. J AAPOS, 2000, 4(1): 15-20. DOI: 10.1016/s1091-8531(00)90006-5.
[7]	甘晓玲. 斜视疗效评价标准.中国斜视与小儿眼科杂志, 1996, 4(4): 145.
[8]	曾仁攀, 梁小琼, 王国平, 等. 共同性斜视患儿手术前后三级视功能的临床观察. 临床眼科杂志, 2014, 22(4): 314-317. DOI: 10.3969/j.issn.1006-8422.2014.04.012.
[9]	赵博文, 周金琼, 齐梦, 等. 斜视患者术后短期双眼视觉功能改变的临床观察. 中国斜视与小儿眼科杂志, 2015, 23(3): 7-11. DOI: 10.3969/j.issn.1005-328X.2015.03.003.
[10]	Liu Y, Liu C, Zhang W, et al. Model of a support vector machine to assess the functional cure for surgery of intermittent exotropia. Sci Rep, 2019, 9(1): 8321. DOI: 10.1038/s41598- 019-38969-x.
[11]	Wu H, Sun J, Xia X, et al. Binocular status after surgery for constant and intermittent exotropia. Am J Ophthalmol, 2006, 142(5): 822-826. DOI: 10.1016/j.ajo.2006.06.045.
[12]	Hua T, Bao P, Huang CB, et al. Perceptual learning improves contrast sensitivity of V1 neurons in cats. Curr Biol, 2010, 20(10): 887-894. DOI: 10.1016/j.cub.2010.03.066.
[13]	Liu XY, Zhang JY. Dichoptic de-masking learning in adults with amblyopia and its mechanisms. Invest Ophthalmol Vis Sci, 2019, 60(8): 2968-2977. DOI: 10.1167/iovs.18-26483.
[14]	Kim YH, Kang DW, Kim D, et al. Real-time strategy video game experience and visual perceptual learning. J Neurosci, 2015, 35(29): 10485-10492. DOI: 10.1523/ JNEUROSCI.3340-14.2015.